@article{MTMT:34628334, title = {Are Platelet-Related Parameters Prognostic Predictors of Renal and Cardiovascular Outcomes in IgA Nephropathy?}, url = {https://m2.mtmt.hu/api/publication/34628334}, author = {Sági, Balázs and Vas, Tibor and Csiky, Botond and Nagy, Judit and Kovács, Tibor}, doi = {10.3390/jcm13040991}, journal-iso = {J CLIN MED}, journal = {JOURNAL OF CLINICAL MEDICINE}, volume = {13}, unique-id = {34628334}, abstract = {Background: IgA nephropathy (IgAN) is associated with chronic inflammation. Platelet-related parameters, such as the platelet (PLT) count, platelet-to-albumin ratio (PAR), and platelet-to-lymphocyte ratio (PLR), were examined as potential prognostic indicators for renal and cardiovascular (CV) outcomes in IgAN. We were interested in whether platelet-related parameters are risk factors for ESKD and CV events in IgAN patients. Methods: In a monocentric retrospective study, 124 IgAN patients were divided into two groups based on the cut-off value of the PAR. All-cause mortality, major CV events, and end-stage renal disease were the primary combined endpoints. Secondary endpoints, such as CV or renal endpoints, were also analyzed separately. Results: The patients’ mean age was 43.7 ± 13.5 years, and the follow-up time was 124 ± 67 months. The K-M curve showed that the PLR, PAR, and PLT were strongly associated with primary combined (p = 0.002, p = 0.004, p = 0.001) and renal outcomes (p < 0.001, p < 0.001, p < 0.001), but not with CV outcomes in IgAN. However, when combined with left ventricular hypertrophy (LVH) or metabolic syndrome (MetS), the PAR was found to be a significant predictor of both primary (p < 0.001, p < 0.001) and secondary outcomes (p = 0.001 and p = 0.038; p = 0.001 and p = 0.015). Additionally, the PLR correlated with albuminuria (r = −0.165, p = 0.033) and LVH (r = −0.178, p = 0.025), while PLT correlated with eGFR (r = 0.158, p = 0.040). Conclusions. Elevated PARs and PLRs may predict progression to end-stage kidney disease, but in combination with LVH and MetS, they were related to CV events in IgAN. The determination of PARs and PLRs can be useful and cost-effective parameters for assessing both cardiovascular and renal risks in IgAN.}, year = {2024}, eissn = {2077-0383} } @article{MTMT:34335477, title = {Renal and cardiovascular prognostic significance of echocardiographic early diastolic mitral annular velocity in IgA nephropathy.}, url = {https://m2.mtmt.hu/api/publication/34335477}, author = {Sági, Balázs and Késői, István and Vas, Tibor and Csiky, Botond and Nagy, Judit and Kovács, Tibor}, doi = {10.1007/s10554-023-02988-7}, journal-iso = {INT J CARDIOVAS IMAG}, journal = {INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING}, volume = {40}, unique-id = {34335477}, issn = {1569-5794}, abstract = {In chronic kidney disease (CKD), as in IgA nephropathy (IgAN), cardiovascular (CV) mortality and morbidity are many times higher than in the general population, and diastolic dysfunction (LVDD) has prognostic significance as well. Tissue Doppler Echocardiography (TDI) is another method for measuring myocardial contractility and determining diastolic dysfunction. 