Jingyi Li , Jicheng Lv , Muh Goet Wong , Sufang Shi , Jincan Zan , Helen Monaghan , Vlado Perkovic , Hong Zhang
{"title":"Correlation of Urinary Soluble CD163 Levels With Disease Activity and Treatment Response in IgA Nephropathy","authors":"Jingyi Li , Jicheng Lv , Muh Goet Wong , Sufang Shi , Jincan Zan , Helen Monaghan , Vlado Perkovic , Hong Zhang","doi":"10.1016/j.ekir.2024.07.031","DOIUrl":"10.1016/j.ekir.2024.07.031","url":null,"abstract":"<div><h3>Introduction</h3><div>The TESTING trial demonstrated that corticosteroids reduce the risk of kidney failure in patients with IgA nephropathy (IgAN) but increase the risk of serious adverse events. Reliable noninvasive biomarkers are needed to identify patients who would benefit most from corticosteroid therapy. Previous studies suggest glomerular macrophage infiltration is associated with response to immunosuppressive therapy in IgAN and urinary soluble CD163 ([u-sCD163], a marker of alternatively activated macrophages [M2]c macrophage) is correlated with clinical remission in vasculitis. This study aims to investigate the association between u-sCD163 and response of steroids therapy in IgAN.</div></div><div><h3>Methods</h3><div>We measured u-sCD163 in patients from a large IgAN cohort and Chinese participants of the TESTING trial. The correlation of baseline or serial u-sCD163 and their response of corticosteroids therapy or kidney outcomes were investigated.</div></div><div><h3>Results</h3><div>In cross-sectional analysis, u-sCD163 levels correlated with kidney macrophage infiltration, especially in crescentic areas, and with active lesions. Subgroup analysis of the TESTING cohort showed higher levels u-sCD163 were associated with greater benefits from corticosteroids therapy in proteinuria remission (odds ratio, 35.56 [95% confidence interval, CI: 7.62–292.34] vs. 3.94 [95% CI: 1.39–12.93], <em>P</em> for interaction: 0.036). Corticosteroids therapy significantly reduced u-sCD163 levels at 6 months compared to placebo group (79% [interquartile range: 58%–91%] vs. 37% [−11% to 58%], <em>P</em> <0.001). There was no difference in the suppressive effects on u-sCD163 by either dosage of corticosteroids (full and reduced-dose). The suppression of u-sCD163 was significantly associated with a reduced risk of kidney progression events (adjusted hazard ratio: 0.52, 95% CI: 0.30–0.93, <em>P</em> = 0.027).</div></div><div><h3>Conclusion</h3><div>u-sCD163 is a reliable noninvasive biomarker associated with active pathological lesions in IgAN and can guide glucocorticoid therapy.</div></div>","PeriodicalId":17761,"journal":{"name":"Kidney International Reports","volume":"9 10","pages":"Pages 3016-3026"},"PeriodicalIF":5.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142181705","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":"Lower Parathyroid Hormone Levels are Associated With Reduced Fracture Risk in Japanese Patients on Hemodialysis","authors":"Hirotaka Komaba , Takahiro Imaizumi , Takayuki Hamano , Naohiko Fujii , Masanori Abe , Norio Hanafusa , Masafumi Fukagawa","doi":"10.1016/j.ekir.2024.07.008","DOIUrl":"10.1016/j.ekir.2024.07.008","url":null,"abstract":"<div><h3>Introduction</h3><div>Secondary hyperparathyroidism (SHPT) affects bone metabolism and may lead to bone fragility. However, there is conflicting evidence as to whether parathyroid hormone (PTH) levels are associated with fracture risk and whether the relationship is linear or U-shaped.</div></div><div><h3>Methods</h3><div>We examined the association between PTH levels and the risk of any fracture and site-specific fractures in a nationwide cohort of 180,333 patients on hemodialysis. We also examined the association between the percent change in PTH levels during the preceding 1 year and subsequent fracture.</div></div><div><h3>Results</h3><div>At baseline, the median intact PTH level was 141 pg/ml (interquartile range, 78–226 pg/ml). During 1 year of follow-up, there were a total of 3762 fractures requiring hospitalization (1361 hip, 551 vertebral, and 1850 other). In an adjusted analysis, higher baseline PTH levels were associated with an incrementally increased risk of any fracture (odds ratio [OR] per doubling of intact PTH, 1.06; 95% confidence interval, 1.03–1.09). The association between PTH levels and fracture risk was more pronounced for hip fractures but not found for vertebral fractures. The absolute risk difference associated with higher PTH levels appeared to be more pronounced in older individuals, females, and those with lower body mass index (BMI). Change in PTH levels was also associated with fracture risk: the adjusted OR for fracture decreased linearly with decreasing PTH levels over 1 year, regardless of the preceding PTH levels.