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Phosphate binders in dialysis: better satisfied than sorry
Mario Cozzolino, Andrea Galassi, Paola Ciceri
doi : 10.1093/ckj/sfab093
Clinical Kidney Journal, Volume 14, Issue 8, August 2021, Pages 1859–1860
High serum phosphate levels have been associated with increased morbidity and mortality in dialysis patients. Nephrologists routinely counteract the positive phosphate balance in dialysis patients through nutritional counselling, stronger phosphate removal by dialysis and prescription of phosphate binders. An individualized choice of phosphate binders is a desirable option to improve the poor adherence with these medications’ prescription that has been associated with hyperphosphataemia.
Assessment of kidney function: clinical indications for measured GFR
Natalie Ebert, Sebastjan Bevc, Arend B?kenkamp, Francois Gaillard, Mads Hornum, Kitty J Jager, Christophe Mariat, Bj?rn Odvar Eriksen, Runolfur Palsson, Andrew D Rule, Marco van Londen, Christine White, Elke Schaeffner
doi : 10.1093/ckj/sfab042
Clinical Kidney Journal, Volume 14, Issue 8, August 2021, Pages 1861–1870
In the vast majority of cases, glomerular filtration rate (GFR) is estimated using serum creatinine, which is highly influenced by age, sex, muscle mass, body composition, severe chronic illness and many other factors. This often leads to misclassification of patients or potentially puts patients at risk for inappropriate clinical decisions. Possible solutions are the use of cystatin C as an alternative endogenous marker or performing direct measurement of GFR using an exogenous marker such as iohexol. The purpose of this review is to highlight clinical scenarios and conditions such as extreme body composition, Black race, disagreement between creatinine- and cystatin C–based estimated GFR (eGFR), drug dosing, liver cirrhosis, advanced chronic kidney disease and the transition to kidney replacement therapy, non-kidney solid organ transplant recipients and living kidney donors where creatinine-based GFR estimation may be invalid. In contrast to the majority of literature on measured GFR (mGFR), this review does not include aspects of mGFR for research or public health settings but aims to reach practicing clinicians and raise their understanding of the substantial limitations of creatinine. While including cystatin C as a renal biomarker in GFR estimating equations has been shown to increase the accuracy of the GFR estimate, there are also limitations to eGFR based on cystatin C alone or the combination of creatinine and cystatin C in the clinical scenarios described above that can be overcome by measuring GFR with an exogenous marker. We acknowledge that mGFR is not readily available in many centres but hope that this review will highlight and promote the expansion of kidney function diagnostics using standardized mGFR procedures as an important milestone towards more accurate and personalized medicine.
Maternal, foetal and child consequences of immunosuppressive drugs during pregnancy in women with organ transplant: a review
Hugoline Boulay, Séverine Mazaud-Guittot, Jeanne Supervielle, Jonathan M Chemouny, Virginie Dardier, Agnes Lacroix, Ludivine Dion, Cécile Vigneau
doi : 10.1093/ckj/sfab049
Clinical Kidney Journal, Volume 14, Issue 8, August 2021, Pages 1871–1878
Genetic kidney diseases as an underrecognized cause of chronic kidney disease: the key role of international registry reports
Roser Torra, M?nica Furlano, Alberto Ortiz, Elisabet Ars
doi : 10.1093/ckj/sfab056
Clinical Kidney Journal, Volume 14, Issue 8, August 2021, Pages 1879–1885
Inherited kidney diseases (IKDs) are among the leading causes of early-onset chronic kidney disease (CKD) and are responsible for at least 10–15% of cases of kidney replacement therapy (KRT) in adults. Paediatric nephrologists are very aware of the high prevalence of IKDs among their patients, but this is not the case for adult nephrologists. Recent publications have demonstrated that monogenic diseases account for a significant percentage of adult cases of CKD. A substantial number of these patients have received a non-specific/incorrect diagnosis or a diagnosis of CKD of unknown aetiology, which precludes correct treatment, follow-up and genetic counselling. There are a number of reasons why genetic kidney diseases are difficult to diagnose in adulthood: (i) adult nephrologists, in general, are not knowledgeable about IKDs; (ii) existence of atypical phenotypes; (iii) genetic testing is not universally available; (iv) family history is not always available or may be negative; (v) lack of knowledge of various genotype–phenotype relationships and (vi) conflicting interpretation of the pathogenicity of many sequence variants. Registries can contribute to visualize the burden of IKDs by regularly grouping all IKDs in their annual reports, as is done for glomerulonephritis or interstitial diseases, rather than reporting only cystic disease and hiding other IKDs under labels such as ‘miscellaneous’ or ‘other’. Any effort to reduce the percentage of patients needing KRT with a diagnosis of ‘nephropathy of unknown etiology’ or an unspecific/incorrect diagnosis should be encouraged as a step towards precision nephrology. Genetic testing may be of value in this context but should not be used indiscriminately, but rather on the basis of a deep knowledge of IKDs.
