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Patients with Kidney Disease: Ready to Use Smartphones for Health Care Delivery?
Lana Schmidt
doi : 10.2215/CJN.17771120
CJASN January 2021, 16 (1) 1-2
Long-Term Safety of Tolvaptan in ADPKD
Dipal M. Patel and Neera K. Dahl
doi : 10.2215/CJN.17981120
CJASN January 2021, 16 (1) 3-5
Forever Starts Now
Sradha Kotwal and Vlado Perkovic
doi : 10.2215/CJN.18141120
CJASN January 2021, 16 (1) 6-8
Dietary Therapy for Managing Hyperphosphatemia
Yoko Narasaki and Connie M. Rhee
doi : 10.2215/CJN.18171120
CJASN January 2021, 16 (1) 9-11
Mobile Health in Dialysis: The Best Engagement Medium Is the One that’s with Patients
Karandeep Singh
doi : 10.2215/CJN.18051120
CJASN January 2021, 16 (1) 12-13
Acute Kidney Injury in a National Cohort of Hospitalized US Veterans with COVID-19
Benjamin Bowe, Miao Cai, Yan Xie, Andrew K. Gibson, Geetha Maddukuri and Ziyad Al-Aly
doi : 10.2215/CJN.09610620
CJASN January 2021, 16 (1) 14-25
Background and objectives Coronavirus disease 2019 (COVID-19) is associated with higher risk of AKI. We aimed to describe rates and characterize predictors and health outcomes associated with AKI in a national cohort of US veterans hospitalized with COVID-19.
Prospective Cohort Study of Renin-Angiotensin System Blocker Usage after Hospitalized Acute Kidney Injury
Sandeep Brar, Kathleen D. Liu, Alan S. Go, Raymond K. Hsu, Vernon M. Chinchilli, Steven G. Coca, Amit X. Garg, Jonathan Himmelfarb, T. Alp Ikizler, James Kaufman, Paul L. Kimmel, Chirag R. Parikh, Edward D. Siew, Lorraine B. Ware, Hui Zeng, Chi-yuan Hsu and for the ASsessment, Serial Evaluation, and Subsequent Sequelae in Acute Kidney Injury (ASSESS-AKI) study investigators
doi : 10.2215/CJN.10840720
CJASN January 2021, 16 (1) 26-36
Background and objectives The risk-benefit ratio of angiotensin-converting enzyme inhibitor or angiotensin receptor blocker therapy after AKI may be altered due to concerns regarding recurrent AKI. We evaluated, in a prospective cohort, the association between use (versus nonuse) of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers and the subsequent risk of AKI and other adverse outcomes after hospitalizations with and without AKI.
NAT8 Variants, N-Acetylated Amino Acids, and Progression of CKD
Shengyuan Luo, Aditya Surapaneni, Zihe Zheng, Eugene P. Rhee, Josef Coresh, Adriana M. Hung, Girish N. Nadkarni, Bing Yu, Eric Boerwinkle, Adrienne Tin, Dan E. Arking, Inga Steinbrenner, Pascal Schlosser, Anna K?ttgen and Morgan E. Grams
doi : 10.2215/CJN.08600520
CJASN January 2021, 16 (1) 37-47
Background and objectives Genetic variants in NAT8, a liver- and kidney-specific acetyltransferase encoding gene, have been associated with eGFR and CKD in European populations. Higher circulating levels of two NAT8-associated metabolites, N-?-acetylornithine and N-acetyl-1-methylhistidine, have been linked to lower eGFR and higher risk of incident CKD in the Black population. We aimed to expand upon prior studies to investigate associations between rs13538, a missense variant in NAT8, N-acetylated amino acids, and kidney failure in multiple, well-characterized cohorts.
