American Journal of Kidney Diseases最新文献

{"title":"US Renal Data System 2024 Annual Data Report: Epidemiology of Kidney Disease in the United States","authors":"Kirsten L. Johansen , David T. Gilbertson , Shuling Li , Suying Li , Jiannong Liu , Nicholas S. Roetker , Allyson Hart , Christopher D. Knapp , Elaine Ku , Neil R. Powe , Jon Snyder , Wendy St. Peter , Eric D. Weinhandl , James B. Wetmore","doi":"10.1053/j.ajkd.2025.02.602","DOIUrl":"10.1053/j.ajkd.2025.02.602","url":null,"abstract":"","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":"85 6","pages":"Pages A8-A11"},"PeriodicalIF":9.4,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143946693","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":"Volume 2: End Stage Renal Disease","authors":"","doi":"10.1053/j.ajkd.2025.04.003","DOIUrl":"10.1053/j.ajkd.2025.04.003","url":null,"abstract":"","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":"85 6","pages":"Pages S188-S565"},"PeriodicalIF":9.4,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143946695","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":"Complex Etiologies of the Discordance Between Cystatin C- and Creatinine-Based Estimated GFR and Its Adverse Associations: Findings From the CRIC Study.","authors":"Ian E McCoy, Jingrong Yang, Alan S Go, Hernan Rincon-Choles, Jonathan Taliercio, Sylvia E Rosas, Mark Unruh, Vallabh Shah, Debbie L Cohen, Jiang He, Jing Chen, James Sondheimer, Afshin Parsa, Wei Yang, Panduranga S Rao, Chi-Yuan Hsu","doi":"10.1053/j.ajkd.2025.03.018","DOIUrl":"https://doi.org/10.1053/j.ajkd.2025.03.018","url":null,"abstract":"<p><strong>Rationale & objective: </strong>The difference between GFR estimated by cystatin C and creatinine (eGFRdiff, defined as eGFRCys - eGFRCr) has been repeatedly associated with adverse outcomes, often ascribed to low muscle mass. However, it is unclear to what extent putative determinants of eGFRdiff, such as low muscle mass, explain associations between eGFRdiff and the outcomes of death and heart failure. Determinants of eGFRdiff have not been investigated to assess impacts on eGFRCys, eGFRCr and ultimately eGFRdiff in a dataset with measured GFR.</p><p><strong>Study design: </strong>Prospective cohort study for outcomes of eGFRdiff and cross-sectional study for determinants of eGFRdiff.</p><p><strong>Setting & participants: </strong>1,290 adult participants in the Chronic Renal Insufficiency Cohort (CRIC) Study with directly measured iothalamate GFR, 24-hour urine creatinine collections, and plasma measurements of larger molecules, such as beta-2-microglobulin.</p><p><strong>Exposure(s): </strong>Baseline eGFRdiff (eGFRCys - eGFRCr) for prospective analysis; putative eGFRdiff determinants for cross-sectional analyses.</p><p><strong>Outcome(s): </strong>Time to all-cause death, heart failure hospitalization for prospective analyses; eGFR for cross-sectional analyses.</p><p><strong>Analytical approach: </strong>Cox proportional hazards regression for prospective analysis and linear regression for cross-sectional analyses.</p><p><strong>Results: </strong>Among adults with CKD, more positive eGFRdiff was associated with decreased risk of death (aHR 0.80, 95% CI 0.74-0.88) and heart failure hospitalization (aHR 0.83, 95% CI 0.73-94). Neither association was substantially changed by adjustment for putative determinants of eGFRdiff. eGFRdiff was weakly correlated with markers of muscle mass, middle molecule clearance, and other putative determinants of eGFRdiff (e.g., obesity, inflammation). Only 36% of the variance in eGFRdiff was explained by these factors.</p><p><strong>Limitations: </strong>Imprecision in measurements, such as 24-hour urine collections.</p><p><strong>Conclusion: </strong>The associations of eGFRdiff with adverse outcomes were unchanged by adjustment for markers of putative determinants, such as muscle mass. Examined putative determinants of eGFRdiff accounted for a minority of the variance in eGFRdiff.