Clinical Journal of the American Society of Nephrology最新文献

{"title":"Obesity and Metabolic Health in CKD.","authors":"Csaba P Kovesdy","doi":"10.2215/CJN.0000000704","DOIUrl":"https://doi.org/10.2215/CJN.0000000704","url":null,"abstract":"<p><p>Obesity is a worldwide epidemic with a future projected growth of 40% over ten years. Obesity increases the risk of diabetes, hypertension and cardiovascular disease, and it also leads to higher risk of chronic kidney disease, both through direct and indirect mechanisms. While obesity is a feature of over-nutrition and is associated with poor outcomes in the general population, obese individuals with chronic kidney disease often display complex metabolic patterns such as sarcopenic obesity, and obesity can be associated with better survival in individuals with advanced chronic kidney disease. Weight loss interventions are proven to improve glycemic control and cardiovascular risk factors, and successful weight loss is associated with improved albuminuria in patients with preexisting chronic kidney disease. The long term effects of weight loss interventions on kidney function and on survival in patients with chronic kidney disease are less well studied, and hence such interventions should be individualized.</p>","PeriodicalId":50681,"journal":{"name":"Clinical Journal of the American Society of Nephrology","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143631022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do Overweight Status and Obesity Affect Progression to ESKD in Autosomal Dominant Polycystic Kidney Disease?","authors":"Sol Carriazo, York Pei","doi":"10.2215/cjn.0000000690","DOIUrl":"https://doi.org/10.2215/cjn.0000000690","url":null,"abstract":"An abstract is unavailable.","PeriodicalId":50681,"journal":{"name":"Clinical Journal of the American Society of Nephrology","volume":"56 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143618610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do Fast Foods Contribute to Food Insecurity in the In-Center Hemodialysis Population?","authors":"David M. White","doi":"10.2215/cjn.0000000686","DOIUrl":"https://doi.org/10.2215/cjn.0000000686","url":null,"abstract":"An abstract is unavailable.","PeriodicalId":50681,"journal":{"name":"Clinical Journal of the American Society of Nephrology","volume":"183 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143618609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extending Kidney Protective Therapy to Type 1 Diabetes: The Time is Now.","authors":"Joshua J Neumiller, Katherine R Tuttle","doi":"10.2215/CJN.0000000685","DOIUrl":"https://doi.org/10.2215/CJN.0000000685","url":null,"abstract":"","PeriodicalId":50681,"journal":{"name":"Clinical Journal of the American Society of Nephrology","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plant-Based Diets across the Spectrum of Kidney Disease.","authors":"Nimrit Goraya, Donald E Wesson","doi":"10.2215/CJN.0000000706","DOIUrl":"10.2215/CJN.0000000706","url":null,"abstract":"<p><p>Diet is gaining traction as a major CKD-related risk factor for death and disability. Furthermore, a \"healthy\" diet in patients with CKD is associated with reduced mortality. The data to be discussed support diet as the foundational, \"food integrated with pharmacologic therapy,\" approach to management of individuals with CKD, and those at risk for it. This is the reverse of the current approach in which pharmacologic therapy is considered as foundational to CKD management. In this review, we will discuss the following: ( 1 ) overview of plant diet approaches-discuss different types of Plant-Based Diet (PBD) Approaches, ( 2 ) evidence from trials and observational studies regarding CKD incidence and progression in participants without known CKD with PBDs, and ( 3 ) efficacy of PBDs in participants with known CKD and across various stages of CKD.</p>","PeriodicalId":50681,"journal":{"name":"Clinical Journal of the American Society of Nephrology","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Cardiovascular-Kidney Connection in the Hispanic/Latino Community.","authors":"Guillermo Garcia-Garcia, Keith C Norris","doi":"10.2215/CJN.0000000691","DOIUrl":"https://doi.org/10.2215/CJN.0000000691","url":null,"abstract":"","PeriodicalId":50681,"journal":{"name":"Clinical Journal of the American Society of Nephrology","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dietary Intake and Gut Microbiome in Chronic Kidney Disease.","authors":"Julie Ann Kemp, Marcia Ribeiro, Natália A Borges, Ludmila Cardozo, Denis Fouque, Denise Mafra","doi":"10.2215/CJN.0000000705","DOIUrl":"https://doi.org/10.2215/CJN.0000000705","url":null,"abstract":"<p><p>Gut dysbiosis, characterized by an imbalance in the gut microbiota, has emerged as a potential factor influencing chronic kidney disease (CKD) progression. This condition plays a crucial role in the gut-kidney axis, where changes in microbial composition can contribute to systemic inflammation and uremic toxin production and ultimately exacerbate kidney damage. Understanding the dynamics of the gut-kidney axis provides new insights into potential therapeutic strategies to mitigate CKD progression. Diet is the primary driver of gut microbiota composition. Therefore, an approach emphasizing healthy nutritional patterns is recommended for improving overall health, cardiovascular disease, and profoundly altered metabolic patterns in CKD patients. Dietary modifications have been explored as therapeutic strategies targeting the microbiome to improve outcomes in CKD. An emerging therapeutic target is the production of dysmetabolites by the gut microbiota, which may help alleviate uremic and cardiovascular toxicity. Additionally, future research should broaden the scope to include other microorganisms, such as fungi, archaea, and viruses. This expanded focus will enable a more comprehensive understanding of the gut-kidney axis and pave the way for more personalized and effective treatment strategies for CKD patients. This review explores the role of lifestyle, particularly diet, in kidney health, highlights new gut microbiome therapies, and identifies research opportunities in CKD.