Journal of The American Society of Nephrology最新文献

{"title":"ASN Kidney Health Guidance on Potassium and Phosphorus Food Additives.","authors":"Annabel Biruete,Cheryl Anderson,Amélie Bernier-Jean,Catherine M Clase,Deborah Clegg,Deidra C Crews,Michelle Denburg,Kathleen M Hill Gallant,Orlando M Gutierrez,Joachim H Ix,Melody Kienholz,Kelly Lambert,Soo-Yeun Lee,Scott E Liebman,Christina L Nelms,Biff F Palmer,Farzana Perwad,Kelly Picard,David E St-Jules,Andrew S Terker,Jaime Uribarri,Csaba P Kovesdy, ","doi":"10.1681/asn.0000000873","DOIUrl":"https://doi.org/10.1681/asn.0000000873","url":null,"abstract":"","PeriodicalId":17217,"journal":{"name":"Journal of The American Society of Nephrology","volume":"68 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145083577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing eGFRcr-cys Accuracy in Extreme Body Mass Index Groups: Addressing Body Composition and Methodological Heterogeneity.","authors":"Xiling Li,Fan Zhang,Heng Yang","doi":"10.1681/asn.0000000833","DOIUrl":"https://doi.org/10.1681/asn.0000000833","url":null,"abstract":"","PeriodicalId":17217,"journal":{"name":"Journal of The American Society of Nephrology","volume":"50 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High Phosphate and Low Protein Mediate Arterial and Cutaneous Vascular Calcification in CKD Mice.","authors":"Ying Jin,Fei Cao,Yangzhouyun Xie,Sean Davis,Grace Dong,Sagar U Nigwekar,James E Hansen,Raul J Guzman,Yujun Cai","doi":"10.1681/asn.0000000875","DOIUrl":"https://doi.org/10.1681/asn.0000000875","url":null,"abstract":"BACKGROUNDMedial artery calcification and cutaneous arteriolar calcification are prevalent in patients with chronic kidney disease (CKD) and are strongly associated with increased morbidity and mortality. Current experimental CKD models, however, often fail to fully replicate the patterns of medial artery calcification and cutaneous arteriolar calcification, limiting our ability to elucidate their underlying molecular pathways. Developing a reliable experimental model for CKD-associated calcification and using it to identify therapeutic targets is essential for advancing treatment strategies for these vascular complications. In this study, we used a novel strategy that incorporated a high phosphate and low protein diet to promote medial artery and cutaneous vascular calcification in CKD mice.METHODSMice underwent 5/6 nephrectomy and were then fed various diets. Vascular calcification was assessed using micro-CT scans, Alizarin Red staining, Von Kossa staining, and calcium assays. Kidney impairment and fibrosis were also evaluated. RNA sequencing (RNA-Seq) analysis was performed to identify key molecular pathways. The pharmacological inhibitor SB203580 was used to determine the significance of p38 MAPK signaling in vivo.RESULTSThe high phosphate and low protein (HPi-Lp) diet markedly induced both medial artery and cutaneous vascular calcification in 5/6 nephrectomy mice while exacerbating kidney dysfunction and fibrosis. The p38 MAPK signaling was specifically highly activated. Pharmacological inhibition of p38 MAPK signaling significantly reduced medial artery and cutaneous vascular calcification as well as associated kidney fibrosis.CONCLUSIONSThe 5/6 nephrectomy CKD mouse model combined with a high phosphate and low protein diet effectively replicated medial artery and cutaneous arteriolar calcification.","PeriodicalId":17217,"journal":{"name":"Journal of The American Society of Nephrology","volume":"35 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Authors' Reply: Enhancing eGFRcr-cys Accuracy in Extreme Body Mass Index Groups: Addressing Body Composition and Methodological Heterogeneity.","authors":"William A Russel,Andrew S Levey,Juan J Carrero","doi":"10.1681/asn.0000000834","DOIUrl":"https://doi.org/10.1681/asn.0000000834","url":null,"abstract":"","PeriodicalId":17217,"journal":{"name":"Journal of The American Society of Nephrology","volume":"35 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erythroid ACKR1 Deficiency Aggravates Immune-Mediated Kidney Disease.","authors":"Katharina Artinger,Igor Novitzky-Basso,Konstantin A Klötzer,Nathaly Anto-Michel,Corinna Schabhuettl,Julia Christine Gutjahr,Maryna Samus,Elin Hub,Alexander H Kirsch,Daniel Leitinger,Stefan Wernitznig,Theophilus Umeizudike,Marion Pollheimer,Maria H Ulvmar,Agnes A Mooslechner,Andrea