Scholars@Duke
Julia Jarrard Scialla

Julia Jarrard Scialla

Adjunct Associate Professor in the Department of Medicine
Medicine, Nephrology
julia.scialla@duke.edu
Rm 7042 N Pavillion Bldg, 2400 Pratt Street, Durham, NC 27705
2400 Pratt Street, Rm 7042, Durham, NC 27705

Selected Publications

Chronic kidney disease-mineral and bone disorder: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference.

Conference Kidney Int · March 2025 In 2017, Kidney Disease: Improving Global Outcomes (KDIGO) published a Clinical Practice Guideline Update for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD). Since then, new lines of evide ... Full text Link to item Cite

Association of Coprescribing of Gabapentinoid and Other Psychoactive Medications With Altered Mental Status and Falls in Adults Receiving Dialysis.

Journal Article Am J Kidney Dis · February 2025 RATIONALE & OBJECTIVE: Prescribing psychoactive medications for patients with kidney disease is common, but for patients receiving dialysis some medications may be inappropriate. We evaluated the association of coprescribing gabapentinoids and other psycho ... Full text Link to item Cite

Progression of Coronary Artery Calcification and Risk of Clinical Events in CKD: The Chronic Renal Insufficiency Cohort Study.

Journal Article Am J Kidney Dis · January 2025 RATIONALE & OBJECTIVE: Coronary artery calcification (CAC) progresses rapidly in people with chronic kidney disease (CKD) compared with the general population. We studied the association between CAC progression and higher risks of atherosclerotic cardiovas ... Full text Link to item Cite

Distinguishing Among Causes of Death for Patients with Kidney Failure on Hemodialysis.

Journal Article Kidney360 · December 16, 2024 BACKGROUND: Patients treated with maintenance hemodialysis (HD) are at high risk of death from a variety of causes. METHODS: To identify markers (i.e., risk phenotypes) that distinguish among causes of death, we used dialysis electronic health record data ... Full text Link to item Cite

Sudden Cardiac Death Reporting in US Patients on Dialysis: Comparison of United States Renal Data System and National Death Index Data.

Journal Article Clin J Am Soc Nephrol · December 1, 2024 KEY POINTS: For patients with ESKD treated with hemodialysis, the causes of death reported by the United States Renal Data System and the National Death Index show substantial disagreement. In particular, the proportion of sudden cardiac death was almost t ... Full text Link to item Cite

Breast and Prostate Cancer Screening by Life Expectancy in Patients with Kidney Failure on Dialysis.

Journal Article Clin J Am Soc Nephrol · December 1, 2024 KEY POINTS: Breast and prostate cancer screening were more frequent among patients on hemodialysis waitlisted for kidney transplant. Among patients not waitlisted for transplant, we found that screening rates were generally higher among patients with highe ... Full text Link to item Cite

Longitudinal Pilot Evaluation of the Gut Microbiota Comparing Patients With and Without Chronic Kidney Disease.

Journal Article J Ren Nutr · July 2024 OBJECTIVE: The gut microbiota contributes to metabolic diseases, such as diabetes and hypertension, but is poorly characterized in chronic kidney disease (CKD). DESIGN AND METHODS: We enrolled 24 adults within household pairs, in which at least one member ... Full text Link to item Cite

Designing an Implementable Clinical Prediction Model for Near-Term Mortality and Long-Term Survival in Patients on Maintenance Hemodialysis.

Journal Article Am J Kidney Dis · July 2024 RATIONALE & OBJECTIVE: The life expectancy of patients treated with maintenance hemodialysis (MHD) is heterogeneous. Knowledge of life-expectancy may focus care decisions on near-term versus long-term goals. The current tools are limited and focus on near- ... Full text Link to item Cite

Fruit and Vegetable Intake Patterns, Kidney Failure, and Mortality in Adults with and without Chronic Kidney Disease in the United States.

Journal Article J Nutr · July 2024 BACKGROUND: Fruits and vegetables (F&Vs) are vital components of healthy diets but may be restricted in chronic kidney disease (CKD) to avoid high-potassium intake. We previously generated F&V patterns for patients in the National Health and Nutrition Exam ... Full text Link to item Cite

Role of Age and Competing Risk of Death in the Racial Disparity of Kidney Failure Incidence after Onset of CKD.

Journal Article J Am Soc Nephrol · March 1, 2024 SIGNIFICANCE STATEMENT: Black adults in the United States have 2-4 times higher incidence of kidney failure than White adults. Yet, the reasons underlying this disparity remain poorly understood. Among 547,188 US veterans with new-onset CKD, according to a ... Full text Link to item Cite

Comparative Effectiveness of Alternative Treatment Approaches to Secondary Hyperparathyroidism in Patients Receiving Maintenance Hemodialysis: An Observational Trial Emulation.

Journal Article Am J Kidney Dis · January 2024 RATIONALE & OBJECTIVE: Optimal approaches to treat secondary hyperparathyroidism (SHPT) in patients on maintenance hemodialysis (HD) have yet to be established in randomized controlled trials (RCTs). STUDY DESIGN: Two observational clinical trial emulation ... Full text Link to item Cite

Diversity of plant DNA in stool is linked to dietary quality, age, and household income.

Journal Article Proc Natl Acad Sci U S A · July 4, 2023 Eating a varied diet is a central tenet of good nutrition. Here, we develop a molecular tool to quantify human dietary plant diversity by applying DNA metabarcoding with the chloroplast trnL-P6 marker to 1,029 fecal samples from 324 participants across two ... Full text Link to item Cite

Association of Acute Kidney Injury and Cardiovascular Disease Following Percutaneous Coronary Intervention: Assessment of Interactions by Race, Diabetes, and Kidney Function.