Multicenter Study of Long-Term Safety of Tolvaptan in Later-Stage Autosomal Dominant Polycystic Kidney Disease
Vicente E. Torres, Arlene B. Chapman, Olivier Devuyst, Ron T. Gansevoort, Ronald D. Perrone, Jennifer Lee, Molly E. Hoke, Alvin Estilo and Olga Sergeyeva
doi : 10.2215/CJN.10250620
CJASN January 2021, 16 (1) 48-58
Background and objectives Tolvaptan slows kidney function decline in patients with autosomal dominant polycystic kidney disease (ADPKD) at risk of rapid progression. In the 3-year Tolvaptan Efficacy and Safety in Management of ADPKD and Its Outcomes (TEMPO) 3:4, 2-year extension to TEMPO 3:4 (TEMPO 4:4), and 1-year Replicating Evidence of Preserved Renal Function: An Investigation of Tolvaptan Safety and Efficacy in ADPKD (REPRISE) trials, aquaretic adverse events were common. Serum alanine aminotransferase (ALT) or aspartate aminotransferase (AST) elevations occurred in all three studies. Three patients met Hy Law criteria (ALT or AST more than three times and total bilirubin more than two times the upper limit of normal) for severe drug-induced liver injury (two in TEMPO 3:4 and one in TEMPO 4:4). In REPRISE, liver enzyme monitoring frequency was increased to monthly, with no Hy Law cases. A long-term, phase 3 safety study has further characterized tolvaptan safety.
Effects of the Soluble Guanylate Cyclase Stimulator Praliciguat in Diabetic Kidney Disease
John P. Hanrahan, Ian H. de Boer, George L. Bakris, Phebe J. Wilson, James D. Wakefield, Jelena P. Seferovic, Jennifer G. Chickering, Yueh-tyng Chien, Kenneth Carlson, Michael D. Cressman, Mark G. Currie, G. Todd Milne and Albert T. Profy
doi : 10.2215/CJN.08410520
CJASN January 2021, 16 (1) 59-69
Background and objectives Impaired nitric oxide signaling through soluble guanylate cyclase has been implicated in the pathophysiology of diabetic kidney disease. Praliciguat, a soluble guanylate cyclase stimulator that amplifies nitric oxide signaling, inhibited kidney inflammation and fibrosis in animal models.
Network Meta-Analysis of Novel Glucose-Lowering Drugs on Risk of Acute Kidney Injury
Min Zhao, Shusen Sun, Zhenguang Huang, Tiansheng Wang and Huilin Tang
doi : 10.2215/CJN.11220720
CJASN January 2021, 16 (1) 70-78
Background and objectives Little is known about the comparative effects of dipeptidyl peptidase-4 (DPP-4) inhibitors, glucagon-like peptide-1 receptor agonists (GLP-1RAs), or sodium glucose cotransporter-2 (SGLT2) inhibitors on risk of AKI. This study aimed to compare the effects of these three novel classes of glucose-lowering drugs on AKI risk in patients with or without type 2 diabetes, by network meta-analysis of event-driven cardiovascular or kidney outcome trials.
Availability, Accessibility, and Quality of Conservative Kidney Management Worldwide
Meaghan Lunney, Aminu K. Bello, Adeera Levin, Helen Tam-Tham, Chandra Thomas, Mohamed A. Osman, Feng Ye, Ezequiel Bellorin-Font, Mohammed Benghanem Gharbi, Mohammad Ghnaimat, Htay Htay, Yeoungjee Cho, Vivekanand Jha, Shahrzad Ossareh, Eric Rondeau, Laura Sola, Irma Tchokhonelidze, Vladimir Tesar, Kriang Tungsanga, Rumeyza Turan Kazancioglu, Angela Yee-Moon Wang, Chih-Wei Yang, Alexander Zemchenkov, Ming-hui Zhao, Kitty J. Jager, Kailash K. Jindal, Ikechi G. Okpechi, Edwina A. Brown, Mark Brown, Marcello Tonelli, David C. Harris, David W. Johnson, Fergus J. Caskey and Sara N. Davison
doi : 10.2215/CJN.09070620
CJASN January 2021, 16 (1) 79-87
Background and objectives People with kidney failure typically receive KRT in the form of dialysis or transplantation. However, studies have suggested that not all patients with kidney failure are best suited for KRT. Additionally, KRT is costly and not always accessible in resource-restricted settings. Conservative kidney management is an alternate kidney failure therapy that focuses on symptom management, psychologic health, spiritual care, and family and social support. Despite the importance of conservative kidney management in kidney failure care, several barriers exist that affect its uptake and quality.
