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Time to press the reset button—can we use the COVID-19 pandemic to rethink the process of transplant assessment?
Mukesh Kumar, David van Dellen, Holly Loughton, Alexander Woywodt
doi : 10.1093/ckj/sfab118
Clinical Kidney Journal, Volume 14, Issue 10, October 2021, Pages 2137–2141
Coronavirus disease 2019 has taken a severe toll on the transplant community, with significant morbidity and mortality not just among transplant patients and those on the waiting list, but also among colleagues. It is therefore not surprising that clinicians in this field have viewed the events of the last 18?months as predominantly negative. As the pandemic is gradually ebbing away, we argue that this is also a unique opportunity to rethink transplant assessment. First, we have witnessed a step-change in the use of technology and virtual assessments. Another effect of the pandemic is that we have had to make do with what was available—which has often worked surprisingly well. Finally, we have learned to think the unthinkable: maybe things do not have to continue the way they have always been. As we emerge on the other side of the pandemic, we should rethink which parts of the transplant assessment process are necessary and evidence-based. We emphasize the need to involve patients in the redesign of pathways and we argue that the assessment process could be made more transparent to patients. We describe a possible roadmap towards transplant assessment pathways that are truly fit for the 21st century.
Tweet me: conferencing in the era of COVID-19 and 280 characters
Kate I Stevens, Edoardo Melilli, Hugo Diniz, Keith Gillis, Dominique Guerrot, Nuria Montero, Maria Jose Soler, Tejas Desai
doi : 10.1093/ckj/sfab075
Clinical Kidney Journal, Volume 14, Issue 10, October 2021, Pages 2142–2150
The European Renal Association – European Dialysis and Transplant Association (ERA-EDTA) Social Media (SoMe) Team provides Twitter coverage of the annual congress. During the coronavirus disease 2019 (COVID-19) pandemic, #ERAEDTA20 was the first major Nephrology congress to be delivered virtually. The effect of The SoMe Team and the consequences of the COVID-19 pandemic have not been explored previously. Tweets of the ERA-EDTA congresses 2016–20, using official hashtags, were evaluated. Metadata of each tweet were collected prospectively; original tweets, retweets and evidence-based tweets were identified. The gender of tweet author and location of Twitter activity were established. Network maps were created to ascertain the degree of polarization between the 2019 and 2020 Twitter activity, using Gephi 0.9.2.
Acute tubulointerstitial nephritis and COVID-19
Jia H Ng, Mohamad Zaidan, Kenar D Jhaveri, Hassan Izzedine
doi : 10.1093/ckj/sfab107
Clinical Kidney Journal, Volume 14, Issue 10, October 2021, Pages 2151–2157
Coronavirus disease 2019 (COVID-19) is an ongoing pandemic that to date has spread to >100 countries. Acute kidney injury is not uncommon with this disease. The most common kidney biopsy finding is acute tubular injury. Glomerular diseases such as collapsing glomerulopathy and vasculitis, and thrombotic microangiopathy have been reported. Viral inclusion particles with distinctive spikes in the tubular epithelium and podocytes, and endothelial cells of the glomerular capillary loops, have been visualized by electron microscopy by some but disputed by others as non-viral structures. Interstitial infiltrates have not commonly been described in the published kidney biopsy series from patients with COVID-19. Medications used to treat COVID-19 can lead to interstitial nephritis, but very few have been reported. In summary, interstitial kidney disease is a rare finding in COVID-19.
Review of intravitreal VEGF inhibitor toxicity and report of collapsing FSGS with TMA in a patient with age-related macular degeneration
Gautam Phadke, Ramy M Hanna, Antoney Ferrey, Everardo Arias Torres, Anjali Singla, Amit Kaushal, Kamyar Kalantar-Zadeh, Ira Kurtz, Kenar D Jhaveri
doi : 10.1093/ckj/sfab066
Clinical Kidney Journal, Volume 14, Issue 10, October 2021, Pages 2158–2165
Intravitreal vascular endothelial growth factor (VEGF) receptor blockade is used for a variety of retinal pathologies. These include age-related macular degeneration (AMD), diabetic macular edema (DME) and central retinal vein obstruction. Reports of absorption of intravitreal agents into systemic circulation have increased in number and confirmation of depletion of VEGF has been confirmed. Increasingly there are studies and case reports showing worsening hypertension, proteinuria, renal dysfunction and glomerular disease. The pathognomonic findings of systemic VEGF blockade, thrombotic microangiopathies (TMAs), are also being increasingly reported. One lesion that occurs in conjunction with TMAs that has been described is collapsing focal segmental glomerulosclerosis (cFSGS). cFSGS has been postulated to occur due to TMA-induced chronic glomerular hypoxia. In this updated review we discuss the mechanistic, pharmacological, epidemiological and clinical evidence of intravitreal VEGF toxicity. We review cases of biopsy-proven toxicity presented by our group and other investigators. We also present the third reported case of cFSGS in the setting of intravitreal VEGF blockade with a chronic TMA component that was crucially found on biopsy. This patient is a 74-year-old nondiabetic male receiving aflibercept for AMD. Of the two prior cases of cFSGS in the setting of VEGF blockade, one had AMD and the other had DME. This case solidifies the finding of cFSGS and its association with chronic TMA as a lesion that may be frequently encountered in patients receiving intravitreal VEGF inhibitors.