</div></div><div><h3>Conclusion</h3><div>Lower PTH levels are associated with a graded reduction in fracture risk. Further studies are needed to determine whether intensive PTH control reduces fracture risk.</div></div>","PeriodicalId":17761,"journal":{"name":"Kidney International Reports","volume":"9 10","pages":"Pages 2956-2969"},"PeriodicalIF":5.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141845714","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}
Jessica K. Kaufeld , Lucas Kühne , Ulf Schönermarck , Jan Hinrich Bräsen , Constantin von Kaisenberg , Bodo B. Beck , Florian Erger , Carsten Bergmann , Anke von Bergwelt-Baildon , Paul T. Brinkkötter , Linus A. Völker , Jan Menne
{"title":"Erratum to “Features of Postpartum Hemorrhage-Associated Thrombotic Microangiopathy and Role of Short-Term Complement Inhibition” [Kidney International Reports Volume 9, Issue 4, April 2024, Pages 919-928]","authors":"Jessica K. Kaufeld , Lucas Kühne , Ulf Schönermarck , Jan Hinrich Bräsen , Constantin von Kaisenberg , Bodo B. Beck , Florian Erger , Carsten Bergmann , Anke von Bergwelt-Baildon , Paul T. Brinkkötter , Linus A. Völker , Jan Menne","doi":"10.1016/j.ekir.2024.08.001","DOIUrl":"10.1016/j.ekir.2024.08.001","url":null,"abstract":"","PeriodicalId":17761,"journal":{"name":"Kidney International Reports","volume":"9 10","pages":"Page 3081"},"PeriodicalIF":5.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141941210","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":"Fracture Risk in Patients on Hemodialysis: the Lower the Parathyroid Hormone the Better?","authors":"Michel Y. Jadoul , Laura Labriola","doi":"10.1016/j.ekir.2024.08.023","DOIUrl":"10.1016/j.ekir.2024.08.023","url":null,"abstract":"","PeriodicalId":17761,"journal":{"name":"Kidney International Reports","volume":"9 10","pages":"Pages 2854-2856"},"PeriodicalIF":5.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142223890","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}
Thomas A. Mavrakanas , Amélie Marsot , Efrosyne Tsirella , Norka Rios , Ari Gritsas , Rita S. Suri
{"title":"Canagliflozin Pharmacokinetics at Steady State in Patients on Maintenance Hemodialysis","authors":"Thomas A. Mavrakanas , Amélie Marsot , Efrosyne Tsirella , Norka Rios , Ari Gritsas , Rita S. Suri","doi":"10.1016/j.ekir.2024.07.038","DOIUrl":"10.1016/j.ekir.2024.07.038","url":null,"abstract":"","PeriodicalId":17761,"journal":{"name":"Kidney International Reports","volume":"9 10","pages":"Pages 3049-3052"},"PeriodicalIF":5.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142181696","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}
Jihyun Yang , Kyu-Beck Lee , Hyang Kim , Soo Wan Kim , Yeong Hoon Kim , Su Ah Sung , Jayoun Kim , Kook-Hwan Oh , Ji Yong Jung , Young Youl Hyun
{"title":"Statin Use and the Progression of Coronary Artery Calcification in CKD: Findings From the KNOW-CKD Study","authors":"Jihyun Yang , Kyu-Beck Lee , Hyang Kim , Soo Wan Kim , Yeong Hoon Kim , Su Ah Sung , Jayoun Kim , Kook-Hwan Oh , Ji Yong Jung , Young Youl Hyun","doi":"10.1016/j.ekir.2024.07.033","DOIUrl":"10.1016/j.ekir.2024.07.033","url":null,"abstract":"<div><h3>Introduction</h3><div>Statin treatment can reduce the risk of cardiovascular disease (CVD). Paradoxically, previous studies have shown that the use of statin is associated with the progression coronary artery calcification (CAC), a well-known predictor of CVD, in individuals with preserved renal function or in patients on dialysis. However, little is known about the association in patients with predialysis chronic kidney disease (CKD). The aim of this study was to characterize the relationship between statin use and progression of CAC in a CKD cohort of Korean adults.</div></div><div><h3>Methods</h3><div>We analyzed 1177 participants registered in the Korean Cohort Study for Outcome in Patients with Chronic Kidney Disease (KNOW-CKD) cohort. Coronary artery calcium score (CACS) was assessed using cardiac computed tomography at baseline and 4 years after enrollment. CAC progression was defined using the Sevrukov method. Statin users were defined as those who used statins for 50% or more of the follow-up period.