Enough is enough: Targeted eculizumab withdrawal in atypical haemolytic uremic syndrome
The introduction of the complement-C5 inhibitor eculizumab has greatly benefitted patients with atypical hemolytic uremic syndrome (aHUS). Initially, eculizumab was proposed as life-long therapy, a societal burden because of its very high costs. Based on limited data, restrictive treatment strategies have been proposed with therapeutic drug monitoring, eculizumab tapering, or early withdrawal.(1) However, the PROS and CONS of such strategies have not been defined. A recent study by Fakhouri and colleagues published in Blood sought to address the feasibility of eculizumab withdrawal in patients with aHUS.(2) (Source: Kidney International)
Source: Kidney International - March 2, 2021 Category: Urology & Nephrology Authors: R.N. Bouwmeester, N.C.A.J. van de Kar, J.F.M. Wetzels Tags: nephrology digest Source Type: research

Zero healthcare-associated respiratory viral infections: impact of enhanced infection prevention on a renal unit during the COVID-19 pandemic
We read with interest the study by Thaunat et al. that identified significant excess mortality attributed to COVID-19 amongst dialysis patients.1 Indeed, the COVID-19 pandemic has provided the impetus for the introduction of strategies to optimise protection of hemodialysis patients from SARS-CoV-2.2 Outside the pandemic setting, however, patients with chronic-kidney-disease have significantly higher risk of nosocomial acquisition of other common respiratory-viral-infections (RVIs), with increased mortality and length-of-stay. (Source: Kidney International)
Source: Kidney International - March 2, 2021 Category: Urology & Nephrology Authors: Liang En Wee, Chieh Suai Tan, Edwin Philip Conceicao, Indumathi Venkatachalam Tags: letters to the editor Source Type: research

PIEZO2, a mechanosensor in the urinary bladder.
The functions of the lower urinary tract to store and eliminate urine are regulated by complex neural pathways that coordinate the activity of the smooth and striated muscles of the bladder, urethra, and urethral sphincters.1 Besides control by the central nervous system, micturition reflexes are triggered by bladder filling that stretches the bladder wall and by urine flow in the urethra that triggers a urethra-to-bladder reflex facilitating bladder contraction and emptying. Both the urothelium and the mechanically sensitive afferents from the dorsal root ganglia are involved in stretch and pressure detection. (Source: Kidney International)
Source: Kidney International - March 2, 2021 Category: Urology & Nephrology Authors: Philippe Gailly, Olivier Devuyst Tags: nephrology digest Source Type: research

Suggestions for the prevention of clostridioides difficile spread within outpatient hemodialysis facilities
In this report, a panel of experts in clinical nephrology, infectious diseases, and infection prevention provide guidance, based on expert opinion and published literature, aimed at preventing the spread of CDI in outpatient hemodialysis facilities. (Source: Kidney International)
Source: Kidney International - March 2, 2021 Category: Urology & Nephrology Authors: E.M.C. D ’Agata, I.W. Apata, S. Booth, J.M. Boyce, K. Deaver, N. Gualandi, A. Neu, D. Nguyen, S. Novosad, P.M. Palevsky, D. Rodgers, the Nephrologist Transforming Dialysis Safety Committee Tags: editorial: special report Source Type: research

Decreased monocyte calcium sensing receptor expression in patients with chronic kidney disease is associated with impaired monocyte ability to reduce vascular calcification.
In chronic kidney disease (CKD), calcium-sensing receptor (CaSR) expression and function have been extensively studied in parathyroid tissue and vascular tissues. To examine whether similar changes occurred in other tissues, we measured total and surface CaSR expression in monocytes of patients with various stages of CKD and healthy volunteers respectively in cross-sectional studies. We further explored in vitro the impact of uremic serum on CaSR expression in monocytes (U937 and THP-1 cell lines), and whether human peripheral blood mononuclear cells or U937 and THP-1 monocytes might modify vascular calcium deposition in r...
Source: Kidney International - February 26, 2021 Category: Urology & Nephrology Authors: Thibaut Objois, Aur élien Mary, Michel Brazier, Y. Bennis, Cédric Boudot, Gaëlle Lenglet, Julien Paccou, Jean-Marc Bugnicourt, Gabriel Choukroun, Tilman B. Drueke, Ziad A. Massy, Saïd Kamel, Isabelle Six, Romuald Mentaverri R Tags: basic research Source Type: research

