Kidney360最新文献

{"title":"Lived Experiences of Older Adults with Advanced CKD and Their Caregivers: A Qualitative Study Uncovering Risk and Resilience Dynamics.","authors":"Margherita Cameranesi, Rebecca Mollard, Oksana Harasemiw, Sarah Curtis, Yasmin Iman, Jeann Buenafe, Jennifer L P Protudjer, Navdeep Tangri, Dylan MacKay","doi":"10.34067/KID.0000000723","DOIUrl":"https://doi.org/10.34067/KID.0000000723","url":null,"abstract":"<p><strong>Background: </strong>To date, very little is known about the lived experiences of families impacted by chronic kidney disease (CKD), especially regarding the adaptive coping strategies these families use to successfully cope with the chronic stress they must face due to CKD.</p><p><strong>Methods: </strong>An exploratory qualitative descriptive study was conducted by recruiting a sub-sample of adults with advanced CKD participating in the Canadian Frailty Observation and Interventions Trial (CanFIT) study and some of their caregivers. As part of this ongoing larger study, 12 adults with advanced CKD and seven of their caregivers (N = 19) completed one focus group discussion that explored topics related to their unique lived experiences of individuals impacted by CKD. Narrative data was analyzed using a 3-step inductive thematic analysis process.</p><p><strong>Results: </strong>Three themes that portray participants' lived experiences were identified, including 1) experiencing chronic stress due to CKD; 2) coping successfully with the stress caused by CKD; and 3) recommendations to improve family well-being.</p><p><strong>Conclusions: </strong>Social and health services for families impacted by CKD may be more effective in promoting the health, well-being, and quality of life of both adults with CKD and their caregivers if they acknowledge the chronic stressors these families face daily and provide support strategies that help them successfully cope with such stressors.</p>","PeriodicalId":17882,"journal":{"name":"Kidney360","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uptake of Peritoneal Dialysis (PD) by Minoritized Patients: The Role of Modality Education.","authors":"Ivelina Arnaoudova, Clara Wilson, Katherine Rizzolo, Jenny Shen, Nahian Ehtesham, Jennifer Wilson, Ladan Golestaneh","doi":"10.34067/KID.0000000702","DOIUrl":"https://doi.org/10.34067/KID.0000000702","url":null,"abstract":"<p><strong>Background: </strong>In a cohort of patients with late-stage kidney disease who completed dialysis modality education and who self-identified as racial ethnic minorities, we studied characteristics of those choosing PD, and perception of usefulness of the education session in modality selection.</p><p><strong>Methods: </strong>In this study of individuals with kidney failure cared for by nephrologists at Montefiore Medical Center, Bronx, NY, who were referred for modality education, we: 1-tested the association of patient characteristics with modality selection in 113 patients from 2021-2023, and 2-examined patient perception of the quality of modality education from 13 semi-structured interviews. We compared sociodemographic, clinical attributes, and patient responsiveness to attempts made by staff among those who selected and initiated PD to those who a-did not select PD, or b-initiated on HD urgently . We performed qualitative analysis of interviews to reach consensus on theoretical domain framework concepts and how they fit events in the kidney failure trajectory.</p><p><strong>Results: </strong>Compared to individuals who required urgent HD, those who selected, and were initiated on, PD were younger (54 yrs vs 66 yrs), had fewer comorbidities, and did not require as many attempts to schedule modality education. Qualitative analysis of interviews showed that experience with staff and quality of information conveyed during education was generally positive, but the following gaps were identified: lack of support for the emotional trauma of kidney failure diagnosis, inability to address structural barriers to PD specific to the patient population, and the lack of a deliberate program to lessen anxiety about the responsibility of PD.</p><p><strong>Conclusions: </strong>Incorporation of tailored content that addresses clinical comorbidity, structural barriers to care and emotional trauma constitute aspects of modality education that can be improved to increase PD uptake among minoritized patients.