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Autosomal dominant polycystic kidney disease: possibly the least silent cause of chronic kidney disease
Roser Torra, Maria Vanessa Pérez-Gómez, Mónica Furlano
doi : 10.1093/ckj/sfab132
Clinical Kidney Journal, Volume 14, Issue 11, November 2021, Pages 2281–2284
Pain is the highest prioritized patient-reported outcome in people with autosomal dominant polycystic kidney disease (ADPKD) but it remains infrequently and inconsistently measured across countries, studies and trials. The study by El-Damanawi et al. integrated a network of ADPKD expert clinicians, pain specialists, researchers and patient representatives from the national UK PKD charity, with the aim of addressing the lack of validated ADPKD-specific pain assessment tools (APATs). The APAT designed by the authors included several pain measurement tools and was tested in ADPKD patients, although further validation through assessment in larger cohorts is needed. Establishing a standardized instrument for pain measurement will ensure that pain is measured and reported in a consistent way to inform decision-making and identify effective interventions aimed at managing pain and minimizing the impact pain has on patients with ADPKD. In this context, the APAT established by the authors is to be warmly welcomed.
Aguascalientes: one of the hottest chronic kidney disease (CKD) hotspots in Mexico and a CKD of unknown aetiology mystery to be solved
Priscila Villalvazo, Sol Carriazo, Catalina Martin-Cleary, Alberto Ortiz
doi : 10.1093/ckj/sfab136
Clinical Kidney Journal, Volume 14, Issue 11, November 2021, Pages 2285–2294
In a recent issue of Clinical Kidney Journal (CKJ), Gutierrez-Peña et al. reported a high incidence and prevalence of advanced chronic kidney disease (CKD) in Aguascalientes, Mexico. This contradicts Global Burden of Disease estimates, which should be updated. A key component of this high burden of CKD relates to young people ages 20–40 years in whom the cause of CKD was unknown [CKD of unknown aetiology (CKDu)]. The incidence of kidney replacement therapy in this age group in Aguascalientes is among the highest in the world, second only to Taiwan. However, high-altitude Aguascalientes, with a year-round average temperature of 19°C, does not fit the geography of other CKDu hotspots. Furthermore, kidney biopsies in young people showed a high prevalence of focal segmental glomerulosclerosis. Potential causes of CKDu in Aguascalientes include the genetic background (no evidence, although podocytopathy genes should be explored) and environmental factors. The highest prevalence of CKD was found in Calvillo, known for guava farming. Thus guava itself, known to contain bioactive, potentially nephrotoxic molecules and pesticides, should be explored. Additionally, there are reports of water sources in Aguascalientes contaminated with heavy metals and/or pesticides. These include fluoride (increased levels found in Calvillo drinking water) as well as naturally occurring arsenic, among others. Fluoride may accumulate in bone and cause kidney disease years later, and maternal exposure to excess fluoride may cause kidney disease in offspring. We propose a research agenda to clarify the cause of CKDu in Aguascalientes that should involve international funders. The need for urgent action to identify and stem the cause of the high incidence of CKD extends to other CKD hotspots in Mexico, including Tierra Blanca in Veracruz and Poncitlan in Jalisco.
How to manage cigarette smoking in kidney transplant candidates and recipients?
Arnaud Devresse, Sophie Gohy, Arnaud Robert, Nada Kanaan
doi : 10.1093/ckj/sfab072
Clinical Kidney Journal, Volume 14, Issue 11, November 2021, Pages 2295–2303
Tobacco smoking is a frequent problem affecting many kidney transplant (KT) candidates and recipients. The negative impact of active smoking on KT outcomes has been demonstrated. Consequently, most guidelines strongly recommend quitting smoking before considering kidney transplantation. However, nicotine addiction is a complex multifactorial disease and only 3–5% of the patients who try to quit by themselves achieve prolonged abstinence. Smoking cessation programmes (SCPs) have proven their efficacy in the general population to increase the rate of quitting and should therefore be proposed to all smoking KT candidates and recipients. Nevertheless, SCPs have not been evaluated in the KT field and not all KT centres have easy access to these programmes. In this work, we aim to review the current knowledge on the subject and provide an overview of the available interventions to help smoking patients quit. We detail non-pharmaceutical and pharmaceutical approaches and discuss their use in KT candidates and recipients.
