Kidney Medicine最新文献

{"title":"Prognostic Significance of Baseline Lean Tissue Mass Percentage in Incident Peritoneal Dialysis Patients","authors":"Lixing Xu , Jack Kit-Chung Ng , Gordon Chun-Kau Chan , Winston Wing-Shing Fung , Kai-Ming Chow , Cheuk-Chun Szeto","doi":"10.1016/j.xkme.2026.101260","DOIUrl":"10.1016/j.xkme.2026.101260","url":null,"abstract":"<div><h3>Rationale & Objective</h3><div>Bioimpedance spectroscopy is a convenient method to measure lean tissue mass (LTM), which is commonly taken as the skeletal muscle mass, in peritoneal dialysis (PD) patients. We investigated the prognostic significance of LTM as the percentage of body weight (%LTM) and as the marker of sarcopenia in incident PD patients.</div></div><div><h3>Study Design</h3><div>A retrospective review of a prospective cohort.</div></div><div><h3>Setting & Participants</h3><div>349 incident PD patients in a single center.</div></div><div><h3>Predictor</h3><div>Baseline %LTM.</div></div><div><h3>Outcomes</h3><div>Patient survival, technique survival, peritonitis-free survival, peritonitis rate, hospitalization rate, and the duration of hospitalization.</div></div><div><h3>Analytical Approach</h3><div>Time-to-event survival analyses; linear regression for hospitalization.</div></div><div><h3>Results</h3><div>The 5-year patient survival rates were 50.2%, 55.3%, 61.0%, and 72.6% for patients with %LTM quartiles I-IV, respectively (log-rank test; <em>P</em> = 0.02). Multivariable Cox regression analysis confirmed that baseline %LTM was associated with patient survival (adjusted HR, 0.982; 95% CI, 0.966-0.999; <em>P</em> = 0.04). Baseline %LTM was also associated with peritonitis-free survival (adjusted HR, 0.983; 95% CI, 0.968-0.998; <em>P</em> = 0.031), but not technique survival. %LTM was also significantly and inversely associated with the hospitalization rate (<em>P</em> = 0.002) and the duration of hospitalization (<em>P</em> = 0.02). Yet, %LTM was unrelated to the 5-year technique survival (<em>P</em> = 0.29) and the peritonitis rate (<em>P</em> = 0.15). The number of hospital admissions was 2.72, 2.39, 2.36, and 1.67 per year of follow-up for quartiles I-IV of baseline %LTM (Jonckheere-Terpstra test; <em>P</em> = 0.002), and the duration of hospital stay was 23.31, 20.84, 22.27, and 13.96 d/y, respectively (<em>P</em> = 0.02).</div></div><div><h3>Limitations</h3><div>Observational study with baseline measures only.</div></div><div><h3>Conclusions</h3><div>Baseline %LTM as measured using bioimpedance spectroscopy is associated with patient survival, peritonitis-free survival, the number of hospital admissions, and the duration of hospital stay in incident PD patients.</div></div><div><h3>Plain-Language Summary</h3><div>Muscle wasting is a common problem in dialysis patients. In patients starting peritoneal dialysis, we measured their lean tissue mass using bioimpedance spectroscopy. We found that patients with higher percentages of lean tissue mass had better survival rates over 5 years, fewer and shorter hospital stays, and a lower risk of infection complications (peritonitis). Overall, measuring muscle mass in new peritoneal dialysis patients can help predict who is likely to do better with treatment and have fewer hospital problems, suggesting that monitoring and possibly improving muscle mass could be important ","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":"8 3","pages":"Article 101260"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147325716","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":"An Exceptional Case of Crohn-Associated IgA-Mediated Goodpasture Disease","authors":"Rebecca Ryan ,&nbsp;Thomas Fairhead ,&nbsp;Sophie Seager ,&nbsp;Mona Jain ,&nbsp;Rauri Clark","doi":"10.1016/j.xkme.2026.101252","DOIUrl":"10.1016/j.xkme.2026.101252","url":null,"abstract":"<div><div>Anti-glomerular basement membrane (anti-GBM) disease is typically mediated by IgG autoantibodies and presents with pulmonary hemorrhage and rapidly progressive glomerulonephritis, classically referred to as Goodpasture disease. We describe a novel IgA-mediated variant in a 53-year-old man with Crohn colitis, who presented with oligo-anuric acute kidney injury and hemoptysis. Despite having negative serology for