Clinical Kidney Journal最新文献

{"title":"Should intrinsic capacity be assessed in addition to frailty in older kidney transplantation candidates?","authors":"A. Garnier-Crussard, Sarah Collette-Robert, Candice Montredon, Eloïse Francq, Florent Guerville","doi":"10.1093/ckj/sfae226","DOIUrl":"https://doi.org/10.1093/ckj/sfae226","url":null,"abstract":"","PeriodicalId":505254,"journal":{"name":"Clinical Kidney Journal","volume":"33 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141639982","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":"Activation of the inflammasome and pyroptosis cascade in podocytes of patients with minimal change disease","authors":"Yuki Kajio, Taihei Suzuki, Kazuki Kobayashi, N. Kanazawa, M. Iyoda, Hirokazu Honda, Kazuho Honda","doi":"10.1093/ckj/sfae216","DOIUrl":"https://doi.org/10.1093/ckj/sfae216","url":null,"abstract":"\u0000 \u0000 \u0000 In contrast to childhood minimal change disease (MCD), adult-onset MCD frequently recurs and requires prolonged immunosuppressive therapy. Accordingly, an investigation of the pathogenesis of adult MCD is required. MCD is usually accompanied by severe dyslipidaemia. Oxidized low-density lipoprotein (ox-LDL) is known to function in a damage-associated molecular pattern (DAMP) through CD36, triggering the NOD-like receptor thermal protein domain-associated protein 3 (NLRP3) inflammasome and programmed cell death called pyroptosis. However, the relationship between MCD pathogenesis and NLRP3 inflammasome/pyroptosis activation via CD36 is not fully understood.\u0000 \u0000 \u0000 \u0000 We conducted comprehensive histological and clinical evaluations by analyzing renal biopsy (RBx) specimens and urine samples obtained from 26 patients with MCD. These samples were compared to control kidneys from 15 transplant donors and urine samples from 15 healthy volunteers.\u0000 \u0000 \u0000 \u0000 The number of podocytes was lower in the MCD group than in the control group. Urinary ox-LDL levels were higher in the MCD group than in the control group. Immunofluorescence staining revealed that NLRP3 and CD36 were upregulated in MCD podocytes. Urinary interleukin (IL)-18 levels increased in patients with MCD. Steroid therapy performed before RBx appeared to maintain the podocyte number and reduce urinary ox-LDL and IL-18 levels.\u0000 \u0000 \u0000 \u0000 In MCD, the NLRP3 inflammasome and pyroptosis cascade seem to be activated via upregulation of CD36 in podocytes, associated with increased urinary ox-LDL. Elevated urinary IL-18 levels suggest that pyroptosis may occur in MCD. Further research is required to confirm the significance of the podocyte NLRP3 inflammasome/pyroptosis in MCD.\u0000","PeriodicalId":505254,"journal":{"name":"Clinical Kidney Journal","volume":"26 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141643887","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":"Safety and efficacy of very low calorie diet (VLCD) in patients receiving haemodialysis therapy","authors":"Julie E Woods, Anne Snelson, Joanne Kok, Melinda A Leger, J. Wei, Jessica Hung, Ruth Rio, Sujatha Medara, Seema Prasad, Kalaiselvi Ganesh, Peter G Kerr, K. Polkinghorne","doi":"10.1093/ckj/sfae217","DOIUrl":"https://doi.org/10.1093/ckj/sfae217","url":null,"abstract":"\u0000 \u0000 \u0000 Very low calorie diets (VLCDs) are an obesity treatment option in the general population, but their efficacy and safety in patients on haemodialysis (HD) is unknown.\u0000 \u0000 \u0000 \u0000 Prospective single arm study of VLCD in haemodialysis patients. All participants received 2.5–3.3 MJ/day for 12 weeks. Weekly assessment of VLCD, pre and post dialysis weight, interdialytic weight gain, and blood electrolytes occurred for the first 4 weeks, then fortnightly for another 8 weeks. Linear mixed models compared the change in weight over time as well as biochemical outcomes including potassium.\u0000 \u0000 \u0000 \u0000 22 participants (9 home HD (HHD) and 13 satellite HD (SHD)) enrolled with 19 completing the 12 week intervention. Mean post-dialysis weight declined from 121.1 kg at baseline to 109.9 at week 12 resulting in average decline of 0.88 kg per week (95% C.I. 0.71, 1.05, p < 0.001) with 12 week mean percentage weight loss9.3% (SD 3.5). Mean post-dialysis BMI declined from 40.9 kg/m2 at baseline to 37.1 kg/m2 at week 12 (95% C.I. 0.25, 0.35, p < 0.001). Serum potassium rose from week 1 to 3, stabilised week 4 to 6 and fell from week 8, returning near baseline by week 12. Six of the nine (66.6%) HHD participants and seven of the thirteen (70%) SHD participants had at least one episode of hyperkalaemia (K > 6 mmol/L). There were no clinical changes in serum sodium, corrected calcium, phosphate levels during the study.\u0000 \u0000 \u0000 \u0000 VLCD with dietitian supervision was effective in producing significant weight reduction, with an acceptable safety profile in patients treated with haemodialysis.