Hypophosphatemia in cancer patients
Shreedhar Adhikari, Omar Mamlouk, Helbert Rondon-Berrios, Biruh T Workeneh
doi : 10.1093/ckj/sfab078
Clinical Kidney Journal, Volume 14, Issue 11, November 2021, Pages 2304–2315
Dysregulation of phosphorus homeostasis resulting in hypophosphatemia is common in cancer patients and can result in serious complications and impact outcomes. Several factors, including critical illness, nutritional status, cancer type and therapy, influence the development of hypophosphatemia. Hypophosphatemia can develop as a result of phosphaturic mesenchymal tumors or as a paraneoplastic phenomenon. The clinical presentation for hypophosphatemia varies depending on the duration and severity of the hypophosphatemia and affects several organ systems. Among other serious effects, hypophosphatemia can impair tissue oxygenation and can cause hemolysis, leukocyte and platelet dysfunction, encephalopathy, seizures, arrhythmias, cardiomyopathy, rhabdomyolysis and coma. Multiple studies have demonstrated that hypophosphatemia is an adverse prognostic marker in inpatients with increased in-hospital stay, mortality and postoperative complications. The phosphate level is homeostatically regulated and maintained in a narrow range by three main hormones: parathyroid hormone, fibroblast growth factor 23 and 1,25-dihydroxyvitaminD3. Together, these hormones regulate how the intestine, kidneys and bones traffic phosphorus. Several hematological malignancies and cancer therapies are associated with proximal tubular dysfunction (Fanconi syndrome), resulting in phosphaturia. Caution should be taken with parenteral administration of phosphate salts, because secondary complications can develop, principally due to hypocalcemia. The general approach to hypophosphatemia should target the underlying cause. Early recognition and prevention are essential and the approach to hypophosphatemia in the cancer patient, because of the nuances and complexity, should be multidisciplinary.
Point-of-care testing technologies for the home in chronic kidney disease: a narrative review
Richard Bodington, Xenophon Kassianides, Sunil Bhandari
doi : 10.1093/ckj/sfab080
Clinical Kidney Journal, Volume 14, Issue 11, November 2021, Pages 2316–2331
Point-of-care testing (POCT) performed by the patient at home, paired with eHealth technologies, offers a wealth of opportunities to develop individualized, empowering clinical pathways. The non-dialysis-dependent chronic kidney disease (CKD) patient who is at risk of or may already be suffering from a number of the associated complications of CKD represents an ideal patient group for the development of such initiatives. The current coronavirus disease 2019 pandemic and drive towards shielding vulnerable individuals have further highlighted the need for home testing pathways. In this narrative review we outline the evidence supporting remote patient management and the various technologies in use in the POCT setting. We then review the devices currently available for use in the home by patients in five key areas of renal medicine: anaemia, biochemical, blood pressure (BP), anticoagulation and diabetes monitoring. Currently there are few devices and little evidence to support the use of home POCT in CKD. While home testing in BP, anticoagulation and diabetes monitoring is relatively well developed, the fields of anaemia and biochemical POCT are still in their infancy. However, patients’ attitudes towards eHealth and home POCT are consistently positive and physicians also find this care highly acceptable. The regulatory and translational challenges involved in the development of new home-based care pathways are significant. Pragmatic and adaptable trials of a hybrid effectiveness–implementation design, as well as continued technological POCT device advancement, are required to deliver these innovative new pathways that our patients desire and deserve.
Conducting correlation analysis: important limitations and pitfalls
Roemer J Janse, Tiny Hoekstra, Kitty J Jager, Carmine Zoccali, Giovanni Tripepi, Friedo W Dekker, Merel van Diepen
doi : 10.1093/ckj/sfab085
Clinical Kidney Journal, Volume 14, Issue 11, November 2021, Pages 2332–2337
The correlation coefficient is a statistical measure often used in studies to show an association between variables or to look at the agreement between two methods. In this paper, we will discuss not only the basics of the correlation coefficient, such as its assumptions and how it is interpreted, but also important limitations when using the correlation coefficient, such as its assumption of a linear association and its sensitivity to the range of observations. We will also discuss why the coefficient is invalid when used to assess agreement of two methods aiming to measure a certain value, and discuss better alternatives, such as the intraclass coefficient and Bland–Altman’s limits of agreement. The concepts discussed in this paper are supported with examples from literature in the field of nephrology.
