Pediatric kidney dimensions and risk of persistent albuminuria in Mexican adolescents
In Mexico, chronic kidney disease of unknown origin is highly prevalent. Screening studies in adolescents have shown persistent microalbuminuria (pACR), adaptive podocytopathy and decreased kidney volume (KV). Here, we sought to develop normality tables of kidney dimensions by ultrasound in the Mexican state of Aguascalientes pediatric population (0 to 18y) and evaluate the relationship between the KV and pACR among the region ´s adolescents in a cross-sectional study. Kidney length (KL) and KV were determined by ultrasound. (Source: Kidney International)
Source: Kidney International - January 24, 2024 Category: Urology & Nephrology Authors: M ónica Linneth Alcalde-Ortiz, Fernando Jaramillo-Arriaga, Daniel Ibarra-Orenday, Salomón Israel González-Domínguez, Héctor David Calzada-Gallegos, Alma Alejandra Pinales-Jiménez, Itzel Alondra Carrillo-Aguilera, Dimitri Alejandro Flota-Marin, Maria Tags: clinical investigation Source Type: research
Sweet phosphate in the proximal tubule
Phosphorus is present in the body as both organic and inorganic phosphate. Eighty-five percent of body inorganic phosphate (Pi) is found within bone and teeth, 15% is located inside cells, and less than 1% is present in the extracellular fluid. Within cells, phosphate participates in the control of key enzymatic processes and serves as an essential structural component of nucleic acids and phospholipid membranes. Normal plasma phosphate concentrations in adults range from 0.8 to 1.4 mmol/l with known circadian fluctuation; plasma phosphate concentration is the lowest in the morning and is significantly higher in the aftern...
Source: Kidney International - January 18, 2024 Category: Urology & Nephrology Authors: Pascal Houillier Tags: Nephrology Digest Source Type: research
Sodium zirconium cyclosilicate mimicking enteric radiocontrast
A 66-year-old woman with a history of cryptogenic cirrhosis complicated by hepatocellular carcinoma underwent a living donor liver transplant. Her course was complicated by hilar bleeding and shock requiring surgical repair. After a complicated postoperative course, she was eventually discharged home. One month later, the patient presented to the emergency department with hypotension and bradycardia. Electrocardiography showed junctional rhythm with rate of 40/min. Laboratory tests revealed hyperkalemia, with a serum potassium level of 6.2 mEq/L, which was treated with a single 10-g dose of sodium-zirconium cyclosilicate (...
Source: Kidney International - January 18, 2024 Category: Urology & Nephrology Authors: Farid Arman, Daniel Kadosh, Pietro Canetta Tags: Nephrology Image Source Type: research
Anakinra-associated renal amyloidosis
A 28-year-old woman with genetically confirmed neonatal-onset multisystem inflammatory disease with a history of central nervous system inflammation complicated with severe sensorineural hearing loss, optic nerve atrophy, and neurocognitive delay, presented with new onset of proteinuria (1.1 g/d, predominantly albuminuria). She started treatment with anakinra injections (5 mg/kg/d) at the age of 9 years and is currently receiving 450 mg/d. Caregivers noticed subcutaneous nodules at the injection site, which were biopsied and showed amyloidosis. (Source: Kidney International)
Source: Kidney International - January 18, 2024 Category: Urology & Nephrology Authors: Samih H. Nasr, Sara Alehashemi, Surendra Dasari, Meryl Waldman, Behdad Afzali, April Chiu, Jonathan Bolanos, Raphaela Goldbach-Mansky, Ellen D. McPhail Tags: Nephrology Image Source Type: research
The Case | Neonatal seizures and tubular dysfunction in childhood: joining the dots!
