Kidney Medicine最新文献

{"title":"Health Care Access, Socioeconomic Status, and Acute Kidney Injury Outcomes: A Prospective National Study","authors":"Ali AlSahow , Omar Alkandari , Anas AlYousef , Bassam AlHelal , Heba AlRajab , Ahmed AlQallaf , Yousif Bahbahani , Monther AlSharekh , Abdulrahman AlKandari , Gamal Nessim , Bassem Mashal , Ahmad Mazroue , Alaa Abdelmoteleb , Mohamed Saad , Ali Abdelzaher , Emad Abdallah , Mohamed Abdellatif , Ziad ElHusseini , Ahmed Abdelrady","doi":"10.1016/j.xkme.2024.100867","DOIUrl":"10.1016/j.xkme.2024.100867","url":null,"abstract":"<div><h3>Rationale & Objectives</h3><p>Acute kidney injury (AKI) incidence and outcome in Kuwait are unknown. Moreover, non-Kuwaitis, who represent 66% of the population, have lower income, and their access to public health services is restricted compared with Kuwaitis who have free full access.</p></div><div><h3>Study Design</h3><p>Observational prospective multicenter cohort study.</p></div><div><h3>Setting & Participants</h3><p>Adult inpatients with AKI in 7 public hospitals from January 1 to December 31, 2021.</p></div><div><h3>Exposure</h3><p>AKI identified using Kidney Disease: Improving Global Outcomes serum creatinine-based criteria.</p></div><div><h3>Outcomes</h3><p>For hospitalized patients with AKI, the outcomes included 30-day outcomes of mortality, need for dialysis, kidney recovery rates, and differences in outcomes between Kuwaitis and non-Kuwaitis.</p></div><div><h3>Analytical Approach</h3><p>A backward stepwise multiple logistic regression analysis was performed to assess possible independent risk factors for the outcomes.</p></div><div><h3>Results</h3><p>We recruited 3,744 patients (mean age: 63 years; mean baseline estimated glomerular filtration rate [eGFR]: 66.7<!--> <!-->mL/min; non-Kuwaitis: 42.3%), representing 3.2% of hospitalizations and 19.5% of intensive care unit (ICU) admissions. Non-Kuwaitis were significantly younger (57.6 vs 66.9 years), with higher baseline eGFR (73.1 vs. 62<!--> <!-->mL/min), more frequent community acquired AKI (53.8% vs 46.7%), and AKI in summer (34.7% vs 26.9%). Dialysis was provided to 33.5% of patients, with a higher need for non-Kuwaitis (35.5% vs 32.1%). At 30 days, 34.4% of patients died, representing 24.8% of hospital mortality and 59.8% of ICU mortality. No differences in mortality or kidney recovery were noted between Kuwaitis and non-Kuwaitis. Low eGFR did not affect the mortality rate.</p></div><div><h3>Limitations</h3><p>Observational nature and short follow-up period of 30 days only.</p></div><div><h3>Conclusions</h3><p>AKI was associated with high dialysis need and mortality. Non-Kuwaitis accounted for less cases despite representing 66% of the population because they were younger with higher baseline eGFR and fewer comorbid conditions. Non-Kuwaitis had higher rates of community acquired AKI and AKI in summer and a higher need for dialysis but had similar mortality and complete kidney recovery rates.</p></div><div><h3>Plain-Language Summary</h3><p>Incidences of acute kidney injury (AKI), its management, and its outcomes are unknown in Kuwait. In addition, Kuwait has a large population of ethnically diverse expatriates who have lower income and do not enjoy the same level of access to public hospital services. We recruited hospitalized adults who have a diagnosis of AKI in several public hospitals in Kuwait. We analyzed characteristics, management, and outcomes data for more than 3,700 patients and found that AKI affects 3.2% of hospitalized patients. AKI leads to high dia","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590059524000785/pdfft?md5=7e66c63dab85c949cf8667d2395264bf&pid=1-s2.0-S2590059524000785-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141702500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Reply to “Pulse of Prudence: Navigating Isolated Lung Ultrasound in Hemodialysis Patients”","authors":"Emily H. Chang MD , Jennifer E. Flythe