Scholars@Duke
Daniel Len Edmonston

Daniel Len Edmonston

Assistant Professor of Medicine
Medicine, Nephrology

Selected Publications

Klotho and Clinical Outcomes in CKD: Findings From the Chronic Renal Insufficiency Cohort (CRIC) Study.

Journal Article Am J Kidney Dis · September 2024 RATIONALE & OBJECTIVE: Klotho deficiency may affect clinical outcomes in chronic kidney disease (CKD) through fibroblast growth factor-23 (FGF23)-dependent and -independent pathways. However, the association between circulating Klotho and clinical outcomes ... Full text Link to item Cite

Kidney and Cardiovascular Effectiveness of SGLT2 Inhibitors vs GLP-1 Receptor Agonists in Type 2 Diabetes.

Journal Article J Am Coll Cardiol · August 20, 2024 BACKGROUND: Emerging data suggest that glucagon-like peptide-1 receptor agonists (GLP-1 RAs) improve kidney outcomes for people with type 2 diabetes (T2D). Direct comparisons of the kidney and cardiovascular effectiveness of GLP-1 RA with sodium-glucose co ... Full text Open Access Link to item Cite

Kidney and Cardiovascular Effectiveness of Empagliflozin Compared With Dipeptidyl Peptidase-4 Inhibitors in Patients With Type 2 Diabetes.

Journal Article Am J Cardiol · June 15, 2024 Placebo-controlled trials of sodium-glucose co-transporter-2 inhibitors demonstrate kidney and cardiovascular benefits for patients with type 2 diabetes and chronic kidney disease (CKD). We used real-world data to compare the kidney and cardiovascular effe ... Full text Open Access Link to item Cite

Concordance With Screening and Treatment Guidelines for Chronic Kidney Disease in Type 2 Diabetes.

Journal Article JAMA Netw Open · June 3, 2024 IMPORTANCE: Chronic kidney disease (CKD) is an often-asymptomatic complication of type 2 diabetes (T2D) that requires annual screening to diagnose. Patient-level factors linked to inadequate screening and treatment can inform implementation strategies to f ... Full text Open Access Link to item Cite

FGF23 and klotho at the intersection of kidney and cardiovascular disease.

Journal Article Nat Rev Cardiol · January 2024 Cardiovascular disease is the leading cause of death in patients with chronic kidney disease (CKD). As CKD progresses, CKD-specific risk factors, such as disordered mineral homeostasis, amplify traditional cardiovascular risk factors. Fibroblast growth fac ... Full text Link to item Cite

Plasma Serotonin and Cardiovascular Outcomes in Chronic Kidney Disease.

Journal Article J Am Heart Assoc · September 5, 2023 Background Platelet-poor plasma serotonin levels are associated with adverse cardiovascular outcomes. Although plasma serotonin levels increase in chronic kidney disease, the cardiovascular implications remain unknown. Methods and Results In 1114 participa ... Full text Link to item Cite

Association of Chronic Renal Insufficiency with Inhospital Outcomes in Primary Heart Failure Hospitalizations (Insights from the National Inpatient Sample 2004 to 2018).

Journal Article Am J Cardiol · September 1, 2023 Chronic kidney disease (CKD) is a major co-morbidity in patients with heart failure (HF). There are limited contemporary data characterizing the clinical profile, inhospital outcomes, and resource use in patients hospitalized for HF with co-morbid CKD. We ... Full text Link to item Cite

Sildenafil and Kidney Function in Heart Failure with Preserved Ejection Fraction.

Journal Article Kidney360 · May 1, 2023 KEY POINTS: Sildenafil induced an acute effect on eGFR without change in the overall eGFR slope after 24 weeks in a heart failure with preserved ejection fraction (HFpEF) cohort. N-terminal pro–brain natriuretic peptide levels and baseline diuretic use wer ... Full text Link to item Cite

Kidney Recovery and Death in Critically Ill Patients With COVID-19-Associated Acute Kidney Injury Treated With Dialysis: The STOP-COVID Cohort Study.