Membranous nephropathy: a single disease or a pattern of injury resulting from different diseases
Sanjeev Sethi
doi : 10.1093/ckj/sfab069
Clinical Kidney Journal, Volume 14, Issue 10, October 2021, Pages 2166–2169
Membranous nephropathy (MN) is defined as disease entity characterized by thickening of the glomerular basement membranes due to subepithelial (SE) deposition of immune complexes. It is typically classified into primary MN (70%) when there is no disease association, and secondary MN (30%) when there is an underlying disease association such as lupus, malignancy, infections or drugs. Phospholipase A2 receptor (PLA2R) and thrombospondin type-1 domain-containing 7A (THSD7A) are target antigens in 70% and 1–5% of primary MN, respectively. The antigens in the remaining MN were not known. Recently, multiple novel proteins/target antigens have been identified in MN. These include exostosin 1/2, neural epidermal growth-like 1 protein, semaphorin 3B, protocadherin 7 and neural cell adhesion molecule 1. Some of these antigens are present in the setting of primary MN, some in secondary MN and some in both, thus blurring the lines between primary and secondary MN. Preliminary studies show that each of the new antigen-associated MN has distinct clinical, kidney biopsy findings and outcome data. We propose that each new protein/antigen-associated MN is a specific disease that results in the common MN pattern of injury characterized by thickened glomerular basement membrane (GBM) with or without spikes or pinholes on light microscopy, granular immunoglobulin G with or without complement 3 on immunofluorescence microscopy and SE electron-dense deposits on electron microscopy. In other words, MN is truly only a pattern of injury resulting from specific diseases that cause deposition of SE immune deposits along the GBM. It is of paramount importance to ascertain the specific disease entity causing the MN pattern not only for precise diagnosis and management, but also for future studies on these newly described diseases.
Diminished antiproteinuric effect of the angiotensin receptor blocker losartan during high potassium intake in patients with CKD
Rosa D Wouda, Femke Waanders, Dick de Zeeuw, Gerjan Navis, Liffert Vogt, the K+ Consortium
doi : 10.1093/ckj/sfab031
Clinical Kidney Journal, Volume 14, Issue 10, October 2021, Pages 2170–2176
Angiotensin II type 1 receptor blockers (ARBs) lower blood pressure (BP) and proteinuria and reduce renal disease progression in many—but not all—patients. Reduction of dietary sodium intake improves these effects of ARBs. Dietary potassium intake affects BP and proteinuria. We set out to address the effect of potassium intake on BP and proteinuria response to losartan in non-diabetic proteinuric chronic kidney disease (CKD) patients.
Impact of nutritional vitamin D supplementation on parathyroid hormone and 25-hydroxyvitamin D levels in non-dialysis chronic kidney disease: a meta-analysis
Jordi Bover, Joel Gunnarsson, Philipp Csomor, Edelgard Kaiser, Giuseppe Cianciolo, Rosa Lauppe
doi : 10.1093/ckj/sfab035
Clinical Kidney Journal, Volume 14, Issue 10, October 2021, Pages 2177–2186
Secondary hyperparathyroidism (SHPT) is a common and major complication in chronic kidney disease (CKD), reflecting the increase of parathyroid hormone (PTH) in response to reduced vitamin D signalling and hypocalcaemia. This meta-analysis evaluated the impact of nutritional vitamin D (NVD) (cholecalciferol or ergocalciferol) on SHPT-related biomarkers.
Global longitudinal strain by feature-tracking cardiovascular magnetic resonance imaging predicts mortality in patients with end-stage kidney disease
Alastair J Rankin, Luke Zhu, Kenneth Mangion, Elaine Rutherford, Keith A Gillis, Jennifer S Lees, Rosie Woodward, Rajan K Patel, Colin Berry, Giles Roditi, Patrick B Mark
doi : 10.1093/ckj/sfab020
Clinical Kidney Journal, Volume 14, Issue 10, October 2021, Pages 2187–2196
Patients with end-stage kidney disease (ESKD) are at increased risk of premature death, with cardiovascular disease being the predominant cause of death. We hypothesized that left ventricular global longitudinal strain (LV-GLS) measured by feature-tracking cardiovascular magnetic resonance imaging (CMRI) would be associated with all-cause mortality in patients with ESKD.
