Kidney Medicine最新文献

{"title":"Establishing the Future Direction of Clinical Outcomes in C3 Glomerulopathy: Perspectives From a Patient and a Physician","authors":"Anuja Java ,&nbsp;Lindsey Fuller","doi":"10.1016/j.xkme.2024.100928","DOIUrl":"10.1016/j.xkme.2024.100928","url":null,"abstract":"<div><div>Complement 3 glomerulopathy (C3G) is an ultra-rare glomerulonephritis caused by dysregulation of the alternative complement pathway. C3G has an estimated incidence of 1-3 cases per million people in the United States. Diagnosing C3G based solely on clinical and laboratory features is challenging because it mimics several other glomerular diseases; therefore, diagnosis requires a kidney biopsy. In the absence of disease-modifying therapies and optimal patient management strategies, C3G poses a significant physical and emotional burden on patients and caregivers. Common symptoms of glomerulonephritis include fatigue, edema, anxiety, and/or depression, which have profound effects on patients’ daily lives. Approximately half of all patients progress to kidney failure within 10 years of diagnosis. Encouragingly, the treatment landscape in C3G is poised to change, with several targeted complement inhibitors in late-stage development. This perspectives article explores a patient’s journey in C3G and discusses the current and future status of clinical outcomes and patient management from the viewpoints of a practicing nephrologist and a patient.</div></div>","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":"7 1","pages":"Article 100928"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11699595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932278","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":"Peritoneal Dialysis-Associated Peritonitis Rates in the Outpatient and Hospital Setting Among Incident Dialysis Patients With Medicare, 2009–2018","authors":"Christopher Knapp MD, MPH ,&nbsp;Shuling Li PhD ,&nbsp;Chuanyu Kou MS ,&nbsp;James B. Wetmore MD ,&nbsp;Kirsten L. Johansen MD","doi":"10.1016/j.xkme.2024.100931","DOIUrl":"10.1016/j.xkme.2024.100931","url":null,"abstract":"","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":"7 1","pages":"Article 100931"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932293","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":"Tolvaptan and Autosomal Dominant Polycystic Kidney Disease Progression in Individuals Aged 18-35 Years: A Pooled Database Analysis","authors":"Fouad T. Chebib ,&nbsp;Neera Dahl ,&nbsp;Xiaolei Zhou ,&nbsp;Diana Garbinsky ,&nbsp;Jinyi Wang ,&nbsp;Sasikiran Nunna ,&nbsp;Dorothee Oberdhan ,&nbsp;Ancilla W. Fernandes","doi":"10.1016/j.xkme.2024.100935","DOIUrl":"10.1016/j.xkme.2024.100935","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Rational &amp; Objective&lt;/h3&gt;&lt;div&gt;Data are limited regarding the long-term efficacy of tolvaptan in adults aged 18-35 years with autosomal dominant polycystic kidney disease (ADPKD) at increased risk of rapid progression. We assessed the effects of tolvaptan within a larger population of younger adults and over longer follow-up than individual clinical trials could provide.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study Design&lt;/h3&gt;&lt;div&gt;Pooled database study.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Setting &amp; Study Populations&lt;/h3&gt;&lt;div&gt;A consolidated clinical study database with ADPKD patients aged 18-35 years.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Selection Criteria for Studies&lt;/h3&gt;&lt;div&gt;Studies that enrolled patients who received either tolvaptan or standard-of-care treatment not including tolvaptan.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Data Extraction&lt;/h3&gt;&lt;div&gt;Annual rate of change in estimated glomerular filtration rate (eGFR) and time to kidney failure.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Analytical Approach&lt;/h3&gt;&lt;div&gt;For individuals participating in multiple studies, their data were longitudinally linked to extend the follow-up period. We matched tolvaptan-treated patients with controls based on age, sex, chronic kidney disease stage, eGFR, and, where possible, Mayo Imaging Classification. We compared eGFR decline between groups using mixed-effects modeling.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The matched analysis set encompassed 204 tolvaptan-treated individuals and 204 controls. Median follow-up was 4.6 years for the tolvaptan group and 1.7 years for controls. In the mixed-effects model, the eGFR decline rate (in mL/min/1.73&lt;!--&gt; &lt;!