Zolpidem Versus Trazodone Initiation and the Risk of Fall-Related Fractures among Individuals Receiving Maintenance Hemodialysis
Magdalene M. Assimon and Jennifer E. Flythe
doi : 10.2215/CJN.10070620
CJASN January 2021, 16 (1) 88-97
Background and objectives Zolpidem, a nonbenzodiazepine hypnotic, and trazodone, a sedating antidepressant, are the most common medications used to treat insomnia in the United States. Both drugs have side effect profiles (e.g., drowsiness, dizziness, and cognitive and motor impairment) that can heighten the risk of falls and fractures. Despite widespread zolpidem and trazodone use, little is known about the comparative safety of these medications in patients receiving hemodialysis, a vulnerable population with an exceedingly high fracture rate.
The Mobile Health Readiness of People Receiving In-Center Hemodialysis and Home Dialysis
Wael F. Hussein, Paul N. Bennett, Sloane Pace, Shijie Chen, Veronica Legg, Jugjeet Atwal, Sumi Sun and Brigitte Schiller
doi : 10.2215/CJN.11690720
CJASN January 2021, 16 (1) 98-106
Background and objectives Mobile health is the health care use of mobile devices, such as smartphones. Mobile health readiness is a prerequisite to successful implementation of mobile health programs. The aim of this study was to examine the status and correlates of mobile health readiness among individuals on dialysis.
Effect of Phosphate-Specific Diet Therapy on Phosphate Levels in Adults Undergoing Maintenance Hemodialysis
David E. St-Jules, Mary R. Rozga, Deepa Handu and Juan Jesus Carrero
doi : 10.2215/CJN.09360620
CJASN January 2021, 16 (1) 107-120
Background and objectives Hyperphosphatemia is a persistent problem in individuals undergoing maintenance hemodialysis, which may contribute to vascular and bone complications. In some dialysis centers, dietitians work with patients to help them manage serum phosphate. Given the regularity of hyperphosphatemia in this population and constraints on kidney dietitian time, the authors aimed to evaluate the evidence for this practice.
COVID-19 in Peritoneal Dialysis Patients
Hua-Jun Jiang, Hui Tang, Fei Xiong, Wen-Li Chen, Jian-Bo Tian, Jing Sun, Jun-Wu Dong, Xiao-Hui Wang, Xiao-Fei Jin, Yan-Qiong Ding, Li Xu, Xiao-Ping Miao and Chun Zhang
doi : 10.2215/CJN.07200520
CJASN January 2021, 16 (1) 121-123
Anticoagulation Strategies and Filter Life in COVID-19 Patients Receiving Continuous Renal Replacement Therapy
Divya Shankaranarayanan, Thangamani Muthukumar, Tarek Barbar, Aarti Bhasin, Supriya Gerardine, Perola Lamba, Lorenz Leuprecht, Sanjay P. Neupane, Thalia Salinas, Daniil Shimonov, Elly Varma and Frank Liu
doi : 10.2215/CJN.08430520
CJASN January 2021, 16 (1) 124-126
Clinical Integration of Genome Diagnostics for Congenital Anomalies of the Kidney and Urinary Tract
Rik Westland, Kirsten Y. Renkema and Nine V.A.M. Knoers
doi : 10.2215/CJN.14661119
CJASN January 2021, 16 (1) 128-137
Revolutions in genetics, epigenetics, and bioinformatics are currently changing the outline of diagnostics and clinical medicine. From a nephrologist’s perspective, individuals with congenital anomalies of the kidney and urinary tract (CAKUT) are an important patient category: not only is CAKUT the predominant cause of kidney failure in children and young adults, but the strong phenotypic and genotypic heterogeneity of kidney and urinary tract malformations has hampered standardization of clinical decision making until now. However, patients with CAKUT may benefit from precision medicine, including an integrated diagnostics trajectory, genetic counseling, and personalized management to improve clinical outcomes of developmental kidney and urinary tract defects. In this review, we discuss the present understanding of the molecular etiology of CAKUT and the currently available genome diagnostic modalities in the clinical care of patients with CAKUT. Finally, we discuss how clinical integration of findings from large-scale genetic, epigenetic, and gene-environment interaction studies may improve the prognosis of all individuals with CAKUT.