MD, MPH","doi":"10.1016/j.xkme.2024.100863","DOIUrl":"10.1016/j.xkme.2024.100863","url":null,"abstract":"","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590059524000748/pdfft?md5=bad77ea64dd4a77b32cf5cc99702ff36&pid=1-s2.0-S2590059524000748-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141701719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Telemedicine in Advanced Kidney Disease and Kidney Transplant: A Qualitative Meta-Analysis of Studies of Patient Perspectives","authors":"Christopher D. Manko ,&nbsp;Benjamin J. Apple ,&nbsp;Alexander R. Chang ,&nbsp;Katrina M. Romagnoli ,&nbsp;Bobbie L. Johannes","doi":"10.1016/j.xkme.2024.100849","DOIUrl":"10.1016/j.xkme.2024.100849","url":null,"abstract":"<div><h3>Rationale &amp; Objective</h3><p>While the use of telemedicine has increased dramatically across disciplines, patient perspectives on telemedicine related to chronic kidney disease are not well understood. We systematically reviewed qualitative studies on patients with chronic kidney disease as well as those with kidney transplant to better understand these patients’ perspectives related to telemedicine.</p></div><div><h3>Study Design</h3><p>Qualitative meta-analysis.</p></div><div><h3>Setting &amp; Participants</h3><p>Pre-dialysis chronic kidney disease and kidney transplant patients that used telemedicine.</p></div><div><h3>Selection Criteria for Studies</h3><p>English language studies published in the year 2000 and beyond that investigated patient perspectives in a qualitative manner. Works that were not qualitative or did not focus on provider-patient interactive modes of telemedicine were excluded.</p></div><div><h3>Data Extraction</h3><p>375 articles were pulled from PubMed, Embase, and Academic Science Premier. After filtering, 8 final articles were selected. These articles were critically appraised for quality and were used in the final analysis.</p></div><div><h3>Analytical Approach</h3><p>We used a grounded theory approach to develop a codebook to systematically review each of the selected articles through a qualitative meta-analysis of the included literature.</p></div><div><h3>Results</h3><p>Telemedicine was seen by patients to have notable strengths as well as weaknesses. These characteristics can be organized into 4 primary themes (autonomy, logistics, privacy/confidentiality, and trust). Within each primary theme, we identified subthemes. Universally, all articles included the subtheme “fewer trips to the health care facility” as a beneficial factor of telemedicine within the primary theme “logistics.” A majority (6 of 8) of the articles included positive patient perspectives on the primary theme “autonomy” in terms of telemedicine promoting the subtheme of “engagement.” Patients’ views on telemedicine were mixed regarding the primary themes of “privacy/confidentiality” and “trust” related to telemedicine.</p></div><div><h3>Limitations</h3><p>Lack of provider perspectives, non-English studies, and studies published before the year 2000. Articles published after the start of data extraction were also not included.</p></div><div><h3>Conclusions</h3><p>Telemedicine should continue to be offered to patients with chronic kidney disease and kidney transplant patients to facilitate access. Additional research should focus on ways to decrease negative factors experienced by some patients such as difficulty using the technology.</p></div><div><h3>Plain Language Summary</h3><p>Telemedicine is the ability to do medical visits using technology such as telephone and video calls. For this study, we researched the experiences and perspectives of patients with chronic kidney disease or kidney transplant, who often require complex, coordin","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590059524000608/pdfft?md5=48d906e1d7b97118ebaf4aa2638e1eee&pid=1-s2.0-S2590059524000608-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141138171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reach, Acceptability, and Patient Preferences of a Mobile Health-Based Survey to Assess COVID-19 Vaccine Hesitancy Among Patients Receiving Dialysis","authors":"Sri Lekha Tummalapalli ,&nbsp;Natalie C. Benda ,&nbsp;Daniel Cukor ,&nbsp;Daniel M. Levine ,&nbsp;Jeffrey Silberzweig ,&nbsp;Meghan Reading Turchioe","doi":"10.1016/j.xkme.2024.100847","DOIUrl":"10.1016/j.xkme.2024.100847","url":null,"abstract":"<div><h3>Rationale &amp; Objective</h3><p>The majority of patients with kidney failure receiving dialysis own mobile devices, but the use of mobile health (mHealth) technologies to conduct surveys in this population is limited. We assessed the reach and acceptability of a short message service (SMS) text message-based survey that assessed coronavirus disease 2019 (COVID-19) vaccine hesitancy among patients receiving dialysis.</p></div><div><h3>Study Design &amp; Exposure</h3><p>A cross-sectional SMS-based survey conducted in January 2021.</p></div><div><h3>Setting &amp; Participants</h3><p>Patients receiving in-center hemodialysis, peritoneal dialysis, or home hemodialysis in a nonprofit dialysis organization in New York City.</p></div><div><h3>Outcomes</h3><p>(1) Reach of the SMS survey, (2) Acceptability using the 4-item Acceptability of Intervention Measure, and (3) Patient preferences for modes of survey administration.</p></div><div><h3>Analytical Approach</h3><p>We used Fisher exact tests and multivariable logistic regression to assess sociodemographic and clinical predictors of SMS survey response. Qualitative methods were used to analyze open-ended responses capturing patient preferences.</p></div><div><h3>Results</h3><p>Among 1,008 patients, 310 responded to the SMS survey (response rate 31%). In multivariable adjusted analyses, participants who were age 80 years and above (aOR, 0.49; 95% CI, 0.25-0.96) were less likely to respond to the SMS survey compared with those aged 18 to 44 years. Non-Hispanic Black (aOR, 0.58; 95% CI, 0.39-0.86), Hispanic (aOR, 0.31; 95% CI, 0.19-0.51), and Asian or Pacific Islander (aOR, 0.46; 95% CI, 0.28-0.74) individuals were less likely to respond compared with non-Hispanic White participants. Participants residing in census tracts with higher Social Vulnerability Index, indicating greater neighborhood-level social vulnerability, were less likely to respond to the SMS survey (fifth vs first quintile aOR, 0.61; 95% CI, 0.37-0.99). Over 80% of a sample of survey respondents and nonrespondents completely agreed or agreed with the Acceptability of Intervention Measure. Qualitative analysis identified 4 drivers of patient preferences for survey administration: (1) convenience (subtopics: efficiency, multitasking, comfort, and synchronicity); (2) privacy; (3) interpersonal interaction; and (4) accessibility (subtopics: vision, language, and fatigue).</p></div><div><h3>Limitations</h3><p>Generalizability, length of survey.</p></div><div><h3>Conclusions</h3><p>An SMS text message-based survey had moderate reach among patients receiving dialysis and was highly acceptable, but response rates were lower in older (age<!--> <!-->≥<!--> <!-->80), non-White individuals and those with greater neighborhood-level social vulnerability. Future research should examine barriers and facilitators to mHealth among patients receiving dialysis to ensure equitable implementation of mHealth-based technologies.</p></div><div><h3>Plain-L","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S259005952400058X/pdfft?md5=4df26fe70867f012f01f78938a620d45&pid=1-s2.0-S259005952400058X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141137942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular and Thromboembolic Events in Children and Adults With Glomerular Disease: Findings From the Cure GlomeruloNephropathy (CureGN) Network","authors":"S. Wadhwani, Sarah A. Mansfield, Abigail R. Smith, Bruce M. Robinson, E. Abdelghani, A. Al-Uzri, I. Ashoor, Sharon M. Bartosh, A. Chishti, Salim S. Hayek, Michelle A Hladunewich, B. Kerlin, Siddharth S. Madapoosi, Laura H. Mariani, Amy K. Mottl, M.N. Rheault, Michelle M. O’Shaughnessy, C. J. Sperati, T. Srivastava, D. Selewski, C. Wang, Craig S. Wong, Donald J. Weaver, Myda