European hemodialysis patient satisfaction with phosphate binders is associated with serum phosphorus levels: the Dialysis Outcomes and Practice Patterns Study
Keith McCullough, Friedrich K Port, Patricia de Sequera, Hugh Rayner, Roberto Pecoits-Filho, Sebastian Walpen, Pieter Evenepoel, Ronald L Pisoni, DOPPS Country Investigators
doi : 10.1093/ckj/sfab098
Clinical Kidney Journal, Volume 14, Issue 8, August 2021, Pages 1886–1893
Hemodialysis (HD) patients are commonly prescribed phosphate binders (PBs) to manage serum phosphorus levels, as hyperphosphatemia is strongly associated with poorer survival. Nonadherence with the PB prescription is associated with elevated serum phosphorus levels. We studied associations between patient satisfaction with their PB and serum phosphorus levels and mortality rates.
Effect of high cut-off dialysis for acute kidney injury secondary to cast nephropathy in patients with multiple myeloma: a systematic review and meta-analysis
Blanca Tarrag?n, Nan Ye, Martin Gallagher, Shaundeep Sen, Jose Maria Portolés, Amanda Y Wang
doi : 10.1093/ckj/sfaa220
Clinical Kidney Journal, Volume 14, Issue 8, August 2021, Pages 1894–1900
Acute kidney injury (AKI) caused by cast nephropathy is associated with increased morbidity and mortality among patients with multiple myeloma (MM). High cut-off haemodialysis (HCO-HD) has proven to be effective in the removal of serum light chains but the effect on clinical outcomes, especially renal recovery, remains uncertain.
Strategies for asymmetrical triacetate dialyser heparin-free effective haemodialysis: the SAFE study
Ines Vandenbosch, Sander Dejongh, Kathleen Claes, Bert Bammens, Katrien De Vusser, Amaryllis Van Craenenbroeck, Dirk Kuypers, Pieter Evenepoel, Bj?rn Meijers
doi : 10.1093/ckj/sfaa228
Clinical Kidney Journal, Volume 14, Issue 8, August 2021, Pages 1901–1907
In haemodialysis, maintaining patency of the extracorporeal circuit requires the use of anticoagulants. Although (low molecular weight) heparins are the mainstay, these are not well tolerated in all patients. Alternative approaches include saline infusion, citrate-containing dialysate, regional citrate anticoagulation or the use of heparin-coated membranes. Asymmetric cellulose triacetate (ATA) dialysers have a low degree of platelet contact activation and might be an alternative to heparin-coated dialysers. The aim of this study was to test the clotting propensity of ATA when used without systemic anticoagulation.
Belatacept-based immunosuppressive regimen in HIV-positive kidney transplant recipients
Karim El Sakhawi, Giovanna Melica, Anne Scemla, Dominique Bertrand, Cyril Garrouste, Paolo Malvezzi, Philippe Rémy, Anissa Moktefi, Alexandre Ingels, Cécile Champy, Jean-Daniel Lelièvre, David Kheav, Antoine Morel, David Mokrani, Philippe Attias, Philippe Grimbert, Marie Matignon
doi : 10.1093/ckj/sfaa231
Clinical Kidney Journal, Volume 14, Issue 8, August 2021, Pages 1908–1914
Kidney allograft survival in human immunodeficiency virus (HIV)-positive patients is lower than that in the general population. Belatacept increases long-term patient and allograft survival rates when compared with calcineurin inhibitors (CNIs). Its use in HIV-positive recipients remains poorly documented.
Survival with low- and high-flux dialysis
Emilio S?nchez-?lvarez, Minerva Rodr?guez-Garc?a, Francesco Locatelli, Carmine Zoccali, Alejandro Mart?n-Malo, Jürgen Floege, Markus Ketteler, Gerard London, José L G?rriz, Boleslaw Rutkowski, Anibal Ferreira, Drasko Pavlovic, Jorge B Cannata-And?a, José L Fern?ndez-Mart?n, the COSMOS group
doi : 10.1093/ckj/sfaa233
Clinical Kidney Journal, Volume 14, Issue 8, August 2021, Pages 1915–1923
Besides advances in haemodialysis (HD), mortality rates are still high. The effect of the different types of HD membranes on survival is still a controversial issue. The aim of this COSMOS (Current management Of Secondary hyperparathyroidism: a Multicentre Observational Study) analysis was to survey, in HD patients, the relationship between the use of conventional low- or high-flux membranes and all-cause and cardiovascular mortality.
