2022
Hemoconcentration of Creatinine Minimally Contributes to Changes in Creatinine during the Treatment of Decompensated Heart Failure
Maulion C, Chen S, Rao VS, Ivey-Miranda JB, Cox ZL, Mahoney D, Coca SG, Negoianu D, Asher JL, Turner JM, Inker LA, Wilson FP, Testani JM. Hemoconcentration of Creatinine Minimally Contributes to Changes in Creatinine during the Treatment of Decompensated Heart Failure. Kidney360 2022, 3: 1003-1010. PMID: 35845336, PMCID: PMC9255871, DOI: 10.34067/kid.0007582021.Peer-Reviewed Original ResearchMortality 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 ResearchMeSH KeywordsAcute Kidney InjuryCreatinineHumansImmune Checkpoint InhibitorsKidneyNephritis, InterstitialConceptsAcute 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
Early diuretic strategies and the association with In-hospital and Post-discharge outcomes in acute heart failure
Fudim M, Spates T, Sun JL, Kittipibul V, Testani JM, Starling RC, Tang WHW, Hernandez AF, Felker GM, O'Connor CM, Mentz RJ. Early diuretic strategies and the association with In-hospital and Post-discharge outcomes in acute heart failure. American Heart Journal 2021, 239: 110-119. PMID: 34052212, DOI: 10.1016/j.ahj.2021.05.011.Peer-Reviewed Original ResearchMeSH KeywordsCreatinineDiureticsDrug MonitoringFemaleFurosemideHeart FailureHospitalizationHumansInfusions, IntravenousInjections, IntravenousMaleMiddle AgedMortalityNatriuretic Peptide, BrainOutcome and Process Assessment, Health CarePatient ReadmissionPeptide FragmentsTime-to-TreatmentUnited StatesConceptsIntermittent bolus administrationAcute heart failureDecompensated heart failureHeart failurePost-discharge outcomesDiuretic strategyDay mortalityBolus administrationDays/dischargeHigher baseline creatinineIntermittent bolus groupTotal urine outputBaseline creatinineDiuretic regimenHigh NTproBNPCause mortalityHF readmissionHF rehospitalizationHospital outcomesBaseline characteristicsCardiovascular mortalityIn-HospitalRenal functionBolus groupContinuous therapyThe 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 InjuryAgedC-Reactive ProteinCohort StudiesCOVID-19CreatinineDiureticsFemaleHospital 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
Accelerated decline in renal function after hospitalization for acute heart failure: an opportunity to intervene, or a sign of the inevitable?
McNaughton CD, Collins SP, Testani JM. Accelerated decline in renal function after hospitalization for acute heart failure: an opportunity to intervene, or a sign of the inevitable? European Journal Of Heart Failure 2020, 22: 1800-1802. PMID: 32840958, DOI: 10.1002/ejhf.1992.Commentaries, Editorials and LettersCystatin C and Muscle Mass in Patients With Heart Failure
Ivey-Miranda JB, Inker LA, Griffin M, Rao V, Maulion C, Turner JM, Wilson FP, Tang WHW, Levey AS, Testani JM. Cystatin C and Muscle Mass in Patients With Heart Failure. Journal Of Cardiac Failure 2020, 27: 48-56. PMID: 32750487, PMCID: PMC8672303, DOI: 10.1016/j.cardfail.2020.07.013.Peer-Reviewed Original ResearchMeSH KeywordsCreatinineCystatin CGlomerular Filtration RateHeart FailureHumansMusclesRenal Insufficiency, ChronicConceptsHeart failureCreatinine clearanceMuscle massCystatin CHigher muscle massAssociation of eGFRcysGlomerular filtration rateLow muscle massCystatin C levelsAccurate GFR estimationMultivariable analysisFiltration rateEGFRcysEGFRcrBody compositionGFR estimationPatientsCreatinineC levelsClearanceMortalityAssociationReal-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 nitrogen
2019
Development and Validation of a Model for Predicting the Risk of Acute Kidney Injury Associated With Contrast Volume Levels During Percutaneous Coronary Intervention