Khalid","doi":"10.1016/j.xkme.2024.100877","DOIUrl":"https://doi.org/10.1016/j.xkme.2024.100877","url":null,"abstract":"","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141844076","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":"Impact of Race-Free Glomerular Filtration Rate Estimations on CKD Prevalence in the US Military Health System: A Retrospective Cohort Study","authors":"James D. Oliver III ,&nbsp;Robert Nee ,&nbsp;Hava Marneweck ,&nbsp;Amanda Banaag ,&nbsp;Alain K. Koyama ,&nbsp;Meda E. Pavkov ,&nbsp;Tracey Pérez Koehlmoos","doi":"10.1016/j.xkme.2024.100861","DOIUrl":"10.1016/j.xkme.2024.100861","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Rationale &amp; Objective&lt;/h3&gt;&lt;p&gt;The 2021 CKD-EPI removes Black race as a factor in calculating the estimated glomerular filtration rate (eGFR). We assessed its effect on CKD prevalence in the demographically-diverse US Military Health System.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study Design&lt;/h3&gt;&lt;p&gt;A retrospective calculation of the eGFR from serum creatinine measured over 2016-2019 using both the 2009 and 2021 CKD-EPI equations.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Setting &amp; Population&lt;/h3&gt;&lt;p&gt;Multicenter health care network with data from 1,502,607 adults in the complete case analysis and from 1,970,433 adults in an imputed race analysis.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Predictors&lt;/h3&gt;&lt;p&gt;Serum creatinine, age, sex, and race.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Outcome&lt;/h3&gt;&lt;p&gt;CKD stages 3-5, defined as the last eGFR persistently&lt;!--&gt; &lt;!--&gt;&lt;&lt;!--&gt; &lt;!--&gt;60&lt;!--&gt; &lt;!--&gt;mL/min/1.73m&lt;sup&gt;2&lt;/sup&gt; for&lt;!--&gt; &lt;!--&gt;≥90 days.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Analytical Approach&lt;/h3&gt;&lt;p&gt;The t test and Kruskal-Wallis test were used for continuous variables and Χ&lt;sup&gt;2&lt;/sup&gt; for categorical data.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;p&gt;The population in the complete case analysis had a median age of 40 years and was 18.8% Black race and 35.4% female. With the 2021 equation, the number of Black adults with CKD stages 3-5 increased by 58.1% from 4,147 to 6,556, a change in the crude prevalence from 1.47% to 2.32%. The number of non-Black adults with CKD stages 3-5 decreased by 30.4% from 27,596 to 19,213, a crude prevalence change from 2.26% to 1.58%. Similar results were seen with race imputation. Cumulatively, among adults with CKD stages 3-5 by at least one equation, 45.8% of Black adults were reclassified to more advanced stages of CKD and 44.0% of non-Black adults were reclassified to less severe stages across eGFR thresholds that could change clinical management.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Limitations&lt;/h3&gt;&lt;p&gt;Potential underestimation of CKD in individuals with only 1 measurement.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;p&gt;Adoption of the 2021 CKD-EPI equation in the Military Health System reclassifies many Black adults into new CKD stages 3-5 or into more advanced CKD stages, with the opposite effect on non-Black adults. This may have an effect on CKD treatment and outcomes in ways that are yet unknown.&lt;/p&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Plain-Language Summary&lt;/h3&gt;&lt;p&gt;Until recently, kidney function level was calculated from equations that adjusted the result if the individual was of Black race. Because this may contribute to racial disparities in kidney disease care, a new equation was developed in 2021 that excludes race as a factor. We assessed the possible effects of this equation using data from adults in the US Military Health System from 2016 to 2019. With the new equation, the number of Black adults classified with kidney disease increased while that of non-Black adults decreased. There were similar trends seen in the more severe levels of kidney disease, which could affect decisions in clinical care. These results emphasize the potential