Marcel Zorgdrager,Yi Liu,Jingyao Hong,Nidhi Ghildayal,Tim D A Swaab,Stephan J L Bakker,Alain R Viddeleer,Babak J Orandi,Omid Shafaat,Clifford R Weiss,Dorry Segev,Mara McAdams-DeMarco,Robert A Pol
BACKGROUNDSarcopenia and myosteatosis are indicators of abnormal body composition (BC). Computed tomography (CT) imaging has proven to be an accurate modality for BC quantification in kidney transplantation (KT). We tested whether pre-KT CT-based BC was associated with both all-cause graft loss (ACGL) and mortality among adult recipients from two centers (Johns Hopkins Hospital [JHH] and University Medical Center Groningen [UMCG]).METHODSPatients who underwent a KT between 2003 and 2020 were followed for a median (interquartile range) follow-up of 6.4 (4.6-8.5) years at JHH and 6.3 (5.1-7.5) years at UMCG. Cox proportional hazard models were used to estimate the associations of BC with ACGL/ mortality. Fine and Gray regression analysis was performed to assess the association between BC and death-censored graft loss. Prior to KT, 49% of recipients had sarcopenia and 66% had myosteatosis.RESULTSIn total 608 patients were included from JHH (N= 294) and UMCG (N=314). Sarcopenia was not associated with post-KT outcomes. Myosteatosis was associated with a higher risk of ACGL (adjusted hazard ratio 1.78, 95%CI:1.08 - 2.93) and mortality (adjusted hazard ratio 2.35, 95%CI: 1.27 - 4.33) at JHH, but showed no significant association at UMCG after adjusting for confounders. Myosteatosis did not show a significant association with death-censored graft loss at both centers.CONCLUSIONMyosteatosis ascertained from existing CT scans could help identify recipients at higher risk for ACGL who may benefit most from prehabilitation.
{"title":"Association of Myosteatosis and of Graft Loss after Kidney Transplantation: An International Observational Study.","authors":"Marcel Zorgdrager,Yi Liu,Jingyao Hong,Nidhi Ghildayal,Tim D A Swaab,Stephan J L Bakker,Alain R Viddeleer,Babak J Orandi,Omid Shafaat,Clifford R Weiss,Dorry Segev,Mara McAdams-DeMarco,Robert A Pol","doi":"10.2215/cjn.0000000862","DOIUrl":"https://doi.org/10.2215/cjn.0000000862","url":null,"abstract":"BACKGROUNDSarcopenia and myosteatosis are indicators of abnormal body composition (BC). Computed tomography (CT) imaging has proven to be an accurate modality for BC quantification in kidney transplantation (KT). We tested whether pre-KT CT-based BC was associated with both all-cause graft loss (ACGL) and mortality among adult recipients from two centers (Johns Hopkins Hospital [JHH] and University Medical Center Groningen [UMCG]).METHODSPatients who underwent a KT between 2003 and 2020 were followed for a median (interquartile range) follow-up of 6.4 (4.6-8.5) years at JHH and 6.3 (5.1-7.5) years at UMCG. Cox proportional hazard models were used to estimate the associations of BC with ACGL/ mortality. Fine and Gray regression analysis was performed to assess the association between BC and death-censored graft loss. Prior to KT, 49% of recipients had sarcopenia and 66% had myosteatosis.RESULTSIn total 608 patients were included from JHH (N= 294) and UMCG (N=314). Sarcopenia was not associated with post-KT outcomes. Myosteatosis was associated with a higher risk of ACGL (adjusted hazard ratio 1.78, 95%CI:1.08 - 2.93) and mortality (adjusted hazard ratio 2.35, 95%CI: 1.27 - 4.33) at JHH, but showed no significant association at UMCG after adjusting for confounders. Myosteatosis did not show a significant association with death-censored graft loss at both centers.CONCLUSIONMyosteatosis ascertained from existing CT scans could help identify recipients at higher risk for ACGL who may benefit most from prehabilitation.","PeriodicalId":50681,"journal":{"name":"Clinical Journal of the American Society of Nephrology","volume":"11 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145296208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Importance of the Patient Perspective and Real-World Experience in Home Dialysis Training.","authors":"Pesh Patel","doi":"10.2215/cjn.0000000903","DOIUrl":"https://doi.org/10.2215/cjn.0000000903","url":null,"abstract":"","PeriodicalId":50681,"journal":{"name":"Clinical Journal of the American Society of Nephrology","volume":"1 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145288243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Sepsis-Related Hospitalization and Mortality in Patients with Chronic Kidney Disease.","authors":"Ninad Khandekar,Shung