Amanda Lima Deluque, Henrik Dimke, R Todd Alexander
{"title":"Biology of calcium homeostasis regulation in intestine and kidney","authors":"Amanda Lima Deluque, Henrik Dimke, R Todd Alexander","doi":"10.1093/ndt/gfae204","DOIUrl":"https://doi.org/10.1093/ndt/gfae204","url":null,"abstract":"Calcium (Ca2+) is an essential divalent cation involved in many bodily functions including bone composition, cell growth and division, blood clotting, and muscle contraction. The bone, intestine, and kidneys are important to the maintenance of Ca2+ homeostasis. Ninety-nine percent of body Ca2+ is stored in the skeleton as hydroxyapatite. The small, and to a lesser extent the large intestine absorbs Ca2+ from the diet. Once in the circulation, Ca2+ is filtered by the glomerulus and the majority, >95%, is reabsorbed along the nephron. The remainder is excreted in the urine. Two general (re)absorptive pathways contribute to the vectorial transport of Ca2+ across renal and intestinal epithelia: 1) a paracellular pathway, which is reliant on claudins in the tight junction of epithelium and the electrochemical gradient and 2) a transcellular pathway, which requires different influx, intracellular buffering/shuttling and basolateral efflux mechanisms, to actively transport Ca2+ across the epithelial cell. Blood Ca2+ levels are maintained by hormones including parathyroid hormone, 1,25-dihydroxyvitamin D3, fibroblast growth factor 23 and through effects of Ca2+−sensing receptor (CaSR) signaling. Disruption of Ca2+ homeostasis can result in altered blood Ca2+ levels and/or hypercalciuria, the latter is a phenomenon closely linked to the formation of kidney stones. Genetic alterations affecting renal Ca2+ handling can cause hypercalciuria, an area of expanding investigation. This review explores the molecular mechanisms governing Ca2+ homeostasis by the intestine and kidneys and discusses clinical aspects of genetic disorders associated with Ca2+-based kidney stone disease.","PeriodicalId":19078,"journal":{"name":"Nephrology Dialysis Transplantation","volume":null,"pages":null},"PeriodicalIF":6.1,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142225429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Margo Bowers,Chengcheng Hu,Annika Gompers,Ana Rossi,Stephen Pastan,Rachel E Patzer,Jessica L Harding
{"title":"Geographic variation in sex disparities in access to the kidney transplant waitlist: a national US cohort study 2015-2021.","authors":"Margo Bowers,Chengcheng Hu,Annika Gompers,Ana Rossi,Stephen Pastan,Rachel E Patzer,Jessica L Harding","doi":"10.1093/ndt/gfae202","DOIUrl":"https://doi.org/10.1093/ndt/gfae202","url":null,"abstract":"","PeriodicalId":19078,"journal":{"name":"Nephrology Dialysis Transplantation","volume":null,"pages":null},"PeriodicalIF":6.1,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142225412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Carolt Arana, Evelyn Hermida, Jordi Rovira, José Luis Caro, David Cucchiari, Ana Belén Larque, Eduard Palou, Juan Torres, Enrique Montagud-Marrahi, Elena Cuadrado-Páyan, Diana Rodriguez, Judit Cacho, Angela Gonzalez, Johanna Reinoso, Carlos Nicolau, Nuria Esforzado, Vicente Torregrosa, Gastón Piñeiro, Ignacio Revuelta, Federico Cofan, Fritz Diekmann, Pedro Ventura-Aguiar, Federico Oppenheimer
{"title":"Antibody-mediated rejection diagnosed in early protocol biopsies in high immunological risk kidney transplant recipients","authors":"Carolt Arana, Evelyn Hermida, Jordi Rovira, José Luis Caro, David Cucchiari, Ana Belén Larque, Eduard Palou, Juan Torres, Enrique Montagud-Marrahi, Elena Cuadrado-Páyan, Diana Rodriguez, Judit Cacho, Angela Gonzalez, Johanna Reinoso, Carlos Nicolau, Nuria Esforzado, Vicente Torregrosa, Gastón Piñeiro, Ignacio Revuelta, Federico Cofan, Fritz Diekmann, Pedro Ventura-Aguiar, Federico Oppenheimer","doi":"10.1093/ndt/gfae186","DOIUrl":"https://doi.org/10.1093/ndt/gfae186","url":null,"abstract":"Background Renal transplant recipients with donor-specific anti-HLA antibodies are at an increased risk of antibody-mediated