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Patrick C. Ahearn and Xingxing S. Cheng

Chronic kidney disease (CKD) is associated with physical function decline and worsening comorbidity burden. A recent study published in the Journal of the American Society of Nephrology (1) reports findings from the LANDMARK III study, a years-long, longitudinal randomized study of a multi-disciplinary, clinic-based and lifestyle intervention for Australian patients with CKD stages 3a−4. The intensive intervention required a treatment team of nurse practitioners, exercise physiologists, dieticians, diabetes educators, psychologists, and nephrologists. Risk factors addressed included blood pressure, weight, and cardiorespiratory fitness. The 81 intervention-group patients attended 4 weeks of behavior and lifestyle intervention and 8

Sonia Rodriguez-Ramirez and Naoka Murakami
Case description

A 23-year-old female with primary focal segmental glomerulosclerosis (FSGS), diagnosed at the age of 16, underwent a living-related kidney transplantation (KT). She was on hemodialysis for 2 years before transplant but still had residual urine output of 500 mL/day with a random urine protein-to-creatinine ratio (UPCR) of 1.5 g/gCr. On post-operative day 4, UPCR was noted as 14 g/gCr. A kidney allograft biopsy demonstrated diffuse effacement of podocyte foot processes with no evidence of acute rejection.

What are the risk factors and mechanisms of recurrent primary FSGS posttransplant? What treatment options (pre- and posttransplant) might benefit this patient?

Ala Abudayyeh and Rimda Wanchoo

A llogeneic stem cell transplant (SCT) is used to cure several hematological disorders. The incidence of both acute kidney injury and chronic kidney disease (CKD) post-SCT remains high. A rare cause of CKD post-allogeneic SCT is development of glomerular disease, which by many is considered to be a manifestation of chronic graft-versus-host disease (GVHD) affecting the kidney (1). Based on mouse models, it has been proposed that GVHD could be a direct T cell-mediated injury or that the chronic systemic inflammatory state of GVHD leads to autoimmune induction and glomerulopathy (2). The incidence of nephrotic syndrome

Bridget M. Kuehn

When the pandemic hit more than 2 years ago, nephrologists and their patients had to pivot on a dime to adapt to telehealth technologies. Those technologies have proved popular with both nephrologists and patients. But now, clinicians face new challenges as they try to develop sustainable and equitable hybrid telehealth and in-person care models for the long term.

Provisions in the 2020 Coronavirus Aid, Relief, and Economic Security (CARES) Act enabled the Centers for Medicare & Medicaid Services to temporarily waive restrictions on where and how patients could receive telehealth (1). This policy change led to a rapid

Shruti Gupta and Paul E. Hanna

Immune checkpoint inhibitors (ICPis) have transformed the landscape of oncology, and they are now approved for the treatment of over one dozen different types of cancer. ICPis block immune checkpoints—the “brakes” of the immune system—and therefore activate cytotoxic T-cells to eliminate cancer cells. However, enhancement of T-cell activity also leads to autoimmune toxicities or immune-related adverse events (irAEs), which can affect multiple organ systems, including the kidneys. ICPi-associated acute kidney injury (ICPi-AKI) can have major repercussions, including discontinuation from therapy and prolonged courses of immunosuppression.

Recently, Gupta et al. (1) conducted a multicenter study of 429 cases of

An analysis of a large cohort of patients with autosomal-dominant polycystic kidney disease (ADPKD) adds new knowledge about risk factors for intracranial aneurysm (IA), including an increase in IA risk for women after menopause, according to a pre-proof paper in Nephrology Dialysis Transplantation.

The cross-sectional, population-based study included 2449 patients with ADPKD (median age, 55 years) from 26 nephrology centers in western France. On genetic analysis in 2386 patients, 67.6% had PKD1 pathogenic variants, and 19.0% had PKD2 pathogenic variants. The researchers analyzed the frequency of diagnosis of ruptured and unruptured IA, along with

Prabhat Chauhan and Raja Ramachandran

The prevalence of malignancy in patients with membranous nephropathy (MN) ranges from 4% to 10% (1, 2). In adults, MN is the most common cause of nephrotic syndrome outside of diabetes and is well described but not well studied in patients with cancer.

In a recent article by Thet and colleagues (3) in Translational Oncology, the authors impart on an update on cancer risks in patients with a glomerular diseases. Thet et al. (3) used MN as a prototype to understand malignancy-related glomerular disease. Malignancy-related MN is a disease of

Chelsea C. Estrada and Sandeep K. Mallipattu

Peripheral arterial disease (PAD) is three times as prevalent in patients with chronic kidney disease (CKD) compared with their non-CKD counterparts (1). This increased susceptibility has been attributed to the uremic milieu; however, specific mechanisms remain unknown. Recently, in the Journal of Clinical Investigation, Arinze and colleagues (2) shed new light on the detrimental impact of dietary and gut-converted, tryptophan-based uremic toxins (indoxyl sulfate and its metabolites) on neovascularization in PAD.

In a series of elegant studies, the investigators demonstrated that serum from patients with uremia, as well as indoxyl sulfate alone, induced a

Sheila Bermejo

Cancer is a worldwide epidemic that has increased its prevalence exponentially over the last decades. In 2020, 19.3 million new cases of cancer were diagnosed, and there were 10 million deaths from cancer worldwide (1). Cancer patients are susceptible to chemotherapy and immunotherapy treatments that can cause renal complications, such as acute kidney injury (secondary to glomerular disease, acute interstitial nephritis, or acute tubular necrosis), electrolyte disorder, proteinuria, and others (2). Additionally, a higher prevalence of cancer has been demonstrated in patients with chronic kidney disease from various types, those with a kidney transplant, and patients

Paul E. Hanna and Meghan E. Sise

Important decisions about diagnosing kidney disease, managing drug dosing, and considering kidney replacement therapy rely on an accurate estimation of the glomerular filtration rate (GFR), especially in patients with cancer (1, 2). Despite its continued use, the Cockcroft-Gault equation (3), originally created to assess kidney function based on serum creatinine in 1976, has significant limitations that may be even greater in patients with cancer who have sarcopenia. To address this, Costa E Silva and colleagues (4) compared the measured GFR using chromium-51-labeled ethylenediamine tetraacetic acid (51Cr-EDTA) clearance in 1200 patients