Kidney Medicine最新文献

{"title":"Uptake of Newly Licensed Influenza Vaccine Formulations Among Patients Receiving Chronic Hemodialysis During the 2010/2011 to 2021/2022 Influenza Seasons","authors":"John M. Sahrmann MA , J. Bradley Layton PhD , Katelin B. Nickel MPH , John W. Davis MD, PhD , Vikas R. Dharnidharka MD, MPH , David J. Weber MD, MPH , Anne M. Butler PhD","doi":"10.1016/j.xkme.2026.101243","DOIUrl":"10.1016/j.xkme.2026.101243","url":null,"abstract":"","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":"8 3","pages":"Article 101243"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146165861","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":"Efficacy of Low-Dose Tolvaptan for Treatment of Profound Hyponatremia in Syndrome of Inappropriate Antidiuresis (SIAD): The EFFLUX-FLUID TRIAL","authors":"Narongchai Jaiyen , Sutatip Chinpraditsuk , Pattharawin Pattharanitima , Pichaya Tantiyavarong , Pajaree Krisanapan","doi":"10.1016/j.xkme.2025.101239","DOIUrl":"10.1016/j.xkme.2025.101239","url":null,"abstract":"<div><h3>Rationale & Objective</h3><div>Although tolvaptan is effective for treating hyponatremia in the syndrome of inappropriate antidiuresis (SIAD), fluid restriction remains the first-line therapy because of safety concerns. This study evaluated whether low-dose tolvaptan is more effective than a combination of fluid restriction, furosemide, and sodium chloride tablets in patients with profound hyponatremia and clinical predictors of fluid restriction failure.</div></div><div><h3>Study Design</h3><div>Single-center, open-label, randomized controlled trial.</div></div><div><h3>Setting & Participants</h3><div>Hospitalized adults with chronic SIAD and serum sodium concentration [Na<sup>+</sup>] ≤125 mmol/L, meeting ≥ 1 predictor of fluid restriction failure (urine osmolality >500 mOsm/kg H<sub>2</sub>O, sum of urine sodium and potassium > [Na<sup>+</sup>], or urine volume <1,500 mL/day). Twenty-nine patients were randomized (13 to tolvaptan, 16 to control).</div></div><div><h3>Exposure(s)</h3><div>Tolvaptan 7.5 mg/day with liberal fluid intake versus fluid restriction (800 mL/day), furosemide (20-40 mg/day), and sodium chloride tablets (3 g/day) for 28 days.</div></div><div><h3>Outcome(s)</h3><div>The primary outcome was change in [Na<sup>+</sup>] from baseline to day 4. Secondary outcomes include change in [Na<sup>+</sup>] through day 28, achievement of [Na<sup>+</sup>] ≥130 mmol/L at day 4, time to correction, and adverse events.</div></div><div><h3>Analytical Approach</h3><div>Intention-to-treat analysis using <em>t</em> tests, Fisher exact test, Kaplan–Meier estimates, and generalized estimating equation models.</div></div><div><h3>Results</h3><div>Mean baseline [Na<sup>+</sup>] was 120 ± 3 mmol/L. By day 4, [Na<sup>+</sup>] increased significantly more with tolvaptan (12.2 ± 3.4 vs 6.3 ± 6.0 mmol/L; <em>P</em> = 0.004), with continued benefit on days 7 and 14. More patients achieved [Na<sup>+</sup>] ≥130 mmol/L at day 4 (77% vs 25%; <em>P</em> = 0.009), with shorter median time to correction (2 vs 14 days; <em>P</em> = 0.02). Hypokalemia was less frequent with tolvaptan (8% vs 44%; <em>P</em> = 0.04). Overcorrection occurred in 3 tolvaptan patients (23%) without clinical sequelae (<em>P</em> = 0.08).</div></div><div><h3>Limitations</h3><div>Small sample size and single-center design.</div></div><div><h3>Conclusions</h3><div>Low-dose tolvaptan effectively and rapidly increases [Na<sup>+</sup>] in SIAD patients with predictors of fluid restriction failure, with acceptable safety under close monitoring.</div></div><div><h3>Plain-Language Summary</h3><div>Hyponatremia, or low blood sodium levels, is a common and potentially serious condition in hospitalized patients. Fluid restriction is the standard first-line treatment, but it is often ineffective in patients with the syndrome of inappropriate antidiuresis (SIAD). This study evaluated whether low-dose tolvaptan could improve outcomes in patients at high risk of fluid restrict","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":"8 3","pages":"Article 101239"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146165804","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":"Complete Remission After Percutaneous Renal Artery Angioplasty for Focal Segmental Glomerulosclerosis due to Takayasu Disease: A Case Report","authors":"Yusuke Ushio ,&nbsp;Shun Manabe ,&nbsp;Anna Nakai ,&nbsp;Momoko Seki ,&nbsp;Shiho Makabe ,&nbsp;Shizuka Kobayashi ,&nbsp;Yuki Kawaguchi ,&nbsp;Hiroshi Kataoka ,&nbsp;Naoko Ito ,&nbsp;Sekiko Taneda ,&nbsp;Kazuho Honda ,&nbsp;Junichi Hoshino","doi":"10.1016/j.xkme.2026.101251","DOIUrl":"10.1016/j.xkme.2026.101251","url":null,"abstract":"<div><div>Renal artery stenosis is a common complication of Takayasu disease; however, the presence of nephrotic syndrome is rare. Percutaneous transluminal renal angioplasty (PTRA) is performed for renal artery stenosis; however, its efficacy is unclear for renal artery stenosis complicated with nephrotic syndrome. This is a case report of Takayasu disease in an 18-year-old woman with no relevant medical history. Magnetic resonance angiography revealed bilateral renal artery stenosis, and nephrotic syndrome was noted. Focal segmental glomerulosclerosis was diagnosed based on renal biopsy. As atrophy was observed in the right kidney, PTRA was performed for the left renal artery stenosis. Urine protein levels decreased subsequently, leading to remission. Renal artery stenosis may commonly occur due to Takayasu disease; however, the resulting accentuation of the renin-angiotensin-aldosterone cascade and increased intraglomerular pressure may cause focal segmental glomerulosclerosis. PTRA may induce remission if renal dysfunction is mild, and it should be performed as early as possible.</div></div>","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":"8 3","pages":"Article 101251"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147326669","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 Impact of Tenapanor on Serum Phosphate in Adult Dialysis Patients: A Narrative Review","authors":"Malki Waldman,&nbsp;Stephani Johnson,&nbsp;Melanie Newkirk,&nbsp;Corey Hawes,&nbsp;Laura Byham-Gray","doi":"10.1016/j.xkme.2025.101237","DOIUrl":"10.1016/j.xkme.2025.101237","url":null,"abstract":"<div><div>Managing hyperphosphatemia remains a challenging feat in the dialysis population. In 2023, tenapanor, a sodium hydrogen exchanger inhibitor, was approved in the United States for treating hyperphosphatemia in adults with chronic kidney disease receiving dialysis. This narrative review evaluated the recent literature on tenapanor, its effects on serum phosphate, and the achievement of target serum phosphate reference ranges in individuals undergoing peritoneal and hemodialysis. In addition to efficacy, this review examined the prevalence of drug-induced diarrhea. Twelve articles met the inclusion criteria. Results indicate clinical and statistical differences in the mean change in serum phosphate and a greater tendency to achieve serum phosphate target reference ranges among individuals receiving dialysis who take tenapanor compared with those who do not. These findings support using tenapanor independently or in conjunction with phosphate binders to treat hyperphosphatemia. However, drug-induced diarrhea may lead to discontinuation of tenapanor therapy. Future research should focus on nutrition counseling to mitigate drug-induced diarrhea and extend tenapanor tolerance in individuals receiving dialysis.</div></div>","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":"8 3","pages":"Article 101237"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147399572","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":"Causal Effect of Kidney Function on Lipid Metabolism: An Integrated Population-Scale Observational Analysis and Mendelian Randomization Study","authors":"Minsang Kim ,&nbsp;Jung Hun Koh ,&nbsp;Seong Geun Kim ,&nbsp;Soojin Lee ,&nbsp;Yaerim Kim ,&nbsp;Jeong Min Cho ,&nbsp;Semin Cho ,&nbsp;Kwangsoo Kim ,&nbsp;Yong Chul Kim ,&nbsp;Seung Seok Han ,&nbsp;Hajeong Lee ,&nbsp;Jung Pyo Lee ,&nbsp;Kwon Wook Joo ,&nbsp;Chun Soo Lim ,&nbsp;Yon Su Kim ,&nbsp;Dong Ki Kim ,&nbsp;Sehoon Park","doi":"10.1016/j.xkme.2026.101245","DOIUrl":"10.1016/j.xkme.2026.101245","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Rationale &amp; Objective&lt;/h3&gt;&lt;div&gt;Additional investigations into the causal effects of kidney function on various metabolites, particularly lipoprotein lipids in detailed subfractions of lipoprotein particles, in the general population are warranted.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study Design&lt;/h3&gt;&lt;div&gt;Integrated cross-sectional observational and Mendelian randomization (MR) analyses.