Kidney International Reports最新文献

{"title":"Bringing a Systems Approach to Living Donor Kidney Transplantation","authors":"Anna Horton ,&nbsp;Katya Loban ,&nbsp;Peter Nugus ,&nbsp;Marie-Chantal Fortin ,&nbsp;Lakshman Gunaratnam ,&nbsp;Greg Knoll ,&nbsp;Istvan Mucsi ,&nbsp;Prosanto Chaudhury ,&nbsp;David Landsberg ,&nbsp;Michel R. Pâquet ,&nbsp;Marcelo Cantarovich ,&nbsp;Shaifali Sandal","doi":"10.1016/j.ekir.2024.07.014","DOIUrl":"10.1016/j.ekir.2024.07.014","url":null,"abstract":"<div><h3>Introduction</h3><div>Living donor kidney transplantation (LDKT) is the best treatment option for patients with kidney failure. Efforts to increase LDKT have focused on microlevel interventions and the need for systems thinking has been highlighted. We aimed to identify and compare health system–level attributes and processes that are facilitators and barriers to LDKT.</div></div><div><h3>Methods</h3><div>We conducted a qualitative comparative case study analysis of 3 Canadian provincial health care systems with variable LDKT performance (Quebec: low, Ontario: moderate-high, British Columbia: high). Data collection entailed semistructured interviews (<em>n</em> = 91), document review (<em>n</em> = 97) and focus groups (<em>n</em> = 5 with 40 participants), analyzed using inductive thematic analysis.</div></div><div><h3>Results</h3><div>Our findings showed a strong relationship between the degree of centralized coordination between governing organizations and the capacity to deliver LDKT as follows. (i) macro-level coordination between governing organizations in British Columbia and Ontario increased capacities, whereas Québec was seen as decentralized with little formal coordination; (ii) a higher degree of centralized coordination facilitated more effective resource deployment in the form of human resources and initiatives in British Columbia and Ontario, whereas in Québec resource deployment relied on hospital budgets leading to competition for resources and reduced capacity of initiatives; (iii) informal resource sharing through strong communities of practice and local champions facilitated LDKT in Ontario and British Columbia and was limited in Québec.</div></div><div><h3>Conclusion</h3><div>Our findings suggest that interventions that account for full-system function, particularly macro-level coordination between governing organizations can improve LDKT delivery. Findings may be used to guide structured organizational change toward increasing LDKT and mitigating the global burden of kidney failure.</div></div>","PeriodicalId":17761,"journal":{"name":"Kidney International Reports","volume":null,"pages":null},"PeriodicalIF":5.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141843234","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":"Increased Blood-Brain Barrier Permeability and Cognitive Impairment in Patients With ESKD","authors":"Mickaël Bobot ,&nbsp;Eric Guedj ,&nbsp;Noémie Resseguier ,&nbsp;Julien Faraut ,&nbsp;Philippe Garrigue ,&nbsp;Vincent Nail ,&nbsp;Guillaume Hache ,&nbsp;Sandra Gonzalez ,&nbsp;Nathalie McKay ,&nbsp;Romain Vial ,&nbsp;Dammar Bouchouareb ,&nbsp;Guillaume Lano ,&nbsp;Noémie Jourde-Chiche ,&nbsp;Ariane Duval-Sabatier ,&nbsp;Fabrice Guilaume ,&nbsp;Benjamin Guillet ,&nbsp;Stéphane Burtey","doi":"10.1016/j.ekir.2024.07.021","DOIUrl":"10.1016/j.ekir.2024.07.021","url":null,"abstract":"<div><h3>Introduction</h3><div>Chronic kidney disease (CKD) is associated with an increased risk of cognitive impairment. This cognitive impairment is associated with an increased permeability of blood-brain barrier (BBB) in rodents with CKD, linked to activation of aryl hydrocarbon receptor (AhR) by indoxyl sulphate (IS). The objective of the BREIN study was to confirm the increased BBB permeability in humans with CKD.</div></div><div><h3>Method</h3><div>The BREIN comparative study (NCT04328415) prospectively included patients with end-stage kidney disease (ESKD) and controls healthy volunteers matched in age, sex, and level of education to a patient. In all participants, BBB permeability was quantified by brain ^99mTc-DTPA SPECT/CT as a percentage of injected activity (% IA). A battery of neurocognitive tests was performed, and serum uremic toxins accumulation and AhR activation were assessed.