Sandra Habbig,Hanna Debiec,Malha Chedik,Dirk L Stippel,Florian Erger,Alexia Lourenço,Max C Liebau,Pierre Ronco
{"title":"Anti-nephrin antibodies guide living donor kidney transplantation in a pediatric patient with primary focal segmental glomerular sclerosis.","authors":"Sandra Habbig,Hanna Debiec,Malha Chedik,Dirk L Stippel,Florian Erger,Alexia Lourenço,Max C Liebau,Pierre Ronco","doi":"10.1016/j.kint.2025.04.015","DOIUrl":"https://doi.org/10.1016/j.kint.2025.04.015","url":null,"abstract":"INTRODUCTIONDisease recurrence after kidney transplantation (KTx) remains a major challenge in patients with primary focal segmental glomerulosclerosis (pFSGS). Antibodies targeting the slit diaphragm protein nephrin have been identified in patients with early disease recurrence. Here, we describe monitoring and effective pre-transplant elimination of anti-nephrin antibodies in an adolescent with pFSGS prior to living-donor KTx.METHODSAnti-nephrin antibodies were assessed in pre- and post-transplant serum samples by ELISA, Western blot and immunoprecipitation using three different nephrin proteins.RESULTSPre-transplant treatment including rituximab and repetitive therapeutic plasma exchanges resulted in effective and sustainable reduction of anti-nephrin antibodies. Allograft function has remained excellent without albuminuria over a follow-up of more than one year. Further analysis showed, that the antibodies were cross-reactive with NEPH3 (filtrin), another key slit diaphragm protein.CONCLUSIONSMonitoring and pre-transplant elimination of anti-slit diaphragm antibodies may become a standard, personalized approach in patients with pFSGS requiring KTx.","PeriodicalId":17801,"journal":{"name":"Kidney international","volume":"132 1","pages":""},"PeriodicalIF":19.6,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144087501","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}
Ida Lihme,Saima Basit,Frederikke Lihme,Mette B Damholt,Sarah Hjorth,Ellen A Nohr,Heather A Boyd
{"title":"A nationwide register-based cohort study examined the association between preeclampsia in mothers and the risk of kidney disease in their offspring.","authors":"Ida Lihme,Saima Basit,Frederikke Lihme,Mette B Damholt,Sarah Hjorth,Ellen A Nohr,Heather A Boyd","doi":"10.1016/j.kint.2025.04.017","DOIUrl":"https://doi.org/10.1016/j.kint.2025.04.017","url":null,"abstract":"INTRODUCTIONWomen with preeclampsia often deliver preterm (under37 weeks gestation). Preterm birth is associated with an increased risk of offspring kidney disease, but whether preeclampsia is independently associated with kidney disease risk is unknown. Here, we conducted a register-based cohort study to explore associations between maternal preeclampsia and offspring kidney disease after accounting for preterm birth.METHODSUsing Cox regression, we estimated hazard ratios (HRs) comparing kidney disease rates, overall and by subtype, in offspring with and without exposure to maternal preeclampsia.RESULTSThe study included 2,288,589 persons born in Denmark 1978-2017 of whom 63,191 were exposed to preeclampsia; 37,782 individuals developed kidney disease during 43,137,193 person-years of follow-up. Offspring exposed to preeclampsia and born at term (37 or more weeks' gestation) were 26% more likely than offspring born at term but not exposed to preeclampsia to develop kidney disease in infancy (HR 1.26, 95% confidence interval [1.09-1.46]), and had increased rates of all kidney disease subtypes except acute kidney disease after one year of age (HR range 1.11 to 1.88). Associations between term preeclampsia and offspring chronic, and unspecified and diabetic kidney disease were strongest after 25 years of age (HRs 1.36, 1.70 and 2.85, respectively). Conversely, there was little evidence that exposure to preeclampsia with preterm delivery was associated with increased rates of offspring kidney disease beyond the first year of life (under 1 year: 1.41, [1.05-1.90]; one year or more: 0.94, [ 0.79- 1.11]).CONCLUSIONSAssociations of maternal term preeclampsia with offspring kidney disease hint at underlying mechanisms different from those potentially explaining established associations with preterm birth.","PeriodicalId":17801,"journal":{"name":"Kidney international","volume":"126 1","pages":""},"PeriodicalIF":19.6,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144087499","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":"Metabolic Dysfunction Associated Kidney Disease: Pathogenesis and Clinical Manifestations.","authors":"Anip Bansal,Michel Chonchol","doi":"10.1016/j.kint.2025.01.044","DOIUrl":"https://doi.org/10.1016/j.kint.2025.01.044","url":null,"abstract":"In