Rationale & Objective Prior studies have demonstrated the diagnostic potential of urinary chemokines CXCL9 and CXCL10 for kidney transplant rejection. However, their benefit in addition to clinical information has not been demonstrated. We evaluated the diagnostic performance for detecting acute rejection of urinary CXCL9 and CXCL10 when integrated with clinical information. Study Design Single-center

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Rationale & Objective Rituximab is the first-choice therapy for patients with primary membranous nephropathy (MN) and nephrotic syndrome (NS). However, approximately 30% of patients are treatment-resistant or become treatment-intolerant with hypersensitivity reactions upon repeated drug exposures. We aimed to assess whether ofatumumab, a fully human second-generation anti-CD20 antibody, could be a

Rationale & Objective Atrial fibrillation (AF) and chronic kidney disease (CKD) often coexist. However, it is not known whether CKD is an independent risk factor for incident AF. Therefore, we evaluated the association between markers of CKD, estimated glomerular filtration rate (eGFR) and albuminuria, and incident AF. Study Design Systematic review and meta-analysis of cohort studies and randomized

IgA nephropathy (IgAN) is the most common glomerular disease in the world. However, the approach to treatment remains controversial. There has been an explosion of clinical trials over the past decade both further examining corticosteroid use and ushering in additional treatment considerations, including two newly approved therapies for IgAN. Sodium glucose cotransporter-2 inhibitors are proving to

Rationale & Objective Outcomes of kidney transplantation for patients with renal AA amyloidosis are uncertain, with reports of poor survival and high rates of disease recurrence. However, data are inconclusive and mostly based on studies from the early 2000s and earlier. Study Design Retrospective multicenter cohort study. Setting & Participants We searched the French national transplant database to

Rationale & Objective Apathy reflects diminished motivation, goal-directed behavior, and emotions, as well as less engagement in social interactions. Apathy overlaps with depression and is associated with cognitive decline. In the older individuals with chronic kidney disease (CKD), both depression and cognitive impairments are common, but apathy symptoms have been underreported. We investigated the

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Rationale & Objective Frailty is common in individuals with chronic kidney disease (CKD) and increases the risk of adverse outcomes in adults with kidney failure requiring dialysis. However, this relationship has not been thoroughly evaluated among those with non-dialysis dependent CKD. Study Design Prospective cohort study. Setting & Participants: 2,539 adults in the Chronic Renal Insufficiency Cohort

Rationale & Objective Membranoproliferative glomerulonephritis (MPGN), encompassing several distinct diseases, is a rare but significant cause of kidney failure in the US. Potential etiologies of MPGN are unclear, but prior studies have suggested dysregulation of the alternative complement pathway, and recently, autoimmunity as potential mechanisms driving MPGN pathogenesis. In this study, we examined

Rationale & Objective Survivors of acute kidney injury (AKI) are at high risk of adverse outcomes. Monitoring of kidney function, screening for proteinuria, use of statins and renin-angiotensin-aldosterone system inhibitors (RAASi), and nephrology follow-up among survivors have not been fully characterized. We sought to examine these processes of care after discharge in survivors of hospitalized AKI

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A 68-year-old woman with autosomal dominant polycystic kidney disease (ADPKD) on hemodialysis was admitted for progressive dyspnea over 6 months. On chest X-ray, her cardiothoracic ratio (CTR) had increased from 52.2% 6 months prior, to 71%, and echocardiography revealed diffuse pericardial effusion and right ventricular diastolic insufficiency. A resultant pericardial tamponade was thought to be the

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Rationale & Objective Due to the high risk of waitlist mortality and post-transplant complications, kidney transplant (KT) patients may benefit from advance care planning (ACP) and palliative care consultation (PCC). We quantified the prevalence and racial disparities in ACP and PCC among KT candidates and recipients. Study Design Prospective cohort study Setting & Participants 2,575 adult KT candidates

Monoclonocal gammopathy with cryoactivity (i.e. cryoglobulins) that causes glomerulonephritis is considered within the spectrum of monoclonal gammopathy of renal significance (MGRS). Cryofibrinogenemia (cryoactivity of coagulation factors) is very rarely associated with glomerulonephritis. We present a 39 year old woman with a relapsing nephrotic syndrome. Laboratory investigation detected cryofibrinogen

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Rationale & Objective Urinary biomarkers of injury, inflammation and repair may help phenotype observed AKI in clinical trials. We evaluated differences in biomarkers between those randomized to monotherapy or to combination RAAS blockade in VA NEPHRON-D, acknowledging an increased proportion of observed AKI in the combination arm. Study Design Longitudinal analysis. Setting & Participants: A sub-study

Rationale & Objective Vaccination for influenza is strongly recommended for people with chronic kidney disease (CKD) due to their immunocompromised state. Identifying risk factors for not receiving an influenza vaccine (“non-vaccination”) could inform strategies for improving vaccine uptake in this high-risk population. Study Design Longitudinal observational study. Setting & Participants: 3,692 Chronic

