Monoclonal Immunoglobulin Crystalline Nephropathies
Monoclonal immunoglobulin (MIg) crystalline nephropathies are rare lesions resulting from precipitation of MIgs in the kidney as crystalline inclusions. They can be categorized into lesions with predominant intracellular crystals (light chain [LC] proximal tubulopathy, LC crystal-storing histiocytosis, LC crystalline podocytopathy] and lesions with predominant extracellular crystals (crystalglobulin-induced nephropathy, crystalline variant of LC cast nephropathy). The majority of these lesions are associated with low tumor burden lymphoproliferative disorders, with the exception of crystalline variant of LC cast nephropath...
Source: Kidney International - May 7, 2024 Category: Urology & Nephrology Authors: Samih H. Nasr, Christophe Sirac, Nelson Leung, Frank Bridoux Tags: mini review Source Type: research
Frailty in Patients on Dialysis
Frailty is a condition that is frequently observed among patients performing dialysis. It is characterised by a decline in both physiological and cognitive state, leading to a combination of symptoms such as weight loss, exhaustion, low physical activity, weakness, and slow walking speed. Frail patients not only experience a poor quality of life, but they are also at a higher risk of hospitalization, infection, cardiovascular events, dialysis-associated complications, and death.Frailty occurs as a result of a combination and interaction of various medical issues in patients who are on dialysis. (Source: Kidney International)
Source: Kidney International - May 3, 2024 Category: Urology & Nephrology Authors: Gordon Chun-Kau CHAN, Kamyar KALANTAR-ZADEH, Jack Kit-Chung NG, Na TIAN, Aine BURNS, Kai-Ming CHOW, Cheuk-Chun SZETO, Philip Kam-Tao LI Tags: review Source Type: research
Long-term impact of immediate versus deferred antiretroviral therapy on kidney health in people with HIV
People with human immunodeficiency virus (HIV) are at risk for chronic kidney disease (CKD) due to HIV and antiretroviral therapy (ART) nephrotoxicity. Immediate ART initiation reduces mortality and is now the standard of care, but the long-term impact of prolonged ART exposure on CKD is unknown. To evaluate this, the Strategic Timing of Antiretroviral Treatment (START) trial randomized 4,684 ART-na ïve adults with CD4 cell count under 500 cells/mm3 to immediate versus deferred ART. We previously reported a small but statistically significantly greater decline in estimated glomerular filtration rate (eGFR) over a median o...
Source: Kidney International - April 30, 2024 Category: Urology & Nephrology Authors: Annegret Pelchen-Matthews, Amanda Mocroft, Lene Ryom, Michael J. Ross, Shweta Sharma, Steven Coca, Amit Achhra, Elaine Cornell, Russell Tracy, Andrew Phillips, Marta Montero Alonso, Giota Toulomi, Brian K. Agan, Nicholas Medland, Christina M. Wyatt, INSIG Tags: clinical investigation Source Type: research
Podocyte-derived soluble RARRES1 drives kidney disease progression through direct podocyte and proximal tubular injury
Retinoic acid receptor responder protein-1 (RARRES1) is a podocyte-enriched transmembrane protein whose increased expression correlates with human glomerular disease progression. RARRES1 promotes podocytopenia and glomerulosclerosis via p53-mediated podocyte apoptosis. Importantly, the cytopathic actions of RARRES1 are entirely dependent on its proteolytic cleavage into a soluble protein (sRARRES1) and subsequent podocyte uptake by endocytosis, as a cleavage mutant RARRES1 exerted no effects in vitro or in vivo. (Source: Kidney International)
Source: Kidney International - April 30, 2024 Category: Urology & Nephrology Authors: Ye Feng, Zeguo Sun, Jia Fu, Fang Zhong, Weijia Zhang, Chengguo Wei, Anqun Chen, Bi-Cheng Liu, John C. He, Kyung Lee Tags: basic research Source Type: research
Assessment of biological organ age using molecular pathology in pre-transplant kidney biopsies.
