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Keeping Dialysis Patients Safe
Roberta L. Wager
doi : 10.2215/CJN.08090621
CJASN August 2021, 16 (8) 1141-1142
Better Nutrition Care for Patients on Hemodialysis
T. Alp Ikizler
doi : 10.2215/CJN.06800521
CJASN August 2021, 16 (8) 1143-1145
Evidence-Based Practices to Reduce COVID-19 Transmission in Dialysis Facilities
Alan S. Kliger and Renee Garrick
doi : 10.2215/CJN.07220521
CJASN August 2021, 16 (8) 1146-1148
New Insights into Epidemiology and Outcome of Bacterial Infection–Related Glomerulonephritis
Nicholas R. Medjeral-Thomas and Charles D. Pusey
doi : 10.2215/CJN.07910621
CJASN August 2021, 16 (8) 1149-1151
The Promise of Metabolomics in Decelerating CKD Progression in Children
Ulla T. Schultheiss and Peggy Sekula
doi : 10.2215/CJN.07400521
CJASN August 2021, 16 (8) 1152-1154
Cardiovascular Safety of Roxadustat in CKD Anemia
Wolfgang C. Winkelmayer and Carl P. Walther
doi : 10.2215/CJN.08280621
CJASN August 2021, 16 (8) 1155-1157
Predictive Approaches for Acute Dialysis Requirement and Death in COVID-19
Akhil Vaid, Lili Chan, Kumardeep Chaudhary, Suraj K. Jaladanki, Ishan Paranjpe, Adam Russak, Arash Kia, Prem Timsina, Matthew A. Levin, John Cijiang He, Erwin P. B?ttinger, Alexander W. Charney, Zahi A. Fayad, Steven G. Coca, Benjamin S. Glicksberg, Girish N. Nadkarni and on behalf of MSCIC
doi : 10.2215/CJN.17311120
CJASN August 2021, 16 (8) 1158-1168
Background and objectives AKI treated with dialysis initiation is a common complication of coronavirus disease 2019 (COVID-19) among hospitalized patients. However, dialysis supplies and personnel are often limited.
Temporal Trends of Acute Kidney Injury and Associated Risk Exposures in Extremely Preterm Infants
Chih-Chia Chen, Yung-Chieh Lin, Shan-Tair Wang, Chao-Ching Huang and The Preterm Research Group
doi : 10.2215/CJN.19301220
CJASN August 2021, 16 (8) 1169-1177
Background and objectives Neonatal AKI in the preterm population is an under-recognized morbidity. Detecting AKI in preterm infants is important for their long-term kidney health. We aimed to examine the yearly trends of incidence and the related morbidities and care practices affecting the occurrence of neonatal AKI in extremely preterm (gestational age <29 weeks) and very preterm (gestational age 29–32 weeks) infants.
Metabolite Biomarkers of CKD Progression in Children
Michelle R. Denburg, Yunwen Xu, Alison G. Abraham, Josef Coresh, Jingsha Chen, Morgan E. Grams, Harold I. Feldman, Paul L. Kimmel, Casey M. Rebholz, Eugene P. Rhee, Ramachandran S. Vasan, Bradley A. Warady and Susan L. Furth; for the CKD Biomarkers Consortium
doi : 10.2215/CJN.00220121
CJASN August 2021, 16 (8) 1178-1189
Background and objectives Metabolomics facilitates the discovery of biomarkers and potential therapeutic targets for CKD progression.
Efficacy and Cardiovascular Safety of Roxadustat for Treatment of Anemia in Patients with Non–Dialysis-Dependent CKD
Robert Provenzano, Lynda Szczech, Robert Leong, Khalil G. Saikali, Ming Zhong, Tyson T. Lee, Dustin J. Little, Mark T. Houser, Lars Frison, John Houghton and Thomas B. Neff
doi : 10.2215/CJN.16191020
CJASN August 2021, 16 (8) 1190-1200
Background and objectives We evaluated the efficacy and cardiovascular safety of roxadustat versus placebo by analyzing data pooled from three phase 3 studies of roxadustat in patients with non–dialysis-dependent CKD and CKD-related anemia.
