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Rationale and objective Acute kidney injury (AKI) is common among hospitalized children and is associated with increased hospital length of stay and costs. However, there are limited data on post-discharge healthcare utilization after AKI hospitalization. Our objectives were to evaluate healthcare utilization and physician follow-up patterns after pediatric dialysis-treated AKI. Study design Retrospective

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In the past decade, advances in the validation of surrogate end points for chronic kidney disease (CKD) progression have heightened interest in evaluating therapies in early CKD. In December 2020, the National Kidney Foundation sponsored a scientific workshop in collaboration with the US Food and Drug Administration (FDA) to explore patient, provider, and payor perceptions of the value of treating

Focal and segmental glomerulosclerosis (FSGS) is a histological lesion due to many causes including rare mutations of podocyte related genes. Recently, it has been found that TBC1D8B mutations can lead to early-onset FSGS and steroid-resistant nephrotic syndrome (NS) by influencing endocytic and recycling of nephrin. Here, we report a 19-year-old Chinese patient with NS and normal renal function. He

Calciphylaxis is a life-threatening complication most often associated with chronic kidney disease that occurs due to the deposition of calcium in dermal and adipose microvasculature. However, this condition may also be seen in patients with acute kidney injury. The high morbidity and mortality associated with calciphylaxis highlight the importance to correctly diagnose and treat this condition. However

Rationale & Objective Patients with advanced chronic kidney disease (CKD) have been reported to experience profound psychosocial distress. Other work has established that patients with CKD from marginalized populations (including individuals who on the basis of race often face racism and related discrimination, termed “racialization”) experience health care inequities. Given limited information on

Rationale and Objective The safety and efficacy of long-term exercise training in reducing physical functional loss in older adults with advanced CKD and co-morbidity is uncertain. Study Design Multi-center, parallel group, randomized controlled trial. Settings and Participants Adults 55 years and older with CKD stage G3b-4 enrolled from centers in Baltimore and Boston. Intervention Twelve months of

Rare cases of IgG-dominant immune complex mediated GN (ICGN) demonstrate immunoglobulin (Ig) subclass restriction without light chain restriction. Some of these cases may represent proliferative glomerulonephritis with monotypic immunoglobulin deposits (PGNMID) in which monotypic Ig is obscured by coexisting polytypic Ig. However, rigorous demonstration of this possibility is lacking to date. Here

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Rationale & Objective Collaborative approaches to vascular access (VA) selection are being increasingly encouraged to elicit patients’ preferences and priorities where no unequivocally superior choice exists. We aimed to explore how patients, their caregivers, and clinicians integrate principles of shared decision-making when engaging in VA discussions. Study Design Qualitative description. Setting

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Rationale & Objective Risk-prediction tools for assisting acute kidney injury (AKI) management have focused on AKI onset but have infrequently addressed kidney recovery. We developed clinical models for risk-stratification of mortality and major adverse kidney events in critically ill patients with incident AKI. Study Design Multicenter cohort study. Setting & Participants 9,587 adult patients admitted

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Rationale & Objective Lumasiran reduces urinary and plasma oxalate (POx) in patients with primary hyperoxaluria type 1 (PH1) and relatively preserved kidney function. ILLUMINATE-C evaluates the efficacy, safety, pharmacokinetics, and pharmacodynamics of lumasiran in patients with PH1 and advanced kidney disease. Study Design Phase 3, open-label, single-arm trial. Setting & Participants Multinational

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Adenosine deaminase 2 (ADA2) deficiency is a rare autosomal recessive disease, caused by loss-of-function mutations in the ADA2 gene, and is considered a monogenic form of polyarteritis nodosa (PAN) with frequently positive type I interferon (IFN-I) signature. Renal manifestations in ADA2 deficiency are poorly characterised. We herein report two cases of ADA2 deficiency with different kidney patterns

Rationale & Objective Lower estimated glomerular filtration rate (eGFR) is associated with heart failure (HF) risk. However, eGFR based on cystatin C (eGFRcys) and creatinine (eGFRcr) may differ substantially within an individual. The clinical implications of these differences for risk of HF among persons with chronic kidney disease (CKD) are unknown. Study Design Prospective cohort study. Setting

Rationale & Objective Treatment of asymptomatic hyperuricemia is not commonly implemented. However, it is unclear whether urate deposition that begins during asymptomatic hyperuricemia can induce nephropathy. Dysfunction of ATP-binding cassette subfamily G member 2 (ABCG2), a urate efflux transporter, leads to elevated serum urate concentration (SUA). We investigated the association between asymptomatic

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Ammonium is a major urinary buffer that is necessary for the normal excretion of the daily acid load. Its urinary rate of excretion (UNH4) may be increased several fold in the presence of extrarenal metabolic acidosis. Therefore, measurement of UNH4 can provide important clues about causes of metabolic acidosis. Because UNH4 is not commonly measured in clinical laboratories, the urinary anion gap (UAG)

Evaluation of hematuria and microscopic examination of urine sediment are commonly used tools by nephrologists in their assessment of glomerular diseases. Certain morphological aspects of urine red blood cells (RBCs) seen by microscopy may help in identifying the source of hematuria as glomerular or not. Recognized signs of glomerular injury are RBC casts or dysmorphic RBCs, in particular acanthocytes

Rationale & Objective Children with kidney disease and primary hypertension may be more vulnerable to COVID-19 disease. We examined COVID-19 vaccine hesitancy among parents of children with CKD or hypertension. Study Design Sequential explanatory mixed-methods design; survey followed by in-depth interviews. Setting & Participants Parents of children <18 years with kidney disease or primary hypertension

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Rationale & objectives Ambulatory blood pressure (ABP) monitoring allows concurrent evaluation of BP control and nocturnal BP dipping status, both related to adverse outcomes. However, very few studies have assessed the prognostic role of combining information on dipping status and achieved ABP in patients with chronic kidney disease (CKD). Study Design Prospective observational cohort study. Setting

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Rationale & Objective Little is known about the risk of cardiovascular disease (CVD) in patients with various primary glomerular diseases. In a population-level cohort of adults with primary glomerular disease, we sought to describe the risk of CVD compared to the general population and the impact of traditional and kidney-related risk factors on CVD risk. Study Design Observational cohort study. Setting

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RATIONALE & OBJECTIVE Allopurinol should be started at lower doses in patients with chronic kidney disease (CKD) to avoid adverse effects. We examined the risk of severe cutaneous reactions in older adults with CKD who were newly prescribed allopurinol at varied doses. STUDY DESIGN Population-based cohort study using linked health care databases. SETTING & PARTICIPANTS Patients in Ontario, Canada (2008-2019)

Uncontrolled hypertension persists as an important health issue, despite the availability of many medications, and non-drug therapies, which lower blood pressure. Increasingly, non-adherence to medication is found in about 2 out of 5 patients with uncontrolled hypertension. In the search for interventions which lower blood pressure without reliance upon adhering to a regimen requiring daily ingestion

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