Removing Race from GFR Estimates: Balancing Potential Benefits and Unintended Consequences
In recent years, there has been growing concern about the use of race, a social construct, in medical decision-making (1-4). Calls for change reached a new volume in 2020, sparked by widespread protests against systemic racism in the United States (US). Recognizing significant racial disparities in kidney health in the US and worldwide, questions have been raised about the inclusion of race in equations to estimate creatinine-based GFR (eGFRCr)(2). (Source: Kidney International)
Source: Kidney International - February 26, 2021 Category: Urology & Nephrology Authors: Anika Lucas, Christina Wyatt, Lesley A. Inker Tags: nephrology digest Source Type: research

Kidney Disorders as Serious Adverse Drug Reactions of Remdesivir in Covid-19: A Retrospective Case-Non case Study
Remdesivir is a novel adenosine-like nucleotide analogue, representing the first drug approved for coronavirus disease 2019 (Covid-19), albeit an uncertain clinical relevance. In clinical trials and case series, acute kidney injury (AKI), including renal replacement, have been frequently reported.1,2 Although causality is debatable, kidney injuries especially proximal tubular epithelial cell necrosis have also been observed in animal studies during remdesivir development. (Source: Kidney International)
Source: Kidney International - February 25, 2021 Category: Urology & Nephrology Authors: Laurent Chouchana, Laure-H élène Preta, Mylène Tisseyre, Benjamin Terrier, Jean-Marc Treluyer, François Montastruc Tags: letters to the editor Source Type: research

Searching for the origin of the myofibroblast one cell at a time
Chronic kidney disease (CKD), regardless of the initial injury, is often characterized by relentless progression with ultimate development of tubular atrophy, interstitial fibrosis, and glomerulosclerosis. The extent of tubulointerstitial fibrosis is the morphologic parameter most closely associated with decreased glomerular filtration rate (1). Interstitial fibrosis and tubular atrophy (IF/TA) almost invariably develop in parallel and increased IF/TA is a morphologic indicator of poor prognosis across the full spectrum of kidney diseases. (Source: Kidney International)
Source: Kidney International - February 25, 2021 Category: Urology & Nephrology Authors: Agnes B. Fogo Tags: nephrology digest Source Type: research

Presence of a survival benefit of HLA-incompatible living donor kidney transplantation compared to waiting or HLA-compatible deceased donor kidney transplantation with a long waiting time.
HLA-incompatible living donor kidney transplantation (LDKT) is one of efforts to increase kidney transplantation opportunity for sensitized patients with kidney failure. However, there are conflicting reports for outcomes of HLA-incompatible kidney transplantation compared to patients who wait for HLA-compatible deceased donor kidney transplantation (DDKT) in the United States and United Kingdom. Waiting for an HLA-compatible DDKT is relatively disadvantageous in Korea, because the average waiting time is more than five years. (Source: Kidney International)
Source: Kidney International - February 25, 2021 Category: Urology & Nephrology Authors: Tai Yeon Koo, Ju Han Lee, Sang-Il Min, Yonggu Lee, Myung Soo Kim, Jongwon Ha, Soon Il Kim, Curie Ahn, Yu Seun Kim, Jayoun Kim, Kyu Ha Huh, Jaeseok Yang Tags: clinical investigation Source Type: research

KDIGO 2021 Clinical Practice Guideline for the Management of Blood Pressure in Chronic Kidney  Disease
The development and publication of this guideline were supported by KDIGO. The opinions or views expressed in this professional education supplement are those of the authors and do not necessarily reflect the opinions or recommendations of the International Society of Nephrology or Elsevier. Dosages, indications, and methods of use for products that are referred to in the supplement by the authors may reflect their clinical experience or may be derived from the professional literature or other clinical sources. (Source: Kidney International)
Source: Kidney International - February 23, 2021 Category: Urology & Nephrology Authors: Kidney Disease: Improving Global Outcomes (KDIGO) Blood Pressure Work Group Tags: Practice Guideline Source Type: research

Editorial Board
(Source: Kidney International)
Source: Kidney International - February 23, 2021 Category: Urology & Nephrology Source Type: research

Subscription Information
(Source: Kidney International)
Source: Kidney International - February 23, 2021 Category: Urology & Nephrology Source Type: research

Title Page
(Source: Kidney International)
Source: Kidney International - February 23, 2021 Category: Urology & Nephrology Source Type: research

Table of Contents
(Source: Kidney International)
Source: Kidney International - February 23, 2021 Category: Urology & Nephrology Source Type: research