Developing a patient-centred tool for pain measurement and evaluation in autosomal dominant polycystic kidney disease
Ragada El-Damanawi, Michael Lee, Tess Harris, Laura B Cowley, Ingrid Scholtes, Simon Bond, Richard N Sandford, Ian B Wilkinson, Niek F Casteleijn, Marie C Hogan, Fiona E Karet Frankl, Thomas F Hiemstra
doi : 10.1093/ckj/sfaa259
Clinical Kidney Journal, Volume 14, Issue 11, November 2021, Pages 2338–2348
Pain affects 60% of the autosomal dominant polycystic kidney disease (ADPKD) population. Despite being an early and debilitating symptom, it is poorly characterized and management is suboptimal. This study aimed to develop an ADPKD-specific pain assessment tool (APAT) to facilitate pain research.
Humoral response to a third injection of BNT162b2 vaccine in patients on maintenance haemodialysis
Marine Dekervel, Nicolas Henry, Massimo Torreggiani, Lise-Marie Pouteau, Jean-Paul Imiela, Chloé Mellaza, Anne-Sophie Garnier, Amaury Dujardin, Marine Asfar, Alexandra Ducancelle, Axelle Paquin, Sophie Blanchi, Virginie Besson, Giorgina Barbara Piccoli, Jean-François Augusto
doi : 10.1093/ckj/sfab152
Clinical Kidney Journal, Volume 14, Issue 11, November 2021, Pages 2349–2355
Humoral response against sudden acute respiratory syndrome coronavirus 2 (SARS-CoV-2) after two doses of BNT162b2 (Pfizer-BioNTech) has been proven to be less intense in maintenance dialysis patients as compared with healthy subjects, leading the French authorities to recommend a third injection in this population. Here we investigated the response to the third injection in two cohorts of haemodialysis (HD) patients.
Acute kidney injury in COVID-19: multicentre prospective analysis of registry data
Yize I Wan, Zuzanna Bien, Vanessa J Apea, Chloe M Orkin, Rageshri Dhairyawan, Christopher J Kirwan, Rupert M Pearse, Zudin A Puthucheary, John R Prowle
doi : 10.1093/ckj/sfab071
Clinical Kidney Journal, Volume 14, Issue 11, November 2021, Pages 2356–2364
Acute kidney injury (AKI) is a common and important complication of coronavirus disease 2019 (COVID-19). Further characterization is required to reduce both short- and long-term adverse outcomes.
Development and design of the Hantavirus registry - HantaReg - for epidemiological studies, outbreaks and clinical studies on hantavirus disease
Felix C Koehler, Linda Blomberg, Thomas Theo Brehm, Stefan Büttner, Oliver A Cornely, Olaf Degen, Veronica Di Cristanziano, Sebastian Dolff, Lukas Eberwein, Elion Hoxha, K Johanna R Hoyer-Allo, Sarah Rudolf, Martin R Späth, Manuel Wanken, Roman-Ulrich Müller, Volker Burst
doi : 10.1093/ckj/sfab053
Clinical Kidney Journal, Volume 14, Issue 11, November 2021, Pages 2365–2370
Frequent outbreaks around the globe and endemic appearance in different parts of the world emphasize the substantial risk of hantavirus diseases. Increasing incidence rates, trends of changing distribution of hantavirus species and new insights into clinical courses of hantavirus diseases call for multinational surveillance. Furthermore, evidence-based guidelines for the management of hantavirus diseases and scoring systems, which allow stratification of patients into risk categories, are lacking.
Association of leukocyte telomere length with chronic kidney disease in East Asians with type 2 diabetes: a Mendelian randomization study
Resham L Gurung, Rajkumar Dorajoo, Yiamunaa M, Ling Wang, Sylvia Liu, Jian-Jun Liu, Yi Ming Shao, Yuqing Chen, Xueling Sim, Keven Ang, Tavintharan Subramaniam, Wern Ee Tang, Chee Fang Sum, Jian-Jun Liu, Su Chi Lim
doi : 10.1093/ckj/sfab067
Clinical Kidney Journal, Volume 14, Issue 11, November 2021, Pages 2371–2376
Chronic kidney disease (CKD) is common among people with type 2 diabetes (T2D), and increases the risk of kidney failure and cardiovascular diseases. Shorter leukocyte telomere length (LTL) is associated with CKD in patients with T2D. We previously reported single-nucleotide polymorphisms (SNPs) associated with LTL in an Asian population. In this study, we elucidated the association of these SNPs with CKD in patients with T2D using the Mendelian randomization (MR) approach.