Journal Article Am J Kidney Dis · June 2023 RATIONALE & OBJECTIVE: Black patients and those with diabetes or reduced kidney function experience a disproportionate burden of acute kidney injury (AKI) and cardiovascular events. However, whether these factors modify the association between AKI and card ... Full text Link to item Cite

Diet and Metabolism in CKD-Related Metabolic Acidosis.

Journal Article Semin Nephrol · March 2023 Metabolic acidosis is a common complication in patients with chronic kidney disease that occurs when the daily nonvolatile acid load produced in metabolism cannot be excreted fully by the kidney. A reduction in urine net acid excretion coupled with a high ... Full text Link to item Cite

Patterns of Fruit and Vegetable Intake in Adults With and Without Chronic Kidney Disease in the United States.

Journal Article J Ren Nutr · January 2023 OBJECTIVE: To characterize patterns of fruit and vegetable (F&V) intake in US adults with and without chronic kidney disease (CKD). METHODS: We used 24-hour dietary recall data from multiple cycles of the National Health and Nutrition Examination Survey sp ... Full text Link to item Cite

Development of an Administrative Data-Based Frailty Index for Older Adults Receiving Dialysis.

Journal Article Kidney360 · September 29, 2022 BACKGROUND: Frailty is present in ≥50% of older adults receiving dialysis. Our objective was to a develop an administrative data-based frailty index and assess the frailty index's predictive validity for mortality and future hospitalizations. METHODS: We u ... Full text Link to item Cite

Bioavailability of phosphorus and kidney function in the Jackson Heart Study.

Journal Article Am J Clin Nutr · August 4, 2022 BACKGROUND: High phosphorus (P) exposure may have negative effects on kidney function. Nutrient databases provide total P, but bioavailability varies by source. OBJECTIVES: We aimed to assess natural, added, and bioavailable P intake, and to relate these t ... Full text Link to item Cite

Importance of Metabolic Acidosis as a Health Risk in Chronic Kidney Disease.

Journal Article Adv Chronic Kidney Dis · July 2022 Human kidneys are well adapted to excrete the daily acid load from diet and metabolism in order to maintain homeostasis. In approximately 30% of patients with more advanced stages of CKD, these homeostatic processes are no longer adequate, resulting in met ... Full text Link to item Cite

High-Throughput Metabolomics and Diabetic Kidney Disease Progression: Evidence from the Chronic Renal Insufficiency (CRIC) Study.

Journal Article Am J Nephrol · 2022 INTRODUCTION: Metabolomics could offer novel prognostic biomarkers and elucidate mechanisms of diabetic kidney disease (DKD) progression. Via metabolomic analysis of urine samples from 995 CRIC participants with diabetes and state-of-the-art statistical mo ... Full text Link to item Cite

Urine tricarboxylic acid cycle signatures of early-stage diabetic kidney disease.

Journal Article Metabolomics · December 20, 2021 INTRODUCTION: Urine tricarboxylic acid (TCA) cycle organic anions (OAs) are elevated in diabetes and may be biomarkers for diabetic kidney disease (DKD) progression. OBJECTIVES: We assessed associations of 10 urine TCA cycle OAs with estimated glomerular f ... Full text Open Access Link to item Cite

Psychosocial determinants of cardiovascular events among black Americans with chronic kidney disease or associated risk factors in the Jackson heart study.

Journal Article BMC Nephrol · November 11, 2021 BACKGROUND: Individuals with chronic kidney disease (CKD), hypertension (HTN), or diabetes mellitus (DM) are at increased risk for cardiovascular disease (CVD). The extent to which psychosocial factors are associated with increased CVD risk within these in ... Full text Link to item Cite

Estimated Glomerular Filtration Rate Variability in Patients With Heart Failure and Chronic Kidney Disease.

Journal Article J Card Fail · November 2021 BACKGROUND: Greater variability in the estimated glomerular filtration rate (eGFR) is associated with higher mortality in patients with chronic kidney disease (CKD). Heart failure (HF) is common in CKD and may increase variability through changes in hemody ... Full text Link to item Cite

Clinical events and patient-reported outcome measures during CKD progression: findings from the Chronic Renal Insufficiency Cohort Study.

Journal Article Nephrol Dial Transplant · August 27, 2021 BACKGROUND: Patients with chronic kidney disease (CKD) face risks of not only end-stage kidney disease (ESKD), cardiovascular disease (CVD) and death, but also decline in kidney function, quality of life (QOL) and mental and physical well-being. This study ... Full text Link to item Cite

Effect of Bicarbonate on Net Acid Excretion, Blood Pressure, and Metabolism in Patients With and Without CKD: The Acid Base Compensation in CKD Study.

Journal Article Am J Kidney Dis · July 2021 RATIONALE & OBJECTIVE: Patients with CKD are at elevated risk of metabolic acidosis due to impaired net acid excretion (NAE). Identifying early markers of acidosis may guide prevention in chronic kidney disease (CKD). This study compared NAE in participant ... Full text Link to item Cite

Risks associated with continuation of potentially inappropriate antihypertensive medications in older adults receiving hemodialysis.

Journal Article BMC Nephrol · June 19, 2021 BACKGROUND AND OBJECTIVES: After dialysis initiation, older adults may experience orthostatic or post-dialysis hypotension. Some orthostasis-causing antihypertensives (i.e., central alpha agonists and alpha blockers), are considered potentially inappropria ... Full text Link to item Cite

Urine and Plasma Metabolome of Healthy Adults Consuming the DASH (Dietary Approaches to Stop Hypertension) Diet: A Randomized Pilot Feeding Study.