Prevalence, recognition and management of chronic kidney disease in Japan: population-based estimate using a healthcare database with routine health checkup data
Masato Takeuchi, Kanna Shinkawa, Motoko Yanagita, Koji Kawakami
doi : 10.1093/ckj/sfab016
Clinical Kidney Journal, Volume 14, Issue 10, October 2021, Pages 2197–2202
We aimed to update information on the prevalence of chronic kidney disease (CKD) in Japan. We also explored whether CKD was properly recognized and managed.
Adverse clinical outcomes associated with RAAS inhibitor discontinuation: analysis of over 400?000 patients from the UK Clinical Practice Research Datalink (CPRD)
Toby J L Humphrey, Glen James, Eric T Wittbrodt, Donna Zarzuela, Thomas F Hiemstra
doi : 10.1093/ckj/sfab029
Clinical Kidney Journal, Volume 14, Issue 10, October 2021, Pages 2203–2212
Users of guideline-recommended renin–angiotensin–aldosterone system (RAAS) inhibitors may experience disruptions to their treatment, e.g. due to hyperkalaemia, hypotension or acute kidney injury. The risks associated with treatment disruption have not been comprehensively assessed; therefore, we evaluated the risk of adverse clinical outcomes in RAAS inhibitor users experiencing treatment disruptions in a large population-wide database.
Secondary hyperparathyroidism and adverse health outcomes in adults with chronic kidney disease
Yang Xu, Marie Evans, Marco Soro, Peter Barany, Juan Jesus Carrero
doi : 10.1093/ckj/sfab006
Clinical Kidney Journal, Volume 14, Issue 10, October 2021, Pages 2213–2220
Secondary hyperparathyroidism (sHPT) develops frequently in patients with chronic kidney disease (CKD). However, the burden and long-term impact of sHPT on the risk of adverse health outcomes are not well studied.
Anemia and atrial fibrillation as independent risk factors for new-onset chronic kidney disease: the TAMA-MED Project—CKD and AF
Tomohiro Kaneko, Eitaro Kodani, Hitomi Fujii, Risa Asai, Miyako Seki, Rei Nakazato, Hiroyuki Nakamura, Hajime Sasabe, Yutaka Tamura
doi : 10.1093/ckj/sfab014
Clinical Kidney Journal, Volume 14, Issue 10, October 2021, Pages 2221–2226
Various risk factors have been identified for the new onset or rapid deterioration of chronic kidney disease (CKD). However, it is thought that many risk factors that have not yet been clarified remain.
Hypernatraemia and low eGFR at hospitalization in COVID-19 patients: a deadly combination
Elisa Longhitano, Chiara Nardi, Vincenzo Calabrese, Roberta Messina, Giuliana Mazzeo, Emmanuele Venanzi Rullo, Manuela Ceccarelli, Antoine Chatrenet, Patrick Saulnier, Massimo Torreggiani, Giuseppe Nunnari, Giorgina Barbara Piccoli, Domenico Santoro
doi : 10.1093/ckj/sfab122
Clinical Kidney Journal, Volume 14, Issue 10, October 2021, Pages 2227–2233
The coronavirus disease 2019 (COVID-19) pandemic has had a profound impact on the general population and the burden of pre-existing comorbidities has heavily affected the outcome of the infection. Hyponatraemia has been frequently described. Conversely, hypernatraemia has rarely been described in COVID-19.
Antibody response to mRNA SARS-CoV-2 vaccines in haemodialysis patients
Michael Paal, Florian M Arend, Tobias Lau, Sandra Hasmann, Daniela Soreth-Rieke, Johanna Sorodoc-Otto, Wilke Beuthien, Julia Krappe, Marcell Toepfer, Gero von Gersdorff, Norbert Thaller, Simon Rau, Bernd Northoff, Daniel Teupser, Mathias Bruegel, Michael Fischereder, Ulf Schönermarck
doi : 10.1093/ckj/sfab127
Clinical Kidney Journal, Volume 14, Issue 10, October 2021, Pages 2234–2238
Some studies have shown an attenuated immune response in haemodialysis patients after vaccination. The present study examines the humoral response after mRNA vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a large population of haemodialysis patients from different outpatient dialysis centres.
