Kidney international最新文献

{"title":"Neglected no longer: lymphatic vessels in the rejecting allograft","authors":"Griffith B. Perkins, Maarten Naesens","doi":"10.1016/j.kint.2026.01.012","DOIUrl":"10.1016/j.kint.2026.01.012","url":null,"abstract":"","PeriodicalId":17801,"journal":{"name":"Kidney international","volume":"110 1","pages":"Pages 23-25"},"PeriodicalIF":21.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147276620","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":"Asymptomatic serologic reactivation in patients with lupus nephritis in clinical remission: to treat or not to treat?","authors":"Antonis Fanouriakis,&nbsp;Y.K. Onno Teng","doi":"10.1016/j.kint.2026.04.005","DOIUrl":"10.1016/j.kint.2026.04.005","url":null,"abstract":"<div><div>Lupus nephritis flares are occasionally preceded by a rise in serologic activity. To date, watchful waiting is the suggested approach for patients with such a serologic reactivation. Yap <em>et al.</em> performed a randomized trial testing a pre-emptive increase in immunosuppression versus watchful monitoring in patients with stable lupus nephritis who had a rise in their anti–double-stranded DNA antibodies. We discuss their results in the context of the current landscape and expanding therapeutic options for the management of lupus nephritis.</div></div>","PeriodicalId":17801,"journal":{"name":"Kidney international","volume":"110 1","pages":"Pages 39-41"},"PeriodicalIF":21.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148277864","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":"Perrault syndrome unmasked: genomic reclassification of a Fabry-like CKDx phenotype","authors":"Izabela N. Zakrocka,&nbsp;Andreas Kronbichler,&nbsp;Dimitra Bouzarelou,&nbsp;Wojciech Załuska,&nbsp;Eirini Papadopoulou,&nbsp;Georgios Nasioulas","doi":"10.1016/j.kint.2026.01.034","DOIUrl":"10.1016/j.kint.2026.01.034","url":null,"abstract":"","PeriodicalId":17801,"journal":{"name":"Kidney international","volume":"110 1","pages":"Pages 260-262"},"PeriodicalIF":21.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147489852","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":"Finding the etiology of membranoproliferative glomerulonephritis","authors":"Sanjeev Sethi","doi":"10.1016/j.kint.2026.02.030","DOIUrl":"10.1016/j.kint.2026.02.030","url":null,"abstract":"<div><div>Membranoproliferative glomerulonephritis (MPGN) has undergone a change in classification that is focused on the etiology of MPGN. Thus, MPGN is classified into immune-complex (IC)–mediated MPGN and complement-mediated MPGN (C3 glomerulopathy) based on immunofluorescence microscopy studies that show positive staining for Igs and/or C3. IC-MPGN typically results from an infection or an autoimmune disease. Deposition of monotypic/monoclonal Ig also results in an MPGN. On the other hand, MPGN with bright C3 and minimal/no Ig is classified as C3 glomerulopathy. On the basis of the absence of any clinical evidence of an infection, autoimmune disease, or monoclonal gammopathy, the IC-MPGN is often labeled as primary/idiopathic MPGN. As such, increasing numbers of primary/idiopathic IC-MPGN are being diagnosed. In my renal biopsy practice, I have rarely seen an MPGN in an adult kidney biopsy in which I could not find an underlying etiology after diligent and careful evaluation of the biopsy. Some of the primary/idiopathic IC-MPGN falls into the monotypic/monoclonal Ig-associated MPGN, some into uncommon diseases, such as fibrillary glomerulonephritis, whereas others represent C3 glomerulopathy to begin with where the Ig is often entrapped in areas of scarring and does not represent true IC-MPGN. On the other hand, infection-related glomerulonephritis may be misclassified into C3 glomerulonephritis when there is sparse IgG on immunofluorescence microscopy. Chronic thrombotic microangiopathies can present with an MPGN pattern of injury and may be mislabeled as IC-MPGN or C3 glomerulonephritis from entrapment of IgM and/or C3. It is thus critical that we perform a thorough clinical and pathologic evaluation before labeling a case as idiopathic/primary IC-MPGN. Kidney biopsy evaluation should include complete immunofluorescence microscopy, including light chains, and electron microscopy. Pronase immunofluorescence microscopy and IgG subclass staining should be available to rule out masked Ig deposits and monotypic/monoclonal Ig-associated MPGN. An accurate diagnosis with identification of the etiology of IC-MPGN will allow for targeted treatment of the MPGN.