Feature Channels: Kidney Disease

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• When considering treatments, patients with glomerular disease and their caregivers gave highest priority to the health outcomes of kidney function, mortality, and need for dialysis or transplant. • They also highly prioritized patient-reported outcomes such as life participation and fatigue that are not typically reported in clinical trials.

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A very high level of a protein known as suPAR in the blood of patients with COVID-19 may be a predictor of severe respiratory failure, according to new research published in the Journal of Critical Care on April 30.

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The American Academy of Neurology (AAN), the world’s largest association of neurologists, is pleased to announce the recipients of the 2020 AAN Research Program. This year’s program has awarded more than $3 million toward neuroscience research and training.

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. Ashita Tolwani, a nephrologist at the University of Alabama at Birmingham, explains how COVID-19 is impacting patients and putting a strain on the availability of dialysis supplies..

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For more information about coronavirus disease (COVID-19) from Johns Hopkins Medicine, visit hopkinsmedicine.org/coronavirus. For information on coronavirus disease (COVID-19) from around the Johns Hopkins enterprise, including from the Johns Hopkins Bloomberg School of Public Health and The Johns Hopkins University, visit coronavirus.jhu.edu.

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A new review suggests that higher-than-normal levels of an enzyme involved in blood clot prevention may be a common risk factor for developing COVID-19—a respiratory disease caused by the novel coronavirus SARS-CoV-2—in some populations. The review is published in Physiological Reviews.

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Using next-generation RNA sequencing techniques, a team of scientists from the University of Michigan Rogel Cancer Center has uncovered the gene signature of chromophobe renal cell carcinoma (ChRCC) and have extensively tested the expression of three new biomarkers. The subtype is the third most common type of renal cell carcinoma, comprising about 5% of cases.

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Manoj Monga, MD, recognized as an international authority in endourology and stone disease, has been named chair of the Department of Urology at University of California San Diego School of Medicine and will see patients at UC San Diego Health.

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Kidney cancers that metastasize to the pancreas have a fundamentally different biology from those that metastasize elsewhere

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Researchers from the Center for Precision Disease Modeling at the University of Maryland School of Medicine (UMSOM) have uncovered a mechanism that appears to explain how certain genetic mutations give rise to a rare genetic kidney disorder called nephrotic syndrome. Using a drosophila (fruit fly) model, they found mutations in genes that code for certain proteins lead to a disruption of the recycling of the cell membrane.

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• In a study of urban-dwelling individuals, housing insecurity was linked with a higher risk of developing albuminuria, a sign of kidney disease.

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Two newer types of medications commonly used to treat type 2 diabetes are similar in their ability to reduce major heart complications, including heart attack, stroke and death from cardiovascular disease, according to research accepted for presentation at ENDO 2020, the Endocrine Society’s annual meeting, and publication in a special supplemental section of the Journal of the Endocrine Society.

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• The American Society of Nephrology has launched several initiatives to provide guidance on COVID-19 as it relates to the care of patients with kidney disease.

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New therapeutic strategies proposed for some lung and kidney cancers. Study shows cancers with high levels of the SLC7A11 gene may respond to glucose transporter inhibitor treatment.

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• Two studies examine potential benefits of blood pressure monitoring outside of doctors’ offices for patients with kidney disease.

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• In an analysis of information on adults who began treatment for kidney failure at any Georgia, North Carolina, or South Carolina dialysis facility, the distance from a patient’s residence to the nearest transplant center did not appear to affect the likelihood of transplant-related referrals and evaluations.

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Available evidence supports the use of marked changes in urine oxalate in CKD stages 1-3a and plasma oxalate in CKD stages 3b-5 as surrogate end points for clinical trials in primary hyperoxaluria. Worsening kidney function is considered an acceptable clinical trial end point; however in many patients with primary hyperoxaluria, kidney function is not lost at a rapid rate until very advanced stages of disease. Kidney stones are clinically meaningful, though lack sufficient standards for measurement and monitoring. Their role as a feasible clinical end point should be reconsidered as more data becomes available.

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• Study results call into question the utility of testing blood pressure load—the proportion of elevated blood pressure readings detected over 24 hours—for diagnosing hypertension in children.

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Now, as part of an effort to reduce the rate of patients with diabetic kidney disease who develop kidney failure, researchers at Penn Medicine are spearheading a collaboration to better understand the progression of DKD and advance research aimed at preserving kidney function in these patients.

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• In a study of kidney transplant recipients, the composition of certain immune cells in the blood 1 year after kidney transplantation was linked with a patient’s subsequent risk of kidney transplant failure.

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Tod Ibrahim, executive vice president of the American Society of Nephrology, was recently named president of the Council of Medical Specialty Societies (CMSS).