79 IgAN patients (age 46 ± 11 years) with CKD stages 1-3 were investigated and followed for 70 ± 28.7 months. Doppler echocardiography was used to measure the E (early) and A (late) waves, as well as the E wave deceleration time (EDT) during mitral inflow. TDI was used to measure early (Ea) and late (Aa) diastolic velocities (lateral and septal basal wall fragment average). From these, we calculated the E/Ea and Ea/Aa ratios. The primary combined endpoints were total mortality, major CV events, and end-stage renal disease, and the secondary endpoints were cardiovascular or renal (eGFR decreased below 15 ml/min/1.73 m2 or renal replacement therapy was started). Patients with decreased Ea (< 13 cm/s) had significantly more endpoints (20/42 vs. 3/37; p = 0.001) than patients with higher Ea (≥ 13 cm/s). The secondary renal endpoints were also significantly higher (p = 0.004). In a multivariate model, the eGFR showed independent correlation with the E/A ratio (r = 0.466; p < 0.01), EDT (r = - 0.270; p < 0.01), Ea/Aa ratio (r = 0.455; p < 0.01), and decreased Ea (r = 0.544; p < 0.01). Independent factors influencing Ea were only EDT by uni- and multivariate regression but age and albuminuria by logistic regression. Decreased Ea measured by TDI seems to be an eligible factor to predict the prognosis of IgA nephropathy. The decreased Ea may be a helpful parameter to identify high-risk CKD patients.}, keywords = {chronic kidney disease; Cardiovascular risk; diastolic dysfunction; IgA nephropathy; Tissue Dopper imaging echocardiography}, year = {2024}, eissn = {1875-8312}, pages = {307-319} } @article{MTMT:34128942, title = {Relationship between arterial stiffness, left ventricular diastolic function, and renal function in chronic kidney disease}, url = {https://m2.mtmt.hu/api/publication/34128942}, author = {Sági, Balázs and Késői, István and Vas, Tibor and Csiky, Botond and Nagy, Judit and Kovács, Tibor}, doi = {10.1186/s12882-023-03308-w}, journal-iso = {BMC NEPHROL}, journal = {BMC NEPHROLOGY}, volume = {24}, unique-id = {34128942}, issn = {1471-2369}, abstract = {In chronic kidney disease, IgA nephropathy, and left ventricular diastolic dysfunction have prognostic significance as well. However, the relationship between diastolic dysfunction, arterial stiffness, and renal function has not been fully elucidated.}, year = {2023}, eissn = {1471-2369} } @article{MTMT:34039025, title = {Genome-wide association analyses define pathogenic signaling pathways and prioritize drug targets for IgA nephropathy}, url = {https://m2.mtmt.hu/api/publication/34039025}, author = {Kiryluk, Krzysztof and Sanchez-Rodriguez, Elena and Zhou, Xu-Jie and Zanoni, Francesca and Liu, Lili and Mladkova, Nikol and Khan, Atlas and Marasa, Maddalena and Zhang, Jun Y and Balderes, Olivia and Sanna-Cherchi, Simone and Bomback, Andrew S and Canetta, Pietro A and Appel, Gerald B and Radhakrishnan, Jai and Trimarchi, Hernan and Sprangers, Ben and Cattran, Daniel C and Reich, Heather and Pei, York and Ravani, Pietro and Galesic, Kresimir and Maixnerova, Dita and Tesar, Vladimir and Stengel, Benedicte and Metzger, Marie and Canaud, Guillaume and Maillard, Nicolas and Berthoux, Francois and Berthelot, Laureline and Pillebout, Evangeline and Monteiro, Renato and Nelson, Raoul and Wyatt, Robert J and Smoyer, William and Mahan, John and Samhar, Al-Akash and Hidalgo, Guillermo and Quiroga, Alejandro and Weng, Patricia and Sreedharan, Raji and Selewski, David and Davis, Keefe and Kallash, Mahmoud and Vasylyeva, Tetyana L and Rheault, Michelle and Chishti, Aftab and Ranch, Daniel and Wenderfer, Scott E and Samsonov, Dmitry and Claes, Donna J and Akchurin, Oleh and Goumenos, Dimitrios and Stangou, Maria and Nagy, Judit and Kovács, Tibor and Fiaccadori, Enrico and Amoroso, Antonio and Barlassina, Cristina and Cusi, Daniele and Del Vecchio, Lucia and Battaglia, Giovanni Giorgio and Bodria, Monica and Boer, Emanuela and Bono, Luisa and Boscutti, Giuliano and Caridi, Gianluca and Lugani, Francesca and Ghiggeri, GianMarco and Coppo, Rosanna and Peruzzi, Licia and Esposito, Vittoria and Esposito, Ciro and Feriozzi, Sandro and