--&gt;m&lt;sup&gt;2&lt;/sup&gt;/year) was –2.58 for the tolvaptan cohort and -4.28 for controls. This indicates reduction in the eGFR decline rate by 1.69&lt;!--&gt; &lt;!--&gt;mL/min/1.73&lt;!--&gt; &lt;!--&gt;m&lt;sup&gt;2&lt;/sup&gt;/year (95% confidence interval: 0.87-2.52; &lt;em&gt;P&lt;/em&gt; &lt;!--&gt;&lt;&lt;!--&gt; &lt;!--&gt;0.001) with tolvaptan, a 40% improvement. Extrapolating eGFR over 35 years, tolvaptan could delay kidney failure onset by approximately 11 years.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Limitations&lt;/h3&gt;&lt;div&gt;Median follow-up was shorter in the control cohort than the tolvaptan cohort. The projection of time to kidney failure assumed a linear model of eGFR decline.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;This analysis offers insights into the anticipated treatment benefits of tolvaptan for young adults with ADPKD. These findings are crucial for weighing treatment benefits against any associated risks.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Plain-Language Summary&lt;/h3&gt;&lt;div&gt;Tolvaptan is the only approved treatment for delaying kidney function decline in patients with autosomal dominant polycystic kidney disease (ADPKD) at high risk of rapid progression. Clinical trials have included few patients aged 18-35 years, a group potentially benefiting significantly from early tolvaptan initiation. We pooled clinical study data, matching tolvaptan-treated patients with untreated controls by baseline characteristics. The results showed a statistically significant reduction in kidney functi","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":"7 1","pages":"Article 100935"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11731472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983910","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":"Vascular Access for Home Hemodialysis: A Perspective on Tunneled Central Venous Catheters at Home","authors":"Michael Alexander Aragon ,&nbsp;Osama El Shamy ,&nbsp;Sijie Zheng ,&nbsp;Glenn M. Chertow ,&nbsp;Joel Glickman ,&nbsp;Eric Weinhandl ,&nbsp;Paul Komenda ,&nbsp;Stephan Dunning ,&nbsp;Frank Liu ,&nbsp;Charmaine Lok","doi":"10.1016/j.xkme.2024.100916","DOIUrl":"10.1016/j.xkme.2024.100916","url":null,"abstract":"<div><div>Expansion of home hemodialysis (HHD) provides an opportunity to improve clinical outcomes, reduce cost of care, and address the staffing challenges currently faced in caring for patients with kidney failure on replacement therapy. To increase HHD expansion, current practices and barriers to home dialysis must be examined and addressed. One such barrier is vascular access for HHD; although tunneled hemodialysis central venous catheters (CVCs) have been used for decades, physicians still hesitate to send patients home without a mature, functional arteriovenous access. An expert panel of clinicians was convened by Outset Medical, a manufacturer of hemodialysis systems, to review the literature and generate consensus recommendations regarding the use of CVCs for HHD. Consistent with the most recent Kidney Disease Outcomes vascular access guidelines, the end-stage kidney disease life plan should be created via shared decision making for modality choices, with the corresponding dialysis access individualized for the patient, and for whom a CVC may represent the most appropriate vascular access to provide HHD.</div></div>","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":"7 1","pages":"Article 100916"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11721530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971548","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":"“The Heart of the Center”: Exploring the Role of the Patient Care Technician in US Dialysis Care","authors":"Megan Urbanski ,&nbsp;Emma Blythe ,&nbsp;Alicia Hamblin ,&nbsp;Alexis A. Bender ,&nbsp;Courtney Hoge ,&nbsp;Clarica Douglas-Ajayi ,&nbsp;Fran Rickenbach ,&nbsp;Jessica Joseph ,&nbsp;Kelli Collins Damron ,&nbsp;Jennifer Craft Morgan ,&nbsp;Bernard Jaar ,&nbsp;Laura Plantinga","doi":"10.1016/j.xkme.2024.100934","DOIUrl":"10.1016/j.xkme.2024.100934","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Rationale &amp; Objective&lt;/h3&gt;&lt;div&gt;Dialysis patient care technicians (PCTs) provide essential, frontline care for patients receiving in-center hemodialysis. We qualitatively explored perceptions of the PCT job role, responsibilities, and training among current PCTs, non-PCT dialysis staff, and patients receiving hemodialysis.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study Design&lt;/h3&gt;&lt;div&gt;Focus group study.