American Journal of Kidney Diseases最新文献

{"title":"Urine Oxalate Excretion and CKD Stage in Patients With Primary Hyperoxaluria Type 1.","authors":"Lisa Vaughan,Phillip J Schulte,Felix Knauf,David J Sas,Dawn Milliner,John C Lieske","doi":"10.1053/j.ajkd.2025.07.013","DOIUrl":"https://doi.org/10.1053/j.ajkd.2025.07.013","url":null,"abstract":"","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":"2 1","pages":""},"PeriodicalIF":13.2,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145117154","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":"Pharmaceutical Practice Considerations Regarding Adoption of the Race-Free Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) 2021 Equations.","authors":"Ruth Tarzi,Jennifer McKenzie,Michel Reid,Sophia Goodison,James Oyee,Thomas F Hiemstra,Maciej J Zamek-Gliszczynski,Mary Muoneke,Leslie A Obert,Nneka Nwokolo,Benjamin Young,Anna Richards","doi":"10.1053/j.ajkd.2025.06.022","DOIUrl":"https://doi.org/10.1053/j.ajkd.2025.06.022","url":null,"abstract":"The race-free Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) 2021 estimated glomerular filtration rate-creatinine (eGFRcr) equation is being adopted in the US. Elsewhere there is debate regarding its validation and adoption. Absence of a perfect solution and a lack of alignment present challenges when considering global clinical trials. Whilst acknowledging these challenges, GSK decided to adopt the CKD-EPI 2021 eGFRcr equation for new adult trials to support health equity and delivery benefits from standardized data management. The eGFRcr obtained using the CKD-EPI 2021 equation versus CKD-EPI 2009 equation is moderately lower in US Black individuals and moderately higher in non-Black individuals. Analyses before adoption suggested no major impact for study safety or efficacy evaluations although racial/ethnic representation may need to be examined in trials with an eGFR ≥60 mL/min/1.73m2 inclusion criterion, since enrollment of eligible Black participants could be reduced. Sensitivity analyses using 2009 and 2021 equations may be necessary to understand any effect size with population change, especially where there are kidney endpoints or relevant safety concerns. GSK plans to monitor the impact of adopting the CKD-EPI 2021 eGFRcr equation on adverse event reporting across studies and pharmacovigilance outcomes, and to monitor the evolution of regulatory guidance for eGFR equation implementation.","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":"22 1","pages":""},"PeriodicalIF":13.2,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103421","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":"A 16-Year-Old With a Hypertension Emergency: A Quiz","authors":"Travis Churilla , Joe B. Baker , Anthony Chang , Gal Finer","doi":"10.1053/j.ajkd.2025.05.007","DOIUrl":"10.1053/j.ajkd.2025.05.007","url":null,"abstract":"","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":"86 4","pages":"Pages A13-A16"},"PeriodicalIF":8.2,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145098623","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":"Understanding Estimated GFR.","authors":"Stephanie M Hu","doi":"10.1053/j.ajkd.2025.04.023","DOIUrl":"https://doi.org/10.1053/j.ajkd.2025.04.023","url":null,"abstract":"","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145084978","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":"Effectiveness of Bivalent mRNA COVID-19 Vaccine Among Adults With Kidney Failure Receiving Dialysis: A Cohort Study From the Centers for Medicare and Medicaid Services.","authors":"Amanda B Payne,Shannon Novosad,Heng-Ming Sung,Yue Zhang,Ryan Wiegand,Carla S Gomez Victor,Megan Wallace,Danica J Gomes,Morgan Najdowski,Bradley Lufkin,Yoganand Chillarige,Eduardo Lacson,Lorien S Dalrymple,Ruth Link-Gelles","doi":"10.1053/j.ajkd.2025.07.012","DOIUrl":"https://doi.org/10.1053/j.ajkd.2025.07.012","url":null,"abstract":"RATIONAL & OBJECTIVEPatients with kidney failure treated with maintenance dialysis have an increased risk of severe disease due to SARS-CoV-2 infection, the virus that causes COVID-19. Previous studies have shown that COVID-19 vaccination is effective against severe COVID-19 illness in the general population. However, less is known about populations at greater risk for severe disease. This investigation examined the real-world effectiveness of bivalent mRNA COVID-19 vaccination against clinical outcomes among patients treated with maintenance dialysis.STUDY DESIGNRetrospective cohort study.SETTING & PARTICIPANTSMedicare Fee-for-Service (FFS) claims data for beneficiaries aged ≥18 years with kidney failure receiving maintenance dialysis between September 