Clinical Kidney Journal最新文献

{"title":"Ethnic and seasonal variations in FGF-23 and markers of chronic kidney disease - mineral and bone disorder","authors":"Hulya Taskapan, Sara Mahdavi, Antonio Bellasi, Salome Martin, Saeeda Kuvadia, Anfal Patel, Berkay Taskapan, Paul Tam, Tabo Sikaneta","doi":"10.1093/ckj/sfae188","DOIUrl":"https://doi.org/10.1093/ckj/sfae188","url":null,"abstract":"Fibroblast growth factor 23 (FGF-23) and other markers of chronic kidney disease-mineral and bone disorder (CKD-MBD) provide valuable insights into disease processes, treatment options, and patient prognosis. However, limited research has explored potential associations with ethnicity or season, particularly in multi-ethnic populations residing in high-latitude regions. We evaluated CKD-BMD markers in a diverse cohort of CKD patients, who were participants of the CAN AIM to PREVENT study. FGF-23, calcium, phosphate, 25-hydroxyvitamin D (25-OHD), and intact parathyroid hormone (iPTH) in 1,234 participants with pre-dialysis CKD (mean eGFR: 41.8±14.3 mL/min) were analyzed. Mixed-effects general linear regression models adjusted for demographic and biological factors were used to compare repeated measurements across patient groups categorized by ethnicity (East Asian, White, South Asian, Black, Southeast Asian) and seasons. Compared to other groups, White participants exhibited 8.0-18.5% higher FGF-23 levels, Black participants had 0.17-0.32 mg/dL higher calcium levels, White participants had 10.0-20.1% higher 25-OHD levels, South Asian participants had 7.3-20.1% lower 25-OHD levels, and Black participants had 22.1-73.8% higher iPTH levels, while East Asian participants ad 10.7-73.8% lower iPTH levels. Seasonal variations were also observed. FGF-23 levels were 11.9-15.5% higher in summer compared to other seasons, while calcium levels were 0.03-0.06 mg/dL lower in summer. 25-OHD levels were 5.6-10.6% higher in summer and autumn compared to other seasons. This study shows that FGF-23 and CKD-MBD markers in a Canadian pre-dialysis CKD cohort vary independently by ethnicity and season. Further research is needed to understand the reasons and clinical significance of these findings.","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141522606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between magnesium, erythropoietin resistance and mortality: the Japanese dialysis outcomes and practice patterns study (J-DOPPS)","authors":"Sawako Kato, Jui Wang, Yoshihiro Onishi, Masaomi Nangaku","doi":"10.1093/ckj/sfae153","DOIUrl":"https://doi.org/10.1093/ckj/sfae153","url":null,"abstract":"Background Limited data are now available to evaluate the relationship between serum magnesium level, anemia, and mortality in the dialysis population. Methods Using data from the Japanese Dialysis Outcomes and Practice Patterns Study (J-DOPPS) phases 5 and 6, we analyzed the association between serum magnesium (s-Mg) levels and the erythropoiesis-stimulating agents resistance index (ERI) as the primary outcome. To estimate the longitudinal relationship, a mixed-effect model was used with ERI at each 4-month period as the dependent variable, quintiles of s-Mg at the previous 4-month period as the independent variable. We also examined incidence of infectious events, the all-cause and cardiovascular disease (CVD)-related deaths as secondary outcomes by Cox regression with quintiles of s-Mg at baseline. Results Of the 4776 participants in J-DOPPS, 1650 were included in the analysis. The median of s-Mg at baseline was 2.5 mg/dL. A significant linear association of s-Mg with ERI (p for trend < 0.001) was revealed. Low and high s-Mg levels were not associated with the clinical outcomes of interest, except for the highest quintile of s-Mg being significantly associated with lower incidence of all-cause mortality and CVD-related deaths compared with the middle (reference) quintile. Conclusions We observed that lower s-Mg levels subsequently induced higher ERI and that mild higher s-Mg levels were possibly associated with good rather than poor outcomes in Japanese hemodialysis patients. Adjustment of s-Mg levels may be proposed as a new strategy at low cost and risk to reduce the risk of premature mortality.","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141522607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognosis is still poor in patients with posttransplant C3 glomerulopathy despite eculizumab use.","authors":"Safak Mirioglu, Rabia Hacer Hocaoglu, Arzu