American Journal of Kidney Diseases最新文献

{"title":"Diagnostic Challenges of Acute Kidney Injury in a Patient With High-Risk Multiple Myeloma: A Quiz","authors":"Emmanuel Garrastegui Mercado, Sarwat Gilani, Tareq Nassar, Swetha R. Kanduri","doi":"10.1053/j.ajkd.2025.11.020","DOIUrl":"10.1053/j.ajkd.2025.11.020","url":null,"abstract":"","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":"88 1","pages":"Pages A11-A14"},"PeriodicalIF":9.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148283036","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":"Association of Ertugliflozin on Kidney Outcomes in People After and Without an Interval Cardiovascular Event: Observations From the VERTIS CV Trial","authors":"Ayodele Odutayo, Francesco Cosentino, Richard E. Pratley, Christopher P. Cannon, Chih-Chin Liu, Robert Frederich, Urszula Masiukiewicz, Nilo B. Cater, Ira Gantz, David Z.I. Cherney, VERTIS CV Investigators","doi":"10.1053/j.ajkd.2026.01.017","DOIUrl":"10.1053/j.ajkd.2026.01.017","url":null,"abstract":"","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":"88 1","pages":"Pages 118-121"},"PeriodicalIF":9.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147735536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"KDOQI US Commentary on the KDIGO 2026 Clinical Practice Guideline for the Management of Anemia in CKD","authors":"Diana I. Jalal,&nbsp;Nisha Bansal,&nbsp;Monique E. Cho,&nbsp;Steven Fishbane,&nbsp;Orlando M. Gutierrez,&nbsp;Csaba P. Kovesdy,&nbsp;Abhijit Kshirsagar,&nbsp;Bruce Spinowitz,&nbsp;Jay Wish","doi":"10.1053/j.ajkd.2026.03.036","DOIUrl":"10.1053/j.ajkd.2026.03.036","url":null,"abstract":"<div><div>The prevalence of anemia is high in people with chronic kidney disease (CKD) and increases as the disease advances. The Kidney Disease Outcomes Quality Initiative (KDOQI) convened a work group to review the Kidney Disease: Improving Global Outcomes (KDIGO) 2026 clinical practice guideline for the management of anemia in CKD. The previous KDIGO anemia guideline was published in 2012; in 2019 and 2021 KDIGO convened conferences addressing controversies in iron management and hypoxia-inducible factor-prolyl hydroxylase inhibitor (HIF-PHI) use, respectively. The KDOQI work group provides perspective for implementation of the KDIGO 2026 anemia guideline within the context of clinical practice in the United States. The KDOQI work group agrees with most of the KDIGO recommendations, particularly the proactive use of intravenous (IV) iron in hemodialysis patients and the preference for erythropoiesis stimulating agents (ESAs) over HIF-PHIs for first-line anemia therapy, due to greater familiarity with safety of the former. Specific issues regarding recommendations and practice points for providers in the United States include higher serum ferritin targets and mean levels among people receiving hemodialysis than in the rest of the world; the availability of a single HIF-PHI product with approval only for patients receiving dialysis for ≥3 months; and payment barriers that may drive the choice of therapeutic agents. Additional commentary is provided on topics including IV iron therapy in people receiving hemodialysis and an iron-based phosphate binder, the incidence and significance of hypophosphatemia among people with CKD not on dialysis but receiving IV iron therapy, the physiologic importance of iron repletion in people with CKD and iron deficiency without anemia, possible therapeutic benefits of HIF-PHIs compared with ESAs, and assessing risk versus harm of red blood cell transfusions.</div></div>","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":"88 1","pages":"Pages 1-17"},"PeriodicalIF":9.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obesity in CKD: Core Curriculum 2026","authors":"Holly J. Kramer,&nbsp;Linda-Marie Lavenburg,&nbsp;Sankar D. Navaneethan","doi":"10.1053/j.ajkd.2026.02.641","DOIUrl":"10.1053/j.ajkd.2026.02.641","url":null,"abstract":"<div><div>Obesity is a chronic disease the requires lifelong care. The prevalence of obesity has surpassed diabetes and hypertension and is now the most common risk factor for chronic kidney disease (CKD) and its progression. Excess weight not only increases CKD risk but also heightens the risk for heart failure, sleep apnea, steatotic liver disease, osteoarthritis, and a myriad of other chronic conditions. The interplay between obesity, kidney, cardiovascular, and metabolic health