Kidney Medicine最新文献

{"title":"CKD Prevalence and Incidence in Hispanic/Latino Adults Using Race-Free Estimated Glomerular Filtration Rate Equations","authors":"Claire T. Larkin , Jesse C. Seegmiller , Pei Yang , Ana C. Ricardo , Daniela Sotres Alvarez , Holly Kramer , Tanya S. Johns , Martha L. Daviglus , Nora Franceschini , James P. Lash","doi":"10.1016/j.xkme.2025.101097","DOIUrl":"10.1016/j.xkme.2025.101097","url":null,"abstract":"<div><h3>Rationale & Objective</h3><div>The impact of the race-free Chronic kidney disease Epidemiology Collaboration (CKD-EPI) 2021 estimating glomerular filtration rate equations (eGFR) on CKD prevalence and incidence in Hispanic/Latino adults is unknown. This study evaluated changes in CKD prevalence and incidence in Hispanic/Latino adults using race-free 2021 CKD-EPI equations.</div></div><div><h3>Study Design</h3><div>A prospective population-based cohort.</div></div><div><h3>Setting & Participants</h3><div>Estimates of CKD prevalence used data from 14,944 cohort participants. Incidence rates analyses used data from 9,038 participants who completed a visit ∼6 years following a baseline visit.</div></div><div><h3>Analytical Approach</h3><div>Prevalence of Kidney Disease Improving Global Outcomes eGFR categories and CKD (defined as eGFR < 60 mL/min per 1.73m<sup>2</sup> or albuminuria-to-creatinine ratio [ACR] ≥ 30 mg/g) were compared using CKD-EPI 2009 and 2021 creatinine (cr)-based equations, and the 2012 and 2021 creatinine-cystatin C (cr-cys) equations. Reclassification across eGFR categories was estimated. Poisson regression was used to estimate rates of incident CKD (defined as eGFR < 60 mL/min/1.73m<sup>2</sup> with eGFR decline > 1 mL/min/1.73m<sup>2</sup> per year, or ACR ≥ 30 mg/g).</div></div><div><h3>Results</h3><div>The prevalence of eGFR > 90 mL/min/1.73m<sup>2</sup> was higher using 2021 CKD-EPIcr than 2009 CKD-EPIcr (77.8 vs 72.1); 7.4% were classified to a higher (less severe) eGFR category. Prevalence of CKD was lower using 2021 CKD-EPIcr (10.5 vs 11.2%) and differences were more pronounced among those >55 years (20.5 vs 22.7%) and individuals of Puerto Rican background (13.8 vs 15.0%). Incidence rates were lower using the 2021 equation (9.2 vs 9.6 per 1,000 person-years) and differences were most prominent for those >55 years (20.1 vs 22.1 per 1,000 person-years). Similar findings were observed comparing eGFRcr-cys equations.</div></div><div><h3>Limitations</h3><div>The eGFR equations evaluated have not been validated in Hispanics/Latinos.</div></div><div><h3>Conclusions</h3><div>The 2021 CKD-EPI equations estimate lower CKD prevalence and incidence in US Hispanic/Latino adults, which has implications for public health and clinical practice.</div></div><div><h3>Plain-Language Summary</h3><div>The race-free Chronic kidney disease Epidemiology Collaboration CKD-EPI 2021 estimating glomerular filtration rate equations have been widely adopted into clinical practice. However, the impact of using these equations in the Hispanic/Latino population is not known. Therefore, using data from a study of almost 15,000 Hispanic/Latino patients, we evaluated the influence of these newer equations on estimates of prevalent CKD and new onset CKD. We found that the 2021 CKD-EPI estimated glomerular filtration rate equations resulted in lower estimates of CKD prevalence and lower estimates of new onset CKD in this pop","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":"7 11","pages":"Article 101097"},"PeriodicalIF":3.4,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145157268","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 Connection Between Cognitive and Cardiac Function Following Kidney Transplant: The VINTAGE Study","authors":"Sumi Hidaka ,&nbsp;Akinori Nishimura ,&nbsp;Kazunari Tanabe ,&nbsp;Shuzo Kobayashi ,&nbsp;The VINTAGE Investigators","doi":"10.1016/j.xkme.2025.101096","DOIUrl":"10.1016/j.xkme.2025.101096","url":null,"abstract":"<div><h3>Rationale &amp; Objective</h3><div>The effects of successful kidney transplant (KT) on cognitive function remain unclear. To clarify how the presence or absence of pre-KT mild cognitive impairment (MCI) affects cognitive changes (overall and domain) after KT. To determine whether the cognitive improvement after KT is associated with improved cardiac function.