Huang C, Li SX, Mahajan S, Testani JM, Wilson FP, Mena CI, Masoudi FA, Rumsfeld JS, Spertus JA, Mortazavi BJ, Krumholz HM. Development and Validation of a Model for Predicting the Risk of Acute Kidney Injury Associated With Contrast Volume Levels During Percutaneous Coronary Intervention. JAMA Network Open 2019, 2: e1916021. PMID: 31755952, PMCID: PMC6902830, DOI: 10.1001/jamanetworkopen.2019.16021.Peer-Reviewed Original ResearchConceptsCreatinine level increaseAcute kidney injuryPercutaneous coronary interventionContrast volumeAKI riskKidney injuryCoronary interventionBaseline riskCardiology National Cardiovascular Data Registry's CathPCI RegistryNational Cardiovascular Data Registry CathPCI RegistryRisk of AKIAcute Kidney Injury AssociatedDifferent baseline risksPCI safetyCathPCI RegistryInjury AssociatedMean ageDerivation setPreprocedural riskMAIN OUTCOMEAmerican CollegePrognostic studiesUS hospitalsCalibration slopeValidation setAdverse Renal Response to Decongestion in the Obese Phenotype of Heart Failure With Preserved Ejection Fraction
Reddy YNV, Obokata M, Testani JM, Felker GM, Tang WHW, Abou-Ezzeddine OF, Sun JL, Chakrabothy H, McNulty S, Shah SJ, Lewis GD, Stevenson LW, Redfield MM, Borlaug BA. Adverse Renal Response to Decongestion in the Obese Phenotype of Heart Failure With Preserved Ejection Fraction. Journal Of Cardiac Failure 2019, 26: 101-107. PMID: 31618698, PMCID: PMC7036022, DOI: 10.1016/j.cardfail.2019.09.015.Peer-Reviewed Original ResearchConceptsRenal functionNonobese patientsHeart failureObese HFpEFObese patientsEjection fractionRenal responseAdverse renal responsesRight ventricular remodelingGlomerular filtration rateBody mass indexPlasma volume expansionSimilar weight lossCardiorenal hemodynamicsRenal dysfunctionPathophysiologic featuresMass indexAtrial fibrillationDecongestive therapyVentricular remodelingPericardial restraintFiltration rateHFpEFObese phenotypeSevere worseningEffect on Survival of Concurrent Hemoconcentration and Increase in Creatinine During Treatment of Acute Decompensated Heart Failure
Griffin M, Rao VS, Fleming J, Raghavendra P, Turner J, Mahoney D, Wettersten N, Maisel A, Ivey-Miranda JB, Inker L, Tang WHW, Wilson FP, Testani JM. Effect on Survival of Concurrent Hemoconcentration and Increase in Creatinine During Treatment of Acute Decompensated Heart Failure. The American Journal Of Cardiology 2019, 124: 1707-1711. PMID: 31601358, PMCID: PMC6959849, DOI: 10.1016/j.amjcard.2019.08.034.Peer-Reviewed Original ResearchConceptsAcute decompensated heart failureDecompensated heart failureHeart failureImproved survivalHigher loop diuretic dosesLoop diuretic dosesNet fluid lossPlasma volume reductionAggressive decongestionAggressive diuresisPostdischarge survivalDiuretic dosesPostdischarge outcomesSerum creatinineHospital treatmentHospital parametersBetter survivalCreatinineHemoconcentrationPatient carePatientsSurvivalLonger lengthVolume reductionTreatmentControlled decongestion by Reprieve therapy in acute heart failure: results of the TARGET‐1 and TARGET‐2 studies
Biegus J, Zymlinski R, Siwolowski P, Testani J, Szachniewicz J, Tycińska A, Banasiak W, Halpert A, Levin H, Ponikowski P. Controlled decongestion by Reprieve therapy in acute heart failure: results of the TARGET‐1 and TARGET‐2 studies. European Journal Of Heart Failure 2019, 21: 1079-1087. PMID: 31127666, DOI: 10.1002/ejhf.1533.Peer-Reviewed Original ResearchConceptsAcute heart failureEnd of therapyHeart failureDiuretic-based regimenStandard diuretic therapyPatient global assessmentPrimary efficacy endpointCentral venous pressureSystolic blood pressureDiuretic therapyEffective decongestionMean diuresisEfficacy endpointRenal injuryBlood pressureVenous pressureMean creatinineOwn controlPatientsTherapyGlobal assessmentFluid lossSodium lossTherapy supportDecongestionRenal Effects of Intensive Volume Removal in Heart Failure Patients With Preexisting Worsening Renal Function
