Seminars in nephrology最新文献

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Genetic Nephrology - Key Foundations for Kidney Medicine. 遗传肾脏病学-肾脏医学的关键基础。
IF 2.8 3区 医学
Seminars in nephrology Pub Date : 2025-07-24 DOI: 10.1016/j.semnephrol.2025.151661
Janewit Wongboonsin, Andrew J Mallett
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引用次数: 0
Communicating Risk Alleles in Kidney Genes: Lessons from APOL1 and New Discoveries of Risk Alleles. 肾脏基因中的风险等位基因交流:APOL1的经验教训和风险等位基因的新发现。
IF 2.8 3区 医学
Seminars in nephrology Pub Date : 2025-07-21 DOI: 10.1016/j.semnephrol.2025.151656
Yasar Caliskan, Ana Iltis, Janewit Wongboonsin, Krista L Lentine
{"title":"Communicating Risk Alleles in Kidney Genes: Lessons from APOL1 and New Discoveries of Risk Alleles.","authors":"Yasar Caliskan, Ana Iltis, Janewit Wongboonsin, Krista L Lentine","doi":"10.1016/j.semnephrol.2025.151656","DOIUrl":"https://doi.org/10.1016/j.semnephrol.2025.151656","url":null,"abstract":"<p><p>Effective communication of genetic risk alleles, particularly APOL1 renal risk variants, is essential for enhancing patient comprehension, guiding clinical decision-making, and ensuring equitable health care. This review explores the communication and implications of risk alleles in kidney-related genes, emphasizing the need for genetic training for nephrologists, expanded genetic counseling services, and multidisciplinary collaboration to optimize test interpretation and patient-centered care. Increasing ancestral diversity in genetic databases remains critical for refining risk assessments and minimizing uncertainty in result interpretation. Additionally, addressing concerns regarding genetic discrimination through legal protections is necessary to promote ethical use of genetic information. Collaborating with experts in risk communication and engaging community members, as exemplified by the APOLLO Consortium's Community Advisory Council, will aid in integrating genetic and nongenetic risk factors to improve health outcomes. Moving forward, research efforts must focus on elucidating APOL1-associated disease mechanisms, refining risk stratification, and developing targeted therapeutics. Implementing innovative communication strategies, including culturally competent counseling, digital education tools, and standardized decision aids, will be vital in making genetic information both accessible and actionable. By addressing these challenges, the medical community can fully leverage genetic testing to advance personalized medicine, improve patient outcomes, and reduce disparities in kidney disease care.</p>","PeriodicalId":21756,"journal":{"name":"Seminars in nephrology","volume":" ","pages":"151656"},"PeriodicalIF":2.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Genetic Nephrology: An Arising Subspecialty in Kidney Medicine. 遗传肾脏病学:肾脏医学中一个新兴的分支专业。
IF 2.8 3区 医学
Seminars in nephrology Pub Date : 2025-07-19 DOI: 10.1016/j.semnephrol.2025.151652
Janewit Wongboonsin, Andrew J Mallett
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引用次数: 0
Utility of Genetic Information for Management in Kidney Transplantation and Living Donation. 遗传信息在肾移植和活体捐献管理中的应用。
IF 2.8 3区 医学
Seminars in nephrology Pub Date : 2025-07-17 DOI: 10.1016/j.semnephrol.2025.151658
Yasar Caliskan, Christie P Thomas
{"title":"Utility of Genetic Information for Management in Kidney Transplantation and Living Donation.","authors":"Yasar Caliskan, Christie P Thomas","doi":"10.1016/j.semnephrol.2025.151658","DOIUrl":"https://doi.org/10.1016/j.semnephrol.2025.151658","url":null,"abstract":"<p><p>Kidney transplantation is the best treatment for kidney failure in eligible patients, significantly improving survival and quality of life. While short-term post-transplant survival has improved, long-term outcomes remain limited. Advances in genetic research have the potential to transform kidney transplantation. The shortage of donor organs underscores the need for improved organ availability, optimized immunosuppression, and enhanced monitoring to minimize repeat transplants. Improved understanding of monogenic kidney diseases and availability of genetic testing are increasingly informing the evaluation of transplant candidates and living donors. Expanding genetic testing to include