Chiu,Lauren Tong,Deepa Raghavan,Nishank Jain","doi":"10.2215/cjn.0000000861","DOIUrl":"https://doi.org/10.2215/cjn.0000000861","url":null,"abstract":"","PeriodicalId":50681,"journal":{"name":"Clinical Journal of the American Society of Nephrology","volume":"12 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145283521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Bridging the \"Employment Gap\" for Dialysis Patients: From Association to Action.","authors":"Karthik Tennankore,Annie-Claire Nadeau-Fredette","doi":"10.2215/cjn.0000000907","DOIUrl":"https://doi.org/10.2215/cjn.0000000907","url":null,"abstract":"","PeriodicalId":50681,"journal":{"name":"Clinical Journal of the American Society of Nephrology","volume":"43 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145283693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Frank Liu,Graham Abra,Nupur Gupta,Brigitte Schiller,Matthew B Rivara
{"title":"How I Treat Nocturnal Home Hemodialysis - an under-prescribed but essential home dialysis modality in the United States.","authors":"Frank Liu,Graham Abra,Nupur Gupta,Brigitte Schiller,Matthew B Rivara","doi":"10.2215/cjn.0000000927","DOIUrl":"https://doi.org/10.2215/cjn.0000000927","url":null,"abstract":"","PeriodicalId":50681,"journal":{"name":"Clinical Journal of the American Society of Nephrology","volume":"28 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145261211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Is Assisted Home Dialysis Feasible In the US? Addressing Legislative and Regulatory Levers.","authors":"Yuvaram N V Reddy,Suzanne Watnick,Nupur Gupta","doi":"10.2215/cjn.0000000925","DOIUrl":"https://doi.org/10.2215/cjn.0000000925","url":null,"abstract":"","PeriodicalId":50681,"journal":{"name":"Clinical Journal of the American Society of Nephrology","volume":"72 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145261451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Andrzej S Krolewski,Jani K Haukka,Zaipul I Md Dom,Viktor R Curovic,Chunyi Wu,Mario Luca Morieri,Katsuhito Ihara,Sok Cin Tye,Hiroki Kobayashi,Youngshin Keum,Sathishkumar Baskaran,Stefan Mutter,Simone Theilade,Eiichiro Satake,Narges Rashidi,Valma Harjutsalo,Tarunveer S Ahluwalia,Monika A Niewczas,Fergus Fleming,Marlon Pragnell,Robert G Nelson,Joseph V Bonventre,Per-Henrik Groop,Peter Rossing,Niina Sandholm,Andrzej Galecki,Alessandro Doria
BACKGROUNDTo facilitate personalized treatment of diabetic kidney disease (DKD), we developed the Joslin Kidney Panel (JKP) of 21 circulating proteins associated with progression to end-stage kidney disease (ESKD). Prognostic models using baseline concentrations of JKP proteins in circulation and clinical markers were then developed to stratify individuals according to ESKD risk and according to response to fenofibrate, a potential reno-protective drug.METHODSThe custom-made Joslin OLINK multipurpose proteomics platform was used to quantify JKP proteins. Association between baseline serum/plasma concentrations of these proteins and kidney outcomes was examined in five independent study groups.RESULTSIn Type 1 diabetes individuals from Joslin (N=59), FinnDiane (N=389), and Steno (N=283), all JKP proteins were good discriminators of ESKD risk during 10-year follow-up. Baseline concentrations of KIM-1 and WFDC2 performed the best, matching or outperforming the clinical markers. An optimal model to discriminate ESKD risk that included three clinical markers and eight JKP proteins (KIM1, TNF-R2, TNF-R3, TNF-R19L, PVRL4, WFDC2, DLL1, SYND1), was developed using the FinnDiane cohort (C-index 0.868, SE±0.019) and validated in the Steno cohort (C-index 0.913, SE±0.104) and in Type 2 diabetes Joslin study (C-index 0.807, SE±0.036). In each of these studies the optimal model performed better than models based solely on three clinical markers. In a subgroup of 450 individuals with Type 2 diabetes from the ACCORD-Lipid trial, high levels of three JKP proteins (EFNA4, DLL1, IL-1RT1) predicted amelioration of fast kidney function decline during four years of follow-up in those treated with fenofibrate compared to placebo.CONCLUSIONQuantification of circulating JKP proteins using the Joslin OLINK platform discriminates ESKD risk in individuals with diabetes and their response to reno-protective drugs. Use of this multi-purpose precision medicine tool should facilitate studies on the etiology of DKD and enable the development of effective personalized treatment protocols for individuals with DKD.