</div></div><div><h3>Study Design</h3><div>A hybrid retrospective and prospective observational cohort study.</div></div><div><h3>Setting &amp; Participants</h3><div>We obtained data from 70 recipients who underwent living donor KT (2017-2021).</div></div><div><h3>Predictors</h3><div>Pre-KT MCI status and left ventricular (LV) remodeling.</div></div><div><h3>Outcomes</h3><div>Changes in mean Montreal cognitive assessment (MoCA) scores before and after KT.</div></div><div><h3>Statistical Analysis</h3><div>We evaluated whether the presence or absence of pre-KT MCI modified the effect of KT (total and each domain). We also evaluated the association between changes in MoCA total score and LV reverse remodeling effect.</div></div><div><h3>Results</h3><div>MoCA total score: no significant change was observed in the non-MCI group (27.6 ± 1.2 to 27.6 ± 1.6, <em>P</em> = 0.81). In contrast, the score in the MCI group improved from 22.9 ± 2.0 to 24.7 ± 2.0 (<em>P</em> &lt; 0.001; <em>P</em>_int &lt; 0.001). MoCA domain score: the effect of KT varied between the non-MCI group and the MCI group in each domain; the visuospatial and executive domains increased for the MCI group but not non-MCI group (<em>P</em>_int = 0.01). Cognitive and cardiac function: improvement in MoCA score was positively correlated with the effect of LV reverse remodeling (<em>P</em> = 0.02), even after adjusting for age and tacrolimus trough level.</div></div><div><h3>Limitations</h3><div>Incomplete cerebral blood flow data.</div></div><div><h3>Conclusions</h3><div>The effect of KT was changed by pre-KT MCI status. Heterogeneous cognitive improvement after KT can be explained by the LV reverse remodeling effect.</div></div><div><h3>Plain-Language Summary</h3><div>Kidney transplant can greatly improve health, but how they affect thinking skills wasn’t fully understood, especially in people with mild thinking problems before the transplant. We looked at 70 patients. We compared their thinking skills before and after the transplant. We found that for those with normal thinking before, their scores didn’t change much. But surprisingly, people with mild thinking problems actually showed improvement in their thinking skills after the transplant. We also saw a link between this improvement in thinking and the heart getting healthier after the transplant. Our study suggests that a successful kidney transplant might help improve thinking in those who had some difficulties beforehand, and this could be related to better heart function.</div></div>","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":"7 11","pages":"Article 101096"},"PeriodicalIF":3.4,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145157195","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":"Clinicopathological Features and Outcomes of Fibrillary Glomerulonephritis in an Indian Cohort: A Multicentric Study","authors":"Priti Meena MD, DNB ,&nbsp;Anila Kurien MD ,&nbsp;Raja Ramachandran MD, DM ,&nbsp;Mahesha Vankalakunti MD ,&nbsp;Vinant Bhargava MD, DNB ,&nbsp;Manisha Sahay MD, DNB ,&nbsp;Vishwanath Siddini MD, DNB ,&nbsp;Pallav Gupta MD ,&nbsp;Atanu Pal MD, DM ,&nbsp;Prit Pal Singh MD, DM ,&nbsp;Gayatri Pegu MD, DM ,&nbsp;G. Gireesh Reddy MD, DM ,&nbsp;P.S. Priyamvada MD, DM ,&nbsp;Sai Sameera MD, DM ,&nbsp;Pinaki Mukhopadhyay MD, DM ,&nbsp;Vinay Rathore MD, DM ,&nbsp;Saurabh Nayak MD, DM ,&nbsp;Shivendra Singh MD, DM ,&nbsp;Arun Prabhahar MD, DM ,&nbsp;Ganesh Srinivasa Prasad MD, DNB ,&nbsp;Sandip Kumar Panda MD, DM","doi":"10.1016/j.xkme.2025.101085","DOIUrl":"10.1016/j.xkme.2025.101085","url":null,"abstract":"","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":"7 10","pages":"Article 101085"},"PeriodicalIF":3.4,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145118800","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":"A