Brad Urquhart

Matthew WeirBrad Urquhart

A study of older adults in Ontario found that taking the antibiotic clarithromycin while also using certain blood pressure medications, known as angiotensin receptor blockers, was associated with a higher risk of hospital visits for high potassium levels and acute kidney injury compared to taking azithromycin. This risk of high potassium was even greater for individuals with pre-existing reduced kidney function. These findings suggest a significant drug interaction occurs because clarithromycin interferes with the body's ability to transport and eliminate these blood pressure medications through the liver.

Brad Urquhart

This study used a rat model to investigate how the progression of chronic kidney disease affects the liver's ability to break down medications. Researchers found that key liver enzymes responsible for drug metabolism were significantly reduced very early in the disease process, even before significant shifts in gut bacteria or the buildup of waste products in the blood occurred. These findings suggest that kidney disease may impair drug clearance much earlier than previously recognized, potentially impacting how medications should be dosed as kidney function declines.

Brad Urquhart

Researchers in Ontario, Canada, studied older adults taking low-dose methotrexate to see if also taking the antibiotic trimethoprim-sulfamethoxazole increased the risk of death compared to taking a cephalosporin antibiotic. While the risk of death within 30 days was similar between the two groups, patients prescribed trimethoprim-sulfamethoxazole had a higher risk of being hospitalized for any cause or for persistent infections. These findings suggest that while the combination may not be more lethal in the short term, it is associated with a higher rate of serious illness requiring hospital care.

Matthew WeirAmit GargBrad Urquhart

In older adults taking digoxin, starting a course of the antibiotic trimethoprim-sulfamethoxazole was associated with a nearly sixfold higher risk of hospitalization for digoxin toxicity compared to starting amoxicillin. While the absolute risk of this complication remained low at less than one percent, the interaction is clinically significant because digoxin has a narrow safety range. Physicians should consider using alternative antibiotics or reducing the digoxin dose when these medications must be used together.

Brad Urquhart

Researchers tested the movement and breakdown of a new anti-inflammatory drug called SY-005 in patients hospitalized with severe COVID-19 and normal kidney function. The study found that the drug was cleared from the bloodstream within six hours of administration without building up in the body or affecting the blood's ability to clot. These findings help determine the appropriate dosing schedule for future clinical trials of this medication.

Brad Urquhart

This review explores the field of pharmacometabolomics, which involves analyzing small molecules in blood or urine to predict how an individual will respond to specific medications. By identifying these metabolic markers, researchers can better understand drug metabolism and transport, potentially allowing for more precise dosing to improve treatment effectiveness and reduce harmful side effects. The authors highlight examples of this approach in treating major depressive disorder and managing cancer chemotherapy, while also discussing the current challenges in moving these techniques into routine clinical practice.

Matthew WeirAmit GargBrad UrquhartPeter Blake

A study of older adults in Ontario, Canada, found that those with chronic kidney disease who started low-dose methotrexate had double the risk of serious adverse events, such as sepsis or lung and liver toxicity, compared to those starting hydroxychloroquine. This risk was even higher for individuals with more advanced kidney impairment, particularly those with an estimated glomerular filtration rate below 45. These findings suggest that the potential for severe complications should be carefully weighed against the benefits when prescribing methotrexate to patients with reduced kidney function.

Matthew WeirAndrew HouseAmit GargBrad Urquhart

Researchers developed a new laboratory test to measure a molecule called TMAP in the blood and evaluated its potential as a marker for kidney function across several patient groups. The study found that TMAP levels were significantly higher in patients with chronic kidney disease and those receiving dialysis compared to healthy individuals, with levels rising as the kidney's filtering capacity declined. Because TMAP was also found in other species and even in maple tree sap, it appears to be part of a biological process that is widely conserved across nature.

Brad Urquhart

Researchers used mouse models to identify 26 specific substances in the blood, urine, and kidneys that change early on after exposure to the chemotherapy drug cisplatin. These metabolic markers, which are linked to energy production in cells and the gut microbiome, could help identify kidney injury much sooner than current standard tests. This study provides a potential panel of markers to help monitor and understand how cisplatin damages the kidneys in clinical settings.

Matthew WeirAmit GargBrad Urquhart

This randomized trial investigated whether a highly absorbable form of curcumin could slow the progression of chronic kidney disease in adults with high levels of protein in their urine. Researchers found that taking 90 milligrams of micro-particle curcumin daily for six months did not significantly improve kidney function or reduce protein leakage compared to a placebo. These results suggest that this specific curcumin formulation does not provide measurable benefits for managing albuminuric chronic kidney disease over a short-term period.

Brad Urquhart

Researchers studied patients with head and neck cancer to identify markers in the blood and urine that could predict or detect early kidney damage caused by the chemotherapy drug cisplatin. They found that specific metabolites related to energy production and mitochondrial health were significantly different in patients who developed kidney injury compared to those who did not. These findings suggest that testing for these specific substances before or shortly after treatment could help identify patients at high risk for this serious side effect.

Brad Urquhart

This review explores why individuals with chronic kidney disease face a significantly higher risk of heart disease and stroke, focusing on the role of toxins that accumulate when kidney function declines. These substances, including those produced by gut bacteria and systemic metabolic processes, contribute to vascular damage beyond what is explained by traditional risk factors like high blood pressure. The authors suggest that reducing these toxins through specialized diets, intensive dialysis, kidney transplantation, or specific vitamin therapies may be necessary to improve cardiovascular outcomes in this population.