Clinical Kidney Journal最新文献

{"title":"Multiparametric MRI: can we assess renal function differently?","authors":"Corentin Tournebize, Maxime Schleef, Aurélie De Mul, Sophie Pacaud, Laurence Derain-Dubourg, Laurent Juillard, Olivier Rouvière, Sandrine Lemoine","doi":"10.1093/ckj/sfae365","DOIUrl":"10.1093/ckj/sfae365","url":null,"abstract":"<p><p>We are lacking tools to evaluate renal performance. In this review, we presented the current knowledge and potential future applications in nephrology of new magnetic resonance imaging (MRI) techniques, focusing on diffusion-weighted (DWI) MRI, blood oxygen level-dependent (BOLD) MRI, and magnetic resonance relaxometry (T1 and T2 mapping). These sequences are sensitive to early changes in biological processes such as perfusion, oxygenation, edema, or fibrosis without requiring contrast medium injection and avoids irradiation and nephrotoxicity. Combining these different sequences into the so-called \"multiparametric MRI\" enables noninvasive, repeated exploration of renal performance on each kidney separately. DWI MRI, which evaluates the movement of water molecules, is a promising tool for noninvasive assessment of interstitial fibrosis and the cortical restricted diffusion has a prognostic value for the deterioration of renal function in diabetic nephropathy. BOLD MRI is sensitive to changes in renal tissue oxygenation based on the paramagnetic properties of deoxyhemoglobin and is of particular interest in the setting of renal artery stenosis to assess tissue oxygenation in the post-stenotic kidney. This sequence can be used for predicting degradation of renal function in chronic kidney diseases (CKD) and might be useful in preclinical studies to assess nephroprotective and nephrotoxic effects of drugs in development. T1 and T2 relaxation times change with tissue water content and might help assessing renal fibrosis. A corticomedullary dedifferentiation in T1 has been observed in CKD and negatively correlates with glomerular filtration rate. Data on the significance of T2 values in renal imaging is more limited. Multiparametric MRI has the potential to provide a better understanding of renal physiology and pathophysiology, a better characterization of renal lesions, an earlier and more sensitive detection of renal disease, and an aid to personalized patient-centered therapeutic decision-making. Further data and clinical trials are needed to allow its routine application in clinical practice.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 1","pages":"sfae365"},"PeriodicalIF":3.9,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11852294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143499633","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":"Urinary RANTES and MCP-1 as noninvasive biomarkers for differential diagnosis and prediction of treatment response in acute interstitial nephritis.","authors":"Song In Baeg, Kyungho Lee, Junseok Jeon, Jung Eun Lee, Ghee Young Kwon, Wooseong Huh, Hye Ryoun Jang","doi":"10.1093/ckj/sfae354","DOIUrl":"10.1093/ckj/sfae354","url":null,"abstract":"<p><strong>Background: </strong>Although kidney biopsy is definitive for the diagnosis of acute interstitial nephritis (AIN) and acute tubular necrosis (ATN), its invasiveness limits its use. We aimed to identify urine biomarkers for differentiating AIN and ATN and to predict the response of patients with AIN to steroid treatment.</p><p><strong>Methods: </strong>In this prospective cohort study, biopsy-proven ATN (<i>n</i> = 34) and AIN (<i>n</i> = 55) were included. Urinary cytokine/chemokine [interleukin-9, monocyte chemoattractant protein-1 (MCP-1), regulated on activation, normal T cell expressed and secreted (RANTES), tumor necrosis factor-α, tumor growth factor-β and vascular endothelial growth factor] levels and the proportion of immune cells [expressing cluster of differentiation (CD)45, CD3, CD20] and proliferating tubular cells (expressing Ki-67) were analyzed by immunohistochemistry. Cytokine/chemokine levels and intrarenal immunohistochemistry data according to the response to steroid treatment in the AIN patients were also analyzed.