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 ResearchConceptsSubphenotype 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
2022
Clinically adjudicated deceased donor acute kidney injury and graft outcomes
Mansour SG, Khoury N, Kodali R, Virmani S, Reese PP, Hall IE, Jia Y, Yamamoto Y, Thiessen-Philbrook HR, Obeid W, Doshi MD, Akalin E, Bromberg JS, Harhay MN, Mohan S, Muthukumar T, Singh P, Weng FL, Moledina DG, Greenberg JH, Wilson FP, Parikh CR. Clinically adjudicated deceased donor acute kidney injury and graft outcomes. PLOS ONE 2022, 17: e0264329. PMID: 35239694, PMCID: PMC8893682, DOI: 10.1371/journal.pone.0264329.Peer-Reviewed Original ResearchConceptsDonor Acute Kidney InjuryAcute kidney injuryGraft failureAKI phenotypesKidney injuryUrine biomarkersLack of associationAKI casesGraft functionHigher DGFPotential kidneyGraft outcomeDeceased donorsOrgan utilizationMCP-1YKL-40Donor StudyEGFRDGFAncillary analysisAvailable chartsBiomarkersInjuryPhenotypeAssociationAngiopoietins as Prognostic Markers for Future Kidney Disease and Heart Failure Events after Acute Kidney Injury
Mansour SG, Bhatraju PK, Coca SG, Obeid W, Wilson FP, Stanaway IB, Jia Y, Thiessen-Philbrook H, Go AS, Ikizler TA, Siew ED, Chinchilli VM, Hsu CY, Garg AX, Reeves WB, Liu KD, Kimmel PL, Kaufman JS, Wurfel MM, Himmelfarb J, Parikh SM, Parikh CR. Angiopoietins as Prognostic Markers for Future Kidney Disease and Heart Failure Events after Acute Kidney Injury. Journal Of The American Society Of Nephrology 2022, 33: 613-627. PMID: 35017169, PMCID: PMC8975075, DOI: 10.1681/asn.2021060757.Peer-Reviewed Original ResearchConceptsCKD progressionHeart failureLower riskAngpt-1Highest quartileFuture kidney diseaseSetting of AKIAcute kidney injuryHeart failure admissionsHeart failure eventsProspective cohort studyMortality 3 monthsPlasma angiopoietinsKidney injuryCohort studySecondary outcomesEndothelial injuryMedian agePrimary outcomeKidney diseasePrognostic markerAngiopoietin-2AKIAngiopoietin-1Vessel destabilization
2021
Post-transplant Diabetes Mellitus in Kidney Transplant Recipients: A Multicenter Study
Malik RF, Jia Y, Mansour SG, Reese PP, Hall IE, Alasfar S, Doshi MD, Akalin E, Bromberg JS, Harhay MN, Mohan S, Muthukumar T, Schröppel B, Singh P, Weng FL, Philbrook H, Parikh CR. Post-transplant Diabetes Mellitus in Kidney Transplant Recipients: A Multicenter Study. Kidney360 2021, 2: 1296-1307. PMID: 35369651, PMCID: PMC8676388, DOI: 10.34067/kid.0000862021.Peer-Reviewed Original ResearchConceptsPost-transplant diabetes mellitusKidney Donor Profile IndexGraft failureKidney transplantRecipient ageRisk factorsDevelopment of PTDMDeath-censored graft failureAdult kidney recipientsCause graft failureDocumentation of diabetesMulticenter longitudinal cohortOlder recipient ageYear post-KTKidney transplant recipientsHigher baseline BMIDetailed chart reviewElectronic medical recordsKidney recipientsMaintenance immunosuppressionPost-KTBaseline BMIHCV infectionHLA mismatchesKT recipientsPredicting 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-2Urinary EGF and MCP-1 and risk of CKD after cardiac surgery