Walkaway PIRRT (as SLED) for Acute Kidney Injury
Anna Burgner and Thomas Golper
doi : 10.2215/CJN.07510520
CJASN January 2021, 16 (1) 138-140
Gender and CKD
Sofia B. Ahmed, Nathalie Saad and Sandra M. Dumanski
doi : 10.2215/CJN.03030320
CJASN January 2021, 16 (1) 141-143
Addressing Polypharmacy in Outpatient Dialysis Units
Marisa Battistella and Patrick Ng
doi : 10.2215/CJN.05270420
CJASN January 2021, 16 (1) 144-146
Incremental and Twice-Weekly Hemodialysis Program in Practice
Mariana Murea and Kamyar Kalantar-Zadeh
doi : 10.2215/CJN.04170320
CJASN January 2021, 16 (1) 147-149
What Does Uromodulin Do?
Anne Kipp and Eric Olinger
doi : 10.2215/CJN.06390420
CJASN January 2021, 16 (1) 150-153
Optimizing Peritoneal Dialysis–Associated Peritonitis Prevention in the United States
Jeffrey Perl, Douglas S. Fuller, Neil Boudville, Alan S. Kliger, Douglas E. Schaubel, Isaac Teitelbaum, Bradley A. Warady, Alicia M. Neu, Priti R. Patel, Beth Piraino, Martin Schreiber and Ronald L. Pisoni
doi : 10.2215/CJN.11280919
CJASN January 2021, 16 (1) 154-161
Peritoneal dialysis (PD)–associated peritonitis is the leading cause of permanent transition to hemodialysis among patients receiving PD. Peritonitis is associated with higher mortality risk and added treatment costs and limits more widespread PD utilization. Optimizing the prevention of peritonitis in the United States will first require standardization of peritonitis definitions, key data elements, and outcomes in an effort to facilitate nationwide reporting. Standardized reporting can also help describe the variability in peritonitis rates and outcomes across facilities in the United States in an effort to identify potential peritonitis prevention strategies and engage with stakeholders to develop strategies for their implementation. Here, we will highlight considerations and challenges in developing standardized definitions and implementation of national reporting of peritonitis rates by PD facilities. We will describe existing peritonitis prevention evidence gaps, highlight successful infection-reporting initiatives among patients receiving in-center hemodialysis or PD, and provide an overview of nationwide quality improvement initiatives, both in the United States and elsewhere, that have translated into a reduction in peritonitis incidence. We will discuss opportunities for collaboration and expansion of the Nephrologists Transforming Dialysis Safety (NTDS) initiative to develop knowledge translation pathways that will lead to dissemination of best practices in an effort to reduce peritonitis incidence.
Klotho in Clinical Nephrology
Javier A. Neyra, Ming Chang Hu and Orson W. Moe
doi : 10.2215/CJN.02840320
CJASN January 2021, 16 (1) 162-176
?Klotho (called Klotho here) is a membrane protein that serves as the coreceptor for the circulating hormone fibroblast growth factor 23 (FGF23). Klotho is also cleaved and released as a circulating substance originating primarily from the kidney and exerts a myriad of housekeeping functions in just about every organ. The vital role of Klotho is shown by the multiorgan failure with genetic deletion in rodents, with certain features reminiscent of human disease. The most common causes of systemic Klotho deficiency are AKI and CKD. Preclinical data on Klotho biology have advanced considerably and demonstrated its potential diagnostic and therapeutic value; however, multiple knowledge gaps exist in the regulation of Klotho expression, release, and metabolism; its target organs; and mechanisms of action. In the translational and clinical fronts, progress has been more modest. Nonetheless, Klotho has potential clinical applications in the diagnosis of AKI and CKD, in prognosis of progression and extrarenal complications, and finally, as replacement therapy for systemic Klotho deficiency. The overall effect of Klotho in clinical nephrology requires further technical advances and additional large prospective human studies.