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Keck Medicine of USC urologists are launching a clinical trial to evaluate the effectiveness of spinal cord stimulation in patients with an overactive bladder due to neurological conditions, such as a spinal cord injury or stroke, and idiopathic (unknown) causes.

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The March 2020 issue of Toxicological Sciences features leading research in toxicology, covering investigations in biotransformation, toxicokinetics, and pharmacokinetics in addition to work in exposure sciences and environmental toxicology.

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• Exposure to higher amounts of fine particulate matter air pollution was associated with a higher degree of albuminuria—a marker of kidney dysfunction—as well as a higher risk of developing chronic kidney disease over time.

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• Among patients with kidney failure and atrial fibrillation, Black, Hispanic White, and Asian patients filled prescriptions of stroke-preventive medications less often than non-Hispanic White patients, and they were more likely to experience stroke. • Equalizing the distribution of these medications would prevent 7%–12% of the stroke disparity among racial/ethnic minorities.

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• Researchers observed incremental increases in the incidence of 2 types of kidney disease—lupus nephritis and ANCA-related glomerulonephritis—with increasingly lower income.

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An experimental drug already shown to be safe and help some patients with clear cell renal cell carcinoma, a deadly form of kidney cancer, effectively disables its molecular target.

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New research shows that both strands of microRNA cooperate to drive growth and aggressiveness across cancer types, suggesting that these molecules may be more central in deadly cancers than previously thought.

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More than 10,000 uninsured patients sought care at Texas emergency departments for lifesaving kidney dialysis in 2017, incurring more than $21.8 million in hospital costs, according to researchers from UTHealth.

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• This study examined the validity of national quality measures used to assess the quality of kidney-related care in the United States. • Of 60 existing quality metrics related to kidney care, only half were rated as highly valid.

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• Survival after kidney transplantation during childhood has improved over the last 40 years in Australia. • Survival rates improved primality due to decreases in deaths from cardiovascular disease and infection.

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We know that stress can have a profound impact on health. But it’s rare to discover a health issue that is caused directly by stress.  That’s exactly what one Michigan State University researcher and his team have found.  Nathan Tykocki, an assistant professor of pharmacology and toxicology in the College of Osteopathic Medicine, set out to understand why children who seemingly have nothing wrong with them lose bladder function, a condition also known as stress-induced bladder dysfunction, or SIBD.

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Scientists report promising activity of a novel drug that targets a key molecular driver of clear cell renal cell carcinoma (ccRCC) in patients with metastatic disease.

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The insights from the PEXIVAS Trial, a 10-year study, shows treatment for ANCA-associated vasculitis can become much more patient-friendly by using half the typical dose of steroids and no blood plasma exchanges

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Mayo Clinic的研究人员发现，活体捐献者的肾脏中有一些用显微镜才能观察到的细微结构特征，从这些结构特征中或许可以预测肾脏在接受者体内移植失败的风险。这一发现发表于在线版的Journal of the American Society of Nephrology《美国肾脏学会期刊》上。

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American Society of Nephrology briefing on kidneyx: accelerating the future of kidney care

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About 29 million Americans use over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) to treat pain. Every year in the U.S., NSAID use is attributed to approximately 100,000 hospitalizations and 17,000 deaths. All of these drugs have benefits and risks, but deciding which one to use is complicated for health care providers and their patients. To assist in clinical decision-making, researchers address cardiovascular risks and beyond, which include gastrointestinal and kidney side effects of pain relievers.

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Physician-Scientists and other researchers at Rush University Medical Center, in collaboration with colleagues at other institutions, have revealed a new treatment target that may help change the outcome for patients at risk of AKI.

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People with chronic kidney disease have a higher risk for heart disease and heart-disease death. Now, for the first time in humans, researchers have identified a pathological change that appears to link kidney disease to progressive heart disease.

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Forscher von Mayo Clinic haben entdeckt, dass subtile Strukturmerkmale in Nieren von lebenden Spendern, die nur mit einem Mikroskop gesehen werden können, auf das Risiko für eine Abstoßung beim Empfänger hindeuten können.

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Des chercheurs de Mayo Clinic ont découvert que de subtiles caractéristiques que l’on peut observer uniquement au microscope au niveau de la structure des reins provenant de donneurs vivants, pourraient prédire le risque d'échec des greffes chez les receveurs.

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Los investigadores de Mayo Clinic descubrieron que algunas características estructurales sutiles de los riñones de los donantes vivos, las cuales solo es posible ver en el microscopio, pueden predecir el riesgo del fracaso del trasplante en el receptor.

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Pesquisadores da Mayo Clinic descobriram que características estruturais sutis nos rins de doadores vivos que só podem ser vistas com um microscópio podem ajudar a prever o risco de transplantes malsucedidos nos receptores. Os achados foram publicados virtualmente no Journal of the American Society of Nephrology (Revista da Sociedade Americana de Nefrologia).