Velioglu, Yasemin Ozluk, Ahmet Burak Dirim, Aysegul Oruc, Ozgur Akin Oto, Halil Yazici, Yasar Caliskan","doi":"10.1093/ckj/sfae190","DOIUrl":"10.1093/ckj/sfae190","url":null,"abstract":"","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11252667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141632857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kidney involvement in myelodysplastic syndromes.","authors":"Marie-Camille Lafargue, Jean-Paul Duong Van Huyen, Helmut G Rennke, Marie Essig, Mickaël Bobot, Noémie Jourde-Chiche, Hamza Sakhi, Alexandre Karras, Idris Boudhabhay, Philippe Brunet, Hugoline Boulay, Vincent Grobost, Carole Philipponnet, Juliette Jeannel, Jonathan Chemouny, Jean-Jacques Boffa, Dorra Braham-Stambouli, Umut Selamet, Leonardo V Riella, Olivier Fain, Lionel Adès, Pierre Fenaux, Camille Cohen, Arsène Mekinian","doi":"10.1093/ckj/sfae185","DOIUrl":"10.1093/ckj/sfae185","url":null,"abstract":"<p><strong>Introduction: </strong>The objective of this study was to describe kidney involvement in patients with myelodysplastic syndromes (MDS), their treatments, and outcomes.</p><p><strong>Methods: </strong>We conducted a multicenter retrospective study in seven centers, identifying MDS patients with acute kidney injury (AKI), chronic kidney disease (CKD), and urine abnormalities.</p><p><strong>Results: </strong>Fifteen patients developed a kidney disease 3 months after MDS diagnosis. Median urine protein-to-creatinine ratio was 1.9 g/g, and median serum creatinine was 3.2 mg/dL. Ten patients had AKI at presentation, and 12 had extra-renal symptoms. The renal diagnoses included anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV), ANCA negative vasculitis, C3 glomerulonephritis, immune complex-mediated glomerulonephritis, polyarteritis nodosa, and IgA vasculitis. All patients but one received a specific treatment for the MDS-associated kidney injury. The effect of MDS treatment on kidney injury could be assessed in six patients treated with azacitidine, and renal function evolution was heterogenous. After a median follow-up of 14 months, four patients had CKD stage 3, five had CKD stage 4, and three had end stage kidney disease. On the other hand, three evolved to an acute myeloid leukemia and three died. Compared to 84 MDS controls, patients who had kidney involvement were younger, had a higher number of dysplasia lineages, and were more eligible to receive hypomethylating agents, but no survival difference was seen between the two groups. Compared to 265 AAV without MDS, the ten with MDS-associated pauci-immune vasculitis were older, ANCA serology was more frequently negative, and more cutaneous lesions were seen.</p><p><strong>Conclusion: </strong>The spectrum of kidney injuries associated with MDS is mostly represented by vasculitis with glomerular involvement, and especially AAV.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11292217/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141888677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospective study of the effect of rituximab on kidney function in membranous nephropathy.","authors":"Durga A K Kanigicherla, Angie A Kehagia, Babak Jamshidi, Lina Manounah, Anna Barnes, Hannah Patrick, Helen Powell, Catrin Austin, Stephen Norton, Lisa Willcocks, Megan Griffith, Fiona Braddon, Retha Steenkamp, William S McKane, Arif Khwaja","doi":"10.1093/ckj/sfae179","DOIUrl":"10.1093/ckj/sfae179","url":null,"abstract":"<p><strong>Background: </strong>Patients with membranous nephropathy (MN) and poor kidney function or active disease despite previous immunosuppression are underrepresented in clinical trials. It is unknown how effective rituximab is in this population.</p><p><strong>Methods: </strong>This prospective, multi-centre, single-arm, real-world study of patients with active MN [urine protein-creatinine ratio (uPCR) >350 mg/mmol and serum albumin <30 g/L, or a fall in estimated glomerular filtration rate (eGFR) of at least 20% or more over at least 3 months] evaluated rituximab in those with contraindications to calcineurin inhibitors and cytotoxic therapy. The primary outcome was change in rate of eGFR decline before and after rituximab. Complete or partial remission were defined as uPCR <30 mg/mmol or uPCR <350 mg/mmol with a ≥50% fall from baseline, respectively.