</p>","PeriodicalId":17882,"journal":{"name":"Kidney360","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exosomes Derived from Dialysis Patients Serum enhance Endothelial-Mesenchymal Transition and Calcification in Endothelial Cells.","authors":"Keren Cohen-Hagai, Eran Kuchuk, Shelly Tartakover Matalon, Sydney Benchetrit, Tali Zitman-Gal","doi":"10.34067/KID.0000000678","DOIUrl":"https://doi.org/10.34067/KID.0000000678","url":null,"abstract":"<p><strong>Background: </strong>Vascular calcification (VC) is prevalent among patients with end stage kidney disease (ESKD). Exosomes, small extracellular vesicles actively secreted by cells, contain proteins, nucleic acids, lipids and other bioactive substances and are considered major mediators of cell-cell interactions. Endothelial-Mesenchymal Transition (EndMT) has been observed in a variety of pathological conditions, such as abnormal shear stress, vascular damage, and chronic inflammation. The aim of this research was to assess the effects of serum-derived exosomes from ESKD patients with VC on the induction of EndMT in endothelial cells and their potential role in accelerating VC.</p><p><strong>Methods: </strong>Twenty hemodialysis patients with VC and 10 healthy volunteers were recruited. Cardiac and brain VC were assessed among patients with ESKD treated with dialysis. Serum samples were taken at dialysis initiation for exosome isolation. Human umbilical vein endothelial cells (HUVEC) were treated with 100 µg/mL exosomes for 24-96 hours. At the end of incubation, cells were collected for mRNA and protein analysis.</p><p><strong>Results: </strong>Exosomes isolated from dialysis patients with VC induced EndMT in HUVECs. After 24h, endothelial markers CD31 and VE-cadherin were decreased (31% and 51%, respectively; P<0.001) and the mesenchymal proteins Vimentin and N-cadherin were increased (283% and 156%, respectively; P<0.001), compared to healthy exosomes. After 96h of incubation, expression of genes essential for osteoblast differentiation, including the bone morphogenetic genes (BMP2, BMPR2, BMP4 and BMP9), and the transcription factor RUNX2 were significantly elevated.</p><p><strong>Conclusions: </strong>Exosomes derived from the serum of dialysis patients with VC, induced EndMT and contributed to calcification. The vicious cycle highlighted the intricate interplay between exosomes, EC and VC, emphasizing the critical necessity for therapeutic strategies to disrupt this pathway and mitigate calcification advancement.</p>","PeriodicalId":17882,"journal":{"name":"Kidney360","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peripheral Transcriptomics in Acute and Long-Term Kidney Dysfunction in SARS-CoV2 Infection.","authors":"Pushkala Jayaraman, Madhumitha Rajagopal, Ishan Paranjpe, Mayte Suarez-Farinas, Lora Liharska, Ryan Thompson, Diane Marie Del Valle, Noam Beckmann, Anina N Lund, Pooja Gownivaripally, Wonsuk Oh, Faris F Gulamali, Justin Kauffman, Edgar Gonzalez-Kozlova, Sergio Dellepiane, George Vasquez-Rios, Akhil Vaid, Joy Jiang, Ben Fox, Ankit Sakhuja, Steven Chen, Ephraim Kenigsberg, John Cijiang He, Steven G Coca, Lili Chan, Miram Merad, Seunghee Kim-Schulze, Sacha Gnjatic, Ephraim Tsalik, Raymond Langley, Alexander W Charney, Girish N Nadkarni","doi":"10.34067/KID.0000000727","DOIUrl":"https://doi.org/10.34067/KID.0000000727","url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury (AKI) is common in SARS-CoV-2 infection and COVID-19, often leading to long-term kidney dysfunction. However, the transcriptomic features of AKI severity and its long-term effects are underexplored.</p><p><strong>Methods: </strong>We performed bulk RNA sequencing on peripheral blood mononuclear cells (PBMCs) from hospitalized SARS-CoV-2 patients and complemented these findings with proteomic data from the same cohort. We compared the functional enrichment findings with historical sepsis-AKI data and subsequently examined the association between molecular signatures and long-term kidney function changes.