Neurocognition in Pediatric Chronic Kidney Disease: A Review of Data From the Chronic Kidney Disease in Children (CKiD) Study
Summary: Pediatric chronic kidney disease (CKD) is associated with deficits in neurocognitive functioning, ranging from mild to severe, and correlated with the severity of kidney disease. Clinical variables that are associated with neurocognitive deficits include lower kidney function, hypertension, proteinuria, and metabolic acidosis. Commonly reported neurocognitive difficulties include academic underachievement and deficits in attention regulation and executive function as well as somewhat lower intellectual abilities compared with peer and normative data. (Source: Seminars in Nephrology)
Source: Seminars in Nephrology - September 1, 2021 Category: Urology & Nephrology Authors: Rebecca J. Johnson, Lyndsay A. Harshman Source Type: research
Decreased Neural Connectivity in the Default Mode Network Among Youth and Young Adults With Chronic Kidney Disease
An increasing amount of literature has indicated that chronic kidney disease (CKD) is associated with cognitive deficits that increase with worsening disease severity. Although abnormalities in brain structure have been widely documented, few studies to date have examined the functioning of brain areas associated with the specific cognitive domains affected by CKD (namely, attention and executive functions). Furthermore, few studies have examined functional connectivity among CKD youth who are relatively early in the course of the disease. (Source: Seminars in Nephrology)
Source: Seminars in Nephrology - September 1, 2021 Category: Urology & Nephrology Authors: John D. Herrington, Erum A. Hartung, Nina C. Laney, Stephen R. Hooper, Susan L. Furth Source Type: research
Functional Magnetic Resonance Imaging Findings in Children and Adolescents With Chronic Kidney Disease: Preliminary Findings
This cross-sectional study provides preliminary findings from one of the first functional brain imaging studies in children with chronic kidney disease (CKD). The sample included 21 children with CKD (ages, 14.4 ± 3.0 y) and 11 healthy controls (ages, 14.5 ± 3.4 y). Using functional magnetic resonance imaging during a visual-spatial working memory task, findings showed that the CKD group and healthy controls invoked similar brain regions for encoding and retrieval phases of the task, but significant group differences were noted in the activation patterns for both components of the task. (Source: Seminars in Nephrology)
Source: Seminars in Nephrology - September 1, 2021 Category: Urology & Nephrology Authors: Waverly Harrell, Debbie S. Gipson, Aysenil Belger, Mina Matsuda-Abedini, Bruce Bjornson, Stephen R. Hooper Source Type: research
Patient-Reported Outcomes in Children With Chronic Kidney Disease
Summary: Patient-reported outcomes (PROs) are quantitative assessments of a patient's perspective on their health and are derived directly from the patient, as opposed to clinician interpretation. PROs can serve as unique tools to improve health care providers ’ understanding of the patient's daily lived experience and highlight salient domains that are specific to children with chronic kidney disease (CKD). As such, PROs fill an important gap in achieving optimal health and well-being for children with CKD. (Source: Seminars in Nephrology)
Source: Seminars in Nephrology - September 1, 2021 Category: Urology & Nephrology Authors: Leonela Villegas, Sandra Amaral Source Type: research
Masthead
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Source: Seminars in Nephrology - September 1, 2021 Category: Urology & Nephrology Source Type: research
Editorial Board
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Source: Seminars in Nephrology - September 1, 2021 Category: Urology & Nephrology Source Type: research
Table of Contents
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Source: Seminars in Nephrology - September 1, 2021 Category: Urology & Nephrology Source Type: research
Introduction: Obesity and the kidney
As has been widely reported, there is a global pandemic of overweight and obesity evident in the United States and increasingly around the world. The spectrum of overweight, obesity, and associated type 2 diabetes on population health has nephrology-related implications affecting the following: (1) the general population, (2) the end-stage renal disease system, (3) nephrology practitioners, and (4) nephrology researchers. (Source: Seminars in Nephrology)
Source: Seminars in Nephrology - July 1, 2021 Category: Urology & Nephrology Authors: Jeffrey B. Kopp, Avi Z. Rosenberg, Moshe Levi Source Type: research
The Renal Pathology of Obesity: Structure-Function Correlations
The kidney is one of the target organs that may show health disorders as a result of obesity. Obesity-related glomerulopathy (ORG) is a kidney disease category based on a biopsy diagnosis that may occur secondary to obesity. Detailed clinicopathologic observations of ORG have provided significant knowledge regarding obesity-associated renal complications. Glomerulomegaly with focal segmental glomerulosclerosis of perihilar locations is a typical renal histopathologic finding in ORG, which has long been considered to represent a state of single-nephron glomerular hyperfiltration. (Source: Seminars in Nephrology)
Source: Seminars in Nephrology - July 1, 2021 Category: Urology & Nephrology Authors: Nobuo Tsuboi, Yusuke Okabayashi Source Type: research
Podocytopathy in Obesity: Challenges of Living Large
Summary: Renal injury resulting from obesity is a growing concern caused by the global obesity epidemic. We discuss the glomerular structure, obesity-related glomerular changes, and diagnostic pathologic criteria for obesity-related glomerulopathy. The three main hypothesized mechanisms of podocyte injury are mechanical stress on the podocytes, metabolic derangement, and genetic/molecular factors. Weight loss, renin-angiotensin-aldosterone system inhibitors, and improved insulin resistance may slow the progression. (Source: Seminars in Nephrology)
Source: Seminars in Nephrology - July 1, 2021 Category: Urology & Nephrology Authors: Gabriel Giannini, Jeffrey B. Kopp, Avi Z. Rosenberg Source Type: research
Nuclear Receptors and Transcription Factors in Obesity-Related Kidney Disease
Both obesity and chronic kidney disease are increasingly common causes of morbidity and mortality worldwide. Although obesity often co-exists with diabetes and hypertension, it has become clear over the past several decades that obesity is an independent cause of chronic kidney disease, termed obesity-related glomerulopathy. This review defines the attributes of obesity-related glomerulopathy and describes potential pharmacologic interventions. Interventions discussed include peroxisome proliferator-activated receptors, the farnesoid X receptor, the Takeda G-protein –coupled receptor 5, and the vitamin D receptor. (Sourc...