</p>","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":" ","pages":""},"PeriodicalIF":9.4,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144075356","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":"Fenofibrate-Induced Osmotic Nephropathy: A Novel Mechanism of Acute Kidney Injury.","authors":"Raymond Lin,Seethalakshmi Viswanathan,Nikki L Wong","doi":"10.1053/j.ajkd.2025.03.019","DOIUrl":"https://doi.org/10.1053/j.ajkd.2025.03.019","url":null,"abstract":"Fibrates are a commonly utilized medication in the management of dyslipidaemia and cardiovascular risk. These agents have a well-documented association with reversible elevations in serum creatinine and in some instances acute kidney injury. The mechanism underlying the renal effects of fibrates are currently not well-understood. We describe a case of acute kidney injury in a patient who was administered an unadjusted dose of fenofibrate in the setting of severe renal impairment. Kidney biopsy demonstrated extensive isometric vacuolization within tubular epithelial cells consistent with osmotic-type injury. Fenofibrate in this case was the likely causative agent based on the temporal relationship of drug administration and acute kidney injury. The acute kidney injury also recovered over a timeframe consistent with the known half-life of the drug metabolite. There were no other drugs, extremes instances of hyperglycaemia, or intravenous agents administered to account for the biopsy findings. This case demonstrates a potential novel mechanism of fenofibrate-associated acute kidney injury with osmotic nephropathy. We review the current understanding of the effects of fenofibrate on the kidney and possible pathogenesis of osmotic nephropathy.","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":"40 1","pages":""},"PeriodicalIF":13.2,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143982535","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":"Finding Barriers for the Implementation of Advanced Care Planning in Patients Receiving Dialysis.","authors":"Marie Evans,Jenny Lindberg,Johan Sundelöf","doi":"10.1053/j.ajkd.2025.03.013","DOIUrl":"https://doi.org/10.1053/j.ajkd.2025.03.013","url":null,"abstract":"","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":"52 1","pages":""},"PeriodicalIF":13.2,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143893286","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":"Comparative Effectiveness of Glucagon-Like Peptide-1 Receptor Agonists and Sodium/Glucose Cotransporter 2 Inhibitors in Preventing Chronic Kidney Failure and Mortality in Patients With Type 2 Diabetes and CKD","authors":"Yen-Chieh Lee MD PhD, Li-Chiu Wu MS, Vin-Cent Wu MD PhD, Chia-Hsuin Chang MD ScD","doi":"10.1053/j.ajkd.2025.03.016","DOIUrl":"https://doi.org/10.1053/j.ajkd.2025.03.016","url":null,"abstract":"Both glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium/glucose cotransporter 2 (SGLT2) inhibitors improve cardiovascular, kidney, and survival outcomes in patients with type 2 diabetes; however, the comparative effectiveness of these drugs in a real-world setting remains unclear.","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":"35 1","pages":""},"PeriodicalIF":13.2,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143901638","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 Delivery of Kidney Care in Rural or Sparsely Populated Settings.","authors":"Sireesha Koppula,Krishna Patel,Mark Unruh","doi":"10.1053/j.ajkd.2025.03.017","DOIUrl":"https://doi.org/10.1053/j.ajkd.2025.03.017","url":null,"abstract":"Social determinants of health and limited access to medical care contribute to underdiagnosis and late presentation of chronic kidney disease (CKD). Rural areas face unique challenges in providing optimal care for patients with CKD due to poverty, limited healthcare access, and geographical barriers. This review will address the challenges of caring for rural patients with CKD and discuss potential strategies to increase healthcare equity. Furthermore, we will examine rural disparities in patients with CKD, patients with kidney failure on in-center or home dialysis, and patients with kidney transplants, highlighting the need for targeted interventions to address these disparities. Addressing the challenges faced by rural patients with CKD requires a multifaceted approach, including improving access to healthcare services, implementing telemedicine and telemonitoring technologies, enhancing the knowledge of primary care physicians around CKD, improving care coordination, and increasing preventive