</div></div><div><h3>Results</h3><div>Fifteen patients with ESKD and 14 healthy volunteers were analyzed. Patients with ESKD had higher BBB permeability compared to controls: 0.29 ± 0.07 versus 0.14 ± 0.06 %IA, <em>P</em> = 0.002. Patients with ESKD displayed lower Montreal Cognitive Assessment test (MoCA) score: 22.0 ± 5.0 versus 27.3 ± 2.8, <em>P</em> = 0.008; impaired short-term memory (doors test): 12.5 ± 3.4 versus 16.5 ± 3.4, <em>P</em> = 0.005; higher Beck depression score 8.1 ± 9.1 versus 2.7 ± 3.4, <em>P</em> = 0.046; and slightly more daily cognitive complaints: 42.5 ± 29.3 versus 29.8 ± 14.0 <em>P</em> = 0.060. Patients with ESKD displayed higher IS levels (86.1 ± 48.4 vs. 3.2 ± 1.7 μmol/l, <em>P</em> = 0.001) and AhR activating potential (37.7 ± 17.8% vs. 24.7 ± 10.4%, <em>P</em> = 0.027). BBB permeability was inversely correlated with MoCA score (<em>r</em> = −0.60, 95% confidence interval [−0.772 to −0.339], <em>P</em> = 0.001) in the overall population.</div></div><div><h3>Conclusion</h3><div>Patients with ESKD display an increased BBB permeability compared to matched healthy volunteers. Association with uremic toxins and cognitive impairment needs to be assessed in larger cohorts of patients.</div></div>","PeriodicalId":17761,"journal":{"name":"Kidney International Reports","volume":null,"pages":null},"PeriodicalIF":5.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141849757","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":"Coronaries, Calcium, and Kidney Consequences","authors":"Brian Rifkin ,&nbsp;Anthony Valeri","doi":"10.1016/j.ekir.2024.06.040","DOIUrl":"10.1016/j.ekir.2024.06.040","url":null,"abstract":"","PeriodicalId":17761,"journal":{"name":"Kidney International Reports","volume":null,"pages":null},"PeriodicalIF":5.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142181672","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":"Biomarkers of Kidney Disease Progression in ADPKD","authors":"Ahmad Ghanem ,&nbsp;Abdul Hamid Borghol ,&nbsp;Fadi George Munairdjy Debeh ,&nbsp;Stefan Paul ,&nbsp;Bassel AlKhatib ,&nbsp;Peter C. Harris ,&nbsp;Pranav S. Garimella ,&nbsp;Christian Hanna ,&nbsp;Timothy L. Kline ,&nbsp;Neera K. Dahl ,&nbsp;Fouad T. Chebib","doi":"10.1016/j.ekir.2024.07.012","DOIUrl":"10.1016/j.ekir.2024.07.012","url":null,"abstract":"<div><div>Autosomal dominant polycystic kidney disease (ADPKD) is the most common monogenic kidney disorder and the fourth leading cause of kidney failure (KF) in adults. Characterized by a reduction in glomerular filtration rate (GFR) and increased kidney size, ADPKD exhibits significant variability in progression, highlighting the urgent need for reliable and predictive biomarkers to optimize management and treatment approaches. This review explores the roles of diverse biomarkers—including clinical, genetic, molecular, and imaging biomarkers—in evaluating disease progression and customizing treatments for ADPKD. Clinical biomarkers such as biological sex, the predicting renal outcome in polycystic kidney disease <strong>(</strong>PROPKD) score, and body mass index are shown to correlate with disease severity and progression. Genetic profiling, particularly distinguishing between truncating and non-truncating pathogenic variants in the <em>PKD1</em> gene, refines risk assessment and prognostic precision. Advancements in imaging significantly enhance our ability to assess disease severity. Height-adjusted total kidney volume (htTKV) and the Mayo imaging classification (MIC) are foundational, whereas newer imaging biomarkers, including texture analysis, total cyst number (TCN), cyst-parenchyma surface area (CPSA), total cyst volume (TCV), and cystic index, focus on detailed cyst characteristics to offer deeper insights. Molecular biomarkers (including serum and urinary markers) shed light on potential therapeutic targets that could predict disease trajectory. Despite these advancements, there is a pressing need for the development of response biomarkers in both the adult and pediatric populations, which can evaluate the biological efficacy of treatments. The holistic evaluation of these biomarkers not only deepens our understanding of kidney disease progression in ADPKD, but it also paves the way for personalized treatment strategies aiming to significantly improve patient outcomes.</div></div>","PeriodicalId":17761,"journal":{"name":"Kidney International Reports","volume":null,"pages":null},"PeriodicalIF":5.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141705006","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":"Randomized Trial of Nitrate-Replete Beetroot Juice on Blood Pressure in Hypertensive Adults with ADPKD","authors":"Priyanka S. Sagar ,&nbsp;James Elhindi ,&nbsp;Katrina Chau ,&nbsp;David C. Harris ,&nbsp;Vincent Lee ,&nbsp;Kamal Sud ,&nbsp;Nikki Wong ,&nbsp;Gopala K. Rangan","doi":"10.1016/j.ekir.2024.07.017","DOIUrl":"10.1016/j.ekir.2024.07.017","url":null,"abstract":"","PeriodicalId":17761,"journal":{"name":"Kidney International Reports","volume":null,"pages":null},"PeriodicalIF":5.