Journal of The American Society of Nephrology最新文献_第9页

The Use of Time-Lapse HR-pQCT for Noninvasive Bone Turnover and Bone Quality Assessment in CKD. 延时HR-pQCT在CKD无创骨转换和骨质量评估中的应用。

IF 13.6 1区医学

Journal of The American Society of Nephrology Pub Date : 2025-08-08 DOI: 10.1681/asn.0000000848

Minhao Zhou,Isabel Yu,Isidro B Salusky,Thomas L Nickolas,Joachim H Ix,Galateia J Kazakia

引用次数: 0

Validation of the Klinrisk Machine Learning Model for CKD Progression in a Large Representative US Population. Klinrisk机器学习模型在美国大量代表性人群中CKD进展的验证

IF 13.6 1区医学

Journal of The American Society of Nephrology Pub Date : 2025-08-06 DOI: 10.1681/asn.0000000817

Navdeep Tangri,Thomas W Ferguson,Chia-Chen Teng,Ryan J Bamforth,Joseph L Smith,Maria Guzman,Ashley Goss

{"title":"Validation of the Klinrisk Machine Learning Model for CKD Progression in a Large Representative US Population.","authors":"Navdeep Tangri,Thomas W Ferguson,Chia-Chen Teng,Ryan J Bamforth,Joseph L Smith,Maria Guzman,Ashley Goss","doi":"10.1681/asn.0000000817","DOIUrl":"https://doi.org/10.1681/asn.0000000817","url":null,"abstract":"BACKGROUNDEarly identification of high-risk chronic kidney disease (CKD) can facilitate optimal medical management and improve outcomes. We aimed to validate the Klinrisk machine learning model for prediction of CKD progression in large US commercial, Medicare, and Medicaid populations.METHODSWe developed three cohorts, consisting of insured adults enrolled in a) commercial, b) Medicare, and c) Medicaid plans between 01/01/2007 and 12/31/2020 with ≥1 serum creatinine test, an eGFR between 15ml/min/1.73m 2 and 180ml/min/1.73m 2 , and ≥7 of the 19 other laboratory analytes available. Two primary sub-cohorts were evaluated within each insurer: (1) all patients with ≥7 laboratory analytes; and (2) patients in (1) with available urinalysis results. Disease progression was defined as the composite outcome of a sustained 40% decline in eGFR or kidney failure. Discrimination, accuracy, and calibration were assessed using the area under the receiver operator characteristic curve (AUC), Brier scores, and calibration plots.RESULTSIn the commercial cohort, the Klinrisk model achieved AUCs ranging from 0.83 (95% confidence interval: 0.82 - 0.83) to 0.87 (0.86 - 0.87) and a maximum Brier score of 0.005 (0.0005 - 0.005) at 2 years. In Medicare patients, AUCs ranged from 0.80 (0.79 - 0.80) to 0.81 (0.80 - 0.82), with a maximum Brier score of 0.026 (0.025 - 0.027). In Medicaid patients, we found AUCs ranging from 0.82 (0.82 - 0.82) to 0.84 (0.82 - 0.86) and a maximum Brier score of 0.014 (0.012 - 0.015).CONCLUSIONSThe Klinrisk machine learning model was accurate in predicting CKD progression in 4.8 million US adults across commercial, Medicare, and Medicaid populations.","PeriodicalId":17217,"journal":{"name":"Journal of The American Society of Nephrology","volume":"27 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144792132","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}

引用次数: 0

Noninvasive Diagnosis of Kidney Allograft Rejection. 异体肾移植排斥反应的无创诊断。

IF 13.6 1区医学

Journal of The American Society of Nephrology Pub Date : 2025-08-06 DOI: 10.1681/asn.0000000842

Rute Cardoso de Aguiar,Michelle Willicombe,Candice Roufosse

{"title":"Noninvasive Diagnosis of Kidney Allograft Rejection.","authors":"Rute Cardoso de Aguiar,Michelle Willicombe,Candice Roufosse","doi":"10.1681/asn.0000000842","DOIUrl":"https://doi.org/10.1681/asn.0000000842","url":null,"abstract":"Despite regular conventional monitoring of kidney transplant recipients, allograft rejection remains a barrier for the long-term success of kidney transplantation and is one of the leading causes of graft failure. Kidney transplant rejection and graft failure are reported as the most feared outcomes by patients. Timely diagnosis of rejection and early treatment enable interventions which may attenuate alloimmune processes before irreversible graft injury has occurred. The evolving landscape of noninvasive diagnostic tools presents promising opportunities for early detection of kidney allograft rejection. These tools, alone or combined, may promptly signal the need for a biopsy, reduce the need for surveillance biopsies, or even potentially inform treatment monitoring. Therefore, they are of utmost importance, and their use should be informed by evidence, guiding both patients and their clinical teams. This review will cover noninvasive tests used for the diagnosis of kidney allograft rejection available or soon to be available in the clinical setting, and describe their diagnostic context, strengths and limitations, while proposing an ideal clinical framework for their use.","PeriodicalId":17217,"journal":{"name":"Journal of The American Society of Nephrology","volume":"6 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144792069","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}