External validation of the Madrid Acute Kidney Injury Prediction Score
Jacqueline Del Carpio, Maria Paz Marco, Maria Luisa Martin, Lourdes Craver, Elias Jatem, Jorge Gonzalez, Pamela Chang, Mercedes Ibarz, Silvia Pico, Gloria Falcon, Marina Canales, Elisard Huertas, Iñaki Romero, Nacho Nieto, Alfons Segarra
doi : 10.1093/ckj/sfab068
Clinical Kidney Journal, Volume 14, Issue 11, November 2021, Pages 2377–2382
The Madrid Acute Kidney Injury Prediction Score (MAKIPS) is a recently described tool capable of performing automatic calculations of the risk of hospital-acquired acute kidney injury (HA-AKI) using data from from electronic clinical records that could be easily implemented in clinical practice. However, to date, it has not been externally validated. The aim of our study was to perform an external validation of the MAKIPS in a hospital with different characteristics and variable case mix.
The association of glucose metabolism and kidney function in middle-aged adults
Marielle A Schroijen, Renée de Mutsert, Friedo W Dekker, Aiko P J de Vries, Eelco J P de Koning, Ton J Rabelink, Frits R Rosendaal, Olaf M Dekkers
doi : 10.1093/ckj/sfab074
Clinical Kidney Journal, Volume 14, Issue 11, November 2021, Pages 2383–2390
Previous clinical studies have shown that various measures of glucose metabolism are associated with a risk of chronic kidney disease in different populations, but results were not consistent. In this study we assessed measures of glucose metabolism and their association with kidney function in a population-based study.
Hyperkalaemia management and related costs in chronic kidney disease patients with comorbidities in Spain
Antonio Olry de Labry Lima, Óscar Díaz Castro, Jorge M Romero-Requena, M de los Reyes García Díaz-Guerra, Virginia Arroyo Pineda, M Belén de la Hija Díaz, Meritxell Ascanio, Josep Darbà, Josep M Cruzado
doi : 10.1093/ckj/sfab076
Clinical Kidney Journal, Volume 14, Issue 11, November 2021, Pages 2391–2400
Hyperkalaemia (HK) is a common electrolyte disorder in patients with chronic kidney disease (CKD) and/or treated with renin–angiotensin–aldosterone system inhibitors (RAASis). The aim of this study is to determine the severity, current management and cost of chronic HK.
Sclerostin and DKK1 circulating levels associate with low bone turnover in patients with chronic kidney disease Stages 3 and 4
Ricardo Neto, Luciano Pereira, Juliana Magalhães, Janete Quelhas-Santos, Sandra Martins, Catarina Carvalho, João Miguel Frazão
doi : 10.1093/ckj/sfab081
Clinical Kidney Journal, Volume 14, Issue 11, November 2021, Pages 2401–2408
Disordered mineral and bone metabolism is a common complication of chronic kidney disease (CKD). Bone biopsy remains the gold standard tool for evaluating renal osteodystrophy (ROD), but it is an invasive procedure. Despite a growing interest in the ability of newer bone biomarkers to discriminate between different forms of ROD, data on pre-dialysis patients are scarce.
Multimorbidity and the risk of major adverse kidney events: findings from the UK Biobank cohort
Michael K Sullivan, Bhautesh Dinesh Jani, Jennifer S Lees, Claire E Welsh, Alex McConnachie, Bethany Stanley, Paul Welsh, Barbara I Nicholl, Donald M Lyall, Juan-Jesus Carrero, Dorothea Nitsch, Naveed Sattar, Frances S Mair, Patrick B Mark
doi : 10.1093/ckj/sfab079
Clinical Kidney Journal, Volume 14, Issue 11, November 2021, Pages 2409–2419
Multimorbidity [the presence of two or more long-term conditions (LTCs)] is associated with a heightened risk of mortality, but little is known about its relationship with the risk of kidney events.
