Featured Publications
Urine TNF-α and IL-9 for clinical diagnosis of acute interstitial nephritis
Moledina DG, Wilson FP, Pober JS, Perazella MA, Singh N, Luciano RL, Obeid W, Lin H, Kuperman M, Moeckel GW, Kashgarian M, Cantley LG, Parikh CR. Urine TNF-α and IL-9 for clinical diagnosis of acute interstitial nephritis. JCI Insight 2019, 4: e127456. PMID: 31092735, PMCID: PMC6542610, DOI: 10.1172/jci.insight.127456.Peer-Reviewed Original ResearchConceptsAcute interstitial nephritisAcute kidney diseasePrebiopsy diagnosisKidney biopsyKidney diseaseIL-9AIN diagnosisUrine TNFInterstitial nephritisSpecific T cell subsetsAcute tubular injuryDiabetic kidney diseaseIL-9 levelsTNF-α levelsT cell subsetsAddition of biomarkersPlasma cytokinesCytokine levelsTubular injuryHighest quartileMultivariable analysisCell subsetsUrinary TNFBlood eosinophilsGlomerular diseaseThe Association of COVID-19 With Acute Kidney Injury Independent of Severity of Illness: A Multicenter Cohort Study
Moledina DG, Simonov M, Yamamoto Y, Alausa J, Arora T, Biswas A, Cantley LG, Ghazi L, Greenberg JH, Hinchcliff M, Huang C, Mansour SG, Martin M, Peixoto A, Schulz W, Subair L, Testani JM, Ugwuowo U, Young P, Wilson FP. The Association of COVID-19 With Acute Kidney Injury Independent of Severity of Illness: A Multicenter Cohort Study. American Journal Of Kidney Diseases 2021, 77: 490-499.e1. PMID: 33422598, PMCID: PMC7791318, DOI: 10.1053/j.ajkd.2020.12.007.Peer-Reviewed Original ResearchMeSH KeywordsAcute Kidney InjuryAgedCohort StudiesCOVID-19C-Reactive ProteinCreatinineDiureticsFemaleHospital MortalityHumansIntensive Care UnitsLength of StayMaleMiddle AgedProportional Hazards ModelsRenal DialysisRenal Insufficiency, ChronicRespiration, ArtificialRisk FactorsSARS-CoV-2Severity of Illness IndexUnited StatesVasoconstrictor AgentsConceptsAcute kidney injurySARS-CoV-2Cohort studyRisk factorsCOVID-19Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testingTime-updated Cox proportional hazards modelsDialysis-requiring acute kidney injuryYale New Haven Health SystemHigher inflammatory marker levelsMore acute kidney injuryCox proportional hazards modelMulticenter cohort studyHigh rateInflammatory marker levelsTraditional risk factorsProportional hazards modelCoronavirus disease 2019KDIGO criteriaNephrotoxin exposureKidney injuryInjury independentUnivariable analysisNasopharyngeal samplesMarker levels
2023
Joint Modeling of Clinical and Biomarker Data in Acute Kidney Injury Defines Unique Subphenotypes with Differing Outcomes
Vasquez-Rios G, Oh W, Lee S, Bhatraju P, Mansour S, Moledina D, Gulamali F, Siew E, Garg A, Sarder P, Chinchilli V, Kaufman J, Hsu C, Liu K, Kimmel P, Go A, Wurfel M, Himmelfarb J, Parikh C, Coca S, Nadkarni G. Joint Modeling of Clinical and Biomarker Data in Acute Kidney Injury Defines Unique Subphenotypes with Differing Outcomes. Clinical Journal Of The American Society Of Nephrology 2023, 18: 716-726. PMID: 36975209, PMCID: PMC10278836, DOI: 10.2215/cjn.0000000000000156.Peer-Reviewed Original ResearchMeSH KeywordsAcute Kidney InjuryBiomarkersDisease ProgressionFemaleHumansInflammationLipocalin-2MaleMiddle AgedConceptsSubphenotype 2Pro-brain natriuretic peptideNeutrophil gelatinase-associated lipocalinCox proportional hazards modelAKI stage 1AKI stage 2AKI stage 3Three-fold riskAcute kidney injuryTroponin T levelsGelatinase-associated lipocalinBiomarkers of inflammationKidney injury moleculeLongitudinal clinical outcomesTumor necrosis factor receptor 1Proportional hazards modelNecrosis factor receptor 1Factor receptor 1AKI subphenotypesCardiorenal eventsSepsis-AKISubphenotype 1Cardiovascular eventsKidney injuryHazard ratio