Hyperphosphatemia in chronic kidney disease exacerbates atherosclerosis via a mannosidases-mediated complex-type conversion of SCAP N-glycans
Blood phosphate levels are linked to atherosclerotic cardiovascular disease in patients with chronic kidney disease (CKD), but the molecular mechanisms remain unclear. Emerging studies indicate an involvement of hyperphosphatemia in CKD accelerated atherogenesis through disturbed cholesterol homeostasis. Here, we investigated a potential atherogenic role of high phosphate concentrations acting through aberrant activation of sterol regulatory element-binding protein (SREBP) and cleavage-activating protein (SCAP)-SREBP2 signaling in patients with CKD, hyperphosphatemic apolipoprotein E (ApoE) knockout mice, and cultured vasc...
Source: Kidney International - February 22, 2021 Category: Urology & Nephrology Authors: Chao Zhou, Quan He, Hua Gan, Tingting Zeng, Qiao Liu, John F. Moorhead, Zac Varghese, Nan Ouyang, Xiong Z. Ruan Tags: basic research Source Type: research

Proteinuria converts hepatic heparan sulfate to an effective proprotein convertase subtilisin kexin type 9 enzyme binding partner
In this study, we investigated the effects of proteinuria on PCSK9, hepatic heparan sulfate proteoglycan and plasma triglyceride-rich remnant lipoproteins. (Source: Kidney International)
Source: Kidney International - February 17, 2021 Category: Urology & Nephrology Authors: Pragyi Shrestha, Saleh Yazdani, Romain R. Viv ès, Rana El Masri, Wendy Dam, Bart van de Sluis, Jacob van den Born Tags: basic research Source Type: research

Making human collecting ducts and modelling disease in the laboratory
Human pluripotent stem cells (hPSCs) are derived from early embryos (embryonic SCs) or made by regressing mature tissues (induced PSCs). Theoretically, such cells have the potential to form all tissue types. Reasons to generate kidney tissues from hPSCs include: understanding normal kidney development; modeling kidney disorders; and making kidney cells for regenerative medicine therapies.1 (Source: Kidney International)
Source: Kidney International - February 16, 2021 Category: Urology & Nephrology Authors: Adrian S. Woolf Tags: nephrology digest Source Type: research

The time of onset of intradialytic hypotension during a hemodialysis session associates with clinical parameters and mortality.
Intradialytic hypotension (IDH) is a common complication of hemodialysis, but there is no data about the time of onset during treatment. Here we describe the incidence of IDH throughout hemodialysis and associations of time of hypotension with clinical parameters and survival by analyzing data from 21 dialysis clinics in the United States to include 785682 treatments from 4348 patients. IDH was defined as a systolic blood pressure of 90 mmHg or under while IDH incidence was calculated in 30-minute intervals throughout the hemodialysis session. (Source: Kidney International)
Source: Kidney International - February 16, 2021 Category: Urology & Nephrology Authors: David F. Keane, Jochen G. Raimann, Hanjie Zhang, Joanna Willetts, M.S. Stephan Thijssen, Peter Kotanko Tags: clinical investigation Source Type: research

A multicenter blinded preclinical randomized controlled trial on Jak1/2 inhibition in MRL/MpJ-Faslpr mice with proliferative lupus nephritis predicts low effect size.
Data reproducibility and single-center bias are concerns in preclinical research and compromise translation from animal to human. Multicenter preclinical randomized controlled trials (pRCT) may reduce the gap between experimental studies and RCT and improve the predictability of results, for example Jak1/2 inhibition in lupus nephritis. To evaluate this, we conducted the first pRCT in the kidney domain at two Spanish and two German academic sites. Eligible MRL/MpJ-Faslpr mice (female, age13-14 weeks, stress scores of less than two and no visible tumor or signs of infection) were equally randomized to either oral treatment ...
Source: Kidney International - February 16, 2021 Category: Urology & Nephrology Authors: Yutian Lei, Bettina Sehnert, Reinhard E. Voll, Conxita Jacobs-Cach á, Maria Jose Soler, Maria D. Sanchez-Niño, Alberto Ortiz, Roman D. Bülow, Peter Boor, Hans-Joachim Anders Tags: basic research Source Type: research

The urgent need to vaccinate dialysis patients against severe acute respiratory syndrome coronavirus 2: a call to action
The coronavirus disease 2019 (COVID-19) pandemic is causing extreme stress to many health systems and an ever-mounting death toll. Out of the darkness of the last 14 months comes a beacon of hope in the form of multiple severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines. To best utilize this precious resource, we must efficiently deploy vaccination to high-risk groups. (Source: Kidney International)
Source: Kidney International - February 11, 2021 Category: Urology & Nephrology Authors: Anna Francis, Colin Baigent, T. Alp Ikizler, Paul Cockwell, Vivekanand Jha Tags: Editorial Source Type: research