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Setting &amp; Participants&lt;/h3&gt;&lt;div&gt;Discussions were conducted in March–May 2023 among US PCTs, non-PCT staff, and patients.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Analytical Approach&lt;/h3&gt;&lt;div&gt;Thematic analysis was conducted using inductive and deductive strategies.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Seven focus groups (N = 36 participants) were conducted (3 with PCTs [n = 19], 2 with non-PCT staff [n = 6], and 2 with patients [n = 11]). Eight themes emerged: (1) value of PCT role is not reflected in job or organizational policies and structures; (2) PCTs play a flexible and often ill-defined role in dialysis clinics; (3) despite being in a position with high risk of burnout, PCTs find ways to persevere and provide high-quality care; (4) PCTs are often perceived as “helpers” or ancillary rather than an integral part of the dialysis care team; (5) PCT job training and qualifications are not standardized and often not commensurate with job expectations and responsibilities; (6) PCT-patient relationships are deeply valued, but boundaries can be fluid and become blurred because of the frequency and nature of dialysis care; (7) dialysis patients and staff are vulnerable to multilevel workplace safety issues; and (8) PCT-staff dynamics have a strong impact on employee morale, clinic efficiency, and patient satisfaction.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Limitations&lt;/h3&gt;&lt;div&gt;Non-English-speaking participants and physicians were excluded, limiting diversity in perspectives.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;PCTs play a multifaceted role in dialysis care that is highly valued among patients and staff but not always reflected in actual tasks performed by PCTs, training received by PCTs, or the respect afforded to PCTs. Our findings are actionable and can inform future intervention-based work aimed at improving the PCT role in US hemodialysis care.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Plain-Language Summary&lt;/h3&gt;&lt;div&gt;In the United States, patient care technicians (PCTs) spend the most chair-side time with patients receiving hemodialysis, but little is known about the role of patient care technicians (PCTs) in dialysis care. We conducted 7 focus groups with US PCTs, other dialysis staff, and patients receiving hemodialysis. Discussions showed that the PCT role is highly valued among dialysis staff and patients, but this is often poorly reflected in organizational structures. PCTs also often work outside of their scope and training. Additionally, PCTs and patients form strong bonds, but these relationships are sometimes viewed as problematic. Results highlight the complex, valuable role PCT","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":"7 1","pages":"Article 100934"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11683225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142907367","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":"Acute Kidney Injury Prognosis Prediction Using Machine Learning Methods: A Systematic Review","authors":"Yu Lin ,&nbsp;Tongyue Shi ,&nbsp;Guilan Kong","doi":"10.1016/j.xkme.2024.100936","DOIUrl":"10.1016/j.xkme.2024.100936","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Rationale &amp; Objective&lt;/h3&gt;&lt;div&gt;Accurate estimation of in-hospital outcomes for patients with acute kidney injury (AKI) is crucial for aiding physicians in making optimal clinical decisions. We aimed to review prediction models constructed by machine learning methods for predicting AKI prognosis using administrative databases.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study Design&lt;/h3&gt;&lt;div&gt;A systematic review following PRISMA guidelines.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Setting &amp; Study Populations&lt;/h3&gt;&lt;div&gt;Adult patients diagnosed with AKI who are admitted to either hospitals or intensive care units.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Search Strategy &amp; Sources&lt;/h3&gt;&lt;div&gt;We searched PubMed, Embase, Web of Science, Scopus, and Cumulative Index to Nursing and Allied Health for studies published between January 1, 2014 and February 29, 2024. Eligible studies employed machine learning models to predict in-hospital outcomes of AKI based on administrative databases.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Data Extraction&lt;/h3&gt;&lt;div&gt;Extracted data included prediction outcomes and population, prediction models with performance, feature selection methods, and predictive features.