2021
Predicting patients with false negative SARS-CoV-2 testing at hospital admission: A retrospective multi-center study
Ghazi L, Simonov M, Mansour SG, Moledina DG, Greenberg JH, Yamamoto Y, Biswas A, Wilson FP. Predicting patients with false negative SARS-CoV-2 testing at hospital admission: A retrospective multi-center study. PLOS ONE 2021, 16: e0251376. PMID: 33979353, PMCID: PMC8115794, DOI: 10.1371/journal.pone.0251376.Peer-Reviewed Original ResearchConceptsSARS-CoV-2 infectionHours of hospitalizationReceiver operator characteristicAdult patientsNegative SARS-CoV-2 testYale New Haven Health SystemLower white blood cell countAvailable electronic health record dataRetrospective multi-center studySARS-CoV-2 positivityWhite blood cell countSARS-CoV-2 testSARS-CoV-2 testingPositive COVID testHospitalized adult patientsRetrospective cohort studyPopulation of patientsElectronic health record dataBlood cell countVital sign abnormalitiesMulti-center studyFalse-negative testingHealth record dataSARS-CoV-2 virusSARS-CoV-2Assessment of Acute Kidney Injury and Longitudinal Kidney Function After Hospital Discharge Among Patients With and Without COVID-19
Nugent J, Aklilu A, Yamamoto Y, Simonov M, Li F, Biswas A, Ghazi L, Greenberg J, Mansour S, Moledina D, Wilson FP. Assessment of Acute Kidney Injury and Longitudinal Kidney Function After Hospital Discharge Among Patients With and Without COVID-19. JAMA Network Open 2021, 4: e211095. PMID: 33688965, PMCID: PMC7948062, DOI: 10.1001/jamanetworkopen.2021.1095.Peer-Reviewed Original ResearchMeSH KeywordsAcute Kidney InjuryAgedAged, 80 and overBlack or African AmericanCohort StudiesComorbidityCOVID-19CreatinineFemaleFollow-Up StudiesGlomerular Filtration RateHispanic or LatinoHumansHypertensionKidney Function TestsLongitudinal StudiesMaleMiddle AgedPatient DischargeProportional Hazards ModelsRenal Insufficiency, ChronicRetrospective StudiesSARS-CoV-2United StatesConceptsCOVID-19-associated acute kidney injuryAcute kidney injuryHospital acute kidney injurySubgroup of patientsKidney functionKidney injuryCohort studyHospital dischargeAKI recoveryKidney diseaseCOVID-19Peak creatinine levelsRetrospective cohort studyChronic kidney diseaseDays of dischargeHalf of patientsGlomerular filtration rateCoronavirus disease 2019AKI severityBaseline comorbiditiesEGFR decreaseDialysis requirementEGFR slopeKidney recoveryCreatinine levelsElectronic health record alerts for acute kidney injury: multicenter, randomized clinical trial
Wilson FP, Martin M, Yamamoto Y, Partridge C, Moreira E, Arora T, Biswas A, Feldman H, Garg AX, Greenberg JH, Hinchcliff M, Latham S, Li F, Lin H, Mansour SG, Moledina DG, Palevsky PM, Parikh CR, Simonov M, Testani J, Ugwuowo U. Electronic health record alerts for acute kidney injury: multicenter, randomized clinical trial. The BMJ 2021, 372: m4786. PMID: 33461986, PMCID: PMC8034420, DOI: 10.1136/bmj.m4786.Peer-Reviewed Original ResearchConceptsAcute kidney injuryElectronic health record alertsKidney injuryPrimary outcomeMedical recordsYale New Haven Health SystemCare practicesGlobal Outcomes creatinine criteriaLarge tertiary care centerComposite of progressionDays of randomizationReceipt of dialysisPrespecified secondary outcomesTertiary care centerPatients' medical recordsSmall community hospitalNon-teaching hospitalsElectronic health recordsCreatinine criteriaUsual careSecondary outcomesAdult inpatientsKidney diseaseClinical centersWorse outcomes