The urgent need to vaccinate dialysis patients against SARS-CoV-2: A call to action
The COVID-19 pandemic is causing extreme stress to many health systems and an ever-mounting death toll. Out of the darkness of the last 14 months comes a beacon of hope in the form of multiple SARS-Cov-2 vaccines. To best utilize this precious resource, we must efficiently deploy vaccination to high-risk groups. (Source: Kidney International)
Source: Kidney International - February 11, 2021 Category: Urology & Nephrology Authors: Anna Francis, Colin Baigent, T. Alp Ikizler, Paul Cockwell, Vivekanand Jha Tags: editorial Source Type: research

Glomerular filtrate affects the dynamics of podocyte detachment in a model of diffuse toxic podocytopathy
Podocyte injury and subsequent detachment are hallmarks of progressive glomerulosclerosis. In addition to cell injury, unknown mechanical forces on the injured podocyte may promote detachment. To identify the nature of these mechanical forces, we studied the dynamics of podocyte detachment using sequential ultrastructural geometry analysis by transmission electron microscopy in NEP25, a mouse model of podocytopathy induced by anti-Tac(Fv)-PE38 (LMB2), a fusion protein attached to Pseudomonas exotoxin A, targeting CD25 on podocytes. (Source: Kidney International)
Source: Kidney International - February 11, 2021 Category: Urology & Nephrology Authors: Nobuyuki Saga, Kazuo Sakamoto, Taiji Matsusaka, Michio Nagata Tags: basic research Source Type: research

Glomerular basement membrane nephritis: crescentic renal inflammation and immunosuppressive intervention in the time of the severe acute respiratory syndrome coronavirus 2 pandemic
The diagnosis and management of autoimmune disorders is challenging in the current pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Here, we describe the case of a patient with anti –glomerular basement membrane disease complicated by a SARS-CoV-2 infection to highlight the importance of appropriate immunosuppression and individualized care in respect of these 2 disease processes. (Source: Kidney International)
Source: Kidney International - February 10, 2021 Category: Urology & Nephrology Authors: Silke R. Brix, Rachel B. Jones, David R.W. Jayne Tags: Letter to the Editor Source Type: research

GBM nephritis - Crescentic renal inflammation and immunosuppressive intervention in the time of the SARS-CoV-2 pandemic
the diagnosis and management of autoimmune disorders is challenging in the current pandemic of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Here, we describe the case of a patient with anti-glomerular-basement-membrane (GBM) disease complicated by a SARS-CoV-2 infection to highlight the importance of appropriate immunosuppression and individualized care in respect of these two disease processes. (Source: Kidney International)
Source: Kidney International - February 10, 2021 Category: Urology & Nephrology Authors: Silke R. Brix, Rachel B. Jones, David R.W. Jayne Tags: letters to the editor Source Type: research

AI Applications in Renal Pathology
The explosive growth of artificial intelligence (AI) technologies, especially deep learning methods, has been translated at revolutionary speed to efforts in AI-assisted healthcare. New applications of AI to renal pathology have recently become available, driven by the successful AI deployments in digital pathology. However, synergetic developments of renal pathology and AI require close interdisciplinary collaborations between computer scientists and renal pathologists. Computer scientists should understand that not every AI innovation is translatable to renal pathology, while renal pathologists should capture high-level ...
Source: Kidney International - February 10, 2021 Category: Urology & Nephrology Authors: Yuankai Huo, Ruining Deng, Quan Liu, Agnes B. Fogo, Haichun Yang Tags: review Source Type: research

Uromodulin fights UTI with sugars
Modification of host receptor proteins with sugars, or glycosylation, is essential for the binding of many pathogens. For instance, Group B streptococcus, Helicobacter pylori, and uropathogenic Type 1 fimbriated Escherichia coli (UPEC), among others, all bind to sugars present on the membrane proteins of epithelial cells. In a recent study published in Science, Weiss et al. have shown that a specific glycosylation on uromodulin is required for it to bind UPEC and prevent colonization of bladder epithelia. (Source: Kidney International)
Source: Kidney International - February 4, 2021 Category: Urology & Nephrology Authors: Andrew Beenken, Qais Al-Awqati Tags: nephrology digest Source Type: research