Functional megalin is expressed in renal cysts in a mouse model of adult polycystic kidney disease
Marlene L Nielsen, Mia C Mundt, Dorte L Lildballe, Maria Rasmussen, Lone Sunde, Vicente E Torres, Peter C Harris, Henrik Birn
doi : 10.1093/ckj/sfab088
Clinical Kidney Journal, Volume 14, Issue 11, November 2021, Pages 2420–2427
Autosomal dominant polycystic kidney disease (ADPKD) is characterized by the progressive growth of cysts and a decline of renal function. The clinical feasibility of the number of potential disease-modifying drugs is limited by systemic adverse effects. We hypothesize that megalin, a multiligand endocytic receptor expressed in the proximal tubule, may be used to facilitate drug uptake into cysts, thereby allowing for greater efficacy and fewer side effects.
Influence of doctors’ perception on the diagnostic status of chronic kidney disease: results from 976?409 individuals with electronic health records in China
Huai-Yu Wang, Guo-Hui Ding, Hongbo Lin, Xiaoyu Sun, Chao Yang, Suyuan Peng, Jinwei Wang, Jian Du, Yu Zhao, Zhengyue Chen, Beiyan Bao, Guilan Kong, Luxia Zhang
doi : 10.1093/ckj/sfab089
Clinical Kidney Journal, Volume 14, Issue 11, November 2021, Pages 2428–2436
The diagnostic status of chronic kidney disease (CKD) and its underlying reasons provide evidence that can improve CKD management. However, the situation in developing countries remains under-investigated.
Active vitamin D increases the risk of hypercalcaemia in non-dialysis chronic kidney disease patients with secondary hyperparathyroidism: a systematic review and meta-analysis
Mario Cozzolino, Laurence Bernard, Philipp A Csomor
doi : 10.1093/ckj/sfab091
Clinical Kidney Journal, Volume 14, Issue 11, November 2021, Pages 2437–2443
This study evaluates the effects of active (1?-hydroxylated) vitamin D (AVD) therapy on hypercalcaemia in patients with non-dialysis chronic kidney disease (ND-CKD) and secondary hyperparathyroidism (SHPT).
Roxadustat in the treatment of a hemodialysis patient with anti-erythropoietin antibody-mediated pure red cell aplasia
Bojun Xu, Suying Liu, Yan Li, Liangbin Zhao, Xinyao Song, Tong Chen
doi : 10.1093/ckj/sfab134
Clinical Kidney Journal, Volume 14, Issue 11, November 2021, Pages 2444–2445
Longevity and correlation with disease severity of the humoral and cellular response to SARS-CoV-2 infection in haemodialysis patients
An S De Vriese, Jens Van Praet, Marijke Reynders, Line Heylen, Liesbeth Viaene, Rogier Caluwé, Melanie Schoutteten, Dirk De Bacquer
doi : 10.1093/ckj/sfab147
Clinical Kidney Journal, Volume 14, Issue 11, November 2021, Pages 2446–2448
Renal long-term outcome of critically ill COVID-19 patients with acute kidney failure and continuous renal replacement therapy
Rosa Melero, Antonia Mijaylova, Patrocinio Rodriguez-Benitez, Nicolas Macías, Ines Aragoncillo, Maria Luisa Rodriguez-Ferrero, Ana Garcia-Prieto, Arturo Bascuñana, Adriana Acosta, Angela Gonzalez-Rojas, Alejandra Muñoz de Morales, Javier Carbayo, Luis Sanchez-Cámara, Ursula Verdalles, Soraya Abad, Almudena Vega, Eduardo Verde, David Arroyo, Ana Perez de Jose, Patricia Piñero, Jamil Cedeño, Fernando Anaya, Manuel Antonio Rengel, Daniel Barraca, María Olmedo, Marian Goicoechea
doi : 10.1093/ckj/sfab150
Clinical Kidney Journal, Volume 14, Issue 11, November 2021, Pages 2449–2450
Erratum to: Founding mutations explains hotspots of polycystic kidney disease in Southern Spain
Carmen García Rabaneda, Francisco Perea, María Luz Bellido Díaz, Ana I Morales García, Margarita Martínez Atienza, Lisbeth Sousa Silva, Miguel Ángel García González, Francisco Ruiz-Cabello, Rafael J Esteban de la Rosa
doi : 10.1093/ckj/sfab141
Clinical Kidney Journal, Volume 14, Issue 11, November 2021, Page 2451