Organ shortage is a major challenge in kidney transplantation but the use of older donors, often with co-morbidities, is hampered by inconsistent outcomes. Methods of accurately stratifying marginal donor organs by clinical and histological assessment are lacking. To better understand organ variability, we profiled the transcriptomes of 271 kidneys from deceased donors at retrieval. Following correction for biopsy composition, we assessed molecular pathways that associated with delayed, and sub-optimal one-year graft function. (Source: Kidney International)
Source: Kidney International - April 29, 2024 Category: Urology & Nephrology Authors: Roy Zhang, Patrick B. Trotter, James McCaffrey, Rory Fitzroy, Giorgio Trivioli, Benjamin J. Stewart, John R. Ferdinand, Kevin W. Loudon, Alexandra Riding, Jonathan West, Ashley Ferro, Menna R. Clatworthy Tags: basic research Source Type: research
High-dimensional Mass Cytometry identified circulating Natural Killer T-cell subsets associated with protection from Cytomegalovirus infection in kidney transplant recipients
Cytomegalovirus (CMV) infection is associated with poor kidney transplant outcomes. While innate and adaptive immune cells have been implicated in its prevention, an in-depth characterization of the in vivo kinetics of multiple cell subsets and their role in protecting against CMV infection has not been achieved. Here, we performed high-dimensional immune phenotyping by mass cytometry, and functional assays, on 112 serially collected samples from CMV seropositive kidney transplant recipients. Advanced unsupervised deep learning analysis was used to assess immune cell populations that significantly correlated with preventio...
Source: Kidney International - April 27, 2024 Category: Urology & Nephrology Authors: Laura Donadeu, Thomas Jouve, Sofia Bin, Susan Hartzell, Elena Crespo, Alba Torija, Marta Jarque, Delphine Kevella, Jos é Zúñiga, Weijia Zhang, Zeguo Sun, Alberto Verlato, Mónica Martínez-Gallo, Cristina Font-Miñarro, Maria Meneghini, Nestor Toapanta Tags: clinical investigation Source Type: research
A cohort study of sodium-glucose cotransporter-2 inhibitors after acute kidney injury among Veterans with diabetic kidney disease.
Sodium-glucose cotransporter-2 inhibitors (SGLT2i) reduce the risk for several adverse outcomes among patients with diabetic kidney disease. Yet, optimal timing for SGLT2i after acute kidney injury (AKI) is uncertain, as are the providers responsible for post-AKI SGLT2i initiation. Using a retrospective cohort of United States Veterans with diabetes mellitus type 2 and proteinuria, we examined encounters by provider specialty before SGLT2i initiation and subsequent all-cause mortality after hospitalization with AKI, defined by a 50% or more rise in serum creatinine. (Source: Kidney International)
Source: Kidney International - April 26, 2024 Category: Urology & Nephrology Authors: Daniel P. Murphy, Julian Wolfson, Scott Reule, Kirsten L. Johansen, Areef Ishani, Paul E. Drawz Tags: clinical investigation Source Type: research
Bacillus Calmette-Gu érin–induced kidney granulomas
A 59-year-old woman presented with asymptomatic right kidney masses on surveillance computed tomography. She underwent transurethral resection of the bladder tumor for urothelial carcinoma 3 months prior and received regular intravesical Bacillus Calmette-Gu érin therapy. Abdominal computed tomography showed multiple mild homogeneous enhancement masses in the right kidney (Figure 1a). Magnetic resonance imaging demonstrated masses with hyperintensity on the diffusion-weighted image (Figure 1b). Coronal contrast–enhanced magnetic resonance revealed masses with hypointensity located at the superior pole of the right kid...
