Kidney Research and Clinical Practice最新文献

{"title":"Medium cut-off dialyzer improves reduction ratios of large middle molecules associated with vascular calcification.","authors":"Hyo Jin Kim, Eun Young Seong, Sang Heon Song","doi":"10.23876/j.krcp.23.061","DOIUrl":"10.23876/j.krcp.23.061","url":null,"abstract":"<p><strong>Background: </strong>We aimed to investigate the change in the large middle molecule (>15 kDa) removal rate, which is associated with vascular calcification, when using a medium cut-off (MCO) dialyzer compared to a high-flux (HF) dialyzer.</p><p><strong>Methods: </strong>Twenty patients with clinically stable maintenance hemodialysis were investigated over a 15-week study period. Dialyzer efficacies were evaluated during the last midweek hemodialysis treatment for each consecutive dialyzer membrane use: 1st HF, MCO, and 2nd HF dialyzer; 5 weeks each period. Changes in α1-microglobulin (33 kDa) during a dialysis session were analyzed to assess the efficacy of the MCO dialyzer as a reference. The levels and reduction ratios of fibroblast growth factor 23 (FGF23, 32 kDa), osteoprotegerin (OPG, 60 kDa), and sclerostin (22 kDa) were analyzed. Large middle molecules were measured using an enzyme-linked immunosorbent assay.</p><p><strong>Results: </strong>Serum hemoglobin, phosphorus, and corrected calcium levels were not significantly different for each dialyzer period. Total protein and albumin values during the MCO dialyzer period did not decrease compared with the HF dialyzer period. The reduction ratio of α1-microglobulin was significantly higher in the MCO dialyzer than in the HF dialyzer (p < 0.001). The reduction ratios of FGF23 (p < 0.001), OPG (p < 0.001), and sclerostin (p < 0.001) were significantly higher in the MCO dialyzer than those in the HF dialyzer.</p><p><strong>Conclusion: </strong>The reduction rate of large middle molecules related to vascular calcification, such as FGF23, OPG, and sclerostin, was significantly higher when using the MCO dialyzer than the HF dialyzer.</p>","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":"753-762"},"PeriodicalIF":2.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11615443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139546665","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}

{"title":"Patient-reported mental health problems and clinical outcomes in adults with non-dialysis chronic kidney disease.","authors":"Jihyun Yang, Young Youl Hyun, Kyu-Beck Lee, Hyo Jin Kim, Sang Heon Suh, Hayne Cho Park, Yun Kyu Oh, Sue Kyung Park, Kook-Hwan Oh","doi":"10.23876/j.krcp.24.034","DOIUrl":"https://doi.org/10.23876/j.krcp.24.034","url":null,"abstract":"<p><strong>Background: </strong>Mental health affects well-being and physical health. Among adults with chronic kidney disease (CKD), mental health (MH) problems are common and can induce adverse clinical outcomes. We examined the association between patient-reported MH problems and clinical outcomes in adults with non-dialysis CKD.</p><p><strong>Methods: </strong>This prospective observational study included 1,879 participants from the KNOW-CKD (KoreaN Cohort Study for Outcomes in Patients With CKD). Patients-reported MH problems were determined using four indicators of the Korea National Health and Nutrition Examination Survey questionnaire. We described the cross-sectional differences in health-related quality of life according to MH problems. We prospectively evaluated the hazard ratio (HR) of all-cause death and end-stage kidney disease (ESKD) according to the MH problems for a median follow-up of 6.4 years.</p><p><strong>Results: </strong>The participants (mean age 53 years; 61.6% male) had patient-reported MH problems of inadequate sleep duration (17.4%), subjective distress (27.3%), depressive symptoms (13.2%), and suicidal ideation (16.8%). In the fully adjusted Cox proportional model, poor MH (≥2 problems) was associated with a high risk of ESKD (HR, 1.46; 95% confidence interval [CI], 1.18-1.08) and death (HR, 1.55; 95% CI, 1.04-2.32) compared with good MH. Furthermore, the single indicator of suicidal ideation was associated with a high risk of ESKD (HR, 1.37; 95% CI, 1.11-1.69) and death (HR, 1.98; 95% CI, 1.34-2.92).</p><p><strong>Conclusion: </strong>Patient-reported MH problems are common in adults with CKD. Poor MH and only suicidal ideation are associated with a high risk of ESKD and early death. Age and sex modify the association between poor MH and adverse clinical outcomes in non-dialysis CKD.</p>","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622914","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}