recent years, there have been significant changes in the lifestyle and eating behaviors of the population characterized by increased intake of high-calories food and a sedentary lifestyle without physical activity. The increased prevalence of overweight and obesity has led to metabolic dysfunction and their related complications, such as cardiovascular disease and chronic kidney disease (CKD). The purpose of this review is to highlight the importance, clinical features and pathogenesis of metabolic dysfunction-associated kidney disease (MDAKD). MDAKD is a term that describes kidney disease arising from metabolic dysfunction, often in the context of metabolic syndrome (MetS) and is characterized by the presence of CKD in individuals with metabolic abnormalities such as obesity, insulin resistance, diabetes mellitus, dyslipidemia, and hypertension. MDAKD includes diabetic kidney disease (DKD), obesity-related kidney disease (ORKD) and with increasing recognition of other rarer kidney diseases where metabolic dysfunction may impact progression. MDAKD is part of the spectrum of diseases whose pathogenesis is driven by metabolic dysfunction and has recently led to the proposal of new nomenclature including metabolic dysfunction associated steatotic liver disease (MASLD) and Cardio-Kidney-Metabolic Syndrome (CKM Syndrome). The new terminology of MDAKD provides additional emphasis on the pathogenic role of metabolic dysfunction on kidney disease.","PeriodicalId":17801,"journal":{"name":"Kidney international","volume":"36 1","pages":""},"PeriodicalIF":19.6,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144083292","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":"Regulation of podocyte surface proteins by the enzyme A Disintegrin And Metalloproteinase 10 (ADAM10).","authors":"David Rosenbaum,Julia Reichelt,Simonas Gudaitis,Stine Kühne,Stephanie Zielinski,Desiree Loreth,Lukas Blume,Johannes Brand,Helga Vitzthum,Wiebke Sachs,Alina Lampert,Lisa Seipold,Matthias Voss,Catherine Meyer-Schwesinger,Paul Saftig","doi":"10.1016/j.kint.2025.04.010","DOIUrl":"https://doi.org/10.1016/j.kint.2025.04.010","url":null,"abstract":"INTRODUCTIONPodocytes are terminally differentiated cells of the kidney filtration barrier. Their network of interdigitating foot processes embraces the glomerular capillaries and are likely remodeled by cleavage of podocyte surface proteins. The metalloproteinase ADAM10 is a major regulator of such surface protein shedding and was recently implicated in the pathophysiology of antibody-mediated podocyte injury.METHODSHere, we studied the contribution of ADAM10 in podocyte biology in health and disease and analyzed prominently expressed and disease-relevant podocyte membrane proteins in detail. We used genetically deficient mice, ADAM 10 inhibited pig glomeruli, and various in vitro experimental systems where detailed biochemical and imaging techniques were performed.RESULTSWe found that thrombospondin type 1 domain containing 7A (THSD7A) and phospholipase A2 receptor 1 (PLA2R1), both of which are primary membranous nephropathy antigens, accumulated upon ADAM10 inhibition/deficiency. Moreover, increased proteins levels of the foot process adhesion protein β-dystroglycan (β-DG) were found. Detailed biochemical analyses in different experimental systems revealed that THSD7A, PLA2R1, and β-DG are true ADAM10 substrates and subject to γ-secretase-mediated intramembrane proteolysis. These substrates co-localize and interact with the protease in podocytes and their shedding regulates filopodogenesis (THSD7A and β-DG) and cell matrix adhesion (β-DG). ADAM10 substrate usage, but also the stability of the podocyte cell surface proteins, are regulated by tetraspanin (Tspan) 15, which is likewise present at podocyte foot processes. A tricomponent complex of THSD7A/ADAM10/Tspan15 was found, with THSD7A acting as both an ADAM10 substrate and regulator.CONCLUSIONSAltogether, our data emphasizes the importance of ADAM10/Tspan15-mediated regulation of podocyte foot process surface proteins that serve as antigens in primary membranous nephropathy and impact cytoskeletal dynamics.","PeriodicalId":17801,"journal":{"name":"Kidney international","volume":"110 1","pages":""},"PeriodicalIF":19.6,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143926475","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}
Julia Melina Wolff,Konrad Lang,Mengmeng Chen,Julian Milosavljevic,Séverine Kayser,Martin Helmstädter,Gerd Walz,Ahmed Abed,Lea Gerstner,Sami Bahar,Maximilian H Ulbrich,Tobias Hermle
