Nutrition and dietary intake and their association with mortality and hospitalisation in adults with chronic kidney disease treated with haemodialysis: protocol for DIET-HD, a prospective multinational cohort study.

Nutrition and dietary intake and their association with mortality and hospitalisation in adults with chronic kidney disease treated with haemodialysis: protocol for DIET-HD, a prospective multinational cohort study.

BMJ Open. 2015;5(3):e006897

Authors: Palmer SC, Ruospo M, Campbell KL, Garcia Larsen V, Saglimbene V, Natale P, Gargano L, Craig JC, Johnson DW, Tonelli M, Knight J, Bednarek-Skublewska A, Celia E, Del Castillo D, Dulawa J, Ecder T, Fabricius E, Frazão JM, Gelfman R, Hoischen SH, Schön S, Stroumza P, Timofte D, Török M, Hegbrant J, Wollheim C, Frantzen L, Strippoli GF, DIET-HD Study investigators

Abstract
INTRODUCTION: Adults with end-stage kidney disease (ESKD) treated with haemodialysis experience mortality of between 15% and 20% each year. Effective interventions that improve health outcomes for long-term dialysis patients remain unproven. Novel and testable determinants of health in dialysis are needed. Nutrition and dietary patterns are potential factors influencing health in other health settings that warrant exploration in multinational studies in men and women treated with dialysis. We report the protocol of the “DIETary intake, death and hospitalisation in adults with end-stage kidney disease treated with HaemoDialysis (DIET-HD) study,” a multinational prospective cohort study. DIET-HD will describe associations of nutrition and dietary patterns with major health outcomes for adults treated with dialysis in several countries.
METHODS AND ANALYSIS: DIET-HD will recruit approximately 10?000 adults who have ESKD treated by clinics administered by a single dialysis provider in Argentina, France, Germany, Hungary, Italy, Poland, Portugal, Romania, Spain, Sweden and Turkey. Recruitment will take place between March 2014 and June 2015. The study has currently recruited 8000 participants who have completed baseline data. Nutritional intake and dietary patterns will be measured using the Global Allergy and Asthma European Network (GA(2)LEN) food frequency questionnaire. The primary dietary exposures will be n-3 and n-6 polyunsaturated fatty acid consumption. The primary outcome will be cardiovascular mortality and secondary outcomes will be all-cause mortality, infection-related mortality and hospitalisation.
ETHICS AND DISSEMINATION: The study is approved by the relevant Ethics Committees in participating countries. All participants will provide written informed consent and be free to withdraw their data at any time. The findings of the study will be disseminated through peer-reviewed journals, conference presentations and to participants via regular newsletters. We expect that the DIET-HD study will inform large pragmatic trials of nutrition or dietary interventions in the setting of advanced kidney disease.

PMID: 25795691 [PubMed – as supplied by publisher]

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CXCR4 Antagonism as a Therapeutic Approach to Prevent Acute Kidney Injury.

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CXCR4 Antagonism as a Therapeutic Approach to Prevent Acute Kidney Injury.

Am J Physiol Renal Physiol. 2014 Jul 30;

Authors: Zuk A, Gershenovich M, Ivanova Y, MacFarland RT, Fricker SP, Ledbetter SR

Abstract
We examined whether antagonism of the CXCR4 receptor ameliorates the loss of renal function following ischemia-reperfusion. CXCR4 is ubiquitously expressed on leukocytes, known mediators of renal injury, and on bone marrow hematopoietic stem cells (HSC). Plerixafor (AMD3100, Mozobil ) is a small molecule CXCR4 antagonist that mobilizes HSCs into the peripheral blood and also modulates the immune response in in vivo rodent models of asthma and rheumatoid arthritis. Treatment with plerixafor before and after ischemic clamping ameliorated kidney injury in a rat model of bilateral renal ischemia-reperfusion. Serum creatinine and blood urea nitrogen were significantly reduced 24 hours after reperfusion, as was tissue injury and cell death. Plerixafor prevented the renal increase in the pro-inflammatory chemokines CXCL1 and CXCL5 and the cytokine IL-6. Flow cytometry of kidney homogenates confirmed the presence of significantly fewer leukocytes with plerixafor treatment; additionally, myeloperoxidase activity was reduced. AMD3465, a monocyclam analogue of AMD3100, was likewise renoprotective. Four weeks post-reperfusion, long-term effects included diminished fibrosis, inflammation and ongoing renal injury. The mechanism by which CXCR4 inhibition ameliorates AKI is due to modulation of leukocyte infiltration and expression of pro-inflammatory chemokines/cytokines, rather than a HSC mediated effect. The data suggest that CXCR4 antagonism with plerixafor may be a potential option to prevent AKI.

PMID: 25080523 [PubMed – as supplied by publisher]

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Cancer Research UK to Repurpose AstraZeneca Asthma Drug for Kidney Cancer – Genetic Engineering News


Drug Discovery & Development

Cancer Research UK to Repurpose AstraZeneca Asthma Drug for Kidney Cancer
Genetic Engineering News
AZD2098 was originally designed to treat asthma. CRUK says this deal with AZ will enable its Drug Development Office (DDO) to complete preclinical development and carry out early clinical trials of the compound to see if it can benefit kidney cancer
Cancer Research UK, AstraZeneca To Repurpose Asthma Drug for Kidney CancerDrug Discovery & Development

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Cancer Research UK, AstraZeneca To Repurpose Asthma Drug for Kidney Cancer – Drug Discovery & Development


Drug Discovery & Development

Cancer Research UK, AstraZeneca To Repurpose Asthma Drug for Kidney Cancer
Drug Discovery & Development
Cancer Research UK and Cancer Research Technology–the charity's development and commercialization arm–have reached an agreement with AstraZeneca to take AZD2098, an experimental drug originally designed for asthma, into a clinical trial to treat 
Cancer Research UK to Repurpose AstraZeneca Asthma Drug for Kidney CancerGenetic Engineering News

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