Effect of Vitamin D Supplementation on Kidney Function in Adults with Prediabetes
Sun H. Kim, Irwin G. Brodsky, Ranee Chatterjee, Sangeeta R. Kashyap, William C. Knowler, Emilia Liao, Jason Nelson, Richard Pratley, Neda Rasouli, Ellen M. Vickery, Mark Sarnak, Anastassios G. Pittas and D2d Research Group
doi : 10.2215/CJN.00420121
CJASN August 2021, 16 (8) 1201-1209
Background and objectives Low serum 25-hydroxyvitamin D (25[OH]D) concentration has been associated with higher levels of proteinuria and lower levels of eGFR in observational studies. In the Vitamin D and Type 2 Diabetes (D2d) study, we investigated the effect of vitamin D supplementation on kidney outcomes in a population with prediabetes.
Latency, Anti-Bacterial Resistance Pattern, and Bacterial Infection–Related Glomerulonephritis
Elenjickal Elias John, Athul Thomas, Jeethu Joseph Eapen, Sabina Yusuf, Sanjeet Roy, Anna T. Valson, Vinoi George David, Santosh Varughese and Suceena Alexander
doi : 10.2215/CJN.18631120
CJASN August 2021, 16 (8) 1210-1220
Background and objectives Bacterial infection–related GN occurs concurrent to or after known or unknown infections. It is important to understand the clinical implications of the bacterial isolates, antimicrobial resistance patterns, and effect of latency-based classification on kidney and patient outcomes.
HLA Alleles and Prognosis of PLA2R-Related Membranous Nephropathy
Wei-Bo Le, Jing-Song Shi, Yang Fan and Si-Wen Gong
doi : 10.2215/CJN.18021120
CJASN August 2021, 16 (8) 1221-1227
Background and objectives Associations between HLA alleles and susceptibility to M-type phospholipase A2 receptor (PLA2R)–related membranous nephropathy have been well defined previously in Chinese patients. However, the relationships between HLA alleles and kidney outcome remain unclear.
The Effects of Oral Energy-Dense Supplements on Nutritional Status in Nondiabetic Maintenance Hemodialysis Patients
Yaya Yang, Xianhui Qin, Junzhi Chen, Qi Wang, Yaozhong Kong, Qijun Wan, Huiqin Tao, Aiqun Liu, Youbao Li, Zizhen Lin, Yan Huang, Yanhuan He, Zihan Lei and Min Liang
doi : 10.2215/CJN.16821020
CJASN August 2021, 16 (8) 1228-1236
Background and objectives Fat-based energy-dense nutritional supplements may offer benefits over protein- or carbohydrate-dense supplements for patients receiving dialysis because of the adverse metabolic consequences of the latter. We conducted a randomized controlled trial to assess the effects of the short-term use of a fat-based nutritional supplement on various measures of nutritional status in patients receiving maintenance hemodialysis who have low dietary energy intake.
Risk of COVID-19 Disease, Dialysis Unit Attributes, and Infection Control Strategy among London In-Center Hemodialysis Patients
Ben Caplin, Damien Ashby, Kieran McCafferty, Richard Hull, Elham Asgari, Martin L. Ford, Nicholas Cole, Marilina Antonelou, Sarah A. Blakey, Vinay Srinivasa, Dandisonba C.B. Braide-Azikwe, Tayeba Roper, Grace Clark, Helen Cronin, Nathan J. Hayes, Bethia Manson, Alexander Sarnowski, Richard Corbett, Kate Bramham, Eirini Lioudaki, Nicola Kumar, Andrew Frankel, David Makanjuola, Claire C. Sharpe, Debasish Banerjee, Alan D. Salama and on behalf of the Pan-London COVID-19 Renal Audit Group
doi : 10.2215/CJN.03180321
CJASN August 2021, 16 (8) 1237-1246
Background and objectives Patients receiving in-center hemodialysis treatment face unique challenges during the coronavirus disease 2019 (COVID-19) pandemic, specifically the need to attend for treatment that prevents self-isolation. Dialysis unit attributes and isolation strategies that might reduce dialysis center COVID-19 infection rates have not been previously examined.