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Setting &amp; Participants&lt;/h3&gt;&lt;div&gt;We included 157,541 participants aged 40-69 years from the UK Biobank study, a population-scale prospective cohort. Genetic instruments for estimated glomerular filtration rate (eGFR) were developed from the Chronic Kidney Disease Genetics genome-wide association study meta-analysis results, which comprised 567,460 individuals of European ancestry.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Exposure&lt;/h3&gt;&lt;div&gt;eGFR for observational analysis and genetically predicted eGFR for MR analysis.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Outcomes&lt;/h3&gt;&lt;div&gt;Each of the 178 metabolites from recently updated metabolomics data, including detailed lipoprotein components within 14 subclasses of lipoprotein particles.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Analytical Approach&lt;/h3&gt;&lt;div&gt;Observational analysis was performed using multivariate linear regression adjusted for various clinicodemographic characteristics. A 2-sample MR analysis was performed using the random-effects inverse-variance weighted method as the main MR method.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;In the integrated results of the observational and MR analyses, 25 metabolites were causally associated with eGFR. A lower eGFR causally decreased lipoprotein components of high-density lipoprotein and several of its subclasses, particularly medium-sized high-density lipoprotein. Conversely, a lower eGFR causally increased triglyceride levels in smaller-sized very low–density lipoprotein and intermediate-density lipoprotein, as well as increased lipoprotein particle concentrations and total lipids in small very low–density lipoprotein. Additionally, a lower eGFR causally increased the ratio of monounsaturated fatty acids to total fatty acids and that of apolipoprotein B to apolipoprotein A-1.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Limitations&lt;/h3&gt;&lt;div&gt;Possibility of false-negative findings when integrating observational and MR analyses.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Decreased kidney function causally aggravates lipoprotein lipid profiles; therefore, clinicians should closely monitor the lipid profiles of individuals with impaired kidney function.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Plain-Language Summary&lt;/h3&gt;&lt;div&gt;The kidney plays an essential role in body metabolism and interacts with metabolic risk factors that can lead to adverse clinical outcomes. We aimed to identify how declining kidney function affects various metabolites, including lipids within detailed subclasses of lipoproteins, by integrating observational and Mendelian randomization analyses. We used a large, published genetic dataset and a database including 157,541 participants in the United","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":"8 3","pages":"Article 101245"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147326645","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":"Determining Physical Function Measures for Estimating VO2Peak in Patients Receiving Hemodialysis","authors":"Nolan W. Groninger ,&nbsp;Monique Campos ,&nbsp;Eliott Arroyo ,&nbsp;Gayatri Narayanan ,&nbsp;Heather N. Burney ,&nbsp;Xiaochun Li ,&nbsp;Drake E. Dillman ,&nbsp;Keith G. Avin ,&nbsp;S. Jawad Sher ,&nbsp;Sharon L. Karp ,&nbsp;Sharon M. Moe ,&nbsp;Kenneth Lim","doi":"10.1016/j.xkme.2026.101244","DOIUrl":"10.1016/j.xkme.2026.101244","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Rationale &amp; Objective&lt;/h3&gt;&lt;div&gt;Cardiopulmonary exercise testing is the gold standard for evaluating cardiovascular functional capacity, as assessed by oxygen uptake at peak exercise (VO&lt;sub&gt;2&lt;/sub&gt;Peak). Traditional physical function tests have been proposed as predictive of VO&lt;sub&gt;2&lt;/sub&gt;Peak, although their associations remain inconclusive in individuals with kidney failure. This study aimed to assess whether comprehensive physical function metrics are associated with VO&lt;sub&gt;2&lt;/sub&gt;Peak in patients receiving hemodialysis.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study Design&lt;/h3&gt;&lt;div&gt;Cross-sectional analysis from the “Effects of Long Interdialytic Intervals on Cardiovascular Functional Capacity (ECON)” study.