2023
Outcomes Associated with Sodium-Glucose Cotransporter-2 Inhibitor Use in Acute Heart Failure Hospitalizations Complicated by AKI
Aklilu A, Kumar S, Yamamoto Y, Moledina D, Sinha F, Testani J, Wilson F. Outcomes Associated with Sodium-Glucose Cotransporter-2 Inhibitor Use in Acute Heart Failure Hospitalizations Complicated by AKI. Kidney360 2023, 4: 1371-1381. PMID: 37644648, PMCID: PMC10615381, DOI: 10.34067/kid.0000000000000250.Peer-Reviewed Original ResearchMeSH KeywordsAcute Kidney InjuryGlucoseHeart FailureHospitalizationHumansSodiumSodium-Glucose Transporter 2 InhibitorsConceptsAcute kidney injuryHeart failure hospitalizationSodium-glucose cotransporter-2 inhibitor useSodium-glucose cotransporter 2 inhibitorsAcute heart failure hospitalizationCotransporter 2 inhibitorsCox regression analysisRenal recoveryFailure hospitalizationAKI diagnosisKidney injuryInhibitor useLower riskStage 5 chronic kidney diseaseTime-varying Cox regression analysisKidney Disease Improving Global OutcomesInverse probability-weighted analysisMulticenter retrospective cohort studyMultivariable Cox regression analysisStage 5 CKDAcute heart failureRetrospective cohort studyChronic kidney diseaseKidney function recoveryGlomerular filtration rateA 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 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
Electronic 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
Sotagliflozin in Patients with Diabetes and Recent Worsening Heart Failure
Bhatt DL, Szarek M, Steg PG, Cannon CP, Leiter LA, McGuire DK, Lewis JB, Riddle MC, Voors AA, Metra M, Lund LH, Komajda M, Testani JM, Wilcox CS, Ponikowski P, Lopes RD, Verma S, Lapuerta P, Pitt B. Sotagliflozin in Patients with Diabetes and Recent Worsening Heart Failure. New England Journal Of Medicine 2020, 384: 117-128. PMID: 33200892, DOI: 10.1056/nejmoa2030183.Peer-Reviewed Original ResearchConceptsPrimary end-point eventEnd-point eventsHeart failureSotagliflozin groupCardiovascular causesPlacebo groupRate of deathFirst doseUrgent visitsSodium-glucose cotransporter 2 inhibitorsType 2 diabetes mellitusWorsening Heart FailureAcute kidney injuryDecompensated heart failureDouble-blind trialPrimary end pointStable heart failureCotransporter 2 inhibitorsPercentage of patientsRisk of hospitalizationKidney injuryPrespecified subgroupsDiabetes mellitusSevere hypoglycemiaSGLT2 inhibitorsAcute Kidney Function Declines in the Context of Decongestion in Acute Decompensated Heart Failure
McCallum W, Tighiouart H, Testani JM, Griffin M, Konstam MA, Udelson JE, Sarnak MJ. Acute Kidney Function Declines in the Context of Decongestion in Acute Decompensated Heart Failure. JACC Heart Failure 2020, 8: 537-547. PMID: 32535124, PMCID: PMC9027677, DOI: 10.1016/j.jchf.2020.03.009.Peer-Reviewed Original ResearchConceptsB-type natriuretic peptideAcute decompensated heart failureDecompensated heart failureHeart failureKidney functionAdverse outcomesAcute declineNT-proBNPComposite outcomeNatriuretic peptideHigh riskMultivariable Cox regression modelsTotal proteinAcute kidney functionMarkers of decongestionN-terminal prohormoneGlomerular filtration rateCox regression modelEGFR declineCardiovascular deathVolume overloadFiltration rateEGFRHospital changesDecongestionReal-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
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 setA simple real-time model for predicting acute kidney injury in hospitalized patients in the US: A descriptive modeling study
Simonov M, Ugwuowo U, Moreira E, Yamamoto Y, Biswas A, Martin M, Testani J, Wilson FP. A simple real-time model for predicting acute kidney injury in hospitalized patients in the US: A descriptive modeling study. PLOS Medicine 2019, 16: e1002861. PMID: 31306408, PMCID: PMC6629054, DOI: 10.1371/journal.pmed.1002861.Peer-Reviewed Original ResearchMeSH KeywordsAcute Kidney InjuryAgedAged, 80 and overConnecticutDecision Support TechniquesElectronic Health RecordsFemaleHospital MortalityHumansInpatientsMaleMiddle AgedPatient AdmissionPredictive Value of TestsPrognosisRenal DialysisRetrospective StudiesRisk AssessmentRisk FactorsSeverity of Illness IndexTime FactorsConceptsAcute kidney injuryImminent acute kidney injuryElectronic health recordsKidney injuryHospital 1Prediction of AKIRenal replacement therapyOptimal treatment strategyLaboratory dataReceiver operator characteristic curveInternal validation setAKI occurrenceAKI severityHospitalized adultsMedical comorbiditiesOverall cohortAdverse eventsHospitalized patientsSurgical wardsSignificant morbidityReplacement therapyExternal validation data setsHospital 2Hospital 3Study hospital
2018
Enhancing the prediction of acute kidney injury risk after percutaneous coronary intervention using machine learning techniques: A retrospective cohort study