引用次数: 0

Remote Measurement of Volume Status in Heart Failure. 心力衰竭患者容量状态的远程测量。

IF 13.6 1区医学

Journal of The American Society of Nephrology Pub Date : 2025-08-06 DOI: 10.1681/asn.0000000843

Nayan Arora,Conrad J Macon,Christopher Chien

引用次数: 0

Regulation of Glucose Handling in the Kidney: New Layers of Complexity. 肾脏中葡萄糖处理的调节：复杂性的新层面。

IF 13.6 1区医学

Journal of The American Society of Nephrology Pub Date : 2025-08-04 DOI: 10.1681/asn.0000000821

Nicola Wanner,Tobias B Huber

引用次数: 0

Authors' Reply: Questions Regarding the Analysis of Long-Term Outcomes in Nephrotic Syndrome. 作者回复：关于肾病综合征长期结局分析的问题。

IF 13.6 1区医学

Journal of The American Society of Nephrology Pub Date : 2025-08-01 DOI: 10.1681/asn.0000000812

David Pitcher,Bruce Hendry,Alex Mercer,Jonathan Barratt,Retha Steenkamp,Katie Wong,A Neil Turner,Wu Gong,Daniel P Gale,Moin A Saleem

引用次数: 0

New Discoveries in Podocyte Mechanosensing and Mechanotransduction. 足细胞机械传感和机械转导的新发现。

IF 13.6 1区医学

Journal of The American Society of Nephrology Pub Date : 2025-08-01 DOI: 10.1681/asn.0000000815

Stuart J Shankland,Rose Z Hill,Oliver Wessely

引用次数: 0

Clonal Haematopoiesis of Indeterminate Potential and Clinical Outcomes in Kidney Diseases: Unraveling Interconnection between Age, Kidney Disease, and Comorbidities. 肾脏疾病的不确定潜力和临床结果的克隆造血：揭示年龄、肾脏疾病和合并症之间的联系

IF 13.6 1区医学

Journal of The American Society of Nephrology Pub Date : 2025-08-01 DOI: 10.1681/asn.0000000808

Julia Jefferis,Andrew J Mallett

引用次数: 0

Questions Regarding the Analysis of Long-Term Outcomes in Nephrotic Syndrome. 关于肾病综合征长期预后分析的问题。

IF 13.6 1区医学

Journal of The American Society of Nephrology Pub Date : 2025-08-01 DOI: 10.1681/asn.0000000811

Zhiwei Dai,Fangfang Zhou,Qun Luo

引用次数: 0

Microbes and Glomerular Filtration Rate in Health and CKD in Mice. 微生物与健康小鼠肾小球滤过率及CKD的关系。

IF 13.6 1区医学

Journal of The American Society of Nephrology Pub Date : 2025-07-29 DOI: 10.1681/asn.0000000814

Jiaojiao Xu,Eesha Verma,Jason Sanchez,Sepideh Gharaie,Sunyoung Jeong,Shishir Kumar Patel,Mahta Gooya,Xavier de la Rosa,Kunal Gupta,Markus M Rinschen,Hamid Rabb,Jennifer L Pluznick

{"title":"Microbes and Glomerular Filtration Rate in Health and CKD in Mice.","authors":"Jiaojiao Xu,Eesha Verma,Jason Sanchez,Sepideh Gharaie,Sunyoung Jeong,Shishir Kumar Patel,Mahta Gooya,Xavier de la Rosa,Kunal Gupta,Markus M Rinschen,Hamid Rabb,Jennifer L Pluznick","doi":"10.1681/asn.0000000814","DOIUrl":"https://doi.org/10.1681/asn.0000000814","url":null,"abstract":"BACKGROUNDMicrobes are implicated in a variety of host physiological and pathophysiological processes. In this study, we tested the hypothesis that microbes modulate glomerular filtration rate (GFR) in health and chronic kidney disease.METHODSTo uncover the effect of gut microbiota on kidney function in health and in a chronic kidney disease (CKD) model, we examined GFR, plasma creatinine, and kidney histology in mice when gut microbes were manipulated.RESULTSIn healthy mice, GFR was significantly increased when gut microbiota were either suppressed (oral antibiotics) or absent (germ-free). In mice challenged with adenine diet to induce CKD with impaired GFR, suppressing gut microbes with antibiotics also increased GFR. In females on an adenine diet, antibiotics increased GFR versus adenine alone on weeks 4 and 6. In males, antibiotics elevated GFR on week 2. Adenine diet significantly increased plasma creatinine and kidney fibrosis; this was suppressed by antibiotics in both sexes. To explore the mechanism, we tested the hypothesis that altered tubuloglomerular feedback contributes to elevated GFR using the sodium-glucose cotransporter 2 inhibitor empagliflozin; empagliflozin impairs Na+ reabsorption in the proximal tubule, altering tubuloglomerular feedback. Empagliflozin impaired antibiotic-induced GFR increases on week 3 but not week 5, suggesting that altered tubuloglomerular feedback contributes to the initial increase in GFR.CONCLUSIONSThe microbiome plays a key role in 'setting' baseline GFR by a mechanism which partially involves tubuloglomerular feedback, and, suppressing gut microbes can elevate GFR even in CKD mice.","PeriodicalId":17217,"journal":{"name":"Journal of The American Society of Nephrology","volume":"6 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144737354","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}

引用次数: 0