Kidney360最新文献

{"title":"The Cardio-ankle Vascular Index Predicts Long-term Kidney Prognosis in Non-diabetic Chronic Kidney Disease Patients Who Underwent Kidney Biopsy.","authors":"Akihiro Shimizu, Hideo Okonogi, Tetsuya Kawamura, Shinya Yokote, Masahiro Suyama, Kentaro Koike, Yoichi Miyazaki, Nobuo Tsuboi, Masato Ikeda, Takashi Yokoo","doi":"10.34067/KID.0000000774","DOIUrl":"https://doi.org/10.34067/KID.0000000774","url":null,"abstract":"<p><strong>Background: </strong>The cardio-ankle vascular index (CAVI) is a noninvasive index of arterial stiffness that is independent of blood pressure at the time of measurement. Although the role of CAVI as a predictor of cardiovascular events has been reported, few studies have considered kidney prognosis. This study investigated the association between CAVI and long-term kidney prognosis in patients with non-diabetic chronic kidney disease who underwent kidney biopsy.</p><p><strong>Methods: </strong>This study was a longitudinal, observational, single-center study of patients with chronic kidney disease stages 1-4 and follow-up ≥1 year who had CAVI measured at the time of kidney biopsy. The primary outcome was a 30% decline in the estimated glomerular filtration rate (eGFR) from the baseline or end-stage kidney disease.</p><p><strong>Results: </strong>Forty-six patients (mean age, 53 years; median eGFR, 61.5 mL/min/1.73 m2; median follow-up period, 98 months) were enrolled. Eighteen patients achieved the primary outcome and a higher CAVI was significantly associated with this outcome. Multivariate analyses consistently identified CAVI as an independent factor associated with the outcome. Using receiver operating characteristic curve analysis, the cutoff value for CAVI was 7.7 (sensitivity, 78%; specificity, 79%). Kaplan-Meier analysis showed significantly lower outcome-free survival in the CAVI ≥7.7 group than in the CAVI <7.7 group. No consistent trend was observed between kidney histopathology and CAVI.</p><p><strong>Conclusions: </strong>CAVI at the time of kidney biopsy is independently associated with long-term kidney prognosis in patients with non-diabetic chronic kidney disease.</p>","PeriodicalId":17882,"journal":{"name":"Kidney360","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663882","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":"Kidney Allograft Rejection as an Independent Non-traditional Risk Factor for Post-transplant Cardiovascular Events.","authors":"Peemai Amornkanjanawat, Stephen J Kerr, Thunyatorn Wuttiputhanun, Natavudh Townamchai, Asada Leelahavanichkul, Pichaya Tantiyavarong, Kearkiat Praditpornsilpa, Somchai Eiam-Ong, Yingyos Avihingsanon, Suwasin Udomkarnjananun","doi":"10.34067/KID.0000000773","DOIUrl":"https://doi.org/10.34067/KID.0000000773","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular death is the leading cause of mortality in kidney transplant recipients (KTR). While risk factors for post-transplant cardiovascular events (CVE) have been established, previous studies primarily focused on factors at the time of transplantation without integrating post-transplant factors into the analyses. Additionally, most studies were conducted in a mixed population of cyclosporine A and tacrolimus-based immunosuppression, which have different metabolic effects. This study aims to evaluate factors for post-transplant CVE, including both pre- and post-transplant variables, specifically in a population of KTR receiving tacrolimus-based immunosuppression.</p><p><strong>Methods: </strong>Competing risk regression was performed modelling participant demographics, transplant characteristics, and post-transplant time-updated variables. The primary outcome was the composite of post-transplant CVE, which included myocardial infarction, heart failure, ischemic stroke, peripheral arterial disease, and cardiovascular death.</p><p><strong>Results: </strong>The incidence of post-transplant CVE was 15.88 per 1,000 patient-years among 553 KTR included in the study. Key factors significantly associated with post-transplant CVE included recipient age, diabetes mellitus status, post-transplant HbA1c, 24-hour urine creatinine clearance, post-transplant serum calcium, and rejection. KTR with a history of T cell-mediated rejection or antibody-mediated rejection were at a 3.0-fold (95% CI 1.22-7.37, p-value 0.016) and 3.38-fold (95% CI 1.13-10.09, p-value 0.029) higher risk for post-transplant CVE, respectively. Compared to models using pre-transplant factors alone, models that included both pre- and post-transplant variables demonstrated significantly higher prediction performance.