American Journal of Kidney Diseases最新文献

{"title":"Guidance on Care for Autosomal Dominant Polycystic Kidney Disease: A Patient Perspective.","authors":"Brittany Dickerson,Randy Fennel,Cari Maxwell,Christina Revere,Kelli Collins Damron","doi":"10.1053/j.ajkd.2026.01.005","DOIUrl":"https://doi.org/10.1053/j.ajkd.2026.01.005","url":null,"abstract":"","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":"60 1","pages":"508-510"},"PeriodicalIF":13.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147493084","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":"Beyond the Individual: Toward a Family-Centered Understanding of Dialysis Caregiving.","authors":"Jeanette Finderup,Malene Deele,Hanne Agerskov,Ann Bonner","doi":"10.1053/j.ajkd.2026.02.634","DOIUrl":"https://doi.org/10.1053/j.ajkd.2026.02.634","url":null,"abstract":"","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":"146 1","pages":"511-513"},"PeriodicalIF":13.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147493083","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":"A Young Man With Nephrotic Syndrome and Facial Rash: A Quiz.","authors":"Kannan Geetha Sushmitha,Ilakyaa Rajakumar,Tanuj Moses Lamech,Janardanan Subramonia Kumar,Anila Abraham Kurien,Varadharajan Jayaprakash","doi":"10.1053/j.ajkd.2025.10.020","DOIUrl":"https://doi.org/10.1053/j.ajkd.2025.10.020","url":null,"abstract":"","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":"401 1","pages":"A14-A16"},"PeriodicalIF":13.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147493085","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":"KDOQI US Commentary on the KDIGO 2025 Clinical Practice Guideline for the Evaluation, Management, and Treatment of Autosomal Dominant Polycystic Kidney Disease (ADPKD).","authors":"Neera K Dahl,Phyllis August,Whitney Besse,Fouad T Chebib,Michel Chonchol,Benjamin D Cowley,Simin Goral,Lisa M Guay-Woodford,Ashima Gulati,Marie C Hogan,Ronak Lakhia,Dana Miskulin,Kristen L Nowak,Frederic Rahbari-Oskoui,Meyeon Park,Stephen Seliger,Alan Yu,Terry Watnick","doi":"10.1053/j.ajkd.2025.11.006","DOIUrl":"https://doi.org/10.1053/j.ajkd.2025.11.006","url":null,"abstract":"The Kidney Disease Outcomes Quality Initiative (KDOQI) convened a work group to review the 2025 KDIGO (Kidney Disease: Improving Global Outcomes) clinical practice guideline for the evaluation, management, and treatment of autosomal dominant polycystic kidney disease (ADPKD). The KDOQI work group reviewed the KDIGO guideline statements and practice points and provided perspective for implementation within the context of clinical practice in the United States. In general, the KDOQI work group concurs with several recommendations and practice points proposed by the KDIGO guidelines regarding the diagnosis, kidney manifestations of ADPKD, chronic kidney disease management and progression, and therapies to delay the progression of disease, along with management of extrarenal manifestations. The KDOQI work group acknowledges the growing evidence base to support a change in the nomenclature for ADPKD. In this commentary, the work group has also assessed and discussed various barriers and potential opportunities for implementing the recommendations put forth in the 2025 KDIGO guidelines while the scientific community continues to focus on prospective high-quality evidence to support specific recommendations for this systemic condition.","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":"83 1","pages":"447-507"},"PeriodicalIF":13.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147493086","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":"Hemodiafiltration: A Mini Review.","authors":"Jonathan T Lin, Jeffrey I Silberzweig","doi":"10.1053/j.ajkd.2025.09.028","DOIUrl":"10.1053/j.ajkd.2025.09.028","url":null,"abstract":"<p><p>Hemodialysis allows people with kidney failure to survive vital organ failure; however, most do not recover premorbid functional status. Despite early efforts focused on increased removal of small molecular weight solutes, high levels of morbidity and mortality persist due to the condition underlying kidney failure, comorbid medical conditions, and poor clearance of larger molecules. Early studies demonstrated that hemodiafiltration increases the removal of larger molecules through convective clearance. Recent studies have documented improvements in cardiovascular events, quality of life, and mortality. We review the mechanics of hemodiafiltration and the scientific data supporting improved outcomes.</p>","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":" ","pages":"569-572"},"PeriodicalIF":8.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146197091","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":"Family Matters: Dissecting the Impact of Family Medical History, APOL1 Genotype, and Sociodemographic Factors on CKD Progression in the Chronic Renal Insufficiency Cohort (CRIC) Study.","authors":"Clara J Fischman, Jarcy Zee, Kirk N Campbell","doi":"10.1053/j.ajkd.2026.01.003","DOIUrl":"10.1053/j.ajkd.2026.01.003","url":null,"abstract":"","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":" ","pages":"514-516"},"PeriodicalIF":8.