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219
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Introduction
Additional affiliations
March 2002 - present
Position
- Professor (Assistant)
Description
- Nephrology, Dialysis, Renal Transplantation, Diabetes
Publications
Publications (219)
Membranoproliferative Glomerulonephritis (MPGN) comprises a histologic pattern of glomerular injury with different underlying diseases.
Here we report on a 47-year-old female with rapidly progressive glomerulonephritis (RPGN) on top of a previously diagnosed idiopathic MPGN after receiving the first dose of the Pfizer-BioNTech COVID-19 mRNA vaccine...
Zusammenfassung
Nierenkrankheiten stellen ein zunehmendes Gesundheitsproblem dar, dessen Eindämmung eine effektive Kommunikation zwischen den an Erfassung, Diagnostik und Therapie Beteiligten sowie den betroffenen Patientinnen und Patienten erfordert. Die Nomenklatur für Nierenfunktion und Nierenkrankheiten ist jedoch bislang nicht einheitlich. Die...
Background Patients with end-stage kidney disease (ESKD) on hemodialysis (HD) are at increased risk for bleeding. However, despite relevant clinical implications regarding dialysis modalities or anticoagulation, no bleeding risk assessment strategy has been established in this challenging population.
Methods Analyses on bleeding risk assessment mod...
Aims:
Sodium glucose co-transporter-2 inhibitors (SGLT-2i) improve cardiorenal outcomes in chronic kidney disease (CKD) patients with and without type 2 diabetes. The molecular mechanisms underlying these pleiotropic effects remain unclear, yet it is speculated that SGLT-2i elicit a neurohormonal modulation resulting in renin-angiotensin system (R...
This study aimed to determine the specific cytokine profile in peripheral blood during the early onset of COVID-19 infection. This was a cross-sectional exploratory, single center study. A total of 55 plasma samples were studied. Serum samples of adults showing symptoms of COVID-19 infection who were tested positive for SARS-CoV-2 infection (CoV+,...
Background
Evidence supporting the use of anticoagulation for the prevention of stroke and thromboembolism in patients with kidney failure on hemodialysis (HD) and atrial fibrillation (AF) is limited. We prospectively assessed the incidences of stroke and major bleeding, as well as anticoagulation strategies in patients on HD with AF.
Methods
We r...
Background
Renin–angiotensin–aldosterone system (RAAS) blockade with angiotensin-converting enzyme inhibitors (ACEi) or angiotensin receptor blockers (ARB) is the cornerstone of antihypertensive treatment in patients with chronic kidney disease (CKD) and diabetes mellitus. Mineralocorticoid receptor antagonists (MRA) on top of conventional RAAS blo...
Rationale: Kidney homeostasis is critically determined by the coordinated activity of the renin-angiotensin system (RAS) including the balanced synthesis of its main effector peptides angiotensin (Ang) II and Ang-(1-7). The condition of enzymatic overproduction of Ang II relative to Ang- (1-7) is termed RAS dysregulation, and leads to cellular sign...
Background:
A positive pregnancy test in acute or chronically ill patients has implications for the use of potentially mutagenic or teratogenic products in urgent medical therapies such as the use of chemotherapies or therapies with immunosuppressants, for anesthesia, and for time-sensitive indications like urgent surgery or organ Transplantation....
Background and aims:
Cardiovascular disease (CVD) is common in patients with end-stage renal disease (ESRD) on hemodialysis (HD). However, antithrombotic therapy to prevent CVD increases the risk of bleeding. We aimed to investigate the prevalence of CVD and the practice patterns of antithrombotic agents in patients with ESRD on HD.
Methods:
In...
Angiotensin-converting enzyme inhibitors (ACEis) are beneficial in patients with chronic kidney disease (CKD). Yet, their clinical effects after kidney transplantation (KTx) remain ambiguous and local renin-angiotensin system (RAS) regulation including the ‘classical’ and ‘alternative’ RAS has not been studied so far. Here, we investigated both sys...