Menez S, Ju W, Menon R, Moledina DG, Thiessen Philbrook H, McArthur E, Jia Y, Obeid W, Mansour SG, Koyner JL, Shlipak MG, Coca SG, Garg AX, Bomback AS, Kellum JA, Kretzler M, Parikh CR, . Urinary EGF and MCP-1 and risk of CKD after cardiac surgery. JCI Insight 2021, 6: e147464. PMID: 33974569, PMCID: PMC8262289, DOI: 10.1172/jci.insight.147464.Peer-Reviewed Original ResearchMeSH KeywordsAcute Kidney InjuryAgedAged, 80 and overCardiac Surgical ProceduresChemokine CCL2Disease ProgressionEpidermal Growth FactorFemaleGene Expression ProfilingHumansIncidenceMalePostoperative ComplicationsProportional Hazards ModelsRenal Insufficiency, ChronicRNA, MessengerRNA-SeqSingle-Cell AnalysisConceptsAcute kidney injuryCardiac surgeryMCP-1CKD outcomesUrinary EGFLong-term kidney outcomesChronic kidney disease riskTRIBE-AKI (Translational Research Investigating Biomarker Endpoints for Acute Kidney Injury) ConsortiumKidney disease riskMCP-1 levelsRisk of CKDAmerican Heart AssociationPostoperative urine samplesHealth Research InstituteLong-term careCKD incidenceKidney outcomesKidney injuryKidney Precision Medicine ProjectComposite outcomeTubular damageHeart AssociationCCL2 expressionGlomerular functionKidney CenterDeceased-Donor Acute Kidney Injury and BK Polyomavirus in Kidney Transplant Recipients
Hall IE, Reese PP, Mansour SG, Mohan S, Jia Y, Thiessen-Philbrook HR, Brennan DC, Doshi MD, Muthukumar T, Akalin E, Harhay MN, Schröppel B, Singh P, Weng FL, Bromberg JS, Parikh CR. Deceased-Donor Acute Kidney Injury and BK Polyomavirus in Kidney Transplant Recipients. Clinical Journal Of The American Society Of Nephrology 2021, 16: 765-775. PMID: 33692117, PMCID: PMC8259491, DOI: 10.2215/cjn.18101120.Peer-Reviewed Original ResearchConceptsDonor AKIBKV DNAemiaGraft failureLower riskOPTN databaseKidney Donor Profile IndexCox proportional hazards modelMean recipient ageAcute kidney injuryAdjusted hazard ratioKidney transplant recipientsTransplantation Network databaseRecipient-related factorsProportional hazards modelIschemia-reperfusion processAllograft failureAllograft integrityKidney recipientsBKV infectionKidney injuryKidney transplantationRecipient ageTransplant recipientsHazard ratioProspective cohortAssessment 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 outcomesContemporary incidence and risk factors of post transplant Erythrocytosis in deceased donor kidney transplantation
Alasfar S, Hall IE, Mansour SG, Jia Y, Thiessen-Philbrook HR, Weng FL, Singh P, Schröppel B, Muthukumar T, Mohan S, Malik RF, Harhay MN, Doshi MD, Akalin E, Bromberg JS, Brennan DC, Reese PP, Parikh CR. Contemporary incidence and risk factors of post transplant Erythrocytosis in deceased donor kidney transplantation. BMC Nephrology 2021, 22: 26. PMID: 33435916, PMCID: PMC7802150, DOI: 10.1186/s12882-021-02231-2.Peer-Reviewed Original ResearchConceptsKidney Donor Profile IndexRAAS inhibitorsRisk factorsLower kidney donor profile indexDeceased donor kidney transplantationWorld Health Organization criteriaHigh kidney donor profile indexCurrent transplant practiceHigh-quality kidneysPost-transplant erythrocytosisDonor kidney transplantationMajority of patientsLarge recent cohortPolycystic kidney diseaseRisk of PTEsKidney recipientsTransplant erythrocytosisCerebrovascular eventsKidney transplantationPTE patientsConclusionsThe incidenceGraft failureContemporary incidenceDeceased donorsKidney 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
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 ResearchUromodulin to Osteopontin Ratio in Deceased Donor Urine Is Associated With Kidney Graft Outcomes.