{"title":"Blood osteoprotegerin is associated with arteriovenous access thrombosis in hemodialysis patients.","authors":"Tung-Ling Chung, Yi-Hsueh Liu, Pei-Yu Wu, Jiun-Chi Huang, Yi-Chun Tsai, Ya-Ling Hsu, Mei-Chuan Kuo, Yi-Wen Chiu, Ping-Hsun Wu, Szu-Chia Chen","doi":"10.23876/j.krcp.24.153","DOIUrl":"https://doi.org/10.23876/j.krcp.24.153","url":null,"abstract":"<p><strong>Background: </strong>A functioning arteriovenous (AV) access is essential for hemodialysis efficiency and the quality of life in hemodialysis patients. Blood osteoprotegerin (OPG) and soluble receptor activator of nuclear factor kappa B ligand (RANKL) have been linked to cardiovascular diseases and vascular calcification. This study investigated the relationship between blood OPG, RANKL, and the occurrence of AV access thrombosis.</p><p><strong>Methods: </strong>This prospective cohort study was conducted from August 2016 to August 2021 and included patients undergoing prevalent hemodialysis in two hospital-based hemodialysis units. Cox proportional hazards models and Kaplan-Meier analysis were used to evaluate the association between blood OPG, RANKL, and AV access (AV fistula [AVF] and AV graft [AVG]) outcomes.</p><p><strong>Results: </strong>A total of 333 hemodialysis patients were enrolled, with an AV access thrombosis rate of 22.2%. Cox regression identified several factors associated with AV access thrombosis: AV access type (AVF vs. AVG; hazard ratio [HR], 0.24; p < 0.001), C-reactive protein (HR, 1.07; p = 0.002), and log-transformed OPG (HR, 5.52; p = 0.005). Subgroup analysis revealed high log-transformed OPG and RANKL were associated with AVF thrombosis (HR, 10.77; p = 0.002 and HR, 3.26; p = 0.009, respectively), while high C-reactive protein increased the risk of AVG thrombosis (HR, 1.31; p < 0.001). Kaplan-Meier analysis showed that patients with AVF in the highest tertile of log OPG (>402 pg/mL) had the highest AVF thrombosis incidence (p = 0.03).</p><p><strong>Conclusion: </strong>High blood OPG was associated with AV access thrombosis, particularly in the AVF.</p>","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622909","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}

{"title":"Baseline characteristics and associated factors for hypertension in children with chronic kidney disease: results from the Korean Cohort Study for Outcome in Patients with Pediatric Chronic Kidney Disease study.","authors":"Ji Yeon Song, Keum Hwa Lee, Jae Il Shin, Hee Gyung Kang, Yo Han Ahn, Hee Sun Baek, Min Hyun Cho, Jiwon Jung, Joo Hoon Lee, Heeyeon Cho, Kyoung Hee Han, Eujin Park, Eun Mi Yang, Seong Heon Kim","doi":"10.23876/j.krcp.24.006","DOIUrl":"https://doi.org/10.23876/j.krcp.24.006","url":null,"abstract":"<p><strong>Background: </strong>Hypertension is one of the most important complications of chronic kidney disease (CKD) as it exacerbates disease progression in children. The aim of this study is to identify characteristics and factors associated with hypertension in children with CKD.</p><p><strong>Methods: </strong>This is a cross-sectional study using baseline data from the 10-year ongoing cohort study named KNOW-PedCKD (Korean Cohort Study for Outcome in Patients with Pediatric Chronic Kidney Disease). We enrolled finally 378 patients aged <18 years at seven major pediatric nephrology centers in Republic of Korea. Blood pressure was measured and samples and clinical data were collected during the patients' annual hospital visits.</p><p><strong>Results: </strong>We found that 30.7% of the patients had hypertension (n = 116); specifically, 16.4% (n = 62) had systolic hypertension, and 22.8% (n = 86) had diastolic hypertension. Multiple logistic regression analysis indicated that older age (odds ratio [OR], 1.13; p < 0.001), female sex (OR, 2.32; p = 0.002), a high left ventricular mass index (OR, 1.05; p < 0.001), and a high urine protein/creatinine ratio (OR, 1.12; p = 0.02) were significant associated factors for systolic or diastolic hypertension.</p><p><strong>Conclusion: </strong>This study analyzed the associated factors for hypertension in children with CKD. Hypertension is associated with various factors, including age, sex, heart status, and proteinuria. Therefore, clinicians should consider these factors during patient evaluations to improve health outcomes.</p>","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142503035","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}