2020
Variation in Best Practice Measures in Patients With Severe Hospital-Acquired Acute Kidney Injury: A Multicenter Study
Moledina DG, Belliveau O, Yamamoto Y, Arora T, Carey KA, Churpek M, Martin M, Partridge CM, Mansour SG, Parikh CR, Koyner JL, Wilson FP. Variation in Best Practice Measures in Patients With Severe Hospital-Acquired Acute Kidney Injury: A Multicenter Study. American Journal Of Kidney Diseases 2020, 77: 547-549. PMID: 33075389, PMCID: PMC8672301, DOI: 10.1053/j.ajkd.2020.08.013.Peer-Reviewed Original ResearchReal-Time Prediction of Acute Kidney Injury in Hospitalized Adults: Implementation and Proof of Concept
Ugwuowo U, Yamamoto Y, Arora T, Saran I, Partridge C, Biswas A, Martin M, Moledina DG, Greenberg JH, Simonov M, Mansour SG, Vela R, Testani JM, Rao V, Rentfro K, Obeid W, Parikh CR, Wilson FP. Real-Time Prediction of Acute Kidney Injury in Hospitalized Adults: Implementation and Proof of Concept. American Journal Of Kidney Diseases 2020, 76: 806-814.e1. PMID: 32505812, PMCID: PMC8667815, DOI: 10.1053/j.ajkd.2020.05.003.Peer-Reviewed Original ResearchConceptsAKI alertsHospitalized adultsKidney injuryUrban tertiary care hospitalAcute kidney injurySerum creatinine levelsObservational cohort studyTertiary care hospitalSerum creatinine concentrationBeats/minElectronic health recordsAKI diagnosisCohort studyCreatinine levelsInpatient mortalitySystolic bloodFractional excretionCenter studyBlood biomarkersUnivariable associationsUrine microscopyCreatinine concentrationClinical careElevated riskUrea nitrogenAssociation Between Early Recovery of Kidney Function After Acute Kidney Injury and Long-term Clinical Outcomes
Bhatraju PK, Zelnick LR, Chinchilli VM, Moledina DG, Coca SG, Parikh CR, Garg AX, Hsu CY, Go AS, Liu KD, Ikizler TA, Siew ED, Kaufman JS, Kimmel PL, Himmelfarb J, Wurfel MM. Association Between Early Recovery of Kidney Function After Acute Kidney Injury and Long-term Clinical Outcomes. JAMA Network Open 2020, 3: e202682. PMID: 32282046, PMCID: PMC7154800, DOI: 10.1001/jamanetworkopen.2020.2682.Peer-Reviewed Original ResearchConceptsMajor adverse kidney eventsAcute kidney injuryProgressive chronic kidney diseaseChronic kidney diseaseKidney function recoverySerum creatinine concentrationKidney injuryClinical outcomesFunction recoveryKidney diseaseCreatinine concentrationHigh riskLong-term clinical outcomesAdverse kidney eventsAdjusted hazard ratioMulticenter cohort studyGlomerular filtration rateLong-term dialysisPopulation of patientsLong-term outcomesPatient risk stratificationRecognition of patientsLong-term riskAKI diagnosisAKI severity
2019
Differentiating Acute Interstitial Nephritis from Acute Tubular Injury: A Challenge for Clinicians
Moledina DG, Parikh CR. Differentiating Acute Interstitial Nephritis from Acute Tubular Injury: A Challenge for Clinicians. Nephron 2019, 143: 211-216. PMID: 31203275, PMCID: PMC6821567, DOI: 10.1159/000501207.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsAcute interstitial nephritisAcute tubular injuryAcute kidney injuryUrine TNFTubular injuryInterstitial nephritisClinical featuresHistological diagnosisInterleukin-9Novel biomarkersClinical practiceChronic kidney diseaseProspective cohort studyHigh-risk populationDisease-specific therapiesCourse of careImmunosuppressive therapyKidney injuryCohort studyKidney biopsyKidney diseasePlasma levelsKidney fibrosisInter-rater variabilityLaboratory assessmentThe Association of Angiogenesis Markers With Acute Kidney Injury and Mortality After Cardiac Surgery
