Anuya A. Natu , Ishan Gupta , Nelson Leung , Mariam P. Alexander , Mrinal M. Patnaik
{"title":"Clonal monocytosis of renal significance","authors":"Anuya A. Natu , Ishan Gupta , Nelson Leung , Mariam P. Alexander , Mrinal M. Patnaik","doi":"10.1016/j.kint.2024.07.036","DOIUrl":"10.1016/j.kint.2024.07.036","url":null,"abstract":"<div><div>Clonal monocytosis reflects a preneoplastic or neoplastic sustained increase in the absolute monocyte count in the absence of reactive causes. Causes of clonal monocytosis include clonal cytopenias with monocytosis and acute and chronic myeloid neoplasms. Chronic myelomonocytic leukemia is a prototypical myelodysplastic/myeloproliferative overlap neoplasm in adults, characterized by sustained peripheral blood monocytosis. Kidney abnormalities, including acute kidney injury and chronic kidney disease, are frequent in patients with chronic myelomonocytic leukemia and are predictors of worse outcomes. In addition, acute kidney injury/chronic kidney disease often limits eligibility for allogeneic stem cell transplantation or enrollment in clinical trials. In this review, we highlight clonal monocytosis–related etiologies that give rise to acute kidney injury and chronic kidney disease, with special emphasis on chronic myelomonocytic leukemia and lysozyme-induced nephropathy. Monocytes produce lysozyme, which, in excess, can accumulate in and damage the proximal renal tubular epithelium. Early identification of this etiology and a timely reduction in monocyte counts can salvage kidney function. Other etiologies of kidney injury associated with clonal monocytosis include direct renal infiltration by monocytes, renal extramedullary hematopoiesis, myeloproliferative neoplasm–associated glomerulopathy, autoimmune (membranous nephropathy, minimal change disease) and paraneoplastic manifestations, thrombotic microangiopathy, obstructive nephropathy due to myeloproliferation, and urate nephropathy due to tumor lysis syndrome. We propose to group these mechanistic etiologies of kidney injury as clonal monocytosis of renal significance and provide guidance on their diagnosis and management.</div></div>","PeriodicalId":17801,"journal":{"name":"Kidney international","volume":"106 6","pages":"Pages 1062-1071"},"PeriodicalIF":14.8,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142290288","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":"NAVKIDS2: a lesson in matching outcome measures to interventions","authors":"Rachel Willard-Grace , Delphine S. Tuot","doi":"10.1016/j.kint.2024.07.018","DOIUrl":"10.1016/j.kint.2024.07.018","url":null,"abstract":"<div><p>Patient navigator programs may improve outcomes among individuals with chronic kidney disease by reducing barriers to evidence-based care. The NAVKIDS<sup>2</sup> trial evaluated a patient navigation program among 162 children with chronic kidney disease from marginalized populations. The intervention was not associated with quantitative changes in self-reported health, but qualitative data indicated substantial benefit in alleviating caregiver strain and facilitating care coordination. Future studies should identify quantitative measures that capture the benefits experienced by patients in care coordination, empowerment, and self-management.</p></div>","PeriodicalId":17801,"journal":{"name":"Kidney international","volume":"106 4","pages":"Pages 568-570"},"PeriodicalIF":14.8,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0085253824005404/pdfft?md5=ccb1fed914bcfacbe1cd9e4a64ef748e&pid=1-s2.0-S0085253824005404-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142274733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A new mechanism in adrenal control of aldosterone secretion involving the macrophage and VEGF","authors":"Tilman B. Drüeke , François Alhenc-Gelas","doi":"10.1016/j.kint.2024.08.030","DOIUrl":"10.1016/j.kint.2024.08.030","url":null,"abstract":"","PeriodicalId":17801,"journal":{"name":"Kidney international","volume":"106 6","pages":"Pages 1011-1014"},"PeriodicalIF":14.8,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142273496","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":"The renal function trajectory in clinical trial design: challenges and opportunities","authors":"Steven Rosansky , Richard Glassock","doi":"10.1016/j.kint.2024.07.023","DOIUrl":"10.1016/j.kint.2024.07.023","url":null,"abstract":"<div><p>The changes in renal function over time as surrogate endpoints for new drug trials are complicated by many factors, including the often-expected initial decrease in estimated glomerular filtration rate when a new drug is started. Two articles in the journal address this challenge, but multiple other challenges are explored in this commentary. To maximize the benefits of expensive new drugs that may slow decline in renal function, these drugs should be reserved for those patients who have a high probability of rapid loss of kidney function.</p></div>","PeriodicalId":17801,"journal":{"name":"Kidney international","volume":"106 4","pages":"Pages 565-568"},"PeriodicalIF":14.8,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0085253824005507/pdfft?md5=f6e4206dabb00871bb1bebd4015d4cd4&pid=1-s2.0-S0085253824005507-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142274732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Elucidating the role of clonal hematopoiesis in acute kidney injury","authors":"Yang Pan , Xiao Sun , Tanika N. Kelly","doi":"10.1016/j.kint.2024.06.017","DOIUrl":"10.1016/j.kint.2024.06.017","url":null,"abstract":"","PeriodicalId":17801,"journal":{"name":"Kidney international","volume":"106 4","pages":"Pages 554-556"},"PeriodicalIF":14.8,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142274734","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":"Unpicking the multi-omic response to endurance training: relevance for exercise benefits in chronic kidney disease.","authors":"Nicolette C Bishop","doi":"10.1016/j.kint.2024.09.005","DOIUrl":"https://doi.org/10.1016/j.kint.2024.09.005","url":null,"abstract":"","PeriodicalId":17801,"journal":{"name":"Kidney international","volume":"23 1","pages":""},"PeriodicalIF":19.6,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142275251","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":"Relmapirazin, a new exogenous filtration marker, and more widespread use of measured GFR","authors":"Marcelle Tuttle , Andrew S. Levey","doi":"10.1016/j.kint.2024.07.019","DOIUrl":"10.1016/j.kint.2024.07.019","url":null,"abstract":"<div><p>Plasma or urinary clearance of exogenous filtration markers is required for assessment of measured glomerular filtration rate. Although multiple methods are available, none is widely used because of their complexity, each has measurement error, and standardization is limited. Recently, a study validated the plasma clearance of a new exogenous filtration marker, relmapirazin, which can be detected by its transdermal fluorescence, potentially simplifying the procedure and increasing access to measured glomerular filtration rate.</p></div>","PeriodicalId":17801,"journal":{"name":"Kidney international","volume":"106 4","pages":"Pages 562-565"},"PeriodicalIF":14.8,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0085253824005416/pdfft?md5=e1b2629eafc80d55260a35b7fed83894&pid=1-s2.0-S0085253824005416-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142274731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}