A5065227292- Dialysis and Renal Disease Management
- Chronic Kidney Disease and Diabetes
- Renal Diseases and Glomerulopathies
- Diet and metabolism studies
- Erythropoietin and Anemia Treatment
- Pharmacological Effects and Toxicity Studies
- Renin-Angiotensin System Studies
- Metabolism and Genetic Disorders
- Renal function and acid-base balance
- Muscle and Compartmental Disorders
- Acute Kidney Injury Research
- Renal Transplantation Outcomes and Treatments
- Neurological and metabolic disorders
- Electrolyte and hormonal disorders
- Muscle metabolism and nutrition
- Renal and Vascular Pathologies
- Central Venous Catheters and Hemodialysis
- Biomedical Research and Pathophysiology
- Organ Transplantation Techniques and Outcomes
- Blood Pressure and Hypertension Studies
- Hormonal Regulation and Hypertension
- Gut microbiota and health
- Ion Transport and Channel Regulation
- Diabetes Treatment and Management
- Heart Failure Treatment and Management
Stanford University
2016-2025
VA Palo Alto Health Care System
2015-2024
Palo Alto Veterans Institute for Research
1990-2023
Stanford Medicine
2009-2023
University of Bonn
2023
Escola Brasileira de Economia e Finanças
2021
Oxfam
2020
John Wiley & Sons (United States)
2020
John Wiley & Sons (United Kingdom)
2020
Hudson Institute
2020
Two groups of adult male Munich-Wistar rats and a third group nondiabetic age-matched weight-matched normal control underwent micropuncture study 1 mo, morphologic studies 14 after induction streptozotocin diabetes or sham treatment. All animals were fed standard rat chow. Diabetic received daily ultralente insulin to maintain stable moderate hyperglycemia (approximately 350 mg/dl). In addition, one diabetic was treated with the angiotensin I converting enzyme inhibitor, enalapril, 15...
Micropuncture and morphologic studies were performed in four groups of male Munich-Wistar rats after removal the right kidney segmental infarction two-thirds left kidney. Groups 1 3 received no specific therapy. 2 4 treated with angiotensin I converting enzyme inhibitor, enalapril, 50 mg/liter which was put their drinking water. All fed standard chow. underwent micropuncture study wk renal ablation. Untreated group exhibited systemic hypertension elevation single nephron glomerular...
Six groups of Munich-Wistar rats underwent micropuncture study 2-10 weeks and morphologic studies 11-13 months after induction streptozotocin diabetes or sham treatment. Diabetic received diets containing 6% (group D6), 12% (D12), 50% protein (D50) were maintained under similar conditions moderate hyperglycemia by daily injections ultralente insulin. Age- weight-matched normal control also given (Group N6), (N12), (N50). Kidney weight, whole-kidney single-nephron glomerular filtration rate,...
Microbes in the colon produce compounds, normally excreted by kidneys, which are potential uremic toxins. Although p-cresol sulfate and indoxyl well studied examples, few other compounds known. Here, we compared plasma from hemodialysis patients with without colons to identify further characterize colon-derived solutes. HPLC confirmed colonic origin of sulfate, but levels hippurate, methylamine, dimethylamine were not significantly lower colons. High-resolution mass spectrometry detected...
Background and objectives Numerous uremic solutes are derived from the action of colon microbes. Two such solutes, indoxyl sulfate p-cresol sulfate, have been associated with adverse outcomes in renal failure. This study tested whether increasing dietary fiber form resistant starch would lower plasma levels these patients on hemodialysis. Design, setting, participants, & measurements Fifty-six maintenance hemodialysis were randomly assigned to receive supplements containing (n=28) or control...
The effects of angiotensin II (AII) blockade were compared with the converting enzyme inhibition in rats reduced nephron number. Rats subjected to five-sixths renal ablation and divided into four groups similar values for blood pressure serum creatinine after 2 wk. Group 1 then served as untreated controls, while group received AII receptor antagonist MK954 (which has previously been designated DuP753), 3 inhibitor enalapril, 4 a combination reserpine, hydralazine, hydrochlorothiazide....
With the goal of identifying optimal platforms for developing better models diabetic nephropathy in mice, we compared renal effects streptozotocin (STZ)-induced diabetes among five common inbred mouse strains (C57BL/6, MRL/Mp, BALB/c, DBA/2, and 129/SvEv). We also evaluated consequences chemical genetic on same background (C57BL/6). There was a hierarchical response blood glucose level to STZ regimen (DBA/2 > C57BL/6 MRL/MP 129/SvEv BALB/c). In all strains, males demonstrated much more...
Protein-bound solutes are poorly cleared by dialysis. Among the most extensively studied of these is p-cresol, which has been shown to be toxic in vitro. This study examined form p-cresol circulates and quantified its removal hemodialysis. HPLC analysis plasma from hemodialysis patients contained a peak whose mobility corresponded synthetic sulfate (PCS) but no detectable unconjugated p-cresol. Treatment with sulfatase resulted recovery this as confirming identity. Subsequent studies...
Differential solute clearances were used to examine the effects of a 90-day course enalapril on glomerular barrier function in 16 proteinuric patients with diabetic glomerulopathy. By day 90, plasma renin and prorenin became elevated, arterial pressure declined. Transglomerular passage dextrans broad size distribution (radii 28-60 A) was lowered significantly. In subset 8 patients, withdrawal followed after an additional 30 days by return levels pretreatment levels. The dextran-sieving...
The uremic solutes p-cresol sulfate (PCS) and indoxyl (IS) are generated by colon bacteria acting on food components that escape absorption in the small bowel. production of these potentially toxic compounds may thus be influenced diet. This study examined whether PCS IS is different vegetarians omnivores.The was assessed measuring their urinary excretion rates participants with normal kidney function. Studies were carried out 15 11 individuals consuming an unrestricted Participants recorded...
The development of progressive glomerulosclerosis in the renal ablation model has been ascribed to a number humoral and hemodynamic events, including peptide growth factor, transforming factor-beta 1 (TGF-beta 1). An important role also attributed angiotensin II (AII), which, addition its effects, can stimulate transcription TGF-beta 1. We postulated that increased glomerular production AII, resulting from enhanced intrinsic angiotensinogen expression, stimulates local synthesis, activating...
Cardiovascular disease causes over 50% of the deaths in dialysis patients, and risk death is higher white than black patients. The underlying mechanisms for these findings are unknown. We determined association proatherogenic metabolite trimethylamine N -oxide (TMAO) with cardiovascular outcomes hemodialysis patients assessed whether this differs by race. measured TMAO stored serum samples obtained 3–6 months after randomization from a total 1232 Hemodialysis Study, analyzed using Cox models...
Dialytic clearance of urea is efficient, but other small solutes normally secreted by the kidney may be cleared less efficiently. This study tested whether high concentrations these in hemodialysis patients reflect a failure passive diffusion methods to duplicate efficacy tubular secretion. We compared plasma and rates four secretion with creatinine receiving maintenance normal subjects. The predialysis (relative subjects) unbound phenylacetylglutamine (122-fold), hippurate (108-fold),...
Large size, protein binding and intracellular sequestration are well known to limit dialytic removal of compounds. In studying the normal renal handling trimethylamine oxide (TMAO), a molecule associated with cardiovascular disease in general population, we discovered two largely unrecognized additional limitations sustained reduction solute by chronic hemodialysis. We measured levels subjects on hemodialysis (ESRD, n = 7) compared these clearance controls (NLS, 6). The ESRD patients had...