Current Opinion in Nephrology and Hypertension最新文献_第9页

Novel indications for referral and care for simultaneous liver kidney transplant recipients. 肝肾同时移植受者转诊和护理的新适应症。

IF 3.2 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2024-05-01 Epub Date: 2024-02-12 DOI: 10.1097/MNH.0000000000000970

Erik L Lum, Suphamai Bunnapradist, Alexander C Wiseman, Ahmet Gurakar, Antoney Ferrey, Uttam Reddy, Fawaz Al Ammary

{"title":"Novel indications for referral and care for simultaneous liver kidney transplant recipients.","authors":"Erik L Lum, Suphamai Bunnapradist, Alexander C Wiseman, Ahmet Gurakar, Antoney Ferrey, Uttam Reddy, Fawaz Al Ammary","doi":"10.1097/MNH.0000000000000970","DOIUrl":"10.1097/MNH.0000000000000970","url":null,"abstract":"Purpose of review: Kidney dysfunction is challenging in liver transplant candidates to determine whether it is reversible or not. This review focuses on the pertinent data on how to best approach liver transplant candidates with kidney dysfunction in the current era after implementing the simultaneous liver kidney (SLK) allocation policy and safety net.Recent findings: The implementation of the SLK policy inverted the steady rise in SLK transplants and improved the utilization of high-quality kidneys. Access to kidney transplantation following liver transplant alone (LTA) increased with favorable outcomes. Estimating GFR in liver transplant candidates remains challenging, and innovative methods are needed. SLK provided superior patient and graft survival compared to LTA only for patients with advanced CKD and dialysis at least 3 months. SLK can provide immunological protection against kidney rejection in highly sensitized candidates. Post-SLK transplant care is complex, with an increased risk of complications and hospitalization.Summary: The SLK policy improved kidney access and utilization. Transplant centers are encouraged, under the safety net, to reserve SLK for liver transplant candidates with advanced CKD or dialysis at least 3 months while allowing lower thresholds for highly sensitized patients. Herein, we propose a practical approach to liver transplant candidates with kidney dysfunction.","PeriodicalId":10960,"journal":{"name":"Current Opinion in Nephrology and Hypertension","volume":" ","pages":"354-360"},"PeriodicalIF":3.2,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10990015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139722014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Deep learning applications for kidney histology analysis. 深度学习在肾脏组织学分析中的应用

IF 3.2 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2024-05-01 Epub Date: 2024-02-19 DOI: 10.1097/MNH.0000000000000973

Pourya Pilva, Roman Bülow, Peter Boor

{"title":"Deep learning applications for kidney histology analysis.","authors":"Pourya Pilva, Roman Bülow, Peter Boor","doi":"10.1097/MNH.0000000000000973","DOIUrl":"10.1097/MNH.0000000000000973","url":null,"abstract":"Purpose of review: Nephropathology is increasingly incorporating computational methods to enhance research and diagnostic accuracy. The widespread adoption of digital pathology, coupled with advancements in deep learning, will likely transform our pathology practices. Here, we discuss basic concepts of deep learning, recent applications in nephropathology, current challenges in implementation and future perspectives.Recent findings: Deep learning models have been developed and tested in various areas of nephropathology, for example, predicting kidney disease progression or diagnosing diseases based on imaging and clinical data. Despite their promising potential, challenges remain that hinder a wider adoption, for example, the lack of prospective evidence and testing in real-world scenarios.Summary: Deep learning offers great opportunities to improve quantitative and qualitative kidney histology analysis for research and clinical nephropathology diagnostics. Although exciting approaches already exist, the potential of deep learning in nephropathology is only at its beginning and we can expect much more to come.","PeriodicalId":10960,"journal":{"name":"Current Opinion in Nephrology and Hypertension","volume":" ","pages":"291-297"},"PeriodicalIF":3.2,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139971314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

New therapies for immunoglobulin A nephropathy: what's the standard of care in 2023? 免疫球蛋白 A 肾病的新疗法：2023 年的治疗标准是什么？

IF 3.2 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2024-05-01 Epub Date: 2024-02-23 DOI: 10.1097/MNH.0000000000000979

Bryce Barr, Sean Barbour

{"title":"New therapies for immunoglobulin A nephropathy: what's the standard of care in 2023?","authors":"Bryce Barr, Sean Barbour","doi":"10.1097/MNH.0000000000000979","DOIUrl":"10.1097/MNH.0000000000000979","url":null,"abstract":"Purpose of review: As the most common primary glomerulonephritis, immunoglobulin A (IgA) nephropathy (IgAN) is an important cause of kidney failure and mortality. Until recently, therapeutic options were limited. Fortunately, there have been numerous recent clinical trials demonstrating efficacy of new therapies in slowing chronic kidney disease (CKD) progression at varying stages of disease.Recent findings: The TESTING trial has provided high-quality evidence for slowing estimated glomerular filtration rate (eGFR) decline with a reduced-dose glucocorticoid regimen, while demonstrating an improved safety profile. Targeted-release budesonide represents a well tolerated therapy for reducing eGFR decline. Mycophenolate mofetil may reduce CKD progression in some populations, while hydroxychloroquine is efficacious in reducing proteinuria. Sodium-glucose cotransporter (SGLT2) inhibitors and sparsentan are effective therapies for CKD due to IgAN, but should not be used in lieu of disease-modifying immunosuppressive therapy. Many new therapies are approaching readiness for clinical use.Summary: Numerous therapeutic options now exist and include disease-modifying and nephroprotective drugs. Identifying the right treatment for the right patient is now the clinical challenge and, with new drugs on the horizon, represents the primary unmet research need in this rapidly-developing field.","PeriodicalId":10960,"journal":{"name":"Current Opinion in Nephrology and Hypertension","volume":" ","pages":"311-317"},"PeriodicalIF":3.2,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139971318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A basic solution for a complex problem: does treatment of metabolic acidosis slow CKD progression? 复杂问题的基本解决方案：治疗代谢性酸中毒能减缓慢性肾脏病的进展吗？

