Kidney360最新文献

{"title":"Short Course Immunosuppression to Prevent Transfusion-related Human Leukocyte Antigen Sensitisation in Kidney Transplant Candidates: CON.","authors":"Alessandra Orsillo, Georgina L Irish","doi":"10.34067/KID.0000000827","DOIUrl":"https://doi.org/10.34067/KID.0000000827","url":null,"abstract":"","PeriodicalId":17882,"journal":{"name":"Kidney360","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206634","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":"Short Course Immunosuppression to Prevent Transfusion-related Human Leukocyte Antigen Sensitisation in Kidney Transplant Candidates: PRO.","authors":"Samantha Ng","doi":"10.34067/KID.0000000848","DOIUrl":"https://doi.org/10.34067/KID.0000000848","url":null,"abstract":"","PeriodicalId":17882,"journal":{"name":"Kidney360","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206705","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":"Short Course Immunosuppression to Prevent Transfusion-related Human Leukocyte Antigen Sensitisation in Kidney Transplant Candidates: Commentary.","authors":"Jennifer Li","doi":"10.34067/KID.0000001008","DOIUrl":"https://doi.org/10.34067/KID.0000001008","url":null,"abstract":"","PeriodicalId":17882,"journal":{"name":"Kidney360","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206696","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":"Strategic Innovations to Reduce Disincentives and Increase Living Kidney Donation.","authors":"Amanda Leonberg-Yoo, Robert Redfield, Ty Dunn, James N Fleming, Janny Fonk, Garet Hil, Matthew Cooper","doi":"10.34067/KID.0000001001","DOIUrl":"https://doi.org/10.34067/KID.0000001001","url":null,"abstract":"<p><strong>Background: </strong>While up to 59% of the U.S. population report willingness to donate a kidney, only about 6,000 living kidney donations occur annually. This study described the use and impact of National Kidney Registry (NKR) programs designed to eliminate disincentives to living kidney donation.</p><p><strong>Methods: </strong>This was a retrospective cohort analysis utilizing administrative data records from the NKR, a national database capturing information on potential living kidney donors at 103 transplant centers across the continental US. Descriptive statistics were used to summarize donor characteristics, program participation, and outcome measures. An interrupted time series was used to analyze changes in registration conversion rates before and after program implementation.</p><p><strong>Results: </strong>Following the implementation of Donor Connect, the registration conversion rate increased from 8.4% immediately preceding implementation to 18.4% by the end of follow-up. At the time of intervention, a statistically significant 8% increase in registration conversion rate was observed (p<0.001), with an additional 0.3% increase per quarter thereafter (p=0.017). Remote donors were significantly more likely to live > 150 miles from the recipient's transplant center (84% vs 21%); the Remote Donor Program reduced travel burden by 597 [205,1196] miles. Referral conversion rates were significantly higher for donors living within 50 miles (8.3%) compared to those 51-150 miles (6.5%, p<0.001) and >150 miles (5.3%, p<0.003), corresponding to an increased donation odds of 1.31 and 1.62, respectively). Fifty-one percent of donors received cost reimbursement through the Donor Shield program. Donors who participated were more racially diverse and were more likely to reside further from the transplant center.</p><p><strong>Conclusions: </strong>This analysis indicates that the outcomes from NKR's programs support the efficacy of disincentive-targeted innovations as a way to increase donation rates by supporting donors and streamlining the donation process. These innovations represent a modern, donor-centered approach to living kidney donation. By addressing known barriers, these programs have the potential to expand the donor pool, improve the efficiency in donor evaluation, and improve the overall donor experience.</p>","PeriodicalId":17882,"journal":{"name":"Kidney360","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206664","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":"The Association between Neighborhood Socioeconomic Status and Posttransplant Cancer Outcomes among Kidney Transplant Recipients in the United States.","authors":"Yue-Harn Ng, Shyfuddin Ahmed, Nathan Pan, Jun Tao, Bessie Young, Qianlai Luo, Ruth M Pfeiffer, Christopher Blosser, Eric A Engels","doi":"10.34067/KID.0000000979","DOIUrl":"https://doi.org/10.34067/KID.0000000979","url":null,"abstract":"<p><strong>Background: </strong>Cancer is a leading cause of death among kidney transplant recipients (KTRs) and may disproportionately affect disadvantaged individuals. We assessed the association between neighborhood socioeconomic status and cancer outcomes among KTRs in the US.