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141842265","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":"APOL1 High-Risk Genotype is Not Associated With New or Worsening of Proteinuria or Kidney Function Decline Following COVID-19 Vaccination","authors":"","doi":"10.1016/j.ekir.2024.06.023","DOIUrl":"10.1016/j.ekir.2024.06.023","url":null,"abstract":"<div><h3>Introduction</h3><p>SARS-CoV-2 infection increases systemic inflammatory cytokines which act as a second-hit driver of Apolipoprotein L1 (APOL1)-mediated collapsing glomerulopathy. SARS-CoV-2 vaccination also increases cytokines. Recent reports of new glomerular disease in individuals with <em>APOL1</em> high-risk genotype (HRG) following SARS-CoV-2 vaccination raised the concern SARS-CoV-2 vaccination may also act as a second-hit driver of APOL1-mediated glomerulopathy.</p></div><div><h3>Methods</h3><p>We screened 1507 adults in the Duke’s Measurement to Understand Reclassification of Disease of Cabarrus and Kannapolis (MURDOCK) registry and enrolled 105 eligible participants with available SARS-CoV-2 vaccination data, prevaccination and postvaccination serum creatinine, and urine protein measurements. Paired data were stratified by number of APOL1 risk alleles (RAs) and compared within groups using Wilcoxon signed rank test and across groups by analysis of variance.</p></div><div><h3>Results</h3><p>Among 105 participants, 30 (28.6%) had 2, 39 (37.1%) had 1, and 36 (34.3%) had 0 APOL1 RA. Most of the participants (94%) received at least 2 doses of vaccine. Most (98%) received the BNT162B2 (Pfizer) or mRNA-1273 (Moderna) vaccine. On average, the prevaccine and postvaccine laboratory samples were drawn 648 days apart. There were no detectable differences between pre- and post-serum creatinine or pre- and post-urine albumin creatinine ratio irrespective of the participants’ APOL1 genotype. Finally, most participants with APOL1 RA had the most common haplotype (E150, I228, and K255) and lacked the recently described protective N264K haplotype.</p></div><div><h3>Conclusion</h3><p>In this observational study, <em>APOL1</em> HRG is not associated with new or worsening of proteinuria or decline in kidney function following SARS-CoV-2 vaccination. Validation of this result in larger cohorts would further support the renal safety of SARS-CoV-2 vaccine in individuals with APOL1 HRG.</p></div>","PeriodicalId":17761,"journal":{"name":"Kidney International Reports","volume":null,"pages":null},"PeriodicalIF":5.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468024924017996/pdfft?md5=d3c49dbecbb47ba9f8c51ddac05179c5&pid=1-s2.0-S2468024924017996-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141553287","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":"Kidney Biopsy Findings After Lung Transplantation","authors":"David de Saint Gilles ,&nbsp;Marion Rabant ,&nbsp;Aurélie Sannier ,&nbsp;Charlotte Mussini ,&nbsp;Alexandre Hertig ,&nbsp;Antoine Roux ,&nbsp;Alexandre Karras ,&nbsp;Eric Daugas ,&nbsp;Vincent Bunel ,&nbsp;Jerome Le Pavec ,&nbsp;Renaud Snanoudj","doi":"10.1016/j.ekir.2024.07.005","DOIUrl":"10.1016/j.ekir.2024.07.005","url":null,"abstract":"<div><h3>Introduction</h3><p>The early diagnosis of histological kidney damage after lung transplantation (LT) is of paramount importance given the negative prognostic implications of kidney disease.</p></div><div><h3>Methods</h3><p>Three pathologists analyzed all kidney biopsies (KBs) (N = 100) performed from 2010 to 2021 on lung transplant patients in 4 Paris transplantation centers.</p></div><div><h3>Results</h3><p>The main indication for biopsy was chronic renal dysfunction (72% of patients). Biopsies were performed at a median of 26.3 months after transplantation and 15 months after a decline in estimated glomerular filtration rate (eGFR) or the onset of proteinuria. Biopsies revealed a wide spectrum of chronic lesions involving the glomerular, vascular, and tubulointerstitial compartments. The 4 most frequent final diagnoses, observed in 18% to 49% of biopsies, were arteriosclerosis, acute calcineurin inhibitor (CNI) toxicity, thrombotic microangiopathy (TMA) and acute tubular necrosis (ATN). TMA was significantly associated with a combination of mTOR inhibitors (mTORi) or CNIs with biological signs present in only 50% of patients. The eGFR was poorly correlated with most lesions, particularly percent glomerulosclerosis, and with the risk of end-stage renal disease (ESRD). Thirty-four patients progressed to ESRD at an average of 20.1 months after biopsy. Three factors were independently associated with the risk of ESRD: postoperative dialysis, proteinuria &gt;3 g/g and percent glomerulosclerosis &gt;4%.