4, 2022, and April 1, 2023.EXPOSUREBivalent mRNA COVID-19 vaccination compared with receipt of original monovalent COVID-19 doses alone.OUTCOMESMedically attended COVID-19, which was defined as the occurrence of a COVID-19-associated outpatient encounter, COVID-19-associated hospitalization, critical COVID-19 illness, or COVID-19-associated death, overall as well as each COVID-19-associated outcome individually.ANALYTICAL APPROACHRelative vaccine effectiveness against COVID-19-associated outcomes was calculated as 1 - adjusted hazard ratio, with the adjusted hazard ratio comparing rates of outcomes by vaccination status estimated using a weighted Cox regression model.RESULTSCompared with receipt of original monovalent COVID-19 vaccine doses, the relative estimated effectiveness of a bivalent mRNA COVID-19 vaccine dose was 41% (95% CI: 37%, 46%) against medically attended COVID-19, 49% (95% CI: 43%, 54%) against COVID-19-associated hospitalization, 53% (95% CI: 44%, 61%) against critical COVID-19 illness, and 54% (95% CI: 42%, 63%) against COVID-19-associated death among adults with kidney failure treated with maintenance dialysis without additional immunocompromising conditions. Estimated vaccine effectiveness against medically attended COVID-19 was 50% (95% CI: 44%, 55%) 7-59 days after bivalent vaccination and 33% (95% CI: 26%, 39%) 60-206 days after bivalent vaccination.LIMITATIONSPotential misclassification bias, residual confounding, and generalizability concerns may exist.CONCLUSIONSThese findings suggest a bivalent mRNA COVID-19 vaccine dose provided protection against COVID-19 disease among previously vaccinated persons with kidney failure receiving maintenance dialysis, but the estimated effectiveness waned over time.","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":"1 1","pages":""},"PeriodicalIF":13.2,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103420","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":"Nephrologist Perspectives on Using Telemedicine During In-Center Hemodialysis: A Qualitative Study.","authors":"Trenton M Haltom, Susie Q Lew, Wolfgang C Winkelmayer, Glenn M Chertow, Allison Jaure, Kevin F Erickson","doi":"10.1053/j.ajkd.2025.08.008","DOIUrl":"https://doi.org/10.1053/j.ajkd.2025.08.008","url":null,"abstract":"<p><strong>Rationale & objective: </strong>During the coronavirus disease 2019 (COVID-19) pandemic, the United States (US) government expanded originating telemedicine sites to include outpatient dialysis units. For the first time, nephrology care providers (nephrologists and affiliated advanced practice providers) across the US could use telemedicine in lieu of face-to-face visits to deliver care for patients receiving in-center hemodialysis. In this study, we describe perspectives and experiences of nephrologists using telemedicine to deliver in-center hemodialysis care.</p><p><strong>Study design: </strong>Qualitative research study.</p><p><strong>Setting & participants: </strong>Nephrologists in three health systems who used telemedicine for in-center hemodialysis during the COVID-19 pandemic.</p><p><strong>Analytical approach: </strong>We conducted 16 semi-structured telephone interviews. Transcripts were thematically analyzed.</p><p><strong>Results: </strong>We identified five themes and respective subthemes: maintaining safety and quality of care (making up missed appointments, fostering continuity of care, addressing urgent medical issues); maximizing efficiency (reducing nephrologist's travel burden, allowing for flexibility); operational complexities (dependence on facility resources; challenges coordinating with facility staff; modifying visit duration/length); diminished depth of clinical encounters (excess formality, constrained communication, incomplete physical exams); supporting confidence in telemedicine (complementing in-person care, accounting for patient preferences, requiring reimbursement).</p><p><strong>Limitations: </strong>The transferability of the findings outside of an urban academic setting is uncertain.</p><p><strong>Conclusion: </strong>Although nephrologists encountered operational (both technical and personal level) challenges such as communication constraints when using telemedicine for in-center hemodialysis care, they reported improvements in aspects of care quality and enhanced efficiency. These findings inform the potential use of a hybrid in-center hemodialysis care delivery model in which telemedicine supplements in-person visits.