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Setting &amp; Participants&lt;/h3&gt;&lt;div&gt;Thirty patients with kidney failure receiving maintenance thrice-weekly hemodialysis.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Predictors&lt;/h3&gt;&lt;div&gt;Physical function tests.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Outcomes&lt;/h3&gt;&lt;div&gt;VO&lt;sub&gt;2&lt;/sub&gt;Peak (mL·min&lt;sup&gt;−1&lt;/sup&gt;·kg&lt;sup&gt;−1&lt;/sup&gt;) measured by cardiopulmonary exercise testing, with participants dichotomized into Low (n=14) and High (n=16) VO&lt;sub&gt;2&lt;/sub&gt;Peak groups.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Analytical Approach&lt;/h3&gt;&lt;div&gt;Group comparisons for demographics and physical function measures were performed. Multivariable linear regression was used to assess associations.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The Low and High groups were well matched by age, sex, and race (all &lt;em&gt;P&lt;/em&gt; ≥ 0.05). However, body mass index (32.7 ± 6.7 kg/m&lt;sup&gt;2&lt;/sup&gt; vs 26.9 ± 6.5 kg/m&lt;sup&gt;2&lt;/sup&gt;; &lt;em&gt;P&lt;/em&gt; = 0.02) and fat mass composition (41.8 ± 7.3% vs 28.9 ± 12.0%; &lt;em&gt;P&lt;/em&gt; = 0.002) were significantly higher in the Low group. The Short Form-36-Physical Function Scale total score, standing static balance test score, number of sit-to-stands in 30 seconds (30sec-STS), total Short Physical Performance Battery score, Patient-Reported Outcomes Measurement Information System physical function computerized adaptive testing, Patient-Reported Outcomes Measurement Information System physical mobility computerized adaptive testing, handgrip strength, and 6-minute walk test were all significantly associated with VO&lt;sub&gt;2&lt;/sub&gt;Peak (all &lt;em&gt;P&lt;/em&gt; &lt; 0.05). However, after adjusting for age, sex, and fat mass composition, only 30sec-STS was significantly associated with VO&lt;sub&gt;2&lt;/sub&gt;Peak (&lt;em&gt;P&lt;/em&gt; = 0.04).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Limitations&lt;/h3&gt;&lt;div&gt;The study’s small sample size and cross-sectional design limit statistical power and causal inference.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Metrics of basic physical function demonstrate limited association with VO&lt;sub&gt;2&lt;/sub&gt;Peak in patients on hemodialysis, except for the 30sec-STS test.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Plain-Language Summary&lt;/h3&gt;&lt;div&gt;People with kidney failure often have serious heart and muscle problems that limit their ability to exercise. This study tested how simple physical function tests relate to cardiovascular fitness, measured by oxygen use during exer","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":"8 3","pages":"Article 101244"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146165782","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":"Multinational Real-World Practice Patterns in the Use of Antithrombotic Therapy Among Patients on Hemodialysis and Peritoneal Dialysis","authors":"Murilo Guedes ,&nbsp;Calvin Andrews ,&nbsp;Junhui Zhao ,&nbsp;G. Brandon Atkins ,&nbsp;Irina Barash ,&nbsp;Lori D. Bash ,&nbsp;Catelyn R. Coyle ,&nbsp;Xuehua Ke ,&nbsp;Dena R. Ramey ,&nbsp;David W. Johnson ,&nbsp;Pablo Ureña-Torres ,&nbsp;Pietro Manuel Ferraro ,&nbsp;Mohammed Al Ghonaim ,&nbsp;Marc P. Bonaca ,&nbsp;Roberto Pecoits-Filho ,&nbsp;Angelo Karaboyas","doi":"10.1016/j.xkme.2025.101211","DOIUrl":"10.1016/j.xkme.2025.101211","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Rationale &amp; Objective&lt;/h3&gt;&lt;div&gt;Patients with kidney failure requiring maintenance dialysis have a high risk of cardiovascular events warranting antithrombotic therapies, including oral anticoagulant (OAC) or antiplatelet therapy (APT). However, chronic use of antithrombotic therapy can increase the bleeding risk in patients receiving dialysis. However, little is known about medication use patterns and risk of bleeding events in real-world clinical practice.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study Design&lt;/h3&gt;&lt;div&gt;Retrospective analysis of data from 2 prospective cohort studies.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Setting &amp; Participants&lt;/h3&gt;&lt;div&gt;We included 27,612 patients from the Dialysis Outcomes and Practice Patterns Study (DOPPS) and 5,289 patients from the Peritoneal DOPPS (PDOPPS), international cohorts of hemodialysis (HD) and peritoneal dialysis (PD) patients.