measures. We must create a kidney health model combining early detection, prevention, and disease surveillance to decrease disease progression. Healthcare policies should also incentivize and support the expansion of the rural healthcare workforce. Targeted interventions aimed at reducing rural disparities for patients with CKD and those using in-center hemodialysis, home dialysis, or transplantation are crucial to ensure equitable care.","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":"75 1","pages":""},"PeriodicalIF":13.2,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143902938","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":"Variability in Estimated GFR: When the Signal Is the Noise.","authors":"Ann M O'Hare,Ziyad Al-Aly","doi":"10.1053/j.ajkd.2025.03.014","DOIUrl":"https://doi.org/10.1053/j.ajkd.2025.03.014","url":null,"abstract":"","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":"36 1","pages":""},"PeriodicalIF":13.2,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143889228","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 Topiramate and Zonisamide Cause Kidney Stones?","authors":"Harshil A Fichadiya,John C Lieske","doi":"10.1053/j.ajkd.2025.04.001","DOIUrl":"https://doi.org/10.1053/j.ajkd.2025.04.001","url":null,"abstract":"","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":"71 1","pages":""},"PeriodicalIF":13.2,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143872009","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":"Longitudinal Income Dynamics and Risk of End-Stage Kidney Disease in Type 2 Diabetes: A South Korean Population-Based Cohort Study.","authors":"Min Woo Kang,Jae-Ik Oh,Jinsun Lee,Minsang Kim,Jung Hun Koh,Jeong Min Cho,Seong Geun Kim,Semin Cho,Soojin Lee,Yaerim Kim,Dong Ki Kim,Kyungdo Han,Sehoon Park","doi":"10.1053/j.ajkd.2025.02.609","DOIUrl":"https://doi.org/10.1053/j.ajkd.2025.02.609","url":null,"abstract":"RATIONALE & OBJECTIVEThe prevalence of end-stage kidney disease (ESKD) continues to rise, with socioeconomic status (SES), particularly income, having associations with ESKD risk among individuals with type 2 diabetes (T2D). This study examined the longitudinal association of income changes with ESKD risk among non-elderly adults with T2D in South Korea.STUDY DESIGNPopulation-based retrospective cohort study.SETTING & PARTICIPANTS1,481,371 adults aged 30 to 64 years with T2D represented in the South Korean National Health Insurance Service (NHIS) database in 2015 and 2016, followed to 2020.EXPOSURESustained income levels, income variability, and income changes over five years prior to entry into the study cohort.OUTCOMESPrimary outcome was progression to ESKD, defined as initiation of dialysis or kidney transplantation.ANALYTICAL APPROACHCox proportional hazards models were used to assess the risk of ESKD, adjusting for demographic, behavioral, and clinical variables.RESULTSCompared with those who never reached the lowest income quartile, individuals who spent any time (1-5 years) in the lowest quartile had a higher risk of ESKD (P for trend < 0.001). Conversely, spending 2-5 years in the highest quartile was significantly associated with a lower ESKD risk (P for trend < 0.001), whereas spending only 1 year in the highest quartile was not associated with ESKD risk. Income that dropped from a higher quartile to the lowest quartile was associated with higher risk, and even those moving from the lowest to the highest quartile had a higher ESKD risk than those who remained consistently in the highest quartile. Individuals with the highest income variability exhibited an increased risk of ESKD (hazard ratio 1.14, 95% confidence interval 1.01-1.29, P for trend = 0.02).LIMITATIONSResidual confounding, lack of data on medication adherence, and missing laboratory results.CONCLUSIONSDynamic changes in income were associated with ESKD risk among adults with T2D, findings that may inform healthcare policies that address the economic factors potentially contributing to kidney disease progression in South Korean adults with diabetes.","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":"29 1","pages":""},"PeriodicalIF":13.2,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143885076","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}