Kidney international最新文献

{"title":"Causal assessment of CKD-MBD biomarker alterations on CKD progression through a g-formula analysis in the EQUAL Study.","authors":"Lorenza Magagnoli,Mario Cozzolino,Fergus J Caskey,Claudia Torino,Friedo W Dekker,Marie Evans,Maciej Szymczak,Christoph Wanner,Maria Pippias,Christiane Drechsler,Antonio Vilasi,Esmee Driehuis,Peter Stenvinkel,Vianda S Stel,Kitty J Jager,Nicholas C Chesnaye, ","doi":"10.1016/j.kint.2025.07.032","DOIUrl":"https://doi.org/10.1016/j.kint.2025.07.032","url":null,"abstract":"INTRODUCTIONChronic Kidney Disease - Mineral and Bone Disorder (CKD-MBD) may both be a cause and a consequence of CKD progression. Here, we examine the individual and joint effect of longitudinal circulating phosphate, parathyroid hormone, and calcium levels on estimated glomerular filtration rate (eGFR) decline, the risk of starting dialysis and the composite risk of death or dialysis, in a cohort of elderly patients with advanced CKD not on dialysis. Secondly, we explore whether these effects differ between men and women.METHODSWe used data from 1709 participants in the European Quality study, which includes patients aged 65 and older with eGFR 20 ml/min per 1.73m2 or less from six European countries. To avoid bias due to informative censoring, competing risks and time-varying confounding, we used the g-formula for causal inference.RESULTSIsolated hyperphosphatemia and hyperparathyroidism were associated with a higher risk of CKD progression, whereas isolated hypercalcemia was not. The combination of hyperphosphatemia with hyperparathyroidism, and of hypocalcemia with hyperparathyroidism were also associated with significantly higher risk. The most adverse phenotype was the combination of hyperphosphatemia, hypocalcemia and hyperparathyroidism, which led to a mean difference in eGFR after three years of -3.71 ml/min (95% confidence intervals: -5.44, -2.15) and a 75% higher risk of starting dialysis (hazard ratio 1.75, 95% confidence interval 1.35-2.10), compared to having all biomarkers in their reference ranges. Most of this risk was attributable to hyperphosphatemia. Although the effect of abnormal mineral biomarkers on eGFR decline was similar between sexes, the associated risk of starting dialysis seemed stronger in men than in women.CONCLUSIONAmong older men and women with advanced CKD not receiving dialysis, the presence of hyperphosphatemia, especially when combined with hypocalcemia and hyperparathyroidism, leads to an increased risk of CKD progression.","PeriodicalId":17801,"journal":{"name":"Kidney international","volume":"41 1","pages":""},"PeriodicalIF":19.6,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145035801","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}

{"title":"A stronger type I interferon signature distinguishes ANCA-associated vasculitis phenotypes and predicts kidney prognosis.","authors":"Benoît Brilland,Maïa Despré,Robin Khatri,Thomas Quéméneur,Cyrille Vandenbussche,Nathalie Merillon,Andrea Boizard-Moracchini,Maëva Roy,Laurence Preisser,Jérémie Riou,Giorgina Barbara Piccoli,Assia Djema,Nicolas Henry,Odile Blanchet,Stefan Bonn,Céline C Berthier,Peter Grayson,Yves Delneste,Viviane Gnemmi,Patrick Blanco,Marie-Christine Copin,David Langlais,Jean-François Augusto, ","doi":"10.1016/j.kint.2025.07.034","DOIUrl":"https://doi.org/10.1016/j.kint.2025.07.034","url":null,"abstract":"INTRODUCTIONAnti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) causes severe multisystemic organ damage. The main phenotypes, microscopic polyangiitis (MPA) and granulomatosis with polyangiitis (GPA), share similarities but differ in clinical presentation and outcome. To uncover their molecular differences, we performed transcriptomic profiling of kidney tissue, then focused on type I interferon (IFN-I) pathway activation in kidney and blood and its clinical implications.METHODSWe analyzed two independent cohorts (Maine-Anjou and RENVAS registries) totaling 193 patients with AAV and glomerulonephritis. NanoString nCounter transcriptomic profiling, and serum inflammatory molecules quantification were conducted. Comparative analyses of MPA vs. GPA (and MPO-AAV vs. PR3-AAV) were validated using independent public datasets (including kidney spatial transcriptomic datasets, European cDNA Renal Biobank and blood from the RAVE trial).RESULTSThe kidney IFN-I signature found in AAV-GN is upregulated in MPA/MPO-AAV compared to GPA/PR3-AAV and controls. Quantitative PCR, MxA immunohistochemistry, and analysis of external datasets confirmed these findings. This IFN-I signature, close to the one found in lupus nephritis, is linked to the extent of pDC infiltration. Kidney IFN-I activation correlated with increased kidney fibrosis, independently of kidney function. High kidney IFN-I signatures were linked to lower kidney survival, independently of kidney function and pathological scores. MPA kidneys also exhibited higher mast cell and T cell infiltration. Systemic analyses showed elevated IFNα and interferon related inflammatory molecules in all patients with AAV, but a stronger IFN-I gene signature was found in immune cells from MPA.CONCLUSIONOur study identifies an IFN-I signature in AAV, especially in MPA/MPO-AAV, underscoring its potential role in disease heterogeneity and kidney pathology. IFN-I emerges as a potential prognostic biomarker and therapeutic target in AAV, particularly for MPA. Further studies are needed to clarify its mechanisms and explore IFN-I modulation in clinical trials.","PeriodicalId":17801,"journal":{"name":"Kidney international","volume":"170 1","pages":""},"PeriodicalIF":19.6,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145035803","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}