</p><p><strong>Results: </strong>The urinary RANTES/creatinine ratio and the percentages of intrarenal CD45-, CD3-, CD20- and Ki-67-positive cells were significantly higher in the AIN group than in the ATN group (<i>P </i>< .05 for all). Among steroid-administered patients with AIN, renal function improved significantly in the steroid responder group. These patients had higher urinary MCP-1/creatinine and intrarenal CD45 and Ki-67 levels than those in the non-responder group.</p><p><strong>Conclusions: </strong>The potential of the urinary RANTES/creatinine ratio as a noninvasive biomarker for differentiating AIN from ATN is highlighted. Urinary MCP-1/creatinine levels and the proportion of total intrarenal leukocytes and proliferating tubular cells may serve as indicators for predicting the response of patients with AIN to steroid treatment.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 1","pages":"sfae354"},"PeriodicalIF":3.9,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11704796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945853","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":"Does <i>de novo</i> malignancy heighten the risk of rejection in kidney transplant recipients?","authors":"Erol Demir, Mevlut Tamer Dincer, Cebrail Karaca, Cansu Erel, Latif Karahan, Aslihan Pekmezci, Sinan Trabulus, Nurhan Seyahi, Aydin Turkmen","doi":"10.1093/ckj/sfae349","DOIUrl":"10.1093/ckj/sfae349","url":null,"abstract":"<p><strong>Background: </strong>Malignancies are the third leading cause of death among kidney transplant recipients. These patients face increased mortality and challenges such as allograft loss and rejection, which may arise from surgical complications, changes in immunosuppressive therapy or the use of chemotherapeutics. This study aims to examine the risk of allograft rejection and loss in kidney transplant recipients diagnosed with <i>de novo</i> malignancies.</p><p><strong>Methods: </strong>This retrospective case-control study included adult kidney transplant patients from 1986 to 2020 who developed <i>de novo</i> malignancies. Each patient with a malignancy was matched with a control without malignancy using the nearest neighbor matching method. The outcomes measured were biopsy-confirmed allograft rejection, death-censored allograft loss and overall mortality after the diagnosis of malignancy in the malignancy group and at any point in the control group.</p><p><strong>Results: </strong>Of 2750 records reviewed, 267 patients (9.7%) had biopsy-confirmed malignancies, with a median age of 60 years and 66.3% men. The median follow-up was 218 months. Kaplan-Meier analysis showed that the allograft rejection rates were lower in the malignancy group compared with the control group (26 vs 60, <i>P </i>< .001). Overall mortality was higher in the malignancy group, although this difference was not statistically significant (104 vs 73, <i>P </i>= .25). Death-censored allograft loss was similar between groups (22 vs 32, <i>P </i>= .49). Chemotherapy and older recipient age were associated with reduced allograft rejection risk, as indicated by multivariable regression analysis.</p><p><strong>Conclusions: </strong>In kidney transplant recipients with <i>de novo</i> malignancies, death with a functioning graft remains significant. However, allograft loss rates do not increase compared with those without malignancies, and rejection risk is reduced, especially in older and chemotherapy-treated patients. These findings suggest that managing immunosuppression reduction in this population may be appropriate, but further research is needed to determine optimal care strategies.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"17 12","pages":"sfae349"},"PeriodicalIF":3.9,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11646098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827476","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":"Sex-specific temporal trends in incidence and prevalence of chronic kidney disease: a Danish population-based cohort study.","authors":"Anne Høy Seemann Vestergaard, Simon Kok Jensen, Uffe Heide-Jørgensen, Søren Andreas Ladefoged, Henrik Birn, Christian Fynbo Christiansen","doi":"10.1093/ckj/sfae351","DOIUrl":"10.1093/ckj/sfae351","url":null,"abstract":"<p><strong>Background: </strong>Rates of chronic kidney disease (CKD) may change with ageing populations, rising metabolic and cardiovascular disease prevalence, increasing CKD awareness and new treatments. We examined sex-specific temporal trends in CKD incidence and prevalence from 2011 through 2021.