Rao VS, Ahmad T, Brisco-Bacik MA, Bonventre JV, Wilson FP, Siew ED, Felker GM, Anstrom KK, Mahoney DD, Bart BA, Tang WHW, Velazquez EJ, Testani JM. Renal Effects of Intensive Volume Removal in Heart Failure Patients With Preexisting Worsening Renal Function. Circulation Heart Failure 2019, 12: e005552. PMID: 31163974, PMCID: PMC6585463, DOI: 10.1161/circheartfailure.118.005552.Peer-Reviewed Original ResearchConceptsRenal tubular injury biomarkersTubular injury biomarkersHeart failure patientsAcute decompensated heart failure patientsDecompensated heart failure patientsTubular injury markersInjury biomarkersFailure patientsRenal functionInjury markersAcute decompensated heart failureVolume removalCARRESS-HF trialRenal function recoveryDecompensated heart failureRenal tubular injuryRenal effectsSerum creatinineTubular injuryBiomarker substudyHeart failurePharmacological therapyClinical outcomesFunction recoveryHigh incidence
2018
Worsening Renal Function in Patients With Acute Heart Failure Undergoing Aggressive Diuresis Is Not Associated With Tubular Injury
Ahmad T, Jackson K, Rao VS, Tang WHW, Brisco-Bacik MA, Chen HH, Felker GM, Hernandez AF, O'Connor CM, Sabbisetti VS, Bonventre JV, Wilson FP, Coca SG, Testani JM. Worsening Renal Function in Patients With Acute Heart Failure Undergoing Aggressive Diuresis Is Not Associated With Tubular Injury. Circulation 2018, 137: 2016-2028. PMID: 29352071, PMCID: PMC6066176, DOI: 10.1161/circulationaha.117.030112.Peer-Reviewed Original ResearchMeSH KeywordsAcetylglucosaminidaseAcute DiseaseAcute Kidney InjuryAgedAged, 80 and overBiomarkersCreatinineCystatin CDiuresisFemaleGlomerular Filtration RateHeart FailureHepatitis A Virus Cellular Receptor 1HumansKidneyLipocalin-2MaleMiddle AgedSodium Potassium Chloride Symporter InhibitorsTime FactorsTreatment OutcomeUnited StatesConceptsKidney injury molecule-1Neutrophil gelatinase-associated lipocalinInjury molecule-1Acute heart failureGelatinase-associated lipocalinRenal tubular injuryTubular injury biomarkersAggressive diuresisROSE-AHF trialsTubular injuryInjury biomarkersRenal functionHeart failureMolecule-1D-glucosaminidaseHigh-dose loop diuretic therapyAcute heart failure treatmentKidney tubular injuryLoop diuretic therapyAcute kidney injuryGlomerular filtration rateHeart failure treatmentDiuretic therapyFurosemide equivalentsKidney injury
2016
Plasma NGAL So, it Really Is Just Expensive Creatinine!∗
Testani JM, Brisco MA. Plasma NGAL So, it Really Is Just Expensive Creatinine!∗. Journal Of The American College Of Cardiology 2016, 68: 1432-1434. PMID: 27659465, PMCID: PMC5497471, DOI: 10.1016/j.jacc.2016.07.730.Commentaries, Editorials and LettersRelevance of Changes in Serum Creatinine During a Heart Failure Trial of Decongestive Strategies: Insights From the DOSE Trial
Brisco MA, Zile MR, Hanberg JS, Wilson FP, Parikh CR, Coca SG, Tang WH, Testani JM. Relevance of Changes in Serum Creatinine During a Heart Failure Trial of Decongestive Strategies: Insights From the DOSE Trial. Journal Of Cardiac Failure 2016, 22: 753-760. PMID: 27374839, PMCID: PMC5435117, DOI: 10.1016/j.cardfail.2016.06.423.Peer-Reviewed Original ResearchMeSH KeywordsAgedBiomarkersCause of DeathCreatinineDisease ProgressionDisease-Free SurvivalDiureticsDose-Response Relationship, DrugDouble-Blind MethodDrug Administration ScheduleFemaleFurosemideGlomerular Filtration RateHeart FailureHumansInfusions, IntravenousKidney Function TestsMaleMiddle AgedPrognosisSurvival RateTreatment OutcomeConceptsStable renal functionRenal functionComposite endpointDecongestive strategiesSerum creatinineDose trialAdverse outcomesClinical trialsSurrogate endpointsDiuretic Optimization Strategies Evaluation (DOSE) trialHeart failure clinical trialsHeart Failure TrialPoor prognostic signCoprimary endpointsComposite outcomeDecongestive therapyFailure TrialPrognostic signEmergency roomImproved outcomesLower riskCreatinineEndpointTrialsAbsence of riskReduced Cardiac Index Is Not the Dominant Driver of Renal Dysfunction in Heart Failure
Hanberg JS, Sury K, Wilson FP, Brisco MA, Ahmad T, Maaten J, Broughton JS, Assefa M, Tang WH, Parikh CR, Testani JM. Reduced Cardiac Index Is Not the Dominant Driver of Renal Dysfunction in Heart Failure. Journal Of The American College Of Cardiology 2016, 67: 2199-2208. PMID: 27173030, PMCID: PMC4867078, DOI: 10.1016/j.jacc.2016.02.058.Peer-Reviewed Original ResearchConceptsPulmonary artery catheterizationBlood urea nitrogenCardiac indexRenal functionHeart failureRenal dysfunctionGood renal functionReduced cardiac indexHigher cardiac indexGlomerular filtration rateSignificant inverse correlationMultiple subgroupsMulticenter populationWorse eGFRHF patientsCreatinine ratioArtery catheterizationPatient subgroupsFiltration rateSerial assessmentLinear mixed modelingESCAPE trialPatientsUrea nitrogenDysfunction