</p><p><strong>Results: </strong>A total of 180 patients [median age 59 years, interquartile range (IQR) 48-68] received rituximab and were followed up for a median duration of 17 months. Seventy-seven percent had prior immunosuppression. Median eGFR and uPCR at baseline were 49.2 mL/min/1.73 m² (IQR 34.4-80.6) and 766 mg/mmol (IQR 487-1057), respectively. The annual rate of decline of eGFR fell from 13.9 to 1.7 mL/min/1.73 m²/year following rituximab (Z score = 2.48, <i>P </i>< .0066). At 18 months 12% and 42% of patients were in complete or partial remission, respectively. Rituximab was well tolerated; patient survival was 95.6% at 2 years and in patients in whom eGFR was available, kidney survival was 93% at 2 years.</p><p><strong>Conclusion: </strong>Rituximab significantly reduced the rate of eGFR decline in active MN including those who had received prior immunosuppression or with poor baseline kidney function.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11299108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141893046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dapagliflozin treatment in patients with chronic kidney disease associated with autosomal dominant polycystic kidney disease.","authors":"Masatoshi Yoshimoto, Akinari Sekine, Tatsuya Suwabe, Yuki Oba, Hiroki Mizuno, Masayuki Yamanouchi, Yoshifumi Ubara, Junichi Hoshino, Noriko Inoue, Kiho Tanaka, Eiko Hasegawa, Naoki Sawa, Takehiko Wada","doi":"10.1093/ckj/sfae186","DOIUrl":"10.1093/ckj/sfae186","url":null,"abstract":"<p><strong>Introduction: </strong>The DAPA-CKD study showed a protective effect of dapagliflozin on kidney function in chronic kidney disease (CKD) patients with and without diabetes mellitus. Although dapagliflozin is expected to be effective also in CKD patients with autosomal dominant polycystic kidney disease (ADPKD), its efficacy and safety in this population remain unknown because ADPKD was an exclusion criterion in the DAPA-CKD study. Therefore, we evaluated the effects of dapagliflozin in CKD patients with ADPKD.</p><p><strong>Methods: </strong>We performed a retrospective observational study of seven patients with ADPKD treated with dapagliflozin at Toranomon Hospital, Tokyo, Japan. We analyzed changes in estimated glomerular filtration rate (eGFR) slope and annual height-corrected total kidney volume before and after starting dapagliflozin treatment.</p><p><strong>Results: </strong>The median observation period after starting dapagliflozin was 20 months. Four patients received concomitant tolvaptan. The eGFR slope before and after initiation of dapagliflozin could be calculated in six patients and improved in all of them except the one who did not receive a renin-angiotensin system (RAS) inhibitor. Annual height-corrected total kidney volume increased in all patients. Concurrent tolvaptan treatment had no effect.</p><p><strong>Conclusion: </strong>In CKD patients with ADPKD, dapagliflozin may increase kidney volume but may have a protective effect on kidney function when used concomitantly with RAS inhibitors.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11292219/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141888607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disturbance in the potential cardiovascular-bone-skeletal muscle axis and morbidity and mortality in patients undergoing haemodialysis: the Q-Cohort Study.","authors":"Hokuto Arase, Shunsuke Yamada, Masatomo Taniguchi, Hiroaki Ooboshi, Kazuhiko Tsuruya, Takanari Kitazono, Toshiaki Nakano","doi":"10.1093/ckj/sfae154","DOIUrl":"10.1093/ckj/sfae154","url":null,"abstract":"<p><strong>Background: </strong>Disturbances in the cardiovascular system, bone and skeletal muscle are independent risk factors for death among patients receiving haemodialysis (HD). However, the combined impact of disorders of these three organs on morbidity and mortality is unclear in the HD population.</p><p><strong>Methods: </strong>A total of 3031 Japanese patients on maintenance HD were prospectively followed. The outcomes were all-cause mortality, major adverse cardiovascular events (MACE) and bone fracture. Patients were divided into four groups (G1-G4) according to the baseline number of diseased organs represented as histories of cardiovascular disease and bone fractures and the presence of low skeletal muscle mass as follows: G1, no organ; G2, one organ; G3, two organs; G4, three organs. Multivariable-adjusted survival models were used to analyse associations between the number of diseased organs and outcomes.