Nephrology Dialysis Transplantation




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A call for a better understanding of the role of dietary amino acids and post-translational protein modifications of the microbiome in the progression of CKD

Laetitia Koppe, Srinivasan Beddhu, Philippe Chauveau, Csaba P Kovesdy, Denise Mafra, Shivam Joshi, Kamyar Kalantar-Zadeh, Denis Fouque

doi : 10.1093/ndt/gfab033

Nephrology Dialysis Transplantation, Volume 36, Issue 8, August 2021, Pages 1357–1360

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On the evolution of the language of nephrology

Garabed Eknoyan, Medha Airy, Samaya Anumudu

doi : 10.1093/ndt/gfab052

Nephrology Dialysis Transplantation, Volume 36, Issue 8, August 2021, Pages 1361–1365

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Kidney donors with fibromuscular dysplasia, is it time to open the doors?

Constantina Chrysochou, Arnaud Devresse, Nada Kanaan, Alexandre Persu

doi : 10.1093/ndt/gfab181

Nephrology Dialysis Transplantation, Volume 36, Issue 8, August 2021, Pages 1365–1368

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Are all erythropoiesis-stimulating agents created equal?

Francesco Locatelli, Lucia Del Vecchio, Luca De Nicola, Roberto Minutolo

doi : 10.1093/ndt/gfaa034

Nephrology Dialysis Transplantation, Volume 36, Issue 8, August 2021, Pages 1369–1377

Erythropoiesis-stimulating agents (ESAs) are effective drugs to correct and maintain haemoglobin (Hb) levels, however, their use at doses to reach high Hb targets has been associated with an increased risk of cardiovascular adverse events, mortality and cancer. Presently used ESAs have a common mechanism of action but different pharmacokinetic and pharmacodynamic characteristics. Accordingly, the mode of activation of the erythropoietin (EPO) receptor can exert marked differences in downstream events. It is unknown whether the various ESA molecules have different efficacy/safety profiles. The relative mortality and morbidity risks associated with the use of different types of ESAs remains poorly evaluated. Recently an observational study and a randomized clinical trial provided conflicting results regarding this matter. However, these two studies displayed several differences in patient characteristics and ESA molecules used. More importantly, by definition, randomized clinical trials avoid bias by indication and suffer less from confounding factors. Therefore they bring a higher degree of evidence. The scenario becomes even more complex when considering the new class of ESAs, called prolyl-hydroxylase domain (PHD) inhibitors. They are oral drugs that mimic exposure to hypoxia and stabilize hypoxia-inducible factor ?. They profoundly differ from presently used ESAs, as they have multiple targets of action, including the stimulation of endogenous EPO synthesis, direct mobilization/absorption of iron and a higher reduction of hepcidin. Accordingly, they have the potential to be more effective in inflamed patients with functional iron deficiency, i.e. the setting of patients who are at higher risk of cardiovascular events and mortality in response to present ESA use. As for ESAs, individual PHD inhibitors differ in molecular structure and degree of selectivity for the three main PHD isoforms; their efficacy and safety profiles may therefore be different from that of presently available ESAs.

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The problem with transferrin saturation as an indicator of iron ‘sufficiency’ in chronic kidney disease

Anatole Besarab, Tilman B Drueke

doi : 10.1093/ndt/gfaa048

Nephrology Dialysis Transplantation, Volume 36, Issue 8, August 2021, Pages 1377–1383

After a brief review of physiological iron metabolism, we describe diagnostic tests for iron status and iron deficiency anemia in patients without chronic kidney disease (CKD) or inflammation. Thereafter we review the dysregulation of iron metabolism in CKD. Specific emphasis is placed on the role of the ‘inflammatory’ state that develops with the progression of CKD. It invokes changes in iron metabolism that are the exact opposite of those occurring during pure iron deficiency. As a result, transferrin saturation (TSAT) becomes a poorer index of iron availability to the bone marrow and serum ferritin no longer represents iron that can be used during erythropoiesis. We argue that serum iron may provide more information to guide iron therapy than TSAT. In other words, the emphasis on TSAT is misplaced. With the development of a number of hypoxia-inducible factor prolyl hydroxylase inhibitors, which restore iron metabolism toward the ‘physiologic state’, the iron indices indicating sufficient iron availability to avoid functional iron deficiency during therapy of CKD-associated anemia are likely to change. We summarize these changes in the section ‘A peek into things to come!’, citing the available data.