pharmacogenomics and improved immunologic matching between transplant recipients and donors can improve post-transplant outcomes. Living kidney donors have perioperative risks and a 5-10 times higher likelihood of developing kidney failure, particularly if biologically related to the recipient. Some of this risk may be attributable to genetic factors that should be ascertained during donor evaluation. Polygenic risk scores offer promise for early risk identification, personalized interventions, and better long-term outcomes, though further validation is needed across diverse populations. Additionally, gene-editing technologies and personalized genomics may enhance donor-recipient compatibility, reduce graft rejection, and improve transplant success. These advancements in precision medicine are set to transform kidney transplantation by improving patient care and allograft longevity. Semin Nephrol 36:x-xx © 20XX Elsevier Inc. All rights reserved.</p>","PeriodicalId":21756,"journal":{"name":"Seminars in nephrology","volume":" ","pages":"151658"},"PeriodicalIF":2.8,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Beyond Kidney Genes: Broad Clinical Implications of Genetic Testing for Nephrology Patients. 超越肾脏基因:肾脏病患者基因检测的广泛临床意义。
IF 2.8 3区 医学
Seminars in nephrology Pub Date : 2025-07-17 DOI: 10.1016/j.semnephrol.2025.151660
Naama Elefant, Maddalena Marasà, Hila Milo Rasouly
{"title":"Beyond Kidney Genes: Broad Clinical Implications of Genetic Testing for Nephrology Patients.","authors":"Naama Elefant, Maddalena Marasà, Hila Milo Rasouly","doi":"10.1016/j.semnephrol.2025.151660","DOIUrl":"https://doi.org/10.1016/j.semnephrol.2025.151660","url":null,"abstract":"<p><p>Genetic testing in nephrology is evolving beyond diagnosis of kidney diseases to significantly influence broader patient care. This review evaluates the expanding role of genetic information in nephrology practice. We compare various testing technologies-including targeted gene panels, exome/genome sequencing, and single nucleotide polymorphism (SNP) arrays-highlighting their clinical utility and limitations in various medical specialties. We discuss existing tests where genetic results could impact the care of patients with chronic kidney disease (CKD): management of CKD-associated comorbidities, clinical implications of American Society of Medical Genetics and Genomics actionable genes, pharmacogenomic tests to optimize medication selection and dosing, and Human Leukocyte Antigen testing. As novel genetic tools emerge, such as polygenic risk scores and clonal hematopoiesis of indeterminate potential, we discuss how they may soon be reported in clinical settings. Given the complexity of interpreting diverse genetic data, we advocate for the integration of genetics professionals into nephrology care teams. This review concludes that genetic testing beyond kidney-specific genes holds immense promise for improving the care of patients with kidney diseases, but further research is necessary to establish guidelines for its integration into nephrology practice. Semin Nephrol 36:x-xx © 20XX Elsevier Inc. All rights reserved.</p>","PeriodicalId":21756,"journal":{"name":"Seminars in nephrology","volume":" ","pages":"151660"},"PeriodicalIF":2.8,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
How to Suspect and Approach Patients With Genetic Tubular Disease. 如何怀疑和处理遗传性小管病患者。
IF 2.8 3区 医学
Seminars in nephrology Pub Date : 2025-07-17 DOI: 10.1016/j.semnephrol.2025.151654
Fiona E Karet Frankl
{"title":"How to Suspect and Approach Patients With Genetic Tubular Disease.","authors":"Fiona E Karet Frankl","doi":"10.1016/j.semnephrol.2025.151654","DOIUrl":"https://doi.org/10.1016/j.semnephrol.2025.151654","url":null,"abstract":"<p><p>Suspecting that a patient has an inherited renal tubular disorder usually involves a mixture of listening to their story, asking the right questions, looking at the whole patient and their context, examining components of blood and urine, and assessing relevant imaging. Usually, inherited tubulopathies are rare, and they may include extrarenal features. Genetic testing has become widely available and can be used to establish a firm diagnosis in many situations, but this should not replace attempts to work out the diagnosis biochemically. Patients with tubular disorders often wait a long time for a diagnosis because many such conditions are very rare; genetic confirmation may well improve their quality of life. Semin Nephrol 36:x-xx © 20XX Elsevier Inc. All rights reserved.</p>","PeriodicalId":21756,"journal":{"name":"Seminars in nephrology","volume":" ","pages":"151654"},"PeriodicalIF":2.8,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Gene-Environment Interaction: Lessons From Complement-Mediated Kidney Disease. 基因-环境相互作用:补体介导肾病的经验教训。
