Kidney International Reports最新文献

{"title":"Associations of Urine Epidermal Growth Factor With Kidney and Cardiovascular Outcomes in Individuals With CKD in SPRINT","authors":"Merve Postalcioglu ,&nbsp;Ronit Katz ,&nbsp;Simon B. Ascher ,&nbsp;Trenton Hall ,&nbsp;Pranav S. Garimella ,&nbsp;Stein I. Hallan ,&nbsp;Joachim H. Ix ,&nbsp;Michael G. Shlipak","doi":"10.1016/j.ekir.2024.08.004","DOIUrl":"10.1016/j.ekir.2024.08.004","url":null,"abstract":"<div><h3>Introduction</h3><div>Urine epidermal growth factor (uEGF) has been found to be inversely associated with kidney function loss, whereas its associations with cardiovascular disease (CVD) and mortality have not been studied.</div></div><div><h3>Methods</h3><div>We measured baseline uEGF levels among 2346 Systolic Blood Pressure Intervention Trial (SPRINT) participants with an estimated glomerular filtration rate (eGFR) &lt; 60 ml/min per 1.73 m². A linear mixed-effects model was used to investigate the associations of uEGF with the annual eGFR change; Cox proportional hazards regression models were used to analyze its associations with the ≥30% eGFR decline, CVD, and all-cause mortality outcomes. To account for the competing risk of death, the Fine and Gray method was utilized for acute kidney injury (AKI) and end-stage kidney disease (ESKD) outcomes.</div></div><div><h3>Results</h3><div>At baseline, the study participants had mean age of 73 ± 9 years, mean eGFR of 46 ± 11 ml/min per 1.73 m², and median urine albumin-to-creatinine ratio (UACR) of 15 mg/g (interquartile range: 7–49). In the multivariable-adjusted analysis including baseline urine albumin and eGFR, each 50% lower uEGF concentration was associated with 0.74% (95% confidence interval [CI]: 0.29–1.19) per year faster decline in eGFR and 1.17 times higher risk of ≥30% eGFR decline (95% CI: 1.00–1.36). Lower uEGF concentrations were found to be associated with increased risks of ESKD, AKI, CVD, and all-cause mortality; however, these associations did not reach statistical significance when the models were controlled for baseline urine albumin and eGFR.</div></div><div><h3>Conclusion</h3><div>Among hypertensive adults with chronic kidney disease (CKD), lower baseline uEGF concentration was associated with faster eGFR decline independent of baseline albuminuria and eGFR; but not with ESKD, AKI, CVD, and all-cause mortality.</div></div>","PeriodicalId":17761,"journal":{"name":"Kidney International Reports","volume":"9 11","pages":"Pages 3167-3176"},"PeriodicalIF":5.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142181692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adverse Events Associated With SARS-CoV-2 Vaccination in Patients With Glomerular Diseases and the Potential Risk of Disease Reactivation","authors":"Sophia Lionaki ,&nbsp;Pelagia Kriki ,&nbsp;Smaragdi Marinaki ,&nbsp;Dimitra Gkalitsiou ,&nbsp;Evangelia Dounousi ,&nbsp;Vassilios Liakopoulos ,&nbsp;Ioannis Bellos ,&nbsp;Vasileios Vaios ,&nbsp;Petros Kalogeropoulos ,&nbsp;Zoe Kleinaki ,&nbsp;Sofia Flouda ,&nbsp;Louisa Gkika-Zervou ,&nbsp;Marios Papasotiriou ,&nbsp;Dimitrios Goumenos ,&nbsp;Aliki Venetsanopoulou ,&nbsp;Paraskevi Voulgari ,&nbsp;Georgios Moustakas ,&nbsp;Eirini Grapsa ,&nbsp;Kostas Stylianou ,&nbsp;Stylianos Panagoutsos ,&nbsp;Ioannis Boletis","doi":"10.1016/j.ekir.2024.08.003","DOIUrl":"10.1016/j.ekir.2024.08.003","url":null,"abstract":"","PeriodicalId":17761,"journal":{"name":"Kidney International Reports","volume":"9 11","pages":"Pages 3324-3327"},"PeriodicalIF":5.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142181693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic Review of Individual Patient Data COVID-19 Infection and Vaccination–Associated Thrombotic Microangiopathy","authors":"Pujan Moradiya ,&nbsp;Priyanka Khandelwal ,&nbsp;Rupesh Raina ,&nbsp;Ruchi Gupta Mahajan","doi":"10.1016/j.ekir.2024.07.034","DOIUrl":"10.1016/j.ekir.2024.07.034","url":null,"abstract":"<div><h3>Introduction</h3><div>Sporadic cases of atypical hemolytic uremic syndrome (aHUS) have been described in the literature in association with COVID-19 infection and vaccination in adults and pediatric patients. The exact mechanisms underlying COVID-19–associated thrombotic microangiopathies (TMAs) remain incompletely understood. Herein, we present a detailed meta-analysis of the clinical characteristics, outcomes, and management strategies of COVID-19–associated aHUS and thrombotic thrombocytopenic purpura (TTP).