Effects of sodium zirconium cyclosilicate on sodium and potassium excretion in healthy adults: a Phase 1 study
Mats N?g?rd, Bhupinder Singh, David W Boulton
doi : 10.1093/ckj/sfaa237
Clinical Kidney Journal, Volume 14, Issue 8, August 2021, Pages 1924–1931
Sodium zirconium cyclosilicate (SZC; formerly ZS-9) is a potassium (K+) binder for treatment of hyperkalemia in adults. SZC binds K+ in exchange for sodium (Na+) or hydrogen (H+) in the gastrointestinal tract, conveying potential for systemic absorption of Na+.
Causal effects of education on chronic kidney disease: a Mendelian randomization study
Sehoon Park, Soojin Lee, Yaerim Kim, Yeonhee Lee, Min Woo Kang, Kwangsoo Kim, Yong Chul Kim, Seung Seok Han, Hajeong Lee, Jung Pyo Lee, Kwon Wook Joo, Chun Soo Lim, Yon Su Kim, Dong Ki Kim
doi : 10.1093/ckj/sfaa240
Clinical Kidney Journal, Volume 14, Issue 8, August 2021, Pages 1932–1938
Poor socio-economic status, including low education attainment, has been reported in chronic kidney disease (CKD) patients. We aimed to investigate the causal effects of education attainment on the risk of CKD.
Outcome of atypical haemolytic uraemic syndrome relapse after eculizumab withdrawal
Caroline Duineveld, Romy Bouwmeester, Joost W van der Heijden, Stefan P Berger, Nicole C A J van de Kar, Jack F M Wetzels, the Dutch aHUS Working Group
doi : 10.1093/ckj/sfaa241
Clinical Kidney Journal, Volume 14, Issue 8, August 2021, Pages 1939–1945
The introduction of eculizumab has significantly improved the outcome of patients with atypical haemolytic uraemic syndrome (aHUS). Because of the risk of relapse after discontinuation, eculizumab was proposed as life-long therapy. However, data on the outcome of relapse are limited. In the Netherlands, patients with aHUS are treated with a restrictive eculizumab regime and are included in a national observational study (CUREiHUS, Dutch Trial Register NTR5988/NL5833).
Haemolytic uraemic syndrome associated with pancreatitis: report of four cases and review of the literature
Justo Sandino-Pérez, Eduardo Gutiérrez, Fernando Caravaca-Font?n, Enrique Morales, Lucia Aubert-Girbal, Ram?n Delgado-Lillo, Manuel Praga
doi : 10.1093/ckj/sfaa245
Clinical Kidney Journal, Volume 14, Issue 8, August 2021, Pages 1946–1952
The incidence of acute kidney injury (AKI) in patients with acute pancreatitis ranges from 15% to 40% and is associated with poor prognosis. Haemolytic uraemic syndrome (HUS) in the setting of acute pancreatitis is an uncommon association with fewer than 30 cases reported in the literature.
IgA vasculitis (Henoch–Sch?nlein purpura): refractory and relapsing disease course in the adult population
Els Van de Perre, Rachel B Jones, David R W Jayne
doi : 10.1093/ckj/sfaa251
Clinical Kidney Journal, Volume 14, Issue 8, August 2021, Pages 1953–1960
The disease course of adult immunoglobulin A (IgA) vasculitis (IgAV; Henoch–Sch?nlein purpura) has not been well defined.
Predictive value of triglyceride/high-density lipoprotein cholesterol for major clinical outcomes in advanced chronic kidney disease: a nationwide population-based study
Yaerim Kim, Soojin Lee, Yeonhee Lee, Min Woo Kang, Sehoon Park, Sanghyun Park, Kyungdo Han, Jin Hyuk Paek, Woo Yeong Park, Kyubok Jin, Seugyeup Han, Seung Seok Han, Hajeong Lee, Jung Pyo Lee, Kwon Wook Joo, Chun Soo Lim, Yon Su Kim, Dong Ki Kim
doi : 10.1093/ckj/sfaa252
Clinical Kidney Journal, Volume 14, Issue 8, August 2021, Pages 1961–1968
Dyslipidemia is an essential parameter in the prediction of cardiovascular disease (CVD). We aimed to explore whether lipid profiles could predict major outcomes in patients with advanced chronic kidney disease (CKD).