</p>","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":" ","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145111672","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":"Infectious Tropical Diseases That Acutely Affect the Kidneys: What Physicians and Health Care Workers in Non-Endemic Countries Should Know.","authors":"Emmanuel A Burdmann,Lucia C Andrade","doi":"10.1053/j.ajkd.2025.07.011","DOIUrl":"https://doi.org/10.1053/j.ajkd.2025.07.011","url":null,"abstract":"The tropics, a large and heavily inhabited area, are characterized by deep contrasts in sociopolitical, economic, and social development, which are reflected in the epidemiology of diseases. Common noncommunicable chronic diseases, such as diabetes and hypertension, coexist with acute infectious tropical diseases. Global warming, immigration, tourism, and commercial travel have helped spread tropical diseases to temperate zones by facilitating the spread of vectors, the infection of animal reservoirs, and the introduction of contaminated individuals into non-endemic areas. Infectious tropical diseases are currently a significant global public health concern worldwide. Their timely diagnosis and adequate treatment might be a considerable challenge to health workers from non-tropical areas since most share very similar initial clinical presentations. It is essential that healthcare teams worldwide can recognize and treat a broad spectrum of tropical diseases. Several of these infectious tropical diseases can affect the kidneys, acutely or chronically. In this review, we explore and discuss the epidemiology, pathophysiological mechanisms, and clinical aspects of the most relevant infectious tropical diseases that can be associated with acute kidney injury. Such diseases include, but are not limited to, dengue, yellow fever, Chikungunya, malaria, leptospirosis, and scrub typhus.","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":"23 1","pages":""},"PeriodicalIF":13.2,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103422","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":"Living Kidney Donors' Residential Neighborhoods: Driver or Barrier of Post-Donation Follow-Up?","authors":"Yiting Li,Gayathri Menon,Byoungjun Kim,Mario P DeMarco,Babak J Orandi,Sunjae Bae,Wenbo Wu,Allan B Massie,Macey L Levan,Jonathan C Berger,Dorry L Segev,Mara A McAdams-DeMarco","doi":"10.1053/j.ajkd.2025.06.020","DOIUrl":"https://doi.org/10.1053/j.ajkd.2025.06.020","url":null,"abstract":"","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":"16 1","pages":""},"PeriodicalIF":13.2,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145093511","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":"Exercise Prehabilitation in Kidney Transplant Candidates: Insights From the FRAILMar Trial.","authors":"Carly Weaver,Babak J Orandi,Mara McAdams-DeMarco","doi":"10.1053/j.ajkd.2025.08.007","DOIUrl":"https://doi.org/10.1053/j.ajkd.2025.08.007","url":null,"abstract":"","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":"5 1","pages":""},"PeriodicalIF":13.2,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145093507","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":"IgG3κ Monoclonal Membranous Nephropathy Associated With Acquired Lecithin Cholesterol Acyltransferase Deficiency.","authors":"Lihong Bu,Jae H Lee,Michael M Quigley,Reza Elahimehr,Jason D Theis,Robert L Perrizo,Surendra Dasari,Timothy J Garrett,Samih H Nasr","doi":"10.1053/j.ajkd.2025.06.021","DOIUrl":"https://doi.org/10.1053/j.ajkd.2025.06.021","url":null,"abstract":"Lecithin cholesterol acyltransferase (LCAT) deficiency, inherited or acquired, is characterized by markedly low plasma high density lipoprotein (HDL)-cholesterol levels and increased unesterified cholesterol. We report a case of an elderly patient with persistently very low HDL and proteinuria. Serum cholesteryl esters were markedly low, and kidney biopsy revealed diffuse global glomerular lipid deposition, classic for LCAT deficiency, whereas genetic testing for variants associated with LCAT deficiency was negative. Kidney biopsy also showed concomitant monoclonal (IgG3κ) membranous nephropathy. Proteomic analysis of glomeruli detected spectra for LCAT and serum amyloid P (SAP), suggesting that LCAT could be a target antigen in monoclonal MN with SAP-enrichment and associated LCAT deficiency. Furthermore, lipidomic analysis revealed an accumulation of phosphatidylcholines and sphingomyelin and a decrease in ceramides. The patient was treated with daratumumab, and at 22 months follow-up his proteinuria was decreased while HDL level remained low.","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":"128 1","pages":""},"PeriodicalIF":13.2,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145093514","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}