has been termed the cardiovascular-kidney-metabolic syndrome. However, obesity is not just a driver of cardiovascular events because it also increases the risk of multiple types of cancers, osteoarthritis, and inhibited physical functioning. Among patients with kidney failure, obesity poses challenges to dialysis treatments, precludes access to transplantation, and contributes to frailty. Helping patients safely achieve and maintain weight loss could have cascading positive effects on kidney health and overall well-being. Medical and surgical therapies now provide clinicians with opportunities to treat obesity, but such treatments need to be coupled with team-based approaches. In this Core Curriculum, we provide a review of the diagnosis of obesity and its surrounding controversies, and we outline steps for obesity management in the setting of CKD.</div></div>","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":"88 1","pages":"Pages 142-153"},"PeriodicalIF":9.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148004125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What We Cannot Dialyze","authors":"Adam Krieger MD","doi":"10.1053/j.ajkd.2026.04.005","DOIUrl":"10.1053/j.ajkd.2026.04.005","url":null,"abstract":"","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":"88 1","pages":"Pages A9-A10"},"PeriodicalIF":9.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148283030","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 Need to Stress Patient Distress in Transitioning to Dialysis","authors":"Tamara Glavinovic,&nbsp;Deborah Zimmerman","doi":"10.1053/j.ajkd.2026.05.004","DOIUrl":"10.1053/j.ajkd.2026.05.004","url":null,"abstract":"","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":"88 1","pages":"Pages 41-43"},"PeriodicalIF":9.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148283047","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":"Remote Ischemic Preconditioning: Is This Star Still Rising?","authors":"John A. Kellum,&nbsp;Dana Y. Fuhrman,&nbsp;Oladipupo Olafiranye,&nbsp;Alexander Zarbock","doi":"10.1053/j.ajkd.2025.09.031","DOIUrl":"10.1053/j.ajkd.2025.09.031","url":null,"abstract":"","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":"88 1","pages":"Pages 122-126"},"PeriodicalIF":9.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147524588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cystatin C and Creatinine–Based Estimated GFR and Disease Activity Biomarkers in Rheumatoid Arthritis","authors":"Sho Fukui,&nbsp;Lesley A. Inker,&nbsp;Leah M. Santacroce,&nbsp;Jon T. Giles,&nbsp;Katherine P. Liao,&nbsp;Joan M. Bathon,&nbsp;Daniel H. Solomon","doi":"10.1053/j.ajkd.2026.01.014","DOIUrl":"10.1053/j.ajkd.2026.01.014","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Rationale &amp; Objective&lt;/h3&gt;&lt;div&gt;Creatinine-based estimated glomerular filtration rate (eGFR&lt;sub&gt;cr&lt;/sub&gt;) and cystatin C-based eGFR (eGFR&lt;sub&gt;cys&lt;/sub&gt;) may be inaccurate for patients with rheumatoid arthritis (RA) due to sarcopenia and inflammation. This study characterized changes in eGFR&lt;sub&gt;cys&lt;/sub&gt; and eGFR&lt;sub&gt;cr&lt;/sub&gt; after 2 RA treatment regimens and their association with RA disease activity biomarkers.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study Design&lt;/h3&gt;&lt;div&gt;Secondary observational analysis of randomized controlled trial of tumor necrosis factor (TNF) inhibitor plus methotrexate (MTX) versus triple therapy (MTX, sulfasalazine, and hydroxychloroquine).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Setting &amp; Participants&lt;/h3&gt;&lt;div&gt;Patients with active RA enrolled at multiple US institutions into an immunomodulatory treatment trial.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Exposure&lt;/h3&gt;&lt;div&gt;RA disease activity biomarkers.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Outcome&lt;/h3&gt;&lt;div&gt;eGFR&lt;sub&gt;cys&lt;/sub&gt; and eGFR&lt;sub&gt;cr&lt;/sub&gt; at baseline and weeks 6, 18, and 24.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Analytical Approach&lt;/h3&gt;&lt;div&gt;Describing eGFR&lt;sub&gt;cys&lt;/sub&gt; and eGFR&lt;sub&gt;cr&lt;/sub&gt; at baseline and during the follow-up period in the overall cohort and by treatment arm. Adjusted mixed-effects linear models to estimate the associations of RA activity biomarkers with eGFR.