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Rationale & Objective Genetic etiologies have been identified among approximately 10% of adults with chronic kidney disease. However, data are lacking regarding the prevalence of monogenic etiologies especially among members of minority groups. The objective of this study was to characterize the genetic markers among members of an Israeli minority group with end-stage kidney disease (ESKD). Study Design

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We present a rare case of a patient with toluene exposure manifesting as anti-GBM disease on a background of PLA2R-associated membranous nephropathy. A 23-year-old man presented to the emergency department with hypertension, headache, hemoptysis, anemia, acute kidney injury, glomerular hematuria, and proteinuria. He endorsed repeated exposure to toluene-containing products while repairing dirt bikes

Treatment of hypertension to decrease rates of cardiovascular disease is the most well studied and most broadly applicable treatment in cardiovascular prevention. Blood pressure can be measured anywhere, not just in a physician’s office; medications are readily available, inexpensive, and have highly favorable benefit/harm ratios with relatively minimal side effects; stepped medication regimens can

Rational & Objective Uromodulin (UMOD) is the most abundant protein found in urine and has emerged as a promising biomarker of tubule health. Circulating UMOD is also detectable, but at lower levels. We evaluated whether serum UMOD levels were associated with risk of incident kidney failure with replacement therapy (KFRT) and mortality. Study Design Prospective cohort. Setting & Participants: Participants

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Rationale & Objective Chronic kidney disease (CKD) leads to lipid and metabolic abnormalities, but a comprehensive investigation of lipids, lipoprotein particles, and circulating metabolites associated with the risk of CKD is lacking. We examined the associations of nuclear magnetic resonance (NMR)-based metabolomics data with CKD risk in the UK Biobank study. Study Design Observational cohort study

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Rationale & Objective Optimal approaches to treat secondary hyperparathyroidism (SHPT) in patients on maintenance hemodialysis (HD) are not established in randomized controlled trials (RCTs). Study Design Two observational clinical trial emulations. Setting & Participants: Both emulations included adults receiving in-center HD from a national dialysis organization. Included patients had SHPT in the

Rationale & Objective Patients with glomerular disease (GN) may be at increased risk of severe COVID-19, yet concerns over vaccines causing disease relapse may lead to vaccine hesitancy. We examined the associations of COVID-19 with longitudinal kidney function and proteinuria and compared these to similar associations with COVID-19 vaccination. Study Design Observational cohort study from July 1,

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Rationale & Objective Poor glycemic control may contribute to the high mortality rate in patients with type 2 diabetes receiving hemodialysis. Insulin type may influence glycemic control and its choice may be an opportunity to improve outcomes. This study assessed if treatment with analog insulin compared to human insulin is associated with different outcomes in people with type 2 diabetes and kidney

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Rationale & Objective Cross-sectional studies have reported an association of chronic kidney disease-associated pruritus (CKD-aP) with adverse clinical events and patient-reported outcomes (PROs). We studied the longitudinal associations between changes in CKD-aP and clinical outcomes among patients receiving maintenance hemodialysis. Study Design Prospective cohort study. Setting & Participants 7976

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Kidney stone disease, also known as nephrolithiasis or urolithiasis, is a disorder in which urinary solutes precipitate to form aggregates of crystalline material in the urinary space. The incidence of nephrolithiasis has been increasing, and the demographics have been evolving. Once viewed as a limited disease with intermittent exacerbations that are simply managed by urologists, nephrolithiasis is

Declining kidney function in Tuberous Sclerosis Complex (TSC) is often attributed to large lesions, including angiomyolipomas (AMLs) and cysts, that encroach on the normal parenchyma or that require intervention and loss of parenchyma from surgical debulking or embolization. Consequently, research on inhibitors of the mammalian target of rapamycin (mTOR), a protein complex implicated in TSC pathophysiology

Concerns about hyperkalemia may result in the under-utilization of established and novel therapies that improve kidney and/or cardiovascular outcomes in patients with type 2 diabetes (T2D) and chronic kidney disease (CKD). Hyperkalemia-related issues are of particular relevance in patients with CKD who are commonly on other hyperkalemia-inducing agents such as renin-angiotensin-aldosterone system inhibitors

Rationale & Objective Kidney failure is an established risk factor for active tuberculosis (TB) but the risk of TB has not been reported in specific kidney diseases. We sought to determine the incidence of and risk factors for active TB in patients with glomerular disease. Study Design Observational cohort study. Setting & Participants A provincial kidney pathology registry (2000-2012) was used to

Rationale & Objective Research on shared decision making (SDM) in chronic kidney disease (CKD) has focused almost exclusively on the modality of kidney replacement treatment. We aimed to explore what other CKD decisions are recognized by patients, what their preferences and experiences are regarding these decisions, and how decisions are made during their interactions with medical care professionals

Rationale & Objective While some evidence exists of increased dementia risk from anemia, it is unclear if this association persists among adults with CKD. Anemia may be a key marker for dementia among adults with CKD. We therefore evaluated if anemia is associated with an increased risk of dementia among adults with CKD. Study Design Retrospective cohort study. Setting & Participants The study included