Our faculty research broadens the knowledge of kidney disease.

Cells of NG2 lineage increase in glomeruli of mice following podocyte depletion

Suzuki T, Eng DG, McClelland AD, Pippin JW, Shankland SJ

Under certain circumstances, podocytes can be partially replaced following their loss in disease. The inability of podocytes to proliferate suggests that replacement derives from other cell types.

Telehealth and Home Dialysis: A New Option for Patients in the United States

Bieber SD, Weiner DE

Telehealth and Home Dialysis

Location of glomerular immune deposits, not codeposition of immunoglobulin G, influences definitive renal outcomes in immunoglobulin A nephropathy

Alvarado AS, Andeen NK, Brodsky S, Hinton A, Nadasdy T, Alpers CE, Blosser C, Najafian B, Rovin BH

It has been suggested that the prognosis of immunoglobulin (IgA) nephropathy (IgAN) is adversely affected if there is codeposition of IgG in the glomeruli or if immune deposits are present in the glomerular capillary walls. We sought to understand how these variables affect clinical outcome.

Standardized Review and Approval Process for High-Cost Medication Use Promotes Value-Based Care in a Large Academic Medical System

Durvasula R, Kelly J, Schleyer A, Anawalt BD, Somani S, Dellit TH

To describe a systematic review process to reduce non-evidence-based inpatient use of high-cost medications across a large multi-hospital academic health system. We created a Pharmacy & Therapeutics subcommittee consisting of clinicians, pharmacists, and an ethics representative. This committee developed a standardized process for a timely review (<48 hours) and approval of high-cost medications based on their clinical effectiveness, safety, and appropriateness.

Complications of Immunosuppression in Glomerular Disease

Most glomerular diseases are immunologically mediated disorders of the kidney and are common causes of ESKD. In addition to supportive therapy, a wide range of immunosuppressive agents are used in the management of patients with these conditions. Immunosuppression requires a careful balance of risk and benefits, and many of these agents have a narrow therapeutic window and require close monitoring. This review describes the side effects of immunosuppressive agents used in recent randomized, controlled trials of glomerular disease, and highlights some of the key adverse events that determine the choice and prescription of these medications.

Commentary on Complications of Immunosuppressive Treatments for Glomerulonephritis

Kestenbaum BR, Seliger SL

Commentary

Multicolor Flow Cytometry and Cytokine Analysis Provides Enhanced Information on Kidney Transplant Biopsies

Muczynski KA, Leca N, Anderson AE, Kieran N, Anderson SK.

Current processing of renal biopsy samples provides limited information about immune mechanisms causing kidney injury and disease activity. We used flow cytometry with transplanted kidney biopsy samples to provide more information on the immune status of the kidney.

Association of Inpatient Palliative Care with Health Care Utilization and Postdischarge Outcomes among Medicare Beneficiaries with End Stage Kidney Disease

Chettiar A, Montez-Rath M, Liu S, Hall YN, O'Hare AM, Kurella Tamura M.

Palliative care may improve quality of life and reduce the cost of care for patients with chronic illness, but utilization and cost implications of palliative care in ESKD have not been evaluated. We sought to determine the association of inpatient palliative care with health care utilization and postdischarge outcomes in ESKD.

Management of Physical Frailty in Patients Requiring Hemodialysis Therapy

Matsuzawa R, Roshanravan B.

This review focuses on the underscoring the importance of identifying physical frailty in hemodialysis patients and proposes an algorithm integrating frailty assessment into the routine care of patients treated with dialysis.

Alteration of HDL Protein Composition with Hemodialysis Initiation

Wang K, Zelnick LR, Hoofnagle AN, Vaisar T, Henderson CM, Imrey PB, Robinson-Cohen C, de Boer IH, Shiu YT, Himmelfarb J, Beck GJ, Kestenbaum B; HFM Study

HDL particles obtained from patients on chronic hemodialysis exhibit lower cholesterol efflux capacity and are enriched in inflammatory proteins compared with those in healthy individuals. Observed alterations in HDL proteins could be due to effects of CKD, but also may be influenced by the hemodialysis procedure, which stimulates proinflammatory and prothrombotic pathways. We compared HDL-associated proteins in 143 participants who initiated hemodialysis within the previous year with those of 110 participants with advanced CKD from the Hemodialysis Fistula Maturation Study.