Journal Article Am J Kidney Dis · March 2022 RATIONALE & OBJECTIVE: Acute kidney injury treated with kidney replacement therapy (AKI-KRT) occurs frequently in critically ill patients with coronavirus disease 2019 (COVID-19). We examined the clinical factors that determine kidney recovery in this popu ... Full text Link to item Cite

Noninvasive Risk Score to Screen for Pulmonary Hypertension With Elevated Pulmonary Vascular Resistance in Diseases of Chronic Volume Overload.

Journal Article Am J Cardiol · November 15, 2021 Volume overload promotes pulmonary hypertension (PH) through pulmonary venous hypertension. However, PH with elevated pulmonary vascular resistance (hereafter PH-PVR) may develop in patients with diseases of volume overload, such as heart failure or chroni ... Full text Link to item Cite

Obesity, inflammatory and thrombotic markers, and major clinical outcomes in critically ill patients with COVID-19 in the US.

Journal Article Obesity (Silver Spring) · October 2021 OBJECTIVE: This study aimed to determine whether obesity is independently associated with major adverse clinical outcomes and inflammatory and thrombotic markers in critically ill patients with COVID-19. METHODS: The primary outcome was in-hospital mortali ... Full text Link to item Cite

Performance of crisis standards of care guidelines in a cohort of critically ill COVID-19 patients in the United States.

Journal Article Cell Rep Med · September 21, 2021 Many US states published crisis standards of care (CSC) guidelines for allocating scarce critical care resources during the COVID-19 pandemic. However, the performance of these guidelines in maximizing their population benefit has not been well tested. In ... Full text Link to item Cite

Identification of Distinct Clinical Subphenotypes in Critically Ill Patients With COVID-19.

Journal Article Chest · September 2021 BACKGROUND: Subphenotypes have been identified in patients with sepsis and ARDS and are associated with different outcomes and responses to therapies. RESEARCH QUESTION: Can unique subphenotypes be identified among critically ill patients with COVID-19? ST ... Full text Link to item Cite

Machine Learning Prediction of Death in Critically Ill Patients With Coronavirus Disease 2019

Journal Article Critical Care Explorations · August 19, 2021 OBJECTIVES: Critically ill patients with coronavirus disease 2019 have variable mortality. Risk scores could improve care and be used for prognostic enrichment in trials. We aimed to compare machine learning algorithms and develop a simple tool for predict ... Full text Cite

Design and Rationale of HiLo: A Pragmatic, Randomized Trial of Phosphate Management for Patients Receiving Maintenance Hemodialysis.

Journal Article Am J Kidney Dis · June 2021 RATIONALE & OBJECTIVE: Hyperphosphatemia is a risk factor for poor clinical outcomes in patients with kidney failure receiving maintenance dialysis. Opinion-based clinical practice guidelines recommend the use of phosphate binders and dietary phosphate res ... Full text Link to item Cite

Hypoxia signaling in renal pericytes-is it safe to activate?

Journal Article Kidney Int · June 2021 While excitement has grown for the use of hypoxia-inducible factor (HIF) prolyl hydroxylase inhibitors for treating renal anemia, multiple preclinical studies have shown the complex and cell-type-dependent roles of HIFs in kidney disease pathogenesis, incl ... Full text Link to item Cite

Continuation versus discontinuation of renin-angiotensin system inhibitors in patients admitted to hospital with COVID-19: a prospective, randomised, open-label trial.

Journal Article Lancet Respir Med · March 2021 BACKGROUND: Biological considerations suggest that renin-angiotensin system inhibitors might influence the severity of COVID-19. We aimed to evaluate whether continuing versus discontinuing renin-angiotensin system inhibitors (angiotensin-converting enzyme ... Full text Open Access Link to item Cite

Characteristics and Outcomes of Individuals With Pre-existing Kidney Disease and COVID-19 Admitted to Intensive Care Units in the United States.