</p></div><div><h3>Conclusion</h3><p>Given the great diversity of renal lesions observed in lung transplant recipients, early referral to nephrologists for KB should be considered for these patients when they present with signs of kidney disease.</p></div>","PeriodicalId":17761,"journal":{"name":"Kidney International Reports","volume":null,"pages":null},"PeriodicalIF":5.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468024924018217/pdfft?md5=bcd003313d11c16d92b32eb54ed67920&pid=1-s2.0-S2468024924018217-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141699697","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":"Keep Calm and Dialyze On: Debunking the Myths of Peritoneal Dialysis Leaks","authors":"Susan McGrath ,&nbsp;Arsh K Jain","doi":"10.1016/j.ekir.2024.07.022","DOIUrl":"10.1016/j.ekir.2024.07.022","url":null,"abstract":"","PeriodicalId":17761,"journal":{"name":"Kidney International Reports","volume":null,"pages":null},"PeriodicalIF":5.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468024924018527/pdfft?md5=9014fd5ae9724eb04c9d7537065b8645&pid=1-s2.0-S2468024924018527-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141839320","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":"Timing and Modality of Kidney Replacement Therapy in Children and Adolescents","authors":"","doi":"10.1016/j.ekir.2024.06.009","DOIUrl":"10.1016/j.ekir.2024.06.009","url":null,"abstract":"<div><h3>Introduction</h3><p>The choice and timing of kidney replacement therapy (KRT) is influenced by clinical factors, laboratory features, feasibility issues, family preferences, and clinicians' attitudes. We analyzed the factors associated with KRT modality and timing in a multicenter, multinational prospective pediatric cohort study.</p></div><div><h3>Methods</h3><p>A total of 695 pediatric patients with chronic kidney disease (CKD) enrolled into the Cardiovascular Comorbidity in Children with CKD (4C) study at age 6 to 17 years with estimated glomerular filtration rate (eGFR) of 10 to 60 ml/min per 1.73 m² were investigated. Competing risk regression was performed to identify factors associated with initiation of dialysis or preemptive transplantation (Tx), including primary renal diagnosis, demographics, anthropometrics, and laboratory parameters.</p></div><div><h3>Results</h3><p>During the 8-year observation period, 342 patients (49%) started KRT. Of these, 200 patients started dialysis, whereas 142 patients underwent preemptive Tx. A lower eGFR at enrolment (Hazard ratio [HR]: 0.76 [95% confidence interval: 0.74–0.78]), a steeper eGFR slope (HR: 0.90 [0.85–0.95], and a higher systolic blood pressure SD score (SDS) (HR: 2.07 [1.49–2.87]) increased the likelihood of KRT initiation. Patients with glomerulopathies were more likely to start dialysis than children with congenital anomalies of the kidneys and urinary tracts (CAKUT) (HR: 3.81 [2.52–5.76]). Lower body mass index (BMI) SDS (HR: 0.73 [0.6–0.89]) and lower hemoglobin (HR: 0.8 [0.72–0.9]) were associated with higher likelihood of dialysis. A significant center effect was observed, accounting for 6.8% (dialysis) to 8.7% (preemptive Tx) of explained variation.</p></div><div><h3>Conclusion</h3><p>The timing and choice of KRT in pediatric patients is influenced by the rate of kidney function loss, the underlying kidney disease, nutritional status, blood pressure, anemia and center-specific factors.</p></div>","PeriodicalId":17761,"journal":{"name":"Kidney International Reports","volume":null,"pages":null},"PeriodicalIF":5.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468024924017686/pdfft?md5=0fab4bdd1dcafcbba82780a483e4d82d&pid=1-s2.0-S2468024924017686-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141407640","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 Many Faces of Congenital Anomalies of the Kidney and Urinary Tract","authors":"Miriam Schmidts ,&nbsp;Md Abdul Qader","doi":"10.1016/j.ekir.2024.07.028","DOIUrl":"10.1016/j.ekir.2024.07.028","url":null,"abstract":"","PeriodicalId":17761,"journal":{"name":"Kidney International Reports","volume":null,"pages":null},"PeriodicalIF":5.7,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468024924018588/pdfft?md5=bca5339e482acbcd8b01448430a9b094&pid=1-s2.0-S2468024924018588-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141941212","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}