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y disease. Methods We conducted an observational retrospective cohort study, and we analyzed the data of 1,728,141 million patients extracted from the Cerner Health Facts database (January 1st 2000- June 30th 2018). In this report we investigated the association between hospital-acquired hypernatremia (serum sodium (Na) levels>145 mEq/L) and in-hospital mortality or discharge dispositions with kidney

Background: Early interventions in chronic kidney disease (CKD) have been shown to improve health outcomes; however, gaps in access to nephrology care remain common. Nurse practitioners can improve access to care; however, the quality and outcomes of nurse practitioner care for CKD are uncertain. Methods: In this propensity score matched cohort study, patients with CKD meeting criteria for nurse practitioner

Hematuria was assessed at the initial urinalysis in participants with the following podocytopathies, membranous nephropathy, minimal change disease, and focal segmental glomerulosclerosis, in the Nephrotic Syndrome Study Network (NEPTUNE) and Cure Glomerulonephropathy (CureGN) cohorts with >24 months of follow-up. Multivariable Cox proportional hazards models were fit for time to composite outcome

induce metabolic reprogramming and slow ADPKD progression. We review the available evidence supporting the efficacy and safety of these interventions in ADPKD. Dietary interventions show promise in managing ADPKD by improving metabolic health and reducing oxidative stress. However, while preclinical studies have shown favorable outcomes, limited clinical evidence supports their effectiveness. Also

Background In the US, over 50% of kidneys in the lowest 15% quality range (those with kidney donor profile index>85) are discarded. Studies suggest that utilizing more of these kidneys could benefit patients waiting for a transplant. This study assesses the tradeoffs physicians make when selecting recipients for lower quality kidneys. Methods A discrete-choice experiment (DCE) was administered to surgeons

ts with secondary hyperparathyroidism receiving HD. Methods In this phase 3, double-blind, placebo-controlled study, we randomized Japanese patients undergoing HD with serum intact PTH (iPTH) concentrations >240 pg/ml and corrected calcium concentrations ≥8.4 mg/dl. Either upacicalcet or placebo was administered after each HD session for 24 weeks. The primary outcome was the percentage of participants

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Background: Hypocomplementemia and complement co-deposition with monoclonal immunoglobulins in glomeruli are not rare in proliferative glomerulonephritis with monoclonal immunoglobulin deposits (PGNMID). Deposition of monoclonal immunoglobulins in glomeruli has been suggested to activate complement and cause kidney injury. However, the profiles of complement activation in PGNMID and their clinical

tabase from a large academic medical center was queried retrospectively to identify 1,498 patients (mean age 56 ± 15 years, 48% females, 73% Black patients) undergoing placement of at least one vascular access from 2011-20. For patients who developed access-related distal ischemia requiring surgical intervention, we determined the frequency of distal ischemia, clinical risk factors, and subsequent

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abetes. CINAC prevalence is higher among young, male agricultural workers, but also affects women, children, and non-agricultural workers in affected areas. Biopsies from patients with CINAC across regions commonly demonstrate tubular injury with lysosomal aggregates, tubulointerstitial inflammation and fibrosis, variable glomerular changes. Each endemic area holds environmental risk factors and patient/genetic

, monitoring kidney function during GAHT is challenging, as serum creatinine is confounded by body composition. To investigate the relationship between sex hormones and kidney function, we studied the changes of serum creatinine and serum cystatin C, a filtration marker less affected by sex, during one year of GAHT. Methods: As part of the European Network for the Investigation of Gender Incongruence

-CD20 antibody designed to overcome such situations in B-cell malignancies and recently reported to be safe and effective in other autoimmune diseases affecting the kidneys. Methods We retrospectively report 41 children with steroid-dependent or frequently relapsing nephrotic syndrome treated with a single low-dose infusion of obinutuzumab at Robert-Debre Hospital between April 2018 and December 2020