Journal Article Am J Kidney Dis · February 2021 RATIONALE & OBJECTIVE: Underlying kidney disease is an emerging risk factor for more severe coronavirus disease 2019 (COVID-19) illness. We examined the clinical courses of critically ill COVID-19 patients with and without pre-existing chronic kidney disea ... Full text Link to item Cite

Extracorporeal membrane oxygenation in patients with severe respiratory failure from COVID-19.

Journal Article Intensive Care Med · February 2021 PURPOSE: Limited data are available on venovenous extracorporeal membrane oxygenation (ECMO) in patients with severe hypoxemic respiratory failure from coronavirus disease 2019 (COVID-19). METHODS: We examined the clinical features and outcomes of 190 pati ... Full text Link to item Cite

AKI Treated with Renal Replacement Therapy in Critically Ill Patients with COVID-19.

Journal Article J Am Soc Nephrol · January 2021 BACKGROUND: AKI is a common sequela of coronavirus disease 2019 (COVID-19). However, few studies have focused on AKI treated with RRT (AKI-RRT). METHODS: We conducted a multicenter cohort study of 3099 critically ill adults with COVID-19 admitted to intens ... Full text Link to item Cite

Statins and atherosclerotic cardiovascular outcomes in patients on incident dialysis and with atherosclerotic heart disease.

Journal Article Am Heart J · January 2021 UNLABELLED: Statins failed to reduce cardiovascular (CV) events in trials of patients on dialysis. However, trial populations used criteria that often excluded those with atherosclerotic heart disease (ASHD), in whom statins have the greatest benefit, and ... Full text Link to item Cite

Drug Development in Kidney Disease: Proceedings From a Multistakeholder Conference.

Journal Article Am J Kidney Dis · December 2020 Occasional bursts of discovery and innovation have appeared during the otherwise stagnant past several decades of drug development in nephrology. Among other recent drug discoveries, the unexpected kidney benefits observed with sodium/glucose cotransporter ... Full text Link to item Cite

Echocardiography to Screen for Pulmonary Hypertension in CKD.

Journal Article Kidney Int Rep · December 2020 INTRODUCTION: Pulmonary hypertension (PH) is a common yet incompletely understood complication of chronic kidney disease (CKD). Although transthoracic echocardiogram is commonly used to noninvasively estimate PH, it has not been validated in a CKD populati ... Full text Open Access Link to item Cite

Prescribing rates and characteristics of recipients of tenofovir-containing regimens before and after market entry of tenofovir alafenamide.

Journal Article J Manag Care Spec Pharm · December 2020 BACKGROUND: Tenofovir alafenamide (TAF) is a new formulation of tenofovir disoproxil fumarate (TDF) that was approved in 2015. While clinical trial evidence suggests that TAF has more favorable outcomes related to kidney injury and loss of bone mineral den ... Full text Link to item Cite

Randomized elimination and prolongation of ACE inhibitors and ARBs in coronavirus 2019 (REPLACE COVID) Trial Protocol.

Journal Article J Clin Hypertens (Greenwich) · October 2020 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for coronavirus disease 2019 (COVID-19), is associated with high incidence of multiorgan dysfunction and death. Angiotensin-converting enzyme 2 (ACE2), which facilitates SA ... Full text Open Access Link to item Cite

Therapeutic options for chronic kidney disease-associated pulmonary hypertension.

Journal Article Curr Opin Nephrol Hypertens · September 2020 PURPOSE OF REVIEW: Pulmonary hypertension is a common and devastating complication of chronic kidney disease (CKD). Traditionally considered a consequence of volume overload, recent findings now expand this paradigm. These novel mechanisms herald new treat ... Full text Link to item Cite

Coronavirus Disease 2019 and Hypertension: The Role of Angiotensin-Converting Enzyme 2 and the Renin-Angiotensin System.

