TY - JOUR AU - Sági, Balázs AU - Vas, Tibor AU - Csiky, Botond AU - Nagy, Judit AU - Kovács, Tibor TI - Are Platelet-Related Parameters Prognostic Predictors of Renal and Cardiovascular Outcomes in IgA Nephropathy? JF - JOURNAL OF CLINICAL MEDICINE J2 - J CLIN MED VL - 13 PY - 2024 IS - 4 PG - 15 SN - 2077-0383 DO - 10.3390/jcm13040991 UR - https://m2.mtmt.hu/api/publication/34628334 ID - 34628334 N1 - 2nd Department of Internal Medicine and Nephrology, Diabetes Center, Clinical Center, Medical School, University of Pécs, Pécs, 7624, Hungary Triton Life Dialysis Center, Pécs, 7624, Hungary Export Date: 11 March 2024 Correspondence Address: Kovács, T.J.; 2nd Department of Internal Medicine and Nephrology, Hungary; email: kovacs.tibor.jozsef@pte.hu AB - 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. LA - English DB - MTMT ER - TY - JOUR AU - Sági, Balázs AU - Késői, István AU - Vas, Tibor AU - Csiky, Botond AU - Nagy, Judit AU - Kovács, Tibor TI - Renal and cardiovascular prognostic significance of echocardiographic early diastolic mitral annular velocity in IgA nephropathy. JF - INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING J2 - INT J CARDIOVAS IMAG VL - 40 PY - 2024 IS - 2 SP - 307 EP - 319 PG - 13 SN - 1569-5794 DO - 10.1007/s10554-023-02988-7 UR - https://m2.mtmt.hu/api/publication/34335477 ID - 34335477 AB - 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. LA - English DB - MTMT ER - TY - JOUR AU - Sági, Balázs AU - Késői, István AU - Vas, Tibor AU - Csiky, Botond AU - Nagy, Judit AU - Kovács, Tibor TI - Relationship between arterial stiffness, left ventricular diastolic function, and renal function in chronic kidney disease JF - BMC NEPHROLOGY J2 - BMC NEPHROL VL - 24 PY - 2023 IS - 1 PG - 13 SN - 1471-2369 DO - 10.1186/s12882-023-03308-w UR - https://m2.mtmt.hu/api/publication/34128942 ID - 34128942 N1 - Funding Agency and Grant Number: University of Pecs Funding text: Open access funding provided by University of Pecs. AB - 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. LA - English DB - MTMT ER - TY - JOUR AU - Kiryluk, Krzysztof AU - Sanchez-Rodriguez, Elena AU - Zhou, Xu-Jie AU - Zanoni, Francesca AU - Liu, Lili AU - Mladkova, Nikol AU - Khan, Atlas AU - Marasa, Maddalena AU - Zhang, Jun Y AU - Balderes, Olivia AU - Sanna-Cherchi, Simone AU - Bomback, Andrew S AU - Canetta, Pietro A AU - Appel, Gerald B AU - Radhakrishnan, Jai AU - Trimarchi, Hernan AU - Sprangers, Ben AU - Cattran, Daniel C AU - Reich, Heather AU - Pei, York AU - Ravani, Pietro AU - Galesic, Kresimir AU - Maixnerova, Dita AU - Tesar, Vladimir AU - Stengel, Benedicte AU - Metzger, Marie AU - Canaud, Guillaume AU - Maillard, Nicolas AU - Berthoux, Francois AU - Berthelot, Laureline AU - Pillebout, Evangeline AU - Monteiro, Renato AU - Nelson, Raoul AU - Wyatt, Robert J AU - Smoyer, William AU - Mahan, John AU - Samhar, Al-Akash AU - Hidalgo, Guillermo AU - Quiroga, Alejandro AU - Weng, Patricia AU - Sreedharan, Raji AU - Selewski, David AU - Davis, Keefe AU - Kallash, Mahmoud AU - Vasylyeva, Tetyana L AU - Rheault, Michelle AU - Chishti, Aftab AU - Ranch, Daniel AU - Wenderfer, Scott E AU - Samsonov, Dmitry AU - Claes, Donna J AU - Akchurin, Oleh AU - Goumenos, Dimitrios AU - Stangou, Maria AU - Nagy, Judit AU - Kovács, Tibor AU - Fiaccadori, Enrico AU - Amoroso, Antonio AU - Barlassina, Cristina AU - Cusi, Daniele AU - Del Vecchio, Lucia AU - Battaglia, Giovanni Giorgio AU - Bodria, Monica AU - Boer, Emanuela AU - Bono, Luisa AU - Boscutti, Giuliano AU - Caridi, Gianluca AU - Lugani, Francesca AU - Ghiggeri, GianMarco AU - Coppo, Rosanna AU - Peruzzi, Licia AU - Esposito, Vittoria AU - Esposito, Ciro AU - Feriozzi, Sandro AU - Polci, Rosaria AU - Frasca, Giovanni AU - Galliani, Marco AU - Garozzo, Maurizio AU - Mitrotti, Adele AU - Gesualdo, Loreto AU - Granata, Simona AU - Zaza, Gianluigi AU - Londrino, Francesco AU - Magistroni, Riccardo AU - Pisani, Isabella AU - Magnano, Andrea AU - Marcantoni, Carmelita AU - Messa, Piergiorgio AU - Mignani, Renzo AU - Pani, Antonello AU - Ponticelli, Claudio AU - Roccatello, Dario AU - Salvadori, Maurizio AU - Salvi, Erica AU - Santoro, Domenico AU - Gembillo, Guido AU - Savoldi, Silvana AU - Spotti, Donatella AU - Zamboli, Pasquale AU - Izzi, Claudia AU - Alberici, Federico AU - Delbarba, Elisa AU - Florczak, Michał AU - Krata, Natalia AU - Mucha, Krzysztof AU - Pączek, Leszek AU - Niemczyk, Stanisław AU - Moszczuk, Barbara AU - Pańczyk-Tomaszewska, Malgorzata AU - Mizerska-Wasiak, Malgorzata AU - Perkowska-Ptasińska, Agnieszka AU - Bączkowska, Teresa AU - Durlik, Magdalena AU - Pawlaczyk, Krzysztof AU - Sikora, Przemyslaw AU - Zaniew, Marcin AU - Kaminska, Dorota AU - Krajewska, Magdalena AU - Kuzmiuk-Glembin, Izabella AU - Heleniak, Zbigniew AU - Bullo-Piontecka, Barbara AU - Liberek, Tomasz AU - Dębska-Slizien, Alicja AU - Hryszko, Tomasz AU - Materna-Kiryluk, Anna AU - Miklaszewska, Monika AU - Szczepańska, Maria AU - Dyga, Katarzyna AU - Machura, Edyta AU - Siniewicz-Luzeńczyk, Katarzyna AU - Pawlak-Bratkowska, Monika AU - Tkaczyk, Marcin AU - Runowski, Dariusz AU - Kwella, Norbert AU - Drożdż, Dorota AU - Habura, Ireneusz AU - Kronenberg, Florian AU - Prikhodina, Larisa AU - van Heel, David AU - Fontaine, Bertrand AU - Cotsapas, Chris AU - Wijmenga, Cisca AU - Franke, Andre AU - Annese, Vito AU - Gregersen, Peter K AU - Parameswaran, Sreeja AU - Weirauch, Matthew AU - Kottyan, Leah AU - Harley, John B AU - Suzuki, Hitoshi AU - Narita, Ichiei AU - Goto, Shin AU - Lee, Hajeong AU - Kim, Dong Ki AU - Kim, Yon Su AU - Park, Jin-Ho AU - Cho, BeLong AU - Choi, Murim AU - Van Wijk, Ans AU - Huerta, Ana AU - Ars, Elisabet AU - Ballarin, Jose AU - Lundberg, Sigrid AU - Vogt, Bruno AU - Mani, Laila-Yasmin AU - Caliskan, Yasar AU - Barratt, Jonathan AU - Abeygunaratne, Thilini AU - Kalra, Philip A AU - Gale, Daniel P AU - Panzer, Ulf AU - Rauen, Thomas AU - Floege, Jürgen AU - Schlosser, Pascal AU - Ekici, Arif B AU - Eckardt, Kai-Uwe AU - Chen, Nan AU - Xie, Jingyuan AU - Lifton, Richard P AU - Loos, Ruth J F AU - Kenny, Eimear E AU - Ionita-Laza, Iuliana AU - Köttgen, Anna AU - Julian, Bruce A AU - Novak, Jan AU - Scolari, Francesco AU - Zhang, Hong AU - Gharavi, Ali G TI - Genome-wide association analyses define pathogenic signaling pathways and prioritize drug targets for IgA nephropathy JF - NATURE GENETICS J2 - NAT GENET VL - 55 PY - 