Source: Kidney International - April 18, 2024 Category: Urology & Nephrology Authors: Xueyan Zhang, Huixiu Lian, Xiaolei Song, Jun Li Tags: Nephrology Image Source Type: research
The Case | Acute kidney injury in a patient with systemic necrotizing lesions
A 41-year-old male patient, who had been experiencing joint pain and weakness for the past 3 weeks, was admitted to the intensive care unit because of vasoplegic and cardiogenic shock, accompanied by multiorgan failure. Before the rapid deterioration of his clinical condition, his kidney function was normal (serum creatinine level, 89 μmol/l), with no proteinuria or hematuria. (Source: Kidney International)
Source: Kidney International - April 18, 2024 Category: Urology & Nephrology Authors: S ébastien Kissling, Samuel Rotman, Fadi Fakhouri Tags: Make Your Diagnosis Source Type: research
Calprotectin, a misnomer for another player in vascular calcification
Chronic kidney disease (CKD) is an important risk factor for cardiovascular complications. Both traditional and disease-specific risk factors contribute to the increased risk of cardiovascular complications in patients with CKD.1 Vascular calcification is closely associated with increased morbidity and mortality in patients with CKD,2 and addition of vascular calcification scores (especially coronary artery calcification score) to traditional risk factors improves prediction of cardiovascular risk in patients at different CKD stages. (Source: Kidney International)
Source: Kidney International - April 18, 2024 Category: Urology & Nephrology Authors: Tilman B. Drueke, Ziad A. Massy Tags: Nephrology Digest Source Type: research
B-cell lymphoma with intracellular crystals: a mimic of crystal-storing histiocytosis
A 74-year-old man with chronic kidney disease and splenic marginal zone lymphoma, diagnosed 3 years ago, status post bendamustine and rituximab and now on zanubrutinib due to recurrence, presented with acute kidney injury and proteinuria. On admission, he had a serum creatinine level of 2.7 mg/dl (baseline, ≈1.9 mg/dl), a urine protein-to-creatinine ratio of 5 g/g, and a serum albumin level of 3.2 g/dl. Serum protein electrophoresis showed IgGκ M protein. Serum free light chain ratio was 3.2. (Source: Kidney International)
Source: Kidney International - April 18, 2024 Category: Urology & Nephrology Authors: Michael G. Daniel, Craig R. Soderquist, Satoru Kudose Tags: Nephrology Image Source Type: research
Endogenous adenine as a key player in diabetic kidney disease progression: an integrated multiomics approach
Adenine is 1 of the 2 nitrogenous bases that form purine nucleotides in nucleic acids. Under physiological conditions, exogenous adenine is absorbed through the intestines, metabolized into several adenine derivatives, and excreted as uric acid by the kidneys. High doses of exogenous adenine can be metabolized into 2,8-dihydroxyadenine, which is deposited as crystals in the kidney tubules or interstitium, causing tubulointerstitial fibrosis, inflammation, and tubular atrophy.1 This approach is used to generate the adenine-induced chronic kidney disease (CKD) animal model, which has been widely used as a stable CKD model. (...
Source: Kidney International - April 18, 2024 Category: Urology & Nephrology Authors: Yu Ah Hong, Masaomi Nangaku Tags: Nephrology Digest Source Type: research
Deciphering interleukin 37's therapeutic potential: insights into alleviating inflammation in autosomal dominant polycystic kidney disease
We were intrigued by the article “Modulating Inflammation with Interleukin 37 Treatment Ameliorates Murine Autosomal Dominant Polycystic Kidney Disease,” by Zylberberg et al.1 The study focused on the therapeutic potential of interleukin 37 (IL37) in autosomal dominant polycystic kidney disease (ADPKD).1 IL37, an anti-inflamma tory cytokine, demonstrated promise in reducing collecting duct cyst burden by modulating the interferon signaling pathway in kidney resident macrophages.1 Notably, this modulation occurred without a concurrent increase in macrophage numbers, highlighting the nuanced and context-dependent impact...
Source: Kidney International - April 18, 2024 Category: Urology & Nephrology Authors: Cheng Xue, Chenchen Zhou, Lijun Sun, Liming Zhang, Zhiguo Mao Tags: Letter to the Editor Source Type: research
Levamisole in childhood idiopathic nephrotic syndrome: new promises, and advocacy for global access
This study suggests that both of these st rategies are efficacious and safe. Results of this study should redefine the role of levamisole in future guidelines, and a call for global availability of levamisole should be advocated. (Source: Kidney International)
Source: Kidney International - April 18, 2024 Category: Urology & Nephrology Authors: Eugene Yu-hin Chan, Olivia Boyer Tags: Commentary Source Type: research
Hereditary hypophosphatemic rickets with hypercalciuria (HHRH), a complex disorder in need of precision medicine
Hereditary hypophosphatemic rickets with hypercalciuria is an autosomal recessive phosphate-wasting disorder, associated with kidney and skeletal pathologies, which is caused by pathogenic variants of SLC34A3. In this issue, Zhu et al. describe a pooled analysis of 304 individuals carrying SLC34A3 variants. Their study underscores the complexity of hereditary hypophosphatemic rickets with hypercalciuria, as kidney and bone phenotypes generally do not coexist, heterozygous carriers of SLC34A3 variants also can be affected, an d the response to oral phosphate supplementation is dependent on the genetic status. (Source: Kidney International)
Source: Kidney International - April 18, 2024 Category: Urology & Nephrology Authors: Thorsten Schinke, Ralf Oheim Tags: Commentary Source Type: research