rejection (AMR). Early protocolized renal biopsies may serve as a strategy to improve diagnosis in this patient population. Methods We evaluated 155 highly sensitized renal transplant recipients with cPRA class I + II > 90% pre-transplant from 2015 to 2022. Patients with protocol biopsies within the first two weeks post-transplant were included. Results A total of 122 patients were included in the study. Of these, 13 (10.6%) were diagnosed with very early antibody-mediated rejection (veABMR) within the first two weeks post-transplant. This corresponds to 52% (13/25 patients) of all ABMR cases reported during the follow-up of this population. The graft survival rates at one and three years were significantly lower in patients with veABMR (p < 0.001) compared to patients without rejection in the early protocol biopsy. In terms of severity, the veABMR cohort exhibited a hazard ratio (HR) of 10.33 (95% CI 3.23–33.06; p < 0.001) for graft failure. The presence of donor-specific antibodies (DSA) class II on the day of transplantation and a higher percentage of eplet mismatch (EpMM), particularly EpMM DQA1, correlated with the development of veABMR. Conclusion Early protocol biopsies play a pivotal role in the early detection of veABMR in high-risk immunological patients. Patients with veABMR face significant risks of graft loss, despite early treatment of rejection.","PeriodicalId":19078,"journal":{"name":"Nephrology Dialysis Transplantation","volume":null,"pages":null},"PeriodicalIF":6.1,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142225430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The microbiome and acute organ injury: focus on kidneys","authors":"Shishir Kumar Patel, Mahta Gooya, Qisen Guo, Sanjeev Noel, Hamid Rabb","doi":"10.1093/ndt/gfae196","DOIUrl":"https://doi.org/10.1093/ndt/gfae196","url":null,"abstract":"The microbiome of critically ill patients is significantly altered by both effects of the illnesses and clinical interventions provided during intensive care. Studies have shown that manipulating the microbiome can prevent or modulate complications of critical illness in experimental models and preliminary clinical trials. This review aims to discuss general concepts about the microbiome, including mechanisms of modifying acute organ dysfunction. The focus will be on the effects of microbiome modulation during experimental acute kidney injury (excluding septic AKI) and comparison with other experimental acute organ injuries commonly seen in critically ill patients.","PeriodicalId":19078,"journal":{"name":"Nephrology Dialysis Transplantation","volume":null,"pages":null},"PeriodicalIF":6.1,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142225413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Andrea K Viecelli, Ryan Gately, Zunaid Barday, Soroush Shojai, Silvia Arruebo, Fergus J Caskey, Sandrine Damster, Jo-Ann Donner, Vivekanand Jha, Adeera Levin, Masaomi Nangaku, Syed Saad, Marcello Tonelli, Feng Ye, Ikechi G Okpechi, Aminu K Bello, David W Johnson
{"title":"Worldwide organization and structures for kidney transplantation services.","authors":"Andrea K Viecelli, Ryan Gately, Zunaid Barday, Soroush Shojai, Silvia Arruebo, Fergus J Caskey, Sandrine Damster, Jo-Ann Donner, Vivekanand Jha, Adeera Levin, Masaomi Nangaku, Syed Saad, Marcello Tonelli, Feng Ye, Ikechi G Okpechi, Aminu K Bello, David W Johnson","doi":"10.1093/ndt/gfae144","DOIUrl":"https://doi.org/10.1093/ndt/gfae144","url":null,"abstract":"<p><strong>Background: </strong>Kidney transplantation (KT) is the preferred modality of kidney replacement therapy with better patient outcomes and quality of life compared with dialytic therapies. This study aims to evaluate the epidemiology, accessibility and availability of KT services in countries and regions around the world.</p><p><strong>Methods: </strong>This study relied on data from an international survey of relevant stakeholders (clinicians, policymakers and patient advocates) from countries affiliated with the International Society of Nephrology that was conducted from July to September 2022. Survey questions related to the availability, access, donor type and cost of KT.