Nephron

INTRODUCTION: Inflammation is a risk factor for diabetes in the general population. The role of inflammation in prediabetes or post-transplant diabetes (PTDM) is not clear. We evaluated the association between inflammatory markers in patients on the waiting list for renal transplantation and the onset of prediabetes and PTDM 12 months after transplantation. METHODS: This is a post-hoc analysis of a prospective study, that included non-diabetic patients on the waiting list for kidney transplantation who underwent an oral glucose tolerance test (OGTT) and were followed up to 12 months after transplantation...

Kidney transplant recipients are immunocompromised hosts at risk for comorbidity and mortality due to infection. Currently there are no established guidelines for the management of immunosuppressed transplant recipients with Coronavirus disease 2019 (COVID-19). The impact of COVID-19 and its therapeutic management on chronic active antibody-mediated rejection (CAAMR) are still unclear. Here, we report a case of CAAMR exacerbation with endarteritis and intimal fibrosis after COVID-19. A 41-year-old female kidney transplant recipient with CAAMR was admitted to a local hospital with moderately severe COVID-19...

There is a pandemic of obesity worldwide and in Europe up to 30% of the adult population is already obese. Obesity is strongly related to the risk of CKD, progression of CKD and end-stage renal disease (ESRD), also after adjustment for age, sex, race, smoking status, comorbidities, and laboratory tests. In the general population obesity increases the risk of death. In non-dialysis-dependent CKD patients, the association between body-mass index and weight with mortality is controversial. In ESRD patients, obesity is paradoxically associated with better survival...

INTRODUCTION: Low grade inflammation is seen in many chronic illnesses, including chronic kidney disease (CKD). We have recently reported on beneficiary effects of anti-inflammatory treatment in the interleukin (IL-)1 pathway on anemia as well as CKD extent in a mouse model. Colchicine has been shown to have beneficiary effects in several inflammatory conditions through various mechanisms, including inhibition of tubulin polymerization as well as caspase 1 mediated IL1 activation. METHODS: Kidney injury (KI) was induced by administering an adenine diet to 8-week-old C57BL/6J mice, treated with colchicine (Col) (30µg/kg) or saline injections for 3 weeks, generating 4 groups: C, C-Col, KI and KI-Col...

Members of the Krüppel-like family of transcription factors are widely expressed, including in the kidney. Expression of some KLFs changes in acute kidney injury, and this may be adaptive or maladaptive, and result in effects on various cellular pathways. This mini-review will highlight the roles of KLF6 and KLF15 in control of proximal tubular cell metabolism.

The clinical indications for immune checkpoint inhibitors (ICIs) are rapidly expanding. However, adverse events affecting multiple organs, including kidneys leading to ICI-associated acute kidney injury (AKI), remain a significant challenge with ICI therapy. Although AKI is considered a rare complication, it can be severe and result in treatment interruption or discontinuation of ICIs. Despite a generally favorable kidney prognosis, the possibility of re-challenging ICI therapy remains a subject of debate, particularly for patients who have exhausted other treatment options or experienced severe AKI...

Inflammation is common in patients with acute kidney injury (AKI) and contributes to increased risk of morbidity and mortality. The central nervous system plays an important role in the immune and inflammatory pathways of AKI. In this review, we discuss the preclinical evidence for the neural pathways associated with neuromodulation in AKI and their clinical implications, as well as clinical trials that translate these observations into the clinical context. The ultimate goal of these trials is to design strategies using non-invasive approaches, such as splenic pulsed ultrasonography, to prevent or attenuate inflammatory conditions at the bedside, including AKI...

BACKGROUND: Acute kidney injury (AKI) is a frequent condition, with persisted shortage of large-scale epidemiological studies. We analyzed the population-wide healthcare system of the Italian Lombardy region over the 2000-2019 period, and evaluated AKI incidence, mortality, and related healthcare resources utilization and cost in all citizens 40 years and older. METHODS: The retrospective cohort analysis of an administrative claims database that routinely collects information about health care provision in a high-income region with 10 million citizens...

INTRODUCTION: The age for kidney transplantation (KT) is no longer a limitation and several studies have shown benefits in the survival of elderly patients. The aim of this study was to examine the relationship of the baseline Charlson comorbidity index (CCI) score to morbidity and mortality after transplantation. METHODS: In this multicentric observational retrospective cohort study, we included patients older than 60 years admitted on the waiting list (WL) for deceased donor KT from 01/01/2006 until 31/12/2016...

BACKGROUND: Autosomal dominant polycystic kidney disease (ADPKD) is the most common inherited disease of the kidney. It occurs in adulthood but is also rarely diagnosed in early childhood. The majority of the disease-causing variants observed in ADPKD patients are in two genes: PKD1 and PKD2. METHODS: 237 patients from 198 families with a clinical diagnosis of ADPKD were screened for PKD1 and PKD2 genetic variants using Sanger sequencing and Multiple Ligation-dependent Probe Amplification (MLPA) analysis...