IF 3.2 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2024-05-01 Epub Date: 2024-02-29 DOI: 10.1097/MNH.0000000000000978

Kevin Bodker, Natalie Freidin, Nayan Arora

{"title":"A basic solution for a complex problem: does treatment of metabolic acidosis slow CKD progression?","authors":"Kevin Bodker, Natalie Freidin, Nayan Arora","doi":"10.1097/MNH.0000000000000978","DOIUrl":"10.1097/MNH.0000000000000978","url":null,"abstract":"Purpose of this review: Metabolic acidosis is frequently encountered in patients with chronic kidney disease (CKD), with increasing prevalence as kidney function worsens. Treating electrolyte disturbances is the sine qua non of Nephrologists, and alkali therapy to normalize serum bicarbonate levels and slow progression of kidney disease has been embedded in clinical practice guidelines for decades on the basis of animal models and controversial clinical trials. This review will critically appraise the literature base for this recommendation and determine whether the available evidence supports this common practice, which is a timely endeavor considering the impending demotion of metabolic acidosis treatment from recommendation to practice point in forthcoming KDIGO guidelines.Recent findings: Earlier, open-label, studies supporting the utility of sodium bicarbonate therapy to slow progression of chronic kidney disease have been challenged by more recent, blinded, studies failing to show benefit on CKD progression. This was further demonstrated in the absence of concomitant sodium administration with the hydrochloric acid binder veverimer, which failed to demonstrate benefit on renal death, end stage kidney disease or 40% reduction in estimated glomerular filtration rate in a large multicenter trial.Summary: The current body of literature does not support the routine treatment of metabolic acidosis in patients with CKD and the authors agree with the forthcoming KDIGO guidelines to de-emphasize this common practice.","PeriodicalId":10960,"journal":{"name":"Current Opinion in Nephrology and Hypertension","volume":" ","pages":"304-310"},"PeriodicalIF":3.2,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139989579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Prediction models for earlier stages of chronic kidney disease. 慢性肾脏病早期阶段的预测模型。

IF 3.2 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2024-05-01 Epub Date: 2024-02-29 DOI: 10.1097/MNH.0000000000000981

Mackenzie Alexiuk, Navdeep Tangri

{"title":"Prediction models for earlier stages of chronic kidney disease.","authors":"Mackenzie Alexiuk, Navdeep Tangri","doi":"10.1097/MNH.0000000000000981","DOIUrl":"10.1097/MNH.0000000000000981","url":null,"abstract":"Purpose of review: Identifying patients with risk of developing progressive chronic kidney disease (CKD) early is an important step in improving kidney care. This review discusses four recently developed models, two which predict risk of new onset disease, and two which predict progression earlier in the course of disease.Recent findings: Several models predicting CKD incidence and progression have been recently developed and externally validated. A connecting theme across these models is the use of data beyond estimated glomerular filtration rate, allowing for greater accuracy and personalization. Two models were developed with stratification by diabetes status, displaying excellent model fit with and without variables like use of diabetes medication and hemoglobin A1C. Another model was designed to be patient facing, not requiring the knowledge of any laboratory values for use. The final model was developed using lab data and machine learning. These models demonstrated high levels of discrimination and calibration in external validation, suggesting suitability for clinical use.Summary: Models that predict risk of CKD onset and progression have the potential to significantly reduce disease burden, financial cost, and environmental output from CKD through upstream disease prevention and slowed progression. These models should be implemented and evaluated prospectively in primary care settings.","PeriodicalId":10960,"journal":{"name":"Current Opinion in Nephrology and Hypertension","volume":" ","pages":"325-330"},"PeriodicalIF":3.2,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139989580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Lysine and salt-sensitive hypertension. 赖氨酸与盐敏感性高血压

IF 3.2 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2024-04-22 DOI: 10.1097/mnh.0000000000000994

Lashodya V Dissanayake, Oleg Palygin, Alexander Staruschenko

引用次数: 0

A molecular journey on the pathogenesis of primary hyperoxaluria. 原发性高草酸尿症发病机制的分子之旅。

IF 3.2 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2024-04-12 DOI: 10.1097/mnh.0000000000000987

Barbara Cellini

引用次数: 0

The role of hypoxia in chronic kidney disease: a nuanced perspective. 缺氧在慢性肾脏病中的作用：一个细致入微的视角。

IF 3.2 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2024-04-11 DOI: 10.1097/mnh.0000000000000989

Anna Faivre, Sophie de Seigneux

引用次数: 0

Thiazides for kidney stone recurrence prevention. 噻嗪类药物用于预防肾结石复发。

IF 3.2 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2024-04-11 DOI: 10.1097/mnh.0000000000000990

Matteo Bargagli, Sven Trelle, Olivier Bonny, Daniel G Fuster

引用次数: 0

New tools to study renal fibrogenesis. 研究肾脏纤维形成的新工具。

IF 3.2 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2024-04-08 DOI: 10.1097/mnh.0000000000000988

Xian Liao, Emilia Scheidereit, Christoph Kuppe

引用次数: 0