2023 IS - 7 SP - 1091 EP - 1105 PG - 15 SN - 1061-4036 DO - 10.1038/s41588-023-01422-x UR - https://m2.mtmt.hu/api/publication/34039025 ID - 34039025 AB - 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. LA - English DB - MTMT ER - TY - JOUR AU - Sági, Balázs AU - Vas, Tibor AU - Jakabfi-Csepregi, Rita AU - Horváth-Szalai, Zoltán AU - Kőszegi, Tamás AU - Csiky, Botond AU - Nagy, Judit AU - Kovács, Tibor TI - The Role of Two Heart Biomarkers in IgA Nephropathy JF - INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES J2 - INT J MOL SCI VL - 24 PY - 2023 IS - 12 PG - 11 SN - 1661-6596 DO - 10.3390/ijms241210336 UR - https://m2.mtmt.hu/api/publication/34036926 ID - 34036926 AB - 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. LA - English DB - MTMT ER - TY - JOUR AU - Sever, M.S. AU - Van, Biesen W. AU - Vanholder, R. AU - Mallick, N. AU - London, G. AU - Schena, F.P. AU - Nagy, Judit AU - Buturovic-Ponikvar, J. AU - Heering, P. AU - Maggiore, U. AU - Mariat, C. AU - Watschinger, B. AU - Oniscu, G. AU - Peruzzi, L. AU - Gandolfini, I. AU - Hellemans, R. AU - Abramowicz, D. AU - Pascual, J. AU - Hilbrands, L. TI - Ethical and medical dilemmas in paid living kidney donor transplantation JF - TRANSPLANTATION REVIEWS J2 - TRANSPLANT REV-ORLAN VL - 36 PY - 2022 IS - 4 PG - 7 SN - 0955-470X DO - 10.1016/j.trre.2022.100726 UR - https://m2.mtmt.hu/api/publication/33123457 ID - 33123457 LA - English DB - MTMT ER - TY - JOUR AU - Kékes, Ede AU - Nagy, Judit AU - Vályi, Péter TI - Amit a vérnyomás-variabilitásról tudni kell JF - HYPERTONIA ÉS NEPHROLOGIA J2 - HYPERTONIA NEPHROLOGIA VL - 26 PY - 2022 IS - 4 SP - 168 EP - 179 PG - 12 SN - 1418-477X DO - 10.33668/hn.26.019 UR - https://m2.mtmt.hu/api/publication/33103757 ID - 33103757 AB - 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. LA - Hungarian DB - MTMT ER - TY - JOUR AU - Sági, Balázs AU - Késői, István AU - Vas, Tibor AU - Csiky, Botond AU - Nagy, Judit AU - Kovács, Tibor TI - Left ventricular myocardial mass index associated with cardiovascular and renal prognosis in IgA nephropathy. JF - BMC NEPHROLOGY J2 - BMC NEPHROL VL - 23 PY - 2022 IS - 1 PG - 12 SN - 1471-2369 DO - 10.1186/s12882-022-02909-1 UR - https://m2.mtmt.hu/api/publication/33061358 ID - 33061358 AB - 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. LA - English DB - MTMT ER - TY - JOUR AU - Kékes, Ede AU - Nagy, Judit TI - Extrapulmonalis többszervi károsodás és funkciózavar Covid-19-ben JF - HYPERTONIA ÉS NEPHROLOGIA J2 - HYPERTONIA NEPHROLOGIA VL - 25 PY - 2021 IS - 6 SP - 274 EP - 283 PG - 10 SN - 1418-477X DO - 10.33668/hn.25.028 UR - https://m2.mtmt.hu/api/publication/32542129 ID - 32542129 LA - Hungarian DB - MTMT ER - TY - JOUR AU - Sági, Balázs AU - Késői, István AU - Vas, Tibor AU - Csiky, Botond AU - Nagy, Judit AU - Kovács, Tibor TI - The prognostic role of heart rate recovery after exercise and metabolic syndrome in IgA nephropathy. JF - BMC NEPHROLOGY J2 - BMC NEPHROL VL - 22 PY - 2021 IS - 1 PG - 11 SN - 1471-2369 DO - 10.1186/s12882-021-02596-4 UR - https://m2.mtmt.hu/api/publication/32509128 ID - 32509128 AB - 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. LA - English DB - MTMT ER -