</p><p><strong>Methods: </strong>We conducted a population-based cohort study among adults residing in the North and Central Denmark Regions (population ∼1.5 million in 2021), utilizing routinely collected individual-level laboratory data. We identified individuals with incident or prevalent CKD, using data on plasma creatinine and urine albumin-creatinine ratios from samples performed in outpatient hospital settings or primary care. We estimated annual sex-specific crude and age-standardized incidence and prevalence and tabulated clinical characteristics.</p><p><strong>Results: </strong>Throughout 2011-2021, CKD incidence and prevalence remained higher among females than males. A transient increase in the crude incidence was observed during 2011-2013, followed by a decrease from 11.8 per 1000 person-years in 2013 [95% confidence interval (CI) 11.5-12.1] to 10.7 in 2021 (95% CI 10.5-11.0) among females and from 10.9 (95% CI 10.7-11.2) to 10.6 (95% CI 10.3-10.8) among males. During 2011-2021, the crude prevalence increased among females from 85.1 per 1000 individuals (95% CI 84.4-85.8) to 99.9 (95% CI 99.2-100.6), and among males from 55.3 (95% CI 54.7-55.9) to 82.4 (95% CI 81.8-83.0). After age standardization, declines in incidence persisted, while the prevalence was stable among females, and the increase persisted among males.</p><p><strong>Conclusions: </strong>The CKD incidence and prevalence remained higher among females than males during 2011-2021. Despite a notable decline in incidence rates from 2013 onwards, the crude prevalence increased during 2011-2021.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 1","pages":"sfae351"},"PeriodicalIF":3.9,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11707384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945847","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":"Associations between plasma osteopontin, sex, and 2-year global and cardiorenal outcomes in older outpatients screened for CKD: a secondary analysis of the SCOPE study.","authors":"Luca Soraci, Johan Ärnlöv, Axel C Carlsson, Tobias Rudholm Feldreich, Anders Larsson, Regina Roller-Wirnsberger, Gerhard Wirnsberger, Francesco Mattace-Raso, Lisanne Tap, Francesc Formiga, Rafael Moreno-González, Bartlomiej Soltysik, Joanna Kostka, Rada Artzi-Medvedik, Itshak Melzer, Christian Weingart, Cornel Sieber, Serena Marcozzi, Lucia Muglia, Fabrizia Lattanzio","doi":"10.1093/ckj/sfae336","DOIUrl":"10.1093/ckj/sfae336","url":null,"abstract":"<p><strong>Background: </strong>Plasma osteopontin (pOPN) is a promising aging-related biomarker among individuals with and without kidney disease. The interaction between sex, pOPN levels, and global and cardiorenal outcomes among older individuals was not previously evaluated.</p><p><strong>Methods: </strong>In this study we investigated the association of pOPN with 24-month global mortality, major cardiovascular events (MACEs), MACEs + cardiovascular (CV) mortality, and renal decline among older individuals; we also evaluated whether sex modified observed associations. pOPN levels were measured in a cohort of 2013 outpatients (908 men and 1105 women) aged 75 years or more enrolled in the context of a multicenter prospective cohort study in Europe. Multivariable linear regression, Cox and Fine Gray models, and linear mixed regression models were fitted to evaluate whether sex modified the associations between biomarkers and study outcomes.</p><p><strong>Results: </strong>In total, 2013 older participants with a median age of 79 years, 54.9% of whom women, were included in the study; increased pOPN levels were associated with all-cause mortality specifically among women [reduced fully adjusted model resulting from backward selection, hazard ratio, 95% confidence interval (CI): 1.84, 1.20-2.89]. Addition of pOPN to models containing age, eGFR, and albumin-to-creatinine ratio (ACR) improved the time-dependent area under the curve (AUC) at 6, 12, and 24 months, among women only. No significant association was found between the biomarker levels, MACE, and MACE + CV mortality. Conversely, increased baseline pOPN was associated with eGFR decline in all patients (-0.45, 95%CI: -0.68 to -0.22 ml/min/1.73 m² year) but with slightly steeper declines in women compared to men (-0.57, -0.99 to -0.15 vs -0.47, -0.88 to -0.07).