IF 2.8 3区 医学
Seminars in nephrology Pub Date : 2025-07-15 DOI: 10.1016/j.semnephrol.2025.151657
Nattawat Klomjit, Jing Miao, Anuja Java
{"title":"Gene-Environment Interaction: Lessons From Complement-Mediated Kidney Disease.","authors":"Nattawat Klomjit, Jing Miao, Anuja Java","doi":"10.1016/j.semnephrol.2025.151657","DOIUrl":"https://doi.org/10.1016/j.semnephrol.2025.151657","url":null,"abstract":"<p><p>Atypical hemolytic uremic syndrome (aHUS) or complement-mediated thrombotic microangiopathy (CM-TMA) and C3 glomerulopathy are two prototypical diseases of complement dysregulation occurring due to genetic variants in complement proteins or acquired factors such as autoantibodies. Despite the presence of an underlying genetic etiology, an environmental trigger is often necessary to manifest disease, a phenomenon known as incomplete penetrance. These triggers could include infections, pregnancy, medication, cancers, or ischemia-reperfusion injury and antibody-mediated rejection in the setting of transplantation and highlight the complex interplay between genetic etiology and environmental factors. Other diseases in which complement activation may also be a part of the underlying pathophysiology and where the gene-environment interaction also plays out are IgA nephropathy, lupus nephritis, ANCA-associated vasculitis, and membranous nephropathy. Genetic polymorphisms and haplotypes may further skew the balance between complement over activation and control. In this article, we discuss the activation and regulation of the complement system and the role of complement in various kidney diseases. We also attempt to provide an in-depth understanding of the genetic drivers and environmental triggers associated with complement activation using aHUS as a key example. Semin Nephrol 36:x-xx © 20XX Elsevier Inc. All rights reserved.</p>","PeriodicalId":21756,"journal":{"name":"Seminars in nephrology","volume":" ","pages":"151657"},"PeriodicalIF":2.8,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144650316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Educating the Next-Generation Expert in Nephrology Genetics. 培养下一代肾病遗传学专家。
IF 2.8 3区 医学
Seminars in nephrology Pub Date : 2025-07-15 DOI: 10.1016/j.semnephrol.2025.151648
Matthew B Lanktree, Shaymaa Shurrab, Resham Ejaz, Vanda McNiven, Lauren Brick, Nithiakishna Selvathesan, Peter Margetts, Azim Gangji, Marie Pigeyre, Alexander Chang, Christie P Thomas, Mathieu Lemaire
{"title":"Educating the Next-Generation Expert in Nephrology Genetics.","authors":"Matthew B Lanktree, Shaymaa Shurrab, Resham Ejaz, Vanda McNiven, Lauren Brick, Nithiakishna Selvathesan, Peter Margetts, Azim Gangji, Marie Pigeyre, Alexander Chang, Christie P Thomas, Mathieu Lemaire","doi":"10.1016/j.semnephrol.2025.151648","DOIUrl":"https://doi.org/10.1016/j.semnephrol.2025.151648","url":null,"abstract":"<p><p>The importance of genetics and genomics in general nephrology has rapidly ascended within the last decade. While the genetic literacy of all nephrologists must improve, there is a particular need to develop the next generation of leaders and educators in nephrology genetics. In this review, we summarize how nephrology genetics could fit into the nephrology landscape and discuss components of a nephrology genetics training program. We outline potential objectives and educational content for a nephrology genetics curriculum. Finally, we identify logistical challenges and potential solutions when educating the next-generation expert in nephrology genetics. Semin Nephrol 36:x-xx © 20XX Elsevier Inc. All rights reserved.</p>","PeriodicalId":21756,"journal":{"name":"Seminars in nephrology","volume":" ","pages":"151648"},"PeriodicalIF":2.8,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144650314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Gene-Disease Relationships in Kidney Genetics. 肾脏遗传学中的基因-疾病关系。