Mansour SG, Liu C, Jia Y, Reese PP, Hall IE, El-Achkar TM, LaFavers KA, Obeid W, Rosenberg AZ, Daneshpajouhnejad P, Doshi MD, Akalin E, Bromberg JS, Harhay MN, Mohan S, Muthukumar T, Schröppel B, Singh P, El-Khoury JM, Weng FL, Thiessen-Philbrook HR, Parikh CR. Uromodulin to Osteopontin Ratio in Deceased Donor Urine Is Associated With Kidney Graft Outcomes. Transplantation 2020, 105: 876-885. PMID: 32769629, PMCID: PMC8805736, DOI: 10.1097/tp.0000000000003299.Peer-Reviewed Original ResearchMeSH KeywordsAdultAgedAnimalsBiomarkersCells, CulturedDelayed Graft FunctionFemaleGlomerular Filtration RateGraft SurvivalHistocompatibility Antigens Class IIHumansKidneyKidney TransplantationMacrophagesMaleMiceMiddle AgedOsteopontinProspective StudiesRisk AssessmentRisk FactorsTime FactorsTissue DonorsUnited StatesUromodulinConceptsGraft failureGraft functionGraft outcomePrimary outcomeMajor histocompatibilityDeath-censored graft failureDeceased donor kidney transplantationCause graft failureImproved graft survivalRecipient graft outcomesKidney graft outcomeGlomerular filtration rateDeceased donor kidneysTime of procurementGraft survivalKidney transplantationDirection of associationDeceased donorsFiltration rateKidney qualityLower riskExtensive injuryDonor urineSimilar associationMouse macrophagesReal-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 nitrogenUrine Injury Biomarkers Are Not Associated With Kidney Transplant Failure.
Koyawala N, Reese PP, Hall IE, Jia Y, Thiessen-Philbrook HR, Mansour SG, Doshi MD, Akalin E, Bromberg JS, Harhay MN, Mohan S, Muthukumar T, Schröppel B, Singh P, Weng FL, Parikh CR. Urine Injury Biomarkers Are Not Associated With Kidney Transplant Failure. Transplantation 2020, 104: 1272-1279. PMID: 31568213, PMCID: PMC7384615, DOI: 10.1097/tp.0000000000002948.Peer-Reviewed Original ResearchConceptsAcute kidney injuryDonor Acute Kidney InjuryGraft failureInjury biomarkersSerum creatinineGraft outcomeKidney injuryComposite outcomeDeath-censored graft failureRisk of GFKidney injury molecule-1Cox proportional hazards modelLiver-type fatty acidSimilar allograft survivalStructural kidney damageKidney transplant recipientsInjury molecule-1Kidney transplant failureGlomerular filtration rateProportional hazards modelAKI kidneysAllograft survivalTransplant recipientsChart reviewNeutrophil gelatinaseA Time-Updated, Parsimonious Model to Predict AKI in Hospitalized Children
Sandokji I, Yamamoto Y, Biswas A, Arora T, Ugwuowo U, Simonov M, Saran I, Martin M, Testani JM, Mansour S, Moledina DG, Greenberg JH, Wilson FP. A Time-Updated, Parsimonious Model to Predict AKI in Hospitalized Children. Journal Of The American Society Of Nephrology 2020, 31: 1348-1357. PMID: 32381598, PMCID: PMC7269342, DOI: 10.1681/asn.2019070745.Peer-Reviewed Original ResearchConceptsExternal validation cohortValidation cohortElectronic health recordsSevere AKIClinical risk stratification toolDevelopment of AKIHealth recordsRisk stratification toolInternal validation cohortLength of stayCharacteristic curveElectronic medical recordsNeonatal AKIInpatient mortalitySecondary outcomesHospital admissionPrimary outcomeHospitalized childrenCreatinine valuesMedical recordsStudy populationAKICohortChildrenPredictive variablesAssociation of Deceased Donor Acute Kidney Injury With Recipient Graft Survival