</p><p><strong>Methods: </strong>We evaluated first-time KTRs through a linkage between US transplant and cancer registries (2000-2019). The Yost index, which incorporates neighborhood measurements of income, educational level, housing, and employment, was categorized into quintiles, with the lowest quintile (Q1) corresponding to the most disadvantaged neighborhood. We used Poisson regression to compare the association of Yost quintiles with cancer incidence overall and with seven common cancer types (colorectum, lung, female breast, prostate, kidney, melanoma, and non-Hodgkin lymphoma) as well as to compare the Yost index with cancer stage at diagnosis. Cox regression was used to evaluate cancer-specific mortality.</p><p><strong>Results: </strong>We included 168,028 KTRs. Overall cancer incidence was 12.3 per 1,000 person-years (n=11,146 cases) with no overall difference across Yost quintiles (p-trend=0.893). However, KTRs from the most disadvantaged neighborhoods had higher lung cancer incidence (adjusted incidence rate ratio [IRR] 1.44, 95% confidence interval [95%CI] 1.19-1.73, Q1 vs. Q5; p-trend=0.001) and lower prostate cancer incidence (IRR 0.76, 95%CI 0.63-0.92, Q1 vs. Q5; p-trend=0.022). KTRs in more disadvantaged areas who were diagnosed with melanoma were more likely to present with regional or distant stage cancer (p-trend=0.022). After a cancer diagnosis, cancer-specific mortality was higher among KTRs in lower Yost quintiles (adjusted hazard ratio 1.18, 95%CI 1.05-1.32 for Q1 vs. Q5; p-trend=0.004), although trends were not significant for individual cancer types.</p><p><strong>Conclusions: </strong>KTRs from disadvantaged neighborhoods have increased lung cancer risk and reduced prostate cancer risk, and are more likely to present with advanced-stage melanoma. After a cancer diagnosis, KTRs from disadvantaged neighborhoods are also more likely to die from their cancer. These results point to important disparities among KTRs in cancer screening and treatment.</p>","PeriodicalId":17882,"journal":{"name":"Kidney360","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206632","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":"Spatial Mass Spectrometry-Based Proteomic Analysis of Normal-Appearing Glomeruli from Young and Old Adults.","authors":"Kiran K Mangalaparthi, Gunveen S Sachdeva, Afsana Ansari Shaik, Shilpa Venkataraman, Aidan F Mullan, Ganesh P Pujari, Benjamin J Madden, Muhammad Sohaib Asghar, Vidit Sharma, Mariam P Alexander, Nicholas B Larson, Aleksandar Denic, Akhilesh Pandey, Andrew D Rule","doi":"10.34067/KID.0000000986","DOIUrl":"https://doi.org/10.34067/KID.0000000986","url":null,"abstract":"<p><strong>Background: </strong>Kidney aging is characterized by a loss of glomeruli, predominately in the superficial cortex, with a resultant decline in glomerular filtration rate and an increased risk of various kidney-related diseases. The early molecular alterations in glomeruli associated with the aging process are not well studied.</p><p><strong>Methods: </strong>We combined laser capture microdissection and mass spectrometry-based unbiased proteomic analysis of non-sclerosed, non-ischemic glomeruli in the superficial cortex from young and old adults who underwent a radical nephrectomy for a tumor to understand the age-related molecular changes in glomeruli. 24 young and 30 old adults were used for the discovery dataset and the significant differentially expressed proteins were further validated using an independent set comprising 6 young and 8 old adults.</p><p><strong>Results: </strong>Kidneys from older adults had lower eGFR, less kidney parenchyma on CT imaging, and more glomerulosclerosis and arteriosclerosis on histology. Quantitative proteomic analysis of non-sclerosed, non-ischemic glomeruli identified increased expression of TIMP3, GPC6, SNCG, APOA4 and NT5E in old adults that were further validated in an independent set. Pathway analysis indicated that proteins with increased expression in old adults were enriched in mitochondrial translational processes, aerobic respiration, and TCA cycle, whereas proteins with decreased expression in old adults were enriched in mRNA splicing, mRNA processing, and nonsense mediated decay. Further, Spearman correlation of validated differentially expressed proteins did not show any significant correlation with the kidney pathology independent of age group.