Peter Kotanko

Peter Kotanko
Renal Research Institute

M.D.

About

634
Publications
54,704
Reads
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10,919
Citations
Citations since 2016
267 Research Items
6170 Citations
201620172018201920202021202202004006008001,000
201620172018201920202021202202004006008001,000
201620172018201920202021202202004006008001,000
201620172018201920202021202202004006008001,000
Additional affiliations
December 2014 - present
Icahn School of Medicine at Mount Sinai
Position
  • Adjunct Professor of Medicine
October 2007 - present
Renal Research Institute
Position
  • Research Director
October 1989 - October 2007
Krankenhaus der Barmherzigen Brüder Graz
Position
  • Vice Chair
Education
September 1995 - July 1996
Imperial College Healthcare NHS Trust, Hammersmith Hospital
Field of study
  • Nephrology
October 1976 - April 1982

Publications

Publications (634)
Article
Intensified insulin therapy requires outstanding compliance but no measure of therapy adherence has been agreed upon. The aim of the current study was to test the hypothesis that treatment adherence, as described by a novel multiple regression model, relates to glycosylated haemoglobin and hypoglycaemia frequency in type 1 diabetes. Furthermore, we...
Article
Serum albumin concentration is a powerful predictor of mortality in patients on chronic hemodialysis (CHD). This study sought to investigate variables associated with serum albumin concentration. Cross-sectional study in prevalent chronic hemodialysis patients treated at the Renal Research Institute between July 1, 2005 and October 31, 2005. A tota...
Article
Full-text available
In hemodialysis patients a low body mass index (BMI) is correlated with an unfavorable clinical outcome, a phenomenon known as "reverse epidemiology". Mechanisms underlying this observation are unclear. We propose the following: uremic toxin generation occurs predominantly in visceral organs and the mass of key uremiogenic viscera (gut, liver) rela...
Article
Full-text available
A kinetic model of Ca mass balance during dialysis has been developed. It is a single-compartment, variable-volume model to compute Ca mass balance during dialysis in its volume of distribution, the extracellular fluid. The model was used to analyze literature data which were suitable for the assessment of Ca mass balance over the course of dialysi...
Article
Full-text available
Familial juvenile hyperuricemic nephropathy (FJHN) is an autosomal dominant genetic disorder that is characterized by hyperuricemia, gout, and tubulointerstitial nephritis. FJHN is caused by mutations in the UMOD gene, which encodes for uromodulin, the most abundant urinary protein. Herein is demonstrated that patients with FJHN and renal insuffici...
Chapter
Bioimpedance data are mostly used to quantify the size (body composition, fluid volumes) and sometimes the anatomical location of tissue masses. Such measurements are usually confined to cases where pool sizes are static or slowly changing. These measurements are useful in monitoring patient progress in a variety of evolving clinical situations. Dy...
Article
We have developed a technique to monitor dry weight (DWM) using a segmental bioimpedance technique to continuously measure the change in resistance and resistivity (ρ) in the calf during hemodialysis (HD).The DWM was designed based on multifrequency bioimpedance spectroscopy (BIS) with frequencies from 1 to 300 kHz. An algorithm combines two parame...
Article
Full-text available
Existing national, racial, and ethnic differences in dialysis patient mortality rates largely are unexplained. This study aimed to test the hypothesis that mortality rates related to atherosclerotic cardiovascular disease (ASCVD) in dialysis populations (DP) and in the background general populations (GP) are correlated. In a cross-sectional, multin...
Article
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Existing national, racial, and ethnic differences in dialysis patient mortality rates largely are unexplained. This study aimed to test the hypothesis that mortality rates related to atherosclerotic cardiovascular disease (ASCVD) in dialysis populations (DP) and in the background general populations (GP) are correlated. In a cross-sectional, multin...
Article
Full-text available
Small body mass index is associated with increased mortality in chronic hemodialysis patients. The reasons for this observation are unclear but may be related to body composition. This study aimed to investigate the body composition in chronic hemodialysis patients. The difference between body mass and the sum of muscle, bone, subcutaneous, and vis...
Article
Interdialytic weight gain (IDWG) is an easily measurable parameter in the dialysis unit, routinely assessed at the beginning of the dialysis session. It is used along with clinical symptoms and signs and predialysis blood pressure readings to make decisions regarding the amount of fluid removal during a dialysis session. IDWG is also used as a basi...
