Supawadee Suppadungsuk, Charat Thongprayoon, Nasrin Nikravangolsefid, Waryaam Singh, Wisit Cheungprasitporn, Yue Dong, Kianoush B Kashani
BACKGROUND: The association between magnesium level and progression to acute kidney disease (AKD) in acute kidney injury (AKI) patients was not well-studied. With acute kidney injury (AKI) transition to acute kidney disease (AKD), the burden of the disease on mortality, morbidity, and healthcare costs increases. Serum magnesium disturbances are linked with a decline in renal function and increased risk of death in CKD and hemodialysis patients. This study aims to assess the significance of magnesium derangements as a risk factor for the progression of AKI to AKD in critically ill patients...
June 11, 2024: Nephron
Heini Jyrkilä, Kati Kaartinen, Leena Martola, Olli Halminen, Jari Haukka, Miika Linna, Pirjo Mustonen, Jukka Putaala, Konsta Teppo, Janne Kinnunen, Juha Hartikainen, K E Juhani Airaksinen, Mika Lehto
Introduction Chronic kidney disease (CKD) is associated with increased incidence of atrial fibrillation (AF). Also, patients with AF are prone to adverse kidney outcomes. We examined comorbidities and medication use in patients with CKD and incident AF. Methods The Finnish AntiCoagulation in Atrial Fibrillation (FinACAF) is a nationwide retrospective register-linkage study including data from 168 233 patients with incident AF from 2007 to 2018, with laboratory data from 2010 onwards. Estimated glomerular filtration rate (eGFR) was available for 124 936 patients...
June 11, 2024: Nephron
Pei Zhang, Xiao Yang, Meng-Zhen Fu, Chun-Lin Gao, Xiang Fang, Zheng-Kun Xia
BACKGROUND: Thrombotic microangiopathy (TMA) is an important risk factor for the prognosis of lupus nephritis (LN). Patients with LN complicated with TMA tend to be critically ill with high mortality and poor prognosis. In the present study, we retrospectively analyzed the clinical manifestations, laboratory results, renal pathological manifestations, and prognosis of children with LN-TMA and analyzed the risk factors for end-stage renal disease (ESRD) in children with LN-TMA. METHODS: Seventy-four patients with LN and renal TMA (rTMA) were selected and compared to 128 LN controls without TMA (1:2 ratio) matched according to demographics, pathological type and treatments...
June 7, 2024: Nephron
Lise Bankir, Gilles Crambert, Rosa Vargas-Poussou
Urea is the major endproduct of protein metabolism in mammals. In carnivores and omnivores a large load of urea is excreted daily in urine, with a concentration that is 30 to 100 times above that in plasma (and even more in rodents). This concentrating activity is important for the sake of water economy. Several facilitated transmembrane urea transporters have been identified and their regulation and role in the urinary concentrating mechanism have been well documented. However, too little attention has been given to the existence of energy-dependent urea transport...
May 31, 2024: Nephron
Xianjin Bi, Yanlin Yu, Siyan Zhou, Yue Zhou, Jinghong Zhao, Jiachuan Xiong
Background The renoprotective benefits of adding immunosuppressant therapy to corticosteroid (CS) treatment for immunoglobulin A nephropathy (IgAN) patients with less than 25% crescent formation (C1) remains uncertain, warranting further research. Methods A retrospective study was conducted on IgAN patients with crescent C1 lesions confirmed by renal biopsy at Xinqiao Hospital between May 1, 2017, and May 1, 2020. Patients were stratified into either the CS treatment group or the CS combined with an additional immunosuppressant therapy group...
May 9, 2024: Nephron
Jussi Pohjonen, Katri Kaukinen, Heini Huhtala, Ilkka Pörsti, Katri Lindfors, Jukka Mustonen, Satu Mäkelä
INTRODUCTION: Presence of subclinical intestinal inflammation has repeatedly been shown in IgA nephropathy (IgAN) and the degree of histological inflammation has correlated with abnormal urinary findings. There is lack of noninvasive biomarkers evaluating the presence of subclinical intestinal damage in IgAN. We conducted this study hypothesizing that selected biomarkers regarded as indirect markers of intestinal damage could be elevated in IgAN. METHODS: Eighty-five primary IgAN patients (median age 55 years, 54% men) participated in this single-centre study in Tampere, Finland...
May 9, 2024: Nephron
Alshymaa Rafiek Eltahan, Zulfikar Pondor, Rosemary L Donne, David Lewis, Maharajan Raman, Paul Hinchliffe, Jan Cowperthwaite, Dimitrios Poulikakos
BACKGROUND: Early identification of dysfunctional arteriovenous hemodialysis (HD) vascular access (VA) is important for timely referral and intervention. METHOD: We retrospectively calculated the VA risk score using Vasc-Alert surveillance software technology from HD treatment sessions in 2 satellite HD units over 18 months. We included in the analysis HD patients dialyzing with arteriovenous fistula or graft (AVF/G) with available Vasc-Alert data for≥ 2 months...