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Analytical Approach&lt;/h3&gt;&lt;div&gt;The included studies were qualitatively synthesized with assessments of quality and bias. We calculated the pooled model discrimination of different AKI prognoses using random-effects models.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Of 3,029 studies, 27 studies were eligible for qualitative review. In-hospital outcomes for patients with AKI included acute kidney disease, chronic kidney disease, renal function recovery or kidney failure, and mortality. Compared with models predicting the mortality of patients with AKI during hospitalization, the prediction performance of models on kidney function recovery was less accurate. Meta-analysis showed that machine learning methods outperformed traditional approaches in mortality prediction (area under the receiver operating characteristic curve, 0.831; 95% CI, 0.799-0.859 vs 0.772; 95% CI, 0.744-0.797). The overlapping predictive features for in-hospital mortality identified from&lt;!--&gt; &lt;!--&gt;≥6 studies were age, serum creatinine level, serum urea nitrogen level, anion gap, and white blood cell count. Similarly, age, serum creatinine level, AKI stage, estimated glomerular filtration rate, and comorbid conditions were the common predictive features for kidney function recovery.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Limitations&lt;/h3&gt;&lt;div&gt;Many studies developed prediction models within specific hospital settings without broad validation, restricting their generalizability and clinical application.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Machine learning models outperformed traditional approaches in predicting mortality for patients with AKI, although they are less accurate in predicting kidney function recovery. Overall, these models demonstrate significant potential to help physicians improve clinical decision making and patient outcomes.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Registrati","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":"7 1","pages":"Article 100936"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11699606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932273","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":"Factors Influencing Recruitment, Retention, and Adherence Rates in Exercise Interventions in ESKD: A Scoping Review","authors":"Malvika Agarwal ,&nbsp;Jamie Alexiuk ,&nbsp;Clara Bohm ,&nbsp;Lindsey Sikora ,&nbsp;Deborah Zimmerman","doi":"10.1016/j.xkme.2024.100933","DOIUrl":"10.1016/j.xkme.2024.100933","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Rational &amp; Objective&lt;/h3&gt;&lt;div&gt;Majority of people with end-stage kidney disease (ESKD) are sedentary, which increases risk for decreased quality and quantity of life. Development of exercise programs with characteristics that address individual preferences may increase interest in participating and completing exercise programs. We evaluated which exercise intervention characteristics affect exercise program recruitment, adherence, and completion in people with ESKD receiving dialysis.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study Design&lt;/h3&gt;&lt;div&gt;Scoping review of randomized controlled trials (RCTs) with searching of Medline, Embase, Cochrane, and CINAHL databases through May 12, 2023.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Setting &amp; Study Populations&lt;/h3&gt;&lt;div&gt;Adults with ESKD receiving dialysis.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Selection Criteria&lt;/h3&gt;&lt;div&gt;RCTs with exercise interventions of&lt;!--&gt; &lt;!--&gt;≥12 weeks that included more than 10 people with ESKD receiving dialysis in each study arm.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Data Extraction&lt;/h3&gt;&lt;div&gt;One individual extracted data and the second author checked for accuracy.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Analytical Approach&lt;/h3&gt;&lt;div&gt;Data were synthesized qualitatively. Associations between intervention characteristics and recruitment, retention and adherence rates were assessed through one-way analysis of variance tests. Risk of bias was assessed using the Cochrane Risk of Bias 1.0 tool.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Of 7,396 studies identified, 55 studies with 3,269 trial participants were included. The majority of participants were male (63.2%) and treated with hemodialysis (89.1%). Mean age was 56&lt;!--&gt; &lt;!