Journal Article Nutrients · May 22, 2021 We aimed to identify plasma and urine metabolites altered by the Dietary Approaches to Stop Hypertension (DASH) diet in a post-hoc analysis of a pilot feeding trial. Twenty adult participants with un-medicated hypertension consumed a Control diet for one w ... Full text Link to item Cite

Racial Differences in AKI Incidence Following Percutaneous Coronary Intervention.

Journal Article J Am Soc Nephrol · March 2021 BACKGROUND: Undergoing percutaneous coronary intervention (PCI) is a risk factor for AKI development, but few studies have quantified racial differences in AKI incidence after this procedure. METHODS: We examined the association of self-reported race (Blac ... Full text Link to item Cite

Adherence to Healthy Dietary Patterns and Risk of CKD Progression and All-Cause Mortality: Findings From the CRIC (Chronic Renal Insufficiency Cohort) Study.

Journal Article Am J Kidney Dis · February 2021 RATIONALE & OBJECTIVE: Current dietary guidelines recommend that patients with chronic kidney disease (CKD) restrict individual nutrients, such as sodium, potassium, phosphorus, and protein. This approach can be difficult for patients to implement and igno ... Full text Link to item Cite

State-of-the-Art Management of Hyperphosphatemia in Patients With CKD: An NKF-KDOQI Controversies Perspective.

Journal Article Am J Kidney Dis · January 2021 Phosphate binders are among the most common medications prescribed to patients with kidney failure receiving dialysis and are often used in advanced chronic kidney disease (CKD). In patients with CKD glomerular filtration rate category 3a (G3a) or worse, i ... Full text Link to item Cite

Novel Risk Factors for Progression of Diabetic and Nondiabetic CKD: Findings From the Chronic Renal Insufficiency Cohort (CRIC) Study.

Journal Article Am J Kidney Dis · January 2021 RATIONALE & OBJECTIVE: Identification of novel risk factors for chronic kidney disease (CKD) progression may inform mechanistic investigations and improve identification of high-risk subgroups. The current study aimed to characterize CKD progression across ... 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

Vitamin D in kidney disease

Chapter · January 1, 2021 Vitamin D is obtained from sunlight and dietary intake. After conversion in the liver to 25-hydroxyvitamin D, it is further converted to the active form of 1,25-dihydroxyvitamin D in the kidney. 1,25-Dihydroxyvitamin D is a hormone that interacts with vita ... Full text Cite

Hospitalizations among adults with chronic kidney disease in the United States: A cohort study.

Journal Article PLoS Med · December 2020 BACKGROUND: Adults with chronic kidney disease (CKD) are hospitalized more frequently than those without CKD, but the magnitude of this excess morbidity and the factors associated with hospitalizations are not well known. METHODS AND FINDINGS: Data from 3, ... Full text Link to item Cite

Trends in Mineral Metabolism Treatment Strategies in Patients Receiving Hemodialysis in the United States.

Journal Article Clin J Am Soc Nephrol · November 6, 2020 BACKGROUND AND OBJECTIVES: With multiple medications indicated for mineral metabolism, dialysis providers can apply various strategies to achieve target phosphate and parathyroid hormone (PTH) levels. We describe common prescribing patterns and practice va ... Full text Link to item Cite

Metabolomic Markers of Kidney Function Decline in Patients With Diabetes: Evidence From the Chronic Renal Insufficiency Cohort (CRIC) Study.

Journal Article Am J Kidney Dis · October 2020 RATIONALE & OBJECTIVE: Biomarkers that provide reliable evidence of future diabetic kidney disease (DKD) are needed to improve disease management. In a cross-sectional study, we previously identified 13 urine metabolites that had levels reduced in DKD comp ... Full text Link to item Cite

Serial Fibroblast Growth Factor 23 Measurements and Risk of Requirement for Kidney Replacement Therapy: The CRIC (Chronic Renal Insufficiency Cohort) Study.

Journal Article Am J Kidney Dis · June 2020 RATIONALE & OBJECTIVE: Studies using a single measurement of fibroblast growth factor 23 (FGF-23) suggest that elevated FGF-23 levels are associated with increased risk for requirement for kidney replacement therapy (KRT) in patients with chronic kidney di ... Full text Link to item Cite

Life Course Socioeconomic Status, Allostatic Load, and Kidney Health in Black Americans.

Journal Article Clin J Am Soc Nephrol · March 6, 2020 BACKGROUND AND OBJECTIVES: Low socioeconomic status confers unfavorable health, but the degree and mechanisms by which life course socioeconomic status affects kidney health is unclear. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We examined the associa ... Full text Link to item Cite

Are low-carbohydrate diets safe in diabetic and nondiabetic chronic kidney disease?

Journal Article Ann N Y Acad Sci · February 2020 Diabetes mellitus and obesity both contribute to chronic kidney disease (CKD) and diabetic kidney disease (DKD), and they can accelerate the loss of kidney function. Dietary intake can potentially have wide-reaching effects on the risk of CKD/DKD and their ... Full text Link to item Cite

Longitudinal Evolution of Markers of Mineral Metabolism in Patients With CKD: The Chronic Renal Insufficiency Cohort (CRIC) Study.

Journal Article Am J Kidney Dis · February 2020 RATIONALE & OBJECTIVE: The pathogenesis of disordered mineral metabolism in chronic kidney disease (CKD) is largely informed by cross-sectional studies of humans and longitudinal animal studies. We sought to characterize the longitudinal evolution of disor ... Full text Link to item Cite

Markers of mineral metabolism and vascular access complications: The Choices for Healthy Outcomes in Caring for ESRD (CHOICE) study.

