Kidney International Reports最新文献

{"title":"Estimating Number of Nephrons in Living Pediatric Patients Using Nephrectomy Specimens","authors":"Haruhide Sakaguchi ,&nbsp;Daishi Hirano ,&nbsp;Yuhei Kawakami ,&nbsp;Ai Tokunaga ,&nbsp;Naoto Nishizaki ,&nbsp;Amane Endo ,&nbsp;Hiroki Miyano ,&nbsp;Yuki Yuza ,&nbsp;Saeko Hatanaka ,&nbsp;Takaya Sasaki ,&nbsp;Go Kanzaki ,&nbsp;Nobuo Tsuboi ,&nbsp;Kimihiko Oishi","doi":"10.1016/j.ekir.2024.12.027","DOIUrl":"10.1016/j.ekir.2024.12.027","url":null,"abstract":"<div><h3>Introduction</h3><div>The number of nephrons is a critical determinant of renal health, because chronic kidney disease often results from a reduction in functional nephrons. Variability in the number of nephrons is influenced by genetic, racial, prenatal, and postnatal factors. Estimating the number of nephrons is crucial for establishing a baseline, before the onset of age-related nephron loss. This study aimed to estimate number of nephrons in pediatric patients by using imaging and histological techniques.</div></div><div><h3>Methods</h3><div>This retrospective study included pediatric patients with renal tumors, who are undergoing nephrectomy and contrast-enhanced computed tomography (CT) between January 2010 and January 2021. Postsurgical renal tissue specimens were fixed, stained, and scanned into high-resolution digital images. Nonsclerotic glomerular density was calculated using stereological methods, whereas renal cortical volume was measured using ITK-SNAP software on CT images. The total number of nephrons was estimated based on cortical volume and glomerular density. Statistical analyses were conducted to identify the correlations between the number of nephrons and clinical factors.</div></div><div><h3>Results</h3><div>Twenty-one children met the inclusion criteria. The cohort comprised 13 boys (61.9%) and 8 girls (38.1%) with a median age at nephrectomy of 2.5 years. The median number of nephrons per kidney was 925,000 (interquartile range [IQR]: 845,000–1,020,000). Higher number of nephrons was significantly correlated with older age at nephrectomy (<em>ρ</em> = 0.47, <em>P</em> = 0.036) and larger body surface area (BSA; <em>ρ</em> = 0.45, <em>P</em> = 0.034).</div></div><div><h3>Conclusion</h3><div>This study offers new insights into pediatric nephron endowment, emphasizing the importance of early nephron assessment for predicting long-term renal outcomes.</div></div>","PeriodicalId":17761,"journal":{"name":"Kidney International Reports","volume":"10 3","pages":"Pages 772-779"},"PeriodicalIF":5.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143550808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Single-Cell Profiling of Tubular Epithelial Cells in Adaptive State in the Urine Sediment of Patients With Early and Advanced Diabetic Kidney Disease","authors":"Dongzhao Ma ,&nbsp;Dan Wang ,&nbsp;Jianwen Yu ,&nbsp;Naya Huang ,&nbsp;Ning Luo ,&nbsp;Yue Yang ,&nbsp;Minghui Xu ,&nbsp;Jianbo Li ,&nbsp;Yagui Qiu ,&nbsp;Jinjin Fan ,&nbsp;Zhijian Li ,&nbsp;Wei Chen ,&nbsp;Qin Zhou","doi":"10.1016/j.ekir.2024.11.002","DOIUrl":"10.1016/j.ekir.2024.11.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Tubular epithelial cells (TECs) under adaptive state (aTECs) have been frequently reported in the injured kidney closely associated with disease progression. However, whether aTECs is present in the urine of patients with diabetic kidney disease (DKD) and its clinical implication have not been assessed.</div></div><div><h3>Methods</h3><div>Urine samples from patients with early and advanced DKD were collected and subjected to single-cell RNA sequencing (scRNA-seq). Kidney single nucleus RNA-seq, spatial scRNA-seq, and bulk RNA-seq datasets were employed to reconstruct their local environment and to delineate differences between shed cells and local residence.</div></div><div><h3>Results</h3><div>Most urinary TEC in patients with DKD are under adaptive states. Whereas the composition of urinary TEC is consistent in early and advanced DKD, a higher ratio of aTECs under progenitor and fibrosis state is defined in early DKD. Trajectory inference reveals that some aTECs are early derivatives of injured proximal tubule (PT). Spatial mapping reveals that proliferative and fibrosis aTECs reside close to the glomerulus region. Systemic evaluation of different states of urinary aTECs in patients of diverse-cause kidney injury suggests that the ratio of progenitor or proliferative aTECs to fibrosis aTECs is of diagnostic value.