Huang C, Murugiah K, Mahajan S, Li SX, Dhruva SS, Haimovich JS, Wang Y, Schulz WL, Testani JM, Wilson FP, Mena CI, Masoudi FA, Rumsfeld JS, Spertus JA, Mortazavi BJ, Krumholz HM. Enhancing the prediction of acute kidney injury risk after percutaneous coronary intervention using machine learning techniques: A retrospective cohort study. PLOS Medicine 2018, 15: e1002703. PMID: 30481186, PMCID: PMC6258473, DOI: 10.1371/journal.pmed.1002703.Peer-Reviewed Original ResearchMeSH KeywordsAcute Kidney InjuryAgedClinical Decision-MakingData MiningDecision Support TechniquesFemaleHumansMachine LearningMaleMiddle AgedPercutaneous Coronary InterventionProtective FactorsRegistriesReproducibility of ResultsRetrospective StudiesRisk AssessmentRisk FactorsTime FactorsTreatment OutcomeConceptsPercutaneous coronary interventionNational Cardiovascular Data RegistryRisk prediction modelAKI eventsAKI riskCoronary interventionAKI modelMean ageCardiology-National Cardiovascular Data RegistryAcute kidney injury riskAKI risk predictionRetrospective cohort studyIdentification of patientsCandidate variablesAvailable candidate variablesCohort studyPCI proceduresPoint of careBrier scoreAmerican CollegeData registryPatientsCalibration slopeInjury riskSame cohortWorsening 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
2017
Approaches to Predicting Outcomes in Patients with Acute Kidney Injury
Saly D, Yang A, Triebwasser C, Oh J, Sun Q, Testani J, Parikh CR, Bia J, Biswas A, Stetson C, Chaisanguanthum K, Wilson FP. Approaches to Predicting Outcomes in Patients with Acute Kidney Injury. PLOS ONE 2017, 12: e0169305. PMID: 28122032, PMCID: PMC5266278, DOI: 10.1371/journal.pone.0169305.Peer-Reviewed Original ResearchConceptsAcute kidney injuryLength of stayKidney injuryReceiver operator characteristic curveOutcomes of interestOperator characteristic curveValidation cohortClinical eventsAccurate prognosticationOutcome eventsPredicting OutcomePrognostic modelDeath predictionLab valuesCharacteristic curveGood discrimination abilityPatientsStayInjuryDialysisModel discriminationOutcomesDaysMedicationsMorbidity
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 ResearchMeSH KeywordsAcute Kidney InjuryCreatinineEndpoint DeterminationHumansRandomized Controlled Trials as TopicRisk AssessmentTime FactorsConceptsSerum 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 cohortThe kidney in heart failure: an update
Damman K, Testani JM. The kidney in heart failure: an update. European Heart Journal 2015, 36: 1437-1444. PMID: 25838436, PMCID: PMC4465636, DOI: 10.1093/eurheartj/ehv010.Peer-Reviewed Reviews, Practice Guidelines, Standards, and Consensus StatementsConceptsHeart failureRenal functionPhenotypes of HFReduced renal perfusionCardiorenal interactionsCardiorenal syndromeHF patientsHF statusRenal dysfunctionRenal perfusionGrim prognosisVenous congestionClinical syndromeTreatment strategiesHigh mortalityPatientsRecent evidenceSyndromeKidneyMortalityUpdated classificationMorbidityFailurePrognosisDysfunctionPerioperative heart-type fatty acid binding protein is associated with acute kidney injury after cardiac surgery
Schaub JA, Garg AX, Coca SG, Testani JM, Shlipak MG, Eikelboom J, Kavsak P, McArthur E, Shortt C, Whitlock R, Parikh CR. Perioperative heart-type fatty acid binding protein is associated with acute kidney injury after cardiac surgery. Kidney International 2015, 88: 576-583. PMID: 25830762, PMCID: PMC4556547, DOI: 10.1038/ki.2015.104.Peer-Reviewed Original ResearchMeSH KeywordsAcute Kidney InjuryAgedAged, 80 and overBiomarkersCardiac Surgical ProceduresChi-Square DistributionFatty Acid Binding Protein 3Fatty Acid-Binding ProteinsFemaleHumansLogistic ModelsMaleMiddle AgedMultivariate AnalysisNorth AmericaOdds RatioPerioperative PeriodProportional Hazards ModelsProspective StudiesRisk AssessmentRisk FactorsSeverity of Illness IndexUp-RegulationConceptsAcute kidney injurySevere acute kidney injuryCardiac surgeryKidney injuryKidney injury molecule-1Neutrophil gelatinase-associated lipocalinHeart-type fatty acid binding proteinAKI risk factorsInjury molecule-1Long-term mortalityBrain natriuretic peptideGelatinase-associated lipocalinH-FABP levelsMulti-center cohortTRIBE-AKI cohortFatty acid binding proteinLiver fatty acidHeart fatty acidCommon complicationSecondary outcomesSerum creatininePrimary outcomeInterleukin-18Risk stratificationCardiac injuryAutomated, 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
2014
Terminology and definition of changes renal function in heart failure
Damman K, Tang WH, Testani JM, McMurray JJ. Terminology and definition of changes renal function in heart failure. European Heart Journal 2014, 35: 3413-3416. PMID: 25157110, PMCID: PMC4375406, DOI: 10.1093/eurheartj/ehu320.Commentaries, Editorials and Letters