Polci, Rosaria and Frasca, Giovanni and Galliani, Marco and Garozzo, Maurizio and Mitrotti, Adele and Gesualdo, Loreto and Granata, Simona and Zaza, Gianluigi and Londrino, Francesco and Magistroni, Riccardo and Pisani, Isabella and Magnano, Andrea and Marcantoni, Carmelita and Messa, Piergiorgio and Mignani, Renzo and Pani, Antonello and Ponticelli, Claudio and Roccatello, Dario and Salvadori, Maurizio and Salvi, Erica and Santoro, Domenico and Gembillo, Guido and Savoldi, Silvana and Spotti, Donatella and Zamboli, Pasquale and Izzi, Claudia and Alberici, Federico and Delbarba, Elisa and Florczak, Michał and Krata, Natalia and Mucha, Krzysztof and Pączek, Leszek and Niemczyk, Stanisław and Moszczuk, Barbara and Pańczyk-Tomaszewska, Malgorzata and Mizerska-Wasiak, Malgorzata and Perkowska-Ptasińska, Agnieszka and Bączkowska, Teresa and Durlik, Magdalena and Pawlaczyk, Krzysztof and Sikora, Przemyslaw and Zaniew, Marcin and Kaminska, Dorota and Krajewska, Magdalena and Kuzmiuk-Glembin, Izabella and Heleniak, Zbigniew and Bullo-Piontecka, Barbara and Liberek, Tomasz and Dębska-Slizien, Alicja and Hryszko, Tomasz and Materna-Kiryluk, Anna and Miklaszewska, Monika and Szczepańska, Maria and Dyga, Katarzyna and Machura, Edyta and Siniewicz-Luzeńczyk, Katarzyna and Pawlak-Bratkowska, Monika and Tkaczyk, Marcin and Runowski, Dariusz and Kwella, Norbert and Drożdż, Dorota and Habura, Ireneusz and Kronenberg, Florian and Prikhodina, Larisa and van Heel, David and Fontaine, Bertrand and Cotsapas, Chris and Wijmenga, Cisca and Franke, Andre and Annese, Vito and Gregersen, Peter K and Parameswaran, Sreeja and Weirauch, Matthew and Kottyan, Leah and Harley, John B and Suzuki, Hitoshi and Narita, Ichiei and Goto, Shin and Lee, Hajeong and Kim, Dong Ki and Kim, Yon Su and Park, Jin-Ho and Cho, BeLong and Choi, Murim and Van Wijk, Ans and Huerta, Ana and Ars, Elisabet and Ballarin, Jose and Lundberg, Sigrid and Vogt, Bruno and Mani, Laila-Yasmin and Caliskan, Yasar and Barratt, Jonathan and Abeygunaratne, Thilini and Kalra, Philip A and Gale, Daniel P and Panzer, Ulf and Rauen, Thomas and Floege, Jürgen and Schlosser, Pascal and Ekici, Arif B and Eckardt, Kai-Uwe and Chen, Nan and Xie, Jingyuan and Lifton, Richard P and Loos, Ruth J F and Kenny, Eimear E and Ionita-Laza, Iuliana and Köttgen, Anna and Julian, Bruce A and Novak, Jan and Scolari, Francesco and Zhang, Hong and Gharavi, Ali G}, doi = {10.1038/s41588-023-01422-x}, journal-iso = {NAT GENET}, journal = {NATURE GENETICS}, volume = {55}, unique-id = {34039025}, issn = {1061-4036}, abstract = {IgA nephropathy (IgAN) is a progressive form of kidney disease defined by glomerular deposition of IgA. Here we performed a genome-wide association study of 10,146 kidney-biopsy-diagnosed IgAN cases and 28,751 controls across 17 international cohorts. We defined 30 genome-wide significant risk loci explaining 11% of disease risk. A total of 16 loci were new, including TNFSF4/TNFSF18, REL, CD28, PF4V1, LY86, LYN, ANXA3, TNFSF8/TNFSF15, REEP3, ZMIZ1, OVOL1/RELA, ETS1, IGH, IRF8, TNFRSF13B and FCAR. The risk loci were enriched in gene orthologs causing abnormal IgA levels when genetically manipulated in mice. We also observed a positive genetic correlation between IgAN and serum IgA levels. High polygenic score for IgAN was associated with earlier onset of kidney failure. In a comprehensive functional annotation analysis of candidate causal genes, we observed convergence of biological candidates on a common set of inflammatory signaling pathways and cytokine ligand-receptor pairs, prioritizing potential new drug targets.