</div></div><div><h3>Methods</h3><div>This study was performed following the Preferred Reporting Items for Systematic Reviews and Meta-analyses updated guidelines. PubMed was utilized for searching for case reports and series. Adverse outcome at last follow-up was defined as estimated glomerular filtration rate &lt; 30 ml/min per 1.73 m² (patients with aHUS), no remission with therapy, or patient death. Data were analyzed using Wilcoxon rank and Chi-square tests.</div></div><div><h3>Results</h3><div>Our analysis cohort included 118 studies reporting on 170 patients. These included 84 cases of aHUS and 86 cases of TTP resulting from COVID-19 infection (<em>n</em> = 92) or vaccination (<em>n</em> = 78). Significantly more cases of aHUS were reported after infection (<em>n</em> = 65) than immunization (<em>n</em> = 19), compared to TTP, where the reverse was true (<em>n</em> = 27 and <em>n</em> = 59, respectively; <em>P</em> &lt; 0.001). In patients with aHUS with stage 3 acute kidney injury (AKI), requirement of kidney replacement therapy (KRT) was seen in three-fourths of the cohort for a median of 15. In patients with TTP, severe COVID-19 infection (<em>P</em> = 0.04) predicted nonremission or death at last follow-up. Administration of i.v., rituximab and caplacizumab were protective (<em>P</em> = 0.03 and <em>P</em> = 0.06, respectively). Immune TTP (iTTP) was reported more often than HUS following mRNA vaccines (81% vs. 58%; <em>P</em> = 0.06).</div></div><div><h3>Conclusion</h3><div>COVID-19 infection and vaccination are a potential trigger for onset or relapse of aHUS and TTP, especially in patients who are not on maintenance complement inhibitors or immunosuppression.</div></div>","PeriodicalId":17761,"journal":{"name":"Kidney International Reports","volume":"9 11","pages":"Pages 3134-3144"},"PeriodicalIF":5.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142181697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age-Related Differences in Rejection Rates, Infections, and Tacrolimus Exposure in Pediatric Kidney Transplant Recipients in the CERTAIN Registry","authors":"Maral Baghai Arassi ,&nbsp;Manuel Feißt ,&nbsp;Kai Krupka ,&nbsp;Atif Awan ,&nbsp;Elisa Benetti ,&nbsp;Ali Düzova ,&nbsp;Isabella Guzzo ,&nbsp;Jon Jin Kim ,&nbsp;Birgitta Kranz ,&nbsp;Mieczysław Litwin ,&nbsp;Jun Oh ,&nbsp;Anja Büscher ,&nbsp;Lars Pape ,&nbsp;Licia Peruzzi ,&nbsp;Mohan Shenoy ,&nbsp;Sara Testa ,&nbsp;Lutz T. Weber ,&nbsp;Jakub Zieg ,&nbsp;Britta Höcker ,&nbsp;Alexander Fichtner ,&nbsp;Burkhard Tönshoff","doi":"10.1016/j.ekir.2024.08.025","DOIUrl":"10.1016/j.ekir.2024.08.025","url":null,"abstract":"<div><h3>Introduction</h3><div>Data on age-related differences in rejection rates, infectious episodes, and tacrolimus exposure in pediatric kidney transplant recipients (pKTRs) on a tacrolimus-based immunosuppressive regimen are scarce.</div></div><div><h3>Methods</h3><div>We performed a large-scale analysis of 802 pKTRs from the Cooperative European Paediatric Renal Transplant Initiative (CERTAIN) registry from 40 centers in 14 countries. The inclusion criteria were a tacrolimus-based immunosuppressive regimen and at least 2 years of follow-up. The patient population was divided into 3 age groups (infants and young children aged &lt;6 years, school-aged children 6–12 years, and adolescents aged &gt;12 years) to assess age-related differences in outcome.</div></div><div><h3>Results</h3><div>Median follow-up was 48 months (interquartile range [IQR], 36–72). Within the first 2 years posttransplant, infants, and young children had a significantly higher incidence of infections (80.6% vs. 55.0% in adolescents, <em>P</em> &lt; 0.001) and a significantly higher number of cumulative hospital days (median 13 days vs. 7 days in adolescents, <em>P</em> &lt; 0.001). Adolescents had a significantly higher rate of biopsy-proven acute rejection episodes in the first-year posttransplant (21.7%) than infants and young children (12.6%, <em>P</em> = 0.007). Infants and young children had significantly lower tacrolimus trough levels, lower tacrolimus concentration-to-dose (C/D) ratios as an approximation for higher tacrolimus clearance, and higher tacrolimus interpatient variability (TacIPV) (all <em>P</em> &lt; 0.01) than adolescents.