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Diabetes and renal disease—should we biopsy?

Sheila Bermejo, Clara Garc?a-Carro, Mar?a José Soler

doi : 10.1093/ndt/gfz248

Nephrology Dialysis Transplantation, Volume 36, Issue 8, August 2021, Pages 1384–1386

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Sudden cardiac death in chronic renal disease: aetiology and risk reduction strategies 

Luke C Pickup, Jonathan P Law, Jonathan N Townend, Charles J Ferro

doi : 10.1093/ndt/gfz232

Nephrology Dialysis Transplantation, Volume 36, Issue 8, August 2021, Pages 1386–1388

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The switch from proteasome to immunoproteasome is increased in circulating cells of patients with fast progressive immunoglobulin A nephropathy and associated with defective CD46 expression 

Licia Peruzzi, Rosanna Coppo, Enrico Cocchi, Elisa Loiacono, Massimilano Bergallo, Monica Bodria, Luca Vergano, Alexandra Krutova, Maria Luisa Russo, Alessandro Amore, Sigrid Lundberg, Dita Maixerova, Vladimir Tesar, Agnieszka Perkowska-Ptasi?ska, Magdalena Durlik, Dimitris Goumenos, Marios Papasotiriou, Kresimir Galesic, Luka Toric, Aikaterini Papagianni, Maria Stangou, Malgorzata Mizerska-Wasiak, Loreto Gesualdo, Eustacchio Montemurno, Luisa Benozzi, Stefano Cusinato, Tomasz Hryszko, Marian Klinger, Dorota Kami?ska, Magdalena Krajewska, the VALIGA study group of the ERA-EDTA Immunonephrology Working Group

doi : 10.1093/ndt/gfaa092

Nephrology Dialysis Transplantation, Volume 36, Issue 8, August 2021, Pages 1389–1398

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Efficacy and safety of PT20, an iron-based phosphate binder, for the treatment of hyperphosphataemia: a randomized, double-blind, placebo-controlled, dose-ranging, Phase IIb study in patients with haemodialysis-dependent chronic kidney disease 

Mark Sampson, Nuno Faria, Jonathan J Powell, the PEACH study investigators

doi : 10.1093/ndt/gfaa116

Nephrology Dialysis Transplantation, Volume 36, Issue 8, August 2021, Pages 1399–1407

Hyperphosphataemia is a common complication of chronic kidney disease (CKD). PT20 (ferric iron oxide adipate) is an investigational molecule engineered to offer enhanced phosphate-binding properties relative to other phosphate binders.

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PR3-ANCAs predict relapses in ANCA-associated vasculitis patients after rituximab 

Laura S van Dam, Ebru Dirikgil, Edwin W Bredewold, Argho Ray, Jaap A Bakker, Cees van Kooten, Ton J Rabelink, Yoe K Onno Teng 

doi : 10.1093/ndt/gfaa066

Nephrology Dialysis Transplantation, Volume 36, Issue 8, August 2021, Pages 1408–1417

Background. The primary challenge of anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) patient care is the early detection of relapses to prevent organ damage and increase survival. Potential biomarkers for relapses are ANCA and B cells, but their predictive value is a matter of debate. Therefore this study investigated how ANCA and B-cell status related to relapses in AAV patients treated with rituximab (RTX) as remission induction (RI).

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Health-related quality of life and symptoms of conservative care versus dialysis in patients with end-stage kidney disease: a systematic review

Wouter R Verberne, Iris D van den Wittenboer, Carlijn G N Voorend, Alferso C Abrahams, Marjolijn van Buren, Friedo W Dekker, Brigit C van Jaarsveld, Ismay N van Loon, Simon P Mooijaart, Gurbey Ocak, Johannes J M van Delden, Willem Jan W Bos

doi : 10.1093/ndt/gfaa078

Nephrology Dialysis Transplantation, Volume 36, Issue 8, August 2021, Pages 1418–1433

Non-dialytic conservative care (CC) has been proposed as a viable alternative to maintenance dialysis for selected older patients to treat end-stage kidney disease (ESKD). This systematic review compares both treatment pathways on health-related quality of life (HRQoL) and symptoms, which are major outcomes for patients and clinicians when deciding on preferred treatment.