Bacon,Philipp Eller,Thomas Kroneis,Dagmar Kratky,Alexander R Rosenkranz,Kathrin Eller,Antal Rot","doi":"10.1681/asn.0000000878","DOIUrl":"https://doi.org/10.1681/asn.0000000878","url":null,"abstract":"BACKGROUNDSingle nucleotide polymorphisms of the atypical chemokine receptor 1 (ACKR1) gene encode human Duffy Antigen blood groups. The majority of individuals of West African ancestry carry a single nucleotide polymorphism in the promoter region of the ACKR1 gene that disrupts its transcription in erythroid cells but not in venular endothelial cells, leading to an \"erythroid-silent\", FyBES Duffy phenotype.METHODSWe used two mouse models of erythroid-selective ACKR1 deficiency to delineate the fundamental role of this receptor in the erythroid compartment in regulating the development of experimental immune-mediated kidney disease.RESULTSHumanized transgenic Duffy erythroid-silent FyBESTG mice and chimeric WT mice transplanted with ACKR1-deficient bone marrow, both selectively lacking erythroid ACKR1, showed increased disease activity and fibrosis after induction of nephrotoxic serum nephritis, as compared to their respective controls. Mice lacking erythroid ACKR1 exhibited altered serum chemokine levels and bone marrow monocytes displaying activated and pro-migratory phenotypes. Moreover, they showed an increase in kidney infiltrating macrophages that were characterized by a profibrotic transcriptome signature. No changes in ACKR1 expression in kidney vascular endothelial cells were seen in erythroid ACKR1-deficient mice with or without nephrotoxic serum nephritis.CONCLUSIONSOur data suggest that erythroid-specific ACKR1 deficiency leads to an increased infiltration of the kidney by macrophages with an altered profibrotic phenotype in nephrotoxic serum nephritis, resulting in aggravated kidney disease.","PeriodicalId":17217,"journal":{"name":"Journal of The American Society of Nephrology","volume":"15 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy of Identification of Cardiovascular Events with ICD Diagnosis Codes versus Physician Adjudication in CKD and Kidney Failure.","authors":"Anna M Zemke,Leila R Zelnick,Ian H de Boer,Bryan Kestenbaum,Alan S Go,Nisha Bansal","doi":"10.1681/asn.0000000874","DOIUrl":"https://doi.org/10.1681/asn.0000000874","url":null,"abstract":"BACKGROUNDThe risk of cardiovascular disease is elevated in individuals with chronic kidney disease (CKD), and cardiovascular disease events are common and important end-points for research studies in CKD. Adjudication by a central committee is considered the most rigorous approach of ascertaining cardiovascular disease outcomes, however, it is resource intensive. There are limited data to determine the accuracy of International Classification of Diseases (ICD) code-ascertained outcomes compared to physician-adjudication for cardiovascular disease events in CKD and kidney failure.METHODSUsing data from the Chronic Renal Insufficiency Cohort, we evaluated hospitalization events in participants with CKD and kidney failure to determine accuracy of ICD-9 and 10 codes compared to physician-adjudication of the cardiovascular disease outcomes heart failure, myocardial infarction, stroke, and atrial fibrillation. For ICD codes, we determined the positive predictive value (PPV), negative predictive value (NPV), sensitivity and specificity for each cardiovascular disease outcome based on primary as well as secondary diagnosis codes. Association of known cardiovascular disease risk factors with incident cardiovascular disease outcomes were determined for ICD codes vs. physician-adjudication.RESULTSComparing primary ICD-9 or 10 discharge codes to physician-adjudication, for 3464 participants, we found PPVs of 79% for heart failure, 77% for myocardial infarction, 77% for ischemic stroke, and 85% for atrial fibrillation for individuals with CKD and kidney failure. NPVs ranged from 94% to 99%. Specificities were high at 99% to 100%. Sensitivities were much lower at 15% to 48%. The associations between cardiovascular disease risk factors and co-morbidities (including age, diabetes, eGFR) were similar for ICD code-identified and physician-adjudication identified events, with r-values ranging from 0.82 to 0.98.CONCLUSIONSPPV was near 80% for heart failure, myocardial infarction, stroke, and atrial fibrillation for primary ICD codes versus physician-adjudication, however