Liu C, Hall IE, Mansour S, Philbrook H, Jia Y, Parikh CR. Association of Deceased Donor Acute Kidney Injury With Recipient Graft Survival. JAMA Network Open 2020, 3: e1918634. PMID: 31913491, PMCID: PMC6991314, DOI: 10.1001/jamanetworkopen.2019.18634.Peer-Reviewed Original ResearchConceptsDonor Acute Kidney InjuryAcute kidney injuryRecipient graft survivalDeath-censored graft failureCause graft failureAKI kidneysDeceased donorsGraft failureGraft survivalOrgan procurement organizationsAKI statusGraft functionKidney injuryPrimary nonfunctionMean agePropensity score-matched cohort studyTerminal serum creatinine levelPropensity score-matched analysisFollowing secondary outcomesDelayed graft functionSerum creatinine levelsProcurement organizationsDeceased donor kidneysDates of analysisAKI stage
2019
Association of plasma-soluble ST2 and galectin-3 with cardiovascular events and mortality following cardiac surgery
Patel DM, Thiessen-Philbrook H, Brown JR, McArthur E, Moledina DG, Mansour SG, Shlipak MG, Koyner JL, Kavsak P, Whitlock RP, Everett AD, Malenka DJ, Garg AX, Coca SG, Parikh CR. Association of plasma-soluble ST2 and galectin-3 with cardiovascular events and mortality following cardiac surgery. American Heart Journal 2019, 220: 253-263. PMID: 31911262, PMCID: PMC7008086, DOI: 10.1016/j.ahj.2019.11.014.Peer-Reviewed Original ResearchMeSH KeywordsAcute Kidney InjuryAgedBiomarkersBlood ProteinsCardiac Surgical ProceduresCardiovascular DiseasesCause of DeathCohort StudiesCoronary Artery BypassFemaleGalectin 3GalectinsHeart Valve Prosthesis ImplantationHumansInterleukin-1 Receptor-Like 1 ProteinMalePostoperative ComplicationsProspective StudiesVentricular RemodelingConceptsGal-3 levelsCardiovascular eventsCardiac surgerySignificant post-operative morbidityGalectin-3Gal-3 valuesPlasma soluble ST2Composite primary outcomePrimary composite outcomePost-operative morbidityCongestive heart failurePost-operative changesPotential clinical utilityRandom-effects modelPlasma sST2Soluble suppressionComposite outcomeHazard ratioProspective cohortTumorigenicity 2Heart failurePrimary outcomeMyocardial remodelingClinical covariatesClinical utilityThe Role of Volume Regulation and Thermoregulation in AKI during Marathon Running
Mansour SG, Martin TG, Obeid W, Pata RW, Myrick KM, Kukova L, Jia Y, Bjornstad P, El-Khoury JM, Parikh CR. The Role of Volume Regulation and Thermoregulation in AKI during Marathon Running. Clinical Journal Of The American Society Of Nephrology 2019, 14: 1297-1305. PMID: 31413064, PMCID: PMC6730516, DOI: 10.2215/cjn.01400219.Peer-Reviewed Original ResearchConceptsCore body temperatureBody temperaturePercent of runnersAcute tubular injuryPlasma copeptin concentrationsMajority of runnersContinuous core body temperatureAKIN criteriaDays postmarathonPrior marathonsTransient AKICopeptin concentrationsTubular injuryInjury biomarkersPrimary outcomeProspective cohortNephron damageNegative sodiumUrine microscopyVolume lossUrine sedimentAKIAbstractTextSweat sodiumCopeptinComparison of Urine and Plasma Biomarker Concentrations Measured by Aptamer-Based versus Immunoassay Methods in Cardiac Surgery Patients
Kukova LZ, Mansour SG, Coca SG, de Fontnouvelle CA, Thiessen-Philbrook HR, Shlipak MG, El-Khoury JM, Parikh CR. Comparison of Urine and Plasma Biomarker Concentrations Measured by Aptamer-Based versus Immunoassay Methods in Cardiac Surgery Patients. The Journal Of Applied Laboratory Medicine 2019, 4: 331-342. PMID: 31659071, DOI: 10.1373/jalm.2018.028621.Peer-Reviewed Original ResearchConceptsCardiac surgery patientsSurgery patientsCardiac surgeryBiomarker concentrationsAcute kidney injuryComparison of urinePlasma biomarker concentrationsImmunoassay methodPostoperative biomarkersPostoperative plasmaPreoperative biomarkersKidney injuryInjury cohortBiomarker discoveryBiomarker endpointsClinical settingCurrent immunoassay methodsBiomarker valuesUrine samplesTranslational researchUrineSpearman correlationPaired samplesPatientsSurgery