</div></div><div><h3>Conclusion</h3><div>Urine is an underestimated source of aTECs providing us noninvasive manner to interrogate the injured state of tubule. The ratio of fibrosis aTECs and progenitor or proliferative aTECs in urine features tubular injury state and may help improve DKD diagnosis.</div></div>","PeriodicalId":17761,"journal":{"name":"Kidney International Reports","volume":"10 3","pages":"Pages 892-905"},"PeriodicalIF":5.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143551370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nephron Number in Pediatric Patients","authors":"Aleksandar Denic ,&nbsp;Menno Pruijm ,&nbsp;Andrew D. Rule","doi":"10.1016/j.ekir.2025.01.017","DOIUrl":"10.1016/j.ekir.2025.01.017","url":null,"abstract":"","PeriodicalId":17761,"journal":{"name":"Kidney International Reports","volume":"10 3","pages":"Pages 654-656"},"PeriodicalIF":5.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143551887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cinacalcet for Infants and Young Children on Maintenance Dialysis: Determining the Right Time, the Right Dose and the Right Patients","authors":"Kyle Ying-kit Lin ,&nbsp;Fiona Fung-yee Lai ,&nbsp;Eugene Yu-hin Chan ,&nbsp;Bradley A. Warady","doi":"10.1016/j.ekir.2024.11.032","DOIUrl":"10.1016/j.ekir.2024.11.032","url":null,"abstract":"<div><div>Chronic Kidney Disease - Mineral Bone Disorder (CKD-MBD) is a recognized complication of kidney failure, which can lead to short stature, bone deformity, slipped capital femoral epiphysis, and bone fracture in children. Despite the use of conventional therapies, a subgroup of patients receiving dialysis continues to experience secondary or even tertiary hyperparathyroidism. Cinacalcet, a calcimimetic agent, has been shown to be a promising therapeutic option to control hyperparathyroidism with reasonable safety profiles in adults and older children. Nevertheless, there is a paucity of data and guidance pertaining to its use among the younger children on dialysis, who are often the most challenging patients to manage with severe CKD-MBD. In this review, we summarize the available evidence on cinacalcet use among pediatric patients, especially infants and young children aged &lt; 3 years. We also discuss the unique considerations in management and attempt to provide a pragmatic approach regarding the use of cinacalcet in this specific patient population.</div></div>","PeriodicalId":17761,"journal":{"name":"Kidney International Reports","volume":"10 3","pages":"Pages 696-706"},"PeriodicalIF":5.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143551892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GFR is a Key Determinant of Red Blood Cell Survival in Anemia Associated With Progressive CKD","authors":"Rosi Bissinger ,&nbsp;Lina Schaefer ,&nbsp;Bernhard N. Bohnert ,&nbsp;Anja Schork ,&nbsp;Sebastian Hoerber ,&nbsp;Andreas Peter ,&nbsp;Syed M. Qadri ,&nbsp;Andreas L. Birkenfeld ,&nbsp;Nils Heyne ,&nbsp;Tamam Bakchoul ,&nbsp;Thomas Wieder ,&nbsp;Ferruh Artunc","doi":"10.1016/j.ekir.2024.12.023","DOIUrl":"10.1016/j.ekir.2024.12.023","url":null,"abstract":"<div><h3>Introduction</h3><div>Anemia is a common and clinically significant complication observed in patients with chronic kidney disease (CKD), resulting from complex interactions between renal dysfunction, erythropoietin (EPO) deficiency, and altered iron metabolism. In murine CKD models, red blood cell (RBC) death or eryptosis, characterized by exposure of phosphatidylserine (PS) on the outer membrane of RBCs, was observed to drive anemia. However, there is limited research that has investigated this phenomenon in patients with non–dialysis-dependent CKD (NDD-CKD).</div></div><div><h3>Methods</h3><div>In this cross-sectional cohort study, we describe the relationship between RBC death and anemia in all stages of NDD-CKD (<em>n</em> = 122). Blood samples from 133 healthy blood donors were additionally analyzed as controls.