</p><p><strong>Conclusions: </strong>Allograft rejections significantly increased the risk of post-transplant CVE. Surveillance protocols for post-transplant CVE should include KTR with a history of allograft rejection, in addition to the traditional high-risk groups.</p>","PeriodicalId":17882,"journal":{"name":"Kidney360","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663864","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":"Expanded Hemodialysis With Theranova® Compared to Conventional High-flux Hemodialysis: A Prospective Randomized 12-month Study.","authors":"Maggie Ming Yee Mok, Susan Yung, Lorraine Pui Yuen Kwan, Terence Pok Siu Yip, Sing Leung Lui, Tak Mao Chan","doi":"10.34067/KID.0000000769","DOIUrl":"https://doi.org/10.34067/KID.0000000769","url":null,"abstract":"<p><strong>Background: </strong>Expanded hemodialysis using medium cut-off (MCO) dialyzer enables higher clearance of larger middle molecules. A twice-weekly hemodialysis (HD) regimen is commonly adopted in Hong Kong. This study compared the effect of MCO-HD versus high-flux HD for 12 months on clinical and patient reported outcomes and biomarkers related to nutritional status, inflammation and cardiovascular health with high-flux HD, with over 60% of patients on twice weekly HD.</p><p><strong>Methods: </strong>Stable HD patients, after 6 weeks of high-flux HD run-in, were randomized (1:1) to continue high-flux HD (Control group) or change to MCO-HD with Theranova® dialyzer and observed for 12 months.</p><p><strong>Results: </strong>Sixty patients were randomized (30:30), with 60% on twice-weekly HD. Body mass index, lean and fat tissue indexes remained stable throughout, with no within- or between-group difference. Serum albumin showed a transient decrease in the MCO-HD group, with 6-month value significantly lower than baseline (3.62±0.34 vs. 3.79±0.28g/dL, p=0.043) and that in Controls (3.84±0.34g/dL, p=0.024), before it increased back to baseline level. At 12-month, the two groups showed similar laboratory parameters and patient-reported outcomes related to sleep quality, appetite, itchiness, and quality of life. There was no consistent change in biomarkers related to inflammation and cardiovascular health. The incidence rate of adverse events, cardiovascular events, infection rate and hospitalization rates were similar in the two groups.</p><p><strong>Conclusions: </strong>MCO-HD was safe and well-tolerated and, except for an initial decrease of serum albumin at 6 months which subsequently returned to baseline. It was not associated with significant differences in clinical and nutritional parameters, patient-reported outcomes, inflammatory/cardiovascular biomarkers and adverse clinical event rates in patients on twice weekly HD.</p>","PeriodicalId":17882,"journal":{"name":"Kidney360","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657596","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":"Association of Diabetes with Heart Rate Variability during Hemodialysis: Insights from the Frequent Hemodialysis Network Daily Trial.","authors":"Bróna M Moloney, Glenn M Chertow, Finnian R Mc Causland","doi":"10.34067/KID.0000000765","DOIUrl":"https://doi.org/10.34067/KID.0000000765","url":null,"abstract":"<p><strong>Background: </strong>Autonomic dysfunction is common among patients with diabetes receiving hemodialysis (HD). We wished to explore the association of diabetes with heart rate variability (HRV; a surrogate of autonomic dysfunction) and whether HRV mediates the association of diabetes with intra-dialytic hypotension (IDH).</p><p><strong>Methods: </strong>In this secondary analysis of the Frequent Hemodialysis Network Daily Trial, we performed: 1) random effects linear regression to estimate the association of diabetes with log-transformed low-frequency power [LF, proxy of sympathetic activity], high-frequency power [HF, proxy of parasympathetic activity], ratio of LF/HF (proxy for sympathovagal balance), and standard deviation of the normal-to-normal R-R interval [SDNN] measured at baseline and 12-months); 2) linear regression to explore the association of diabetes with changes in HRV parameters over 12 months. Models were adjusted for age, sex, designated race, height, access type, HD vintage, history of heart failure, pre-HD systolic BP, heart rate, ultrafiltration rate, hemoglobin, serum albumin, beta-blocker use, calcium channel blocker use, diuretic use, left ventricular mass, and randomized treatment assignment.