{"title":"A noninvasive method of diagnosing membranous nephropathy using exosomes derived from urine.","authors":"Giae Yun, Taewoon Kim, Kwang Sik Kim, Kyusoon Shin, Jin-Ho Paik, Jee Yoon Park, Luke P Lee, Jong Wook Hong, Sejoong Kim","doi":"10.23876/j.krcp.23.208","DOIUrl":"https://doi.org/10.23876/j.krcp.23.208","url":null,"abstract":"<p><strong>Background: </strong>Membranous nephropathy (MN) is a specific autoimmune disease affecting kidneys. It is characterized by the accumulation of immune complexes in the glomerular basement membrane. Renal biopsy is currently the standard procedure to confirm the diagnosis, although the presence of autoantibodies against the phospholipase A2 receptor (PLA2R) can also help diagnose. In this study, we aimed to investigate the potential of urinary exosomes as noninvasive markers for diagnosing MN.</p><p><strong>Methods: </strong>Exosomes were extracted from urine samples of five patients with MN and four healthy controls. The concentration of PLA2R was measured in both urine and isolated exosomes using enzyme-linked immunosorbent assay techniques. The measurements were adjusted based on the urine creatinine (UCr) level of each participant.</p><p><strong>Results: </strong>The levels of PLA2R/UCr were investigated in urine and urine-derived exosomes from patients and controls. Results of the analysis revealed significantly higher expression of PLA2R/UCr in patients compared to the control group (p < 0.05). Furthermore, the expression level of PLA2R/UCr was higher in urine-derived exosomes than in urine samples. Additionally, a positive correlation was observed between the expression levels of PLA2R/UCr and the urine protein-to-creatinine ratio, with urine-derived exosomes exhibiting a stronger correlation than urine samples.</p><p><strong>Conclusion: </strong>Studies have indicated that measuring exosomal PLA2R/UCr levels in urine could be a noninvasive method for diagnosing MN. Using urine-derived exosomes could also reduce the burden of performing a biopsy on patients and facilitate follow-up treatment, such as monitoring for future recurrence.</p>","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391554","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}