Source: Seminars in Nephrology - July 1, 2021 Category: Urology & Nephrology Authors: Bryce A. Jones, Xiaoxin X. Wang, Komuraiah Myakala, Moshe Levi Source Type: research
Sodium Glucose Transporter, Type 2 (SGLT2) Inhibitors (SGLT2i) and Glucagon-Like Peptide 1-Receptor Agonists: Newer Therapies in Whole-Body Glucose Stabilization
Summary: Diabetes is a worldwide epidemic that is increasing rapidly to become the seventh leading cause of death in the world. The increased incidence of this disease mirrors a similar uptick in obesity and metabolic syndrome, and, collectively, these conditions can cause deleterious effects on a number of organ systems including the renal and cardiovascular systems. Historically, treatment of type 2 diabetes has focused on decreasing hyperglycemia and glycated hemoglobin levels. However, it now is appreciated that there is more to the puzzle. (Source: Seminars in Nephrology)
Source: Seminars in Nephrology - July 1, 2021 Category: Urology & Nephrology Authors: Blythe D. Shepard, Carolyn M. Ecelbarger Source Type: research
Renal Cellular Autophagy in Obesity: Boon or Bane?
Obesity is a growing human health concern worldwide and imposes adverse effects on many cell types and organ systems, including the kidneys. Obesity interferes with various cellular processes by increasing lipid accumulation and oxidation, insulin resistance, and inflammation. Autophagy is an important cellular process to maintain hemostasis and preserve resources, but might be altered in obesity. Interestingly, experimental studies have shown either an increase or a decrease in the rate of autophagy, and accumulation of byproducts and mediators of this cascade in kidneys of obese individuals. (Source: Seminars in Nephrology)
Source: Seminars in Nephrology - July 1, 2021 Category: Urology & Nephrology Authors: Ramyar Ghandriz, Lilach O. Lerman Source Type: research
Obesity-Related Glomerulopathy: Clinical Management
Obesity-related glomerulopathy (ORG) and other obesity-associated kidney diseases pose a major challenge to the treating nephrologist. We review the benefits of weight loss and optimal management of ORG and kidney disease in the setting of obesity. Therapeutic strategies in ORG were limited mainly in the past to weight loss through lifestyle interventions and bariatric surgery, antihypertensive treatment, and renin-angiotensin-aldosterone system blockade. Current approaches to obtain the desired weight loss include novel pharmacologic therapies that have been approved for the treatment of diabetes while offering kidney pro...
Source: Seminars in Nephrology - July 1, 2021 Category: Urology & Nephrology Authors: Michal Herman-Edelstein, Talia Weinstein, Avry Chagnac Source Type: research
Dialysis of the Obese Patient: Meeting Needs for a Growing Epidemic
Summary: Increasing population obesity and associated metabolic consequences has led to increased number of obese patients with chronic kidney disease and end-stage renal disease. While obesity is associated with increased cardiovascular morbidity and mortality, obese dialysis patients present a seeming paradox for survival benefit, given other acute intervening illnesses for those on dialysis with loss of lean body mass overtime. Challenges remain in providing adequate renal replacement options and therapy for this growing segment of obese patients on dialysis which are discussed in this article. (Source: Seminars in Nephrology)
Source: Seminars in Nephrology - July 1, 2021 Category: Urology & Nephrology Authors: Devasmita Choudhury, Hima Bindu Yalamanchili, Alia Hasan Source Type: research