anti-GBM antibodies, kidney biopsy revealed necrotizing crescentic glomerulonephritis with linear IgA deposition along the glomerular basement membrane. We suspect that a Crohn colitis flare may have incited a novel IgA-driven anti-GBM process which, remarkably, resolved in the absence of conventional immunosuppressive therapy, sharply deviating from previously reported IgA-mediated disease requiring aggressive intervention. Such a case suggests a possible link between abnormal IgA glycosylation in inflammatory bowel disease and the development of a unique IgA-mediated anti-GBM process. Recognition of this entity may broaden the diagnostic approach to seronegative pulmonary-renal syndromes and also highlight the potential for nonimmunosuppressive management.</div></div>","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":"8 3","pages":"Article 101252"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146190426","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":"Glomerular Transcriptome Analysis Reveals Endothelial Disturbances in Patients With Idiopathic Nephrotic Syndrome","authors":"Sarah K. Nelson-Taylor ,&nbsp;Jonathan Troost ,&nbsp;Courtney Giannini ,&nbsp;Colin Bauer ,&nbsp;Tarak Srivastava ,&nbsp;Jarcy Zee ,&nbsp;Markus Bitzer ,&nbsp;Laura Barisoni ,&nbsp;llse Daehn ,&nbsp;Julie A. Dougherty ,&nbsp;William E. Smoyer ,&nbsp;Bryce A. Kerlin ,&nbsp;Audrey Fetsko ,&nbsp;Imtiazul Islam ,&nbsp;Xin Wang ,&nbsp;Christine Sethna ,&nbsp;Richard J. Johnson ,&nbsp;Carmen de Lucas Collantes ,&nbsp;Kazunari Kaneko ,&nbsp;Gabriel Cara-Fuentes","doi":"10.1016/j.xkme.2025.101235","DOIUrl":"10.1016/j.xkme.2025.101235","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Rationale &amp; Objective&lt;/h3&gt;&lt;div&gt;Idiopathic nephrotic syndrome (INS) is viewed as a podocyte-specific disease. Recent reports indicate endothelial involvement, but its significance is unclear. Here, we investigated the relationship between the glomerular expression of selected genes relevant to endothelial health and clinical markers of disease severity.&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;Patients with INS (n = 70 minimal change disease and n = 83 focal segmental glomerulosclerosis) from the Nephrotic Syndrome Study Network cohort study and 53 control participants. Validation studies, including animal and cell culture experiments, were performed.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Exposure&lt;/h3&gt;&lt;div&gt;Gene expression analysis from micro-dissected human glomeruli. The study is focused on 10 genes highly relevant for endothelial homeostasis and barrier integrity (nitric oxide synthase 3 [&lt;em&gt;NOS3&lt;/em&gt;], endothelial cell adhesion molecule, and endothelial cell specific molecule 1 [&lt;em&gt;ESM1&lt;/em&gt;]), endothelial glycocalyx remodeling (&lt;em&gt;HPSE, HYAL1, MMP2, MMP9&lt;/em&gt;, and &lt;em&gt;ADAMTS1&lt;/em&gt;), and endothelial activation (&lt;em&gt;ICAM1 and CAV1&lt;/em&gt;).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Outcomes&lt;/h3&gt;&lt;div&gt;Kidney function, ultrastructural changes in podocytes and glomerular endothelium, interstitial fibrosis and tubular atrophy.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Analytical Approach&lt;/h3&gt;&lt;div&gt;One-way ANOVA and Tukey’s multiple comparisons test, Pearson Correlation and Cohen’s d statistics.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Transcriptomic analysis revealed that all genes of interest were highly expressed in glomeruli from INS patients compared with controls, except for &lt;em&gt;ESM1&lt;/em&gt; and &lt;em&gt;MMP9&lt;/em&gt;, which were decreased. Expression of endothelial-specific genes correlated with those of glycocalyx injury and cell activation. &lt;em&gt;HPSE&lt;/em&gt;, &lt;em&gt;ADAMTS1&lt;/em&gt;, &lt;em&gt;ICAM1&lt;/em&gt;, and &lt;em&gt;CAV1&lt;/em&gt; expression was inversely associated with kidney function, whereas ADAMTS1 showed a positive association with proteinuria. &lt;em&gt;NOS3&lt;/em&gt;, &lt;em&gt;HPSE&lt;/em&gt;, and &lt;em&gt;ADAMTS1&lt;/em&gt; were associated with podocyte foot process effacement, and &lt;em&gt;ICAM1&lt;/em&gt; with podocyte detachment. &lt;em&gt;HPSE&lt;/em&gt; and &lt;em&gt;MMP2&lt;/em&gt; were associated with ultrastructural endothelial injury, whereas &lt;em&gt;HPSE&lt;/em&gt;, &lt;em&gt;MMP2&lt;/em&gt;, &lt;em&gt;ICAM1&lt;/em&gt;, and &lt;em&gt;CAV1&lt;/em&gt; were associated with interstitial fibrosis and tubular atrophy. Several genes (&lt;em&gt;ESM1&lt;/em&gt;, &lt;em&gt;HPSE&lt;/em&gt;, &lt;em&gt;HYAL1&lt;/em&gt;, &lt;em&gt;MMP2&lt;/em&gt;, and &lt;em&gt;ICAM1&lt;/em&gt;) were also dysregulated in experimental INS and validated in cultured glomerular endothelial cells (&lt;em&gt;NOS3&lt;/em&gt; and heparanase) following exposure to INS sera.