Journal Article Hemodial Int · January 2020 INTRODUCTION: Vascular access dysfunction is a major cause of morbidity in patients with end-stage renal disease (ESRD) on chronic hemodialysis. The effects of abnormalities in mineral metabolism on vascular access are unclear. In this study, we evaluated ... Full text Link to item Cite

Serum Calcification Propensity and Clinical Events in CKD.

Journal Article Clin J Am Soc Nephrol · November 7, 2019 BACKGROUND AND OBJECTIVES: Patients with CKD are at high risk for cardiovascular disease, ESKD, and mortality. Vascular calcification is one pathway through which cardiovascular disease risks are increased. We hypothesized that a novel measure of serum cal ... Full text Link to item Cite

DASH Diet and Blood Pressure Among Black Americans With and Without CKD: The Jackson Heart Study.

Journal Article Am J Hypertens · September 24, 2019 BACKGROUND: The Dietary Approaches to Stop Hypertension (DASH) diet lowers blood pressure (BP) more effectively in blacks compared to other US racial subgroups. Considering chronic kidney disease (CKD) raises BP through complex mechanisms, DASH may affect ... Full text Link to item Cite

Predictors of Net Acid Excretion in the Chronic Renal Insufficiency Cohort (CRIC) Study.

Journal Article Am J Kidney Dis · August 2019 RATIONALE & OBJECTIVE: Higher urine net acid excretion (NAE) is associated with slower chronic kidney disease progression, particularly in patients with diabetes mellitus. To better understand potential mechanisms and assess modifiable components, we explo ... Full text Link to item Cite

Association of functional and structural social support with chronic kidney disease among African Americans: the Jackson Heart Study.

Journal Article BMC Nephrol · July 15, 2019 BACKGROUND: There is limited evidence on the relationship between social support and renal outcomes in African Americans. We sought to determine the association of social support with prevalent chronic kidney disease (CKD) and kidney function decline in an ... Full text Link to item Cite

Modifiers of Plasma 25-Hydroxyvitamin D and Chronic Kidney Disease Outcomes in Black Americans: The Jackson Heart Study.

Internet Publication · June 1, 2019 BACKGROUND: 25-hydroxyvitamin D [25(OH)D] is lower in black compared with white Americans but is not consistently associated with outcomes in this group, possibly due to genetic and other biological differences. We examined the association of plasma 25(OH) ... Full text Open Access Link to item Cite

Serum Calcification Propensity and Coronary Artery Calcification Among Patients With CKD: The CRIC (Chronic Renal Insufficiency Cohort) Study.

Journal Article Am J Kidney Dis · June 2019 RATIONALE & OBJECTIVE: Coronary artery calcification (CAC) is prevalent among patients with chronic kidney disease (CKD) and increases risks for cardiovascular disease events and mortality. We hypothesized that a novel serum measure of calcification propen ... 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

Evaluation of Allostatic Load as a Mediator of Sleep and Kidney Outcomes in Black Americans.

Journal Article Kidney Int Rep · March 2019 INTRODUCTION: Poor sleep associates with adverse chronic kidney disease (CKD) outcomes yet the biological mechanisms underlying this relation remain unclear. One proposed mechanism is via allostatic load, a cumulative biologic measure of stress. METHODS: U ... Full text Open Access Link to item Cite

Low use of routine medical care among African Americans with high CKD risk: the Jackson Heart Study.

Journal Article BMC Nephrol · January 10, 2019 BACKGROUND: Use of routine medical care (RMC) is advocated to address ethnic/racial disparities in chronic kidney disease (CKD) risks, but use is less frequent among African Americans. Factors associated with low RMC use among African Americans at risk of ... Full text Open Access Link to item Cite

Dietary Phosphorus and Ambulatory Blood Pressure in African Americans: The Jackson Heart Study.

Journal Article Am J Hypertens · January 1, 2019 Featured Publication BACKGROUND: Higher dietary phosphorus is associated with left ventricular hypertrophy and mortality, which are blood pressure (BP)-related outcomes. For this reason, we hypothesized that dietary phosphorus may be associated with adverse clinic and ambulato ... Full text Link to item Cite

Associations of Fenofibrate Therapy With Incidence and Progression of CKD in Patients With Type 2 Diabetes.

Journal Article Kidney Int Rep · January 2019 INTRODUCTION: Abnormalities in lipid metabolism may contribute to the development and progression of chronic kidney disease (CKD) in patients with type 2 diabetes. Fenofibrate induces early and reversible reduction in estimated glomerular filtration rate ( ... Full text Link to item Cite

Vitamin D Receptor Agonists for Patients Undergoing Hemodialysis.

Journal Article JAMA · December 11, 2018 Featured Publication Full text Link to item Cite

The Role of Vitamin D in CKD Stages 3 to 4: Report of a Scientific Workshop Sponsored by the National Kidney Foundation.

Journal Article Am J Kidney Dis · December 2018 Deficiency of 25-hydroxyvitamin D (25[OH]D) is common in patients with chronic kidney disease stages 3 and 4 and is associated with poor outcomes. However, the evaluation and management of vitamin D deficiency in nephrology remains controversial. This arti ... Full text Link to item Cite

Update on Chronic Kidney Disease Mineral and Bone Disorder in Cardiovascular Disease.

Journal Article Semin Nephrol · November 2018 Featured Publication Chronic kidney disease mineral and bone disorder (MBD) encompasses changes in mineral ion and vitamin D metabolism that are widespread in the setting of chronic kidney disease and end-stage renal disease. MBD components associate with cardiovascular diseas ... Full text Link to item Cite

Metabolic Changes with Base-Loading in CKD.