</div></div><div><h3>Conclusion</h3><div>This is the largest study to date in European pKTRs on a tacrolimus-based immunosuppressive regimen, and it shows important age-related differences in rejection rates, infection episodes, as well as tacrolimus exposure and clearance. This data suggests that immunosuppressive therapy in pKTRs should be tailored and personalized according to the age-specific risk profiles of this heterogeneous patient population. The data may serve as a benchmark for future studies with novel immunosuppressive drugs.</div></div>","PeriodicalId":17761,"journal":{"name":"Kidney International Reports","volume":"9 11","pages":"Pages 3265-3277"},"PeriodicalIF":5.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142268893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Open-Label Phase 1/2 Study of Daratumumab-Based Desensitization Before Kidney Transplantation","authors":"Caroline Pilon ,&nbsp;Nizar Joher ,&nbsp;Cédric Usureau ,&nbsp;Emmanuelle Boutin ,&nbsp;Anna Boueilh ,&nbsp;Jean-Luc Taupin ,&nbsp;Allan Thiolat ,&nbsp;José L. Cohen ,&nbsp;Vissal David Kheav ,&nbsp;Florence Canoui-Poitrine ,&nbsp;Maryvonnick Carmagnat ,&nbsp;Philippe Grimbert ,&nbsp;Marie Matignon","doi":"10.1016/j.ekir.2024.08.020","DOIUrl":"10.1016/j.ekir.2024.08.020","url":null,"abstract":"<div><h3>Introduction</h3><div>The safety and benefit of the anti-CD38 monoclonal antibody daratumumab, which induces lysis of antibody-producing plasma cells in sensitized patients prior to kidney transplantation, remain to be determined.</div></div><div><h3>Methods</h3><div>A 2-phase (1 and 2), monocentric open-label study was conducted to evaluate the month 6 (M6) safety and efficacy of daratumumab in kidney transplant candidates with calculated panel reactive antibody (cPRA) &gt; 95%. In the first (safety) phase, we used 4-weekly escalating doses of daratumumab. Phase 2 tested desensitization with 8 weekly infusions of 16 mg/kg daratumumab. cPRA 10,000 was calculated considering only human leukocyte antigen (HLA) antibodies with mean fluorescence intensity (MFI) of &gt; 10,000.</div></div><div><h3>Results</h3><div>Nine patients were enrolled in phase 1 and 14 in phase 2. Safety analysis showed 4 serious non-treatment-emergent adverse events (non-TEAEs), 36 mild TEAEs, mostly infusion-related reactions, grade 1 and 2 (causing 2 temporary drug discontinuations), but no serious TEAEs. Significant reductions in anti-HLA antibodies were observed at month 3 (M3), with cPRA 10,000 (<em>P</em> = 0.003), number of anti-HLA (<em>P</em> &lt; 0.001), maximum MFI (MFI max) (<em>P</em> = 0.053), and the sum of MFI (MFI sum) (<em>P</em> &lt; 0.001), with complete return to baseline levels at month 12 (M12). At M6, 46.15% (19.22%–74.87%) and 76.92% (46.19%–94.96%) of patients showed sustained response (1% decrease in cPRA) for cPRA 2000 and 10,000, respectively. At month 1 (M1), immune cells (T-reg, CD8 + TEMRA, CD19 + CD138 + B cells, and NK cells) significantly decreased. At M3, other antibodies decreased significantly, but returned to baseline levels at M12, except for gamma globulins, without any infectious complications.</div></div><div><h3>Conclusion</h3><div>The first use of daratumumab in desensitization demonstrated infusion-related adverse (AEs) events and rapid, albeit transient, reductions in anti-HLA antibodies, with less than 40% of durable responders, limiting its potential clinical use.</div></div>","PeriodicalId":17761,"journal":{"name":"Kidney International Reports","volume":"9 11","pages":"Pages 3250-3264"},"PeriodicalIF":5.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142181665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nephrologists’ Views on a Workflow for Returning Genetic Results to Research Participants","authors":"Robyn Weiss ,&nbsp;Hila Milo Rasouly ,&nbsp;Maddalena Marasa ,&nbsp;Hilda Fernandez ,&nbsp;Fangming Lin ,&nbsp;Maya Sabatello","doi":"10.1016/j.ekir.2024.08.026","DOIUrl":"10.1016/j.ekir.2024.08.026","url":null,"abstract":"<div><h3>Introduction</h3><div>Returning research-based genetic results (gRoR) to participants in nephrology research can improve care; however, the practice raises implementational questions and no established guidelines for this process currently exist. Nephrologists' views on this issue can inform the process but are understudied.