Cross-Sectional Social Network Analysis of Decision-Making About Recruiting a Living Donor for Kidney Transplantation","authors":"Briana E. Lee ,&nbsp;Heather M. Gardiner ,&nbsp;Crystal A. Gadegbeku ,&nbsp;Peter P. Reese ,&nbsp;Zoran Obradovic ,&nbsp;Edward L. Fink ,&nbsp;Avrum Gillespie","doi":"10.1016/j.xkme.2025.101095","DOIUrl":"10.1016/j.xkme.2025.101095","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Rationale &amp; Objective&lt;/h3&gt;&lt;div&gt;Most living kidney donors are members of the recipient’s social network. Our study aims to characterize patient and social network factors associated with recruiting a living kidney donor.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study Design&lt;/h3&gt;&lt;div&gt;A cross-sectional study.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Setting &amp; Participants&lt;/h3&gt;&lt;div&gt;A total of 106 patients receiving hemodialysis (mean age 60 ± 13 years, 45% female, 75% Black) identified 508 network members (106 who offered to donate and 38 who received a donation request).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Predictors&lt;/h3&gt;&lt;div&gt;Demographic and network factors (eg instrumental support, strength of relationships between the patients and members).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Outcomes&lt;/h3&gt;&lt;div&gt;Whether the member offered to donate and whether the member’s offer was accepted. Patients’ qualitative reasoning regarding decision-making for recruiting a living kidney donor.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Analytic Approach&lt;/h3&gt;&lt;div&gt;We performed a mixed-methods egocentric network analysis using multilevel logistic regression models as well as qualitative analysis of open-ended survey questions.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Members who provided instrumental support were more likely to offer to donate (odds ratio 3.54; 95% CI [1.80-7.00]; &lt;em&gt;P&lt;/em&gt; &lt; 0.001) and have their offer declined (odds ratio 0.12; 95% CI [0.02-0.74]; &lt;em&gt;P&lt;/em&gt; = 0.02). Members with stronger relationships with the patient (9.4 [1] vs 8.4 [2.5], &lt;em&gt;P&lt;/em&gt; = 0.02) were more likely to be evaluated at a transplant center. Concern and guilt for the member was the most common reason that patients declined offers (41%) or did not make a living donor request (28%), while members’ insistence on donating was a common reason for accepting an offer.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Limitations&lt;/h3&gt;&lt;div&gt;Small sample of only patients receiving hemodialysis.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;For many patients, the barrier to living kidney donation was not a lack of potential donors within their network but reticence to recruit a donor due to concern and guilt for the donor. Future living donor kidney transplantation interventions should engage patients and their networks to facilitate communication, address patient-specific concerns and emphasize donor retention.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Plain-Language Summary&lt;/h3&gt;&lt;div&gt;Despite most living donors being members of a patient’s social network, how these networks impact donation is poorly understood. We examined how characteristics of patients and their networks relate to donor recruitment along with qualitative insights on patients’ decision-making. We found that although many network members offered to donate, patients declined due to concern and guilt on their behalf. A member’s insistence on donating was a common reason for accepting an offer. Members who had stronger relationships with patients were more likely to be evaluated for transplantation. Future interventions should engage patients and their networks to ","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":"7 10","pages":"Article 101095"},"PeriodicalIF":3.4,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145118796","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":"Severe