}, year = {2023}, eissn = {1546-1718}, pages = {1091-1105} } @article{MTMT:34036926, title = {The Role of Two Heart Biomarkers in IgA Nephropathy}, url = {https://m2.mtmt.hu/api/publication/34036926}, author = {Sági, Balázs and Vas, Tibor and Jakabfi-Csepregi, Rita and Horváth-Szalai, Zoltán and Kőszegi, Tamás and Csiky, Botond and Nagy, Judit and Kovács, Tibor}, doi = {10.3390/ijms241210336}, journal-iso = {INT J MOL SCI}, journal = {INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES}, volume = {24}, unique-id = {34036926}, issn = {1661-6596}, abstract = {Cardiovascular mortality is a leading cause of death in chronic kidney disease (CKD), as is IgA nephropathy (IgAN). The purpose of this study is to find different biomarkers to estimate the outcome of the disease, which is significantly influenced by the changes in vessels (characterized by arterial stiffness) and the heart. In our cross-sectional study, 90 patients with IgAN were examined. The N-terminal prohormone of brain natriuretic peptide (NT-proBNP) was measured as a heart failure biomarker by an automated immonoassay method, while the carboxy-terminal telopeptide of collagen type I (CITP) as a fibrosis marker was determined using ELISA kits. Arterial stiffness was determined by measuring carotid–femoral pulse wave velocity (cfPWV). Renal function and routine echocardiography examinations were performed as well. Based on eGFR, patients were separated into two categories, CKD 1-2 and CKD 3-5. There were significantly higher NT-proBNP (p = 0.035), cfPWV (p = 0.004), and central aortic systolic pressure (p = 0.037), but not CITP, in the CKD 3-5 group. Both biomarker positivities were significantly higher in the CKD 3-5 group (p = 0.035) compared to the CKD 1-2 group. The central aortic systolic pressure was significantly higher in the diastolic dysfunction group (p = 0.034), while the systolic blood pressure was not. eGFR and hemoglobin levels showed a strong negative correlation, while left ventricular mass index (LVMI), aortic pulse pressure, central aortic systolic pressure, and cfPWV showed a positive correlation with NT-proBNP. cfPWV, aortic pulse pressure, and LVMI showed a strong positive correlation with CITP. Only eGFR was an independent predictor of NT-proBNP by linear regression analysis. NT-proBNP and CITP biomarkers may help to identify IgAN patients at high risk for subclinical heart failure and further atherosclerotic disease.}, year = {2023}, eissn = {1422-0067} } @article{MTMT:33123457, title = {Ethical and medical dilemmas in paid living kidney donor transplantation}, url = {https://m2.mtmt.hu/api/publication/33123457}, author = {Sever, M.S. and Van, Biesen W. and Vanholder, R. and Mallick, N. and London, G. and Schena, F.P. and Nagy, Judit and Buturovic-Ponikvar, J. and Heering, P. and Maggiore, U. and Mariat, C. and Watschinger, B. and Oniscu, G. and Peruzzi, L. and Gandolfini, I. and Hellemans, R. and Abramowicz, D. and Pascual, J. and Hilbrands, L.}, doi = {10.1016/j.trre.2022.100726}, journal-iso = {TRANSPLANT REV-ORLAN}, journal = {TRANSPLANTATION REVIEWS}, volume = {36}, unique-id = {33123457}, issn = {0955-470X}, year = {2022} } @article{MTMT:33103757, title = {Amit a vérnyomás-variabilitásról tudni kell}, url = {https://m2.mtmt.hu/api/publication/33103757}, author = {Kékes, Ede and Nagy, Judit and Vályi, Péter}, doi = {10.33668/hn.26.019}, journal-iso = {HYPERTONIA NEPHROLOGIA}, journal = {HYPERTONIA ÉS NEPHROLOGIA}, volume = {26}, unique-id = {33103757}, issn = {1418-477X}, abstract = {A vérnyomás 24 órán belüli és hosszabb távú (hetek, hónapok, évek), valamint szezonális, regionális változása, fluktuációja régóta ismert a normotoniás és a hypertoniás betegekben