</p><p><strong>Conclusions: </strong>Overall, this study identified proteins that are specifically associated with the aging process in otherwise normal-appearing glomeruli.</p>","PeriodicalId":17882,"journal":{"name":"Kidney360","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206648","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":"Commemorating the National Institute of Diabetes and Digestive and Kidney Diseases' Advances in Kidney Health: 75 Years of Discovery and Impact.","authors":"Connie M Rhee, Michael Allon, Rajnish Mehrotra","doi":"10.34067/KID.0000001005","DOIUrl":"10.34067/KID.0000001005","url":null,"abstract":"<p><p>This year commemorates the 75th anniversary of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), one of the 27 institutes and centers of the National Institutes of Health. A core mission of the NIDDK has been the advancement and support of biomedical research across a diverse spectrum of disciplines, including endocrine and metabolic diseases, digestive and nutritional disorders, obesity, urologic and benign hematologic conditions, and, notably, kidney diseases, which has been a major focus of the institute's strategic priorities. Through the years, the NIDDK has heavily invested in biomedical infrastructure, foundational studies, and cross-cutting basic science, clinical investigation, epidemiology, and health services research, which have fundamentally shaped the detection, management, and prevention of kidney diseases worldwide. Furthermore, the NIDDK has had a longstanding commitment to promoting workforce development, advancing equal access to kidney health care, and forging collaborative partnerships with academic centers, federal agencies, professional societies, patient advocacy organizations, community groups, and industry stakeholders toward the shared goal of improving kidney disease outcomes. In this review published across the three American Society of Nephrology journals, we celebrate the landmark achievements and profound effect of the NIDDK in improving the health and well-being of people living with kidney diseases worldwide.</p>","PeriodicalId":17882,"journal":{"name":"Kidney360","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145200039","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":"Re-evaluating TIPS Candidacy for Patients with Kidney Disease.","authors":"Megan M Griffin, Cary H Paine, Sarah F Sanghavi","doi":"10.34067/KID.0000001011","DOIUrl":"https://doi.org/10.34067/KID.0000001011","url":null,"abstract":"<p><p>Patients with cirrhosis of the liver are at risk for kidney dysfunction due to portal hypertension-induced splanchnic vasodilation, which results in a decrease in effective arterial blood volume. This can lead to hepatorenal syndrome, which may manifest clinically as ascites that is refractory to diuretics, a rise in creatinine, and hyponatremia. Transjugular intrahepatic portosystemic shunt (TIPS) is a procedure that shunts blood directly from the portal vein to the hepatic vein, bypassing the high-pressure system of the cirrhotic liver. Among patients with diuretic-resistant ascites, TIPS decreases recurrence of ascites and improves kidney function. However, since less blood is passing through the hepatic sinusoids, post-procedure risks of TIPS, including worsening hepatic encephalopathy and liver ischemia, increase with the severity of liver disease. The model for end-stage liver disease (MELD) score quantifies this risk using the INR, bilirubin, and serum creatinine as variables, and has been used to exclude high-risk patients from TIPS. The flaw in this method is that although serum creatinine can indicate worse hepatic function, it is a parameter of this composite score that may improve with TIPS. This review discusses the physiologic changes that occur after TIPS and recommends an individualized approach to TIPS selection in patients with kidney disease.</p>","PeriodicalId":17882,"journal":{"name":"Kidney360","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149643","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":"Circulating Sphingolipids and Incident CKD: The Strong Heart Family Study.","authors":"Amanda M Fretts, Paul N Jensen, Benjamin Lidgard, Colleen M Sitlani, David S Siscovick, Irena B King, Reya H Mokiao, Andrew N Hoofnagle, Jason G Umans, Rozenn N Lemaitre","doi":"10.34067/KID.0000000960","DOIUrl":"https://doi.org/10.34067/KID.0000000960","url":null,"abstract":"<p><strong>Background: </strong>Few studies have assessed whether ceramides and sphingomyelin species are associated with kidney health in community-based studies. We investigated associations of 8 ceramide and sphingomyelin species with incident CKD (eGFR <60 mL/min/1.73 m2) and other markers of kidney health (i.e., rapid decline in kidney function, estimated glomerular filtration rate (eGFR), urine albumin-to-creatinine ratio) in a large cohort of American Indians.