A male infant was delivered to a primigravida mother at 35 weeks (due to severe maternal preeclampsia), weighing 3270 g, with Apgar scores 9 and 9 at 1 and 5 minutes, respectively. The parents were nonconsanguineous with no significant family history. At 6 hours of life, the infant developed respiratory distress and seizures and needed mechanical ventilation in the neonatal intensive care unit with i.v. antibiotics and supportive treatment. The neonate was found to have persistent hypoglycemia (with nadir of blood glucose 20 mg/dl; needing high glucose infusion rates up to 12 mg/kg per minute). (Source: Kidney International)
Source: Kidney International - January 18, 2024 Category: Urology & Nephrology Authors: Sidharth Kumar Sethi, Jieji Hu, Rupesh Raina Tags: Make Your Diagnosis Source Type: research
Predictive models of chronic kidney disease progression in pediatric patients
We read with great interest the study conducted by Ng et al.,1 aimed to develop a suite of predictive models for time to kidney replacement therapy in children with chronic kidney disease (CKD). In this well-designed study, Ng et al.1 used robust data from the Chronic Kidney Disease in Children study2 and a combination of sophisticated strategies, incl uding both conventional statistics and machine learning methods. The authors developed 6 models of CKD progression in pediatric patients. In external validation, the elementary model, which includes the glomerular filtration rate, urine protein-creatinine ratio, and the C...
Source: Kidney International - January 18, 2024 Category: Urology & Nephrology Authors: Eduardo A. Oliveira, Ana Cristina Sim ões e Silva, Enrico A. Colosimo Tags: Letter to the Editor Source Type: research
Cinacalcet in focal segmental glomerular sclerosis: a case report
We read with interest the article by M ühlig et al.,1 recently published in Kidney International. Drug-resistant focal segmental glomerular sclerosis is an open issue, and these patients often rapidly progress to end-stage renal disease.2 In such a setting, any potential new drug is welcome.3 The authors demonstrated that calcium-sensi ng receptor knockout mice manifest up to 3 times proteinuria with respect to wild-type mice when treated with adriamycin. Moreover, the administration of cinacalcet to wild-type mice significantly reduced proteinuria in this model. (Source: Kidney International)
Source: Kidney International - January 18, 2024 Category: Urology & Nephrology Authors: Corrado Murtas, Roberta Guastini, Emanuela Cristi, Teresa Valentina Ranalli, Sandro Feriozzi Tags: Letter to the Editor Source Type: research
The authors reply
We appreciate the interest Soler et al. show in our article.1 Their letter2 introduces important details regarding the relationship between age and nephron loss, suggesting age could be a confounding factor in our analyses. Age was not initially included in our models as the Assessment, Serial Evaluation, and Subsequent Sequelae Aft er Acute Kidney Injury (ASSESS-AKI) study was a matched cohort study, wherein the age category was part of the set of matching characteristics. (Source: Kidney International)
Source: Kidney International - January 18, 2024 Category: Urology & Nephrology Authors: David Hu, Steve Menez, Heather Thiessen-Philbrook, Chirag R. Parikh Tags: Letter to the Editor Source Type: research
The ASSESS-AKI study: urinary epidermal growth factor association with reduced risk of MAKE and age
We read with interest the Assessment, Serial Evaluation, and Subsequent Sequelae After Acute Kidney Injury (ASSESS-AKI) study, published by Menez et al.,1 that evaluated the urinary epidermal growth factor (uEGF) as a predictive biomarker of major adverse kidney events (MAKEs) in patients who develop acute kidney injury during a hospitalization. They demonstrated that in hospitalized adult patients (mean ± SD age, 64.6 ± 12.6 years), high le vels of uEGF at hospitalization and at 3 months after discharge are associated with lower risk of MAKEs. (Source: Kidney International)
Source: Kidney International - January 18, 2024 Category: Urology & Nephrology Authors: Maria Jose Soler, Rodrigo Daza-Arnedo, Natalia Ramos, Jorge Rico-Fontalvo Tags: Letter to the Editor Source Type: research
The authors reply