{"title":"Transgenic human nephrin in Drosophila nephrocytes facilitates variant analysis.","authors":"Julia Melina Wolff,Konrad Lang,Mengmeng Chen,Julian Milosavljevic,Séverine Kayser,Martin Helmstädter,Gerd Walz,Ahmed Abed,Lea Gerstner,Sami Bahar,Maximilian H Ulbrich,Tobias Hermle","doi":"10.1016/j.kint.2025.03.030","DOIUrl":"https://doi.org/10.1016/j.kint.2025.03.030","url":null,"abstract":"INTRODUCTIONNephrin, the key structural protein of the slit diaphragm, is encoded by NPHS1. Pathogenic variants in this gene are the primary cause of congenital nephrotic syndrome. About 400 variants have been described but functional characterization in vitro is very limited.METHODSHere, we express human nephrin in Drosophila nephrocytes, which possess a molecularly conserved slit diaphragm to facilitate functional studies.RESULTSImmunofluorescence of the human transgene revealed assembly into a complex linear architecture after silencing of sns, the Drosophila nephrin. This pattern suggests lateral clustering of human nephrin into a macromolecular configuration which resembles nephrin in vivo but is absent in cultured cells. In Drosophila nephrocytes, transgenic nephrin colocalized with the endogenous slit diaphragm proteins Pyd and Kirre, indicating a hybrid multi-protein complex. Transmission electron microscopy with pre-embedding immunogold labeling revealed an atypical, tubular ultrastructure. The linear nephrin did not adequately restore membrane invaginations, endocytic function or cellular survival, suggesting that proper signaling function requires additional indispensable co-factors. Murine Neph1 alone was insufficient but associated with transgenic nephrin. Notably, the linear nephrin assembly provided a read-out for investigation of patient-derived variants. This distinct pattern was altered in transgenes reflecting patient variants with milder clinical presentation, including novel variant NPHS1-V1241G. The impact on the pattern largely correlated with the age of onset of nephrotic syndrome of the respective variant, as demonstrated by automated image annotation for quantitative evaluation.CONCLUSIONOur findings demonstrate that transgenesis of NPHS1 in nephrocytes is a viable approach for investigation of slit diaphragm formation and precise functional characterization of patient variants.","PeriodicalId":17801,"journal":{"name":"Kidney international","volume":"2 1","pages":""},"PeriodicalIF":19.6,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143903115","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}
Samih H Nasr,Virginie Royal,Alejandro Best Rocha,Maike Büttner-Herold,Candice Roufosse,Frank Bridoux,Wesam Ismail,Lihong Bu,Lynn D Cornell,Amélie Dendooven,Rajib K Gupta,Shigeo Hara,Vincent Javaugue,Nicolas Kozakowski,Satoru Kudose,Gonzalo P Méndez,Kimberley Oliver,Maria M Picken,Dominick Santoriello,Sanjeev Sethi,Akira Shimizu,Geetika Singh,M Barry Stokes,Su-Xia Wang,Nelson Leung,Glen S Markowitz,Vivette D D'Agati
{"title":"Renal Pathology Society/International Kidney and Monoclonal Gammopathy Research Group Consensus on Pathologic Definitions and Terminology of Monoclonal Gammopathy Associated Kidney Lesions.","authors":"Samih H Nasr,Virginie Royal,Alejandro Best Rocha,Maike Büttner-Herold,Candice Roufosse,Frank Bridoux,Wesam Ismail,Lihong Bu,Lynn D Cornell,Amélie Dendooven,Rajib K Gupta,Shigeo Hara,Vincent Javaugue,Nicolas Kozakowski,Satoru Kudose,Gonzalo P Méndez,Kimberley Oliver,Maria M Picken,Dominick Santoriello,Sanjeev Sethi,Akira Shimizu,Geetika Singh,M Barry Stokes,Su-Xia Wang,Nelson Leung,Glen S Markowitz,Vivette D D'Agati","doi":"10.1016/j.kint.2025.04.007","DOIUrl":"https://doi.org/10.1016/j.kint.2025.04.007","url":null,"abstract":"The spectrum of kidney lesions associated with monoclonal gammopathy has significantly expanded over the past 2 decades, with description of new entities and variants of old entities. Pathologic diagnosis is challenging due to lesional complexity, heterogeneity, and reliance on electron microscopy and ancillary techniques. A lack of precise pathologic definitions and uniform terminology has hampered diagnostic accuracy. To address these challenges, the Renal Pathology Society and International Kidney and Monoclonal Gammopathy Research Group jointly tasked a working group of nephropathologists and nephrologists to establish consensus-based terminology and definitions for monoclonal gammopathy-associated kidney lesions. Participants included experts in the field with international representation. This report presents their recommendations. For each lesion, prerequisite (mandatory) diagnostic criteria and supportive (non-mandatory) features are proposed. New terminology is provided for some lesions. Application of standardized terminology and definitions should help harmonize kidney biopsy diagnosis with precision therapy in the monoclonal gammopathy-associated kidney disorders.","PeriodicalId":17801,"journal":{"name":"Kidney international","volume":"18 1","pages":""},"PeriodicalIF":19.6,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143885075","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":"Unlocking the full potential of human pluripotent stem cell derived kidney organoids through bioengineering.","authors":"Iphigénie Goux Corredera,Gaia Amato,Daniel Moya-Rull,Elena Garreta,Nuria Montserrat","doi":"10.1016/j.kint.2025.01.043","DOIUrl":"https://doi.org/10.1016/j.kint.2025.01.043","url":null,"abstract":"Human pluripotent stem cells hold inherent properties allowing to recapitulate key morphogenetic processes. These characteristics, coupled with bioengineering techniques, have led to the definition of early procedures to derive organ-like cell cultures, the so-called organoids. With regards to kidney organoids, challenges stand ahead such as the need to enhance cellular composition, maturation and function to that found in the native organ. To this end, the kidney organoid field has begun to nourish from innovative engineering approaches aiming to gain control on the externally imposed biochemical and biophysical cues. In this review, we first introduce how previous research in kidney development and human pluripotent stem cells have informed the establishment of current kidney organoid procedures. We then discuss recent engineering approaches to guide kidney organoid self-organization, differentiation and maturation. In addition, we present current strategies to engineer vascularization and promote in vivo-like physiological microenvironments as potential solutions to increase kidney organoid lifespan and functionality. We finally emphasize how working at the cusp of cell mechanics and computational biology will set the ground for successful translational applications of kidney organoids.","PeriodicalId":17801,"journal":{"name":"Kidney international","volume":"35 1","pages":""},"PeriodicalIF":19.6,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143885074","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}
An Xiao,Xiaoer Chen,Jingyi Ma,Xiaomei Chen,Tantan Long,Yuanyuan Ma,Qingzhou Chen,Zhiyuan Su,Zheng Hu,Liling Xie,Lei Zhang,Fengxin Zhu,Jing Nie
{"title":"Gene signature-guided drug screening identified narciclasine as a potential therapeutic for interstitial fibrosis of the kidney.","authors":"An Xiao,Xiaoer Chen,Jingyi Ma,Xiaomei Chen,Tantan Long,Yuanyuan Ma,Qingzhou Chen,Zhiyuan Su,Zheng Hu,Liling Xie,Lei Zhang,Fengxin Zhu,Jing Nie","doi":"10.1016/j.kint.2025.03.021","DOIUrl":"https://doi.org/10.1016/j.kint.2025.03.021","url":null,"abstract":"INTRODUCTIONChronic Kidney Disease (CKD) is marked by progressive tubulointerstitial fibrosis (TIF), a pathological feature insufficiently addressed by existing therapies.METHODSTo identify drugs with potential to halt TIF progression, we constructed a TIF-specific gene expression signature using published human CKD kidney transcriptome data and employed the small molecule perturbant library LINCS L1000 database for a high-throughput screening of compounds capable of reversing the expression of TIF-related genes.RESULTSNarciclasine, a natural compound derived from the Narcissus (amaryllis) plant, was identified as a top compound which significantly reversed the gene expression signature of TIF. Administration of narciclasine not only significantly prevented inflammation and fibrotic lesions induced by unilateral ureteral obstruction and unilateral ischemia-reperfusion injury but also delayed the progression of established TIF induced by unilateral ureteral obstruction. Furthermore, in 5/6 nephrectomy induced CKD model, narciclasine significantly lowered serum creatinine, reduced proteinuria, alleviated TIF and inflammation.CONCLUSIONSMechanistically, narciclasine reversed the failed-repair phenotype of tubular epithelial cells and inhibited fibroblasts proliferation and activation, at least partially via inhibiting the activation of NF-κB signaling. Our findings suggest that narciclasine should be further investigated as a promising drug candidate to attenuate CKD.","PeriodicalId":17801,"journal":{"name":"Kidney international","volume":"5 1","pages":""},"PeriodicalIF":19.6,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143876490","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}