Recurrence of IgA Nephropathy after Kidney Transplantation in Adults
Audrey Uffing, Maria José Pérez-Saéz, Thomas Jouve, Mathilde Bugnazet, Paolo Malvezzi, Saif A. Muhsin, Marie-Camille Lafargue, Roman Reindl-Schwaighofer, Alina Morlock, Rainer Oberbauer, Anna Buxeda, Carla Burballa, Julio Pascual, Seraina von Moos, Harald Seeger, Gaetano La Manna, Giorgia Comai, Claudia Bini, Luis Sanchez Russo, Samira Farouk, Pitchaphon Nissaisorakarn, Het Patel, Nikhil Agrawal, Gianna Mastroianni-Kirsztajn, Juliana Mansur, Hélio Tedesco-Silva, Carlucci Gualberto Ventura, Fabiana Agena, Elias David-Neto, Enver Akalin, Omar Alani, Marilda Mazzali, Roberto Ceratti Manfro, Andrea Carla Bauer, Aileen X. Wang, Xingxing S. Cheng, Jesse D. Schold, Stefan P. Berger, Paolo Cravedi and Leonardo V. Riella
doi : 10.2215/CJN.00910121
CJASN August 2021, 16 (8) 1247-1255
Background and objectives In patients with kidney failure due to IgA nephropathy, IgA deposits can recur in a subsequent kidney transplant. The incidence, effect, and risk factors of IgA nephropathy recurrence is unclear, because most studies have been single center and sample sizes are relatively small.
Pharmacokinetics of Remdesivir and GS-441524 during PIRRT and Seraph 100 Therapy
Julius J. Schmidt, Stefanie M. Bode-B?ger, Jens Martens-Lobenhoffer, Marius M. Hoeper and Jan T. Kielstein
doi : 10.2215/CJN.17601120
CJASN August 2021, 16 (8) 1256-1257
Antibody Response to mRNA-1273 SARS-CoV-2 Vaccine in Hemodialysis Patients with and without Prior COVID-19
Lili Chan, Nicholas Fuca, Etti Zeldis, Kirk N. Campbell and Aisha Shaikh
doi : 10.2215/CJN.04080321
CJASN August 2021, 16 (8) 1258-1260
Correction: Major Bleeding and Risk of Death after Percutaneous Native Kidney Biopsies: A French Nationwide Cohort Study
doi : 10.2215/CJN.08200621
CJASN August 2021, 16 (8) 1261
Introduction to Kidney Transplantation: Long-Term Management Challenges
Deirdre Sawinski and Emilio D. Poggio
doi : 10.2215/CJN.13440820
CJASN August 2021, 16 (8) 1262-1263
Long-Term Immunosuppression Management
David Wojciechowski and Alexander Wiseman
doi : 10.2215/CJN.15040920
CJASN August 2021, 16 (8) 1264-1271
The long-term management of maintenance immunosuppression in kidney transplant recipients remains complex. The vast majority of patients are treated with the calcineurin inhibitor tacrolimus as the primary agent in combination with mycophenolate, with or without corticosteroids. A tacrolimus trough target 5–8 ng/ml seems to be optimal for rejection prophylaxis, but long-term tacrolimus-related side effects and nephrotoxicity support the ongoing evaluation of noncalcineurin inhibitor–based regimens. Current alternatives include belatacept or mammalian target of rapamycin inhibitors. For the former, superior kidney function at 7 years post-transplant compared with cyclosporin generated initial enthusiasm, but utilization has been hampered by high initial rejection rates. Mammalian target of rapamycin inhibitors have yielded mixed results as well, with improved kidney function tempered by higher risk of rejection, proteinuria, and adverse effects leading to higher discontinuation rates. Mammalian target of rapamycin inhibitors may play a role in the secondary prevention of squamous cell skin cancer as conversion from a calcineurin inhibitor to an mammalian target of rapamycin inhibitor resulted in a reduction of new lesion development. Early withdrawal of corticosteroids remains an attractive strategy but also is associated with a higher risk of rejection despite no difference in 5-year patient or graft survival. A major barrier to long-term graft survival is chronic alloimmunity, and regardless of agent used, managing the toxicities of immunosuppression against the risk of chronic antibody-mediated rejection remains a fragile balance.