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The study included 157 eligible trial participants (median age, 58 years; 75% female). At baseline, the mean eGFR&lt;sub&gt;cys&lt;/sub&gt; was lower than the eGFR&lt;sub&gt;cr&lt;/sub&gt; (63.3 vs 84.2; difference, −20.9 mL/min/1.73 m&lt;sup&gt;2&lt;/sup&gt; [95% CI, −24.7 to −17.0]). Over 24 weeks, neither eGFR&lt;sub&gt;cys&lt;/sub&gt; nor eGFR&lt;sub&gt;cr&lt;/sub&gt; changed overall (1.74 mL/min/1.73 m&lt;sup&gt;2&lt;/sup&gt; [95% CI, −0.77 to 4.24] and −0.28 mL/min/1.73 m&lt;sup&gt;2&lt;/sup&gt; [95% CI, −3.71 to 3.15], respectively). Multiple disease activity biomarkers, including vascular cell adhesion protein 1, interleukin 6, tumor necrosis factor receptor 1 (TNFR1), leptin, and resistin, were inversely associated with eGFR&lt;sub&gt;cys&lt;/sub&gt; and/or eGFR&lt;sub&gt;cr&lt;/sub&gt; at baseline in adjusted models. During the follow-up period, only TNF-RI change was inversely associated with eGFR&lt;sub&gt;cys&lt;/sub&gt; change (−2.91 mL/min/1.73 m&lt;sup&gt;2&lt;/sup&gt; [95% CI, −4.48 to −1.33]) in adjusted models whereas no biomarker change was significantly related to eGFR&lt;sub&gt;cr&lt;/sub&gt; change.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Limitations&lt;/h3&gt;&lt;div&gt;No measured GFR, a relatively short follow-up period, and potential false discovery because of the large number of associations examined.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Among patients with actively treated RA, eGFRcys is consistently lower than eGFRcr. Overall, neither eGFRcys nor eGFRcr demonstrated a significant change following RA treatments, despite reductions in disease activity biomarkers. Further studies incorporating directly measured GFR are warranted.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Plain-Language Summary&lt;/h3&gt;&lt;div&gt;Rheumatoid arthritis (RA) is a chronic inflammatory joint disease that can also affect the kid","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":"88 1","pages":"Pages 99-109.e1"},"PeriodicalIF":9.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147733783","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":"Obesity Management in End-Stage Kidney Disease: Pathways to Improve Kidney Transplant Access","authors":"Pooja Budhiraja,&nbsp;Babak J. Orandi","doi":"10.1053/j.ajkd.2025.11.019","DOIUrl":"10.1053/j.ajkd.2025.11.019","url":null,"abstract":"<div><div>Obesity is highly prevalent among patients with end-stage kidney disease (ESKD) and remains a major barrier to kidney transplantation, the optimal kidney replacement therapy for improving survival and quality of life. Weight loss strategies tailored to the ESKD population are urgently needed to expand access. This review examines the role of lifestyle interventions, pharmacotherapy, and bariatric surgery in supporting transplant candidacy. Although lifestyle modification is foundational, its effectiveness in ESKD is limited by metabolic, physical, and psychosocial barriers. Pharmacologic agents, particularly glucagon-like peptide-1 receptor agonists, offer promising weight loss and metabolic benefits although access and safety data in ESKD remain limited. Bariatric surgery, increasingly performed in this population, provides durable weight loss, especially for patients requiring ≥20% reduction in weight to meet the transplant body mass index criterion. We also highlight the systemic barriers, including payor policies, program-level variability, and disparities in access, that shape patient outcomes. An integrated approach combining clinical strategies with supportive policies is essential to reduce inequities and expand timely access to kidney transplantation for patients with ESKD and obesity.</div></div>","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":"88 1","pages":"Pages 154-165"},"PeriodicalIF":9.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147536494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Podocyte-Targeted Therapy in Focal Segmental Glomerulosclerosis: Insights From a Phase 2 Trial of TRPC6 Inhibition","authors":"Luis Sanchez-Russo,&nbsp;George Vasquez-Rios,&nbsp;Kirk N. Campbell","doi":"10.1053/j.ajkd.2026.04.006","DOIUrl":"10.1053/j.ajkd.2026.04.006","url":null,"abstract":"","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":"88 1","pages":"Pages 166-169"},"PeriodicalIF":9.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147961917","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}