Article
Aim: Fabry disease is a rare lysosomal storage disorder caused by deficient activity of α-galactosidase A, resulting in progressive cellular accumulation of glycolipids, which may ultimately result in end-stage renal disease. We examined the effects of enzyme replacement therapy (ERT) with A galsidase-α on renal function using data from a large int...
Article
Current evidence demonstrates that both genetic and environmental factors influence blood pressure. The sympathetic nervous system is a key player in blood pressure control and functional genetic variants of the beta-2 adrenergic receptor (B2AR) have been identified and implicated in the pathogenesis of hypertension. The present study aimed to dete...
Article
Peritoneal dialysis (PD) has been used as a home dialysis therapy for renal replacement for more than 30 years. In a recent assessment of treatment quality, the mortality of patients on PD was referenced as being higher than of those on hemodialysis. Several reports suggest that a high proportion of PD patients are overhydrated. Clinical assessment...
Article
Patients with chronic kidney disease and patients undergoing hemodialysis treatment show a sustained overactivity of the sympathetic nervous system, which originates from signals arising in the failing kidneys and traveling via afferent renal nerves to cardiovascular centers in the brainstem. Additional important factors are increased levels of ang...
Article
Full-text available
Xanthinoxidase (XO) derived radical species are involved in bacterial translocation (BT) in cholestatic rats. The mechanism by which XO influences remains unclear. It has been shown recently that nuclear factor-kappa B (NF-kappaB), a ubiquitous transcription factor, can be activated by oxidative stress and thereby promote the process of BT. We inve...
Article
Full-text available
Hereditary multiple exostosis (HME) is an autosomal dominant disorder characterized by the development of benign cartilage-capped tumors at the juxta-epiphyseal regions of long bones. HME is usually caused by mutations of EXT1 or EXT2. The objective of this study was to investigate a three-generation Austrian kindred with HME for EXT1 and EXT2 muta...
Article
Globotriaosylceramide is a neutral glycolipid containing the trihexoside Gal(α1-4)Gal(β1-4)Glc(β1-1′) covalently bound to N-acylsphingosine. It was identified as the main storage substance in the kidney of patients with Fabry disease, an X-linked deficiency of lysosomal α-galactosidase A which can significantly be ameliorated by enzyme replacement...
Article
Anderson-Fabry disease is possibly underdiagnosed in patients with end-stage renal disease. Nationwide screening was therefore undertaken for Anderson-Fabry disease among dialysis patients in Austria. Screening for alpha-galactosidase A (AGAL) deficiency was performed by a blood spot test. In patients with a positive screening test, AGAL activity i...
Article
Full-text available
Anderson-Fabry disease is possibly underdiagnosed in patients with end-stage renal disease. Nationwide screening was therefore undertaken for Anderson-Fabry disease among dialysis patients in Austria. Screening for α-galactosidase A (AGAL) deficiency was performed by a blood spot test. In patients with a positive screening test, AGAL activity in le...
Article
The frequency of serum IgA deficiency (SIgAD) differs between populations. We examined the prevalence of SIgAD in healthy Caucasians. Serum immunoglobulin A (SIgA) was measured in 7293 volunteers (2264 women, 5029 men) aged 30 +/- 14.2 years (mean +/- SD; range: 12-66). Serum immunoglobulin A and subnormal SIgA levels were defined by a SIgA level <...
Article
Fabry disease is an X-linked inherited inborn error of glycosphingolipid catabolism. The deficiency of α-galactosidase A leads to the deposition of glycosphingolipids primarily in lysosomes of blood vessel cells. In classically affected hemizygotes clinical manifestations include pain in the extremities, vessel ectasia (angiokeratoma) in skin and m...
Article
Full-text available
Gout, which is commonly associated with hyperuricemia, affects 0.2% of the population. Hyperuricemia has a heterogeneous etiology that may be due to either over production and/or reduced renal clearance, of urate. In order to identify the mechanisms underlying reduced excretion of urate, we undertook positional cloning studies of familial juvenile...
Article
A male patient presented with oligosymptomatic Fabry disease (end stage renal failure and non-obstructive cardiomyopathy) at around 30 years of age. His leukocyte α-galactosidase activity (α-gal) was 2.6% of controls. A 50-year-old sister had similar cardiac symptoms and her asymptomatic heterozygous daughter (33 years) had normal enzyme activity....
Article
Full-text available
Familial juvenile hyperuricemic nephropathy (FJHN), which is inherited as an autosomal dominant disorder, is characterized by hyperuricemia, a low fractional renal excretion of urate, and chronic renal failure that is associated with interstitial fibrosis. Studies in 4 families (3 European and 1 Japanese) have mapped the gene causing autosomal domi...