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taurolidine 13.5 mg/mL and heparin (1000 units/mL) versus heparin in preventing CRBSIs in participants receiving hemodialysis via CVC. Methods: LOCK IT-100 was a randomized, double-blind, active-control, multicenter, phase 3 study that enrolled adults with kidney failure undergoing maintenance hemodialysis via CVC from 70 US sites. Participants were randomized 1:1 to taurolidine/heparin catheter lock

dialyze at home in the United States. Complex system-level factors have restricted further growth in home dialysis modalities, including limited infrastructure, insufficient staff for patient education and training, patient-specific barriers, and suboptimal physician expertise. In this article, we outline trends in home dialysis use, review our evolving understanding of what constitutes high quality

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use no effect or a slight reduction in plasma K+ concentration in patients with normal kidney function but seem to exert a protective effect against hyperkalemia in the setting of reduced kidney function or when given with drugs that block the renin-angiotensin-aldosterone axis. In this review, we discuss the changes in kidney physiology following administration of SGLT2 inhibitors predicted to cause

count, as a surrogate for interstitial eosinophilic aggregates, and the risk of kidney failure in patients with advanced CKD. Methods: We analyzed datasets from two retrospective cohort studies: 1) The kidney biopsy cohort including 563 patients who underwent native kidney biopsy at Osaka University Hospital between 2009 and 2021, and 2) the retrospective CKD cohort including 2877 patients with an

Writing a home hemodialysis (HD) prescription is a complex, multifactorial process that requires the incorporation of patient values, preferences, and lifestyle. Knowledge of the different options available in terms of home HD modality (conventional, nocturnal, short daily, and alternate nightly) is also important when customizing a prescription. Finally, an understanding of the different home HD machines

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order to affect meaningful change, a multi-faceted innovative approach will be needed to substantially increase the use of home dialysis. Patient and provider education is the first step to enhance home dialysis knowledge awareness. Ideally, one should maximize the number of chronic kidney disease stage V patients transitioning to home therapies. If this is not possible, infrastructures including transitional

n showed more severe clinical phenotypes, active kidney lesions, and rapid progression. Our previous genome-wide association study identified complement factor H variant rs6677604, tightly linked with the deletion of complement factor H-related protein 3 and complement factor H-related protein 1 genes (ΔCFHR3-1), as IgA nephropathy susceptible variant, and additionally revealed its effect on complement

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home and many programs have a relatively small census. Multiple stakeholders including patients, healthcare providers and payers have identified increased home dialysis use as in important goal. In order to realize these goals nephrologists and kidney care professions need a sound understanding of the key considerations in home dialysis center operation. In this review, we outline the core domains

ed care. This reflects the need to address the patient as a person with needs and preferences beyond just the medical perspective. Shared-decision making is central to the recent International Society for Peritoneal Dialysis (ISPD) recommendations for prescribing PD, balancing the potential benefits of PD on patient well-being with the burden associated with treatment. This review considers the role

merulopathy (n=296) or Ig-MPGN (n=102) from a national registry were screened for 3 complement genes, factor H (CFH), factor I (CFI) and C3. Patients with rare variant (minor allele frequency <0.1%) were included. Epidemiological, clinical and immunological data at diagnosis and kidney outcomes of patients were retrospectively collected. Results: Fifty-three different rare variants including 30 (57%)

atment influence dialysis prescription and outcomes, and dysfunction of the peritoneal membrane contributes to fluid overload and associated complications. In this review, we summarize the current knowledge about the structure, function and pathophysiology of the peritoneal membrane with a focus on clinical implications for patient-centered care. We also discuss the molecular and genetic mechanisms