Acute Kidney Injury Associated With Intestinal Ostomies","authors":"Juan A. Gómez-Fregoso ,&nbsp;Jose J. Zaragoza ,&nbsp;Juan Alberto González-Duarte ,&nbsp;Carlos M. Nuño-Guzmán ,&nbsp;Eduardo M. Hernández-Barajas ,&nbsp;Zarahi Andrade-Jorge ,&nbsp;Juarez Correa-de Leon ,&nbsp;Jorge L. Padilla-Armas ,&nbsp;Rebeca Lizzete Ornelas-Ruvalcaba ,&nbsp;José Said Cabrera-Aguilar ,&nbsp;Gael Chávez-Alonso ,&nbsp;Estefania Villalvazo-Maciel ,&nbsp;Carlos E. Orozco-Chan ,&nbsp;Gonzalo Rodríguez-García ,&nbsp;Guillermo Navarro-Blackaller ,&nbsp;Ramón Medina-González ,&nbsp;Alejandro Martínez Gallardo-González ,&nbsp;Luz Alcantar-Vallin ,&nbsp;Gabriela J. Abundis-Mora ,&nbsp;Guillermo García-García ,&nbsp;Jonathan S. Chávez-Iñiguez","doi":"10.1016/j.xkme.2025.101093","DOIUrl":"10.1016/j.xkme.2025.101093","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Rationale &amp; Objective&lt;/h3&gt;&lt;div&gt;People with ostomies can experience high output, a risk of acute kidney injury (AKI). We evaluated patients with AKI associated with ostomies (ostomy-AKI) and compared with AKI of other etiologies (general-AKI) with the objective of describing their clinical presentation and their association with major adverse kidney events at 10 and 30-90 days (major adverse kidney events [MAKE] 10 and 30-90, respectively).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study Design&lt;/h3&gt;&lt;div&gt;A retrospective cohort study.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Setting &amp; Participants&lt;/h3&gt;&lt;div&gt;Conducted at the Hospital Civil of Guadalajara. We included patients with Ostomy-AKI and General-AKI.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Exposure(s) or Predictor(s)&lt;/h3&gt;&lt;div&gt;Ostomy-AKI.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Outcomes&lt;/h3&gt;&lt;div&gt;Describing and differentiating their clinical presentation and their association with MAKE 10 and MAKE 30-90, in addition to its individual components, as death, new requirement for dialysis, or ≥25% decline in the estimated glomerular filtration rate from baseline.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Analytical Approach&lt;/h3&gt;&lt;div&gt;Analyzed the risk by logistic regression model and a multivariate Cox proportional hazard.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;From February 2020 to October 2023, 84 patients with ostomy-AKI and 348 with general-AKI were included. Most ostomy-AKI were male (78.7 vs 56.2%), the mean ostomy output was 980 mL/day (760-1,700), 82.9% requiring fluid adjustment. Ostomies had been created for cancer (46%) 2.3 months before AKI. The etiology of ostomy-AKI, compare to general-AKI, was more frequently due to hypovolemia (48.9% vs 24.5%) and was of greater AKI severity (stage 3, 82.9% vs 63.9%). Both groups had the same frequency of MAKE 10 (94%), and their individual components. MAKE 30-90 occurred more frequently in ostomy-AKI (65.9% vs 49.3%) as well as mortality (59.5% vs 37%), doubling this risk (OR 2.403; 95% CI, 1.090-5.299; &lt;em&gt;P&lt;/em&gt; = 0.03 and OR 2.757; 95% CI, 1.273-5.973; &lt;em&gt;P&lt;/em&gt; = 0.01, respectively).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Limitations&lt;/h3&gt;&lt;div&gt;A retrospective cohort, residual confounding, and small sample size.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;In comparison with general-AKI, patients with ostomy-AKI present more often with hypovolemia and greater AKI stage, had a higher mortality at 30-90 day follow-up, and a 2.5-fold increase in risk of MAKE.