Journal of The American Society of Nephrology最新文献

{"title":"Acute Effect of Moderate-Intensity Interval Intradialytic Exercise on Cerebral Oxygenation in Hemodialysis Patients: A Randomized Crossover Trial.","authors":"Sho Kojima, Naoto Usui, Akimi Uehata, Akihito Inatsu, Yasuo Chiba, Hisadome Hideki, Yusuke Suzuki, Junichiro Nakata, Atsuhiro Tsubaki","doi":"10.1681/ASN.0000000672","DOIUrl":"https://doi.org/10.1681/ASN.0000000672","url":null,"abstract":"<p><strong>Background: </strong>Cognitive dysfunction in hemodialysis (HD) patients is associated with decreased regional cerebral oxygenation (rSO2). Intradialytic exercise improves cognitive function; nonetheless, the acute effect of intradialytic exercise on cerebral circulation remains unknown. This study aimed to evaluate the acute effect of intradialytic exercise on rSO2 during HD.</p><p><strong>Methods: </strong>This single-center, open-label, randomized crossover trial included 20 HD patients. Patients received the control condition as usual care and the intradialytic exercise condition in random order. The intradialytic exercise condition involved the performance of anaerobic threshold-intensity interval exercise for 35 min. Cerebral oxygenation (rSO2, oxygenated hemoglobin, deoxygenated hemoglobin, and total hemoglobin) in the prefrontal cortex was measured using near-infrared spectroscopy during HD. Cardiovascular responses, including the heart rate, cardiac index, mean arterial pressure, and blood gas, were also assessed. The two conditions were compared using two-way repeated-measures analysis of variance.</p><p><strong>Results: </strong>The analysis included 16 patients, four of whom were excluded because of artifacts in the cerebral oxygenation data. The rSO2 (P<0.001), oxygenated hemoglobin (P<0.001), and total hemoglobin (P=0.004) showed significant interactions and were significantly increased at end of exercise (rSO2 1.3%, 95%CI [0.5, 2.1]; oxygenated hemoglobin 0.01 mM, 95%CI [0.00, 0.02]; total hemoglobin 0.01 mM, 95%CI [0.00, 0.03]) and 15-min after exercise (rSO2 1.1%, 95%CI [0.2, 2.0]; oxygenated hemoglobin 0.01 mM, 95%CI [0.00, 0.03]; total hemoglobin 0.02 mM, 95%CI [0.00, 0.03]) in the intradialytic exercise condition compared with the control condition. The rSO2 at the end of HD in the control condition was significantly decreased compared with that during pre-HD (-1.5%, 95%CI [-2.7, -0.3]), but not in the intradialytic exercise condition (-1.2%, 95%CI [-2.8, 0.5]).</p><p><strong>Conclusions: </strong>Intradialytic exercise significantly increased rSO2 during and after exercise and improved rSO2 to the same extent as pre-dialysis.</p>","PeriodicalId":17217,"journal":{"name":"Journal of The American Society of Nephrology","volume":" ","pages":""},"PeriodicalIF":10.3,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605432","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":"Family History in the Context of CKD.","authors":"Francesca Zanoni, Maddalena Marasa, Lucrezia Carlassara, Miguel Verbitsky, Atlas Khan, Chen Wang, Joshua D Bundy, Pietro A Canetta, Andrew S Bomback, Afshin Parsa, Harold I Feldman, Ali G Gharavi, Krzysztof Kiryluk","doi":"10.1681/ASN.0000000653","DOIUrl":"10.1681/ASN.0000000653","url":null,"abstract":"<p><strong>Background: </strong>A family history of health conditions may reflect shared genetic and/or environmental risk. It is not well known to what extent family history impacts outcomes among patients with chronic kidney disease (CKD). Herein, we studied the associations of family history of CKD, diabetes, and other conditions with common comorbidities and kidney disease progression among patients with CKD.</p><p><strong>Methods: </strong>We carried out an observational study of two prospective CKD cohorts, 2,573 adults and children from the Cure Glomerulopathy Network (CureGN) and 3,939 Chronic Renal Insufficiency Cohort (CRIC) adult participants. Self-reported first-degree family history of CKD, diabetes, and other common diseases were tested for associations with the risk of comorbidities and CKD progression using multivariable models.