\u0000","PeriodicalId":505254,"journal":{"name":"Clinical Kidney Journal","volume":"8 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141642645","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":"Urine metabolites imply metabolic rewiring of kidney and predict acute kidney injury after cardiac surgery","authors":"Qi Zeng, Jinghan Feng, Xinni Zhang, Fangyuan Peng, Ting Ren, Zhouping Zou, Chao Tang, Qian Sun, Xiaoqiang Ding, Ping Jia","doi":"10.1093/ckj/sfae221","DOIUrl":"https://doi.org/10.1093/ckj/sfae221","url":null,"abstract":"\u0000 \u0000 \u0000 Acute kidney injury (AKI) is a serious complication in patients undergoing cardiac surgery, with the underlying mechanism remaining elusive, and lack of specific biomarkers for cardiac surgery-associated AKI (CS-AKI).\u0000 \u0000 \u0000 \u0000 We performed an untargeted metabolomics analysis of urine samples procured from a cohort of patients with or without AKI at 6 and 24 hours following cardiac surgery. Based on the differential urinary metabolites discovered, we further examined the expressions of the key metabolic enzymes that regulates these metabolites in kidney during AKI using a mouse model of ischemia-reperfusion injury (IRI) and in hypoxia-treated tubular epithelial cells (TECs).\u0000 \u0000 \u0000 \u0000 The urine metabolomic profiles in AKI patients were significantly different from those in non-AKI patients, including upregulation of tryptophan metabolism- and aerobic glycolysis-related metabolites, such as L-tryptophan and D-glucose 1-phosphate, downregulation of fatty acid oxidation (FAO) and tricarboxylic acid (TCA) cycle-related metabolites. Spearman correlation analysis showed that serum creatinine (Scr) was positively correlated with urinary L-tryptophan and indole, which had high accuracy for predicting AKI. In animal experiments, we demonstrated that the expression of rate-limiting enzymes in glycolysis, such as hexokinase II (HK2), was significantly upregulated during renal IRI. However, TCA cycle-related key enzymes citrate synthase (CS) was significantly downregulated after IRI. In vitro, hypoxia induced downregulation of CS in TECs. In addition, FAO-related gene peroxisome proliferator-activated receptor alpha (PPARα) was remarkably downregulated in kidney during renal IRI.\u0000 \u0000 \u0000 \u0000 This study presents urinary metabolites related to CS-AKI, indicating the rewiring of the metabolism in kidney during AKI, identifying potential AKI biomarkers.\u0000","PeriodicalId":505254,"journal":{"name":"Clinical Kidney Journal","volume":"10 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141641361","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":"Enterogenic bacterial peritonitis and delayed chylous ascites associated with overheated peritoneal dialysis fluid infusion","authors":"Yan Sun, Cui Wang, Leping Shao","doi":"10.1093/ckj/sfae219","DOIUrl":"https://doi.org/10.1093/ckj/sfae219","url":null,"abstract":"","PeriodicalId":505254,"journal":{"name":"Clinical Kidney Journal","volume":"53 25","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141651845","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":"Home dialysis: advantages and limitations","authors":"Ana Carina Ferreira, Ana Mateus","doi":"10.1093/ckj/sfae180","DOIUrl":"https://doi.org/10.1093/ckj/sfae180","url":null,"abstract":"","PeriodicalId":505254,"journal":{"name":"Clinical Kidney Journal","volume":"25 2‐3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141683419","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":"Assessment of SGLT2 Inhibitors' Safety and Discontinuation Causes in Patients with Advanced Chronic Kidney Disease: Insights from a Real-World Data Analysis","authors":"Peggy Perrin, Clotilde Muller, Yves Dimitrov, François Chantrel, Marie Heitz, Amandine Woerly, D. Bazin, A. Faller, T. Krummel, T. Hannedouche","doi":"10.1093/ckj/sfae169","DOIUrl":"https://doi.org/10.1093/ckj/sfae169","url":null,"abstract":"","PeriodicalId":505254,"journal":{"name":"Clinical Kidney Journal","volume":"105 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141683484","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":"Risk factors of peritoneal dialysis-related peritonitis in the Japan Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS)","authors":"Yasuhiko Ito, Charlotte Tu, Makoto Yamaguchi, S. Koide, M. Ryuzaki, B. Bieber, R. Pisoni, Jeffrey Perl, Jun Minakuchi, Hideki Kawanishi, Hideki Kawanishi, Jun Minakuchi, Tadashi Tomo, Ken Tsuchiya, Kousaku Nitta, M. Ryuzaki, Mizuya Fukazawa, Yasuhiro Ito, Hidetomo Nakamoto, Akihiro C Yamashita","doi":"10.1093/ckj/sfae202","DOIUrl":"https://doi.org/10.1093/ckj/sfae202","url":null,"abstract":"\u0000 \u0000 \u0000 Peritoneal dialysis (PD)-related peritonitis is a major complication of PD. Wide variations in peritonitis prevention, treatment strategies, and consequences are seen between countries. These between-country differences may result from modifiable risk factors and clinical practices.