In podocyte-specific calcium-sensing receptor knockout mice, we recently demonstrated a role of calcium-sensing receptor signaling in control of glomerular disease and the therapeutic potential of calcimimetics.1,2 Off-label therapy with cinacalcet together with oral calcium in 4 children with nephrotic syndrome was well tolerated, reduced proteinuria by up to 96%, and resolved edema. Early viral infection –related relapses, however, suggested that the effect of calcium-sensing receptor stimulation was counteracted by additional immunologic triggers. (Source: Kidney International)
Source: Kidney International - January 18, 2024 Category: Urology & Nephrology Authors: Anne K. M ühlig, Claus-Peter Schmitt, Jun Oh Tags: Letter to the Editor Source Type: research
Pitfalls in evaluating the impact of persistent hematuria after induction therapy on kidney prognosis in anti-neutrophil cytoplasmic autoantibody –associated vasculitis
We have a keen interest in the recent article by Benichou et al., which highlights that proteinuria and hematuria following remission induction are associated with outcomes in anti-neutrophil cytoplasmic antibody–associated vasculitis.1 This tackles an important topic, given its challenges for physicians. Notably, the authors assert that persistent hematu ria following induction therapy correlates with renal relapse but has no significant impact on renal prognosis. However, careful consideration is needed when interpreting these findings for 2 reasons. (Source: Kidney International)
Source: Kidney International - January 18, 2024 Category: Urology & Nephrology Authors: Tomoki Taniguchi, Ryosuke Hiwa, Akio Morinobu Tags: Letter to the Editor Source Type: research
The authors reply
We read with interest the comments raised by Taniguchi et al.1 about our study.2 (Source: Kidney International)
Source: Kidney International - January 18, 2024 Category: Urology & Nephrology Authors: Nicolas Benichou, Mouad Abouqateb, Alexandre Karras, French Vasculitis Study Group (FVSG) and European Vasculitis Society (EUVAS) investigators Tags: Letter to the Editor Source Type: research
Improving frozen section evaluation of procurement donor kidney biopsies and reducing the discard rate: a promising role for artificial intelligence
There is a worldwide shortage of deceased-donor kidneys available for transplantation, with too many patients dying while on waiting lists for organs. Meanwhile, and particularly in the United States, many recovered kidneys are discarded, often based on results of frozen section evaluation of a screening biopsy read by an on-call pathologist with limited renal pathology experience. A study in this month ’s issue of Kidney International uses an artificial intelligence–based approach to evaluate these biopsies, which not only improved correlation between biopsy findings and short-to-intermediate term graft survival, but ...
Source: Kidney International - January 18, 2024 Category: Urology & Nephrology Authors: Mark Haas Tags: Commentary Source Type: research
Multi-omics data integration shines a light on the renal medulla
The renal medulla maintains salt and water balance and is prone to dysregulation because of high oxygen demand. Challenges in obtaining high-quality tissue have limited characterization of molecular programs regulating the medulla. Haug et al. leveraged gene expression, chromatin accessibility, long-range chromosomal interactions, and spatial transcriptomics to build a reference set of medullary tissue marker genes to define the medullary role in kidney function, exemplifying the strength and utility of multi-omic data integration. (Source: Kidney International)
Source: Kidney International - January 18, 2024 Category: Urology & Nephrology Authors: Jeffrey B. Hodgin, Cathy Smith, Matthias Kretzler Tags: Commentary Source Type: research
Choosing fluids to reduce the risks of acute electrolyte disturbances in children after a kidney transplant
Intravenous (i.v.) fluid therapy is critically important in pediatric kidney transplantation. Because of the high volumes given perioperatively, transplant recipients can develop significant electrolyte abnormalities depending on the types of fluids used. Current practices in pediatric transplantation aim to balance risks of hyponatremia from traditionally used hypotonic fluids, such as 0.45% sodium chloride, against hyperchloremia and acidosis associated with isotonic 0.9% sodium chloride. Using the balanced solution Plasma-Lyte 148 as an alternative might mitigate these risks. (Source: Kidney International)
Source: Kidney International - January 18, 2024 Category: Urology & Nephrology Authors: Karthik Venkataraman, Steven J. McTaggart, Michael G. Collins Tags: Commentary Source Type: research