Whole exome sequencing of large populations: identification of loss of function alleles and implications for inherited kidney diseases
Technological advances in next-generation DNA sequencing now allow fast and cost-effective sequencing of the ‘exome’, defined as all the exons in the genome. Such is the rapidity and accessibility of this technique that whole exome sequencing (WES) is becoming a first-line diagnostic tool for the investigation of many diseases, including cancers, metabolic disorders, and childhood neurodevelopmental di sorders. (Source: Kidney International)
Source: Kidney International - February 4, 2021 Category: Urology & Nephrology Authors: Robert Geraghty, Eric Olinger, John A. Sayer Tags: nephrology digest Source Type: research

Fungal papillary necrosis with the “ring sign”
A 35-year-old man with no comorbidities presented with a fever of 100 °F, vomiting, and low backache of 3 days’ duration. Examination revealed a soft abdomen with tenderness in the left renal angle. Laboratory investigations showed a raised total leukocyte count of 12,500 cells/mm3 with a differential of polymorphs of 85%, lymphocytes of 15%, and serum creatinine l evel of 4.3 mg/dl. Urine examination was positive for leukocyte esterase and nitrites with 50 to 60 white blood cells per high-power field. (Source: Kidney International)
Source: Kidney International - January 26, 2021 Category: Urology & Nephrology Authors: Satish Mendonca, Rohit Tewari, Arun Dua, Devika Gupta, Giriraj Singh Tags: Nephrology Image Source Type: research

Multiorgan infarcts from aortic thromboembolic disease
A 60-year-old woman presented to the emergency department for abdominal pain, lethargy, and decrease in appetite. (Source: Kidney International)
Source: Kidney International - January 26, 2021 Category: Urology & Nephrology Authors: Sarah B. Eid, Roy A. Raad, Najat I. Joubran Tags: Nephrology Image Source Type: research

The Case | Acute kidney injury associated with chronic myelomonocytic leukemia
A 70-year-old man with a history of high blood pressure and multiple ischemic strokes was diagnosed with stage 2 chronic myelomonocytic leukemia in 2014. At diagnosis, estimated glomerular filtration rate was normal (100 ml/min per 1.73 m2). Bone marrow aspiration showed 15% blasts, for which azacytidine was prescribed. The patient refused the recommended treatment, and hydroxyurea was introduced instead. (Source: Kidney International)
Source: Kidney International - January 26, 2021 Category: Urology & Nephrology Authors: Inna Mohamadou, David Buob, Marion Rabant, J érémy Pichon, Stéphane Gaudry, Yosu Luque, Eric Rondeau, Isabelle Brocheriou, Cédric Rafat Tags: Make Your Diagnosis Source Type: research

The Case | A 64-year-old woman with retroperitoneal fibrosis, acute kidney injury, and active urine sediment
A 64-year-old female ex-smoker with a past medical history of retroperitoneal fibrosis, hypertension, and psoriasis was treated with bilateral robotic ureterolysis for stent-dependent ureteric obstruction from retroperitoneal fibrosis (negative for IgG4). Four weeks later, she presented for scheduled stent removal and routine blood tests. She reported feeling nauseous and tired after the ureterolysis procedure but denied flank pain or fever. Urine output was normal, and physical examination was unremarkable. (Source: Kidney International)
Source: Kidney International - January 26, 2021 Category: Urology & Nephrology Authors: Rute Aguiar, Allifia Abbas, Catherine Horsfield, Dimitrios-Anestis Moutzouris Tags: Make Your Diagnosis Source Type: research

“To take or not to take an aspirin?” The age-old question of cardiovascular disease primary prevention for people with chronic kidney disease
Despite the higher risk of cardiovascular events in patients with chronic kidney disease, the role of aspirin for primary prevention is unclear. In the current issue, Wolfe et  al. present a subgroup analysis of the ASPirin in Reducing Events in the Elderly (ASPREE) trial that suggests there was no reduction in cardiovascular events but bleeding events were doubled. Aspirin cannot be recommended for primary prevention in chronic kidney disease, but the continuation of on going research, such as the Aspirin To Target Arterial Events in Chronic Kidney Disease (ATTACK trial), is warranted. (Source: Kidney International)
Source: Kidney International - January 26, 2021 Category: Urology & Nephrology Authors: Rupert W. Major, James O. Burton Tags: Commentary Source Type: research