</p>","PeriodicalId":50681,"journal":{"name":"Clinical Journal of the American Society of Nephrology","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combination Automated Microfluidics Measurement of Urine CCL2, CXCL9, CXCL10 and VEGF-A for Monitoring Patients with a Kidney Transplant.","authors":"Michael E Seifert, Alvin T Kho, Lea Sheward, Nancy Rodig, Sarah Goldberg, Margaret Diehl, David Zurakowski, Roslyn B Mannon, Vikas R Dharnidharka, Oriol Bestard, Tom D Blydt-Hansen, David M Briscoe","doi":"10.2215/CJN.0000000666","DOIUrl":"https://doi.org/10.2215/CJN.0000000666","url":null,"abstract":"<p><strong>Background: </strong>Recent studies indicate that up to 36% of pediatric and adult kidney transplant recipients with stable serum creatinine levels will have acute rejection detected on surveillance biopsy. The purpose of this study was to develop and validate a risk algorithm for identifying low- and high-risk patients using a novel automated platform that simultaneously measures urinary CCL2, CXCL9, CXCL10 and VEGF-A with high precision.</p><p><strong>Methods: </strong>We designed a multicenter observational study to evaluate the performance of urinary CCL2, CXCL9, CXCL10 and VEGF-A in a training set of 517 banked samples collected at the time of surveillance or indication kidney biopsies from both adult and pediatric recipients. Risk algorithms combining all four analytes were developed in the training set, and subsequently validated in three laboratory sites in two additional pediatric cohorts (N=174).</p><p><strong>Results: </strong>The automated platform had remarkably high throughput, generating reproducible results in 60-70 minutes. Analysis was initially performed in the training set (N=517), which included biopsies read as normal (N=330), acute rejection (N=92) or borderline rejection (N=95). We found that each biomarker independently discriminated normal biopsies vs. those with acute rejection (P < 10-5). A risk algorithm utilizing all four biomarkers (score4) had excellent diagnostic performance for acute rejection in both for-cause and surveillance biopsies performed on patients with stable GFRs, outperforming any individual biomarker as well as estimated GFR assessments. Validation assays performed in the two additional pediatric cohorts in three laboratory sites demonstrated a robust correlation of results; score4 retained excellent diagnostic performance (75% specificity and 92% negative predictive value).</p><p><strong>Conclusions: </strong>Automated measurements of urine CCL2, CXCL9, CXCL10 and VEGF-A can distinguish kidney transplant recipients at low- vs. high-risk for rejection. We suggest that this assay can advantage clinical decision-making in routine post-transplant monitoring due to its low cost, rapid throughput, and operator independence.</p>","PeriodicalId":50681,"journal":{"name":"Clinical Journal of the American Society of Nephrology","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum Metabolomic Markers of Dietary Potassium and Risk of Chronic Kidney Disease.","authors":"Lauren Bernard, Jiaqi Yang, Jingsha Chen, Valerie K Sullivan, Bing Yu, Eugene P Rhee, Paul A Welling, Casey M Rebholz","doi":"10.2215/CJN.0000000675","DOIUrl":"https://doi.org/10.2215/CJN.0000000675","url":null,"abstract":"<p><strong>Background: </strong>Discovering metabolomic markers of dietary potassium may help improve dietary assessment of potassium and trace the impact of dietary potassium on chronic kidney disease (CKD) development.</p><p><strong>Methods: </strong>We included adults from the Atherosclerosis Risk in Communities (ARIC) study without CKD at visit 1 (N = 3,812). Cross-sectional associations between dietary potassium and serum metabolites were assessed using multivariable linear regression models. Cox regression models estimated hazard ratios for potassium-related metabolites and incident CKD. Incident CKD was defined as estimated glomerular filtration rate (<60 mL/min/1.73 m2 and ≥25% decline), CKD-related hospitalization or death, or kidney replacement therapy identified via United States Renal Data System registry from visit 1 (1987-1989) through December 31, 2020.</p><p><strong>Results: </strong>There were 33 significant associations between dietary potassium and serum metabolites, including pyridoxate, N-methylproline, stachydrine, pantothenate, and scyllo-inositol. During more than two decades of follow-up (median: 23 years, 25th-75th percentile: 14-30), 1,616 (42%) of participants developed incident CKD. Ten of the 33 potassium-related metabolites were significantly associated with incident CKD. Metabolites involved in phenylalanine and tyrosine metabolism, 3-(4-hydroxyphenyl)lactate and 3-phenylpropionate, were significantly associated with dietary potassium and CKD. Additionally, glycerate, involved in glucose metabolism, was positively associated with dietary potassium (β=0.09, p=4.01 x 10-17) and inversely associated with CKD (HR 0.77, 95% CI: 0.69-0.85, p=8.57 x 10-7). There was a significant trend for CKD risk across quartiles of 3-(4-hydroxyphenyl)lactate, 3-phenylpropionate, and glycerate.</p><p><strong>Conclusions: </strong>Dietary potassium was associated with 33 serum metabolites. 3-(4-hydroxyphenyl)lactate 3-phenylpropionate, and glycerate are candidate markers of dietary potassium's impact on chronic kidney disease.</p>","PeriodicalId":50681,"journal":{"name":"Clinical Journal of the American Society of Nephrology","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting Kidney Outcomes in Autosomal Dominant Polycystic Kidney Disease: A Comprehensive Biomarker Analysis.","authors":"Thomas Bais, Martine G E Knol, Laixi Xue, Paul Geertsema, Priya Vart, Franz Reichel, Sita Arjune, Roman-Ulrich Müller, Shosha E I Dekker, Mahdi Salih, Esther Meijer, Ron T Gansevoort","doi":"10.2215/CJN.0000000680","DOIUrl":"10.2215/CJN.0000000680","url":null,"abstract":"","PeriodicalId":50681,"journal":{"name":"Clinical Journal of the American Society of Nephrology","volume":" ","pages":""},"PeriodicalIF":8.5,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}