</p><p><strong>Methods: </strong>We included participants from the Strong Heart Family Study, a prospective cohort study of risk factors for cardio-metabolic diseases. We used generalized estimating equations to examine associations of ceramide (Cer)-16, Cer-20, Cer-22, Cer-24, sphingomyelin (SM-16), SM-20, SM-22, and SM-24, with kidney health.</p><p><strong>Results: </strong>In total, 95 participants had CKD at baseline, 79 participants developed CKD during a mean follow up of 5.4 years, 2,167 participants remained free of CKD, and 270 participants experienced rapid decline in eGFR of >3 mL/min per 1.73 m2 per year. After multivariable adjustment, higher levels of SM-16 were associated with greater risk of CKD (RR=1.69, 95% CI: 1.24-2.23), while higher levels of SM-24 were associated with lower risk of rapid decline in kidney function (RR, 95% CI: 0.71, 0.58-0.87). Higher levels of circulating SM-24 were also associated with higher eGFR (RR=1.33, 95% CI, 0.47, 2.18). Cer-16, Cer-20, Cer-22, Cer-24, and SM-20 were not associated with kidney health.</p><p><strong>Conclusions: </strong>Associations of ceramide and sphingomyelins with kidney health differ based on the length of the acylated saturated fatty acid attached to the sphingomyelin.</p>","PeriodicalId":17882,"journal":{"name":"Kidney360","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131253","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":"Nephron Number and Kidney Outcomes in IgA Nephropathy: A Retrospective Cohort Study.","authors":"Hirokazu Marumoto, Takaya Sasaki, Nobuo Tsuboi, Vivette D D'Agati, Yusuke Okabayashi, Kotaro Haruhara, Go Kanzaki, Kentaro Koike, John F Bertram, Toshiharu Ninomiya, Takashi Yokoo","doi":"10.34067/KID.0000000983","DOIUrl":"https://doi.org/10.34067/KID.0000000983","url":null,"abstract":"<p><strong>Background: </strong>We previously reported substantial variability in the number of nephrons in patients with IgA nephropathy (IgAN), even among patients with similar risk factor profiles. This retrospective cohort study aimed to evaluate the clinical significance of nephron number at diagnostic biopsy for subsequent kidney outcomes in patients with IgAN.</p><p><strong>Methods: </strong>The number of nephrons, defined as the total number of non-globally sclerotic glomeruli per kidney, was estimated using computed tomography imaging and biopsy-based stereology. Kidney outcomes were compared based on tertiles of nephron number. The primary endpoint was the annual slope of the estimated glomerular filtration rate (eGFR), and the secondary endpoint was the initiation of kidney replacement therapy.</p><p><strong>Results: </strong>A total of 222 Japanese adults with IgAN were included. Among the entire cohort, eGFR exhibited a gradual decline over time during a median follow-up of 7.6 years. Annual eGFR slopes, adjusted for baseline eGFR, baseline proteinuria, Oxford classification scores, and therapies during the first year after biopsy, were -1.35, -1.11, and -0.97 mL/min/1.73 m2/year for the lowest to highest nephron number tertiles, respectively (P for trend < 0.001). Kidney replacement therapy was initiated in 32.4%, 10.8%, and 0% of patients in the lowest, middle, and highest tertiles, respectively (P for trend < 0.001). A significantly higher risk of kidney replacement therapy initiation with decreasing number of nephrons was confirmed using multivariable adjusted Cox proportional hazards models.</p><p><strong>Conclusions: </strong>Lower number of non-globally sclerotic glomeruli per kidney identified at diagnostic biopsy was independently associated with increased rate of future kidney functional decline in IgAN patients, providing additional information beyond conventional clinical and histopathological risk factors. Incorporating this metric into routine evaluation may enhance risk stratification and inform more personalized, targeted treatment strategies for patients with IgAN.</p>","PeriodicalId":17882,"journal":{"name":"Kidney360","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131257","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}