--&gt;±&lt;!--&gt; &lt;!--&gt;11.5 years. Average recruitment, retention and adherence rates were 77.4%, 81.2%, and 76.0%, respectively. Only 27% of studies reported adherence rates. No significant associations were found between intervention characteristics (ie, exercise type, duration, frequency, setting, and supervision) and recruitment, adherence, and retention rates.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Limitations&lt;/h3&gt;&lt;div&gt;Data were limited by small sample size, suboptimal risk of bias, selective recruiting methods, and variability in definitions of adherence rates.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Average recruitment, retention, and adherence rates in exercise interventions for patients receiving dialysis were high although less than 1 in 4 studies reported adherence rates. These results call for standardized reporting of recruitment, retention, and adherence rates in exercise interventions.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Plain-Language Summary&lt;/h3&gt;&lt;div&gt;Regular exercise for people with end-stage kidney disease (ESKD) can improve their quality of life. We sought to determine if there were certain characteristics of an exercise program such as exercise type, frequency, program length, and setting that were associated with enhanced recruitment, retention, and adherence to the program. From the 55 identified studies, average recruitment, retention, and adherence rates in exercise i","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":"7 1","pages":"Article 100933"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983864","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":"Glomerular and Nephron Size and Kidney Disease Outcomes: A Comparison of Manual Versus Deep Learning Methods in Kidney Pathology","authors":"Jaidip M. Jagtap PhD, MS ,&nbsp;Andrew R. Janowczyk PhD, MS ,&nbsp;Yijiang Chen PhD ,&nbsp;Afsana A. Shaik MBBS ,&nbsp;Aidan F. Mullan MA ,&nbsp;Bradley J. Erickson MD, PhD ,&nbsp;Vidit Sharma MD ,&nbsp;Timothy L. Kline PhD, MS ,&nbsp;Laura Barisoni MD ,&nbsp;Aleksandar Denic MD, PhD ,&nbsp;Andrew D. Rule MD","doi":"10.1016/j.xkme.2024.100939","DOIUrl":"10.1016/j.xkme.2024.100939","url":null,"abstract":"","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":"7 1","pages":"Article 100939"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11728938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142979082","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":"Spinal Cord Compression as the First Presentation of Primary Hyperoxaluria in a Patient With Kidney Failure: A Case Report and Literature Review","authors":"Marwa Kliea ,&nbsp;Mohammad Alsultan ,&nbsp;Safaa Qatleesh ,&nbsp;Yousef Haroun ,&nbsp;Osama Abdul Aziz ,&nbsp;Kassem Basha","doi":"10.1016/j.xkme.2024.100932","DOIUrl":"10.1016/j.xkme.2024.100932","url":null,"abstract":"<div><div>A 50-year-old woman with kidney failure complained of back pain and an inability to walk. The medical history included hypothyroidism, nephrolithiasis, and resistant anemia aligned with several transfusions. The examination showed hepatosplenomegaly, lower limb weakness, absence of reflexes, and lack of sensations with a sensory level T6. Laboratory results showed hypercalcemia with suppression of parathyroid hormone levels. Magnetic resonance imaging showed vertebral fractures and mass-like lesions that compressed the spine at T4, T9, L4, and L5. Vertebral and bone marrow biopsies showed calcium oxalate (CaOx) depositions. Here, we reported a rare case of primary hyperoxaluria (PH) in a patient with kidney failure who presented with spinal cord compression caused by vertebral fractures and mass-like lesions. We summarized a literature review of PH patients with spinal cord compression, which showed only 3 cases. The multiorgan CaOx infiltration in this patient also caused resistant anemia, hepatosplenomegaly, extensive bone lesions, hypoparathyroidism, hypothyroidism, and hypercalcemia. The overdiagnosis of renal osteodystrophy and the negative family history could delay the diagnosis of PH in patients with kidney failure. Thus, clinicians should always consider PH in the differential diagnosis of kidney failure patients with stone events given that the early diagnosis of PH could be lifesaving.