Journal Article Adv Chronic Kidney Dis · September 2020 Hypertension emerged from early reports as a potential risk factor for worse outcomes for persons with coronavirus disease 2019 (COVID-19). Among the putative links between hypertension and COVID-19 is a key counter-regulatory component of the renin-angiot ... Full text Link to item Cite

Controversies of renin-angiotensin system inhibition during the COVID-19 pandemic.

Journal Article Nat Rev Nephrol · June 2020 The current COVID-19 pandemic is associated with unprecedented morbidity and mortality. Early reports suggested an association between disease severity and hypertension but did not account for sources of confounding. However, the responsible virus — SARS-C ... Full text Link to item Cite

Pulmonary Hypertension Subtypes and Mortality in CKD.

Journal Article Am J Kidney Dis · May 2020 RATIONALE & OBJECTIVE: Pulmonary hypertension (PH) contributes to cardiovascular disease and mortality in patients with chronic kidney disease (CKD), but the pathophysiology is mostly unknown. This study sought to estimate the prevalence and consequences o ... Full text Open Access Link to item Cite

FGF23 at the crossroads of phosphate, iron economy and erythropoiesis.

Journal Article Nat Rev Nephrol · January 2020 Fibroblast growth factor 23 (FGF23) was initially characterized as an important regulator of phosphate and calcium homeostasis. New research advances demonstrate that FGF23 is also linked to iron economy, inflammation and erythropoiesis. These advances hav ... Full text Link to item Cite

Single Measurements of Carboxy-Terminal Fibroblast Growth Factor 23 and Clinical Risk Prediction of Adverse Outcomes in CKD.

Journal Article Am J Kidney Dis · December 2019 RATIONALE & OBJECTIVE: An elevated fibroblast growth factor 23 (FGF-23) level is independently associated with adverse outcomes in populations with chronic kidney disease, but it is unknown whether FGF-23 testing can improve clinical risk prediction in ind ... Full text Link to item Cite

Association of post-discharge specialty outpatient visits with readmissions and mortality in high-risk heart failure patients.

Journal Article Am Heart J · June 2019 UNLABELLED: Heart failure (HF) outcomes are especially poor in high-risk patients with certain comorbidities including diabetes mellitus (DM), chronic kidney disease (CKD), and chronic obstructive pulmonary disease (COPD). Whether early specialty or primar ... Full text Link to item Cite

Medical Management of Heart Failure With Reduced Ejection Fraction in Patients With Advanced Renal Disease.

Journal Article JACC Heart Fail · May 2019 Large randomized clinical trials (RCT) supporting guidelines for the management of heart failure with reduced ejection fraction (HFrEF) have typically excluded patients with advanced chronic kidney disease (CKD). Patients with concomitant advanced CKD and ... Full text Link to item Cite

Good Guys, Bad Guys, Guesses, and Near Misses in Nephrology.

Journal Article Clin J Am Soc Nephrol · January 7, 2019 Full text Link to item Cite

The emerging role of novel antihyperglycemic agents in the treatment of heart failure and diabetes: A focus on cardiorenal outcomes.

Journal Article Clin Cardiol · September 2018 Heart failure (HF) and type 2 diabetes mellitus (T2DM) are two global pandemics, affecting over 25 and 420 million people, respectively. The prevalence of comorbid HF and T2DM is rising, and the prognosis remains poor. One central area of overlap of these ... Full text Link to item Cite

Working Toward an Improved Understanding of Chronic Cardiorenal Syndrome Type 4.

Journal Article Adv Chronic Kidney Dis · September 2018 Chronic diseases of the heart and of the kidneys commonly coexist in individuals. Certainly combined and persistent heart and kidney failure can arise from a common pathologic insult, for example, as a consequence of poorly controlled hypertension or of se ... Full text Link to item Cite

Infection rate and risk factor analysis in an orthopaedic ambulatory surgical center.

Journal Article J Surg Orthop Adv · 2010 Surgical site infections (SSI) are a costly problem. The purpose of this study was to determine the rate of infection and identify patient and technical risk factors for SSI in an orthopaedic ambulatory surgical center. Over 11,000 consecutive orthopaedic ... Link to item Cite