</p><p><strong>Results: </strong>In 283 patients, 57 had mild AKI (stage 1) and 49 had severe AKI (stage 2 or 3). Following adjustments for age, sex, severity of infection, and pre-existing chronic kidney disease (CKD), we identified 6,432 differentially expressed genes (DEGs) in the severe AKI vs. control comparison, 840 in the mild AKI vs. control, and 1,213 in the severe vs. mild AKI comparison (FDR<0.05). Common pathways included unfolded protein response, cellular response to stress via eIF2, and IFN-g-mediated inflammatory response. Severe AKI was linked to pathways involved in mitochondrial dysfunction and endoplasmic reticulum stress. Proteomic analysis confirmed 40 established AKI and inflammation biomarkers, while gene-set enrichment of transcription regulators revealed additional biomarkers for severe AKI. Comparison with PBMC transcriptomics from sepsis-related AKI showed significant functional overlap (30%). Analysis of post-discharge eGFR data in 115 patients identified 177 DEGs for severe vs. control, 106 for mild vs. control, and 46 for severe vs. mild AKI. Key associations included kidney function decline related to carbohydrate and mitochondrial metabolism, inflammatory-response, and cardiovascular regulation.</p><p><strong>Conclusions: </strong>We demonstrate that severe AKI in SARS-CoV-2 infection is linked to mitochondrial dysfunction and ER stress. The functional overlap with sepsis-AKI suggests potential broader therapeutic applicability. Long-term kidney dysfunction is influenced by disruptions in cellular energy metabolism and immune response.</p>","PeriodicalId":17882,"journal":{"name":"Kidney360","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevention and Treatment of Acute Kidney Injury Associated with High Dose Methotrexate.","authors":"Stanislas Faguer, Chloé Medrano, Suzanne Tavitian, Lucie Oberic","doi":"10.34067/KID.0000000725","DOIUrl":"https://doi.org/10.34067/KID.0000000725","url":null,"abstract":"<p><p>Acute kidney injury (AKI) is a rare but life-threatening complication of the administration of methotrexate (MTX) at high doses (≥1 g/m2) for treatment of solid or hematological malignancies. MTX overexposure can lead to MTX-AKI, and subsequent higher risk of extra-kidney toxicities, morbidity and mortality. MTX-AKI can also lead to secondary chronic kidney disease requiring a reduced dose or contraindication for subsequent MTX infusions, thus worsening the cancer-related prognosis. Treatment of MTX-AKI is mainly preventive, combining alkaline hyperhydration, withdrawal of all nephrotoxic agents and drugs that modulate the metabolism of MTX, metabolic salvage using leucovorin (folinic acid), and close monitoring of serum MTX and creatinine concentrations. Glucarpidase (carboxypeptidase-G2), a recombinant bacterial enzyme that hydrolyzes MTX into two non-cytotoxic metabolites, should be considered for patients with MTX overexposure to prevent and lessen AKI and other potential toxicities. This article provides a comprehensive review of MTX metabolism, mechanisms and prevention of MTX-AKI, and its management.</p>","PeriodicalId":17882,"journal":{"name":"Kidney360","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Natural Language Processing Identifies Under-Documentation of Symptoms in Patients on Hemodialysis.","authors":"Yang Dai, Huei Hsun Wen, Joanna Yang, Neepa Gupta, Connie Rhee, Carol R Horowitz, Dinushika Mohottige, Girish N Nadkarni, Steven Coca, Lili Chan","doi":"10.34067/KID.0000000694","DOIUrl":"https://doi.org/10.34067/KID.0000000694","url":null,"abstract":"<p><strong>Background: </strong>Patients on hemodialysis (HD) have a high burden of emotional and physical symptoms. These symptoms are often under-recognized. NLP can be used to identify patient symptoms from the EHR. However, whether symptom documentation matches patient reported burden is unclear.</p><p><strong>Methods: </strong>We conducted a prospective study of patients seen at an ambulatory nephrology practice from September 2020 to April 2021. We collected symptom surveys from patients, nurses, and physicians. We then developed a natural language processing (NLP) algorithm to identify symptoms from the patients' electronic health records (EHR) and validated the performance of this algorithm using manual chart review and patient surveys as a reference standard. Using patient surveys as the reference standard, we compared symptom identification by 1) physicians, 2) nurses, 3) physicians or nurses, and 4) NLP.