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Limitations&lt;/h3&gt;&lt;div&gt;Observational study, selection bias, unmeasured confounders.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;INS involves dysregulation of genes relevant for endothelial health.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Plain-Language Summary&lt;/h3&gt;&lt;div&gt;Idiopathic Nephrotic ","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":"8 3","pages":"Article 101235"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146142844","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":"Unmasking of a Heterozygous SLC12A3 Variant","authors":"Chang Xu ,&nbsp;Pietra Greenberg ,&nbsp;Moses Bachan ,&nbsp;Rajeev Rohatgi","doi":"10.1016/j.xkme.2026.101255","DOIUrl":"10.1016/j.xkme.2026.101255","url":null,"abstract":"<div><div>Three months after starting 25 mg chlorthalidone, a patient was admitted to the medical intensive care unit to manage hypokalemia, metabolic alkalosis, hypo-osmolar hyponatremia, hyperglycemia, and 30 lb weight loss. The patient received ∼936 mEq potassium over 8 days, of which 456 mEq was administered during the first 2 days of admission. In the first 24 hours, the individual received intravenous fluids that delivered 406 mEq sodium chloride. By day 2, serum potassium level increased from 2.5 to 3.0 mEq/L, bicarbonate fell from 40 to 35 mEq/L, serum sodium improved from 121 to 134 mEq/L, and serum glucose levels improved from the 400s to the 200s (mg/dL). On day 4, serum chemistries normalized. Twenty-four hours after admission, serum aldosterone level and renin activity were unremarkable, and brain natriuretic peptide concentration was &lt;10 pg/mL. The primary therapeutic interventions were potassium chloride replacement, modest sodium chloride replacement, and subcutaneous insulin administration. Natera Renasight genetic testing identified a pathologic missense variant (p.Glu121Asp) in a single allele of the thiazide-sensitive Na⁺/Cl⁻ cotransporter, solute carrier family 12 member 3 (<em>SLC12A3</em>). We speculate that chlorthalidone unmasked a Gitelman syndrome-like phenotype in a patient with a single functional <em>SLC12A3</em> allele. Moreover, this case informs us of the interrelationships of total body potassium depletion and glucose metabolism and systemic blood pressure.</div></div>","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":"8 3","pages":"Article 101255"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147326492","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 Provider Perspectives on the Patient Journey in Immunoglobulin A Nephropathy","authors":"Abdallah S. Geara ,&nbsp;Kelly B. Chen ,&nbsp;Whitney Simmons","doi":"10.1016/j.xkme.2026.101242","DOIUrl":"10.1016/j.xkme.2026.101242","url":null,"abstract":"<div><div>The clinical presentation and disease course of immunoglobulin A nephropathy (IgAN), the most common primary glomerular disease worldwide, vary considerably from patient to patient, often prolonging and complicating the diagnostic process. Additionally, the IgAN treatment landscape is rapidly changing, with ongoing development of numerous new agents targeting the underlying disease mechanism for greater efficacy. The variability of IgAN disease presentation and progression, the often complex path to diagnosis, and the evolving treatment landscape may pose significant challenges for patients and health care providers along the clinical journey. Furthermore, many factors associated with the health care system, providers, and patients may affect IgAN diagnosis, treatment, and management. This report uses the clinical and personal experiences and perspectives of the authors—a nephrologist treating patients with IgAN, an ambulatory nephrology nurse practitioner diagnosed with IgAN, and an ambulatory infusion center nurse practitioner diagnosed with IgAN—to depict the patient journey with this condition from the first clinical presentation through to long-term management. The clinical journey may be improved by increasing provider awareness of IgAN and its patient impact, as well as encouraging self-advocacy among patients.