A Case of Focal Segmental Glomerulosclerosis
Jonathan J. Hogan
doi : 10.2215/CJN.19591220
CJASN August 2021, 16 (8) 1272-1274
Virtual Interviews for Nephrology Fellowship Candidates
Samira S. Farouk and Kirk N. Campbell
doi : 10.2215/CJN.19971220
CJASN August 2021, 16 (8) 1275-1277
Clinical Implications of an Acute Dip in eGFR after SGLT2 Inhibitor Initiation
Hiddo J. L. Heerspink and David Z.I. Cherney
doi : 10.2215/CJN.02480221
CJASN August 2021, 16 (8) 1278-1280
Prioritizing Peritoneal Catheter Placement during the COVID-19 Pandemic
Matthew J. Oliver and John H. Crabtree
doi : 10.2215/CJN.19141220
CJASN August 2021, 16 (8) 1281-1283
Euglycemic Ketoacidosis as a Complication of SGLT2 Inhibitor Therapy
Biff F. Palmer and Deborah J. Clegg
doi : 10.2215/CJN.17621120
CJASN August 2021, 16 (8) 1284-1291
Sodium-glucose cotransporter-2 (SGLT2) inhibitors are drugs designed to lower plasma glucose concentration by inhibiting Na+-glucose–coupled transport in the proximal tubule. Clinical trials demonstrate these drugs have favorable effects on cardiovascular outcomes to include slowing the progression of CKD. Although most patients tolerate these drugs, a potential complication is development of ketoacidosis, often with a normal or only a minimally elevated plasma glucose concentration. Inhibition of sodium-glucose cotransporter-2 in the proximal tubule alters kidney ATP turnover so that filtered ketoacids are preferentially excreted as Na+ or K+ salts, leading to indirect loss of bicarbonate from the body and systemic acidosis under conditions of increased ketogenesis. Risk factors include reductions in insulin dose, increased insulin demand, metabolic stress, low carbohydrate intake, women, and latent autoimmune diabetes of adulthood. The lack of hyperglycemia and nonspecific symptoms of ketoacidosis can lead to delays in diagnosis. Treatment strategies and various precautions are discussed that can decrease the likelihood of this complication.
The Continuum of Acid Stress
Donald E. Wesson
doi : 10.2215/CJN.17541120
CJASN August 2021, 16 (8) 1292-1299
Acid-related injury from chronic metabolic acidosis is recognized through growing evidence of its deleterious effects, including kidney and other organ injury. Progressive acid accumulation precedes the signature manifestation of chronic metabolic acidosis, decreased plasma bicarbonate concentration. Acid accumulation that is not enough to manifest as metabolic acidosis, known as eubicarbonatemic acidosis, also appears to cause kidney injury, with exacerbated progression of CKD. Chronic engagement of mechanisms to mitigate the acid challenge from Western-type diets also appears to cause kidney injury. Rather than considering chronic metabolic acidosis as the only acid-related condition requiring intervention to reduce kidney injury, this review supports consideration of acid-related injury as a continuum. This “acid stress” continuum has chronic metabolic acidosis at its most extreme end, and high-acid-producing diets at its less extreme, yet detrimental, end.