Background Prostaglandin E2 (PGE2) plays a physiological role in osmoregulation, a process that is affected early in autosomal dominant polycystic kidney disease (ADPKD). PGE2 has also been implicated in the pathogenesis of ADPKD in preclinical models, but human data are limited. Here, we hypothesized that urinary PGE2 excretion is associated with impaired osmoregulation, disease severity, and disease

l, 36-week prospective trial we hypothesized that etelcalcetide improves bone quality and strength without damaging bone-tissue quality. Participants were ≥18 years, on hemodialysis ≥1 year, without calcimimetic exposure within 12-weeks of enrollment. We measured pre- and post-treatment areal bone mineral density by dual energy X-ray absorptiometry, central skeleton trabecular microarchitecture by

three transplant centers in the US, enrolled 61 kidney recipients from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected deceased donors. Using optimal matching methods, we matched every recipient to three comparators receiving kidneys from SARS-CoV-2-negative deceased donors with otherwise highly similar characteristics within the same transplant centers to compare 6-month eGFR

pothesized that urinary PGE2 excretion is associated with impaired osmoregulation, disease severity and disease progression in patients with ADPKD. Methods: Urinary excretions of PGE2 and its metabolite (PGEM) were measured in a prospective cohort of patients with ADPKD. Linear regression was used for the cross-sectional analysis of the associations between urinary PGE2 and PGEM excretions, markers

to dialysis centers, and improved quality of life. Despite its numerous advantages, the peritoneal dialysis utilization has been static or diminishing in parts of the world. Peritoneal dialysis-related infections, such as peritonitis, exit-site infection or tunnel infection, is a major concern for patients, caregivers, and health professionals – which may result in hesitation to consider this as treatment

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odialysis Fistula Maturation (HFM) Study, we determined sensitivities, specificities, positive and negative predictive values of multiple candidate maturation criteria using the HFM Study maturation criteria as the reference. We also compared, across the maturation criteria, relationships between maturation and fistula survival using Cox proportional hazards models. Results: We included 535 of the

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treatment for the primary prevention of cardiovascular disease. Combination therapies consisted of at least two BP-lowering drugs and a statin, with or without aspirin versus placebo or minimal care. Here, we examine the differential effect of fixed-dose combination treatment on the risk of developing cardiovascular disease in participants with a low eGFR (<60 ml/min per 1.73 m2; Chronic Kidney Disease

chronic kidney disease (CKD). We present the case of a 66-year-old woman with diabetic kidney disease who underwent a protocol KPMP kidney biopsy. Her clinical history included diabetes mellitus complicated by neuropathy and eye disease, increased insulin resistance, hypertension, albuminuria, and relatively preserved glomerular filtration rate (early CKD stage 3a). The patient’s histopathology was

gher risk of kidney diseases, including end-stage kidney disease. The mechanisms underlying these associations remain poorly understood. We utilized proteomic profiling to gain insight into the pathobiology of sickle cell trait. Methods: We measured proteomics (N=1,285 proteins assayed by Olink Explore) using baseline plasma samples from 592 African American participants with sickle cell trait and

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promoting home dialysis is presented, and the literature supporting it is critically reviewed. Randomized comparisons of home HD and PD with in-center HD have been challenging to conduct and provide only limited information. Nonrandomized studies are heterogeneous in their design and have often yielded conflicting results. They are prone to bias, and this must be carefully considered when evaluating

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examine how odds of PD use changed by demographic characteristics. The incident PD population increased by 203% from 2009 to 2019, and the odds of PD use increased in every subgroup. PD use increased more among older people, as the odds for those aged ≥75 years increased 15% more per five-year period compared with individuals aged 18-44 years. (OR 1.68, 95% confidence interval [CI] 1.64-1.73 versus

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o limit potentially inappropriate medications use. Our objective was to identify clinicians and patient perspectives on factors related to deprescribing to inform design of a deprescribing program for dialysis clinics. Methods We conducted rapid qualitative analysis of semistructured interviews and focus groups with clinicians (dialysis clinicians, primary care providers, and pharmacists) and patients

iation with the development of disease manifestations is needed to determine the need for Fabry-specific treatment and appropriate frequency of follow-up because clinical manifestations of the disorder may take decennia to develop. Methods We investigated the levels of plasma lysoGb3 levels over time and its association with disease manifestations and disease course in 237 untreated patients with Fabry

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