</div></div>","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":"7 1","pages":"Article 100932"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11699631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932297","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":"Development of a Novel Intraperitoneal Icodextrin/Dextrose Solution for Enhanced Sodium Removal","authors":"Jennifer L. Asher ,&nbsp;Juan B. Ivey-Miranda ,&nbsp;Christopher Maulion ,&nbsp;Zachary L. Cox ,&nbsp;Julian A. Borges-Vela ,&nbsp;Genaro H. Mendoza-Zavala ,&nbsp;Jose A. Cigarroa-Lopez ,&nbsp;Rogelio I. Silva-Rueda ,&nbsp;Cristina Revilla-Monsalve ,&nbsp;Julieta Moreno-Villagomez ,&nbsp;Daniela Ramos-Mastache ,&nbsp;Oliver Goedje ,&nbsp;Ian Crosbie ,&nbsp;Christopher McIntyre ,&nbsp;Fredrick Finkelstein ,&nbsp;Jeffrey M. Turner ,&nbsp;Jeffrey M. Testani ,&nbsp;Veena S. Rao","doi":"10.1016/j.xkme.2024.100938","DOIUrl":"10.1016/j.xkme.2024.100938","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Rationale &amp; Objective&lt;/h3&gt;&lt;div&gt;Peritoneal dialysis (PD) solutions provide both clearance of uremic toxins and sodium and water. An intraperitoneal (IP) solution of icodextrin and glucose designed without the requirement for uremic toxin clearance could provide substantially greater sodium and water removal than PD solutions.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study Design&lt;/h3&gt;&lt;div&gt;We examined varying concentrations of icodextrin and dextrose IP solutions in rats. We evaluated a 30% icodextrin and 10% dextrose IP solution in animals and humans.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Participants&lt;/h3&gt;&lt;div&gt;Small and large animal models, and humans (N&lt;!--&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;10) with kidney failure.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Exposure&lt;/h3&gt;&lt;div&gt;30% icodextrin and 10% dextrose IP solution.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Outcomes&lt;/h3&gt;&lt;div&gt;We evaluated ultrafiltration (UF), sodium removal, and peritoneal health in animals. We evaluated safety, tolerability, and efficacy in humans.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;In rats, increasing concentrations of icodextrin and dextrose IP solutions, up to 30% icodextrin and 10% dextrose, produced progressively greater UF (&lt;em&gt;P&lt;/em&gt; &lt;!--&gt;&lt;&lt;!--&gt; &lt;!--&gt;0.001). In sheep treated with 30% icodextrin and 10% dextrose, the mean UF was ∼3.5-fold greater (1.77&lt;!--&gt; &lt;!--&gt;±&lt;!--&gt; &lt;!--&gt;0.22&lt;!--&gt; &lt;!--&gt;L vs 0.47&lt;!--&gt; &lt;!--&gt;±&lt;!--&gt; &lt;!--&gt;0.34&lt;!--&gt; &lt;!--&gt;L; &lt;em&gt;P&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;0.005) and the mean sodium removal was ∼4-fold greater (7.07&lt;!--&gt; &lt;!--&gt;±&lt;!--&gt; &lt;!--&gt;0.72&lt;!--&gt; &lt;!--&gt;g vs 1.78&lt;!--&gt; &lt;!--&gt;±&lt;!--&gt; &lt;!--&gt;1.27&lt;!--&gt; &lt;!--&gt;g; &lt;em&gt;P&lt;/em&gt; &lt;!--&gt;=&lt;!--&gt; &lt;!--&gt;0.003) compared with commercially available 7.5% icodextrin PD solution. Long-term exposure of mice (30 days) and sheep (30-45 days) to a 30% icodextrin and 10% dextrose IP solution resulted in no significant structural tissue changes compared with the control 4.25% commercially available PD solution. In humans, a 24-hour dwell of a 30% icodextrin and 10% dextrose IP solution resulted in median net UF of 2,498&lt;!--&gt; &lt;!--&gt;mL (IQR, 2,249-2,768), and median sodium removal of 387&lt;!--&gt; &lt;!--&gt;mmol (IQR, 372-434&lt;!--&gt; &lt;!--&gt;mmol). No serious adverse events occurred.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Limitations&lt;/h3&gt;&lt;div&gt;The long-term safety with chronic therapy and the efficacy in patients without kidney failure were not established and require future studies.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;A 30% icodextrin and 10% dextrose IP solution provides more efficient UF and sodium removal than traditional PD solutions. The promising inhuman safety and efficacy results warrant future investigation as a sodium removal therapy in patients with edematous disorders such as heart failure.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Clinical Trial Registration&lt;/h3&gt;&lt;div&gt;NCT05780086.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Summary&lt;/h3&gt;&lt;div&gt;We aimed to design a novel intraperitoneal solution designed for optimal sodium and water removal. A sodium-free 30% icodextrin and 10% dextrose intraperitoneal solution was evaluated in animal models and humans to determine the safety and efficacy. A 30% i","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":"7 1","pages":"Article 100938"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11714391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950822","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}