Journal Article Clin J Am Soc Nephrol · August 7, 2018 Featured Publication Full text Open Access Link to item Cite

Evidence basis for integrated management of mineral metabolism in patients with end-stage renal disease.

Journal Article Curr Opin Nephrol Hypertens · July 2018 Featured Publication PURPOSE OF REVIEW: Treatment of mineral metabolism is a mainstay of dialysis care including some of its most widely used and costly pharmaceuticals. Although many mineral metabolites are associated with increased risk of mortality, cardiovascular disease, ... Full text Link to item Cite

Incidence and Progression of Chronic Kidney Disease in Black and White Individuals with Type 2 Diabetes.

Journal Article Clin J Am Soc Nephrol · June 7, 2018 BACKGROUND AND OBJECTIVES: Type 2 diabetes and associated CKD disproportionately affect blacks. It is uncertain if racial disparities in type 2 diabetes-associated CKD are driven by biologic factors that influence propensity to CKD or by differences in typ ... Full text Link to item Cite

Obesity and synergistic risk factors for chronic kidney disease in African American adults: the Jackson Heart Study.

Journal Article Nephrol Dial Transplant · June 1, 2018 BACKGROUND: African Americans are at high risk for chronic kidney disease (CKD). Obesity may increase the risk for CKD by exacerbating features of the metabolic syndrome and promoting glomerular hyperfiltration. Whether other factors also affecting these p ... Full text Link to item Cite

Nondepressive Psychosocial Factors and CKD Outcomes in Black Americans.

Journal Article Clin J Am Soc Nephrol · February 7, 2018 BACKGROUND AND OBJECTIVES: Established risk factors for CKD do not fully account for risk of CKD in black Americans. We studied the association of nondepressive psychosocial factors with risk of CKD in the Jackson Heart Study. DESIGN, SETTING, PARTICIPANTS ... Full text Link to item Cite

Longitudinal FGF23 Trajectories and Mortality in Patients with CKD.

Journal Article J Am Soc Nephrol · February 2018 Elevated fibroblast growth factor 23 (FGF23) levels, measured at a single time, are strongly associated with increased risk of mortality in patients with CKD. There are minimal data on serial FGF23 measurements in CKD. In a prospective case-cohort study of ... Full text Link to item Cite

Vascular Calcification Markers and Hemodialysis Vascular Access Complications.

Journal Article Am J Nephrol · 2018 BACKGROUND: Arteriovenous (AV) access dysfunction is a common complication in hemodialysis patients. Markers of vascular calcification are associated with cardiovascular outcomes and mortality in this population, but their association with vascular access ... Full text Link to item Cite

Acid Load and Phosphorus Homeostasis in CKD.

Journal Article Am J Kidney Dis · October 2017 BACKGROUND: The kidneys maintain acid-base homeostasis through excretion of acid as either ammonium or as titratable acids that primarily use phosphate as a buffer. In chronic kidney disease (CKD), ammoniagenesis is impaired, promoting metabolic acidosis. ... Full text Link to item Cite

The Authors Reply.

Journal Article Kidney Int · June 2017 Full text Link to item Cite

Role of Acid-Base Homeostasis in Diabetic Kidney Disease.

Journal Article Curr Diab Rep · April 2017 Featured Publication PURPOSE OF REVIEW: Acid-base homeostasis is impaired in chronic kidney disease (CKD) and may contribute to disease progression. Diabetes, a major cause of CKD worldwide, may exacerbate acidosis further due to differences in acid production and excretion. H ... Full text Link to item Cite

Inflammation and elevated levels of fibroblast growth factor 23 are independent risk factors for death in chronic kidney disease.

Journal Article Kidney Int · March 2017 Inflammation is a consequence of chronic kidney disease (CKD) and is associated with adverse outcomes in many clinical settings. Inflammation stimulates production of fibroblast growth factor 23 (FGF23), high levels of which are independently associated wi ... Full text Link to item Cite

Antihypertensive medications and risk of death and hospitalizations in US hemodialysis patients: Evidence from a cohort study to inform hypertension treatment practices.

Journal Article Medicine (Baltimore) · February 2017 Antihypertensive medications are commonly prescribed to hemodialysis patients but the optimal regimens to prevent morbidity and mortality are unknown. The goal of our study was to compare the association of routinely prescribed antihypertensive regimens wi ... Full text Link to item Cite

Intravenous iron administration strategies and anemia management in hemodialysis patients.

Journal Article Nephrol Dial Transplant · January 1, 2017 Featured Publication BACKGROUND: The effect of maintenance intravenous (IV) iron administration on subsequent achievement of anemia management goals and mortality among patients recently initiating hemodialysis is unclear. METHODS: We performed an observational cohort study, i ... Full text Link to item Cite

Higher net acid excretion is associated with a lower risk of kidney disease progression in patients with diabetes.

Journal Article Kidney Int · January 2017 Featured Publication Higher diet-dependent nonvolatile acid load is associated with faster chronic kidney disease (CKD) progression, but most studies have used estimated acid load or measured only components of the gold standard, net acid excretion (NAE). Here we measured NAE ... Full text Link to item Cite

Association of Fibroblast Growth Factor 23 With Atrial Fibrillation in Chronic Kidney Disease, From the Chronic Renal Insufficiency Cohort Study.

Journal Article JAMA Cardiol · August 1, 2016 IMPORTANCE: Levels of fibroblast growth factor 23 (FGF23) are elevated in chronic kidney disease (CKD) and strongly associated with left ventricular hypertrophy, heart failure, and death. Whether FGF23 is an independent risk factor for atrial fibrillation ... Full text Link to item Cite

Genetic African Ancestry and Markers of Mineral Metabolism in CKD.