</div></div><div><h3>Results</h3><div>The median (interquartile range) of CACS was 0 (0–30.33), and 318 (44.2%) participants had CACS above 0 at baseline. There were 447 (38.0%) statin users and 730 (62.0%) statin nonusers. After 4 years, 374 patients (52.0%) demonstrated CAC progression, which was significantly more frequent in statin users than in statin nonusers (218 [58.3%] vs. 156 [41.7%], <em>P</em> < 0.001). The multivariate-adjusted odds ratio for CAC progression in statin users compared to statin nonusers was 1.78 (1.26–2.50).</div></div><div><h3>Conclusion</h3><div>Statin use, significantly and independently, is associated with CAC progression in Korean patients with predialysis CKD. Further research is warranted to verify the prognosis of statin-related CAC progression.</div></div>","PeriodicalId":17761,"journal":{"name":"Kidney International Reports","volume":"9 10","pages":"Pages 3027-3034"},"PeriodicalIF":5.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142181699","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}
Juergen Grafeneder , Wisse van Os , Iris K. Minichmayr , Katarina D. Kovacevic Miljevic , Birgit Reiter , Marcus D. Säemann , Veronika Machold-Fabrizii , Amro Ahmed , Paul Spechtl , Haris Omic , Raute Sunder-Plaßmann , Bernd Jilma , Christian Schoergenhofer , Farsad Eskandary
{"title":"Prospective Trial on the Pharmacokinetics of Clopidogrel in Hemodialysis Patients","authors":"Juergen Grafeneder , Wisse van Os , Iris K. Minichmayr , Katarina D. Kovacevic Miljevic , Birgit Reiter , Marcus D. Säemann , Veronika Machold-Fabrizii , Amro Ahmed , Paul Spechtl , Haris Omic , Raute Sunder-Plaßmann , Bernd Jilma , Christian Schoergenhofer , Farsad Eskandary","doi":"10.1016/j.ekir.2024.07.029","DOIUrl":"10.1016/j.ekir.2024.07.029","url":null,"abstract":"<div><h3>Introduction</h3><div>Hemodialysis patients (HDPs) exhibit extensive cardiovascular risk. The widely prescribed anti-platelet agent clopidogrel is metabolically activated by cytochrome enzymes, which may be impaired by uremia and chronic low-grade inflammation, typically present in HDPs. We conducted a prospective multicenter study to investigate the pharmacokinetics and pharmacodynamics of clopidogrel in HDPs and healthy volunteers (HVs).</div></div><div><h3>Methods</h3><div>We enrolled HDPs receiving long-term clopidogrel (75 mg) and pantoprazole treatment (40 mg). Healthy volunteers received a loading dose of 300 mg clopidogrel, followed by 75 mg once daily. Pantoprazole, a substrate and probe drug of <em>CYP2C19</em>, was administered intravenously (40 mg). Plasma concentrations were quantified by mass spectrometry. Pharmacokinetics were calculated, and a population pharmacokinetic model was developed. The primary endpoint was the maximum concentration of clopidogrel’s active metabolite. Platelet aggregation was measured using adenosine diphosphate-induced whole-blood aggregometry.</div></div><div><h3>Results</h3><div>Seventeen HDPs and 16 HVs were included. The maximum concentration of clopidogrel’s active metabolite was significantly lower in HDPs compared to HVs (median [interquartile range] 12.2 [4.6–23.4] vs. 24.7 [17.8–36.5] ng/ml, <em>P =</em> 0.02). The maximum concentration ratio of clopidogrel’s active metabolite to prodrug was 8.5-fold lower in HDPs, and an 82.7% reduced clopidogrel clearance, including clopidogrel’s active metabolite formation, was found using population pharmacokinetic modeling. From previous studies, adenosine diphosphate-induced platelet aggregation at 120 minutes was significantly higher in HDPs than in HVs (median [interquartile range]: 26 U [14 U–43 U] vs. 12 U [11 U–18 U], <em>P =</em> 0.004. Pantoprazole terminal half-life was ∼1.7-fold higher in HDPs compared to HVs.</div></div><div><h3>Conclusion</h3><div>Our data demonstrate an altered metabolism of clopidogrel in HDPs in the context of lower <em>CYP2C19</em> activity, with potential implications for other substances metabolized by this enzyme.</div></div>","PeriodicalId":17761,"journal":{"name":"Kidney International Reports","volume":"9 10","pages":"Pages 2970-2980"},"PeriodicalIF":5.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142181706","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}
Zhuo-ran Song , Yang Li , Hong Zhang , Xu-jie Zhou
{"title":"A Pilot Study on Protective Effect of Ambrisentan on Proteinuria in Patients With Alport Syndrome","authors":"Zhuo-ran Song , Yang Li , Hong Zhang , Xu-jie Zhou","doi":"10.1016/j.ekir.2024.07.027","DOIUrl":"10.1016/j.ekir.2024.07.027","url":null,"abstract":"","PeriodicalId":17761,"journal":{"name":"Kidney International Reports","volume":"9 10","pages":"Pages 3067-3069"},"PeriodicalIF":5.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142181738","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}