</p><p><strong>Results: </strong>Of the 198 patients without baseline atrial fibrillation, 82 (41%) had self-reported diabetes. In adjusted random effects models, diabetes (vs. no diabetes) was associated with lower SDNN -18% (95%CI -27, -9) on a per session basis. The presence of diabetes was not associated with differences in LF 7% (95%CI -20, 43), HF 10% (95%CI -10, 33), or LF/HF -4% (95%CI -19, 14). Diabetes (vs. no diabetes) was not associated with a change from baseline to 12 months in any HRV parameter. SDNN did not attenuate the observed association of diabetes with IDH.</p><p><strong>Conclusions: </strong>Among participants in the FHN Daily Trial, diabetes (vs. no diabetes) was associated with 18% lower SDNN. The association of diabetes with IDH did not appear to be mediated by SDNN. The reasons for higher rates of IDH in patients with diabetes remain elusive.</p>","PeriodicalId":17882,"journal":{"name":"Kidney360","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625453","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 Difference in Cystatin C- and Creatinine-Based eGFR and Cognition in MrOS.","authors":"Lindsay M Miller, O Alison Potok, Dena E Rifkin, Kristine Yaffe, Kristine Ensrud, Charles Ginsberg","doi":"10.34067/KID.0000000764","DOIUrl":"https://doi.org/10.34067/KID.0000000764","url":null,"abstract":"","PeriodicalId":17882,"journal":{"name":"Kidney360","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605570","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":"Effect of Desmopressin in Post Kidney Biopsy Bleeding Complication in Patients with Reduced Renal Function: A Randomized Controlled Trial.","authors":"Uttayan Chakrabarti, Rajesh Jhorawat, Nitin Kumar Bajpai, Aasma Nalwa, Tapabrata Das, Pushpinder Khera, Premprakash Sharma, Manish Chaturvedy","doi":"10.34067/KID.0000000760","DOIUrl":"https://doi.org/10.34067/KID.0000000760","url":null,"abstract":"<p><strong>Background: </strong>Bleeding complications after kidney biopsy in patients with reduced renal function concern renal physician. We designed this study to examine the impact of desmopressin on reducing bleeding complications at 6 and 24 hours post-procedure in patients with eGFR≤60ml/min/1.73m2.</p><p><strong>Methods: </strong>The patients with reduced renal function were randomized into an interventional group (n=74; intranasal desmopressin at 3mcg/kg) and a control group (n=78; intranasal saline as a placebo). The primary outcome measured was minor and major bleeding complications. The secondary outcome was the size of the hematoma at 6 hours with the risk of major complications.</p><p><strong>Results: </strong>In interventional, 74 and 78 patients were in the control group. In minor complications, lumbar pain (p=1.0); gross hematuria (p=0.677) and hematoma at 6 hours (35.14% vs 46.15%, p-value=0.167) were similar. Hematoma at 24 hours was 18.92% in interventional group and 35.90% in control group (p-value=0.019). The size of hematoma at 6 hours (1.5cc vs. 2.7cc, p=0.342) and at 24 hours (1.25cc vs. 2.0, p=0.698) in the interventional and control groups, respectively. In major complications, blood transfusion (8.11% vs. 6.41%, p=0.686) and embolization procedure (2.70% vs. 1.28%, p=0.613} were similar between the two groups.</p><p><strong>Conclusions: </strong>Both minor and major complications were similar between the two groups post-kidney biopsy. The size of the hematoma was also not different in the two groups.</p>","PeriodicalId":17882,"journal":{"name":"Kidney360","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605501","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":"Oral Ketone Beta-Hydroxybutyrate Supplement Retards the Loss of Glomerular Filtration Rate in Alport Mice on Dual RAS/SGLT2 Blockade.","authors":"Linus P Schreier, Zhihui Zhu, Yoshihiro Kusunoki, Chenyu Li, John Ku, Martin Klaus, Hans-Joachim Anders","doi":"10.34067/KID.0000000747","DOIUrl":"https://doi.org/10.34067/KID.0000000747","url":null,"abstract":"<p><strong>Background: </strong>Several studies suggest that dietary beta hydroxybutyrate supplementation delays the progression of chronic kidney disease (CKD) by suppressing inflammation and fibrosis. We hypothesized that the oral supplementation with the beta-hydroxybutyrate (BHB) precursor 1,3-butanediol in addition to inhibitors of the renin-angiotensin system (RAS) and sodium-glucose transporter (SGLT)2 would be superior to dual RAS/SGLT2 blockade alone in attenuating the loss of glomerular filtration rate in Col4a3-deficient mice with Alport nephropathy, a spontaneous model of progressive CKD.