\u0000 \u0000 \u0000 \u0000 A total of 1225 Japanese PD patients were included and prospectively followed in the Peritoneal Dialysis Outcomes and Practice Patterns Study phase 1 (2014–2018) and phase 2 (2018–2022). Associations between PD-related peritonitis and various risk factors were assessed by Cox proportional hazards survival models.\u0000 \u0000 \u0000 \u0000 During follow-up (median 1.52 years), 539 peritonitis episodes were experienced by 364 patients. The country crude peritonitis rate was 0.27 episodes/patient-year. In the fully adjusted model, noticeable patient-level factors associated with experiencing any peritonitis included age (hazard ratio [HR], 1.07 per 5-year increase; 95% confidence interval [CI], 1.01–1.14), serum albumin level (HR, 0.63 per 1 g/dL higher; 95% CI, 0.48–0.82) and continuous ambulatory peritoneal dialysis (HR, 1.31 vs automated PD; 95% CI, 1.05–1.63). The adoption of antibiotic prophylaxis practice at the time of PD catheter insertion (HR, 0.63; 95% CI, 0.51–0.78), or when having complicated dental procedures (HR, 0.74; 95% CI, 0.57–0.95), or lower endoscopy (HR, 0.69; 95% CI, 0.54–0.89) were associated with lower hazards of any peritonitis while a routine facility practice of having more frequent regular medical visits was associated with a higher hazard.\u0000 \u0000 \u0000 \u0000 Identification of risk factors in Japan may be useful for developing future versions of guidelines and improving clinical practices in Japan. Investigation of country-level risk factors for PD-related peritonitis is useful for developing and implementing local peritonitis prevention and treatment strategies.\u0000","PeriodicalId":505254,"journal":{"name":"Clinical Kidney Journal","volume":"14 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141701385","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 Impact of Dialysate Flow Rate on Hemodialysis Adequacy: A Systematic Review and Meta-Analysis","authors":"Yasmin Iman, Ryan J. Bamforth, Ruth Ewhrudjakpor, P. Komenda, Kelley L. Gorbe, R. Whitlock, C. Bohm, N. Tangri, David T. Collister","doi":"10.1093/ckj/sfae163","DOIUrl":"https://doi.org/10.1093/ckj/sfae163","url":null,"abstract":"\u0000 \u0000 \u0000 Patients with kidney failure treated with maintenance hemodialysis (HD) require appropriate small molecule clearance. Historically, a component of measuring ‘dialysis adequacy’ has been quantified using urea kinetic modeling that is dependent on the HD prescription. However, the impact of dialysate flow rate on urea clearance remains poorly described in vivo and its influence on other patient important outcomes of adequacy is uncertain.\u0000 \u0000 \u0000 \u0000 We searched EMBASE, MEDLINE, and the Cochrane Library from inception until April 2022 for randomized controlled trials and observational trials comparing a higher dialysate flow rate (800 mL/min) and lower dialysate flow rate (300 mL/min) with a standard dialysis flow rate (500 mL/min) in adults (age ≥ 18 years) treated with maintenance HD (>90 consecutive days). We conducted a random effects meta-analysis to estimate pooled mean difference in dialysis adequacy as measured by Kt/V or urea reduction ratio (URR).\u0000 \u0000 \u0000 \u0000 A total of 3118 studies were identified. Of those, 9 met eligibility criteria and 4 were included in meta-analysis. A higher dialysate flow rate (800 mL/min) increased single pool Kt/V by 0.08 (95% CI: 0.05 to 0.10, p-value < 0.00001), and URR by 3.38 (95% CI: 1.97 to 4.78, p-value < 0.00001) in comparison to a dialysate flow rate of 500 mL/min. Clinically relevant outcomes including symptoms, cognition, physical function and mortality were lacking and studies were generally at a moderate risk of bias due to issues with randomization sequence generation, allocation concealment and blinding.\u0000 \u0000 \u0000 \u0000 A higher dialysate flow increased urea-based markers of dialysis adequacy. Additional high-quality research is needed to determine the clinical, economic and environmental impacts of higher dialysate flow rates.\u0000","PeriodicalId":505254,"journal":{"name":"Clinical Kidney Journal","volume":"10 22","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141265661","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":"Testing the waters on home-based albuminuria screening to enhance the detection and management of CKD","authors":"Lauren Floyd, P. Delanaye","doi":"10.1093/ckj/sfae031","DOIUrl":"https://doi.org/10.1093/ckj/sfae031","url":null,"abstract":"","PeriodicalId":505254,"journal":{"name":"Clinical Kidney Journal","volume":"112 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139849706","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}