</p><p><strong>Conclusions: </strong>pOPN levels were significantly lower in women than in men but associated with all-cause mortality in women only; increase in serum pOPN was associated with eGFR decline over time in all patients, but with stronger associations among women. Assessment of pOPN may help identifying older female participants at risk of poor outcomes.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"17 12","pages":"sfae336"},"PeriodicalIF":3.9,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11631127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812279","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":"Liver manifestations in autosomal dominant polycystic kidney disease (ADPKD) and their impact on quality of life.","authors":"Sita Arjune, Polina Todorova, Malte P Bartram, Franziska Grundmann, Roman-Ulrich Müller","doi":"10.1093/ckj/sfae363","DOIUrl":"10.1093/ckj/sfae363","url":null,"abstract":"<p><strong>Background: </strong>ADPKD is the most prevalent monogenic kidney disease with an estimated incidence of 1:1000. The condition is characterized by the formation of kidney cysts, which can cause kidney function loss and bear a significant risk of advancing to kidney failure. This study examined the prevalence of hepatic cysts in individuals with ADPKD, and the possible influence of these cysts on liver function and quality of life. Furthermore, the relationship between hepatic cysts and genotype was analysed.</p><p><strong>Methods: </strong>Clinical data from 880 patients with ADPKD were analysed, including longitudinal patient data, genetic information, and laboratory parameters.</p><p><strong>Results: </strong>The prevalence of hepatic cysts in adult ADPKD patients was 81.71%, consistent with previous studies. Prevalence increased with age, particularly in male patients. No clear association was observed between ADPKD genotype and the presence of liver cysts. Among male patients with liver cysts, glutamate pyruvate transaminase (GPT) levels significantly decreased with age, while female patients showed a significant increase in gamma-glutamyl transferase (γ-GT) levels. Overall, hepatic cysts had minimal impact on liver enzymes. Quality of life assessments using the SF-12 questionnaire revealed no significant influence of hepatic cysts on physical or mental well-being. However, physical quality of life was significantly lower in patients showing polycystic liver disease as a manifestation of ADPKD compared to all other patients, both with and without liver cysts.</p><p><strong>Conclusions: </strong>Hepatic cysts are highly prevalent in adult patients with ADPKD, increasing with age. ADPKD genotype does not appear to be associated with the presence of hepatic cysts. Liver function, as indicated by enzyme levels, is minimally affected by hepatic cysts in most ADPKD patients. The quality of life of ADPKD patients is generally unaffected by the presence of hepatic cysts, except in severe cases of polycystic liver disease (PLD). Further research is needed to develop effective treatments for severe PLD and gain a better understanding of the factors influencing hepatic cyst incidence and progression in patients with ADPKD.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 1","pages":"sfae363"},"PeriodicalIF":3.9,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11852259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143499571","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":"Rituximab as a first-line therapy in children with new-onset idiopathic nephrotic syndrome.","authors":"Xiaojing Zhang, Yanyan Jin, Fei Liu, Qiuyu Li, Yi Xie, Guoping Huang, Junyi Chen, Xue He, Siyi He, Haidong Fu, Jingjing Wang, Huijun Shen, Jianhua Mao","doi":"10.1093/ckj/sfae348","DOIUrl":"10.1093/ckj/sfae348","url":null,"abstract":"<p><strong>Background: </strong>Idiopathic nephrotic syndrome (INS) in children, commonly treated with steroids, poses challenges due to associated side effects. Rituximab, known for its efficacy in reducing relapse frequency in difficult-to-treat cases, emerges a potential first-line therapy for pediatric new-onset INS.</p><p><strong>Method: </strong>This is a single-center, retrospective, observational study to evaluate the efficacy and safety of rituximab as a first-line therapy for pediatric INS. The complete treatment strategy was weekly injections at a dose of 375 mg/m² for four doses. Children with new-onset INS who received rituximab as a first-line monotherapy from 1 January 2022 to 31 December 2023 were included and followed until 31 May 2024.