Kidney International Reports最新文献

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Pilot Study of Sodium-Glucose Cotransporter 2 Inhibitor Empagliflozin Shows Reduced Intrarenal Complement Activation in Patients With Diabetes and CKD

IF 5.7 2区医学 Q1 UROLOGY & NEPHROLOGY

Kidney International Reports

Pub Date : 2025-02-01 DOI: 10.1016/j.ekir.2024.11.014

Mia Jensen , Steffen F. Nielsen , Steffen Thiel , Søren W.K. Hansen , Yaseelan Palarasah , Per Svenningsen , Jesper N. Bech , Frank H. Mose , Boye L. Jensen

引用次数: 0

Cost-Effectiveness of Clinical Decision Support to Improve CKD Outcomes Among First Nations Australians

IF 5.7 2区医学 Q1 UROLOGY & NEPHROLOGY

Kidney International Reports

Pub Date : 2025-02-01 DOI: 10.1016/j.ekir.2024.10.028

Winnie Chen , Kirsten Howard , Gillian Gorham , Asanga Abeyaratne , Yuejen Zhao , Oyelola Adegboye , Nadarajah Kangaharan , Sean Taylor , Louise J. Maple-Brown , Samuel Heard , Mohammad Radwanur Talukder , Abdolvahab Baghbanian , Sandawana William Majoni , Alan Cass

Introduction

The Northern Territory (NT) is a hotspot for chronic kidney disease (CKD) and has a high incidence of kidney replacement therapy (KRT). The Territory Kidney Care clinical decision support (CDS) tool aims to improve diagnosis and management of CKD in remote NT, particularly among First Nations Australians. We model the cost-effectiveness of the CDS versus usual care.

Methods

Taking a health care funder perspective, we modeled a cohort of people from remote NT at risk of or with CKD, as of January 1, 2017. A Markov cohort model was developed using 6 years of observed patient-level data (2017–2023), extrapolated to a 15-year time horizon. The CDS tool was modeled to improve CKD diagnosis (scenario 1), improve management (scenario 2), or improve both diagnosis and management (scenario 3).

Results

The remote NT cohort consisted of 23,195 people, predominantly (89%) First Nations, with a mean age of 42 years. Scenario 3 (improved diagnosis and management) was most cost-effective at an incremental cost-effectiveness ratio (ICER) of $96,684 per patient avoiding KRT, $30,086 per patient avoiding death. Scenario 1 (improved diagnosis) was less cost-effective, and scenario 2 (improved management) was the least cost-effective. The ICER per quality-adjusted life years (QALYs) gained ranged from $3427 (scenario 3) to $63,486 (scenario 2).

Conclusion

Territory Kidney Care is highly cost-effective when it supports early diagnosis of CKD and increases optimal management in diagnosed patients. These results support investing in CDS tools, implemented in strong partnerships, to improve outcomes in settings with a high burden of CKD.

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引用次数: 0

Thrombotic Microangiopathy From Peptide Receptor Radionuclide Therapy

IF 5.7 2区医学 Q1 UROLOGY & NEPHROLOGY

Kidney International Reports

Pub Date : 2025-02-01 DOI: 10.1016/j.ekir.2024.11.009

Paul Delalande , Mickael Bobot , Marie Essig , Corinne Simon , Annie-Pierre Jonville-Béra , Christelle Barbet , Bénédicte Sautenet , Valentin Maisons , Thibaut Carsuzaa , Franck Bruyère , Jean-Michel Halimi

引用次数: 0

WCN25-2590 Long-term outcomes and role of steroids in biopsy-proven Acute Interstitial Nephritis: A single center experience of 10 years from India

IF 5.7 2区医学 Q1 UROLOGY & NEPHROLOGY

Kidney International Reports

Pub Date : 2025-02-01 DOI: 10.1016/j.ekir.2024.11.138

Harshita Sharma ∗ , NARAYAN PRASAD , ANUPMA KAUL , MANAS RANJAN PATEL , RAVI SHANKAR KUSHWAHA , MANAS RANJAN BEHERA

引用次数: 0

WCN25-1953 INVESTIGATING THE ROLE OF INHIBIN βC AND ITS RECEPTOR ALK7 IN ACUTE KIDNEY INJURY AND CHRONIC KIDNEY DISEASE

IF 5.7 2区医学 Q1 UROLOGY & NEPHROLOGY

Kidney International Reports

Pub Date : 2025-02-01 DOI: 10.1016/j.ekir.2024.11.128

Jaina Patel ∗ , Elaheh Bayat , Vincent Lu , Bo Gao , Joan Krepinsky

引用次数: 0

WCN25-2821 Unveiling Hoffmann’s Syndrome: A Case of Spontaneous Rhabdomyolysis Due to Uncontrolled Hypothyroidism