</p><p><strong>Results: </strong>We enrolled 97 patients into our study, 63% were female, 49% were Non-Hispanic Black, and 41% were Hispanic. The most common symptoms reported by patients were fatigue (61%), cramping (59%), dry skin (53%), muscle soreness (43%), and itching (41%). Physicians and nurses significantly under-recognized patients' symptoms (sensitivity 0.51 (95% CI 0.40-0.61) and 0.63 (95% CI 0.52-0.72) respectively). Nurses were better at identifying symptoms when patients reported more severe symptoms. There was no difference in results by patients' sex or ethnicity. NLP had a sensitivity of 0.92, specificity of 0.95, PPV of 0.75, and NPV of 0.99 with manual EHR review as the reference standard, and a sensitivity of 0.58 (95% CI 0.47-0.68), specificity of 0.73 (95% CI 0.48-0.89), PPV of 0.92 (95% CI 0.82-0.97), and NPV of 0.24 (95% CI 0.14-0.38) compared with patient surveys.</p><p><strong>Conclusions: </strong>While patients on HD report high prevalence of symptoms, symptoms are under-recognized and under-documented. NLP was accurate at identifying symptoms when they were documented. Larger studies in representative populations are needed to assess the generalizability of the results of the study.</p>","PeriodicalId":17882,"journal":{"name":"Kidney360","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Properties of Uremic Solutes That Allow Their Effective Control by Hemodialysis.","authors":"Tanuja Yalamarti, Tammy L Sirich, Xin Hai, Josef K Suba, Lindsey S Keo, Kristy H C Chan, Timothy W Meyer","doi":"10.34067/KID.0000000712","DOIUrl":"https://doi.org/10.34067/KID.0000000712","url":null,"abstract":"<p><strong>Background: </strong>If the GFR falls far enough, uremic symptoms such as anorexia and nausea prompt the initiation of dialysis. Thrice weekly hemodialysis can prevent recurrence of these symptoms even when patients become anuric. To accomplish this it must maintain the plasma levels of the uremic solutes which cause these symptoms lower than they were when dialysis was initiated. This study examined kinetic properties that solutes must possess for hemodialysis to accomplish this. We also sought to identify uremic solutes that possess these properties.</p><p><strong>Methods: </strong>Mathematical modeling analyzed how a solute's kinetic properties would determine the relation of its level in an anuric dialysis patients to its level when uremic symptoms prompt dialysis initiation. The previously unstudied solute methylurea was assayed by liquid chromatography tandem mass spectrometry (LC/MS/MS) in 13 participants on hemodialysis, 9 participants with advanced CKD, and 10 participants without kidney disease.</p><p><strong>Results: </strong>Mathematical modeling showed that conventional dialysis can effectively control the plasma levels better than the failing native kidneys only of solutes which have a high dialytic clearance relative to their native kidney clearance and a large volume of distribution. LC/MS/MS measurements showed that methylurea has these properties. The dialytic clearance of methylurea was 255 ± 32 ml/min and its volume of distribution was 1.09 ± 0.25 times the body water volume in hemodialysis patients. The methylurea clearance was lower than the GFR in patients without kidney disease (fractional clearance 0.44 ± 0.19) and patients with advanced CKD (fractional clearance 0.53 ± 0.10). Literature review revealed that urea was the only solute previously known to possess these properties.</p><p><strong>Conclusions: </strong>A further search for solutes whose properties include a high dialytic clearance, a relatively low native kidney clearance, and a high volume of distribution could help identify solutes that contribute to uremic symptoms.</p>","PeriodicalId":17882,"journal":{"name":"Kidney360","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying Research Priorities for Cognition in CKD: A Delphi Study.","authors":"Jamie Alexiuk, Oksana Harasemiw, Jessica Vanderlinden, Davide Verrelli, Brett Tarca, David Collister, Heitor Ribeiro, Bonnie Corradetti, Kevin Fowler, Fabio Manfredini, Mara McAdams-DeMarco, Nadia Chu, Shilpa Jesudason, Clare McKeaveney, Silvia J Leon, Urmila Anandh, James Tollitt, Stephanie Thompson, Indranil Dasgupta, Clara Bohm","doi":"10.34067/KID.0000000708","DOIUrl":"https://doi.org/10.34067/KID.0000000708","url":null,"abstract":"<p><strong>Background: </strong>Cognition is a research priority for people living with chronic kidney disease (CKD), but identification of critical research questions is lacking. This study aimed to determine which cognition-related research questions are most important to CKD stakeholders.