positive and negativ","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590059524000724/pdfft?md5=4fc9aaeaa59ee0ac25db5dc70722205e&pid=1-s2.0-S2590059524000724-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141732017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continuous Insulin Therapy to Prevent Post-Transplant Diabetes Mellitus: A Randomized Controlled Trial","authors":"Amelie Kurnikowski ,&nbsp;Johannes Werzowa ,&nbsp;Sebastian Hödlmoser ,&nbsp;Simon Krenn ,&nbsp;Christopher Paschen ,&nbsp;Sebastian Mussnig ,&nbsp;Andrea Tura ,&nbsp;Jürgen Harreiter ,&nbsp;Michael Krebs ,&nbsp;Peter X.K. Song ,&nbsp;Kathrin Eller ,&nbsp;Julio Pascual ,&nbsp;Klemens Budde ,&nbsp;Manfred Hecking ,&nbsp;Elisabeth Schwaiger","doi":"10.1016/j.xkme.2024.100860","DOIUrl":"10.1016/j.xkme.2024.100860","url":null,"abstract":"<div><h3>Rationale &amp; Objectives</h3><p>Hyperglycemia is frequently observed early after transplantation and associated with development of post-transplant diabetes mellitus (PTDM). Here, we assessed continuous subcutaneous insulin infusion (CSII) targeting afternoon hyperglycemia.</p></div><div><h3>Study Design</h3><p>Open-label randomized parallel 3-arm design.</p></div><div><h3>Settings &amp; Participants</h3><p>In total, 85 kidney transplant recipients without previous diabetes diagnosis were randomized to postoperative CSII therapy, basal insulin, or control.</p></div><div><h3>Interventions</h3><p>Insulin was to be initiated at afternoon capillary blood glucose level of<!--> <!-->≥140<!--> <!-->mg/dL (7.8<!--> <!-->mmol/L; CSII and basal insulin) or fasting plasma glucose level of<!--> <!-->≥200<!--> <!-->mg/dL (11.1<!--> <!-->mmol/L; control).</p></div><div><h3>Outcomes</h3><p>Hemoglobin A1c (HbA1c) levels at 3 months post-transplant (primary endpoint). PTDM assessed using oral glucose tolerance test at 12 and 24 months.</p></div><div><h3>Results</h3><p>CSII therapy lasted until median day 18 and maximum day 88. The median HbA1c value at month 3 was 5.6% (38<!--> <!-->mmol/mol) in the CSII group versus 5.7% (39<!--> <!-->mmol/mol) in the control group (<em>P</em> <!-->=<!--> <!-->0.70) and 5.4% (36<!--> <!-->mmol/mol) in the basal insulin group (<em>P</em> <!-->=<!--> <!-->0.02). At months 12 and 24, the odds for PTDM were similar compared with the control group (odds ratios [95% confidence intervals], 0.80 [0.18-3.49] and 0.71 [0.15-3.16], respectively) and the basal insulin group (0.96 [0.18-5.68] and 1.51 [0.24-12.84], respectively). Mild hypoglycemia events occurred in the CSII and the basal insulin groups.</p></div><div><h3>Limitations</h3><p>This study is limited by outdated insulin pump technology, frequent discontinuations of CSII, a complex protocol, and concerns regarding reliability of HbA1c measurements.</p></div><div><h3>Conclusions</h3><p>CSII therapy was not superior at reducing HbA1c levels at month 3 or PTDM prevalence at months 12 and 24 compared with the control or basal insulin group.</p></div>","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590059524000712/pdfft?md5=a8a7b0b09c146f4cb205f1ac28685f1e&pid=1-s2.0-S2590059524000712-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141729150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obinutuzumab in Refractory Membranous Nephropathy: A Case Series","authors":"Yuxin Lin ,&nbsp;Quan Han ,&nbsp;Liangliang Chen,&nbsp;Yaomin Wang,&nbsp;Pingping Ren,&nbsp;Guangjun Liu,&nbsp;Lan Lan,&nbsp;Xin Lei,&nbsp;Jianghua Chen,&nbsp;Fei Han","doi":"10.1016/j.xkme.2024.100853","DOIUrl":"https://doi.org/10.1016/j.xkme.2024.100853","url":null,"abstract":"<div><h3>Rationale &amp; Objective</h3><p>Membranous nephropathy (MN), recognized as an autoimmune kidney disease, responds well to anti-CD20 monoclonal antibodies. Obinutuzumab, a type Ⅱ humanized anti-CD20 and immunoglobulin G1 Fc-optimized monoclonal antibody, when compared with rituximab, has demonstrated superior efficacy in B-cell leukemia and lymphoma, especially in rituximab-resistant cases. However, the efficacy and safety of obinutuzumab in MN remain unclear.