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Exposures&lt;/h3&gt;&lt;div&gt;Patient demographics and comorbid conditions; OAC and APT use.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Outcomes&lt;/h3&gt;&lt;div&gt;OAC and APT use; a bleeding composite outcome including a hospitalization or death because of a major bleeding event.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Analytical Approach&lt;/h3&gt;&lt;div&gt;Descriptive analyses to explore OAC and APT utilization and crude rates of the bleeding composite outcome and Kaplan–Meier analyses to estimate medication discontinuation.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Baseline OAC and APT use was 9% and 10% in HD patients and 4% and 7% in PD patients, respectively. Patients prescribed antithrombotic drugs were older and more likely to have a history of cardiovascular disease. After 36 months, the Kaplan–Meier estimated proportions of baseline users who remained on therapy were 57% for OAC and 53% for APT. The composite bleeding rates per 100 patient-years among patients with baseline OAC use versus baseline APT use versus neither were 8.6, 5.6, and 4.1 in HD patients and 12.0, 6.1, and 3.9 in PD patients, respectively.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Limitations&lt;/h3&gt;&lt;div&gt;Potential for event misclassification; no over-the-counter medication data; rates unadjusted.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Antithrombotic drugs are infrequently prescribed and often discontinued in patients receiving HD or PD. With major bleeding event rates high among antithrombotic users, new strategies are needed to optimize the risks and benefits of antithrombotic agents in the dialysis setting.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Plain-language Summary&lt;/h3&gt;&lt;div&gt;Patients on dialysis face a difficult balance: they are at high risk for blood clots but also prone to serious bleeding. We examined real-world data from over 30,000 patients across multiple countries to understand how often blood thinners are used and what outcomes follow. We found that these medications are prescribed infrequently and often discontinued. Importantly, patients who received them experienced more major bleeding events. These findings highlight the urgent need for safer, more tailored approaches to managing clotting risks in d","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":"8 3","pages":"Article 101211"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146165864","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 Large Deletion With a Large Impact: Homozygous 5,600 bp Deletion of the GALNT3 Gene Causing Hyperphosphatemic Tumoral Calcinosis","authors":"Julia Maria Portmann ,&nbsp;Katharina Martini ,&nbsp;Angela Bahr ,&nbsp;Alexander Ritter ,&nbsp;Carsten A. Wagner ,&nbsp;Harald Seeger","doi":"10.1016/j.xkme.2026.101241","DOIUrl":"10.1016/j.xkme.2026.101241","url":null,"abstract":"<div><div>Hyperphosphatemic familial tumoral calcinosis (HTC) is a rare disease caused by autosomal recessive loss of function variants in the genes encoding fibroblast growth factor 23 (FGF-23), Klotho, or GalNAc-T3. This results in reduced phosphate excretion in the renal proximal tubule, leading to hyperphosphatemia. The clinical manifestations of HTC are mainly periarticular calcifications accompanied by pain and disability, inflammation, and dental problems. Inactive forms or reduced levels of FGF-23 or resistance to the FGF-23/Klotho complex are the main pathophysiologic characteristics underlying this disease. Treatment options to reduce blood phosphate levels have only been studied in case reports and small cohorts, with positive effects from phosphate binders, acetazolamide, anti-inflammatory drugs, probenecid, nicotinamide, and sodium thiosulfate. In this report, we present the case of a 50-year-old woman with a large (at least 5,600 base pair) deletion in the gene encoding for GalNAc-T3 (<em>GALNT3</em>) who experienced bone pain during childhood and calcifications of her lower limbs at least since her mid-thirties. Intragenic <em>GALNT3</em> copy number variants have, to our knowledge, not yet been described as a cause of HTC.