Journal Article Clin J Am Soc Nephrol · April 7, 2016 Featured Publication BACKGROUND AND OBJECTIVES: Disorders of mineral metabolism are more common in African Americans with CKD than in European Americans with CKD. Previous studies have focused on the differences in mineral metabolism by self-reported race, making it difficult ... Full text Link to item Cite

Examination of Potential Modifiers of the Association of APOL1 Alleles with CKD Progression.

Journal Article Clin J Am Soc Nephrol · December 7, 2015 Featured Publication BACKGROUND AND OBJECTIVES: Common apolipoprotein L1 (APOL1) variants are associated with increased risk of progressive CKD; however, not all individuals with high-risk APOL1 variants experience CKD progression. Identification of factors contributing to het ... Full text Link to item Cite

Food Access, Chronic Kidney Disease, and Hypertension in the U.S.

Journal Article Am J Prev Med · December 2015 Featured Publication INTRODUCTION: Greater distance to full-service supermarkets and low income may impair access to healthy diets and contribute to chronic kidney disease (CKD) and hypertension. The study aim was to determine relationships among residence in a "food desert," ... Full text Link to item Cite

Change in estimated glomerular filtration rate and fracture risk in the Action to Control Cardiovascular Risk in Diabetes Trial.

Journal Article Bone · September 2015 Featured Publication OBJECTIVE: Patients with type 2 diabetes (T2DM) are at increased risk of fracture. High prevalence of chronic kidney disease (CKD) in T2DM may contribute to bone fragility, but whether dynamic change in kidney function is associated with fracture risk is u ... Full text Link to item Cite

When there will never be a randomized controlled trial.

Journal Article Kidney Int · August 2015 Featured Publication There are many unanswered questions about how to manage secondary hyperparathyroidism and associated alterations in mineral metabolism in patients with end-stage renal disease. We provide commentary on an observational study by Komaba et al. that presents ... Full text Link to item Cite

The balance of the evidence on acid-base homeostasis and progression of chronic kidney disease.

Journal Article Kidney Int · July 2015 Featured Publication Normalization of acid-base homeostasis in chronic kidney disease (CKD) holds promise for mitigating disease progression, but whether efforts should focus on patients with low serum bicarbonate or high dietary acid load is unknown. Vallet et al. report that ... Full text Link to item Cite

Epidemiologic insights on the role of fibroblast growth factor 23 in cardiovascular disease.

Journal Article Curr Opin Nephrol Hypertens · May 2015 Featured Publication PURPOSE OF REVIEW: Fibroblast growth factor 23 (FGF23) regulates phosphate and vitamin D homeostasis and rises as kidney function declines. Animal studies have demonstrated direct and indirect effects of FGF23 that may promote heart disease. Herein, we rev ... Full text Link to item Cite

Persistent high serum bicarbonate and the risk of heart failure in patients with chronic kidney disease (CKD): A report from the Chronic Renal Insufficiency Cohort (CRIC) study.

Journal Article J Am Heart Assoc · April 20, 2015 Featured Publication BACKGROUND: Serum bicarbonate varies over time in chronic kidney disease (CKD) patients, and this variability may portend poor cardiovascular outcomes. The aim of this study was to conduct a time-updated longitudinal analysis to evaluate the association of ... Full text Open Access Link to item Cite

Effect of intravenous iron use on hospitalizations in patients undergoing hemodialysis: a comparative effectiveness analysis from the DEcIDE-ESRD study.

Journal Article Nephrol Dial Transplant · April 2015 Featured Publication BACKGROUND: Intravenous iron use in hemodialysis patients has greatly increased over the last decade, despite limited studies on the safety of iron. METHODS: We studied the association of receipt of intravenous iron with hospitalizations in an incident coh ... Full text Link to item Cite

Fibroblast growth factor 23 and incident CKD in type 2 diabetes.

Journal Article Clin J Am Soc Nephrol · January 7, 2015 Featured Publication BACKGROUND AND OBJECTIVES: High levels of fibroblast growth factor 23 are associated with accelerated progression of CKD. Whether high fibroblast growth factor 23 levels also predict incident CKD is uncertain. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: ... Full text Link to item Cite

Race, Mineral Homeostasis and Mortality in Patients with End-Stage Renal Disease on Dialysis.

Journal Article Am J Nephrol · 2015 Featured Publication BACKGROUND: Abnormalities in mineral homeostasis are ubiquitous in patients on dialysis, and influenced by race. In this study, we determine the race-specific relationship between mineral parameters and mortality in patients initiating hemodialysis. METHOD ... Full text Link to item Cite

Intravenous iron exposure and mortality in patients on hemodialysis.

Journal Article Clin J Am Soc Nephrol · November 7, 2014 Featured Publication BACKGROUND AND OBJECTIVES: Clinical trials assessing effects of larger cumulative iron exposure with outcomes are lacking, and observational studies have been limited by assessment of short-term exposure only and/or failure to assess cause-specific mortali ... Full text Link to item Cite

An instrumental variable approach finds no associated harm or benefit with early dialysis initiation in the United States.

Journal Article Kidney Int · October 2014 Featured Publication The estimated glomerular filtration rate (eGFR) at dialysis initiation has been rising. Observational studies suggest harm, but may be confounded by unmeasured factors. As instrumental variable methods may be less biased, we performed a retrospective cohor ... Full text Link to item Cite

Comparative effectiveness of early versus conventional timing of dialysis initiation in advanced CKD.

Journal Article Am J Kidney Dis · May 2014 Featured Publication BACKGROUND: Previous observational studies examining outcomes associated with the timing of dialysis therapy initiation in the United States have often been limited by lead time and survivor bias. STUDY DESIGN: Retrospective cohort study comparing the effe ... Full text Link to item Cite

Incidental findings on cardiac computed tomography in incident hemodialysis patients: the predictors of arrhythmic and cardiovascular events in end-stage renal disease (PACE) study.