{"title":"Artificial intelligence-powered chest computed tomography analysis unveils prognostic insights for COVID-19 mortality among prevalent hemodialysis patients.","authors":"Eunji Kim, Soo-Jin Yoon, Sungbong Yu, Eunsil Ko, Kyungjun Shon, Jooyeon Yoon, Youn Kyung Kee, Do Hyoung Kim, AJin Cho, Hayne Cho Park, Young-Ki Lee","doi":"10.23876/j.krcp.24.079","DOIUrl":"https://doi.org/10.23876/j.krcp.24.079","url":null,"abstract":"<p><strong>Background: </strong>Coronavirus disease 2019 (COVID-19) has led to severe pneumonia and mortality worldwide, however, clinical outcomes in end-stage renal disease patients remain unclear. This study evaluates the prognostic value of chest computed tomography (CT) findings in predicting COVID-19-related outcomes in prevalent hemodialysis patients.</p><p><strong>Methods: </strong>We retrospectively analyzed 326 prevalent hemodialysis patients diagnosed with COVID-19 who underwent chest CT scans. Characteristics assessed included pleural effusion, lung involvement volume, nodular consolidation, patchy infiltration, and ground-glass opacity. Artificial intelligence (AI)-assisted CT analysis quantified lung involvement. The primary endpoint was in-hospital mortality. Clinical data were collected, and logistic regression analysis assessed the association between CT findings and mortality.</p><p><strong>Results: </strong>The mean age of the patients was 66.7 ± 12.6 years, 61.0% were male, and 58.6% were diabetic. Chest CT showed that 18.1% had lung involvement >10%, 32.5% had pleural effusion, 68.7% had nodular consolidation, 57.1% had patchy infiltration, and 58.0% had ground-glass opacity. Seventy patients (21.5%) died. Multivariate logistic regression analysis identified lung involvement >2.7% (odds ratio [OR], 16.70; 95% confidence interval [CI], 4.35-65.63), pleural effusion (OR, 3.28; 95% CI, 1.15-9.35), nodular consolidation (OR, 4.08; 95% CI, 1.12-14.82), and patchy infiltration (OR, 3.75; 95% CI, 1.17-12.03) as significant mortality risk factors.</p><p><strong>Conclusion: </strong>Chest CT findings, including lung involvement >2.7% and the presence of pleural effusion, nodular consolidation, and patchy infiltrates, significantly indicated mortality in COVID-19 pneumonia among prevalent hemodialysis patients. AI-assisted CT analysis proved useful in assessing lung involvement extent, showing that even minimal lung involvement can be associated with increased mortality.</p>","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391555","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}

{"title":"Predicting long-term mortality of patients with postoperative acute kidney injury following noncardiac general anesthesia surgery using machine learning.","authors":"Bo Yeon Choi, Wona Choi, Jiwon Min, Byung Ha Chung, Eun Sil Koh, Su Yeon Hong, Tae Hyun Ban, Yong Kyun Kim, Hye Eun Yoon, In Young Choi","doi":"10.23876/j.krcp.24.106","DOIUrl":"https://doi.org/10.23876/j.krcp.24.106","url":null,"abstract":"<p><strong>Background: </strong>This study addresses the gap in knowledge regarding the long-term mortality implications of postoperative acute kidney injury (PO-AKI) utilizing advanced machine learning techniques to predict outcomes more accurately than traditional statistical models.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted using data from seven institutions between March 2009 and December 2019. Machine learning models were developed to predict all-cause mortality of PO-AKI patients using 23 preoperative variables and one postoperative variable. Model performance was compared to a traditional statistical approach with Cox regression analysis. The concordance index was used as a predictive performance metric to compare prediction capabilities among different models.</p><p><strong>Results: </strong>Among 199,403 patients, 2,105 developed PO-AKI. During a median follow-up of 144 months (interquartile range, 99.61-170.71 months), 472 in-hospital deaths occurred. Subjects with PO-AKI had a significantly lower survival rate than those without PO-AKI (p < 0.001). For predicting mortality, the XGBoost with an accelerated failure time model had the highest concordance index (0.7521), followed by random survival forest (0.7371), multivariable Cox regression model (0.7318), survival support vector machine (0.7304), and gradient boosting (0.7277).</p><p><strong>Conclusion: </strong>XGBoost with an accelerated failure time model was developed in this study to predict long-term mortality associated with PO-AKI. Its performance was superior to conventional models. The application of machine learning techniques may offer a promising approach to predict mortality following PO-AKI more accurately, providing a basis for developing targeted interventions and clinical guidelines to improve patient outcomes.</p>","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391570","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}