</div></div><div><h3>Results</h3><div>Patients with CKD had a significantly lower hemoglobin (Hb) concentration (12.4 [interquartile range: 11.1–13.7] g/dl) when compared with the healthy group (13.8 [13.0–14.8] g/dl, <em>P</em> &lt; 0.001). Hb concentrations exhibited a significant positive correlation with the estimated glomerular filtration rate (eGFR) across the entire cohort (<em>r</em> = 0.5, <em>P</em> &lt; 0.001). RBC death rates, quantified by the binding of freshly isolated RBCs to the ligand annexin V using flow cytometry (FACS), were significantly increased by approximately 1.4-fold in patients with CKD compared with the RBC death rates in healthy blood donors. RBC death correlated with the glomerular filtration rate (GFR) stage but not with the albuminuria stage of CKD, the degree of anemia, and serum iron concentration. Using multiple linear regression, eGFR was identified as the sole independent predictor of RBC death with an inverse relationship.</div></div><div><h3>Conclusion</h3><div>RBC death is stimulated in progressive NDD-CKD, possibly contributing to the development of renal anemia.</div></div>","PeriodicalId":17761,"journal":{"name":"Kidney International Reports","volume":"10 3","pages":"Pages 730-742"},"PeriodicalIF":5.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143550804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Randomized Trial of Pegmolesatide for the Treatment of Anemia in Patients With Nondialysis CKD","authors":"Jianteng Xie ,&nbsp;Aicheng Yang ,&nbsp;Hongyu Qiu ,&nbsp;Xiaomei Peng ,&nbsp;Wanhong Lu ,&nbsp;Xiangyang Huang ,&nbsp;Qinkai Chen ,&nbsp;Aimin Zhong ,&nbsp;Shuifu Tang ,&nbsp;Qin Wang ,&nbsp;Chuan Li ,&nbsp;Liangliang He ,&nbsp;Xiaohong Jia ,&nbsp;Anran Ma ,&nbsp;Fan Wang ,&nbsp;Xueqing Yu","doi":"10.1016/j.ekir.2024.12.002","DOIUrl":"10.1016/j.ekir.2024.12.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Pegmolesatide has been recently approved for treating anemia in chronic kidney disease (CKD) patients in China. We presented the results of the pivotal study conducted in patients with nondialysis-dependent (NDD)-CKD with anemia.</div></div><div><h3>Methods</h3><div>This randomized, active-controlled, open-label, noninferiority phase 3 study was conducted across 38 centers in China. Eligible patients were randomly assigned to receive subcutaneous injection of pegmolesatide in the upper arm once every 4 weeks or epoetin alfa weekly or biweekly, with doses adjusted to maintain hemoglobin (Hb) level of 100 to 120 g/l. The primary outcome was the mean change in Hb level from the baseline during the efficacy evaluation period. Noninferiority of pegmolesatide to epoetin alfa was established if the lower limit of the 2-sided 95% confidence interval (CI) was ≥ −10 g/l.</div></div><div><h3>Results</h3><div>A total of 173 patients received at least 1 dose of pegmolesatide (115 patients) or epoetin alfa (58 patients). During the efficacy evaluation period, the mean change in Hb from baseline level was 19.2 g/l in the pegmolesatide group and 15.4 g/l in the epoetin alfa group with a between-group difference of 3.8 g/l (95% CI: 0.7–6.9). The incidence of adverse events (AEs) and serious AEs (SAEs) were similar between groups, with hypertension being the most reported AE related to the study drug. No drug-related hypersensitivity reactions or fatal events were observed.</div></div><div><h3>Conclusion</h3><div>Pegmolesatide demonstrated comparable efficacy to epoetin alfa in elevating and maintaining Hb levels in patients with NDD-CKD with anemia without new safety concerns (<span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> identifier: <span><span>NCT03903809</span><svg><path></path></svg></span>).</div></div>","PeriodicalId":17761,"journal":{"name":"Kidney International Reports","volume":"10 3","pages":"Pages 720-729"},"PeriodicalIF":5.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143550867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Title Page","authors":"","doi":"10.1016/S2468-0249(25)00035-X","DOIUrl":"10.1016/S2468-0249(25)00035-X","url":null,"abstract":"","PeriodicalId":17761,"journal":{"name":"Kidney International Reports","volume":"10 3","pages":"Page A1"},"PeriodicalIF":5.