Machine learning: it takes more than select models to draw general conclusions
We read with great interest the article by Truchot et al., in which the authors compared the performance of a select subset of machine learning (ML) models with their previously developed and commercially promoted Cox-based prognostication system (iBox). They concluded that, in general, ML models do not outperform the Cox-based prognostication system measured by Harrell's concordance index, discrimination, and calibration.1 It is important to realize that this conclusion is only valid for the limited number of ML models tested, and thus does not necessarily apply to the broader field of ML (Figure 1). (Source: Kidney International)
Source: Kidney International - October 18, 2023 Category: Urology & Nephrology Authors: Tamas Szili-Torok, Uwe J.F. Tietge, Max J. Verbeek, Stephan J.L. Bakker, Martin H. de Borst Tags: Letter to the Editor Source Type: research
Corrigendum to “Successful kidney-alone transplantation in a patient with PH1 on combination RNA-interference therapy.” Kidney International, 2023;104:203–204
DOI of original article: 10.1016/j.kint.2023.04.009 (Source: Kidney International)
Source: Kidney International - October 18, 2023 Category: Urology & Nephrology Authors: Elisabeth L. Metry, Lisa J. Deesker, Sander F. Garrelfs, Michiel J.S. Oosterveld, Kerensa M. Beekman, Elisabeth A.M. Cornelissen, Linda Koster-Kamphuis, Jaap W. Groothoff Tags: Corrigendum Source Type: research
The authors reply
Wei et al.1 argue that the observed outcome differences in our study addressing use of diuretics and calcium channel blockers (CCBs) on top of renin-angiotensin system inhibitors2 might be explained by residual confounding. Although this is a limitation of any observational study, including ours, we do n ot believe their concerns are likely to invalidate our findings. The Kidney Disease: Improving Global Outcomes (KDIGO) guidelines recommend maximum-tolerated renin-angiotensin system inhibitor dose for these patients. (Source: Kidney International)
Source: Kidney International - October 18, 2023 Category: Urology & Nephrology Authors: Anne-Laure Faucon, Juan-Jes ús Carrero Tags: Letter to the Editor Source Type: research
Initiation of diuretics or calcium channel blockers on the top of renin-angiotensin system inhibitors on kidney outcome: which is better?
We appreciate the study performed by Faucon et al.1 and have read it with great interest. The authors conducted a nationwide, well-matched cohort study involving 5875 patients with nondialysis chronic kidney disease (CKD) stage 3–5. The study found that using a diuretic rather than a calcium channel blocker on top of renin-angiotensin system inhibitor (RASi) might improve kidney outcomes (CKD progression) without compromising cardioprotection. RASi is widely recognized as the first-line antihypertensive drug for patients with CKD,2 but there is no optimal recommendation for the choice of second-line antihypertensive th...
Source: Kidney International - October 18, 2023 Category: Urology & Nephrology Authors: Shiyuan Wei, Licong Su, Qi Gao Tags: Letter to the Editor Source Type: research
Predicting pediatric kidney disease progression —are 3 variables all you need?
Accurate estimation of chronic kidney disease (CKD) progression risk is vital for clinical decision-making. Existing risk equations lack validation in pediatric CKD populations. Ng et al. developed new risk equations using the CKD in Children and European Study Consortium for Chronic Kidney Disorders Affecting Pediatric Patients cohorts. The elementary model, incorporating estimated glomerular filtration rate, urine protein-creatinine ratio, and diagnosis, exhibited excellent d iscrimination and calibration at external validation. (Source: Kidney International)
Source: Kidney International - October 18, 2023 Category: Urology & Nephrology Authors: Clarkson R. Crane, Pranav S. Garimella, Georg Heinze Tags: Commentary Source Type: research
The latest model has just arrived! A new experimental mouse model of PLA2R1-associated membranous nephropathy
Much akin to the explosion in number of known target antigens in membranous nephropathy, there has been a rapid expansion in the availability of animal models involving the first 2 antigens discovered in adult disease, phospholipase A2 receptor and thrombospondin type 1 domain-containing 7A. In this issue, Tomas et al. describe a novel mouse model of phospholipase A2 receptor–associated membranous nephropathy that shows great promise for investigating molecular mechanisms of disease and as an experimental system for testing existing and emerging therapies. (Source: Kidney International)
Source: Kidney International - October 18, 2023 Category: Urology & Nephrology Authors: Laurence H. Beck Tags: Commentary Source Type: research
Urinary stone disease: closing the heritability gap by challenging conventional Mendelian inheritance
Urinary stone disease is based on gene-environment interaction with an almost 50% heritability. Despite all efforts from exome-sequencing and genome-wide association studies, the genetic factors making up for observed heritability have been incompletely characterized. The study by Sadeghi-Alavijeh et al. leverages the invaluable resources of the 100,000 Genomes Project and the UK Biobank to identify heterozygous rare variants in the phosphate transporter SLC34A3 as a significant factor of urinary stone disease, challenging the traditional concept of Mendelian inheritance. (Source: Kidney International)
Source: Kidney International - October 18, 2023 Category: Urology & Nephrology Authors: Jan Halbritter Tags: Commentary Source Type: research
in this issue
Tomas et al. developed a mouse that expresses a chimeric human/murine phospholipase A2 receptor 1 (PLA2R1) in podocytes. This chimeric receptor incorporates 3 key regions (fibronectin type II, cysteine rich, and C-type lectin domain-1) of human PLA2R1 with 7 murine domains. Although the mice are healthy at birth, if they are immunized with human PLA2R1, they develop antibodies to the receptor and subsequently nephrotic syndrome with typical membranous nephropathy (MN) histology. Using this model, the investigators determined that in the absence of complement component C3, PLA2R1-immunized chimeric mi ce developed an atte...