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147281801","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 There a Role for Pentoxifylline in Diabetic Kidney Disease?","authors":"David J Leehey,Rajiv Agarwal","doi":"10.1053/j.ajkd.2025.09.030","DOIUrl":"https://doi.org/10.1053/j.ajkd.2025.09.030","url":null,"abstract":"For many years, the only specific pharmacologic intervention to decrease end-stage renal disease (ESRD) in diabetic kidney disease (DKD) was renin-angiotensin system (RAS) blockade. Recently, sodium-glucose co-transporter-2 (SGLT2) inhibitors, non-steroidal mineralocorticoid antagonists (MRAs), and glucagon-like peptide-1 (GLP-1) receptor agonists have been introduced. However, there remains a need for new therapies. The non-specific phosphodiesterase inhibitor pentoxifylline (PTX) has been shown to have anti-proteinuric and anti-inflammatory effects, and small randomized clinical trials and meta-analyses indicate that PTX may have therapeutic benefits in DKD. A large multicenter randomized clinical trial to determine whether PTX decreases time to ESRD or death is being conducted.","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":"401 1","pages":""},"PeriodicalIF":13.2,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147495190","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":"Paid Employment and Ability to Work Among People Receiving Dialysis: A Systematic Review of Qualitative Studies.","authors":"Ao Zhang,Adam Martin,Karine Manera,Chandana Guha,Martin Howell,Patrizia Natale,Nicole Scholes-Robertson,Dharshana Sabanayagam,Adeera Levin,Wolfgang Winkelmayer,Kevin F Erickson,Germaine Wong,Allison Jaure,Anita van Zwieten","doi":"10.1053/j.ajkd.2026.01.008","DOIUrl":"https://doi.org/10.1053/j.ajkd.2026.01.008","url":null,"abstract":"RATIONALE & OBJECTIVEPeople receiving dialysis have reduced workforce participation, which can affect mental well-being and exacerbate the financial burden of dialysis. This study aimed to describe the experiences and perspectives of people receiving dialysis on employment and their ability to work.STUDY DESIGNSystematic review and thematic synthesis of qualitative studies.SETTING & STUDY POPULATIONSAdults aged 16 years and over receiving dialysis.SEARCH STRATEGY & SOURCESMEDLINE, Embase and PsycINFO were searched to May 2025 for qualitative and mixed-methods studies that reported the perspectives of people receiving dialysis on employment or ability to work.DATA EXTRACTIONText from results and conclusions of studies.ANALYTICAL APPROACHThematic synthesis.RESULTS37 studies involving 1374 participants from 17 countries/regions were included. Six themes were identified: impinging on capacity to work (lacking physical endurance and energy, battling with cognitive symptoms, grueling treatment schedule), narrowed vocational opportunities and financial insecurity (unfulfilled dreams and worry about job prospects, struggling to stay afloat financially), discrimination and stigma (overlooked by potential employers, being pushed out of jobs or fired, delaying or avoiding disclosure of dialysis), conducive workplace environments (empathy and support from managers and colleagues, occupational adjustments), managing dialysis around work (choosing a suitable dialysis type to support work, careful time management and scheduling), and fostering esteem, enjoyment and social connection.LIMITATIONSOnly English-language articles were included.CONCLUSIONSAmong people receiving dialysis, the symptom and treatment burdens, lack of workplace accommodations, and discrimination all compromised sustained employment. Conversely, supportive workplaces that implemented tailored occupational adjustments enabled work participation, thereby boosting psychosocial well-being. Workplace advocacy and flexible work arrangements, symptom management, and aligning dialysis modality choices and timing with work demands may help to improve participation and work ability among people on dialysis.","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":"146 1","pages":""},"PeriodicalIF":13.2,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147495191","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":"Medicaid Expansion and Optimal Starts of Treatment for Incident Kidney Failure.","authors":"Nicholas S Roetker,James B Wetmore,Jiannong Liu,Haifeng Guo,David T Gilbertson,Kirsten L Johansen","doi":"10.1053/j.ajkd.2026.01.007","DOIUrl":"https://doi.org/10.1053/j.ajkd.2026.01.007","url":null,"abstract":"RATIONALE & OBJECTIVEBeginning in 2014, some states expanded Medicaid eligibility to include additional low-income adults under age 65. Examining whether the expansion led to improvements in optimal treatment at the start of kidney failure has been understudied and was the focus of this investigation.STUDY DESIGNObservational cohort study.SETTING & PARTICIPANTSPatients aged 26-64 years represented in the United States Renal Data System initiating treatment for kidney failure between 2008 and 2019.EXPOSUREResidence in states that did or did not expand Medicaid in 2014.OUTCOMEOptimal start of kidney failure treatment was defined as undergoing preemptive kidney transplantation, initiating home dialysis, or initiating in-center hemodialysis using an arteriovenous access.ANALYTICAL APPROACHInterrupted time series analyses were implemented to evaluate the adjusted association of residence in a Medicaid expansion state and optimal kidney failure treatment by comparing the trend in optimal kidney failure treatment starts during the pre-expansion vs. the post-expansion periods.RESULTSBefore Medicaid expansion, the percentage with optimal starts increased similarly in expansion and non-expansion states. After Medicaid expansion, the percentage with optimal starts continued increasing