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
Targeting immune cell glutamyl-prolyl-transfer RNA synthetase 1 (EPRS1) to prevent fibrosis after tubulointerstitial nephritis
Glutamyl-prolyl-transfer RNA synthetase 1 is an enzyme that connects glutamic acid and proline to transfer RNA during protein synthesis. In this issue, a study by Kang et al. examined the role of the immune cell glutamyl-prolyl-transfer RNA synthetase 1 in toxin-induced tubulointerstitial nephritis mice. The study demonstrated that blocking glutamyl-prolyl-transfer RNA synthetase 1 may be a therapeutic target to attenuate fibrosis after toxin-induced tubulointersti tial nephritis. (Source: Kidney International)
Source: Kidney International - April 18, 2024 Category: Urology & Nephrology Authors: Shishir Kumar Patel, Hamid Rabb Tags: Commentary Source Type: research
WIP1 inhibition as a new therapeutic strategy for collapsing glomerulopathy
This study highlights the complex interplay of glomerular signaling pathways in CG and offers hope for targeted therapies. (Source: Kidney International)
Source: Kidney International - April 18, 2024 Category: Urology & Nephrology Authors: Shreeram Akilesh Tags: Commentary Source Type: research
A pig kidney supporting human physiology
Because of the global shortage of donor kidneys, xenotransplantation emerges as a potential solution for individuals with kidney failure who face challenges in securing a suitable donor kidney. A study featured in this month ’s issue of Kidney International assesses the kidney physiology of a porcine kidney transplanted into a brain-dead human with kidney failure, demonstrating life-sustaining physiological function for 7 days. Together with preclinical nonhuman primate studies, decedent models provide complementary d ata for development of clinical kidney xenotransplantation. (Source: Kidney International)
Source: Kidney International - April 18, 2024 Category: Urology & Nephrology Authors: Stuart J. Knechtle, Joseph M. Ladowski, Jean Kwun Tags: Commentary Source Type: research
The Ottawa Statement implementation guidance document for cluster randomized trials in the hemodialysis setting
Research teams are increasingly interested in using cluster randomized trial (CRT) designs to generate practice-guiding evidence for in-center maintenance hemodialysis. However, CRTs raise complex ethical issues. The Ottawa Statement on the Ethical Design and Conduct of Cluster Randomized Trials, published in 2012, provides 15 recommendations to address ethical issues arising within 7 domains: justifying the CRT design, research ethics committee review, identifying research participants, obtaining informed consent, gatekeepers, assessing benefits and harms, and protecting vulnerable participants. (Source: Kidney International)
Source: Kidney International - April 18, 2024 Category: Urology & Nephrology Authors: Cory E. Goldstein, Monica Taljaard, Stuart G. Nicholls, Mary Beaucage, Jamie Brehaut, Charles L. Cook, Brenden B. Cote, Jonathan C. Craig, Stephanie N. Dixon, Jessica Du Toit, Catherine C.S. Du Val, Amit X. Garg, Jeremy M. Grimshaw, Shasikara Kalatharan, Tags: Editorial: Special Report Source Type: research
Seeing through the density of dense deposit disease
This study presents the novel finding that large accumulations of apolipoprotein E are present in the deposits of DDD, as revealed by mass spectroscopy and confirmed by both confocal microscopy and immunohistochemistry. The findings suggest a new modality for diagnosis of DDD and introduce potential new mechanisms for understanding DDD pathophysiology. (Source: Kidney International)
Source: Kidney International - April 18, 2024 Category: Urology & Nephrology Authors: Charles E. Alpers Tags: Commentary Source Type: research
journal club
Ishikawa et al. (Bone marrow plasma cells require P2RX4 to sense extracellular ATP. Nature. 2024;626:1102–1107.) (Source: Kidney International)
Source: Kidney International - April 18, 2024 Category: Urology & Nephrology Tags: Journal Club Source Type: research
in this issue
Gosselink et al. examined the effects of Alport syndrome (AS) on pregnancy outcomes and kidney function on a cohort of patients after the 20th week of gestation from the ALPART-Network (mAternaL and fetal PregnAncy outcomes of women with AlpoRT syndrome). Patients were stratified by the inheritance pattern of their AS into X-lined AS, autosomal dominant AS, and autosomal recessive AS. Most patients had X-linked AS. Neonatal outcomes were good overall in terms of gestational age and birth weight. (Source: Kidney International)
Source: Kidney International - April 18, 2024 Category: Urology & Nephrology Tags: In This Issue Source Type: research
