2024
COVID-19−Associated Acute Kidney Injury and Longitudinal Kidney Outcomes
Aklilu A, Kumar S, Nugent J, Yamamoto Y, Coronel-Moreno C, Kadhim B, Faulkner S, O’Connor K, Yasmin F, Greenberg J, Moledina D, Testani J, Wilson F. COVID-19−Associated Acute Kidney Injury and Longitudinal Kidney Outcomes. JAMA Internal Medicine 2024, 184: 414-423. PMID: 38407862, PMCID: PMC10897825, DOI: 10.1001/jamainternmed.2023.8225.Peer-Reviewed Original ResearchCOVID-19-associated acute kidney injuryCOVID-19-associated AKIAcute kidney injuryMulticenter cohort studyKidney function declineKidney functionKidney injuryCohort studyKidney outcomes of patientsIncidence of acute kidney injuryLong-term kidney outcomesHistorical cohort of patientsMultivariate time-to-event analysesPositive influenza ALongitudinal multicenter cohort studyWorsening kidney functionOutcomes of patientsAdverse kidney eventsCohort of patientsComposite of mortalityMarkers of illness severityAdult hospitalized patientsBaseline comorbidity scoreTime-to-event analysisFunctional decline
2023
A randomized clinical trial assessing the effect of automated medication-targeted alerts on acute kidney injury outcomes
Wilson F, Yamamoto Y, Martin M, Coronel-Moreno C, Li F, Cheng C, Aklilu A, Ghazi L, Greenberg J, Latham S, Melchinger H, Mansour S, Moledina D, Parikh C, Partridge C, Testani J, Ugwuowo U. A randomized clinical trial assessing the effect of automated medication-targeted alerts on acute kidney injury outcomes. Nature Communications 2023, 14: 2826. PMID: 37198160, PMCID: PMC10192367, DOI: 10.1038/s41467-023-38532-3.Peer-Reviewed Original ResearchConceptsAcute kidney injuryUsual care groupKidney injuryCare groupAcute Kidney Injury OutcomesAlert groupNon-steroidal anti-inflammatory drugsComposite of progressionHours of randomizationMedications of interestAldosterone system inhibitorsClasses of medicationsProton pump inhibitorsRandomized clinical trialsAnti-inflammatory drugsClinical decision support systemNephrotoxic medicationsHospitalized adultsDiscontinuation ratesCertain medicationsPrimary outcomeSubstantial morbiditySystem inhibitorsPump inhibitorsParallel group
2022
Mortality after acute kidney injury and acute interstitial nephritis in patients prescribed immune checkpoint inhibitor therapy
Baker ML, Yamamoto Y, Perazella MA, Dizman N, Shirali AC, Hafez N, Weinstein J, Simonov M, Testani JM, Kluger HM, Cantley LG, Parikh CR, Wilson FP, Moledina DG. Mortality after acute kidney injury and acute interstitial nephritis in patients prescribed immune checkpoint inhibitor therapy. Journal For ImmunoTherapy Of Cancer 2022, 10: e004421. PMID: 35354588, PMCID: PMC8968986, DOI: 10.1136/jitc-2021-004421.Peer-Reviewed Original ResearchConceptsAcute interstitial nephritisAcute kidney injuryImmune checkpoint inhibitor therapyCheckpoint inhibitor therapyICI therapyKidney injuryInhibitor therapyInterstitial nephritisTime-varying Cox proportional hazards modelsHigher peak serum creatinineSevere acute kidney injuryCancer typesCox proportional hazards modelAssociations of biopsyBaseline laboratory valuesObservational cohort studyPeak serum creatinineFavorable treatment responseProportional hazards modelAKI patientsTherapy initiationCohort studySerum creatinineUnivariable analysisImmune activation
2021
Evidence for SARS-CoV-2 Spike Protein in the Urine of COVID-19 Patients
George S, Pal AC, Gagnon J, Timalsina S, Singh P, Vydyam P, Munshi M, Chiu JE, Renard I, Harden CA, Ott IM, Watkins AE, Vogels CBF, Lu P, Tokuyama M, Venkataraman A, Casanovas-Massana A, Wyllie AL, Rao V, Campbell M, Farhadian SF, Grubaugh ND, Dela Cruz CS, Ko AI, Perez A, Akaho EH, Moledina DG, Testani J, John AR, Ledizet M, Mamoun CB, Team A. Evidence for SARS-CoV-2 Spike Protein in the Urine of COVID-19 Patients. Kidney360 2021, 2: 924-936. PMID: 35373072, PMCID: PMC8791366, DOI: 10.34067/kid.0002172021.Peer-Reviewed Original ResearchConceptsSARS-CoV-2 spike proteinSARS-CoV-2Spike proteinUrine samplesSARS-CoV-2 infectionYale-New Haven HospitalCOVID-19 patientsAntigen capture assayDetectable viral RNANew Haven HospitalPositive PCR resultsPossible long-term consequencesSpike S1 proteinNP PCRChildren's HospitalNasopharyngeal swabsSARS-CoV-2 spike S1 proteinRenal abnormalitiesLong-term effectsCystatin CLong-term consequencesHospitalUrineViral RNAAlbuminuriaElectronic 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 outcomesThe 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
Real-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 nitrogenA 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 variables
2015
Amino-Terminal Pro-B-Type Natriuretic Peptide for Diagnosis and Prognosis in Patients With Renal Dysfunction A Systematic Review and Meta-Analysis
Schaub JA, Coca SG, Moledina DG, Gentry M, Testani JM, Parikh CR. Amino-Terminal Pro-B-Type Natriuretic Peptide for Diagnosis and Prognosis in Patients With Renal Dysfunction A Systematic Review and Meta-Analysis. JACC Heart Failure 2015, 3: 977-989. PMID: 26671676, PMCID: PMC4683413, DOI: 10.1016/j.jchf.2015.07.014.Peer-Reviewed Original ResearchConceptsAcute decompensated heart failureNT-proBNPRenal dysfunctionRenal functionHeart failureNatriuretic peptideDiagnosis of ADHFAmino-terminal pro-B-type natriuretic peptidePro-B-type natriuretic peptidePg/B-type natriuretic peptideAmino-Terminal ProElevated NT-proBNPHigher NT-proBNPDecompensated heart failurePooled risk ratioGlomerular filtration rateCoronary artery diseaseA Systematic ReviewADHF eventsArtery diseasePrognostic utilityWorse prognosisFiltration rateRisk ratio