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Acute kidney injury demographics and outcomes: changes following introduction of electronic acute kidney injury alerts—an analysis of a national dataset

Jennifer Holmes, Kieron Donovan, John Geen, John Williams, Aled O Phillips

doi : 10.1093/ndt/gfaa071

Nephrology Dialysis Transplantation, Volume 36, Issue 8, August 2021, Pages 1433–1439

Electronic alerts for acute kidney injury (AKI) have been widely advocated. Our aim was to describe the changes in AKI demographics and outcomes following implementation of a national electronic AKI alert programme.

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Effects of bariatric surgery on kidney diseases, cardiovascular diseases, mortality and severe hypoglycaemia among patients with Type 2 diabetes mellitus

Carlos K H Wong, Tingting Wu, Simon K H Wong, Betty T T Law, Eleanor Grieve, Enders K W Ng, Olivia Wu, Cindy L K Lam

doi : 10.1093/ndt/gfaa075

Nephrology Dialysis Transplantation, Volume 36, Issue 8, August 2021, Pages 1440–1451

Bariatric surgery has been widely indicated for the management of obesity and related comorbidities. However, there are uncertainties pertaining to the risks of post-bariatric severe hypoglycaemia (SH), cardiovascular diseases (CVDs), end-stage kidney diseases (ESKDs) and all-cause mortality in obese patients with Type 2 diabetes mellitus (T2DM), especially among Asian populations.

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Clinical impact of urinary CD11b and CD163 on the renal outcomes of anti-neutrophil cytoplasmic antibody-associated glomerulonephritis

Yuki Yokoe, Naotake Tsuboi, Takahiro Imaizumi, Akimitsu Kitagawa, Munetoshi Karasawa, Takaya Ozeki, Nobuhide Endo, Yuriko Sawa, Sawako Kato, Takayuki Katsuno, Shoichi Maruyama, Kunihiro Yamagata, Joichi Usui, Michio Nagata, Ken-Ei Sada, Hitoshi Sugiyama, Koichi Amano, Yoshihiro Arimura, Tatsuya Atsumi, Yukio Yuzawa, Hiroaki Dobashi, Yoshinari Takasaki, Masayoshi Harigai, Hitoshi Hasegawa, Hirofumi Makino, Seiichi Matsuo, Japan Research Committee of the Ministry of Health, Labour, and Welfare for Intractable Vasculitis and for Intractable Renal Disease

doi : 10.1093/ndt/gfaa097

Nephrology Dialysis Transplantation, Volume 36, Issue 8, August 2021, Pages 1452–1463

The detection of leukocyte-derived CD11b (? subunit of integrin Mac-1) and CD163 (scavenger receptor) in urine may reflect renal inflammation in antineutrophil cytoplasmic antibody-associated glomerulonephritis (ANCA-GN). The objective of this study was to evaluate the clinical significance of urinary CD11b (U-CD11b) and CD163 (U-CD163) in ANCA-GN.

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Effects of Oxalobacter formigenes in subjects with primary hyperoxaluria Type 1 and end-stage renal disease: a Phase II study

Bernd Hoppe, Patricia A Pellikka, Bastian Dehmel, Ana Banos, Elisabeth Lindner, Ulrike Herberg

doi : 10.1093/ndt/gfaa135

Nephrology Dialysis Transplantation, Volume 36, Issue 8, August 2021, Pages 1464–1473

In primary hyperoxaluria Type 1 (PH1), endogenous oxalate overproduction significantly elevates urinary oxalate excretion, resulting in recurrent urolithiasis and/or progressive nephrocalcinosis and often early end-stage renal disease (ESRD). In ESRD, dialysis cannot sufficiently remove oxalate; plasma oxalate (Pox) increases markedly, inducing systemic oxalate deposition (oxalosis) and often death. Interventions to reduce Pox in PH1 subjects with ESRD could have significant clinical impact. This ongoing Phase II, open-label trial aimed to evaluate whether long-term Oxabact™ (Oxalobacter formigenes, OC5, OxThera Intellectual Property AB, Sweden) lowers Pox in PH1 ESRD subjects, ameliorating clinical outcome.

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Long-term effects of combined B-cell immunomodulation with rituximab and belimumab in severe, refractory systemic lupus erythematosus: 2-year results 

Tineke Kraaij, Eline J Arends, Laura S van Dam, Sylvia W A Kamerling, Paul L A van Daele, Obbo W Bredewold, Argho Ray, Jaap A Bakker, Hans U Scherer, Tom J W Huizinga, Ton J Rabelink, Cees van Kooten, Y K Onno Teng

doi : 10.1093/ndt/gfaa117

Nephrology Dialysis Transplantation, Volume 36, Issue 8, August 2021, Pages 1474–1483

Anti-CD20 B-cell depletion has not shown superior efficacy to standard immunosuppression in patients with systemic lupus erythematosus (SLE). Besides trial design, potential explanations are incomplete B-cell depletion in relation to substantial surges in B-cell-activating factor (BAFF). To improve B-cell targeting strategies, we conducted the first study in SLE patients aimed at investigating immunological effects and feasibility of combining rituximab (RTX; anti-CD20) and belimumab (BLM; anti-BAFF).