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Plain-Language Summary&lt;/h3&gt;&lt;div&gt;Hypovolemia is a frequently observed in patients with high output ostomy. In such cases, the risk of developing acute kidney injury (AKI) is elevated. This complication is strongly related to adverse clinical outcomes. However, the major adverse kidney events during mid-term follow-up have not been adequately explored. In this cohort of patients with AKI, we observed that those with ostomy-related AKI, compared with those without ostomy presented more frequent with hypovolemia attributed to a high output stoma and more severe AKI stages. The risk of major ","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":"7 10","pages":"Article 101093"},"PeriodicalIF":3.4,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145118797","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":"Acute-Onset Posttransplant Lymphoproliferative Disorder After Kidney Transplant","authors":"Ismael Z. Assi ,&nbsp;Shalini Bumb ,&nbsp;Shikha Jaiswal ,&nbsp;Michelle M. Bryant ,&nbsp;Silvi Shah","doi":"10.1016/j.xkme.2025.101094","DOIUrl":"10.1016/j.xkme.2025.101094","url":null,"abstract":"<div><div>Posttransplant lymphoproliferative disorder (PTLD) encompasses a spectrum of potentially life-threatening lymphoid proliferations that can arise after solid-organ transplantation, with a bimodal onset typically occurring approximately 12-14 months or approximately 4 years after transplant. Here, we present a novel case of a patient who developed PTLD with an unusually rapid onset, occurring just 7 weeks after receiving a deceased donor kidney transplant. The patient, an Epstein-Barr virus (EBV)-negative recipient of an EBV-positive donor kidney with a complete human leukocyte antigen mismatch, experienced early posttransplant complications including bacteremia and fungemia. These infections, in conjunction with high-risk EBV serostatus and possible underlying genetic susceptibility, may have contributed to uncontrolled B-cell proliferation in the setting of the patient’s impaired immune surveillance. Kidney biopsy confirmed EBV-positive monomorphic diffuse large B-cell lymphoma. The patient was successfully treated with rituximab and reduction of immunosuppression, resulting in resolution of EBV viremia. This case underscores the need to consider PTLD even in the very early posttransplant period, especially in EBV-mismatched recipients, and highlights the complex interplay among infections, immunosuppression, and lymphoproliferative disease pathogenesis.</div></div>","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":"7 10","pages":"Article 101094"},"PeriodicalIF":3.4,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145096943","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":"Acute Interstitial Nephritis Induced by Monoclonal Antibodies Targeting Calcitonin Gene-Related Peptide (CGRP)—Unveiling a New Association: A Case Report","authors":"Maria J. Vargas-Brochero,&nbsp;Poemlarp Mekraksakit,&nbsp;Arvind K. Garg,&nbsp;Fernando C. Fervenza,&nbsp;Ladan Zand","doi":"10.1016/j.xkme.2025.101092","DOIUrl":"10.1016/j.xkme.2025.101092","url":null,"abstract":"<div><div>Drug-induced acute interstitial nephritis represents an idiosyncratic systemic T-cell-mediated hypersensitivity reaction associated with over 200 different agents, and predicting its occurrence is challenging. Monoclonal antibodies (mAb) that target the calcitonin gene-related peptide (CGRP) (anti-CGRP-mAbs) are among the most promising therapies for migraine treatment, with an increase in prolonged use and a lack of long-term studies. The immunogenicity of biological therapies potentially leads to the production of antidrug antibodies, potentially resulting in hypersensitivity reactions. Here, we report 2 cases of acute interstitial nephritis after more than 15 months of exposure to anti-CGRP-mAb. Both patients responded to corticosteroid therapy and discontinuation of the offending agent, with recovery of kidney function. To our knowledge, this is the first description of acute interstitial nephritis secondary to anti-CGRP-mAbs. Being aware of the possible association between anti-CGRP monoclonal antibodies and interstitial nephritis is critical in the scenario of new therapies for nephrologists.