</p></div><div><h3>Study Design</h3><p>A case series study.</p></div><div><h3>Setting &amp; Participants</h3><p>A total of 18 patients were diagnosed with MN and had received obinutuzumab at our center without secondary MN, undergoing dialysis, having a history of kidney transplantation, or infections requiring treatment.</p></div><div><h3>Exposure</h3><p>Obinutuzumab treatment.</p></div><div><h3>Outcomes</h3><p>Primary outcomes included remission rate, time to first remission, and first relapse-free survival time during the follow-up period.</p></div><div><h3>Analytical Approach</h3><p>Survival analysis was performed with Cox proportional hazards models, log-rank test, and Kaplan–Meier survival analysis.</p></div><div><h3>Results</h3><p>Patients with MN (median age of 52.5 years, 83.3% males) received an average dose of 2.1<!--> <!-->±<!--> <!-->0.8<!--> <!-->g of obinutuzumab during a median follow-up period of 13.6 months. During the follow-up, 17 patients (94.4%) achieved remission, with 12 patients (66.7%) achieving partial remission, and 5 patients (27.8%) achieving complete remission. The median time to first remission and first relapse-free survival time was 2.7 (1.0-6.1) months and 9.8 (2.6-11.2) months, respectively. Of 12 patients with previous rituximab treatment, all achieved remission successfully, with 8 (66.7%) achieving partial remission and 4 (33.3%) achieving complete remission. Adverse events were mostly mild, and no severe treatment-related adverse events were observed.</p></div><div><h3>Limitations</h3><p>Limited or missing data; risks of selection bias; or recall bias; underestimated first relapse-free survival time because of a limited follow-up period; unmonitored counts of CD19⁺ <!-->B-cells and other lymphocyte subsets.</p></div><div><h3>Conclusions</h3><p>Obinutuzumab demonstrated promising efficacy and safety in inducing remission in MN, particularly in patients with an unsatisfactory response to rituximab.</p></div><div><h3>Plain Language Summary</h3><p>Membranous nephropathy (MN), an autoimmune kidney disease, usually responds favorably to rituximab, a chimeric anti-CD20 monoclonal antibody. Nevertheless, certain patients exhibit inadequate responses to rituximab. Obinutuzumab, a novel humanized anti-CD20 monoclonal antibody, has shown enhanced efficacy in cases where rituximab fails to address B-cell leukemias and lymphomas. However, its efficacy and safety in MN treatment remain uncertain. A case series involving 18 patients treated with o","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590059524000645/pdfft?md5=0396f0f15faea8985d0440bce339e8f8&pid=1-s2.0-S2590059524000645-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141594284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric Kidney Biopsy: Clinical Perspectives Based on Survey of Pediatric Nephrologists and Interventional Radiologists","authors":"Nikhil Nair ,&nbsp;Charles Varnell ,&nbsp;Manish Patel ,&nbsp;Jonathan VanGeest ,&nbsp;Matt Grinsell ,&nbsp;Kathleen Altemose ,&nbsp;Sidharth K. Sethi ,&nbsp;Rupesh Raina","doi":"10.1016/j.xkme.2024.100859","DOIUrl":"https://doi.org/10.1016/j.xkme.2024.100859","url":null,"abstract":"","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590059524000700/pdfft?md5=b97aa9ee610882c14ec0447f6ab54ec9&pid=1-s2.0-S2590059524000700-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141595779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lonomia obliqua (Caterpillar)–Related Kidney Failure: A Rare Histopathology Register","authors":"Marcos Adriano Garcia Campos,&nbsp;Bruno Rafael Santos Brito,&nbsp;Priscylla Gouveia Mendonça,&nbsp;Natalino Salgado Filho,&nbsp;Gyl Eanes Barros Silva","doi":"10.1016/j.xkme.2024.100852","DOIUrl":"10.1016/j.xkme.2024.100852","url":null,"abstract":"","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590059524000633/pdfft?md5=1c2b57fdf3b0af4d7dec3e563e1996b1&pid=1-s2.0-S2590059524000633-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141415002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}