IF 5.7 2区医学 Q1 UROLOGY & NEPHROLOGY

Kidney International Reports

Pub Date : 2025-02-01 DOI: 10.1016/j.ekir.2024.11.143

Sachin Srivastava ∗ , Dr Atul Srivastava , Dr Parikshit Singh Chauhan , Dr Sukhwinder Singh Sangha , Dr Rajesh Kumar

引用次数: 0

Kidney Disease: Improving Global Outcomes (KDIGO) Workshop on the Nurse’s Role in Managing the Symptoms of People Receiving Dialysis

IF 5.7 2区医学 Q1 UROLOGY & NEPHROLOGY

Kidney International Reports

Pub Date : 2025-02-01 DOI: 10.1016/j.ekir.2024.11.029

Paul Bennett , Madeleine Warren , Zehra Aydin , Joachim Beige , Elaine Bowes , Michael Cheung , Jeanette Finderup , Daniel Gallego , Manfred Hecking , Helen Hurst , Jennifer M. King , Werner Kleophas , Anastasia Liossatou , Pedro Martins , Afra Masià-Plana , Yvette Meuleman , Luca Neri , Edita Noruišienė , John Ortiz , Marianne Rix , Yusuke Tsukamoto

Adults with kidney failure receiving dialysis frequently report high symptom burden that can limit life participation and decrease the quality of life. Fatigue, itch, pain, anxiety, depressive symptoms, sleep problems, nausea, vomiting, muscle cramps, breathlessness, and decreased cognition can negatively impact important daily activities. Nurses are the majority health professional group that provides care for people receiving dialysis and have a major role in managing these symptoms. However, routine symptom management by nurses is not universal or standardized in dialysis care. In December of 2023, Kidney Disease: Improving Global Outcomes (KDIGO) held a workshop on the Nurse’s Role in Managing the Symptoms of People Receiving Dialysis. The discussions focused on the current barriers nurses face when identifying and assessing symptoms, strategies for identifying symptoms, and the ongoing monitoring and management of symptoms. Nephrology nurses are pivotal in supporting the person with kidney failure receiving dialysis to minimize symptoms, optimize symptom management, decrease dialysis treatment burden, and improve life participation and quality of life.

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引用次数: 0

Explainability of a Deep Learning-Based Classification Model for Antineutrophil Cytoplasmic Autoantibody–Associated Glomerulonephritis

IF 5.7 2区医学 Q1 UROLOGY & NEPHROLOGY

Kidney International Reports

Pub Date : 2025-02-01 DOI: 10.1016/j.ekir.2024.11.005

Maria A.C. Wester Trejo , Maryam Sadeghi , Shivam Singh , Naghmeh Mahmoodian , Samir Sharifli , Zdenka Hruskova , Vladimír Tesař , Xavier Puéchal , Jan Anthonie Bruijn , Georg Göbel , Ingeborg M. Bajema , Andreas Kronbichler

Introduction

The histopathological classification for antineutrophil cytoplasmic autoantibody (ANCA)–associated glomerulonephritis (ANCA-GN) is a well-established tool to reflect the variety of patterns and severity of lesions that can occur in kidney biopsies. It was demonstrated previously that deep learning (DL) approaches can aid in identifying histopathological classes of kidney diseases; for example, of diabetic kidney disease. These models can potentially be used as decision support tools for kidney pathologists. Although they reach high prediction accuracies, their “black box” structure makes them nontransparent. Explainable (X) artificial intelligence (AI) techniques can be used to make the AI model decisions accessible for human experts. We have developed a DL-based model, which detects and classifies the glomerular lesions according to the Berden classification.