</div></div>","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":"7 10","pages":"Article 101092"},"PeriodicalIF":3.4,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145118801","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":"Preoperative Geriatric Nutritional Risk Index Score as a Novel Predictor of Postoperative Acute Kidney Injury in Noncardiac Surgery: The NARA-AKI Cohort Study","authors":"Masatoshi Nishimoto ,&nbsp;Miho Murashima ,&nbsp;Maiko Kokubu ,&nbsp;Masaru Matsui ,&nbsp;Masahiro Eriguchi ,&nbsp;Ken-ichi Samejima ,&nbsp;Yasuhiro Akai ,&nbsp;Kazuhiko Tsuruya","doi":"10.1016/j.xkme.2025.101090","DOIUrl":"10.1016/j.xkme.2025.101090","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Rationale &amp; Objective&lt;/h3&gt;&lt;div&gt;Malnutrition could be a risk factor for postoperative acute kidney injury (AKI). The geriatric nutritional risk index (GNRI) is a simple indicator of malnutrition, and this study examined the association of preoperative GNRI with postoperative AKI in noncardiac surgery.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study Design&lt;/h3&gt;&lt;div&gt;A retrospective cohort study.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Setting &amp; Population&lt;/h3&gt;&lt;div&gt;Adults who underwent noncardiac surgery under general anesthesia from 2007-2011 were included. Obstetric or urologic surgery, missing serum creatinine, baseline estimated glomerular filtration rate &lt;15 mL/min/1.73 m&lt;sup&gt;2&lt;/sup&gt;, and preoperative dialysis were excluded.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Predictor&lt;/h3&gt;&lt;div&gt;Preoperative GNRI.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Outcome&lt;/h3&gt;&lt;div&gt;AKI within 7 days after surgery.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Analytical Approach&lt;/h3&gt;&lt;div&gt;Multivariable logistic regression and restricted cubic spline analysis were performed to examine the association of preoperative GNRI with AKI.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Among 5,148 patients, 301 (5.8%) developed AKI. After adjustment for potential confounders, preoperative lower GNRI scores were independently associated with higher incidence of postoperative AKI (adjusted OR [95% confidence interval], 1.20 [0.84-1.73], 1.37 [0.91-2.06], and 1.88 [1.11-3.20] for those with mild [92 ≤ GNRI &lt; 98], moderate [82≤ GNRI &lt;92], and severe [GNRI &lt;82] malnutrition, respectively (&lt;em&gt;P&lt;/em&gt; for trend = 0.02]). Restricted cubic spline analysis confirmed a monotonous increase in ORs for AKI at GNRI levels &lt;98. Subgroup analyses suggested the association was similar across age, different reasons for surgery, and C-reactive protein levels (&lt;em&gt;P&lt;/em&gt; for interaction = 0.78, 0.55, and 0.84, respectively). In sensitivity analyses, the association of GNRI with AKI was consistent using multiple imputations on missing data. Multinomial logistic regression indicated severe malnutrition tended to be associated with more severe AKI.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Limitations&lt;/h3&gt;&lt;div&gt;The presence of residual unknown confounders is a concern although a maximal effort was made to adjust for possible confounders.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Lower GNRIs were independently associated with postoperative AKI irrespective of patients’ age, malignancy, or inflammation. Improvement of preoperative malnutrition may reduce postoperative AKI.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Plain Language Summary&lt;/h3&gt;&lt;div&gt;The geriatric nutritional risk index (GNRI) is known as a simple indicator of malnutrition. Using GNRI, the association of preoperative malnutrition with postoperative acute kidney injury (AKI) was examined in noncardiac surgery. In this retrospective cohort study, adults with noncardiac surgery under general anesthesia were included. The association of preoperative GNRI with postoperative AKI was examined using multivariable logistic regression models. Among 5,148 patients, 301 developed AKI. ","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":"7 10","pages":"Article 101090"},"PeriodicalIF":3.4,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145096936","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":"Patient