in expansion states but decreased in non-expansion states, resulting in a 3.9% (95% CI 0.5%, 7.2%) higher percentage with optimal starts in expansion vs. non-expansion states by 2019 (P=0.02 for post vs. pre change in trend). Most of the change in trend was attributable to a greater increase in use of home dialysis at initiation of kidney failure treatment in expansion vs. non-expansion states (difference 0.29% per year [95% CI 0.08%, 0.51%]) during the post-expansion period.LIMITATIONSPotential for unmeasured confounding from state-level factors other than Medicaid expansion.CONCLUSIONSMedicaid expansion was associated with an increasing percentage of patients with incident kidney failure experiencing an optimal start to treatment, driven mostly by an increase in the use of home dialysis. Expanding Medicaid coverage may offer an opportunity to improve treatment for low-income patients initiating kidney replacement therapy.PLAIN-LANGUAGE SUMMARYThis study examined whether the expansion of Medicaid eligibility in 2014 led to improvements in the percentage of patients receiving an optimal start (i.e., kidney transplantation before the need to start dialysis, initiation of home dialysis, or initiation of in-center hemodialysis using an arteriovenous access) to treatment for new-onset kidney failure. We compared trends from 2008 to 2019 across U.S. states that expanded Medicaid and those that did not. Before 2014, both groups showed a similar upward trend in optimal starts. However, after Medicaid expansion, states that expanded Medicaid continued to experience a rise in optimal starts while states that did not expand showed a decline over time. Much of the difference was explaine","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":"57 1","pages":""},"PeriodicalIF":13.2,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147495193","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":"Dialysis Facility Closures in the US From 2018 to 2024: A Serial Cross-Sectional Study.","authors":"Meri R J Varkila,Maria Montez-Rath,Xue Yu,Nivetha Subramanian,Douglas K Owens,Brian Brady,Geoffrey A Block,Julie Parsonnet,Glenn M Chertow,Shuchi Anand","doi":"10.1053/j.ajkd.2025.12.003","DOIUrl":"https://doi.org/10.1053/j.ajkd.2025.12.003","url":null,"abstract":"RATIONALE & OBJECTIVEBetween 2006-2016, the number of US dialysis facilities experienced steady annual growth. Recent data suggest a reversal in this trend. We examined trends in US dialysis facility closures and associated facility- and neighborhood-level characteristics.STUDY DESIGNSerial cross-sectional study of dialysis facilities from 2018 through 2024.SETTING & PARTICIPANTSDialysis facilities in the United States.EXPOSURESCalendar year; census region; census tract social vulnerability index; rural or urban area designation; racial and ethnic composition; coronavirus-19 mortality; dialysis facility payer mix, size, and profit status.OUTCOMESNumber of dialysis facility closures; temporal change in number of facilities by census tract.ANALYTICAL APPROACHDialysis facilities listed in the Provider of Services data from Centers for Medicare and Medicaid Services were used to determine openings and closures by quarter. Geocoded dialysis facility data were linked to the American Community Survey, rural urban commuting area codes, and the United States Renal Data System to describe associated facility- and neighborhood-level characteristics of closed facilities, and of census tracts without any remaining dialysis facilities.RESULTS8343 unique dialysis facilities were identified across 7222 census tracts from 2018 through 2024. Annual opening-to-closure ratios were 8.9 (2018: 401 openings, 45 closures), 2.7 (2019: 293 openings, 105 closures), 4.3 (2020: 218 openings, 51 closures), 1.5 (2021: 171 openings, 111 closures), 0.6 (2022: 123 openings, 210 closures), 0.5 (2023: 94 openings, 207 closures), and 0.8 (2024: 56 openings,74 closures). Closures exceeded openings between fourth quarter, 2021 and first quarter, 2024 (n=500, 62.2% of all closures during study period). Closed facilities were smaller than facilities that remained open (median size 58 [25th, 75th percentile 34, 96] for closed versus 112 [66, 165] for open facilities). Closures were observed more frequently in rural versus urban areas (11.2% versus 9.3%, respectively), and among facilities located in the Midwest versus the West (10.8% versus 7.7%, respectively). Closed facilities had a modestly higher proportion of patients eligible for both Medicaid and Medicare-dual eligibility, a marker of economic disadvantage-than facilities that remained open (mean proportion of census dual eligible 36.1% versus 34.6%).LIMITATIONSLack of data on patient outcomes.CONCLUSIONSNationwide, an increasing number of US dialysis facilities closed between 2018 and 2024, with smaller facilities, and rural and Midwest communities disproportionately affected. The patient-level implications of this trend require further study.PLAIN-LANGUAGE SUMMARYUntil recently, the number of dialysis facilities in the US was increasing, but this trend may have reversed in 2022. This study assessed whether dialysis facility closures were relatively more common in rural or socially vulnerable areas. It found a drastic increase in","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":"236 1","pages":""},"PeriodicalIF":13.2,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147495189","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}