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143551142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Rituximab in Antiglomerular Basement Membrane Disease","authors":"Vanja Ivković ,&nbsp;Ingeborg Bajema ,&nbsp;Annette Bruchfeld ,&nbsp;Stephen McAdoo ,&nbsp;Asheesh Kumar ,&nbsp;Richard Klaus ,&nbsp;Nele Kanzelmeyer ,&nbsp;Maxime Touzot ,&nbsp;Georgina Maalouf ,&nbsp;Ajay Jaryal ,&nbsp;Sanjay Vikrant ,&nbsp;Dieter Haffner ,&nbsp;Bärbel Lange-Sperandio ,&nbsp;David Saadoun ,&nbsp;Mårten Segelmark ,&nbsp;Andreas Kronbichler","doi":"10.1016/j.ekir.2024.12.026","DOIUrl":"10.1016/j.ekir.2024.12.026","url":null,"abstract":"<div><h3>Introduction</h3><div>Anti–glomerular basement membrane (GBM) disease is caused by pathogenic antibodies usually targeting the noncollagenous domain of the α3 chain of type IV collagen and frequently presents as rapidly progressive glomerulonephritis and diffuse alveolar hemorrhage (DAH). Rapid reduction of these antibodies is imperative for kidney survival and the mainstay of therapy is the combination of plasma exchange (PLEX), glucocorticoids, and cyclophosphamide. Rituximab has been postulated as a potential treatment for anti-GBM disease; however, data on efficacy and safety are lacking.</div></div><div><h3>Methods</h3><div>We performed a review of case reports and series (<em>n</em> = 28) providing individual patient-level data on the efficacy and safety of rituximab in adult and pediatric anti-GBM disease. In addition, we have received data from authors on 18 patients which stem from 4 studies that did not report on patient-level outcomes or were not previously reported. A search strategy of studies indexed in PubMed/MEDLINE was performed, followed by synthesis and analysis of the data.</div></div><div><h3>Results</h3><div>Sixty-seven patients [37 female (55%); 14 pediatric (21%); median age: 37 years] were followed-up with for a total of 87.1 person-years (median follow-up time: 9.5 months). They received rituximab as first-line (<em>n</em> = 39) or second-line (<em>n</em> = 28). Median serum creatinine was 416 μmol/l with 32 patients (48%) being dialysis-dependent at presentation and 24 (36%) having DAH. Intravenous pulse, oral glucocorticoids and PLEX were used in 85%, 98%, and 93%, respectively; and 54% of them received cyclophosphamide. Patients received a median of 4 (2–4) doses of rituximab with 11 patients (16%) having transient adverse effects. Patient survival was 91% and kidney survival was 67% (53% in adults and 71% in pediatric patients). Kidney survival was lower in initially dialysis-dependent patients (34% vs. 81%, <em>P</em> &lt; 0.001). Patients receiving second-line rituximab had better kidney survival compared with those receiving it as first-line (73% vs. 46%, <em>P</em> = 0.03).</div></div><div><h3>Conclusion</h3><div>Acknowledging the limitations of our study, including publication and selection bias, rituximab had a favorable toxicity and efficacy profile. The results indicate that rituximab can be considered as a second-line therapy in anti-GBM disease when cyclophosphamide is contraindicated.</div></div>","PeriodicalId":17761,"journal":{"name":"Kidney International Reports","volume":"10 3","pages":"Pages 743-752"},"PeriodicalIF":5.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143550805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Targeted-Release Formulation of Budesonide for the Treatment of IgA Nephropathy Patients With Severe Renal Impairment","authors":"Yan Ouyang ,&nbsp;Yafei Zhao ,&nbsp;Miantang Chen ,&nbsp;Junru Li ,&nbsp;Xinyi Zhu ,&nbsp;Qing Zhao ,&nbsp;Hong Ren ,&nbsp;Jiali Wei ,&nbsp;Nan Chen ,&nbsp;Xiaoxia Pan ,&nbsp;Jingyuan Xie","doi":"10.1016/j.ekir.2024.12.007","DOIUrl":"10.1016/j.ekir.2024.12.007","url":null,"abstract":"","PeriodicalId":17761,"journal":{"name":"Kidney International Reports","volume":"10 3","pages":"Pages 935-939"},"PeriodicalIF":5.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143550840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Celebrating 100 Years of Hemodialysis and the Legacy of Georg Haas","authors":"Faeq Husain-Syed ,&nbsp;Ulrike Enke ,&nbsp;Friedrich Lübbecke ,&nbsp;Horst-Walter Birk","doi":"10.1016/j.ekir.2025.01.003","DOIUrl":"10.1016/j.ekir.2025.01.003","url":null,"abstract":"","PeriodicalId":17761,"journal":{"name":"Kidney International Reports","volume":"10 3","pages":"Pages 964-965"},"PeriodicalIF":5.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143550864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}