April 30, 2024: Nephron
Ivan Zepeda-Quiroz, Daniel Juarez-Villa, Víctor Hugo Gomez-Johnson, Omar Humberto Sanchez-Vazquez, Sebastian Eduardo Toledo-Ramirez, Francisco Eugenio Rodriguez-Castellanos, Brenda Guadalupe Cortez-Flores, Alejandro Garcia-Rivera, Magdalena Madero Rovalo, Bernardo Moguel-Gonzalez
INTRODUCTION: The percutaneous kidney biopsy (PKB) is an essential tool in nephrology, small kidney size has been a relative contraindication to PKB and there is limited data on the safety and utility of performing PKB in this setting. Our aim was to describe the complications of PKB in small kidneys and to assess if kidney biopsy results have an impact on medical decisions and outcomes. METHODS: This was a retrospective, descriptive, and observational study. Patients older than 16 years of age with a decreased kidney size (≤ 8 cm), and undergoing PKB of native kidneys from July 2019 to December 2022 were included...
April 24, 2024: Nephron
Francesca Caprio, Giuseppe Orefice, Floriana Secondulfo, Filippo Carone Fabiani, Anna Iervolino, Giovambattista Capasso, Mariadelina Simeoni, Miriam Zacchia, Francesco Trepiccione, Giovanna Capolongo
Cystinuria (CYS) is the most common monogenic kidney stone disease. Starting from an unusual case of CYS associated to Primary Sclerosing Cholangitis, inflammatory bowel disease (IBD) and autoimmune hepatitis in a young male, we carefully review the literature and propose here a working hypothesis regarding the potential risk of cystinuric patients to develop conditions due to immune system dysregulation. To corroborate this hypothesis, we retrospectively evaluate the frequency of dysimmunity in a cohort of cystinuric patients compared to healthy and disease controls...
April 24, 2024: Nephron
Domenico Merante, Henrik Schou, Isabelle Morin, Marius Manu, Akhtar Ashfaq, Charles Bishop, Stephen Strugnell
BACKGROUND: Early secondary hyperparathyroidism (SHPT) diagnosis and treatment are crucial to delay the progression of SHPT and related complications, in particular, cardiovascular events and bone fractures. Extended-release calcifediol (ERC) has been developed for the treatment of SHPT in patients with stage 3/4 chronic kidney disease (CKD) and vitamin D insufficiency (VDI). SUMMARY: This review compares baseline characteristics and treatment responses of SHPT patients receiving ERC in Phase 3 studies with those treated with ERC in a real-world study...
April 24, 2024: Nephron
Wanting Weng, Siow-Yi Wong, Gary Yee Ang, Sheryl Hui Xian Ng, Chee Kong Lim, See Cheng Yeo
Background Accurate identification of individuals at risk of developing chronic kidney disease (CKD) may improve clinical care. Nelson et al developed prediction equations to estimate the risk of incident eGFR of less than 60 ml/min/1.73m2 in diabetic and non-diabetes patients using data from 34 multinational cohorts. We aim to validate the non-diabetes equation in our local multi-ethnic cohort and develop further prediction models. Methods Demographics, clinical and laboratory data of hypertensive non-diabetes patients with baseline eGFR ≥60ml/min/1...
April 18, 2024: Nephron
Pilar Musalem, Cristian Pedreros-Rosales, Hans Müller-Ortiz, Carlos Gutierrez-Navarro, J Daniel Carpio
Complement-mediated thrombotic microangiopathy (CM-TMA) is a rare and life-threatening complication that can occur in kidney transplant recipients, with various potential triggers including immunosuppressive medications. The optimal management and duration of treatment with C5 inhibitors (C5i) for CM-TMA in this patient population remain areas of ongoing investigation. We present the case of a 38-year-old female with a history of IgA nephropathy who underwent preemptive living-related kidney transplantation and subsequently developed CM-TMA seven years post-transplant...
April 14, 2024: Nephron
Ahmet Murt, Batuhan Bayram, Umut Yilmaz, Nurhan Seyahi, Ahmet Emre Eskazan
Lifelong immunosuppression, cytotoxic effects of some immunosuppressive drugs, and opportunistic oncogenic viruses increase malignancy risks in solid-organ recipients. The risk of myeloid neoplasms including chronic myeloid leukemia (CML) is also increased in this patient population. Tyrosine kinase inhibitors (TKIs), the key element of CML therapy should be used cautiously in transplantation patients as they may interact with calcineurin inhibitors. With this report, a 63-year-old female kidney transplant recipient who developed CML 9 years after kidney transplantation is presented...
April 4, 2024: Nephron
Yoshitaka Miyaoka, Takahito Moriyama, Suguru Saito, Sho Rinno, Miho Kato, Ryuji Tsujimoto, Rie Suzuki, Rieko China, Miho Nagai, Yoshihiko Kanno
INTRODUCTION: Sodium-glucose cotransporter 2 inhibitors (SGLT2Is) have beneficial effects on the renal function of chronic kidney disease (CKD) patients, although the types of patients suitable for this treatment remain unclear. METHODS: A retrospective observational study was conducted on CKD patients who were treated with SGLT2I at our department from 2020 to 2023. The estimated glomerular filtration rate (eGFR) just before treatment was defined as the baseline and the difference between pre-and post-treatment eGFR slopes were used to compare the improvement of renal function...