</div></div>","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":"8 3","pages":"Article 101241"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146165776","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 Perceptions of Artificial Intelligence-Generated Kidney Transplant Information: Comparing ChatGPT With the National Kidney Foundation","authors":"Hwarang Stephen Han ,&nbsp;Jihye Lee","doi":"10.1016/j.xkme.2026.101247","DOIUrl":"10.1016/j.xkme.2026.101247","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Rationale &amp; Objective&lt;/h3&gt;&lt;div&gt;Generative artificial intelligence (AI) may help patients better understand the complexities of kidney transplantation. However, little is known about how individuals with chronic kidney disease (CKD) perceive AI-generated health information. This study assessed patient perceptions of AI-generated responses to common kidney transplant queries compared to those from a trusted health resource.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study Design&lt;/h3&gt;&lt;div&gt;A cross-sectional online survey.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Setting &amp; Participants&lt;/h3&gt;&lt;div&gt;A total of 216 adults with CKD, including kidney transplant recipients, residing in the United States participated in the study.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Exposures&lt;/h3&gt;&lt;div&gt;Participants compared kidney transplant-related query responses generated by ChatGPT (GPT-4o), a widely used generative AI tool, with those provided by the National Kidney Foundation (NKF).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Outcomes&lt;/h3&gt;&lt;div&gt;Participant perceptions across several domains: overall preference, perceived information quality, empathy, and learning outcomes.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Analytical Approach&lt;/h3&gt;&lt;div&gt;Participants reviewed paired responses from both ChatGPT and NKF, presented without source attribution. Results were analyzed using mixed-effect models.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Participants preferred ChatGPT-generated responses over NKF’s in 81.3% of comparisons (P &lt; 0.001). ChatGPT responses were rated significantly higher than NKF’s in terms of information quality, empathy, and perceived learning outcomes (all &lt;em&gt;P&lt;/em&gt; &lt; 0.001).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Limitations&lt;/h3&gt;&lt;div&gt;The web-based survey may not fully represent the diverse populations served by transplant centers. Limited prompts were used, which may not capture the full range of transplant scenarios. We were also unable to determine which specific features influenced participant preferences.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Generative AI platforms like ChatGPT may present information in ways that resonate with patients, potentially enhancing their education and engagement. However, as these tools are still in the early stages of integration into everyday life, their use should be guided by careful human oversight.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Plain-language Summary&lt;/h3&gt;&lt;div&gt;This study examined how adults with chronic kidney disease, including transplant recipients, engage with generative artificial intelligence (AI) to learn about kidney transplantation. Participants reviewed answers to common transplant queries from both ChatGPT, a popular AI tool, and the National Kidney Foundation, a trusted educational source, without knowing which source provided each answer. Participants preferred AI-generated responses in 81.3% of cases and rated ChatGPT higher than National Kidney Foundation in information quality, empathy, and perceived learning. These findings suggest that generative AI has the potential to present information in ways that resonate with p","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":"8 3","pages":"Article 101247"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147325680","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":"Stratifying Hepatic Fat in Hemodialysis: The Role of Phenotype and Anemia Therapy","authors":"Hiroki Ito MD, PhD,&nbsp;Takefumi Mori MD, PhD","doi":"10.1016/j.xkme.2026.101306","DOIUrl":"10.1016/j.xkme.2026.101306","url":null,"abstract":"","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":"8 3","pages":"Article 101306"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147326561","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}