</p><p><strong>Methods: </strong>We performed a placebo-controlled study in Col4a3-deficient mice with Alport nephropathy. Treatment was initiated at a late stage of the disease at the age of six weeks. Mice were fed food admixes of 10 μg/g ramipril plus 30 μg/g empagliflozin with or without addition of 0,04g/g 1,3-butanediol (concentration per gram of bodyweight). The mice were monitored daily and sacrificed upon reaching renal failure. The glomerular filtration rate (GFR) was measured at the start of the treatment and after one and four weeks.</p><p><strong>Results: </strong>The addition of beta hydroxybutyrate significantly attenuated the loss of glomerular filtration rate beyond the effect of dual RAS/SGLT2 blockade. The mean glomerular filtration rate after four weeks of treatment was 1.4±5.0 μl/min (vehicle), 61.3±51.1 μl/min (RASi + SGLT2i), and 138.9±68.5 μl/min (RASi + SGLT2i + 1,3-butanediol). No additional effects on lifespan could be observed. Kidney RNA sequencing revealed significant protective effects on inflammation when adding the beta hydroxybutyrate precursor 1,3-butanediol to RAS/SGLT2 inhibition. In histopathology, antifibrotic effects were seen upon beta hydroxybutyrate addition.</p><p><strong>Conclusions: </strong>The results in mice suggest that beta hydroxybutyrate supplementation improves the GFR in Alport syndrome by suppressing inflammation and fibrosis. However, the effects did not lead to a significant increase in lifespan. Furthermore, the observed effects stay behind the effects of finerenone as a combination partner, which was tested earlier in the same mouse model.</p>","PeriodicalId":17882,"journal":{"name":"Kidney360","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605568","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":"Evaluation of Circulating GPC4 in Patients with End-Stage Kidney Disease.","authors":"Axel Muendlein, Eva Maria Brandtner, Judith Schimpf, Michael Piribauer, Kathrin Geiger, Christine Heinzle, Andreas Leiherer, Heinz Drexel, Otto Freistätter, Ulrich Neyer, Emanuel Zitt","doi":"10.34067/KID.0000000744","DOIUrl":"https://doi.org/10.34067/KID.0000000744","url":null,"abstract":"<p><strong>Background: </strong>Glypican-4 (GPC4) is a cell-surface heparan sulfate proteoglycan that can be released into circulation under various clinical conditions. Elevated levels of circulating GPC4 have recently been associated with reduced kidney function and an increased risk of all-cause mortality across different patient populations. The potential of circulating GPC4 for assessing disease status or prognosis in patients with end-stage kidney disease has not yet been explored and was addressed in the present study.</p><p><strong>Methods: </strong>The study included 187 patients starting chronic dialysis treatment. In addition, 108 control subjects with normal or mildly reduced kidney function, matched for sex and age, were included in the study. The median follow-up time of incident dialysis patients was 3.8 years. Blood samples were collected immediately before initiation of dialysis. Serum GPC4 levels were determined using an enzyme-linked immunosorbent assay.</p><p><strong>Results: </strong>Serum GPC4 levels were approximately 10-fold higher in incident dialysis patients compared to controls demonstrating excellent classification ability to distinguish between the two groups. Furthermore, circulating GPC4 was significantly positively correlated with creatinine and phosphate and significantly negatively correlated with estimated glomerular filtration rate, hemoglobin, erythrocytes, calcium, and cholinesterase in incident dialysis patients. There was no significant association between GPC4 levels and all-cause mortality in patients starting dialysis.</p><p><strong>Conclusions: </strong>GPC4 levels were markedly elevated in patients initiating dialysis and were linked with several pathophysiological characteristics commonly observed in end-stage kidney disease. However, our findings did not indicate that elevated serum GPC4 levels serve as a significant predictor of all-cause mortality in this patient population.