Multiparametric MRI assessment of renal structure and function in acute kidney injury and renal recovery
Charlotte Buchanan, Huda Mahmoud, Eleanor Cox, Rebecca Noble, Benjamin Prestwich, Isma Kasmi, Maarten W Taal, Susan Francis, Nicholas M Selby
doi : 10.1093/ckj/sfaa221
Clinical Kidney Journal, Volume 14, Issue 8, August 2021, Pages 1969–1976
Acute kidney injury (AKI) is associated with a marked increase in mortality as well as subsequent chronic kidney disease (CKD) and end-stage kidney disease. We performed multiparametric magnetic resonance imaging (MRI) with the aim of identifying potential non-invasive MRI markers of renal pathophysiology in AKI and during recovery.
Severe hypercalcaemia early after kidney transplantation in two patients with severe secondary hyperparathyroidism previously treated with etelcalcetide
Guillaume Dachy, Jean-Michel Pochet, Laura Labriola, Antoine Buemi, Valentine Gillion, Michel Jadoul, Nada Kanaan, Arnaud Devresse
doi : 10.1093/ckj/sfab063
Clinical Kidney Journal, Volume 14, Issue 8, August 2021, Pages 1977–1979
Cinacalcet and, more recently, etelcalcetide revolutionized the treatment of chronic kidney disease–mineral and bone disorder (CKD–MBD). Kidney transplant (KT) usually improves CKD–MBD. However, a significant proportion of KT recipients have high serum calcium levels, not requiring any treatment. We report two patients previously treated with etelcalcetide who developed severe (>3.3?mmol/L) hypercalcaemia in the early post-KT course, requiring parathyroidectomy. Pathological studies showed parathyroid adenomas and hyperplasia. One patient had a graft biopsy showing numerous intratubular calcium phosphate crystals. These observations should prompt pharmacovigilance studies and careful follow-up of KT recipients previously treated with etelcalcetide.
Acute Page kidney after angioplasty in kidney transplant allografts
Elizabeth Canllavi, Julio Teigell, Hernando Trujillo, Eduardo Gutiérrez, Angel S?nchez, Natalia Miranda-Utrera, Enrique Morales
doi : 10.1093/ckj/sfab064
Clinical Kidney Journal, Volume 14, Issue 8, August 2021, Pages 1980–1982
Acute Page kidney (APK) in kidney transplantation is a rare entity often related to interventional techniques. Percutaneous angioplasty remains an exceptional cause of APK. Herein we describe the clinical course and outcome of APK following percutaneous angioplasty for transplant renal artery stenosis in four kidney transplant recipients, where external compression of the graft was caused by subcapsular haematomas. All patients were treated with surgical drainage, after which two cases recovered baseline kidney function, one developed advanced chronic kidney disease and one remained dialysis-dependent. To our knowledge, the present series is the largest to describe APK in kidney allografts after percutaneous angioplasty.
Seroconversion after COVID-19 vaccine in a dialysis patient on immunosuppressants
Gaetano Alfano, Francesco Fontana, Giacomo Mori, Silvia Giovanella, Francesco Giaroni, Giulia Ligabue, Giovanni Guaraldi, Riccardo Magistroni, Gianni Cappelli
doi : 10.1093/ckj/sfab065
Clinical Kidney Journal, Volume 14, Issue 8, August 2021, Pages 1983–1984
COVID-19 vaccine acceptance among haemodialysis patients: a French survey
Titus Andrian, Laetitia Koppe, Etienne Novel, Maeva Massat, Christophe Barba, Donatella Ioriatti, Cecile Barnel, Emmanuel Villar, Mathilde Luce, Abdallah Guerraoui, Sarah Mezaache, Emilie Kalbacher, Corentin Tournebize, Denis Fouque, Elodie Chalencon
doi : 10.1093/ckj/sfab084
Clinical Kidney Journal, Volume 14, Issue 8, August 2021, Pages 1985–1986
Birth of two healthy girls following preimplantation genetic diagnosis and gestational surrogacy in a rapidly progressive autosomal dominant polycystic kidney disease case using tolvaptan
Ram?n Peces, Roc?o Mena, Carlos Peces, Emilio Cuesta, Pablo Lapunzina, Rafael Selgas, Juli?n Nevado
doi : 10.1093/ckj/sfab082
Clinical Kidney Journal, Volume 14, Issue 8, August 2021, Pages 1987–1989
Historical and geographical distribution of the founder mutation c.610G>A; p.Ala204Thr in the CLCNKB gene linked to Bartter syndrome type III in Spain
Ram?n Peces, Roc?o Mena, Carlos Peces, Pilar Barruz, Hernando Trujillo, Agust?n Carre?o, Laura Espinosa, Rafael Selgas, Pablo Lapunzina, Juli?n Nevado
doi : 10.1093/ckj/sfab083
Clinical Kidney Journal, Volume 14, Issue 8, August 2021, Pages 1990–1993