{"title":"Joslin Kidney Panel of Circulating Proteins: A Tool for ESKD Risk Discrimination and Individualized Diabetic Kidney Disease Treatment.","authors":"Andrzej S Krolewski,Jani K Haukka,Zaipul I Md Dom,Viktor R Curovic,Chunyi Wu,Mario Luca Morieri,Katsuhito Ihara,Sok Cin Tye,Hiroki Kobayashi,Youngshin Keum,Sathishkumar Baskaran,Stefan Mutter,Simone Theilade,Eiichiro Satake,Narges Rashidi,Valma Harjutsalo,Tarunveer S Ahluwalia,Monika A Niewczas,Fergus Fleming,Marlon Pragnell,Robert G Nelson,Joseph V Bonventre,Per-Henrik Groop,Peter Rossing,Niina Sandholm,Andrzej Galecki,Alessandro Doria","doi":"10.2215/cjn.0000000863","DOIUrl":"https://doi.org/10.2215/cjn.0000000863","url":null,"abstract":"BACKGROUNDTo facilitate personalized treatment of diabetic kidney disease (DKD), we developed the Joslin Kidney Panel (JKP) of 21 circulating proteins associated with progression to end-stage kidney disease (ESKD). Prognostic models using baseline concentrations of JKP proteins in circulation and clinical markers were then developed to stratify individuals according to ESKD risk and according to response to fenofibrate, a potential reno-protective drug.METHODSThe custom-made Joslin OLINK multipurpose proteomics platform was used to quantify JKP proteins. Association between baseline serum/plasma concentrations of these proteins and kidney outcomes was examined in five independent study groups.RESULTSIn Type 1 diabetes individuals from Joslin (N=59), FinnDiane (N=389), and Steno (N=283), all JKP proteins were good discriminators of ESKD risk during 10-year follow-up. Baseline concentrations of KIM-1 and WFDC2 performed the best, matching or outperforming the clinical markers. An optimal model to discriminate ESKD risk that included three clinical markers and eight JKP proteins (KIM1, TNF-R2, TNF-R3, TNF-R19L, PVRL4, WFDC2, DLL1, SYND1), was developed using the FinnDiane cohort (C-index 0.868, SE±0.019) and validated in the Steno cohort (C-index 0.913, SE±0.104) and in Type 2 diabetes Joslin study (C-index 0.807, SE±0.036). In each of these studies the optimal model performed better than models based solely on three clinical markers. In a subgroup of 450 individuals with Type 2 diabetes from the ACCORD-Lipid trial, high levels of three JKP proteins (EFNA4, DLL1, IL-1RT1) predicted amelioration of fast kidney function decline during four years of follow-up in those treated with fenofibrate compared to placebo.CONCLUSIONQuantification of circulating JKP proteins using the Joslin OLINK platform discriminates ESKD risk in individuals with diabetes and their response to reno-protective drugs. Use of this multi-purpose precision medicine tool should facilitate studies on the etiology of DKD and enable the development of effective personalized treatment protocols for individuals with DKD.","PeriodicalId":50681,"journal":{"name":"Clinical Journal of the American Society of Nephrology","volume":"115 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145261444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Spatial Atlas Creation at the Single Cell Level: Unveiling the Human Kidney Metaverse.","authors":"Pierre C Dagher,Michael T Eadon,Tarek M El-Achkar","doi":"10.2215/cjn.0000000924","DOIUrl":"https://doi.org/10.2215/cjn.0000000924","url":null,"abstract":"","PeriodicalId":50681,"journal":{"name":"Clinical Journal of the American Society of Nephrology","volume":"25 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145254493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Untangling the Web of Dietary Micronutrient Intake and the Metabolome in Children with CKD.","authors":"Denver D Brown,Kristen Sgambat,Marva Moxey-Mims","doi":"10.2215/cjn.0000000908","DOIUrl":"https://doi.org/10.2215/cjn.0000000908","url":null,"abstract":"","PeriodicalId":50681,"journal":{"name":"Clinical Journal of the American Society of Nephrology","volume":"18 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145254483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"TESTING for the Best Biomarker in IgA Nephropathy.","authors":"Richard A Lafayette","doi":"10.2215/cjn.0000000904","DOIUrl":"https://doi.org/10.2215/cjn.0000000904","url":null,"abstract":"","PeriodicalId":50681,"journal":{"name":"Clinical Journal of the American Society of Nephrology","volume":"32 1","pages":""},"PeriodicalIF":9.8,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：