</div></div>","PeriodicalId":17801,"journal":{"name":"Kidney international","volume":"110 1","pages":"Pages 8-15"},"PeriodicalIF":21.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147530323","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":"When autosomal dominant polycystic kidney disease becomes atypical: aADPKD","authors":"José Enrique Ruiz-Cabello,&nbsp;Andrea Cifuentes-Talavera,&nbsp;Marta Arroyo,&nbsp;Eduardo Gutierrez","doi":"10.1016/j.kint.2025.11.027","DOIUrl":"10.1016/j.kint.2025.11.027","url":null,"abstract":"","PeriodicalId":17801,"journal":{"name":"Kidney international","volume":"110 1","pages":"Page 266"},"PeriodicalIF":21.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147447318","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":"Intragraft clonal expansion of cytotoxic CD8+ and CD4+ T cells in antibody-mediated kidney transplant rejection","authors":"Thibaut Vaulet ,&nbsp;Baptiste Lamarthée ,&nbsp;Jasper Callemeyn ,&nbsp;Priyanka Koshy ,&nbsp;Dany Anglicheau ,&nbsp;Asier Antoranz ,&nbsp;Tim Debyser ,&nbsp;Bertrand Chauveau ,&nbsp;Wilfried Gwinner ,&nbsp;Dirk Kuypers ,&nbsp;Diether Lambrechts ,&nbsp;Pierre Marquet ,&nbsp;Marion Rabant ,&nbsp;Alexandar Senev ,&nbsp;Thomas Vanhoutte ,&nbsp;Maarten Naesens","doi":"10.1016/j.kint.2026.03.012","DOIUrl":"10.1016/j.kint.2026.03.012","url":null,"abstract":"<div><h3>Introduction</h3><div>The traditional dichotomy between antibody-mediated rejection (AMR) and T cell–mediated rejection (TCMR) after kidney transplantation is increasingly challenged. While T cell populations and their clonal expansion have been demonstrated in TCMR, the involvement and clonality of T cells remain unexplored in AMR.</div></div><div><h3>Methods</h3><div>Kidney transplant biopsy datasets from four independent cohorts (192 cases bulk transcriptomics, 16 cases of single-cell RNA/TCR sequencing, along with 18 and 75 cases of multiplex immunostaining) were analyzed to characterize CD4⁺ and CD8⁺ T cell enrichment, clonal expansion and spatial organization in AMR and microvascular inflammation (MVI).</div></div><div><h3>Results</h3><div>Deconvolution of bulk transcriptomes showed a significant enrichment of CD8⁺ T cells in 33 AMR/MVI samples versus 139 no rejection, with comparable levels between AMR/MVI and 20 (borderline) TCMR cases. Unsupervised clustering of scRNA-Seq data identified five major T cell clusters. Clonal expansion was mostly present in CD8⁺ Tem/Temra cells, CD4⁺ cytotoxic T cells and CD8⁺ HLA-DR⁺ CD27⁺ T cells. The CD4⁺ Naïve/Tcm cluster was mostly not expanded. The last CD8⁺ cluster was characterized by early activation markers (CD69⁺, FOS⁺, JUN⁺) and intermediate clonality. The four AMR biopsies had the highest proportion of clonally expanded T cells, most notably in early AMR cases in patients with pre-existing donor-specific antibodies without histological diagnosis of TCMR in three cases. Both the fraction of expanded T cells and the number of distinct expanded clones correlated with the PIRCHE-II score, which estimates the number of donor HLA-derived epitopes presented by the recipient’s HLA molecules. Finally, spatial proteomics confirmed the T-cell enrichment in the intravascular and glomerular compartments of AMR/MVI biopsies.</div></div><div><h3>Conclusions</h3><div>We demonstrated the presence of clonally expanded CD4⁺ and CD8⁺ cytotoxic T cells in early AMR biopsies with pre-existing donor-specific antibodies without histological diagnosis of TCMR. These findings highlight a level of complexity in the cellular mechanisms of rejection not currently captured by routine histology, suggesting that the dichotomy between AMR and TCMR needs reconsideration.</div></div>","PeriodicalId":17801,"journal":{"name":"Kidney international","volume":"110 1","pages":"Pages 89-98"},"PeriodicalIF":21.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147743856","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":"Kidney International introduces new article type: Clinical Journey in Translational Medicine","authors":"Jai Radhakrishnan ,&nbsp;Olivier Devuyst","doi":"10.1016/j.kint.2026.04.004","DOIUrl":"10.1016/j.kint.2026.04.004","url":null,"abstract":"","PeriodicalId":17801,"journal":{"name":"Kidney international","volume":"110 1","pages":"Page 16"},"PeriodicalIF":21.