</p><p><strong>Results: </strong>Family history of common comorbid conditions was associated with higher risk of these conditions in the context of CKD, including approximately by over 3-fold for diabetes (adjusted OR 3.37, 95% C.I. 2.73-4.15), 48% for cancer (adjusted OR 1.48, 95% C.I. 1.05-2.09), and 69% for cardiovascular disease (adjusted OR 1.69, 95% C.I. 1.36-2.10 in combined cohorts). While polygenic risk score for CKD was associated with kidney disease progression (adjusted HR 1.11, 95% C.I. 1.06-1.16 in combined cohorts), family history of kidney disease was not an independent risk factor for disease progression in the context of existing CKD. In contrast, family history of diabetes was significantly associated with a higher risk of CKD progression independently of diabetes occurrence, or polygenic risk score for diabetes (adjusted HR 1.19, 95% C.I. 1.05-1.35 in combined cohorts).</p><p><strong>Conclusions: </strong>Broad collection of family history in the context of CKD improved clinical risk stratification. Family history of diabetes was consistently associated with a higher risk of CKD progression independently of diabetes status or polygenic risk score for diabetes in both cohorts.</p>","PeriodicalId":17217,"journal":{"name":"Journal of The American Society of Nephrology","volume":" ","pages":""},"PeriodicalIF":10.3,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605477","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":"Differential Impact of Hospitalization on Cystatin C- and Creatinine-Based Estimated GFR.","authors":"Ian E McCoy, Alan S Go, Jesse Y Hsu, Xiaoming Zhang, Anthony N Muiru, Vallabh O Shah, Matthew Weir, Hernan Rincon-Choles, Debbie L Cohen, Amanda Anderson, Bernard Jaar, James Sondheimer, Panduranga S Rao, Anand Srivastava, Laura Dember, Jiang He, Jing Chen, Chi-Yuan Hsu","doi":"10.1681/ASN.0000000670","DOIUrl":"https://doi.org/10.1681/ASN.0000000670","url":null,"abstract":"<p><strong>Background: </strong>Cystatin C has entered mainstream clinical care as a measure of kidney function, joining serum creatinine which has been used for almost a century. But many physicians notice that eGFRCr and eGFRCys values can differ considerably. Hospitalization with critical illness is known to acutely decrease eGFRdiff (eGFRCys - eGFRCr). However, whether this effect occurs in all-cause hospitalizations and persists after hospitalization is unknown.</p><p><strong>Methods: </strong>Among 5,599 adult participants in the Chronic Renal Insufficiency Cohort (CRIC) study with serum creatinine and cystatin C measurements, we estimated the association of six categories of total days of hospitalization between annual study visits (never hospitalized, hospitalized <7 days, 7-<14 days, 14-<28 days, 28-<42 days, and ≥ 42 days) and changes in eGFRCr, eGFRCys, and eGFRdiff between those study visits.</p><p><strong>Results: </strong>Compared to no hospitalization between study visits, increasing days of hospitalization were associated with decreases in eGFRCys (e.g., -3.30 [95% CI -5.48, -1.13] ml/min/1.73m2 for ≥ 42 days of hospitalization, test for trend p<0.001), while eGFRCr remained relatively stable (e.g., -1.12 [-2.77, 0.53] ml/min/1.73m2 for ≥ 42 days of hospitalization, test for trend p=0.21). The differential effect resulted in eGFRdiff becoming progressively more negative with more total days of hospitalization (test for trend p<0.001).</p><p><strong>Conclusions: </strong>Prolonged or repeated hospitalization was associated with larger decreases in eGFRCys compared to eGFRCr on measurements months after hospital discharge.