Journal Article BMC Nephrol · May 1, 2014 Featured Publication BACKGROUND: This is the first study that has examined non-cardiac incidental findings in research cardiac computed tomography (CT) of hemodialysis patients and their relationship with patient characteristics. METHODS: We performed a cross-sectional analysi ... Full text Link to item Cite

Roles of phosphate and fibroblast growth factor 23 in cardiovascular disease.

Journal Article Nat Rev Nephrol · May 2014 Featured Publication Disturbances in phosphate homeostasis are common in patients with chronic kidney disease. As kidney function declines, circulating concentrations of phosphate and the phosphate-regulatory hormone, fibroblast growth factor (FGF)-23, rise progressively. High ... Full text Link to item Cite

Predialysis systolic BP variability and outcomes in hemodialysis patients.

Journal Article J Am Soc Nephrol · April 2014 Featured Publication BP variability (BPV) is an important predictor of outcomes in the general population, but its association with clinical outcomes in hemodialysis patients is not clear. We identified 11,291 patients starting dialysis in 2003-2008 and followed them through D ... Full text Link to item Cite

Biomarkers of vascular calcification and mortality in patients with ESRD.

Journal Article Clin J Am Soc Nephrol · April 2014 Featured Publication BACKGROUND: Vascular calcification is common among patients undergoing dialysis and is associated with mortality. Factors such as osteoprotegerin (OPG), osteopontin (OPN), bone morphogenic protein-7 (BMP-7), and fetuin-A are involved in vascular calcificat ... Full text Link to item Cite

Kidney allograft survival of African American and Caucasian American recipients with lupus.

Journal Article Lupus · February 2014 Featured Publication BACKGROUND: African Americans with lupus who receive kidney transplants have high prevalence of predictors of allograft failure, which can explain their poor outcomes. METHODS: Of 1223 African Americans and 1029 Caucasian Americans with lupus who received ... Full text Link to item Cite

Fibroblast growth factor-23 and cardiovascular events in CKD.

Journal Article J Am Soc Nephrol · February 2014 Featured Publication An elevated level of fibroblast growth factor-23 (FGF-23) is the earliest abnormality of mineral metabolism in CKD. High FGF-23 levels promote left ventricular hypertrophy but not coronary artery calcification. We used survival analysis to determine whethe ... Full text Link to item Cite

Predialysis health, dialysis timing, and outcomes among older United States adults.

Journal Article J Am Soc Nephrol · February 2014 Featured Publication Studies of dialysis initiation timing have not accounted for predialysis clinical factors that could impact postdialysis outcomes. We examined the association of predialysis health with timing of dialysis initiation in older adult patients in the United St ... Full text Link to item Cite

Roles of phosphate and fibroblast growth factor 23 in cardiovascular disease

Journal Article Nature Reviews Nephrology · January 1, 2014 Disturbances in phosphate homeostasis are common in patients with chronic kidney disease. As kidney function declines, circulating concentrations of phosphate and the phosphate-regulatory hormone, fibroblast growth factor (FGF)-23, rise progressively. High ... Full text Cite

Trends in anemia management in US hemodialysis patients 2004-2010.

Journal Article BMC Nephrol · December 1, 2013 Featured Publication BACKGROUND: There have been major changes in the management of anemia in US hemodialysis patients in recent years. We sought to determine the influence of clinical trial results, safety regulations, and changes in reimbursement policy on practice. METHODS: ... Full text Open Access Link to item Cite

Patterns in blood pressure medication use in US incident dialysis patients over the first 6 months.

Journal Article BMC Nephrol · November 12, 2013 Featured Publication BACKGROUND: Several observational studies have evaluated the effect of a single exposure window with blood pressure (BP) medications on outcomes in incident dialysis patients, but whether BP medication prescription patterns remain stable or a single exposu ... Full text Open Access Link to item Cite

Association of serum bicarbonate with risk of renal and cardiovascular outcomes in CKD: a report from the Chronic Renal Insufficiency Cohort (CRIC) study.

Journal Article Am J Kidney Dis · October 2013 Featured Publication BACKGROUND: The purpose of this study is to evaluate serum bicarbonate level as a risk factor for renal outcomes, cardiovascular events, and mortality in patients with chronic kidney disease (CKD). STUDY DESIGN: Observational cohort study. SETTING & PARTIC ... Full text Link to item Cite

Fibroblast growth factor 23 is not associated with and does not induce arterial calcification.

Journal Article Kidney Int · June 2013 Featured Publication Elevated fibroblast growth factor 23 (FGF23) is associated with cardiovascular disease in patients with chronic kidney disease. As a potential mediating mechanism, FGF23 induces left ventricular hypertrophy; however, its role in arterial calcification is l ... Full text Open Access Link to item Cite

Dietary acid load: a novel nutritional target in chronic kidney disease?

Journal Article Adv Chronic Kidney Dis · March 2013 Featured Publication Nonvolatile acid is produced from the metabolism of organic sulfur in dietary protein and the production of organic anions during the combustion of neutral foods. Organic anion salts that are found primarily in plant foods are directly absorbed in the gast ... Full text Link to item Cite

Choices in kidney transplantation in type 1 diabetes: are there skeletal benefits of the endocrine pancreas?

Journal Article Kidney Int · March 2013 Featured Publication Previously, recipients of a simultaneous pancreas-kidney transplant versus a kidney transplant alone were thought to have higher fracture risk. Using a large US registry, Nikkel et al. observed lower rates of fracture hospitalization among patients with ty ... Full text Link to item Cite

Mineral metabolites and CKD progression in African Americans.