IF 2.8 3区 医学
Seminars in nephrology Pub Date : 2025-07-15 DOI: 10.1016/j.semnephrol.2025.151647
Vanessa Gitau, Julie Ratliff, Ryan Webb, Andrew Mallett, Pamela Ajuyah
{"title":"Gene-Disease Relationships in Kidney Genetics.","authors":"Vanessa Gitau, Julie Ratliff, Ryan Webb, Andrew Mallett, Pamela Ajuyah","doi":"10.1016/j.semnephrol.2025.151647","DOIUrl":"https://doi.org/10.1016/j.semnephrol.2025.151647","url":null,"abstract":"<p><p>Genomic sequencing technologies are used in diagnostic laboratories to identify genetic causes of disease in patients. Gene curation plays an integral role by determining which genes have sufficient evidence for inclusion in diagnostic panels and those that should be prioritized in genome and exome sequencing. As the precursor to variant curation, gene curation also establishes pathogenicity limits for variant classification. Evaluating the clinical validity of a gene-disease relationship requires assessment of genetic and experimental evidence from literature and databases. The Clinical Genome Resource (ClinGen) has a semiquantitative framework for gene curation that is used across its Gene Curation Expert Panels (GCEPs). The ClinGen Kidney Disease Clinical Domain Working Group oversees five GCEPs covering the glomerulopathies, tubulopathies, complement-mediated kidney diseases, congenital anomalies of the kidney and urinary tract, and renal ciliopathies. These panels use a multidisciplinary approach in their gene curations, which are published and accessible to the public via the ClinGen website. ClinGen's expert-informed curations and other resources outlined in this review will help nephrologists validate whether genetic findings in reports are clinically relevant to their patients. Empowering nephrologists with knowledge of gene curation principles is imperative for informed decision-making in patient care. Semin Nephrol 36:x-xx © 20XX Elsevier Inc. All rights reserved.</p>","PeriodicalId":21756,"journal":{"name":"Seminars in nephrology","volume":" ","pages":"151647"},"PeriodicalIF":2.8,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144650315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Models of Care for the Implementation of Genetic Testing in Nephrology. 肾病学中实施基因检测的护理模式。
IF 2.8 3区 医学
Seminars in nephrology Pub Date : 2025-07-15 DOI: 10.1016/j.semnephrol.2025.151649
Dervla M Connaughton, Andrew J Mallett
{"title":"Models of Care for the Implementation of Genetic Testing in Nephrology.","authors":"Dervla M Connaughton, Andrew J Mallett","doi":"10.1016/j.semnephrol.2025.151649","DOIUrl":"https://doi.org/10.1016/j.semnephrol.2025.151649","url":null,"abstract":"<p><p>Genetic testing holds great potential to enhance the diagnosis and management of kidney disease, yet its integration into routine nephrology care remains limited and often delayed. Despite strong evidence supporting its clinical utility and cost effectiveness, significant barriers hinder its widespread adoption. This review examines care models designed to embed genetic testing into nephrology practice and proposes strategies to improve access for chronic kidney disease patients. Key approaches include enhancing clinical genetic services, establishing kidney genetics clinics, using technology such as virtual consultations, forming variant review boards and multidisciplinary teams, and mainstreaming genetic testing into nephrology care. For each model, the review identifies essential components for success and discusses barriers and facilitators to implementation. By focusing on practical, scalable, and patient-centered solutions, this review advocates for a paradigm shift in nephrology care. It envisions genetic testing as a standard component of kidney disease management, aiming to improve outcomes and promote equitable care for patients globally.</p>","PeriodicalId":21756,"journal":{"name":"Seminars in nephrology","volume":" ","pages":"151649"},"PeriodicalIF":2.8,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144650317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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