</p>","PeriodicalId":17217,"journal":{"name":"Journal of The American Society of Nephrology","volume":" ","pages":""},"PeriodicalIF":10.3,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605442","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":"Global Burden of the Key Components of Cardiovascular-Kidney-Metabolic Syndrome.","authors":"Zhaomin Xie, Chaolun Yu, Qingmei Cui, Xirui Zhao, Juncheng Zhuang, Shiqun Chen, Haixia Guan, Jie Li","doi":"10.1681/ASN.0000000658","DOIUrl":"10.1681/ASN.0000000658","url":null,"abstract":"","PeriodicalId":17217,"journal":{"name":"Journal of The American Society of Nephrology","volume":" ","pages":""},"PeriodicalIF":10.3,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567447","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":"Repair of Isoaspartyl Residues by PCMT1 and Kidney Fibrosis.","authors":"Jia Xia, Yutong Hou, Jie Wang, Jiahui Zhang, Jiajia Wu, Xiang Yu, Hong Cai, Wen Yang, Yingjie Xu, Shan Mou","doi":"10.1681/ASN.0000000652","DOIUrl":"https://doi.org/10.1681/ASN.0000000652","url":null,"abstract":"<p><strong>Background: </strong>Kidney fibrosis, the excessive accumulation and dysregulated remodeling of the extracellular matrix, is the principal pathophysiological process in chronic kidney disease (CKD). Protein L-isoaspartyl/D-aspartyl methyltransferase (PCMT1) is crucial in repairing post-translational modifications of L-isoaspartyl residues, which are important for extracellular matrix proteins because of their low turnover rate and susceptibility to accelerating factors. This study aimed to reveal a novel role of PCMT1 in kidney fibrosis.</p><p><strong>Methods: </strong>Kidney tissues from mice and humans were evaluated for PCMT1 expression and its association with fibrosis and kidney function. PCMT1's effects on the TGF-β1/Smad signaling were analyzed, and its functional role was assessed in tubule-specific Pcmt1 knockout murine models of kidney fibrosis. The ability of secreted PCMT1 to repair L-isoaspartyl residues on the ectodomain of transforming growth factor beta receptor 2 (TGFBR2) was investigated through immunoprecipitation, gene lentivirus overexpression or knockout, and post-translational modification mass spectrometry.</p><p><strong>Results: </strong>PCMT1 expression was decreased in the tubules of human kidney biopsies from patients with CKD and murine fibrosis models. Renal tubule-specific PCMT1 deficiency in murine kidney fibrosis models worsened tubular injury, extracellular matrix protein deposition, myofibroblast activation, and TGF-β1/Smad signaling overactivation. Mechanistically, PCMT1 was unconventionally secreted and enzymatically inhibited TGF-β1-induced extracellular matrix protein deposition in vitro. PCMT1 interacted with TGFBR2, reversing N63 deamination on its ectodomain, which triggered TGFBR2 ubiquitination and degradation. PCMT1 supplementation in kidneys decreased TGFBR2 levels, attenuated TGF-β1/Smad overactivation, and impeded the profibrotic process.</p><p><strong>Conclusions: </strong>Our study highlights the importance of PCMT1 in maintaining extracellular matrix homeostasis and mitigating kidney fibrosis by regulating TGFBR2 deamination and its protein stability, suppressing the TGF-β1/Smad signaling.</p>","PeriodicalId":17217,"journal":{"name":"Journal of The American Society of Nephrology","volume":" ","pages":""},"PeriodicalIF":10.3,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557098","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":"Expanded Hemodialysis with Theranova Dialyzer and Residual Kidney Function in Patients Starting Long-Term Hemodialysis: A Randomized Controlled Trial.","authors":"Jeong-Hoon Lim, Yu Jin Seo, Yena Jeon, You Hyun Jeon, Hee-Yeon Jung, Ji-Young Choi, Sun-Hee Park, Chan-Duck Kim, Seok Hui Kang, Jung-Hwa Ryu, Duk-Hee Kang, Jang-Hee Cho, Yong-Lim Kim","doi":"10.1681/ASN.0000000655","DOIUrl":"10.1681/ASN.0000000655","url":null,"abstract":"","PeriodicalId":17217,"journal":{"name":"Journal of The American Society of Nephrology","volume":" ","pages":""},"PeriodicalIF":10.3,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557072","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":"Opening New Routes for Kidney Therapy.","authors":"Sara Kinstlinger, Moran Dvela-Levitt","doi":"10.1681/ASN.0000000616","DOIUrl":"10.1681/ASN.0000000616","url":null,"abstract":"","PeriodicalId":17217,"journal":{"name":"Journal of The American Society of Nephrology","volume":"36 3","pages":"519-521"},"PeriodicalIF":10.