Mansour SG, Zhang WR, Moledina D, Coca SG, Jia Y, Thiessen-Philbrook H, McArthur E, Inoue K, Koyner JL, Shlipak MG, Wilson FP, Garg AX, Ishibe S, Parikh CR, Consortium T. The Association of Angiogenesis Markers With Acute Kidney Injury and Mortality After Cardiac Surgery. American Journal Of Kidney Diseases 2019, 74: 36-46. PMID: 30955944, PMCID: PMC6591032, DOI: 10.1053/j.ajkd.2019.01.028.Peer-Reviewed Original ResearchMeSH KeywordsAcute Kidney InjuryAgedBiomarkersCardiac Surgical ProceduresCreatinineEndpoint DeterminationFemaleHumansKidneyMaleMiddle AgedNeovascularization, PhysiologicOutcome Assessment, Health CarePostoperative ComplicationsProspective StudiesReceptors, Vascular Endothelial Growth FactorRisk AssessmentUnited StatesVascular Endothelial Growth Factor AConceptsAcute kidney injuryCardiac surgeryAKI durationKidney injuryProangiogenic markersAngiogenesis markersOutcomes of AKILong-term outcomesPlasma VEGF concentrationsTRIBE-AKI cohortAntiangiogenic markersCause mortalityPreoperative concentrationsHospital dischargeProcess of angiogenesisMarker levelsVEGFR1 levelsPGF concentrationsHigher oddsMortality riskHigh riskLower oddsVEGF concentrationsAngiogenic markersSurgery
2018
Kidney Biopsy–Related Complications in Hospitalized Patients with Acute Kidney Disease
Moledina DG, Luciano RL, Kukova L, Chan L, Saha A, Nadkarni G, Alfano S, Wilson FP, Perazella MA, Parikh CR. Kidney Biopsy–Related Complications in Hospitalized Patients with Acute Kidney Disease. Clinical Journal Of The American Society Of Nephrology 2018, 13: 1633-1640. PMID: 30348813, PMCID: PMC6237071, DOI: 10.2215/cjn.04910418.Peer-Reviewed Original ResearchConceptsAcute kidney diseaseBiopsy-related complicationsLow platelet countHospitalized patientsNonhospitalized patientsKidney biopsyKidney diseasePlatelet countHigher BUNFemale sexRisk factorsLarge-sized hematomaStage 1 AKIRate of complicationsProcedure-related bleedingLarger needle gaugeAbdominal ultrasonographyBiopsy cohortBlood transfusionAngiographic interventionMultivariable analysisPostbiopsy complicationsMultivariable associationsHigh riskTransfusion
2017
Performance of Serum Creatinine and Kidney Injury Biomarkers for Diagnosing Histologic Acute Tubular Injury
Moledina DG, Hall IE, Thiessen-Philbrook H, Reese PP, Weng FL, Schröppel B, Doshi MD, Wilson FP, Coca SG, Parikh CR. Performance of Serum Creatinine and Kidney Injury Biomarkers for Diagnosing Histologic Acute Tubular Injury. American Journal Of Kidney Diseases 2017, 70: 807-816. PMID: 28844586, PMCID: PMC5701867, DOI: 10.1053/j.ajkd.2017.06.031.Peer-Reviewed Original ResearchMeSH KeywordsAcute Kidney InjuryAdultArea Under CurveBiomarkersCohort StudiesCreatinineCross-Sectional StudiesFatty Acid-Binding ProteinsFemaleHepatitis A Virus Cellular Receptor 1HumansInterleukin-18Kidney TransplantationKidney TubulesLipocalin-2MaleMiddle AgedProspective StudiesROC CurveSeverity of Illness IndexTissue DonorsConceptsSevere acute tubular injuryAcute kidney injuryAcute tubular injuryTubular injurySCr concentrationNGAL concentrationsUrinary biomarkersDeceased donorsOrgan procurementMulticenter prospective cohortUrinary L-FABPUrinary NGAL concentrationsDeceased kidney donorsKidney injury biomarkersSerum creatinine concentrationPoor diagnostic performanceAKI casesAKI causesDonor hospitalizationKidney injuryProspective cohortSerum creatinineInjury biomarkersKidney biopsyIL-18Plasma Biomarkers and Kidney Function Decline in Early and Established Diabetic Kidney Disease