Rezente epidemiologische Untersuchungen zeigen, dass etwa 2–3 % aller Österreicher Diabetes mit Nierenbeteiligung aufweisen. Diese betrifft somit in Österreich etwa 250.000 Menschen. Das Risiko des Auftretens und Fortschreitens der Erkrankung kann durch Lebensstilinterventionen und Optimierung der Einstellung des Blutdrucks, Blutzuckers und speziel...
The safety and efficacy of sodium‐glucose cotransporter 2 inhibitors in posttransplantation diabetes mellitus is unknown. We converted stable kidney transplant patients to 10 mg empagliflozin, aiming at replacing their insulin therapy (<40 IU/day). N=14 participants (the required sample size) completed the study visits through 4 weeks and N=8 throu...
Diffuse myocardial fibrosis is a key pathophysiologic feature in heart failure and can be quantified by cardiac magnetic resonance (CMR) T1 mapping. However, increases in myocardial free water also prolong native T1 times and may impact fibrosis quantification. Thus far, the impact of systemic patient volume status remains unclear. In this study, n...
Treating hyperglycemia in previously non-diabetic individuals with exogenous insulin immediately after kidney transplantation reduced the odds of developing Posttransplantation Diabetes Mellitus (PTDM) in our previous proof-of-concept clinical trial. We hypothesized that insulin-pump therapy with maximal insulin dosage during the afternoon would im...
ITP-NODAT Protocol.
Study protocol. Accessible online.
(PDF)
SAPT-NODAT Protocol.
Study protocol. Accessible online.
(PDF)
Individual insulin lispro doses (IU) over the day (13:00 to 23:00), total doses per day and mean doses over all patients (IU and % of total daily dose); final doses after titration and duration of titration phase (days).
(DOCX)
Mean serum glucose (mg/dL) over 7 days including standard deviation (SD).
(DOCX)
CONSORT 2010 checklist.
Accessible online.
(DOC)
Individual insulin lispro doses (IU) over the day (0:00 to 13:00) and mean doses over all patients (IU and % of total daily dose).
(DOCX)
the hyperinsulinaemic-euglycaemic clamp (HEC) experiments performed in nine living donor kidney transplant recipients from before to after transplantation by Jørgensen et al. [1] show a reduction in insulin sensitivity, but posttransplantation diabetes mellitus (PTDM) is also a result of beta-cell dysfunction coinciding with a period of excessive i...
The effects of intravenous fluid therapy on fluid compartments and hemodynamics of the human body remain enigmatic. We therefore tested the efficacy of bioimpedance spectroscopy in a crossover study, where 15 males received 0.5 ml/kg/min ELO-MEL-isoton (osmolarity = 302 mosmol/l) during 60 minutes, or nothing at all. In group "Fluid", fluid load in...
Background:
Blockade of the renin-angiotensin system (RAS) represents a main strategy in the therapy of heart failure with reduced ejection fraction (HFrEF), but the role of active renin concentration (ARC) for guiding therapy in the presence of an RAS blockade remains to be established. This study assessed angiotensin profiles of HFrEF patients w...
Background: The aim of this prospective study was to investigate the influence of long-term physical activity on HDL quality, reflected by serum amyloid A (SAA) and surfactant protein B (SPB).
Methods and results: 109 healthy subjects were recruited, 98 completed the study. Participants perform within the calculated training pulse for 8 months. The...
A crucial role of cell metabolism in immune cell differentiation and function has been recently established. Growing evidence indicates that metabolic processes impact both, innate and adaptive immunity. Since a down-stream integrator of metabolic alterations, mammalian target of rapamycin (mTOR), is responsible for controlling the balance between...
Effects of 2-DG on oxygen consumption rates (OCR) and extracellular acidification rates (ECAR) after LPS activation of human monocytes.