{"title":"Felzartamab: a magic bullet to treat microvascular rejection?","authors":"Olivier Thaunat,Robert B Colvin","doi":"10.1016/j.kint.2025.06.023","DOIUrl":"https://doi.org/10.1016/j.kint.2025.06.023","url":null,"abstract":"","PeriodicalId":17801,"journal":{"name":"Kidney international","volume":"56 1","pages":""},"PeriodicalIF":19.6,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145018199","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}

{"title":"Out of chaos, comes tolerance: targeting the T cells driving antibody-mediated rejection.","authors":"Griffith B Perkins,P Toby Coates,Robert L Fairchild","doi":"10.1016/j.kint.2025.07.017","DOIUrl":"https://doi.org/10.1016/j.kint.2025.07.017","url":null,"abstract":"","PeriodicalId":17801,"journal":{"name":"Kidney international","volume":"130 1","pages":""},"PeriodicalIF":19.6,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145018200","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}

{"title":"Sexual dimorphism of age and nephron segment specific gene expression in mouse kidneys: insights from multi-omic and spatial analysis.","authors":"Anita T Layton","doi":"10.1016/j.kint.2025.07.014","DOIUrl":"https://doi.org/10.1016/j.kint.2025.07.014","url":null,"abstract":"","PeriodicalId":17801,"journal":{"name":"Kidney international","volume":"35 1","pages":""},"PeriodicalIF":19.6,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145018005","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}

{"title":"EPO and tumor growth: the key is immunosuppression.","authors":"Kai-Uwe Eckardt","doi":"10.1016/j.kint.2025.07.013","DOIUrl":"https://doi.org/10.1016/j.kint.2025.07.013","url":null,"abstract":"","PeriodicalId":17801,"journal":{"name":"Kidney international","volume":"28 1","pages":""},"PeriodicalIF":19.6,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144995717","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}

{"title":"Albuminuria-based universal screening for CKD should be implemented now in high income countries.","authors":"Lucia Cordero,Alberto Ortiz","doi":"10.1016/j.kint.2025.04.037","DOIUrl":"https://doi.org/10.1016/j.kint.2025.04.037","url":null,"abstract":"","PeriodicalId":17801,"journal":{"name":"Kidney international","volume":"61 1","pages":""},"PeriodicalIF":19.6,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144995707","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}

{"title":"Universal screening for CKD…Just because we can do it should we do it?","authors":"Brad H Rovin","doi":"10.1016/j.kint.2025.08.004","DOIUrl":"https://doi.org/10.1016/j.kint.2025.08.004","url":null,"abstract":"","PeriodicalId":17801,"journal":{"name":"Kidney international","volume":"39 1","pages":""},"PeriodicalIF":19.6,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144995711","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}

{"title":"To screen or not to screen: why universal CKD testing isn't a goer!","authors":"Germaine Wong,Anita van Zwieten","doi":"10.1016/j.kint.2025.05.040","DOIUrl":"https://doi.org/10.1016/j.kint.2025.05.040","url":null,"abstract":"","PeriodicalId":17801,"journal":{"name":"Kidney international","volume":"304 1","pages":""},"PeriodicalIF":19.6,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144995718","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}

{"title":"Distal renal tubular alkalosis: a mirror image of distal renal tubular acidosis?","authors":"Nabil William G Sweis, Daniel Batlle","doi":"10.1016/j.kint.2025.07.007","DOIUrl":"https://doi.org/10.1016/j.kint.2025.07.007","url":null,"abstract":"","PeriodicalId":17801,"journal":{"name":"Kidney international","volume":" ","pages":""},"PeriodicalIF":12.6,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144959319","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}