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Long-term outcome of the survivors of infantile hypercalcaemia with CYP24A1 and SLC34A1 mutations 

Agnieszka Janiec, Paulina Halat-Wolska, ?ukasz Obrycki, El?bieta Ciara, Marek W?jcik, Pawe? P?udowski, Aldona Wierzbicka, Ewa Kowalska, Janusz B Ksi??yk, Zbigniew Ku?aga, Ewa Pronicka, Mieczys?aw Litwin

doi : 10.1093/ndt/gfaa178

Nephrology Dialysis Transplantation, Volume 36, Issue 8, August 2021, Pages 1484–1492

Infantile hypercalcaemia (IH) is a vitamin D3 metabolism disorder. The molecular basis for IH is biallelic mutations in the CYP24A1 or SLC34A1 gene. These changes lead to catabolism disorders (CYP24A1 mutations) or excessive generation of 1,25-dihydroxyvitamin D3 [1,25(OH)2D3] (SLC34A1 mutations). The incidence rate of IH in children and the risk level for developing end-stage renal disease (ESRD) are still unknown. The aim of this study was to analyse the long-term outcome of adolescents and young adults who suffered from IH in infancy.

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Association of renal impairment with cognitive dysfunction in the Northern Ireland Cohort for the Longitudinal Study of Ageing (NICOLA) 

Euan N Paterson, Alexander P Maxwell, Frank Kee, Sharon Cruise, Ian S Young, Bernadette McGuinness, Gareth J McKay

doi : 10.1093/ndt/gfab182

Nephrology Dialysis Transplantation, Volume 36, Issue 8, August 2021, Pages 1492–1499

Chronic kidney disease (CKD) is a recognized risk factor for cognitive impairment. Identification of those at greatest risk of cognitive impairment may facilitate earlier therapeutic intervention. This study evaluated associations between estimated glomerular filtration rate (eGFR) and cognitive function in the Northern Ireland Cohort for the Longitudinal Study of Ageing.

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Urgent-start dialysis in patients referred early to a nephrologist—the CKD-REIN prospective cohort study 

Victor Fages, Natalia Alencar de Pinho, Aghilès Hamroun, Céline Lange, Christian Combe, Denis Fouque, Luc Frimat, Christian Jacquelinet, Maurice Laville, Carole Ayav, Sophie Liabeuf, Roberto Pecoits-Filho, Ziad A Massy, Julie Boucquemont, Bénédicte Stengel, the CKD-REIN study collaborators

doi : 10.1093/ndt/gfab170

Nephrology Dialysis Transplantation, Volume 36, Issue 8, August 2021, Pages 1500–1510

The lack of a well-designed prospective study of the determinants of urgent dialysis start led us to investigate its individual- and provider-related factors in patients seeing nephrologists.

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Electrochemical skin conductance by Sudoscan®: a new tool to predict intradialytic hypotension 

Pauline Reach, Maxime Touzot, Yannis Lombardi, Catherine Maheas, Emmanuelle Sacco, Audrey Fels, Hélène Beaussier, Pablo Ure?a-Torres, Gilles Chatellier, Christophe Ridel, Mathieu Zuber

doi : 10.1093/ndt/gfab183

Nephrology Dialysis Transplantation, Volume 36, Issue 8, August 2021, Pages 1511–1518

Intradialytic hypotension (IDH), a common complication in haemodialysis (HD) patients, is associated with multiple risk factors including cardiac dysfunction and alterations of the peripheral autonomic nervous system. To what extent dysautonomia may contribute to the occurrence of IDH remains elusive. We sought to investigate the clinical utility of Sudocan®, a device that quantifies dysautonomia, in the prediction of IDH.