</p><p><strong>Results: </strong>In total, 167 countries responded to the survey. KT services were available in 70% of all countries, including 86% of high-income countries, but only 21% of low-income countries. In 80% of countries, access to KT was greater in adults than in children. The median global prevalence of KT was 279.0 [interquartile range (IQR) 58.0-492.0] per million people (pmp) and the median global incidence was 12.2 (IQR 3.0-27.8) pmp. Pre-emptive KT remained exclusive to high- and upper-middle-income countries, and living donor KT was the only available modality for KT in low-income countries. The median cost of the first year of KT was $26 903 USD and varied 1000-fold between the most and least expensive countries.</p><p><strong>Conclusion: </strong>The availability, access and affordability of KT services, especially in low-income countries, remain limited. There is an exigent need to identify strategies to ensure equitable access to KT services for people with kidney failure worldwide, especially in the low-income countries.</p>","PeriodicalId":19078,"journal":{"name":"Nephrology Dialysis Transplantation","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142133341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Georgina Irish, Fergus J Caskey, M Razeen Davids, Marcello Tonelli, Chih-Wei Yang, Silvia Arruebo, Sandrine Damster, Jo-Ann Donner, Vivekanand Jha, Adeera Levin, Masaomi Nangaku, Syed Saad, Feng Ye, Ikechi G Okpechi, Aminu K Bello, David W Johnson
{"title":"Global data monitoring systems and early identification for kidney diseases.","authors":"Georgina Irish, Fergus J Caskey, M Razeen Davids, Marcello Tonelli, Chih-Wei Yang, Silvia Arruebo, Sandrine Damster, Jo-Ann Donner, Vivekanand Jha, Adeera Levin, Masaomi Nangaku, Syed Saad, Feng Ye, Ikechi G Okpechi, Aminu K Bello, David W Johnson","doi":"10.1093/ndt/gfae127","DOIUrl":"https://doi.org/10.1093/ndt/gfae127","url":null,"abstract":"<p><strong>Background: </strong>Data monitoring and surveillance systems are the cornerstone for governance and regulation, planning, and policy development for chronic disease care. Our study aims to evaluate health systems capacity for data monitoring and surveillance for kidney care.</p><p><strong>Methods: </strong>We leveraged data from the third iteration of the International Society of Nephrology Global Kidney Health Atlas (ISN-GKHA), an international survey of stakeholders (clinicians, policymakers and patient advocates) from 167 countries conducted between July and September 2022. ISN-GKHA contains data on availability and types of kidney registries, the spectrum of their coverage, as well as data on national policies for kidney disease identification.</p><p><strong>Results: </strong>Overall, 167 countries responded to the survey, representing 97.4% of the global population. Information systems in forms of registries for dialysis care were available in 63% (n = 102/162) of countries, followed by kidney transplant registries (58%; n = 94/162), and registries for non-dialysis chronic kidney disease (19%; n = 31/162) and acute kidney injury (9%; n = 14/162). Participation in dialysis registries was mandatory in 57% (n = 58) of countries; however, in more than half of countries in Africa (58%; n = 7), Eastern and Central Europe (67%; n = 10), and South Asia (100%; n = 2), participation was voluntary. The least-reported performance measures in dialysis registries were hospitalization (36%; n = 37) and quality of life (24%; n = 24).</p><p><strong>Conclusions: </strong>The variability of health information systems and early identification systems for kidney disease across countries and world regions warrants a global framework for prioritizing the development of these systems.</p>","PeriodicalId":19078,"journal":{"name":"Nephrology Dialysis Transplantation","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142133338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Emily K Yeung, Rohan Khanal, Abdulshahid Sarki, Silvia Arruebo, Sandrine Damster, Jo-Ann Donner, Fergus J Caskey, Vivekanand Jha, Adeera Levin, Masaomi Nangaku, Syed Saad, Feng Ye, Ikechi G Okpechi, Aminu K Bello, Marcello Tonelli, David W Johnson