Mononuclear cells isolation with Leucosep columns (Greiner Bio-one) and monocytes separation using Pan Monocyte Isolation Kit (Miltenyi Biotec) was performed according to the protocol of the manufacturer. Analysis...
Impact of AMPK activators on IL-6/ TNF-α induction.
Human monocytes were preincubated for 90 minutes with different concentrations of A-769662 (a, b) or AICAR (c, d) or medium and then stimulated with LPS. Secretion of IL-6 (a, c) and TNF-α (b, d) was determined from 20 hr culture supernatants by ELISA. Data are representative of 3–5 independent ex...
Real-time PCR primers.
Gene symbol, Gene ID and sequences of forward, reverse primers and probe (when applicable) are indicated.
(PDF)
Dataset.
This supporting information file contains all relevant data ordered in line with the figures of the manuscript.
(XLSX)
Background
Because chronic fluid volume overload is associated with higher mortality, we tested whether blood-volume monitored regulation of ultrafiltration and dialysate conductivity (UCR) and/or regulation of ultrafiltration and temperature (UTR) would facilitate dry weight reduction, in comparison to conventional dialysis (CONV).
Methods
We car...
High-density lipoproteins (HDLs) can inhibit inflammatory cytokine expression on innate immune cells, but sometimes they promote cytokine production as suggested in a recent article in Cell Metabolism by van der Vorst et al. (2017). Kopecky et al. point out that the origin, handling, and storage conditions of HDL preparations dictate their function...
Background/aims:
Heart failure (HF) is a main cause of mortality of hemodialysis (HD) patients. While HF with reduced ejection fraction (HFrEF) is known to only affect a minority of patients, little is known about the prevalence, associations with clinical characteristics and prognosis of HF with preserved ejection fraction (HFpEF).
Methods:
We...
Objective:
We aimed at assessing the molecular adaptation of the renin-angiotensin system (RAS) after successful kidney transplantation (KTX).
Materials and methods:
In this prospective, exploratory study we analyzed 12 hemodialysis (HD) patients, who received a KTX and had excellent graft function six to 12 months thereafter. The concentrations...
Atrial fibrillation (AF) adds significant risk of stroke and thromboembolism in patients on hemodialysis (HD). The aim of this study was to investigate the prevalence of AF in a population-based cohort of HD patients and practice patterns of antithrombotic therapy for stroke prevention in AF.The Vienna InVestigation of AtriaL fibrillation and throm...
Blockade of the renin-angiotensin system (RAS) represents a cornerstone in the treatment of heart failure with reduced ejection fraction (HFrEF) [(1)][1]. Beside established pharmacological therapy with angiotensin-converting enzyme inhibitor (ACE-I) and angiotensin II type 1 receptor (AT1R) blocker
Cardiovascular and renal pathologies are frequently associated with an activated renin-angiotensin-system (RAS) and increased levels of its main effector and vasoconstrictor hormone angiotensin II (Ang II). Angiotensin-converting-enzyme-2 (ACE2) has been described as a crucial enzymatic player in shifting the RAS towards its so-called alternative v...
The cardioprotective effect of HDL is thought to be largely determined by its cholesterol efflux capacity, which was shown to inversely correlate with atherosclerotic cardiovascular disease in populations with normal kidney function. Patients with ESRD suffer an exceptionally high cardiovascular risk not fully explained by traditional risk factors....
Background:
Most heart failure with preserved ejection fraction (HFpEF) patients, at some point, present to an emergency department with typical symptoms of volume overload. Clinically, most respond well to standard diuretic therapy, sometimes at the cost of renal function. The study sought to define the prognostic significance of fluid status ver...
The cardioprotective effect of HDL (High-Density Lipoprotein) is largely determined by its cholesterol efflux capacity, which was shown to correlate inversely with atherosclerotic cardiovascular disease in populations with normal kidney function. Patients with end-stage renal disease suffer an exceptionally high cardiovascular risk not fully explai...