Untangling immunotactoid glomerulopathy in the MGRS era
Immunotactoid glomerulopathy (ITG) is a rare disease diagnosed by kidney biopsy showing characteristic microtubules, often in parallel arrays, in glomeruli on electron microscopy. Most cases are caused by lymphoproliferative disorders that produce monoclonal immunoglobulins that cause kidney damage, but these disorders do not meet criteria for overt malignancy. The published literature on ITG is limited. In this issue of Kidney International, 2 manuscripts provide significant insight into the clinical presentation, pathology, and treatment of ITG. (Source: Kidney International)
Source: Kidney International - January 26, 2021 Category: Urology & Nephrology Authors: Jonathan J. Hogan, Dan T. Vogl Tags: Commentary Source Type: research

Therapeutic transformation for diabetic kidney disease
Risks of kidney failure and heart failure are markedly reduced by inhibition of the sodium glucose cotransporter 2 (SGLT2) in patients with diabetic kidney disease. In a post hoc analysis of the Study of Diabetic Nephropathy with Atrasentan (SONAR) trial, drop-in SGLT2 inhibitor usage during the atrasentan enrichment period led to greater reduction in albuminuria compared with atrasentan alone. These data support the hypothesis of greater longer-term kidney protection by combination SGLT2 inhibition and endothelin A receptor antagonism that could be tested in future clinical trials. (Source: Kidney International)
Source: Kidney International - January 26, 2021 Category: Urology & Nephrology Authors: Katherine R. Tuttle, David Z.I. Cherney Tags: Commentary Source Type: research

Incretin-based drugs and the kidney in type 2 diabetes: choosing between DPP-4 inhibitors and GLP-1 receptor agonists
The treatment of people with type 2 diabetes (T2D) has changed substantially in the last decade. Three novel glucose-lowering drug classes —incretin-based therapies and sodium‒glucose cotransporter-2 inhibitors—entered clinical guidelines with evidence from now 18 landmark trials.1 Glucose-lowering drugs were historically approved on glycated hemoglobin (HbA1C)-lowering and safety in several hundred T2D participants over only sev eral months; since 2008, regulatory agencies have required randomized, controlled trials (RCTs) focusing on cardiovascular (CV) safety (cardiovascular outcome trials, CVOTs) involvin...
Source: Kidney International - January 26, 2021 Category: Urology & Nephrology Authors: Johannes F.E. Mann, Marcel H.A. Muskiet Tags: Controversies in Nephrology Source Type: research

Not only incretins for diabetic kidney disease —beneficial effects by DPP-4 inhibitors
Incretin hormones, such as glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide, are secreted in response to high blood glucose levels and stimulate insulin release from pancreatic β cells. Under normal conditions, GLP-1 is rapidly degraded at the N-terminus by dipeptidylpeptidase-4 (DPP-4). To overcome this rapid degradation, both pharmacologic inhibition of DPP-4 and DPP-4‒resistant GLP-1 analogs with extended half-life in the body were developed for the purpose of treat ing type 2 diabetes mellitus. (Source: Kidney International)
Source: Kidney International - January 26, 2021 Category: Urology & Nephrology Authors: Masaomi Nangaku, Christoph Wanner Tags: Controversies in Nephrology Source Type: research

Cardiovascular and renal risk reduction in  type 2 diabetes---which choice?
Type 2 diabetes mellitus is a major risk factor for both cardiovascular and kidney disease, with a shorter life expectancy than in people without diabetes. Until the last decade, the main therapeutic focus was on management of hyperglycemia, although the correction of associated abnormalities such as dyslipidemia, hypertension, hypercoagulability, obesity, and insulin resistance, were important secondary therapeutic goals.1 Close glycemic control was shown to exert beneficial effects on diabetes-specific microvascular complications, including retinopathy, nephropathy, and neuropathy. (Source: Kidney International)
Source: Kidney International - January 26, 2021 Category: Urology & Nephrology Authors: Tilman B. Drueke Tags: Controversies in Nephrology Source Type: research

Living well with kidney disease by patient and care-partner empowerment: kidney health for everyone everywhere
Living with chronic kidney disease (CKD) is associated with hardships for patients and their care partners. Empowering patients and their care partners, including family members and friends involved in their care, may help minimize the burden and consequences of CKD-related symptoms to enable increased life participation. There is a need to broaden the focus on living well with kidney disease and reengagement in life, including emphasis on the patient being in control. The World Kidney Day (WKD) Joint Steering Committee has declared 2021 the year of “Living Well with Kidney Disease” in an effort to increase edu...
Source: Kidney International - January 26, 2021 Category: Urology & Nephrology Authors: Kamyar Kalantar-Zadeh, Philip Kam-Tao Li, Ekamol Tantisattamo, Latha Kumaraswami, Vassilios Liakopoulos, Siu-Fai Lui, Ifeoma Ulasi, Sharon Andreoli, Alessandro Balducci, Sophie Dupuis, Tess Harris, Anne Hradsky, Richard Knight, Sajay Kumar, Maggie Ng, Ali Tags: Editorial: Special Report Source Type: research