sensitivity was lower. ICD code usage in medical research may allow greater efficiency with limited resources for outcome ascertainment.","PeriodicalId":17217,"journal":{"name":"Journal of The American Society of Nephrology","volume":"16 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tirzepatide and Kidney Protection in Obesity: Unanswered Questions.","authors":"Zhengyang Zhu,Kejun Ren","doi":"10.1681/asn.0000000837","DOIUrl":"https://doi.org/10.1681/asn.0000000837","url":null,"abstract":"","PeriodicalId":17217,"journal":{"name":"Journal of The American Society of Nephrology","volume":"18 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Authors' Reply: Tirzepatide and Kidney Protection in Obesity: Unanswered Questions.","authors":"Hiddo J L Heerspink,Petter Bjornstad,David Cherney,Daniel H van Raalte","doi":"10.1681/asn.0000000838","DOIUrl":"https://doi.org/10.1681/asn.0000000838","url":null,"abstract":"","PeriodicalId":17217,"journal":{"name":"Journal of The American Society of Nephrology","volume":"71 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial and Ethnic Disparities in Outcomes following Preemptive Kidney Transplant Waitlisting in the United States from 2009-2024.","authors":"Simeon Adeyemo,Deidra C Crews,Krista L Lentine,Yaara Zisman-Ilani,Karen Lincoln,Glenda M Flores,Suphamai Bunnapradist,Antoney J Ferrey,Uttam G Reddy,Abimereki D Muzaale,Andrew D Rule,Milda Saunders,Amit X Garg,Thu H Le,Connie M Rhee,Kamyar Kalantar-Zadeh,Fawaz Al Ammary","doi":"10.1681/asn.0000000876","DOIUrl":"https://doi.org/10.1681/asn.0000000876","url":null,"abstract":"BACKGROUNDPreemptive kidney transplantation (prior to dialysis initiation) is the optimal therapy for most transplant-eligible advanced CKD patients. While prior research has documented racial and ethnic disparities in preemptive referrals, less is known about distinct outcomes following preemptive waitlisting. This study examines the association between race and ethnicity and outcomes for preemptively waitlisted patients.METHODSWe conducted a secondary analysis of a prospectively maintained U.S. cohort using data from the Scientific Registry of Transplant Recipients (SRTR). The study population included 98,863 adult first-time kidney transplant candidates who were preemptively waitlisted from January 1, 2009, to December 31, 2020, and followed through December 31, 2024. The exposure of interest was race and ethnicity. The primary outcome was three-year preemptive deceased donor kidney transplantation, living donor kidney transplantation, or dialysis initiation. We used competing risk models to estimate adjusted subdistribution hazard ratios (aSHRs). Data were stratified into three-year intervals (2009-2011, 2012-2014, 2015-2017, and 2018-2020).RESULTSBlack and Hispanic patients received preemptive deceased donor kidney transplants as often as White patients (era 2018-2020, aSHRs [95% CI]: 0.99 [0.92-1.07] and 1.02 [0.93-1.12], respectively), while Asian patients had lower rates (0.78 [0.69-0.88]). However, Asian, Black, and Hispanic patients were more likely to initiate dialysis (aSHRs: 1.50 [1.39-1.61]; 1.41 [1.34-1.49]; and 1.21 [1.14-1.29], respectively) and were less likely to receive preemptive living donor kidney transplants than White patients (era 2018-2020, aSHRs: 0.49 [0.44-0.54]; 0.31 [0.29-0.34]; and 0.61 [0.56-0.66], respectively).CONCLUSIONSAmong waitlisted CKD patients in the U.S between 2009 and 2020, rates of preemptive deceased donor kidney transplantation improved for Black and Hispanic patients and became comparable to White patients. However, Asian, Black, and Hispanic patients experienced higher rates of dialysis initiation and lower rates of preemptive living donor kidney transplantation.","PeriodicalId":17217,"journal":{"name":"Journal of The American Society of Nephrology","volume":"24 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reconsidering Biomarker Interpretation and Clinical Applicability in High-Intensity Interval Training and Kidney Function Trials.","authors":"Gaurav Sharma","doi":"10.1681/asn.0000000861","DOIUrl":"https://doi.org/10.1681/asn.0000000861","url":null,"abstract":"","PeriodicalId":17217,"journal":{"name":"Journal of The American Society of Nephrology","volume":"170 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145068394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}