Recent epidemiological evaluations have shown that approximately 5 % of all Austrians suffer from diabetes including renal involvement, i. e. 400.000 people in Austria are affected. The risk of start and progression of this disease can be ameliorated by lifestyle interventions as well as optimization of blood pressure and glucose levels. The presen...
Pregnancy and associated pre-eclampsia carry a high maternal risk in hemodialysis patients, yet no guidelines on how to monitor these patients' cardiovascular function exist. A 34-year-old hemodialysis patient presented with peripartum cardiomyopathy after a late second trimester miscarriage. On cardiac magnetic resonance imaging, diagnostic featur...
Background:
Calcineurin-inhibitors and hepatitis C virus (HCV) infection increase the risk of post-transplant diabetes mellitus. Chronic HCV infection promotes insulin resistance rather than beta-cell dysfunction. The objective was to elucidate whether a conversion from tacrolimus to cyclosporine A affects fasting and/or dynamic insulin sensitivit...
The filled TREND checklist for this study.
(PDF)
The study protocol for this trial.
(DOC)
Despite increasing evidence in favour of prophylactic valganciclovir treatment in kidney transplant recipients for the prevention of CMV infection, the impact of preemptive vs prophylactic treatment on long-term clinical outcomes is unclear. In this retrospective study 187 kidney transplant recipients with serologic intermediate-risk constellation...
High-density lipoproteins (HDLs) are considered as anti-atherogenic. Recent experimental findings suggest that their biological properties can be modified in certain clinical conditions by accumulation of serum amyloid A (SAA). The effect of SAA on the association between HDL-cholesterol (HDL-C) and cardiovascular outcome remains unknown.
We examin...
Posttransplantation diabetes mellitus (PTDM) is a common complication after renal transplantation leading to increased cardiovascular morbidity and mortality. In subjects with type 2 diabetes (T2DM) increased glycemic variability and poor glycemic control have been associated with cardiovascular complications. We therefore aimed at determining glyc...
Angiotensin-converting enzyme inhibitors (ACEis) are beneficial in patients with chronic kidney disease, yet their effects in kidney transplant (TX) recipients remain inconclusive. Allograft quality, transplant vintage and donor-specific antibodies (DSA) might constitute crucial factors, leading to dysregulation of the intrarenal RAS and altered se...
Diabetic kidney disease (DKD) is the leading cause of end-stage renal disease (ESRD) in Austria, accounting for a high burden of morbidity and mortality. In this nationwide study, we aimed to evaluate the incidence and fate of patients with DKD-ESRD over time.
Data (collected annually) from the Austrian Dialysis- and Transplant Registry were analys...
Posttransplantation diabetes mellitus (PTDM) is a major complication after renal transplantation due to its negative impact on patient and graft survival, and affects up to 40 % of renal transplant recipients. The generation of evidence regarding its optimal treatment is now progressing with some emphasis on early postoperative insulin treatment th...
Post-transplantation diabetes mellitus (PTDM) is a serious complication after kidney transplantation, but evidence regarding long-term outcomes of treatment regimens remains scarce.
The aim of this retrospective cohort analysis was to assess the long-term efficiency and safety of antidiabetic treatments in kidney transplant recipients (KTRs), who w...
Post-transplantation diabetes mellitus (PTDM) is a common complication after kidney transplantation that affects up to 40 % of kidney transplant recipients. By pathogenesis, PTDM is a diabetes form of its own, and may be characterized by a sudden, drug-induced deficiency in insulin secretion rather than worsening of insulin resistance over time. In...
Impairment of HDL function has been associated with cardiovascular events in patients with kidney failure. The protein composition of HDLs is altered in these patients, presumably compromising the cardioprotective effects of HDLs. This post hoc study assessed the relation of distinct HDL-bound proteins with cardiovascular outcomes in a dialysis pop...