{"title":"A global overview of health system financing and available infrastructure and oversight for kidney care.","authors":"Emily K Yeung, Rohan Khanal, Abdulshahid Sarki, Silvia Arruebo, Sandrine Damster, Jo-Ann Donner, Fergus J Caskey, Vivekanand Jha, Adeera Levin, Masaomi Nangaku, Syed Saad, Feng Ye, Ikechi G Okpechi, Aminu K Bello, Marcello Tonelli, David W Johnson","doi":"10.1093/ndt/gfae128","DOIUrl":"https://doi.org/10.1093/ndt/gfae128","url":null,"abstract":"<p><strong>Background: </strong>Governance, health financing, and service delivery are critical elements of health systems for provision of robust and sustainable chronic disease care. We leveraged the third iteration of the International Society of Nephrology Global Kidney Health Atlas (ISN-GKHA) to evaluate oversight and financing for kidney care worldwide.</p><p><strong>Methods: </strong>A survey was administered to stakeholders from countries affiliated with the ISN from July to September 2022. We evaluated funding models utilized for reimbursement of medications, services for the management of chronic kidney disease, and provision of kidney replacement therapy (KRT). We also assessed oversight structures for the delivery of kidney care.</p><p><strong>Results: </strong>Overall, 167 of the 192 countries and territories contacted responded to the survey, representing 97.4% of the global population. High-income countries tended to use public funding to reimburse all categories of kidney care in comparison with low-income countries (LICs) and lower-middle income countries (LMICs). In countries where public funding for KRT was available, 78% provided universal health coverage. The proportion of countries that used public funding to fully reimburse care varied for non-dialysis chronic kidney disease (27%), dialysis for acute kidney injury (either hemodialysis or peritoneal dialysis) (44%), chronic hemodialysis (45%), chronic peritoneal dialysis (42%), and kidney transplant medications (36%). Oversight for kidney care was provided at a national level in 63% of countries, and at a state/provincial level in 28% of countries.</p><p><strong>Conclusion: </strong>This study demonstrated significant gaps in universal care coverage, and in oversight and financing structures for kidney care, particularly in in LICs and LMICs.</p>","PeriodicalId":19078,"journal":{"name":"Nephrology Dialysis Transplantation","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142133335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Barnaby Hole, Nicola Wearne, Silvia Arruebo, Fergus J Caskey, Sandrine Damster, Jo-Ann Donner, Vivekanand Jha, Adeera Levin, Masaomi Nangaku, Syed Saad, Marcello Tonelli, Feng Ye, Ikechi G Okpechi, Aminu K Bello, David W Johnson, Sara N Davison
{"title":"Global access and quality of conservative kidney management.","authors":"Barnaby Hole, Nicola Wearne, Silvia Arruebo, Fergus J Caskey, Sandrine Damster, Jo-Ann Donner, Vivekanand Jha, Adeera Levin, Masaomi Nangaku, Syed Saad, Marcello Tonelli, Feng Ye, Ikechi G Okpechi, Aminu K Bello, David W Johnson, Sara N Davison","doi":"10.1093/ndt/gfae129","DOIUrl":"10.1093/ndt/gfae129","url":null,"abstract":"<p><strong>Background: </strong>Conservative kidney management (CKM) describes supportive care for people living with kidney failure who choose not to receive or are unable to access kidney replacement therapy (KRT). This study captured the global availability of CKM services and funding.</p><p><strong>Methods: </strong>Data came from the International Society of Nephrology Global Kidney Health survey conducted between June and September 2022. Availability of CKM, infrastructure, guidelines, medications and training were evaluated.