</div></div><div><h3>Methods</h3><div>We developed a conceptual workflow for gRoR from literature and experience, covering aspects such as which results to return, how, and by whom. We surveyed US nephrologists to gauge their views on the workflow and anticipated barriers and collected participants' demographics, including professional backgrounds.</div></div><div><h3>Results</h3><div>A total of 201 adult and pediatric nephrologists completed the survey. Most of them agreed that all diagnostic kidney-related results (93%), secondary findings (80%), and kidney-related risk variants (83%) should be returned. No significant differences were found between adult and pediatric nephrologists’ responses, except that 48% of adult nephrologists versus 26% of pediatric nephrologists supported returning polygenic risk scores (PRS) (<em>P</em> &lt; 0.01). Seventy-nine percent wanted to know about research results before clinical confirmation. Most of them (63%) believed a genetic counselor should return clinically confirmed results. Key barriers included the cost of clinical validation (77%) and the unavailability of genetic counseling services (63%). Facilitators included educational resources on genetic kidney diseases (91%), a referral list of experts (89%), and clear clinical care guidelines (89%). We discuss findings’ implications and provide “points to consider.”</div></div><div><h3>Conclusion</h3><div>There is significant interest in gRoR among nephrologists; however, logistical and economic concerns need addressing. Identified facilitators can help large nephrology studies planning to return genetic results to participants.</div></div>","PeriodicalId":17761,"journal":{"name":"Kidney International Reports","volume":"9 11","pages":"Pages 3278-3289"},"PeriodicalIF":5.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142253227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to: “Implications of the Choice of Different Calculation Concepts for eGFRcys-to-eGFRcre Ratio Among Community-Dwelling Older Adults”","authors":"Esben Iversen ,&nbsp;Louise Westberg Strejby Christensen ,&nbsp;Aino Leegaard Andersen ,&nbsp;Rikke Lundsgaard Nielsen ,&nbsp;Morten Damgaard ,&nbsp;Trine Meldgaard Lund ,&nbsp;Mads Hornum ,&nbsp;Ove Andersen ,&nbsp;Morten Baltzer Houlind","doi":"10.1016/j.ekir.2024.09.003","DOIUrl":"10.1016/j.ekir.2024.09.003","url":null,"abstract":"","PeriodicalId":17761,"journal":{"name":"Kidney International Reports","volume":"9 11","pages":"Pages 3345-3346"},"PeriodicalIF":5.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142578902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to “Fine-Tuning Dry Weight: a Key Component in Managing Blood Pressure for Dialysis Patients”","authors":"Armida Lefranc Torres ,&nbsp;Simon Correa Gaviria ,&nbsp;Finnian R. McCausland","doi":"10.1016/j.ekir.2024.09.008","DOIUrl":"10.1016/j.ekir.2024.09.008","url":null,"abstract":"","PeriodicalId":17761,"journal":{"name":"Kidney International Reports","volume":"9 11","pages":"Page 3348"},"PeriodicalIF":5.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142578904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Urate in Calcium Stone Formation","authors":"Erika Critell ,&nbsp;Amy A. Yau","doi":"10.1016/j.ekir.2024.08.013","DOIUrl":"10.1016/j.ekir.2024.08.013","url":null,"abstract":"","PeriodicalId":17761,"journal":{"name":"Kidney International Reports","volume":"9 11","pages":"Pages 3338-3341"},"PeriodicalIF":5.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142181675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Subcutaneous Rituximab in Idiopathic Nephrotic Syndrome","authors":"Paolo Cravedi ,&nbsp;Carolina Bigatti ,&nbsp;Xhuliana Kajana ,&nbsp;Enrico E. Verrina ,&nbsp;Gianluca Caridi ,&nbsp;Maurizio Bruschi ,&nbsp;Gian Marco Ghiggeri ,&nbsp;Andrea Angeletti","doi":"10.1016/j.ekir.2024.08.021","DOIUrl":"10.1016/j.ekir.2024.08.021","url":null,"abstract":"","PeriodicalId":17761,"journal":{"name":"Kidney International Reports","volume":"9 11","pages":"Pages 3332-3334"},"PeriodicalIF":5.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142181664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}