</p><p><strong>Results: </strong>Seventeen patients (median age at diagnosis 4.8 years) were included. Twelve patients achieved complete remission within a median time of 19 days. Over a follow-up period ranging from 41 to 112 weeks, 11 patients maintained remission even after B-cell reconstitution, with one patient experiencing a relapse at 85 weeks. Three patients, who presented with hematuria, hypocomplementemia or renal injury at initial diagnosis, exhibited resistance to rituximab. No severe adverse events were noted.</p><p><strong>Conclusion: </strong>Rituximab may be an effective and safe option as a first-line therapy for inducing and maintaining remission in newly diagnosed INS.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 1","pages":"sfae348"},"PeriodicalIF":3.9,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11730066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142982814","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":"Predictive value of residual active histologic lesions on renal flare in lupus nephritis patients with clinical remission.","authors":"Jinhua Hou, Dandan Liang, Songxia Quan, Zhangsuo Liu, Zhihong Liu","doi":"10.1093/ckj/sfae350","DOIUrl":"10.1093/ckj/sfae350","url":null,"abstract":"<p><strong>Background: </strong>Renal flare in lupus nephritis (LN) is a crucial contributing factor to poor kidney outcomes. This study aimed at evaluating the predictive value of residual active histologic lesions on renal flare in proliferative LN patients with clinical remission.</p><p><strong>Methods: </strong>We retrospectively enrolled LN patients with class III/IV ± V (biopsy 1) who had undergone a protocol repeat biopsy (biopsy 2) at 7.3 (IQR: 6.5, 8.4) months after induction therapy with clinical remission and experienced renal flare within 3 years or had been followed up for at least 3 years without renal flare after biopsy 2 with maintenance therapy from two kidney units in China.</p><p><strong>Results: </strong>A total of 114 eligible patients were included, 28 (24.6%) of whom developed a renal flare. Activity index (AI) at biopsy 2 was significantly associated with LN flare (<i>P </i>< .0001). If AI > 1, the OR for LN flare was 23.1 (95%CI, 5.1-103.8, <i>P </i>< .001). For patients with partial clinical remission compared with those with complete clinical remission, the OR for LN flare was 3.0 (95%CI: 1.1-8.3, <i>P </i>= .029). Multivariate analysis showed that anti-dsDNA positivity, presence of cellular/fibrocellular crescent, and endocapillary hypercellularity at biopsy 2 were independent risk factors for LN flare. When residual active histologic lesions were added to clinical variables, the area under the curve of the prediction model for LN flare significantly increased and the misclassification rate significantly decreased.</p><p><strong>Conclusions: </strong>Renal flare in LN patients with clinical remission is strongly associated with the residual active histologic lesions.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"17 12","pages":"sfae350"},"PeriodicalIF":3.9,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11650015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846053","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":"Preimplantation genetic testing for monogenic disorders (PGT-M) for monogenic nephropathy: a single-center retrospective cohort analysis.","authors":"Xinyu Liu, Qian Zhang, Kexin Cao, Jie Li, Yuan Gao, Peiwen Xu, Yuping Niu, Wei Zhou, Tianxiang Ni, Shuzhen Sun, Junhao Yan","doi":"10.1093/ckj/sfae356","DOIUrl":"10.1093/ckj/sfae356","url":null,"abstract":"<p><strong>Background: </strong>Hereditary nephropathy is an important cause of renal insufficiency and end-stage renal disease. Therefore, for couples with monogenic nephropathy, preventing transmission of the disease to offspring is urgent. Preimplantation genetic testing for monogenic disorders (PGT-M) is a means to prevent intergenerational inheritance by screening and transplanting normal embryos. We provide a clinical overview of patients with monogenic nephropathy who underwent PGT-M.