{"title":"A comprehensive review of Alport syndrome: definition, pathophysiology, clinical manifestations, and diagnostic considerations.","authors":"Eunjeong Kang, Byung Hwa Park, Hajeong Lee, Hee Gyung Kang, Ji Hyun Kim, Ye Na Kim, Yeonsoon Jung, Hark Rim, Ho Sik Shin","doi":"10.23876/j.krcp.24.065","DOIUrl":"https://doi.org/10.23876/j.krcp.24.065","url":null,"abstract":"<p><p>Alport syndrome, a rare genetic disorder affecting around 1 in 50,000 individuals, primarily presents as microscopic hematuria and chronic kidney disease (CKD) with associated extrarenal complications. The Alport syndrome results from mutations in COL4A3, COL4A4, and COL4A5 genes, disrupting the formation of the α3-α4-α5 chain in the collagen IV network. The etiology involves X chromosome-related, autosomal dominant, autosomal recessive, and digenic inheritance patterns. The disease primarily manifests as kidney involvement, featuring persistent hematuria, proteinuria, and a progressive decline in renal function. Hearing loss, ocular abnormalities, and extrarenal manifestations further contribute to its complexity. Genotype-phenotype correlations are relatively evident, with distinct presentations in X-linked, autosomal recessive, and autosomal dominant cases. Diagnosis relies on urinalysis, histologic examination, and genetic testing with advancements in next-generation sequencing aiding identification. Although no specific treatment exists, early diagnosis improves outcomes, emphasizing the importance of genetic testing for prognosis and familial screening. The purpose of this review is to advance knowledge and enhance understanding of Alport syndrome.</p>","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391553","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}

{"title":"Exploring new horizons: angiotensin II, angiotensin II type 1 receptor, and renal outer medullary potassium channel interaction in distal convoluted tubule.","authors":"Kun Zhao, Tiantian Han, Linzhen Jia, Libo Wen, Renjun Gao, Xue Li","doi":"10.23876/j.krcp.24.023","DOIUrl":"https://doi.org/10.23876/j.krcp.24.023","url":null,"abstract":"<p><strong>Background: </strong>This study investigates angiotensin II (Ang II)'s regulatory mechanism on renal outer medullary potassium channel (ROMK) activity in the distal convoluted tubule (DCT) during low potassium intake, focusing on the Janus kinase 2 (JAK2) pathway activation mediated by the Ang II type 1 receptor (AT1R).</p><p><strong>Methods: </strong>Utilizing a low potassium diet mouse model, various methods including patch clamping, reverse transcription-quantitative polymerase chain reaction, Western blotting, and immunohistochemical staining were applied to analyze ROMK channel activity and the expression of related proteins.</p><p><strong>Results: </strong>The findings reveal that Ang II inhibits ROMK activity in the DCT2 membrane through AT1R activation, with the JAK2 pathway playing a central role. Further, inhibiting JAK2 reverses this effect, indicating its potential in hypertension treatment.</p><p><strong>Conclusion: </strong>This study provides novel insights into the role of Ang II in renal potassium excretion and hypertension pathophysiology.</p>","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391561","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}

{"title":"Donor-derived cell-free DNA-based liquid biopsies to determine future kidney transplant rejection.","authors":"Weiwei Wang, Cuello Garcia Haider, Yinfeng Wang, Zhoufan Zhang, Yuelin Liu, Fengcheng Xue, Haitao Liu, Tingya Jiang, Jingyi Cao, Yang Zhou","doi":"10.23876/j.krcp.23.286","DOIUrl":"https://doi.org/10.23876/j.krcp.23.286","url":null,"abstract":"<p><p>Donor-derived cell-free DNA (dd-cfDNA) based liquid kidney biopsies have the potential to detect the chances of kidney transplant rejection. Several studies have found that dd-cfDNA can be used to determine the risk of kidney transplant rejection and may correlate with antibody-mediated rejection (ABMR), T cell-mediated rejection (TCMR), and estimated glomerular filtration rate (eGFR). A high concentration of dd-cfDNA in the body fluids may indicate possible transplant rejection since dd-cfDNA is released as a result of apoptotic and necrotic processes initiated by the recipient's immune system. dd-cfDNA assays have advantages over conventional biopsies since they are noninvasive, and therefore, have the potential to provide a safe and reliable biomarker. Different dd-cfDNA levels have been reported above a number of cutoff thresholds: ABMR at 2.45% and TCMR at 1.3%, compared with 0.44% in healthy patients; and eGFR at 2.5%, a decrease of 25% compared with healthy patients. These results indicate the levels of dd-cfDNA that may be used to signal possible kidney rejection. dd-cfDNA assay is a rapid technique, making it particularly useful in emergencies, and further research into its use in the study of kidney rejection should prove beneficial.</p>","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391557","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}