Spike and neutralizing antibodies response to COVID-19 vaccination in haemodialysis patients
Matthieu Giot, Toscane Fourié, Guillaume Lano, Paola Mariela Saba Villarroel, Xavier de Lamballeri, Marion Gully, Laurent Samson, Julien Farault, Dammar Bouchouareb, Océane Jehel, Philippe Brunet, Noémie Jourde-Chiche, Laetitia Ninove, Thomas Robert
doi : 10.1093/ckj/sfab128
Clinical Kidney Journal, Volume 14, Issue 10, October 2021, Pages 2239–2245
Humoral response to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines needs to be evaluated in the fragile population of patients on maintenance haemodialysis (HD).
Unmet needs for CKD care: from the general population to the CKD clinics—how many patients are we missing?
Massimo Torreggiani, Antoine Chatrenet, Antioco Fois, Jean Philippe Coindre, Romain Crochette, Mickael Sigogne, Samuel Wacrenier, Guillaume Seret, Béatrice Mazé, Léna Lecointre, Conrad Breuer, Hafedh Fessi, Giorgina Barbara Piccoli
doi : 10.1093/ckj/sfab055
Clinical Kidney Journal, Volume 14, Issue 10, October 2021, Pages 2246–2254
Prevalence of chronic kidney disease (CKD) varies around the world. Little is known about the discrepancy between the general population's needs and nephrology care offered. We aimed to contribute to filling this gap and propose a means to infer the number of patients needing follow-up.
Impact of insulin adsorption in various containers during hyperkalaemia treatment
Thomas Robert, Patrice Vanelle, Philippe Brunet, Nathalie Martin, Stéphane Burtey, Christophe Curti
doi : 10.1093/ckj/sfab033
Clinical Kidney Journal, Volume 14, Issue 10, October 2021, Pages 2255–2260
Insulin–glucose therapy in hyperkalaemia treatment has a narrow therapeutic index for a safe and efficient use. We assess the variability of the effective delivered insulin under conditions used in the setting of hyperkalaemia treatment.
SARS-CoV-2 breakthrough infections in vaccinated kidney transplant recipients: an issue of concern
Veerle Wijtvliet, Kristien Ledeganck, Bart Peeters, Rachel Hellemans, Daniel Abramowicz
doi : 10.1093/ckj/sfab106
Clinical Kidney Journal, Volume 14, Issue 10, October 2021, Pages 2261–2262
SARS-CoV-2 infection in chronic kidney disease patients vaccinated with Oxford/AstraZeneca COVID-19 vaccine: initial Indian experience
Sanshriti Chauhan, Hari Shankar Meshram, Vivek Kute, Himanshu Patel, Subho Banerjee, Divyesh Engineer, Sandeep Deshmukh, Ruchir Dave
doi : 10.1093/ckj/sfab108
Clinical Kidney Journal, Volume 14, Issue 10, October 2021, Pages 2263–2265
Humoral response after BNT162b2 mRNA COVID-19 vaccination in patients on haemodialysis depends on immune status
Didier Ducloux, Mathilde Colladant, Melchior Chabannes, Maria Yannaraki, Cécile Courivaud
doi : 10.1093/ckj/sfab109
Clinical Kidney Journal, Volume 14, Issue 10, October 2021, Pages 2266–2267
Minimal change disease following vaccination with CoronaVac
Ahmet Burak Dirim, Seda Safak, Berk Andac, Nurana Garayeva, Erol Demir, Ayse Serra Artan, Yasemin Ozluk, Isin Kilicaslan, Ozgur Akin Oto, Savas Ozturk, Halil Yazici
doi : 10.1093/ckj/sfab123
Clinical Kidney Journal, Volume 14, Issue 10, October 2021, Pages 2268–2269
Factors associated with humoral response after BNT162b2 mRNA COVID-19 vaccination in kidney transplant patients
Didier Ducloux, Mathilde Colladant, Melchior Chabannes, Jamal Bamoulid, Cécile Courivaud
doi : 10.1093/ckj/sfab125
Clinical Kidney Journal, Volume 14, Issue 10, October 2021, Pages 2270–2272
Value of FDG-PET/CT in monitoring cyst infections in patients with autosomal dominant polycystic renal disease
Charles Ronsin, Clément Bailly, Paul Le Turnier, Simon Ville
doi : 10.1093/ckj/sfab077
Clinical Kidney Journal, Volume 14, Issue 10, October 2021, Pages 2273–2275
Reporting inherited kidney diseases: pick up the gauntlet
Montserrat Antón-Gamero, Marta Melgosa-Hijosa
doi : 10.1093/ckj/sfab086
Clinical Kidney Journal, Volume 14, Issue 10, October 2021, Pages 2276–2277
Cardio–renal service, time for a change
Nupur N Uppal, Kenar D Jhaveri
doi : 10.1093/ckj/sfab105
Clinical Kidney Journal, Volume 14, Issue 10, October 2021, Pages 2278–2279