2015
Evaluation of Short-Term Changes in Serum Creatinine Level as a Meaningful End Point in Randomized Clinical Trials
Coca SG, Zabetian A, Ferket BS, Zhou J, Testani JM, Garg AX, Parikh CR. Evaluation of Short-Term Changes in Serum Creatinine Level as a Meaningful End Point in Randomized Clinical Trials. Journal Of The American Society Of Nephrology 2015, 27: 2529-2542. PMID: 26712525, PMCID: PMC4978048, DOI: 10.1681/asn.2015060642.Peer-Reviewed Original ResearchConceptsSerum creatinine levelsCreatinine levelsClinical trialsEnd pointAcute elevationRandomized trialsAcute changesPlacebo-controlled randomized trialSafety end pointRandomized clinical trialsStrong risk factorMeaningful clinical outcomesMeaningful end pointsClinical outcomesKidney functionPoor outcomeAcute increaseRisk factorsThorough literature searchObservational studyTemporary elevationMortality rateShort-term effectsPlaceboCKDFalse-Positive Rate of AKI Using Consensus Creatinine–Based Criteria
Lin J, Fernandez H, Shashaty MG, Negoianu D, Testani JM, Berns JS, Parikh CR, Wilson FP. False-Positive Rate of AKI Using Consensus Creatinine–Based Criteria. Clinical Journal Of The American Society Of Nephrology 2015, 10: 1723-1731. PMID: 26336912, PMCID: PMC4594067, DOI: 10.2215/cjn.02430315.Peer-Reviewed Original ResearchConceptsSerum creatinine valuesGlobal Outcomes creatinine criteriaSerum creatinineCreatinine valuesCreatinine criteriaClinical cohortBiologic variabilityProportion of patientsSerum creatinine changesHigher baseline valuesFalse positive rateAKI diagnosisAKI studiesAdult patientsCreatinine changesBlood drawReference cohortOverall false-positive rateBaseline valuesCreatinine measurementsPatientsCreatinineHypothetical patientsDiagnosis rateSimulation cohortBlood urea nitrogen to creatinine ratio is associated with congestion and mortality in heart failure patients with renal dysfunction
Parrinello G, Torres D, Testani JM, Almasio PL, Bellanca M, Pizzo G, Cuttitta F, Pinto A, Butler J, Paterna S. Blood urea nitrogen to creatinine ratio is associated with congestion and mortality in heart failure patients with renal dysfunction. Internal And Emergency Medicine 2015, 10: 965-972. PMID: 26037394, DOI: 10.1007/s11739-015-1261-1.Peer-Reviewed Original ResearchConceptsBUN/CrInferior vena cavaRenal dysfunctionHeart failureVenous congestionBUN/Cr ratioMultiple logistic regression modelNYHA class 3Independent risk factorLong-term mortalityHeart failure patientsGlomerular filtration rateBlood urea nitrogenReceiver-operating characteristic analysisLogistic regression modelsCause deathHF outpatientsHF severityLower eGFRRenal functionAmbulatory visitsFailure patientsCreatinine ratioSingle centerRenal biomarkersAutomated, electronic alerts for acute kidney injury: a single-blind, parallel-group, randomised controlled trial
Wilson FP, Shashaty M, Testani J, Aqeel I, Borovskiy Y, Ellenberg SS, Feldman HI, Fernandez H, Gitelman Y, Lin J, Negoianu D, Parikh CR, Reese PP, Urbani R, Fuchs B. Automated, electronic alerts for acute kidney injury: a single-blind, parallel-group, randomised controlled trial. The Lancet 2015, 385: 1966-1974. PMID: 25726515, PMCID: PMC4475457, DOI: 10.1016/s0140-6736(15)60266-5.Peer-Reviewed Original ResearchConceptsAcute kidney injuryUsual care groupKidney injuryCare groupAlert groupClinical outcomesElectronic alertsEligible participantsKidney Disease Improving Global OutcomesEnd-stage renal diseaseAcute kidney injury alertsEffective treatment optionIntensive care unitElectronic alert systemComputer-generated sequenceRandomisation strataSurgical admissionsUsual carePrimary outcomeRenal diseaseCare unitTreatment optionsCreatinine valuesCreatinine concentrationSuch injuries