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11888944/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autoantibodies Targeting Proteasome Subunit Alpha Type 1 in Autoimmune Podocytopathies.","authors":"Huihui Liu, Chao Zhou, Dongjie Wang, Hanyan Meng, Shifan Zhu, Jiayu Zhang, Jianhua Mao, Qing Ye","doi":"10.1681/ASN.0000000525","DOIUrl":"10.1681/ASN.0000000525","url":null,"abstract":"","PeriodicalId":17217,"journal":{"name":"Journal of The American Society of Nephrology","volume":" ","pages":"406-419"},"PeriodicalIF":10.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11888960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Impact of APOL1 Kidney Risk Variants in West Africa : Insights for Global Kidney Disease Assessment and Treatment.","authors":"Elena Martinelli, Rik Westland, Opeyemi A Olabisi, Simone Sanna-Cherchi","doi":"10.1681/ASN.0000000587","DOIUrl":"10.1681/ASN.0000000587","url":null,"abstract":"","PeriodicalId":17217,"journal":{"name":"Journal of The American Society of Nephrology","volume":" ","pages":"525-528"},"PeriodicalIF":10.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11888956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142739852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nanotherapeutics in Kidney Disease: Innovations, Challenges, and Future Directions.","authors":"Amir Roointan, Rong Xu, Simon Corrie, Christoph E Hagemeyer, Karen Alt","doi":"10.1681/ASN.0000000608","DOIUrl":"10.1681/ASN.0000000608","url":null,"abstract":"<p><p>The treatment and management of kidney diseases present a significant global challenge, affecting over 800 million individuals and necessitating innovative therapeutic strategies that transcend symptomatic relief. The application of nanotechnology to therapies for kidney diseases, while still in its early stages, holds transformative potential for improving treatment outcomes. Recent advancements in nanoparticle-based drug delivery leverage the unique physicochemical properties of nanoparticles for targeted and controlled therapeutic delivery to the kidneys. Current research is focused on understanding the functional and phenotypic changes in kidney cells during both acute and chronic conditions, allowing for the identification of optimal target cells. In addition, the development of tailored nanomedicines enhances their retention and binding to key renal membranes and cell populations, ultimately improving localization, tolerability, and efficacy. However, significant barriers remain, including inconsistent nanoparticle synthesis and the complexity of kidney-specific targeting. To overcome these challenges, the field requires advanced synthesis techniques, refined targeting strategies, and the establishment of animal models that accurately reflect human kidney diseases. These efforts are critical for the clinical application of nanotherapeutics, which promise novel solutions for kidney disease management. This review evaluates a substantial body of in vivo research, highlighting the prospects, challenges, and opportunities presented by nanotechnology-mediated therapies and their potential to transform kidney disease treatment.</p>","PeriodicalId":17217,"journal":{"name":"Journal of The American Society of Nephrology","volume":" ","pages":"500-518"},"PeriodicalIF":10.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11888965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142869512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}