April 1, 2024: Nephron
Dipti Rao, Rutger Maas, Marlies Cornelissen, Jack Wetzels, Michel van Geel
Alport syndrome (AS) is a hereditary kidney disorder of type IV collagen caused by pathogenic variants in the COL4A3, COL4A4 and COL4A5 genes. Previously several cases of digenic AS, caused by two pathogenic variants in two of the three COL4A genes, have been reported. Patients with digenic AS may present with a more severe phenotype compared to patients with single variants, depending on the percentage affected type IV trimeric collagen chain. We report a newly discovered case of trigenic AS. A 52-year-old female presented with hematuria at the age of 24 years and developed hypertension by the age of 30...
March 28, 2024: Nephron
Olga Beltcheva, Kunka Kamenarova, Galia Zlatanova, Kalina Mihova, Dimitar Roussinov, Darina Kachakova, Martin Georgiev, Elena Nikolova, Maria Gaydarova, Vanio Mitev, Radka Kaneva
INTRODUCTION: In pediatric kidney patients, where clinical presentation is often not fully developed and renal biopsy too risky or inconclusive, it may be difficult to establish the underlying pathology. In cases such as these, genetic diagnosis may be used to guide the treatment, prognosis and counselling. Given the large number of genes involved in kidney disease, introducing next generation sequencing with extended gene panels as part of the diagnostic algorithm presents a viable solution...
March 28, 2024: Nephron
Pedro Lisboa Gonçalves, Hugo Diniz, Isabel Tavares, Sofia Dória, Juan Dong, McKenna Kyriss, Lynette Fairbanks, João Paulo Oliveira
Hereditary xanthinuria (HXAN) is a rare metabolic disorder that results from mutations in either the xanthine dehydrogenase (XDH) or the molybdenum cofactor sulfurase genes (MOCOS), respectively defining HXAN type I and type II. Hypouricemia, hypouricosuria, and abnormally high plasma and urine levels of xanthine, causing susceptibility to xanthine nephrolithiasis and deposition of xanthine crystals in tissues, are the metabolic hallmarks of HXAN. Several pathogenic variants in the XDH gene have so far been identified in patients with HXAN type I, but the clinical phenotype associated with the whole deletion of the human XDH gene is unknown...
March 25, 2024: Nephron
Midori Sakashita, Yoshifumi Hamasaki, Rikako Oki, Yohei Komaru, Yoshihisa Miyamoto, Teruhiko Yoshida, Ryo Matsuura, Kent Doi, Masaomi Nangaku
OBJECTIVE: Myostatin, which is known as a negative skeleton muscle regulator, is associated with mortality in maintenance hemodialysis patients. However, the significance of serum myostatin concentrations at dialysis initiation has not been established. We investigated the relation between serum myostatin concentrations and mortality or hospitalization within one year in incident dialysis patients. METHODS: After a patient initiating hemodialysis or peritoneal dialysis during 2016-2018 was enrolled, the patient's serum myostatin at dialysis initiation was measured...
March 23, 2024: Nephron
Ori Wand, Idan Drori, Yael Einbinder, Naomi Nacasch, Sydney Benchetrit, Anna Breslavsky, Keren Cohen-Hagai
Background Infections with B.1.1.529 (Omicron) variants of SARS-CoV-2 became predominant worldwide since late 2021, replacing the previously dominant B.1.617.2 variant (Delta). While those variants are highly transmissible and can evade vaccine protection, population studies suggested that outcomes from infection with Omicron variants are better compared with Delta. Data regarding prognosis of maintenance hemodialysis (MHD) patients infected with Omicron vs. Delta variants, however, is scarce. Methods This retrospective cohort study includes all patients with end-stage kidney disease treated with MHD in Meir Medical Center, Kfar-Saba, Israel that were diagnosed with SARS-CoV-2 infection between June 2021 and May 2022...
March 14, 2024: Nephron
Ryo Tanaka, Ryoichi Imamura, Soichi Matsumura, Shota Fukae, Ayumu Taniguchi, Shigeaki Nakazawa, Kazuaki Yamanaka, Tomoko Namba-Hamano, Yoichi Kakuta, Tetsuya Takao, Hiroaki Fushimi, Norio Nonomura
Although glomerular damage caused by diabetic nephropathy was thought to be irre-versible, in recent years, there have been reports on improvement in glomerular damage with strict glycemic control. However, few reports are available on the pathologic course after renal transplantation of donor-derived grafts with findings of diabetic nephropathy. A 53-year-old woman underwent an ABO blood-type compatible living-donor renal transplant. The recipient had no history of diabetes, and fasting blood glucose and hemo-globin A1c (HbA1c) levels were both normal...
March 7, 2024: Nephron
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