</div></div>","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":"8 3","pages":"Article 101242"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147326597","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 Association of Urine Albumin to Protein Ratio With Kidney Disease Progression","authors":"Reed Jaworski BS ,&nbsp;Afolarin Amodu MD, MPH ,&nbsp;Jing Liu MD ,&nbsp;Ashish Verma MBBS ,&nbsp;Ragnar Palsson MD ,&nbsp;Isaac E. Stillman MD ,&nbsp;Bryan R. Kestenbaum ,&nbsp;Sushrut S. Waikar MD, MPH ,&nbsp;Anand Srivastava MD, MPH","doi":"10.1016/j.xkme.2026.101259","DOIUrl":"10.1016/j.xkme.2026.101259","url":null,"abstract":"","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":"8 3","pages":"Article 101259"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147326571","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":"Cost-Effectiveness Analysis of Artificial Intelligence-Driven Risk Stratification in Patients With Diabetic Kidney Disease in the US Veterans Population","authors":"Jyotirmoy Sarker ,&nbsp;Abdullah I. Abdelaziz ,&nbsp;Jacob Crook ,&nbsp;Richard E. Nelson ,&nbsp;Joanne LaFleur ,&nbsp;Heather Nyman ,&nbsp;Chao-Chin Lu ,&nbsp;Kibum Kim","doi":"10.1016/j.xkme.2026.101261","DOIUrl":"10.1016/j.xkme.2026.101261","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Rationale &amp; Objective&lt;/h3&gt;&lt;div&gt;Efficient risk stratification is essential to optimize care and allocate resources for treatment of diabetic kidney disease (DKD). This study evaluates the cost-effectiveness of an artificial intelligence-driven in vitro kidney disease risk assay (AIKD).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study Design&lt;/h3&gt;&lt;div&gt;Cost-effectiveness analysis using a hybrid model, combining a decision tree followed by a Markov model.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Setting &amp; Population&lt;/h3&gt;&lt;div&gt;Patients with early-stage DKD receiving care within the US Veterans Health Administration health care system.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Intervention(s)&lt;/h3&gt;&lt;div&gt;Risk stratification using AIKD versus Kidney Disease: Improving Global Outcomes (KDIGO) standard of care (SoC).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Outcomes&lt;/h3&gt;&lt;div&gt;Five-year health care costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio (ICER).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Model, Perspective, &amp; Timeframe&lt;/h3&gt;&lt;div&gt;The decision tree delineated clinical pathways based on the prevalence of progressive decline in kidney function and risk stratification performance of AIKD versus KDIGO. The subsequent Markov model simulated DKD stage transitions across the underlying risk–treatment pathways. Model inputs included test performance characteristics, risk prevalence, transition probabilities, costs, and utilities. One-way and probabilistic sensitivity analyses assessed uncertainty. The analysis was conducted from the perspective of the Veterans Health Administration health care system over a 5-year time horizon.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;AIKD-guided care resulted in a total cost of $146,437 and 2.8277 QALYs, compared with $145,120 and 2.8164 QALYs for the SoC arm. The ICER for AIKD relative to SoC was $116,349 per QALY gained. One-way sensitivity analysis showed that the sensitivity and specificity of AIKD and SoC, as well as the prevalence of underlying risk of progressive decline in kidney function, were the most influential inputs affecting the ICER. From the probabilistic sensitivity analysis, AIKD has 69% likelihood of being accepted at the conventional willingness-to-pay threshold of $150,000 per QALY gained.