Eighty five percent of patients with chronic kidney disease (CKD) have hypertension and blood pressure (BP) control is the cornerstone in the management of CKD. Although it is widely accepted that BP should be optimised, BP targets in CKD are not known. Subject of review: Kidney Disease Improving Global Outcomes (KDIGO) clinical practice guideline for the management of blood pressure in chronic kidney disease (Kidney Int. 2021 Mar 1;99(3S):S1-87) recommends targeting blood pressure (BP) to less than 120 mm Hg systolic for patients with CKD...

INTRODUCTION: Herein, we discuss clinicopathological analyses of cases of chronic renal allograft arteriopathy (CRA) after renal transplantation and clarify the mechanisms underlying the development and prognostic significance of CRA. METHODS: CRA was diagnosed in 34 renal allograft biopsy specimens (BS) obtained from 27 renal transplant patients who were followed up at the Department of Urology and Transplant Surgery, Toda Chuo General Hospital, between January 2010 and December 2020...

BACKGROUND: Infection is one of the most common causes of death in patients with chronic kidney disease (CKD). Proton pump inhibitors (PPIs) are widely used in patients with CKD, but also represent a known risk factor for infection in the general population. Here, we investigated associations between PPIs and infection events in patients with incident hemodialysis. METHODS: We analyzed data from 485 consecutive patients with CKD who started hemodialysis at our hospital between January 2013 and December 2019...

BACKGROUND: Progression of chronic kidney disease (CKD) in childhood is associated with multiple long-term adverse outcomes including an increased risk of death. The early diagnosis and recognition of CKD progression allows for enrollment in clinical trials and timely interventions. Early recognition of CKD progression would be enabled by further developing clinically relevant kidney biomarkers which identify those children at highest risk of kidney function decline. SUMMARY: Glomerular filtration rate and proteinuria are traditional markers to classify and prognosticate CKD progression in clinical practice but have several limitations...

The 15th Banff meeting was held in Pittsburgh, September 23-28, 2019. The summary was published as The Banff 2019 Kidney Meeting Report (PMID: 32463180), and transplant kidney biopsy diagnosis based on the Banff 2019 classification is already being practiced worldwide. The changes in the Banff 2019 classification include: the criteria for borderline change (BLC) has been reverted to ≥i1, the t-IFTA score has been incorporated into the classification, the histological classification of polyoma virus nephropathy (PVN) has been adopted, and a category of chronic (inactive) antibody mediated rejection was added...

Several cases of kidney transplantation after hematopoietic stem cell transplantation (HSCT) from the same donor for end-stage renal disease have been reported. In those cases, immunosuppressive drugs were discontinued, since immune tolerance was supposed to be induced. Theoretically, the recipient's immune system recognizes the kidney allograft as its own tissue with the same human leukocyte antigen (HLA) profile, and the kidney allograft will not be rejected, even without the use of immunosuppressive agents...

INTRODUCTION: At present, there is limited evidence of the histological impact of vesicoureteral reflux (VUR) on pediatric kidney allografts. In this study, we aimed to investigate the relationship between VUR diagnosed by voiding cystourethrography (VCUG) and 1-year protocol biopsy results. METHODS: One hundred thirty-eight pediatric kidney transplantations were performed in Toho University Omori Medical Center between 2009 and 2019. We included 87 pediatric transplant recipients who were evaluated for VUR by VCUG prior to or at the time of the 1-year protocol biopsy and underwent a 1-year protocol biopsy after transplantation...

INTRODUCTION: Acute kidney injury (AKI) is a group of highly heterogeneous, complicated clinical syndromes. Although kidney biopsy plays an irreplaceable role in evaluating complex AKI, a few studies have focused on the clinicopathology of AKI biopsies. This study analyzed the pathological disease spectrum, causes, and renal outcomes of biopsied AKI patients. METHODS: We retrospectively included 2,027 AKI patients who underwent kidney biopsies at a national clinical research center of kidney diseases from 2013 through 2018...

INTRODUCTION: Sarcoidosis is characterized by non-caseating granulomatous inflammation in multiple organs. Renal involvement is rare, and granulomatous tubulointerstitial nephritis (GIN) is the predominant histologic feature. Renal sarcoidosis (RS) is usually diagnosed by exclusion, combining clinical and histological findings, and often remains misdiagnosed. This retrospective study aimed to describe the characteristics and prognosis of patients with RS in China. METHODS: 18 patients with RS from a single center were enrolled, of whom 15 had biopsy-proven tubulointerstitial nephritis...

INTRODUCTION: Despite being a leading cause of morbidity and mortality globally, acute kidney injury (AKI) is worse in resource-limited areas. This study explores AKI incidence, inhospital mortality, and long-term outcomes in resource-limited settings. METHODS: This was a prospective study of children with AKI from 2014 to 2019. KDIGO 2012 defined AKI. We assessed the etiology, inhospital mortality, and long-term outcome of AKI in a mission hospital. RESULTS: Only 169 of 201 AKI patients had complete data...