</p><p><strong>Methods: </strong>The single-center retrospective cohort study was conducted at the Center for Reproductive Medicine, Shandong University from January 2014 to December 2022. A total of 352 couples with nephropathy-related disease were included in the cohort totally.</p><p><strong>Results: </strong>Of the 352 couples with nephropathy-related disease, 180 accepted genetic screening. A total of 104 couples with monogenic nephropathy indications underwent PGT-M, including 90 of autosomal dominant inheritance, 10 of autosomal recessive inheritance, 4 of X-linked inheritance. 498 blastocysts were biopsied prior to testing, and 394 embryos underwent genetic testing, of which 76 were transferable, 247 were non-transferable and 71 were recommended for genetic counseling. Finally, 80 vitrified-thawed single blastocyst transfer cycles were performed in the cohort. Live births occurred in 38 women, of which 37 transferred embryos with non-pathogenic genotypes. The invasive prenatal diagnosis results of 18 women with live birth were obtained through follow-up, consistent with the PGT-M results of transferred embryos.</p><p><strong>Conclusions: </strong>PGT-M is an effective means of preventing intergenerational inheritance of monogenic nephropathy. The absence of genetic abnormalities detected by prenatal diagnosis in healthy newborns without monogenic nephropathy also underscore its validity.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 1","pages":"sfae356"},"PeriodicalIF":3.9,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11719030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969908","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":"Quantifying the potential contribution of drugs to the occurrence of acute kidney injury in patients with chronic kidney disease.","authors":"Solène M Laville, Janice Vendar, Ziad A Massy, Valérie Gras-Champel, Julien Moragny, Luc Frimat, Maurice Laville, Christian Jacquelinet, Roberto Pecoits-Filho, Natalia Alencar De Pinho, Aghilès Hamroun, Sophie Liabeuf","doi":"10.1093/ckj/sfae357","DOIUrl":"10.1093/ckj/sfae357","url":null,"abstract":"<p><strong>Background: </strong>We sought to comprehensively describe drug-related components associated with acute kidney injury (AKI) in patients with chronic kidney disease (CKD), describing the incidence of drug-related AKI, the proportion of preventable AKI, identified the various drugs potentially associated with it, explored the risk factors, and assessed the 1-year incidences of the recurrence of drug-related AKI, kidney failure, and death.</p><p><strong>Methods: </strong>CKD-REIN is a French national prospective cohort of 3033 nephrology outpatients with a confirmed diagnosis of CKD (eGFR <60 ml/min/1.73 m²). AKIs and adverse drug reactions (ADRs) were prospectively identified from hospital reports, medical records, and patient interviews. Expert nephrologists used the KDIGO criteria to adjudicate all stages of AKI, and expert pharmacologists used validated tools to adjudicate ADRs (including drug-related AKIs).</p><p><strong>Results: </strong>Over a median [interquartile range] period of 4.9 [3.4-5.1] years, 832 cases of AKI were reported in 639 (21%) of the 3033 study participants. The drug-related component associated with AKI accounted for 236 cases, and 28% were judged to be preventable or potentially preventable. The three most frequently implicated drug classes were diuretics, renin-angiotensin system inhibitors, and contrast agents. A history of cardiovascular events, diabetes, lower levels of hemoglobin and eGFR, poor medication adherence, and ≥5 drugs taken daily were associated with a greater risk of drug-related AKI. Full recovery was not attained in 64 (27%) of the 236 cases of drug-related AKI. The 1-year cumulative incidences of recurrence of drug-related AKI, kidney replacement therapy, and death were 7%, 15%, and 11%, respectively, after the first drug-related AKI.</p><p><strong>Conclusions: </strong>Drug-related AKI is prevalent among patients with CKD. Even though a substantial proportion of these events were classified as stage 1, our findings point to a poor prognosis.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 1","pages":"sfae357"},"PeriodicalIF":3.9,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11707387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945845","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}