egyaránt. Köztudott és ismert az is, hogy súlyosabb fokozatú hypertoniásokban és idősebbeknél a fluktuáció nagyobb mértékű. Az utóbbi évtizedben, illetve napjainkban a vérnyomás változékonysága, variabilitása (BPV) új megvilágításba került, és számos – a fluktuációt befolyásoló – oki tényezőt és következményt részletesen elemeztek. Előtérbe került a valódi diagnosztikai, prognosztikai értéke és szerepe az antihypertensiv kezelés sikerének megítélésében. Ezzel párhuzamosan a mérési módszereket újraértékelték, és az indexek értékelésének szabványosítása is megindult. Az igen rövid időtartamú (beat-to-beat) variabilitás a tudományos kutatás területének része. A rövid távú vérnyomás-változékonyság mérése és értékelése vérnyomás-monitorozással megoldottnak tekinthető, bár itt is történtek előrelépések. Egyre inkább előtérbe került a közepes és hosszú távú variabilitás beépítése a mindennapi klinikai gyakorlatba az otthoni vérnyomásmérés és a rendelői mérés módszereinek, illetve indexeinek standardizálásával. Közleményünkben bemutatjuk, hogy a vérnyomás-változékonyság kórosan megemelkedett értéke (illetve az egyes jellemzői) egyértelműen előre jelzik a szubklinikai (tüneteket még nem okozó) szervi elváltozásokat, funkciózavarokat, illetve a cardiovascularis-renalis klinikai eseményeket és a kedvezőtlen kimenetelt. A hypertonia gyógyszeres kezelésében a siker valódi értékének megítélésében – az elért célvérnyomásérték mellett – döntő szerepe van a vérnyomás-variabilitás csökkentésének. Saját tapasztalataink és az irodalmi adatok alapján ma már jogosan felvetődik, hogy a vérnyomás-fluktuációk csökkentése a jövőben egy második terápiás cél legyen és ez hangsúlyt kapjon a hypertoniával foglalkozó irányelvekben is.}, keywords = {Prognózis; Gyógyszeres kezelés; hypertonia; vérnyomás-variabilitás; otthoni vérnyomásmérés; ambuláns vérnyomás-monitorozás; rendelői vérnyomásmérés}, year = {2022}, eissn = {2498-6259}, pages = {168-179} } @article{MTMT:33061358, title = {Left ventricular myocardial mass index associated with cardiovascular and renal prognosis in IgA nephropathy.}, url = {https://m2.mtmt.hu/api/publication/33061358}, author = {Sági, Balázs and Késői, István and Vas, Tibor and Csiky, Botond and Nagy, Judit and Kovács, Tibor}, doi = {10.1186/s12882-022-02909-1}, journal-iso = {BMC NEPHROL}, journal = {BMC NEPHROLOGY}, volume = {23}, unique-id = {33061358}, issn = {1471-2369}, abstract = {In chronic kidney disease (CKD), like in IgA nephropathy (IgAN), cardiovascular (CV) mortality and morbidity are many times higher than in the general population, and left ventricular hypertrophy (LVH) is an independent risk factor for CV disease. This follow-up study investigated the association between left ventricular mass index (LVMI) and renal or cardiovascular outcomes.We examined 118 IgAN patients prospectively. LVMI and LV geometry was investigated using echocardiography. The primary combined endpoints were total mortality, major CV events, and end-stage renal disease. Secondary endpoints, i.e.-cardiovascular or renal endpoints,-were also examined separately.Sixty seven percent were males, mean age 53.5 ± 13.5. Mean follow-up time: 184 months. LVMI inversely correlated with eGFR (corr. coefficient: -0.365; p < 0.01). We divided the patients into two groups based on the LVMI cut-off suggested by the literature. The presence of LVH caused a worse prognosis in primary (p < 0.001), renal endpoints (p = 0.01), and also in CV endpoints (p = 0.001). The higher LVMI in men significantly worsened the prognosis in all endpoints. Concentric hypertrophy meant a worse prognosis. Independent predictors of LVMI were gender and eGFR in uni- and multivariate regression and hemoglobin levels only in logistic regression. Independent predictors of the primary endpoint were LVMI, eGFR, gender, obesity, HT, DM, and metabolic syndrome in Cox regression analysis.Increased LVMI may predict the progression to end-stage renal disease and CV events in IgAN. Determining LVMI may be a useful parameter not only in CV risk but also in the stratification of renal risk in CKD.