Article
To determine whether the use of more elaborate diagnostic tests can identify possible risk factors for secondary osteoporosis and to evaluate the impact of these possible risk factors on the severity of bone disease in the study population. Cross-sectional study. We have investigated 377 subjects (285 females, 92 males) with osteoporosis (T-score l...
Article
Full-text available
This study aimed to determine the prevalence of renal artery stenosis (RAS) and associated risk factors in patients undergoing cardiac catheterization for suspected coronary artery disease (CAD). One hundred and seventy-seven consecutive patients (62 females) with a serum creatinine concentration <2.0mg.dl(-1) were studied. Abdominal aortography fo...
Article
Full-text available
Familial juvenile hyperuricaemic nephropathy (FJHN, OMIM 162000) is considered a rare cause of end-stage renal disease (ESRD). FJHN is characterized by hyperuricaemia and gout after adolescence and the slow development of renal insufficiency. leading to ESRD in adulthood. The disorder is characterized by a renal under-secretion of urate. which may...
Article
Full-text available
Chronic metabolic acidosis may increase alkali mobilization from the bone and thus promote the development of osteoporosis. The objective of the current study was to compare urinary acidification in patients with reduced bone mineral content with that in control subjects with normal bone density. Forty-six subjects (41 females, 5 males) with osteop...
Article
The study aimed at investigating urinary neopterin, a marker of cellular immune response, and urinary N-acetyl-beta-D-glucosaminidase (NAG), a marker of tubular damage, as noninvasive means to differentiate between acute tubular necrosis (ATN) and rejection in initially nonfunctioning (INF) human renal transplants. Seventy-two renal transplant pati...
Article
We investigated the influence of standardized postprandial walking on the rates of gastric emptying and of intragastric meal distribution in 50 consecutive patients with longstanding insulin-dependent diabetes mellitus. Gastric emptying of a semisolid meal labeled with 99mTc was continuously recorded with a dual-head gamma camera with patients in t...
Article
Recent evidence suggests that the prodownregulatory Gly16 allele of the beta-2 adrenergic receptor (beta-2 AR) is associated with essential hypertension in African Caribbeans. To further investigate the effect of the glycine (Gly)16 and arginine (Arg)16 beta-2 AR variants on hemodynamics, we investigated the agonist-mediated in vivo vasodilation in...
Article
Full-text available
Chronic metabolic acidosis may increase alkali mobilization from bone and thus promote the development of osteoporosis. While it is undisputed that overt metabolic acidosis is associated with metabolic bone disease, renal acidification in patients with idiopathic osteoporosis has not been studied systematically. The purpose of this study was to inv...
Article
Full-text available
The goal of the present study was to develop and evaluate algorithms for non-invasive, real-time, beat-to-beat monitoring of stroke index (SI), blood pressure (BP) and total peripheral resistance index (TPRI) which has a menu-driven interface, suitable for routine use by unskilled staff. In addition, it was our aim to include a meta-analysis for th...
Article
Populations of West African ancestry dwelling in Western communities exhibit greater prevalence of human essential hypertension and higher rates of end-organ damage. The sympathetic nervous system influences cardiac output, vascular tone, renal sodium reabsorption, and renin release and could be implicated in enhanced vascular responsiveness observ...
Article
A mass producible miniaturized device for the simultaneous monitoring of different metabolites was realized by assembling of a biosensor array produced by thin film technology with a flow through cell produced by printed circuit board technology. The biosensor array comprises four working electrodes which can be individually configured. Glucose-lac...
Article
Full-text available
To evaluate a novel technique for on-line continuous glucose measurement in subcutaneous adipose tissue, and to investigate its accuracy for detection of hypoglycemia. The method combined an open-flow microperfusion of subcutaneous adipose tissue using a double lumen catheter and an extracorporeal sensor cell. An isotonic ion-free solution was perf...
Article
Full-text available
This study investigated the prevalence of accelerated gastric emptying in 40 consecutive nonselected patients with longstanding insulin-dependent diabetes mellitus (range 11-54 yr; mean 27 yr). The gastric emptying of a semisolid meal labeled with 99mTc was continuously recorded with a dual-head gamma camera for 90 min in patients who were supine....
Article
Recurrent glomerulonephritis after transplantation is an important cause of graft loss, and should be considered in all at-risk patients who develop renal dysfunction or urinary abnormalities. The distinction of recurrent disease from allograft rejection has important therapeutic implications. Recent advances in the understanding of the pathophysio...