</p>","PeriodicalId":17882,"journal":{"name":"Kidney360","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586253","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":"Dialysis-Imposed Patterns of Nocturnal Sleep Duration: A Multi-Center Prospective Study in Patients Using a Wearable Activity Tracker.","authors":"Maggie Han, Frank M van der Sande, Jeroen P Kooman, Xia Tao, Priscila Preciado, Lela Tisdale, Ohnmar Thwin, Peter Kotanko","doi":"10.34067/KID.0000000761","DOIUrl":"https://doi.org/10.34067/KID.0000000761","url":null,"abstract":"<p><strong>Background: </strong>In patients on hemodialysis, the effects of determinants of sleep duration are not widely studied. Using wearable activity trackers, we aimed to characterize natural and hemodialysis-imposed temporal patterns of nocturnal sleep.</p><p><strong>Methods: </strong>In this yearlong prospective observational study, patients on in-center hemodialysis were equipped with activity trackers (Fitbit® Charge 2™). Nocturnal sleep duration was assessed according to dialysis start time (early starters: before 8 a.m., late starters: others), dialysis versus interdialytic days (post-dialysis day and 2nd interdialytic day), weekdays, and seasons. Clinical, laboratory, and hemodialysis treatment data were extracted from electronic medical records. Linear mixed-effects models were constructed to determine the effect of various time patterns and predictors of nocturnal sleep duration.</p><p><strong>Results: </strong>109 patients contributed data (age 54±12 years, 73% males, 23% diabetic). Sleep duration was 276±91 minutes; 102 (94%) patients slept on average less than the recommended 420 minutes per night. On dialysis days, participants slept 55 (95% CI [51,59]) and 48 (95% CI [43,54]) minutes less compared to post-dialysis and 2nd interdialytic days, respectively. Early starters slept on average 40 (95% CI [6,74]) minutes less compared to late starters. On dialysis days, early starters slept 86 (95% CI [55,118]) minutes less compared to late starters. We observed greater sleep-wake disturbance in early starters. Irrespective of dialysis schedule, patients slept on average 26 (95% CI [19,33]) to 32 (95% CI [24,40]) minutes longer on Sunday. In winter, sleep was 7 (95% CI [1,13]) to 10 (95% CI [5,16]) minutes shorter. In multivariate analysis, higher blood pressure and higher serum creatinine were significantly associated with shorter sleep duration.</p><p><strong>Conclusions: </strong>On average, patients on hemodialysis slept less than the recommended amount of time. The timing of hemodialysis treatment has pronounced effects on sleep duration and could be considered in patient care.</p>","PeriodicalId":17882,"journal":{"name":"Kidney360","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143575737","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":"Pediatric to Adult Nephrology Transition in CKD.","authors":"Vivian Shi, Alex Jang, Hillary Copp, Elaine Ku","doi":"10.34067/KID.0000000762","DOIUrl":"10.34067/KID.0000000762","url":null,"abstract":"<p><p>Chronic kidney disease (CKD) affects roughly 10% of the general population. 1,2 Some adults with CKD were diagnosed with their condition during childhood. Because early CKD is often asymptomatic, obtaining reliable estimates of the true incidence of pediatric CKD (onset prior to age 18) is difficult due to the lack of routine screening for disease in children. 2,3 With advancements in healthcare (e.g. antenatal imaging, genetic testing) and improved survival outcomes for premature infants and children with complex care needs, a growing number of children with CKD will eventually transfer their care to adult specialists. The purpose of this review is to provide a practical summary of the challenges in the transition and transfer of care process for patients with non-dialysis requiring CKD, highlight differences in pediatric and adult care practices based on our experiences, and identify best practices. We will review both practitioner- and patient-related challenges as well as the unique healthcare needs of children with CKD during the transfer of care. We will also provide an overview of the transition and transfer of care for common causes of CKD in children that are less common in adults, such as congenital abnormalities of the kidney and urinary tract (CAKUT).</p>","PeriodicalId":17882,"journal":{"name":"Kidney360","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143575667","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}