</p><p><strong>Results: </strong>During a 4-year follow-up, 499 deaths, 540 MACE and 140 bone fractures occurred. In the Cox proportional hazards model, the risk for all-cause mortality was significantly higher in G2, G3 and G4 than in G1 as the reference {hazard ratio: G2, 2.16 [95% confidence interval (CI) 1.65-2.84], G3, 3.10 [95% CI 2.27-4.23] and G4, 3.11 [95% CI 1.89-5.14]}. Similarly, the risks for developing MACE and bone fractures were significantly elevated as the number of organ disorders increased.</p><p><strong>Conclusions: </strong>Multiple disorders of the cardiovascular-bone-skeletal muscle axis are strong predictors of morbidity and mortality in patients undergoing HD.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11196899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141449903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Compound heterozygous variants of ANKFY1 in a child with infantile-onset proteinuria and movement disorder.","authors":"Luyan Zhang, Xueqin Cheng, Chunli Wang, Wei Zhou, Bixia Zheng, Aihua Zhang","doi":"10.1093/ckj/sfae124","DOIUrl":"10.1093/ckj/sfae124","url":null,"abstract":"<p><p>The ANKFY1 gene encodes a protein that belongs to double zinc finger proteins involved in endocytosis. Only one family with steroid-resistant nephrotic syndrome has been reported carrying a homozygous variant in ANKFY1 so far. Here we describe the second case where a 13-year-old boy presented with infantile-onset proteinuria and movement disorder. Whole-exome sequencing showed compound heterozygous variants (NM_001330063.2: c.2753C>G; p.Ser918Ter, and c.3287-11_3287-10del) in ANKFY1. <i>In vitro</i> functional study revealed the two variants led to reduced protein expression level of ANKFY1. This is the first case of co-existence of renal and nervous system phenotypes in a child with variants in ANKFY1, suggesting that bi-allelic variants in ANKFY1 might be associated with a new neuro-renal syndrome.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11194482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141445755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Urgent Call for Environmental Accountability in Nephrology Clinical Trials","authors":"A. Peired, Ivo Laranjinha, Gulay Demirtas, Ana Carina Ferreira, Sonja Gracin, Susi Knoeller, M. Hourmant","doi":"10.1093/ckj/sfae181","DOIUrl":"https://doi.org/10.1093/ckj/sfae181","url":null,"abstract":"","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141335068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diuretic prescriptions in the first year of hemodialysis: International practice patterns and associations with outcomes","authors":"N. Tabibzadeh, Dongyu Wang, A. Karaboyas, Elke Schaeffner, Stefan H. Jacobson, Almudena Vega, Kosaku Nitta, B. Bieber, R. Pecoits-Filho, Pablo Antonio Ureña Torres","doi":"10.1093/ckj/sfae141","DOIUrl":"https://doi.org/10.1093/ckj/sfae141","url":null,"abstract":"\u0000 \u0000 \u0000 The use of diuretics in patients on hemodialysis (HD) is thought to maintain diuresis. However, this assumption and the optimal dose are based on little scientific evidence, and associations with clinical outcomes are unclear.\u0000 \u0000 \u0000 \u0000 We reported international variation in diuretic use and loop diuretic dose across 27 759 HD patients with dialysis vintage < 1 year in the Dialysis Outcomes and Practice Patterns Study (DOPPS) phases 2–5 (2002–2015), a prospective cohort study. Doses of torsemide (4:1) and bumetanide (80:1) were converted to oral furosemide-equivalent dose. Adjusted Cox, logistic, and linear regressions were used to investigate the association of diuretic use and dose with outcomes.\u0000 \u0000 \u0000 \u0000 Diuretic utilization varied widely by country at vintage < 3 months, ranging from > 80% in Germany and Sweden to < 35% in the US, at a median dose ranging from 400-500 mg/day in Germany and Sweden to <100 mg/day in Japan and the US. Neither diuretic use nor higher doses were associated with a lower risk of all-cause mortality, or a higher risk of hospitalization for fracture, or elevated PTH levels, but the prescription of higher doses (>200 mg/day) was associated with a higher risk of all-cause hospitalization.\u0000 \u0000 \u0000 \u0000 Substantial international differences exist in diuretic prescription, with usage and doses much higher in some European countries than the US. The prescription and higher doses of loop diuretics was not associated with improved outcomes.\u0000","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141341991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}