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Limitations&lt;/h3&gt;&lt;div&gt;Model assumptions regarding risk stratification performance and long-term treatment effects may limit generalizability.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;AIKD is cost-effective compared to KDIGO for patients with early-stage DKD. Its adoption could improve health outcomes and support efficient health care resource utilization management.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Plain-Language Summary&lt;/h3&gt;&lt;div&gt;We studied whether a new artificial intelligence tool, artificial intelligence-driven in vitro kidney disease risk assay (AIKD), is a worthwhile investment for early identification of diabetic kidney disease compared with the current Kidney Disease: Improving Global Outcomes (KDIGO) guideline-recommended risk stratification method. This tool assis","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":"8 3","pages":"Article 101261"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147399573","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":"Ultrastructural Injury of Renal Podocytes in Catastrophic Antiphospholipid Syndrome","authors":"Jing Xu ,&nbsp;Suling Ye ,&nbsp;Hui Shi ,&nbsp;Yanjia Chen ,&nbsp;Chenyang Qi ,&nbsp;Wei Jin ,&nbsp;Xiaoxia Pan","doi":"10.1016/j.xkme.2026.101249","DOIUrl":"10.1016/j.xkme.2026.101249","url":null,"abstract":"","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":"8 3","pages":"Article 101249"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147399970","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":"Novel Occlusion-Reopening Technique for Perigraft Seromas in Arteriovenous Grafts: A Multicenter Case Report","authors":"Wenshen Pu ,&nbsp;Yong Xu ,&nbsp;Jiali Liu ,&nbsp;Ling Chen ,&nbsp;Qiquan Lai ,&nbsp;Xuejing Gao ,&nbsp;Bo Tu ,&nbsp;Bo Hu ,&nbsp;Ziming Wan","doi":"10.1016/j.xkme.2026.101240","DOIUrl":"10.1016/j.xkme.2026.101240","url":null,"abstract":"<div><div>Arteriovenous grafts remain crucial for hemodialysis access despite the risk of perigraft seromas (PSs)—sterile fluid collections causing graft compression, thrombosis, and dysfunction. Current treatments (surgical drainage and compression therapy) show high recurrence rates. We describe a novel occlusion-reopening technique for refractory PSs in 5 patients receiving hemodialysis (mean age, 62.6 years) with expanded polytetrafluoroethylene AVGs. All seromas developed at arterial anastomoses (1-43 days after placement) and recurred after conventional therapies. Our protocol involved (1) intentional graft occlusion via manual compression to induce thrombosis, (2) complete surgical seroma evacuation with pseudocapsule preservation, and (3) percutaneous transluminal angioplasty using 6-mm balloons for graft reopening (see Fig 1 for details). Technical success was achieved in all cases, with immediate restoration of thrill/bruit and mean post–percutaneous transluminal angioplasty flow of 1320 mL/min. No seroma recurrences occurred during follow-up, and all AVGs remained functional. The occlusion-reopening technique addresses PS pathophysiology by eliminating fluid production through temporary thrombosis while preserving graft architecture. This approach demonstrates 100% efficacy in our series for recurrent PSs unresponsive to standard therapies, offering a reproducible solution with durable outcomes.</div></div>","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":"8 3","pages":"Article 101240"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146190425","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":"Relation of Urine Cell-Free Mitochondrial DNA Quantified by Droplet Digital Polymerase Chain Reaction With Tubule Injury, Dysfunction, and Ambulatory Acute Kidney Injury","authors":"Avnee J. Kumar MD ,&nbsp;Katharine E. Epler MD ,&nbsp;Joachim H. Ix MD, MAS ,&nbsp;Vasantha Jotwani MD ,&nbsp;Ronit Katz DPhil ,&nbsp;Michael G. Shlipak MD, MPH ,&nbsp;Mark L. Hepokoski MD","doi":"10.1016/j.xkme.2026.101257","DOIUrl":"10.1016/j.xkme.2026.101257","url":null,"abstract":"","PeriodicalId":17885,"journal":{"name":"Kidney Medicine","volume":"8 3","pages":"Article 101257"},"PeriodicalIF":3.4,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147326220","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}