}, keywords = {chronic kidney disease; Cardiovascular risk; IgA nephropathy; left ventricular hypertrophy; left ventricular mass index}, year = {2022}, eissn = {1471-2369} } @article{MTMT:32542129, title = {Extrapulmonalis többszervi károsodás és funkciózavar Covid-19-ben}, url = {https://m2.mtmt.hu/api/publication/32542129}, author = {Kékes, Ede and Nagy, Judit}, doi = {10.33668/hn.25.028}, journal-iso = {HYPERTONIA NEPHROLOGIA}, journal = {HYPERTONIA ÉS NEPHROLOGIA}, volume = {25}, unique-id = {32542129}, issn = {1418-477X}, year = {2021}, eissn = {2498-6259}, pages = {274-283} } @article{MTMT:32509128, title = {The prognostic role of heart rate recovery after exercise and metabolic syndrome in IgA nephropathy.}, url = {https://m2.mtmt.hu/api/publication/32509128}, author = {Sági, Balázs and Késői, István and Vas, Tibor and Csiky, Botond and Nagy, Judit and Kovács, Tibor}, doi = {10.1186/s12882-021-02596-4}, journal-iso = {BMC NEPHROL}, journal = {BMC NEPHROLOGY}, volume = {22}, unique-id = {32509128}, issn = {1471-2369}, abstract = {Cardiovascular (CV) morbidity and mortality are higher in chronic kidney disease (CKD) than in the general population. Reduced heart rate recovery (HRR) is an independent risk factor for CV disease. The aim of the study was to determine the prognostic role of HRR in a homogenous group of CKD patients.One hundred and twenty-five IgA nephropathy patients (82 male, 43 female, age 54.7 ± 13 years) with CKD stage 1-4 were investigated and followed for average 70 months. We performed a graded exercise treadmill stress test. HRR was derived from the difference of the peak heart rate and the heart rate at 1 min after exercise. Patients were divided into two groups by the mean HRR value (22.9 beats/min). The composite (CV and renal) endpoints included all-cause mortality and any CV event such as stroke, myocardial infarction, revascularisation (CV) and end-stage renal disease, renal replacement therapy (renal).Patients with reduced HRR (< 23 bpm) had significantly more end point events (22/62 patients vs. 9/53 patients, p = 0.013) compared to the higher HRR (≥23 bpm). Of the secondary the endpoints (CV or renal separately) rate of the renal endpoint was significantly higher in the lower HRR group (p = 0.029), while there was no significant difference in the CV endpoint between the two HRR groups (p = 0.285). Independent predictors of survival were eGFR and diabetes mellitus by using Cox regression analysis. Kaplan-Meier curves showed significant differences in metabolic syndrome and non-metabolic syndrome when examined at the combined endpoints (cardiovascular and renal) or at each endpoint separately. The primary endpoint rate was increased significantly with the increased number of metabolic syndrome component (Met.sy. comp. 0 vs. Met. sy. comp. 2+, primary endpoints, p = 0.012).Our results showed that reduced HRR measured by treadmill exercise test has a predictive value for the prognosis of IgA nephropathy. The presence of metabolic syndrome may worsen the prognosis of IgA nephropathy.}, keywords = {chronic kidney disease; renal function; Cardiovascular risk; IgA nephropathy; heart rate recovery}, year = {2021}, eissn = {1471-2369} }