</p><p><strong>Methods: </strong>A modified Delphi technique with 3 survey rounds was used. The study sample included 3 panels (People with lived CKD experience, Researchers, and Clinicians) recruited through international patient and kidney research networks, kidney societies, and snowball sampling with email invitations. Survey rounds were distributed electronically through REDCap. In Round 1 (October 2021-May 2022), respondents contributed three important research questions regarding cognition in CKD (free text). After deduplication and qualitative synthesis, respondents ranked the importance of these questions on a nine-point Likert scale in Round 2 (Feb-April 2023). Questions with mean and median ratings of >7 by at least two respondent panels or rated critically important by the 'lived experience' panel were re-ranked in Round 3 ( Aug-Sept 2023) and assessed for consensus to identify the final list of priority research questions.</p><p><strong>Results: </strong>Respondents (n=152) identified 125 and 44 discrete questions after Rounds 1 and 2, respectively. The final shortlist included 27 questions in 8 categories. The most critical research question identified was \"What factors prevent cognitive impairment in people receiving dialysis?\" Overall, respondents prioritized questions focusing on prevention and treatment of cognitive impairment. Scores between the panels were significantly different for 16 questions. Those with lived CKD experience prioritized quality of life, researchers emphasized developing interventions to mitigate cognitive impairment, and clinicians prioritized the effect of CKD treatment on cognitive impairment.</p><p><strong>Conclusions: </strong>Through an established consensus methodology involving key stakeholder groups, we identified 27 critical research questions about cognition in CKD. These questions should guide future study design and outcome selection.</p>","PeriodicalId":17882,"journal":{"name":"Kidney360","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143033430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and Efficacy of Liraglutide and Semaglutide in Kidney Transplant Recipients.","authors":"Joseph Kahwaji, Sean Hashmi, Chong Young Parke, Roland Lee","doi":"10.34067/KID.0000000706","DOIUrl":"https://doi.org/10.34067/KID.0000000706","url":null,"abstract":"","PeriodicalId":17882,"journal":{"name":"Kidney360","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dose-Response Relationship of Phloretin Therapy on Water and Glucose Transport during Experimental Peritoneal Dialysis.","authors":"Martin Björk, Giedre Martus, Carl M Öberg","doi":"10.34067/KID.0000000717","DOIUrl":"https://doi.org/10.34067/KID.0000000717","url":null,"abstract":"<p><strong>Background: </strong>Water retention, ultrafiltration insufficiency, and metabolic complications due to abnormally high glucose concentrations are still common problems in patients treated with peritoneal dialysis. Phloretin, a nonselective inhibitor of facilitative glucose transporter channels (GLUT), has shown to improve water transport and lower glucose absorption in experimental peritoneal dialysis. However, the dose-response relationship remains unknown, and we therefore performed a dose-response study to elucidate the pharmacodynamic properties of intra-peritoneal phloretin therapy.</p><p><strong>Methods: </strong>Experimental peritoneal dialysis was performed in fifty healthy Sprague-Dawley rats, using glucose-based dialysis fluid containing five different concentrations of phloretin. We utilized radiolabeled 18F-deoxyglucose (18-FDG) to determine the plasma-to-dialysate transport. The data was then analyzed to determine the dose-response relationship of phloretin according to the Hill-model equation.</p><p><strong>Results: </strong>Intraperitoneal phloretin therapy followed a dose-response relationship where higher concentrations of phloretin lowered the diffusion capacity of 18-FDG and conventional glucose, while enhancing ultrafiltration. Phloretin showed high potency for water removal and diffusion outcomes, requiring low concentrations to achieve substantial effects.</p><p><strong>Conclusions: </strong>Intraperitoneal phloretin therapy followed a distinct dose-response relationship, showing high potency in improving ultrafiltration and reducing glucose absorption in experimental PD. These findings support the therapeutic potential of GLUT-inhibitors like phloretin and support future clinical studies to evaluate efficacy and optimal dosing in patients undergoing PD.</p>","PeriodicalId":17882,"journal":{"name":"Kidney360","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}