Associations of urological malignancies with renal progression and mortality in advanced chronic kidney disease: a propensity-matched cohort study

Chinnadurai, Rajkumar; Clarke, Noel W.; Kalra, Philip A.

doi:10.1186/s12882-020-01859-w

Cited by 4 publications

(3 citation statements)

References 23 publications

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“…The Salford Kidney Study (SKS), is a longitudinal, prospectively collected, ongoing observational study with full ethical permission that has recruited and followed-up patients with non-dialysis dependent CKD (NDD-CKD) in the United Kingdom since March 2002 [ 25 , 28 ]. This large NDD-CKD cohort consists of > 3500 patients that have provided their informed consent when admitted to the nephrology inpatient centre at Salford Royal Hospital or referred to nephrology outpatient clinics [ 8 , 26 ].…”

Section: Methodsmentioning

confidence: 99%

Proteomic signature associated with chronic kidney disease (CKD) progression identified by data-independent acquisition mass spectrometry

et al. 2023

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Background Halting progression of chronic kidney disease (CKD) to established end stage kidney disease is a major goal of global health research. The mechanism of CKD progression involves pro-inflammatory, pro-fibrotic, and vascular pathways, but pathophysiological differentiation is currently lacking. Methods Plasma samples of 414 non-dialysis CKD patients, 170 fast progressors (with ∂ eGFR-3 ml/min/1.73 m2/year or worse) and 244 stable patients (∂ eGFR of − 0.5 to + 1 ml/min/1.73 m2/year) with a broad range of kidney disease aetiologies, were obtained and interrogated for proteomic signals with SWATH-MS. We applied a machine learning approach to feature selection of proteins quantifiable in at least 20% of the samples, using the Boruta algorithm. Biological pathways enriched by these proteins were identified using ClueGo pathway analyses. Results The resulting digitised proteomic maps inclusive of 626 proteins were investigated in tandem with available clinical data to identify biomarkers of progression. The machine learning model using Boruta Feature Selection identified 25 biomarkers as being important to progression type classification (Area Under the Curve = 0.81, Accuracy = 0.72). Our functional enrichment analysis revealed associations with the complement cascade pathway, which is relevant to CKD as the kidney is particularly vulnerable to complement overactivation. This provides further evidence to target complement inhibition as a potential approach to modulating the progression of diabetic nephropathy. Proteins involved in the ubiquitin–proteasome pathway, a crucial protein degradation system, were also found to be significantly enriched. Conclusions The in-depth proteomic characterisation of this large-scale CKD cohort is a step toward generating mechanism-based hypotheses that might lend themselves to future drug targeting. Candidate biomarkers will be validated in samples from selected patients in other large non-dialysis CKD cohorts using a targeted mass spectrometric analysis.

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Section: Methodsmentioning

confidence: 99%

Proteomic signature associated with chronic kidney disease (CKD) progression identified by data-independent acquisition mass spectrometry

et al. 2023

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“…(i.e., negative patients developing COVID-19 infection during follow-up). A p-value < 0.05 was considered statistically significant in this study [ 18 ].…”

Section: Methodsmentioning

confidence: 99%

Investigating the utility of COVID-19 antibody testing in end-stage renal disease patients receiving haemodialysis: a cohort study in the United Kingdom

et al. 2021

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Background End-stage renal disease (ESRD) patients receiving haemodialysis (HD) are a vulnerable group of patients with increased mortality from COVID-19. Despite improved understanding, the duration of host immunity following COVID-19 infection and role of serological testing alone or in addition to real-time reverse transcription polymerase chain reaction (rRT-PCR) testing in the HD population is not fully understood, which this study aimed to investigate. Methods There were two parts to this study. Between 15th March 2020 to 15th July 2020, patients receiving HD who tested positive on rRT-PCR for SARS-CoV-2 were recruited into the COVID-19 arm, whilst asymptomatic patients without a previous diagnosis of COVID-19 were recruited to the epidemiological arm of the Salford Kidney Study (SKS). All patients underwent monthly testing for anti-SARS-CoV-2 antibodies as per routine clinical practice since August 2020. The aims were twofold: firstly, to determine seroprevalence and COVID-19 exposure in the epidemiological arm; secondly, to assess duration of the antibody response in the COVID-19 arm. Baseline characteristics were reviewed between groups. Statistical analysis was performed using SPSS. Mann-Whitney U and Chi-squared tests were used for testing significance of difference between groups. Results In our total HD population of 411 patients, 32 were PCR-positive for COVID-19. Of the remaining patients, 237 were recruited into the SKS study, of whom 12 (5.1%) had detectable anti-SARS-CoV-2 antibodies. Of the 32 PCR-positive patients, 27 (84.4%) were symptomatic and 25 patients admitted to hospital due to their symptoms. Of the 22 patients in COVID-19 arm that underwent testing for anti-SARS-CoV-2 IgG antibodies beyond 7 months, all had detectable antibodies. A higher proportion of the patients with COVID-19 were frail compared to patients without a diagnosis of COVID-19 (64.3% vs 34.1%, p = 0.003). Other characteristics were similar between the groups. Over a median follow up of 7 months, a higher number of deaths were recorded in patients with a diagnosis of COVID-19 compared to those without (18.7% vs 5.9%, p = 0.003). Conclusions Serological testing in the HD population is a valuable tool to determine seroprevalence, monitor exposure, and guide improvements for infection prevention and control (IPC) measures to help prevent local outbreaks. This study revealed HD patients mount a humoral response detectable until at least 7 months after COVID-19 infection and provides hope of similar protection with the vaccines recently approved.