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Vasculopathy plays an important role during the development and relapse of encapsulating peritoneal sclerosis with conventional peritoneal dialysis solutions

Mitsuhiro Tawada, Yasuhiko Ito, Masataka Banshodani, Masahiro Yamashita, Sadanori Shintaku, Ting Sun, Yasuhiro Suzuki, Hiroshi Kinashi, Yoko Kubo, Masahiko Ando, Makoto Yamaguchi, Takayuki Katsuno, Masashi Mizuno, Hideki Kawanishi

doi : 10.1093/ndt/gfaa073

Nephrology Dialysis Transplantation, Volume 36, Issue 8, August 2021, Pages 1519–1526

Encapsulating peritoneal sclerosis (EPS) is an uncommon but life-threatening complication of peritoneal dialysis (PD) therapy. The causative factors of EPS remain unclear. Pathological studies of the peritoneum affected by EPS and relationships with clinical factors including PD solutions remain lacking. The objective of this study was to examine peritoneal samples from EPS patients and to identify the associations of peritoneal pathology with different clinical factors.

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Cause of death for people with end-stage kidney disease withdrawing from treatment in Australia and New Zealand

Victor Khou, Nicole L De La Mata, Rachael L Morton, Patrick J Kelly, Angela C Webster

doi : 10.1093/ndt/gfaa105

Nephrology Dialysis Transplantation, Volume 36, Issue 8, August 2021, Pages 1527–1537

Withdrawal from renal replacement therapy is common in patients with end-stage kidney disease (ESKD), but end-of-life service planning is challenging without population-specific data. We aimed to describe mortality after treatment withdrawal in Australian and New Zealand ESKD patients and evaluate death-certified causes of death.

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Long-term outcomes of kidney donors with fibromuscular dysplasia

Horacio E Adrogue, Andrew Evans, Dina N Murad, Hana Nguyen, Sean A Hebert, Duc T Nguyen, Edward A Graviss, Hassan N Ibrahim

doi : 10.1093/ndt/gfab039

Nephrology Dialysis Transplantation, Volume 36, Issue 8, August 2021, Pages 1538–1545

Fibromuscular dysplasia (FMD) is a non-atherosclerotic systemic arterial disease that is not infrequently discovered during kidney donor evaluation. Current guidelines do not provide recommendations regarding the use of kidneys from donors with FMD and there is a paucity of data on the outcomes of these donors.

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Incidence and predictors of non-alcoholic fatty liver disease among patients with chronic kidney disease

Jefferson L Triozzi, Peter A Richardson, L Parker Gregg, Sankar D Navaneethan

doi : 10.1093/ndt/gfab046

Nephrology Dialysis Transplantation, Volume 36, Issue 8, August 2021, Pages 1546–1548

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Effects of hydration status and urine concentration on the quantification of cell-cycle arrest biomarkers in the urine of healthy volunteers: a randomized crossover trial

Laurent Bitker, Lisa Toh, Intissar Bittar, Glenn M Eastwood, Rinaldo Bellomo

doi : 10.1093/ndt/gfab069

Nephrology Dialysis Transplantation, Volume 36, Issue 8, August 2021, Pages 1548–1551

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Measurement of urinary creatinine in chronic SIADH can be used to estimate solute and fluid intake

Guy Decaux

doi : 10.1093/ndt/gfab073

Nephrology Dialysis Transplantation, Volume 36, Issue 8, August 2021, Pages 1551–1553

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Erratum 

Clare McKeaveney, Adrian Slee, Gary Adamson, Andrew Davenport, Ken Farrington, Denis Fouque, Kamyar Kalantar-Zadeh, John Mallett, Alexander P Maxwell, Robert Mullan, Helen Noble, Donal O’Donoghue, Sam Porter, David S Seres, Joanne Shields, Miles Witham, Joanne Reid

doi : 10.1093/ndt/gfaa320

Nephrology Dialysis Transplantation, Volume 36, Issue 8, August 2021, Page 1554

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Erratum to: Performance of Hemodialysis with Novel Medium Cut-Off Dialyzers 

Alexander H Kirsch, Raphael Lyko, Lars-G?ran Nilsson, Michael Amdahl, Petra Lechner, Andreas Schneider, Christoph Wanner, Alexander R Rosenkranz, Detlef H Krieter

doi : 10.1093/ndt/gfaa322

Nephrology Dialysis Transplantation, Volume 36, Issue 8, August 2021, Pages 1555–1556

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Erratum 

Guillaume Dorval, Aude Servais, Olivia Boyer

doi : 10.1093/ndt/gfaa325

Nephrology Dialysis Transplantation, Volume 36, Issue 8, August 2021, Page 1556

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