</p><p><strong>Results: </strong>CKM was available in some form in 61% of the 165 responding countries. CKM chosen through shared decision-making was available in 53%. Choice-restricted CKM-for those unable to access KRT-was available in 39%. Infrastructure to provide CKM chosen through shared decision-making was associated with national income level, reported as being \"generally available\" in most healthcare settings for 71% of high-income countries, 50% of upper-middle-income countries, 33% of lower-middle-income countries and 42% of low-income countries. For choice-restricted CKM, these figures were 29%, 50%, 67% and 58%, respectively. Essential medications for pain and palliative care were available in just over half of the countries, highly dependent upon income setting. Training for caregivers in symptom management in CKM was available in approximately a third of countries.</p><p><strong>Conclusions: </strong>Most countries report some capacity for CKM. However, there is considerable variability in terms of how CKM is defined, as well as what and how much care is provided. Poor access to CKM perpetuates unmet palliative care needs, and must be addressed, particularly in low-resource settings where death from untreated kidney failure is common.</p>","PeriodicalId":19078,"journal":{"name":"Nephrology Dialysis Transplantation","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142133337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yeoungjee Cho, Brett Cullis, Isabelle Ethier, Htay Htay, Vivekanand Jha, Silvia Arruebo, Fergus J Caskey, Sandrine Damster, Jo-Ann Donner, Adeera Levin, Masaomi Nangaku, Syed Saad, Marcello Tonelli, Feng Ye, Ikechi G Okpechi, Aminu K Bello, David W Johnson
{"title":"Global structures, practices, and tools for provision of chronic peritoneal dialysis.","authors":"Yeoungjee Cho, Brett Cullis, Isabelle Ethier, Htay Htay, Vivekanand Jha, Silvia Arruebo, Fergus J Caskey, Sandrine Damster, Jo-Ann Donner, Adeera Levin, Masaomi Nangaku, Syed Saad, Marcello Tonelli, Feng Ye, Ikechi G Okpechi, Aminu K Bello, David W Johnson","doi":"10.1093/ndt/gfae130","DOIUrl":"https://doi.org/10.1093/ndt/gfae130","url":null,"abstract":"<p><strong>Background: </strong>Worldwide, the uptake of peritoneal dialysis (PD) compared with hemodialysis remains limited. This study assessed organizational structures, availability, accessibility, affordability and quality of PD worldwide.</p><p><strong>Methods: </strong>This cross-sectional study relied on data from kidney registries as well as survey data from stakeholders (clinicians, policymakers and advocates for people living with kidney disease) from countries affiliated with the International Society of Nephrology (ISN) from July to September 2022.</p><p><strong>Results: </strong>Overall, 167 countries participated in the survey. PD was available in 79% of countries with a median global prevalence of 21.0 [interquartile range (IQR) 1.5-62.4] per million population (pmp). High-income countries (HICs) had an 80-fold higher prevalence of PD than low-income countries (LICs) (56.2 pmp vs 0.7 pmp). In 53% of countries, adults had greater PD access than children. Only 29% of countries used public funding (and free) reimbursement for PD with Oceania and South East Asia (6%), Africa (10%) and South Asia (14%) having the lowest proportions of countries in this category. Overall, the annual median cost of PD was US$18 959.2 (IQR US$10 891.4-US$31 013.8) with full private out-of-pocket payment in 4% of countries and the highest median cost in LICs (US$30 064.4) compared with other country income levels (e.g. HICs US$27 206.0).</p><p><strong>Conclusions: </strong>Ongoing large gaps and variability in the availability, access and affordability of PD across countries and world regions were observed. Of note, there is significant inequity in access to PD by children and for people in LICs.</p>","PeriodicalId":19078,"journal":{"name":"Nephrology Dialysis Transplantation","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142133339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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