and Stakeholder Collaborative Research: Development of a Community Advisory Board for Nephrology and Transplantation Studies","authors":"Nidhi Ghildayal ,&nbsp;Jennifer Scherer ,&nbsp;Akanksha Nalatwad ,&nbsp;Ilana Mittleman ,&nbsp;Jennifer Jones ,&nbsp;Valen Keefer ,&nbsp;Smiti Nadkarni ,&nbsp;Matthew Palmer ,&nbsp;Macey L. Levan ,&nbsp;Rasheeda Hall ,&nbsp;Dorry L. Segev ,&nbsp;Mara McAdams-DeMarco","doi":"10.1016/j.xkme.2025.101091","DOIUrl":"10.1016/j.xkme.2025.101091","url":null,"abstract":"<div><div>Community input enhances the impact of research. Yet, there are challenges when eliciting community perspectives in nephrology/transplant research: recruitment of patients across a wide spectrum of familiarity with kidney disease; a lack of trust from marginalized patients because of health care barriers, institutionalized structural racism, and historical harm; and retention of members facing high burden of care. To address these challenges, we drafted a mission and formed a community advisory board to provide input on nephrology/transplant research. We worked with kidney disease community organizations that prioritize diversity and equity to recruit members with chronic kidney disease, end-stage kidney disease, or a kidney transplant, as well as nephrology/transplant caregivers and kidney donors. We formed a diverse group of 9 members and received feedback on 5 research proposals over 4 quarterly meetings, bridging a communication gap between community perspectives and researchers. The collaborative environment stimulated feedback that improved our nephrology/transplant research to reflect the perspectives of those most affected by research findings. Eight members have remained active for more than 1 year. In this collaborative paper, we describe our process of forming a nephrology/transplant community advisory board, and participants highlight the benefits of sharing their lived experiences to improve and amplify the impact of nephrology/transplant research.</div></div>","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":"7 10","pages":"Article 101091"},"PeriodicalIF":3.4,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145096939","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":"Taurolidine-induced Severe Anaphylaxis","authors":"Lisa Christina Horvath ,&nbsp;Gottfried Heinz ,&nbsp;Christine Bangert ,&nbsp;Anselm Jorda ,&nbsp;Moritz Staudacher ,&nbsp;Georg Gelbenegger ,&nbsp;Bernd Jilma","doi":"10.1016/j.xkme.2025.101086","DOIUrl":"10.1016/j.xkme.2025.101086","url":null,"abstract":"<div><div>Taurolidine-based catheter lock solutions are widely used for central venous catheters. Although minor infusion-related symptoms and allergic reactions have been documented, no systemic effects or severe cases of anaphylaxis have been observed. Here, we detail a case of taurolidine-induced life-threatening anaphylaxis. We report the case of a 59-year-old man who had a severe anaphylactic reaction to taurolidine following accidental intravenous infusion, which required treatment in the intensive care unit. Anaphylactic shock, which was resistant to conventional treatment with epinephrine, required additional management with norepinephrine and vasopressin. After the resolution of the anaphylactic episode, the patient was discharged from the intensive care unit. An outpatient allergy work-up using a skin prick test was performed, which confirmed a suspected allergy to taurolidine. In conclusion, taurolidine induced a severe, prolonged anaphylactic shock that did not respond to conventional treatment with intravenous and inhaled epinephrine, antihistamines, glucocorticoids, or continuous norepinephrine infusion. New treatment strategies for refractory anaphylactic shock are needed.</div></div>","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":"7 10","pages":"Article 101086"},"PeriodicalIF":3.4,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145096942","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}