Article
This study was undertaken to test the hypothesis that ischemia prior to transplantation causes tubular damage without clinical evidence of graft dysfunction. The urinary excretion of fructose-1,6-bisphosphatase (EC 3.1.3.11, FBPase), a cytosolic enzyme located exclusively in the proximal tubules, and the lysosomal enzyme N-acetyl-beta-D-glucosamini...
Article
Full-text available
The objective of the study was to develop and evaluate a portable device for continuous fractionated blood sampling and continuous ex vivo monitoring of blood glucose. The inner lumen of a double lumen catheter (18 gauge x 45 mm) was placed in a peripheral vein and perfused with heparin solution (1.4 U min-1). The outer lumen was used to collect he...
Article
A miniaturized device for simultaneous measurement of glucose and lactate levels was produced by means of photopatterning of enzyme-containing photosensitive membrane precursors. This device shows no cross-talk and a lifetime for both the glucose and the lactate sensors of more than 2 weeks when continuously operated in undiluted bovine serum. Line...
Conference Paper
The objective of the study was to develop a measurement system for blood glucose and lactate and to evaluate a portable blood withdrawal system. For the blood withdrawal system a double lumen catheter was used. The inner lumen of the catheter was perfused with heparin solution and the outer lumen was used to collect the blood samples into 56 vacuum...
Article
The excretion of urinary N-acetyl-beta-D-glucosaminidase (NAG) was measured daily between day 7 and day 28 in 33 renal allograft recipients enjoying an entirely uncomplicated first postoperative month, Graft status was evaluated after 4 and 6 years and related to NAG excretion. After 4 years, 6 patients had experienced graft loss due to chronic rej...
Article
Full-text available
A pharmacokinetic model is modified to enable quantitation of subcutaneous insulin absorption following insulin injections of soluble insulin and monomeric insulin analogues. The model for soluble insulin includes diffusion, equilibration between hexameric and dimeric insulin and absorption of dimeric insulin molecules. Numerical approximation is c...
Article
Full-text available
A variety of monitoring systems is available for special fields of clinical application and scientific research. Whenever requirements change data acquisition and handling of signal analysis have to be adapted or even completely new structured, especially in real-time applications. This can be a time consuming procedure. In order to be able to focu...
Article
Eine Methode zur Messung der subkutanen Gewebsglucose sowohl im hyper- als auch im hypoglykämischen Bereich wird in dieser Arbeit vorgestellt. Dabei kommt das Prinzip der offenen Perfusion zur Anwendung: ein Doppellumenkatheter wird in das subkutane Gewebe gesetzt, wobei durch das innere Lumen isotones, ionenfreies Perfusat strömt und über das äuße...
Article
Full-text available
Article
A deconvolution method based on a simple clinical protocol for evaluating pathological gastric emptying is presented. 22 patients witb type I diabetes mellitus and 11 healthy volunteers were given a semisolid test meal containing D-xylose. In ten subjects a scintigrapbic method was simultaneously applied in order to validate the presented method. U...
Article
A neural network for non-linear system identification and prediction is presented. A regularization network which is equivalent to radial basis function neural network was used for identification of a Non-linear AutoRegressive Moving Avarage model with/without eXogenous inputs (NARMAX/NARMA). NARMAX system identification and validation was performe...
Conference Paper
A system for continuous simultaneous ex vivo monitoring of blood glucose (b.g.) and subcutaneous tissue fluid glucose (s.g.) is presented. The system is based on two portable devices: (1) a continuous ambulatory blood sampler with a miniaturized thin-film glucose sensor in the sampling line and (2) a s.g. monitoring device using open tissue perfusi...
Conference Paper
A PC-based monitoring system has been developed, which is able to acquire and analyse up to 32 physiological signals of different modality with maximum overall sample frequency of 48 kHz. New algorithms can be added and polygraphical presentation of results can be adjusted for special applications. The system was used to study noninvasively stroke...
Article
A mathematical model for the absorption of subcutaneously administered soluble insulin is presented. A dissociation-diffusion model with distributed parameter was transformed into a lumped parameter model by spatial discretization. Simulations of various insulin injections with this model demonstrate volume and concentration dependant absorption as...
Article
A subcutaneous insulin absorption model is presented for parameter estimation from the time course of plasma insulin. Modifications of a published model were made for the absorption of soluble insulin and monomeric insulin analogues in the range of therapeutic concentrations and volumes. The modified diffusion-dissociation model with distributed pa...