Source: Kidney International - October 18, 2023 Category: Urology & Nephrology Tags: In This Issue Source Type: research
journal club
Roccatello et al. (Nat Med. 2023;29:2041–2047.) (Source: Kidney International)
Source: Kidney International - October 18, 2023 Category: Urology & Nephrology Tags: Journal Club Source Type: research
Matrix metalloproteinase 10 and the slow demise of the peritoneal membrane
Matrix metalloproteinases (MMPs) cleave matrix components along with multiple other effects. They are integral to virtually all biological processes, including inflammation and wound healing. As such, MMPs have been studied in the context of peritoneal membrane injury. MMP10 is a stromelysin and is involved in the degradation of matrix proteoglycans. Ishimura et al. demonstrate that MMP10 is involved in peritoneal membrane fibrosis. The clinical implications of these observations are presently unknown. (Source: Kidney International)
Source: Kidney International - October 18, 2023 Category: Urology & Nephrology Authors: Peter J. Margetts Tags: Commentary Source Type: research
Editorial Board
(Source: Kidney International)
Source: Kidney International - October 18, 2023 Category: Urology & Nephrology Source Type: research
Subscription Information
(Source: Kidney International)
Source: Kidney International - October 18, 2023 Category: Urology & Nephrology Source Type: research
Table of Contents
(Source: Kidney International)
Source: Kidney International - October 18, 2023 Category: Urology & Nephrology Source Type: research
Abnormal lactate metabolism is linked to albuminuria and kidney injury in diabetic nephropathy
Diabetic nephropathy (DN) is characterized by abnormal kidney energy metabolism, but its causes and contributions to DN pathogenesis are not clear. To examine this issue, we carried out targeted metabolomics profiling in a mouse model of DN that develops kidney disease resembling the human disorder. We found a distinct profile of increased lactate levels and impaired energy metabolism in kidneys of mice with DN, and treatment with an angiotensin-receptor blocker (ARB) reduced albuminuria, attenuated kidney pathology and corrected many metabolic abnormalities, restoring levels of lactate toward normal while increasing kidne...
Source: Kidney International - October 16, 2023 Category: Urology & Nephrology Authors: Kengo Azushima, Jean-Paul Kovalik, Takahiro Yamaji, Jianhong Ching, Tze Wei Chng, Jing Guo, Jian-Jun Liu, Mien Nguyen, Rashidah Binte Sakban, Simi E. George, Puay Hoon Tan, Su Chi Lim, Susan B. Gurley, Thomas M. Coffman Tags: Basic Research Source Type: research
Multiple infusions of ex vivo-expanded regulatory T cells promote CD163+ myeloid cells and kidney allograft survival in non-lymphodepleted non-human primates
Clinical verification of adoptively transferred regulatory T cell (Treg) efficacy in transplantation remains challenging. Here, we examined the influence of autologous ex vivo-expanded polyclonal Tregs on kidney graft survival in a clinically relevant non-human primate model. Peripheral blood Tregs were isolated and expanded using artificial antigen presenting cells. Immunosuppression was comprised of tapered tacrolimus and CTLA4 immunoglobulin, in five animals eac h without or with Treg infusions. (Source: Kidney International)
Source: Kidney International - October 13, 2023 Category: Urology & Nephrology Authors: Kazuki Sasaki, Masahiko Kubo, Yu-chao Wang, Lien Lu, Veronica Vujevich, Michelle A. Wood-Trageser, Kayla Golnoski, Andrew Lesniak, Vikraman Gunabushanam, Armando Ganoza, Martin J. Wijkstrom, Abhinav Humar, Anthony J. Demetris, Angus W. Thomson, Mohamed B. Tags: Basic Research Source Type: research