Coca SG, Nadkarni GN, Huang Y, Moledina DG, Rao V, Zhang J, Ferket B, Crowley ST, Fried LF, Parikh CR. Plasma Biomarkers and Kidney Function Decline in Early and Established Diabetic Kidney Disease. Journal Of The American Society Of Nephrology 2017, 28: 2786-2793. PMID: 28476763, PMCID: PMC5576932, DOI: 10.1681/asn.2016101101.Peer-Reviewed Original ResearchMeSH KeywordsAgedBiomarkersCase-Control StudiesDiabetes Mellitus, Type 2Diabetic NephropathiesDisease ProgressionFemaleGlomerular Filtration RateHepatitis A Virus Cellular Receptor 1HumansMaleMiddle AgedPredictive Value of TestsPrognosisProspective StudiesRandomized Controlled Trials as TopicReceptors, Tumor Necrosis Factor, Type IReceptors, Tumor Necrosis Factor, Type IIConceptsKidney injury molecule-1Diabetic kidney diseaseTNF receptor 1Progressive diabetic kidney diseaseRenal outcomesTNFR-2Kidney diseaseBaseline levelsAdvanced diabetic kidney diseaseIncident diabetic kidney diseaseKIM-1 levelsKidney function declineInjury molecule-1Prospective cohort studyBaseline plasma samplesBiomarkers of inflammationClinical prognostic modelDiverse pathophysiologic mechanismsType 2 diabetesCase-control studyHigher baseline levelsEGFR declineCohort studyFunction declinePathophysiologic mechanisms
2015
Association of Perioperative Plasma Neutrophil Gelatinase-Associated Lipocalin Levels with 3-Year Mortality after Cardiac Surgery: A Prospective Observational Cohort Study
Moledina DG, Parikh CR, Garg AX, Thiessen-Philbrook H, Koyner JL, Patel UD, Devarajan P, Shlipak MG, Coca SG, . Association of Perioperative Plasma Neutrophil Gelatinase-Associated Lipocalin Levels with 3-Year Mortality after Cardiac Surgery: A Prospective Observational Cohort Study. PLOS ONE 2015, 10: e0129619. PMID: 26053382, PMCID: PMC4460181, DOI: 10.1371/journal.pone.0129619.Peer-Reviewed Original ResearchMeSH KeywordsAcute Kidney InjuryAcute-Phase ProteinsAgedAged, 80 and overBiomarkersCardiac Surgical ProceduresCause of DeathCohort StudiesCreatinineFemaleFollow-Up StudiesHumansKidney Function TestsLipocalin-2LipocalinsMaleMiddle AgedMortalityPerioperative PeriodProspective StudiesProto-Oncogene ProteinsRisk FactorsTime FactorsConceptsPlasma neutrophil gelatinase-associated lipocalinProspective observational cohort studyLong-term mortalityObservational cohort studySerum creatinineCardiac surgeryCohort studyIndependent associationPlasma neutrophil gelatinase associated lipocalin (NGAL) levelsNeutrophil Gelatinase-Associated Lipocalin LevelsShort-term adverse outcomesNeutrophil gelatinase-associated lipocalinAcute kidney injuryPre-operative variablesIntra-operative variablesGelatinase-associated lipocalinGlomerular filtration ratePre-operative levelsPeri-operative changesPost-operative dayTRIBE-AKI cohortLipocalin levelsCause mortalityKidney injuryNGAL levels
2013
Longitudinal Predictors of Uremic Pruritus
Shirazian S, Kline M, Sakhiya V, Schanler M, Moledina D, Patel C, Hazzan A, Fishbane S. Longitudinal Predictors of Uremic Pruritus. Journal Of Renal Nutrition 2013, 23: 428-431. PMID: 24209894, DOI: 10.1053/j.jrn.2013.08.002.Peer-Reviewed Original ResearchConceptsIntact parathyroid hormoneCalcium-phosphate productParathyroid hormoneUremic pruritusSerum calciumSerum phosphateSerum phosphorusElevated serum phosphorusOriginal study groupDisorders of boneHemodialysis patientsPlacebo treatmentPruritus scoreMineral diseaseStudy groupPruritusBone indicatorsSignificant predictorsPatientsMineral statusBoneWeeksLongitudinal predictorsPredictorsCommon problem