Hyponatremia under MAP kinase inhibitors: a complex relationship between aquaporins and ERK activation
We read with interest the recent review by Workeneh et  al.1 related to the epidemiologic and pathophysiological issues of hyponatremia in cancer. Our group recently reported data about hyponatremia under mitogen-activated protein kinase inhibitors in melanoma.2 We hypothesized that B-Raf (BRAF)/mitogen-activated protein kinase kinase inhibitors could activate aquaporin-2 trafficking in tubular epithelia from intracellular sites to the luminal membrane and discussed potential mechanisms underlying the complex relationship between aquaporins and extracellular signal–regulated kinase (ERK) activation. (Source: Kidney International)
Source: Kidney International - January 26, 2021 Category: Urology & Nephrology Authors: Florence Assan, Ziad A. Massy Tags: Letter to the Editor Source Type: research

Results of the PROPINE randomized controlled trial: determining the ever-elusive target, the optimal plan for relapses of nephrotic syndrome in children
This study reinforces the need for more well-designed studies and the incorporation of predictive biomarkers, genetic studies, and other details to personalize treatment for each child with idiopathic NS. (Source: Kidney International)
Source: Kidney International - January 26, 2021 Category: Urology & Nephrology Authors: John D. Mahan, Mahmoud Kallash, William E. Smoyer Tags: Commentary Source Type: research

Validation of the ANCA renal risk score in a London cohort: potential impact of treatment on prediction outcome
A risk score using 3 clinicopathologic parameters was developed by Brix et  al.1 to predict renal survival at 36 months in patients with newly diagnosed antineutrophil cytoplasm antibody–associated glomerulonephritis.1 Smith et al. validated the tool in 102 Scottish patients.2 (Source: Kidney International)
Source: Kidney International - January 26, 2021 Category: Urology & Nephrology Authors: Pek Ghe Tan, Jennifer O ’Brien, Charles D. Pusey, Stephen P. McAdoo Tags: Letter to the Editor Source Type: research

The authors reply
We would like to thank Tan et  al.1 for validating and confirming our antineutrophil cytoplasm antibody (ANCA) renal risk score.2 In a retrospective, single-center London cohort of 178 patients, the score determined renal survival dependent on patients’ risk groups at the 36-month follow-up (P  (Source: Kidney International)
Source: Kidney International - January 26, 2021 Category: Urology & Nephrology Authors: Silke R. Brix, Rolf A.K. Stahl, Thorsten Wiech Tags: Letter to the Editor Source Type: research

Induction and maintenance therapy of lupus nephritis: an obituary
There was a period when most trials testing new drugs for lupus nephritis (LN) failed, although the presumed pathogenesis of LN, preclinical data, and uncontrolled clinical studies had inspired great confidence about these novel drugs in the lupus community. Therefore, these failures raised concerns about trial design, study endpoints, disease heterogeneity, choice of study populations, and other underlying assumptions that may compromise trial outcomes. In 2016, the International Society of Nephrology held a Nexus meeting in Berlin, Germany, where physicians, clinical trialists, basic scientists, representatives from indu...
Source: Kidney International - January 26, 2021 Category: Urology & Nephrology Authors: Hans-Joachim Anders, Yutian Lei, Brad H. Rovin Tags: Editorial Source Type: research

Diagnosis and management of Bartter syndrome: executive summary of the consensus and recommendations from the European Rare Kidney Disease Reference Network Working Group for Tubular Disorders
Bartter syndrome is a rare inherited salt-losing renal tubular disorder characterized by secondary hyperaldosteronism with hypokalemic and hypochloremic metabolic alkalosis and low to normal blood pressure. The primary pathogenic mechanism is defective salt reabsorption predominantly in the thick ascending limb of the loop of Henle. There is significant variability in the clinical expression of the disease, which is genetically heterogenous with 5 different genes described to date. Despite considerable phenotypic overlap, correlations of specific clinical characteristics with the underlying molecular defects have been demo...
Source: Kidney International - January 26, 2021 Category: Urology & Nephrology Authors: Martin Konrad, Tom Nijenhuis, Gema Ariceta, Aurelia Bertholet-Thomas, Lorenzo A. Calo, Giovambattista Capasso, Francesco Emma, Karl P. Schlingmann, Mandeep Singh, Francesco Trepiccione, Stephen B. Walsh, Kirsty Whitton, Rosa Vargas-Poussou, Detlef Bockenh Tags: Executive Summary Source Type: research