Daniil Shimonov , Sri Lekha Tummalapalli , Stephanie Donahue , Vidya Narayana , Sylvia Wu , Lisa S. Walters , Roberta Billman , Barbara Desiderio , Sandra Pressman , Oliver Fielding , Kariel Sweeney , Daniel Cukor , Daniel M. Levine , Thomas S. Parker , Vesh Srivatana , Jeffrey Silberzweig , Frank Liu , Andrew Bohmart
{"title":"Clinical Outcomes of a Novel Multidisciplinary Care Program in Advanced Kidney Disease (PEAK)","authors":"Daniil Shimonov , Sri Lekha Tummalapalli , Stephanie Donahue , Vidya Narayana , Sylvia Wu , Lisa S. Walters , Roberta Billman , Barbara Desiderio , Sandra Pressman , Oliver Fielding , Kariel Sweeney , Daniel Cukor , Daniel M. Levine , Thomas S. Parker , Vesh Srivatana , Jeffrey Silberzweig , Frank Liu , Andrew Bohmart","doi":"10.1016/j.ekir.2024.07.018","DOIUrl":"10.1016/j.ekir.2024.07.018","url":null,"abstract":"<div><h3>Introduction</h3><div>Multidisciplinary care (MDC) for late-stage chronic kidney disease (CKD) has been associated with improved patient outcomes compared with traditional nephrology care; however, the optimal MDC model is unknown. In 2015, we implemented a novel MDC model for patients with late-stage CKD informed by the Chronic Care Model conceptual framework, including an expanded MDC team, care plan meetings, clinical risk prediction, and a patient dashboard.</div></div><div><h3>Methods</h3><div>We conducted a single-center, retrospective cohort study of adults with late-stage CKD (estimated glomerular filtration rate [eGFR] < 30 ml/min per 1.73 m<sup>2</sup>) enrolled from May 2015 to February 2020 in the Program for Education in Advanced Kidney Disease (PEAK). Our primary composite outcome was an optimal transition to end-stage kidney disease (ESKD) defined as starting in-center hemodialysis (ICHD) as an outpatient with an arteriovenous fistula (AVF) or graft (AVG), or receiving home dialysis, or a preemptive kidney transplant. Secondary outcomes included home dialysis initiation, preemptive transplantation, vascular access at dialysis initiation, and location of ICHD initiation. We used logistic regression to examine trends in outcomes. Results were stratified by race, ethnicity, and insurance payor, and compared with national and regional averages from the United States Renal Data System (USRDS) averaged from 2015 to 2019.</div></div><div><h3>Results</h3><div>Among 489 patients in the PEAK program, 37 (8%) died prior to ESKD and 151 (31%) never progressed to ESKD. Of the 301 patients (62%) who progressed to ESKD, 175 (58%) achieved an optimal transition to ESKD, including 54 (18%) on peritoneal dialysis, 16 (5%) on home hemodialysis, and 36 (12%) to preemptive transplant. Of the 195 patients (65%) starting ICHD, 51% started with an AVF or AVG and 52% started as an outpatient. The likelihood of starting home dialysis increased by 1.34 times per year from 2015 to 2020 (95% confidence interval [CI]: 1.05–1.71, <em>P</em> = 0.018) in multivariable adjusted results. Optimal transitions to ESKD and home dialysis rates were higher than the national USRDS data (58% vs. 30%; 23% vs. 11%) across patient race, ethnicity, and payor.</div></div><div><h3>Conclusion</h3><div>Patients enrolled in a novel comprehensive MDC model coupled with risk prediction and health information technology were nearly twice as likely to achieve an optimal transition to ESKD and start dialysis at home, compared with national averages.</div></div>","PeriodicalId":17761,"journal":{"name":"Kidney International Reports","volume":"9 10","pages":"Pages 2904-2914"},"PeriodicalIF":5.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141851688","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}
Madan M. Bahadur , Nikhil Dhope , Rejitha R. Kaimal , Ashay Shingare
{"title":"Pilot Study of Valganciclovir-Induced Leukopenia in Kidney Transplant Recipients With NUDT15 Genetic Variation","authors":"Madan M. Bahadur , Nikhil Dhope , Rejitha R. Kaimal , Ashay Shingare","doi":"10.1016/j.ekir.2024.07.010","DOIUrl":"10.1016/j.ekir.2024.07.010","url":null,"abstract":"","PeriodicalId":17761,"journal":{"name":"Kidney International Reports","volume":"9 10","pages":"Pages 3070-3073"},"PeriodicalIF":5.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141839194","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}