Journal Article J Am Soc Nephrol · January 2013 Featured Publication CKD progresses more rapidly to ESRD among African Americans compared with Caucasians. Disordered mineral metabolism is more severe among African Americans with CKD, which might partially explain the accelerated progression of their kidney disease. Here, us ... Full text Link to item Cite

Inhibitors of mTOR and risks of allograft failure and mortality in kidney transplantation.

Journal Article Am J Transplant · January 2013 Featured Publication Data on long-term outcomes of users of inhibitors of the mammalian target of rapamycin (mTORI) are lacking in kidney transplantation. In an analysis of 139 370 US kidney transplant recipients between 1999 through 2010, we compared clinical outcomes among u ... Full text Link to item Cite

Comparative effectiveness studies to improve clinical outcomes in end stage renal disease: the DEcIDE patient outcomes in end stage renal disease study.

Journal Article BMC Nephrol · December 6, 2012 Featured Publication BACKGROUND: Evidence is lacking to inform providers' and patients' decisions about many common treatment strategies for patients with end stage renal disease (ESRD). METHODS/DESIGN: The DEcIDE Patient Outcomes in ESRD Study is funded by the United States ( ... Full text Open Access Link to item Cite

Plant protein intake is associated with fibroblast growth factor 23 and serum bicarbonate levels in patients with chronic kidney disease: the Chronic Renal Insufficiency Cohort study.

Journal Article J Ren Nutr · July 2012 Featured Publication BACKGROUND: Protein from plant, as opposed to animal, sources may be preferred in chronic kidney disease (CKD) because of the lower bioavailability of phosphate and lower nonvolatile acid load. STUDY DESIGN: Observational cross-sectional study. SETTING AND ... Full text Link to item Cite

Net endogenous acid production is associated with a faster decline in GFR in African Americans.

Journal Article Kidney Int · July 2012 Featured Publication Increased acid excretion may promote renal injury. To evaluate this in African Americans with hypertensive nephrosclerosis, we studied the association between the net endogenous acid production and progression of kidney disease in 632 patients in the AASK ... Full text Link to item Cite

Earlier onset and greater severity of disordered mineral metabolism in diabetic patients with chronic kidney disease.

Journal Article Diabetes Care · May 2012 Featured Publication OBJECTIVE: Disordered mineral metabolism is a common complication of chronic kidney disease (CKD) and a novel risk factor for CKD progression, cardiovascular disease, and mortality. Although diabetes is the leading cause of CKD and is associated with worse ... Full text Open Access Link to item Cite

Correlates of osteoprotegerin and association with aortic pulse wave velocity in patients with chronic kidney disease.

Journal Article Clin J Am Soc Nephrol · November 2011 Featured Publication BACKGROUND AND OBJECTIVES: Osteoprotegerin (OPG), a cytokine that regulates bone resorption, has been implicated in the process of vascular calcification and stiffness. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Serum OPG was measured in 351 participan ... Full text Link to item Cite

FGF23 induces left ventricular hypertrophy.

Journal Article J Clin Invest · November 2011 Featured Publication Chronic kidney disease (CKD) is a public health epidemic that increases risk of death due to cardiovascular disease. Left ventricular hypertrophy (LVH) is an important mechanism of cardiovascular disease in individuals with CKD. Elevated levels of FGF23 ha ... Full text Link to item Cite

Estimated net endogenous acid production and serum bicarbonate in African Americans with chronic kidney disease.

Journal Article Clin J Am Soc Nephrol · July 2011 Featured Publication BACKGROUND AND OBJECTIVES: Metabolic acidosis may contribute to morbidity and disease progression in patients with chronic kidney disease (CKD). The ratio of dietary protein, the major source of nonvolatile acid, to dietary potassium, which is naturally bo ... Full text Link to item Cite

Fibroblast growth factor 23 and risks of mortality and end-stage renal disease in patients with chronic kidney disease.

Journal Article JAMA · June 15, 2011 Featured Publication CONTEXT: A high level of the phosphate-regulating hormone fibroblast growth factor 23 (FGF-23) is associated with mortality in patients with end-stage renal disease, but little is known about its relationship with adverse outcomes in the much larger popula ... Full text Link to item Cite

Fibroblast growth factor 23 is elevated before parathyroid hormone and phosphate in chronic kidney disease.

Journal Article Kidney Int · June 2011 Featured Publication Fibroblast growth factor 23 (FGF23) regulates phosphorus metabolism and is a strong predictor of mortality in dialysis patients. FGF23 is thought to be an early biomarker of disordered phosphorus metabolism in the initial stages of chronic kidney disease ( ... Full text Link to item Cite

Soluble P-selectin levels are associated with cardiovascular mortality and sudden cardiac death in male dialysis patients.

Journal Article Am J Nephrol · 2011 Featured Publication BACKGROUND/AIMS: P-selectin is released by activated platelets and endothelium contributing to inflammation and thrombosis. We evaluated the association between soluble P-selectin and atherosclerotic cardiovascular disease (ASCVD) in dialysis patients. MET ... Full text Link to item Cite

Low socioeconomic status associates with higher serum phosphate irrespective of race.

Journal Article J Am Soc Nephrol · November 2010 Featured Publication Hyperphosphatemia, which associates with adverse outcomes in CKD, is more common among blacks than whites for unclear reasons. Low socioeconomic status may explain this association because poverty both disproportionately affects racial and ethnic minoritie ... Full text Link to item Cite

A pressing situation.

Journal Article Am J Med · December 2005 Full text Link to item Cite