Improving medication adherence in patients with lupus nephritis
Patients with systemic lupus erythematosus (SLE) with kidney involvement run a high risk of end-stage kidney disease —reaching levels as high as 10% at 10 years—that is partially explained by nonadherence. As with many other chronic diseases, nonadherence to treatment is the rule and perfect adherence the exception. Thus, a Canadian study assessing primary nonadherence in various conditions found that as many as 31% of the 37,506 first prescriptions were never collected from the pharmacy within 9 months. (Source: Kidney International)
Source: Kidney International - January 26, 2021 Category: Urology & Nephrology Authors: Nathalie Costedoat-Chalumeau, Frederic A. Houssiau Tags: Editorial Source Type: research

Cardiac screening prior to renal transplantation —good intentions, rather than good evidence, dictate practice
Cardiovascular disease is the leading cause of death in kidney transplant recipients in many transplant registries. An analysis of transplant recipients from the United Kingdom using propensity score matching (PSM) suggests there are limited or no benefits to cardiovascular screening before transplant listing. We suggest that short of a randomized controlled trial (RCT) in this area, these data are sufficient to suggest that transplant centers should reflect on their current protocols for cardiovascular workup required before transplantation. (Source: Kidney International)
Source: Kidney International - January 26, 2021 Category: Urology & Nephrology Authors: Alastair J. Rankin, Patrick B. Mark Tags: Commentary Source Type: research

Longitudinal SARS-CoV-2 seroconversion and functional heterogeneity in a pediatric dialysis unit
Health care settings have a high risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spread and high seroconversion rates.1,2 Dialysis units are at high risk for SARS-CoV-2 exposure because of frequent close patient contact, a highly mobile patient population, and open bay formats that limit social distancing.3 (Source: Kidney International)
Source: Kidney International - January 26, 2021 Category: Urology & Nephrology Authors: Jorge J. Canas, Michelle C. Starr, Jenaya Hooks, Samuel Arregui, Amy C. Wilson, Aaron E. Carroll, Vijay Saxena, Fatima Amanat, Florian Krammer, Jeffrey Fill, Andrew Schade, Antonio Chambers, Jack Schneider, Andrew L. Schwaderer, David S. Hains Tags: Letter to the Editor Source Type: research

Decline and loss of anti –SARS-CoV-2 antibodies in kidney transplant recipients in the 6 months following SARS-CoV-2 infection
The dynamics of immune response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in kidney transplant recipients (KTRs) remains largely unknown. KTRs have been reported to develop serological responses to SARS-CoV-2.1,2 However, information about the duration and significance of antibody response in this immunocompromised population is still critically lacking. We herein report anti –SARS-CoV-2 IgG trajectory in a cohort of KTRs followed at Necker Hospital (Paris, France) between 2 and 6 months after symptomatic coronavirus disease 2019 (COVID-19) infection. (Source: Kidney International)
Source: Kidney International - January 26, 2021 Category: Urology & Nephrology Authors: Nathalie Chavarot, Marianne Leruez-Ville, Anne Scemla, Carole Burger, Lucile Amrouche, Claire Rouzaud, Xavier Lebreton, Frank Martinez, Rebecca Sberro-Soussan, Christophe Legendre, Julien Zuber, Dany Anglicheau Tags: Letter to the Editor Source Type: research

In This Issue
The Study of Diabetic Nephropathy With Atrasentan (SONAR) and Evaluation of the Effects of Canagliflozin on Renal and  Cardiovascular Outcomes in Participants With Diabetic Nephropathy (CREDENCE) trials showed kidney-protective effects of an endothelin A receptor antagonist (ERA) and a sodium glucose co-transporter 2 (SGLT2) inhibitor in patients with type-2 diabetes and chronic kidney disease, respectively. A lim iting effect of ERA is fluid retention, and diuresis is a consequence of SGLT2 inhibition. (Source: Kidney International)
Source: Kidney International - January 26, 2021 Category: Urology & Nephrology Tags: In This Issue Source Type: research

Are new treatments for lupus nephritis on the horizon?
Severe lupus nephritis (LN) is generally classified based on proliferative and membranous histology, as well as clinical features of proteinuria and decreased glomerular filtration rate. Current therapies for severe LN historically result in complete remission rates of   (Source: Kidney International)
Source: Kidney International - January 26, 2021 Category: Urology & Nephrology Authors: Ellen M. Ginzler Tags: Nephrology Digest Source Type: research