Methods

Kidney biopsy slides of 80 patients with ANCA-GN from 3 European centers, who underwent a diagnostic kidney biopsy between 1991 and 2011, were included. We also investigated the explainability of our model using Gradient-weighted Class Activation Mapping (Grad-CAM) heatmaps. These maps were analyzed by pathologists to compare the decision-making criteria of humans and the DL model and assess the impact of different training settings.

Results

The DL model shows a prediction accuracy of 93% for classifying lesions. The heatmaps from our trained DL models showed that the most predictive areas in the image correlated well with the areas deemed to be important by the pathologist.

Conclusion

We present the first DL-based computational pipeline for classifying ANCA-GN kidney biopsies as per the Berden classification. XAI techniques helped us to make the decision-making criteria of the DL accessible for renal pathologists, potentially improving clinical decision-making.

{"title":"Explainability of a Deep Learning-Based Classification Model for Antineutrophil Cytoplasmic Autoantibody–Associated Glomerulonephritis","authors":"Maria A.C. Wester Trejo , Maryam Sadeghi , Shivam Singh , Naghmeh Mahmoodian , Samir Sharifli , Zdenka Hruskova , Vladimír Tesař , Xavier Puéchal , Jan Anthonie Bruijn , Georg Göbel , Ingeborg M. Bajema , Andreas Kronbichler","doi":"10.1016/j.ekir.2024.11.005","DOIUrl":"10.1016/j.ekir.2024.11.005","url":null,"abstract":"<div><h3>Introduction</h3><div>The histopathological classification for antineutrophil cytoplasmic autoantibody (ANCA)–associated glomerulonephritis (ANCA-GN) is a well-established tool to reflect the variety of patterns and severity of lesions that can occur in kidney biopsies. It was demonstrated previously that deep learning (DL) approaches can aid in identifying histopathological classes of kidney diseases; for example, of diabetic kidney disease. These models can potentially be used as decision support tools for kidney pathologists. Although they reach high prediction accuracies, their “black box” structure makes them nontransparent. Explainable (X) artificial intelligence (AI) techniques can be used to make the AI model decisions accessible for human experts. We have developed a DL-based model, which detects and classifies the glomerular lesions according to the Berden classification.</div></div><div><h3>Methods</h3><div>Kidney biopsy slides of 80 patients with ANCA-GN from 3 European centers, who underwent a diagnostic kidney biopsy between 1991 and 2011, were included. We also investigated the explainability of our model using Gradient-weighted Class Activation Mapping (Grad-CAM) heatmaps. These maps were analyzed by pathologists to compare the decision-making criteria of humans and the DL model and assess the impact of different training settings.</div></div><div><h3>Results</h3><div>The DL model shows a prediction accuracy of 93% for classifying lesions. The heatmaps from our trained DL models showed that the most predictive areas in the image correlated well with the areas deemed to be important by the pathologist.</div></div><div><h3>Conclusion</h3><div>We present the first DL-based computational pipeline for classifying ANCA-GN kidney biopsies as per the Berden classification. XAI techniques helped us to make the decision-making criteria of the DL accessible for renal pathologists, potentially improving clinical decision-making.</div></div>","PeriodicalId":17761,"journal":{"name":"Kidney International Reports","volume":"10 2","pages":"Pages 457-465"},"PeriodicalIF":5.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143161355","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}

引用次数: 0

WCN25-1682 STUDY OF MEAN PLATELET VOLUME AND RED CELL DISTRIBUTION WIDTH IN ACUTE KIDNEY INJURY

IF 5.7 2区医学 Q1 UROLOGY & NEPHROLOGY

Kidney International Reports

Pub Date : 2025-02-01 DOI: 10.1016/j.ekir.2024.11.093

Sayantan Mukherjee ∗ , Anita Tahlan , Mandeep Singla

引用次数: 0

WCN25-4152 ADOLESCENT ANTI-GLOMERULAR BASEMENT DISEASE: A CASE SERIES WITH VARIED PRESENTATIONS AND OUTCOMES

IF 5.7 2区医学 Q1 UROLOGY & NEPHROLOGY

Kidney International Reports

Pub Date : 2025-02-01 DOI: 10.1016/j.ekir.2024.11.164

Shalini Sinha ∗ , Om Kumar , Amresh Krishna , Prit Pal Singh , Prem Shankar Patel , Abhishek Bharadwaj , Aftab Ansari

引用次数: 0

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