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147816739","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":"Resolving the VEGF paradox in DKD: VEGFR1 blockade shows promising renoprotection","authors":"Jakob A. Østergaard ,&nbsp;Mark E. Cooper","doi":"10.1016/j.kint.2026.04.006","DOIUrl":"10.1016/j.kint.2026.04.006","url":null,"abstract":"<div><div>Diabetic kidney disease remains a major clinical challenge despite advances in renoprotective therapies. In this issue of <em>Kidney International</em>, Qi <em>et al.</em> report that selective modulation of the vascular endothelial growth factor (VEGF) system differentially affects diabetic kidney disease progression across multiple advanced diabetic models. Whereas VEGF-A or VEGF receptor 2 inhibition exacerbated albuminuria, targeted VEGF receptor 1 blockade consistently conferred renoprotection, including in established disease. These findings clarify prior conflicting data and identify VEGF receptor 1 inhibition as a therapeutic strategy for diabetic kidney disease.</div></div>","PeriodicalId":17801,"journal":{"name":"Kidney international","volume":"110 1","pages":"Pages 33-34"},"PeriodicalIF":21.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148277896","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":"KDIGO Life Cycle of Guideline Development Series Part 6: Bridging the Gap between Guidelines and Clinical Practice: The KDIGO Approach to Global Implementation and Education in Nephrology.","authors":"Amy Earley,Elie Akl,Chris Carmona,Imuetinyan Edeki,Benjamin Lazarus,Jitendra Meena,Gihad Nesrallah,Laia Oliveras,Joyce Popoola,Amara Sarwal,Robin Vernooij,Reem A Mustafa","doi":"10.1016/j.kint.2026.03.034","DOIUrl":"https://doi.org/10.1016/j.kint.2026.03.034","url":null,"abstract":"The development of evidence-based clinical practice guidelines is a cornerstone of modern nephrology to facilitate shared decision-making, yet the creation of a guideline represents only the initial phase of the mission to improve outcomes for people living with kidney disease. The true impact of the rigorous, scientific process of Kidney Disease: Improving Global Outcomes (KDIGO) guideline development is realized only when recommendations are effectively disseminated, understood by healthcare professionals and patients, and implemented in clinical settings throughout the world. This manuscript outlines the comprehensive strategy employed by KDIGO to bridge the gap between global guidance and local practice. We review the core mission of KDIGO, the philosophy of \"global guidance, local implementation,\" and the robust suite of educational tools, summits, and digital initiatives designed to disseminate the key messages from the guidelines and educate healthcare professionals to implement the guidelines in order to optimize patient outcomes worldwide.","PeriodicalId":17801,"journal":{"name":"Kidney international","volume":"25 1","pages":""},"PeriodicalIF":19.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148365245","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 potential role for effector T cells with Fc receptors in kidney transplant antibody-mediated rejection","authors":"Patrick T. Gauthier ,&nbsp;Philip F. Halloran","doi":"10.1016/j.kint.2026.04.011","DOIUrl":"10.1016/j.kint.2026.04.011","url":null,"abstract":"<div><div>Antibody-mediated rejection, a leading cause of kidney transplant failure, is believed to be largely mediated by natural killer cells, with CD16a (FCGR3a) Fc receptors engaging the Fc portions of donor-specific antibodies on the graft endothelium, possibly in concert with “missing self” recognition. The paper by Vaulet <em>et al.</em> in this issue raises the possibility that clonally expanded effector T cells with Fc receptors may also play a role in the pathogenesis of antibody-mediated rejection.</div></div>","PeriodicalId":17801,"journal":{"name":"Kidney international","volume":"110 1","pages":"Pages 29-32"},"PeriodicalIF":21.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148277849","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}