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“…As most of the continuous values were non-normally distributed, they were expressed as median (interquartile range) and the Mann-Whitney U test was used to calculate the p-value. A p-value <0.05 was considered statistically signi cant in this study (15).…”

Section: Statisticsmentioning

confidence: 99%

Investigating the Utility of COVID-19 Antibody Testing in End-Stage Renal Disease Patients Receiving Haemodialysis: A Cohort Study in the United Kingdom

Wickens

Chinnadurai

Mannan

et al. 2021

Preprint

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BackgroundEnd-stage renal disease (ESRD) patients receiving haemodialysis (HD) are a vulnerable group of patients with increased mortality from COVID-19. Despite improved understanding, the duration of host immunity following COVID-19 infection and role of serological testing alone or in addition to real-time reverse transcription polymerase chain reaction (rRT-PCR) testing in the HD population is not fully understood, which this study aimed to investigate. MethodsThere were two parts to this study. Between 15th March 2020 to 15th July 2020, patients receiving HD who tested positive on rRT-PCR for SARS-CoV-2 were recruited into the COVID-19 arm, whilst PCR-negative patients were recruited to the epidemiological arm of the Salford Kidney Study (SKS). All patients underwent monthly testing for anti-SARS-CoV-2 antibodies as per routine clinical practice since August 2020. The aims were twofold: firstly, to determine seroprevalence and COVID-19 exposure in the epidemiological arm; secondly, to assess duration of the antibody response in the COVID-19 arm. Baseline characteristics were reviewed between groups. Statistical analysis was performed using SPSS. Mann-Whitney U and Chi-squared tests were used for testing significance of difference between groups. ResultsIn our total HD population of 411 patients, 32 were PCR-positive for COVID-19. Of the remaining PCR-negative patients, 237 were recruited into the SKS study, of whom 12 (5.1%) had detectable anti-SARS-CoV-2 antibodies. Of the 32 PCR-positive patients, 27 (84.4%) were symptomatic, with 19 patients admitted to hospital due to their symptoms. A separate six patients were diagnosed with COVID-19 whilst as inpatient. Of the 22 patients in COVID-19 arm that underwent testing for anti-SARS-CoV-2 IgG antibodies beyond seven months, all had detectable antibodies.A higher proportion of the PCR-positive patients were frail compared to PCR-negative patients (64.3% vs 34.1%, p=0.003). Other characteristics were similar between the groups. Over a median follow up of six months, a higher number of deaths were recorded in the PCR-positive group compared to the PCR-negative group (18.8% vs 3.8%, p<0.001).ConclusionsSerological testing in the HD population is a valuable tool to determine seroprevalence, monitor exposure, and guide improvements for infection prevention and control (IPC) measures to help prevent local outbreaks. This study revealed HD patients mount a humoral response detectable until at least seven months after COVID-19 infection and provides hope of similar protection with the vaccines recently approved.

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Associations of urological malignancies with renal progression and mortality in advanced chronic kidney disease: a propensity-matched cohort study

Cited by 4 publications

References 23 publications

Proteomic signature associated with chronic kidney disease (CKD) progression identified by data-independent acquisition mass spectrometry

Proteomic signature associated with chronic kidney disease (CKD) progression identified by data-independent acquisition mass spectrometry

Investigating the utility of COVID-19 antibody testing in end-stage renal disease patients receiving haemodialysis: a cohort study in the United Kingdom

Investigating the Utility of COVID-19 Antibody Testing in End-Stage Renal Disease Patients Receiving Haemodialysis: A Cohort Study in the United Kingdom

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