Our research broadens the knowledge of kidney disease.
An Introduction to Qualitative Inquiry
Many aspects of care for people with kidney disease cannot be meaningfully understood in numerical terms, and benefit from a qualitative approach to inquiry. Qualitative methodologies were originally developed in the social sciences, but are increasingly used in medical research to address questions related to people's lived experiences of illness and care, the meanings they attribute to these experiences, and how health care processes and systems function. In the nephrology literature, qualitative work has helped to identify those health outcomes that matter most to people with kidney disease and their families, which has informed the design and testing of clinical interventions. Other studies have shed light on complex health care processes, such as kidney transplant donation and medical decision making, helping to identify targets for process improvement. Qualitative work may also offer a view into the lives of people with kidney disease, which supports clinicians in better understanding, communicating with, and caring for this group.
DNAm-based signatures of accelerated aging and mortality in blood are associated with low renal function
The difference between an individual's chronological and DNA methylation predicted age (DNAmAge), termed DNAmAge acceleration (DNAmAA), can capture life-long environmental exposures and age-related physiological changes reflected in methylation status. Several studies have linked DNAmAA to morbidity and mortality, yet its relationship with kidney function has not been assessed. We evaluated the associations between seven DNAm aging and lifespan predictors (as well as GrimAge components) and five kidney traits (estimated glomerular filtration rate [eGFR], urine albumin-to-creatinine ratio [uACR], serum urate, microalbuminuria and chronic kidney disease [CKD]) in up to 9688 European, African American and Hispanic/Latino individuals from seven population-based studies.
Body mass index and chronic kidney disease outcomes after acute kidney injury: a prospective matched cohort study
Acute kidney injury (AKI) and obesity are independent risk factors for chronic kidney disease (CKD). This study aimed to determine if obesity modifies risk for CKD outcomes after AKI. This prospective multisite cohort study followed adult survivors after hospitalization, with or without AKI. The primary outcome was a combined CKD event of incident CKD, progression of CKD and kidney failure.
Patient-reported outcomes in hemodialysis vascular access: A call to action
The limited implementation of PROs in clinical trials, patient registries, quality measurement, and other research settings has significantly constrained the patient voice in evaluation of vascular access outcomes and vascular access decision-making. To address these issues, the Kidney Health Initiative, a public-private partnership between the American Society of Nephrology and the U.S. Food and Drug Administration, assembled an interdisciplinary workgroup to enhance uptake of access-related PROs The workgroup provided recommendations for actions to promote the widespread utilization of vascular access-related PRO measures in five categories: (1) development of vascular access-specific PRO measures, (2) ensuring comprehensive assessment when using vascular access PRO measures, (3) ensuring accessibility and applicability of vascular access PRO measures to all end stage kidney disease populations, (4) establishing universal guidelines and accepted vascular access PRO measures, and (5) engaging stakeholders across all facets.
Associations of Microvascular Complications With the Risk of Cardiovascular Disease in Type 1 Diabetes
We examined whether the presence of microvascular complications was associated with increased subsequent risk of cardiovascular disease (CVD) among participants with type 1 diabetes in the Diabetes Control and Complications Trial and Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study followed for >35 years.
Chronic Kidney Disease in Diabetes: Guidelines from KDIGO
The Kidney Disease: Improving Global Outcomes (KDIGO) group, an international organization dedicated to nephrology clinical practice guidelines, has developed a new guideline for management of diabetes with CKD. Team-Based Care: People with diabetes and CKD have high risks of CKD progression, cardiovascular disease (CVD), and mortality, which can be reduced with a comprehensive approach to lifestyle and risk factor management in combination with appropriate pharmacotherapy. Optimal care includes primary care, cardiology, nephrology, endocrinology, psychology, nutrition, and disease management nursing support.
Time-Updated Changes in Estimated GFR and Proteinuria and Major Adverse Cardiac Events: Findings from the Chronic Renal Insufficiency Cohort (CRIC) Study
Rationale and objective: Evaluating repeated measures of estimated glomerular filtration rate (eGFR) and urine protein-to-creatinine ratio (UPCR) over time may enhance our ability to understand the association between changes in kidney parameters and cardiovascular disease risk. Study design: Prospective cohort study. Setting and participants: Annual visit data from 2,438 participants in the Chronic Renal Insufficiency Cohort. Exposures: Average and slope of eGFR and UPCR in time-updated, one-year exposure windows.
3D Cell Culture Models: Drug Pharmacokinetics, Safety Assessment, and Regulatory Consideration
This article reviews the current application and challenges of 3D culture systems in drug PK, safety and efficacy assessment, and provides a focused discussion and regulatory perspectives on the liver-, intestine-, kidney- and neuron-based 3D cellular models.
What Is the “Maintenance” in Maintenance Dialysis?
It is time that we adopt a more patient-centered mindset when caring for patients on dialysis. Other studies indicate that while staying alive is important to patients, their independence and how they spend their time when they are not on dialysis may be of greater value to most. However, nephrologists are more attuned to addressing patients’ biomedical markers of disease activity and risk factors for mortality than patients’ personal goals and function.
Comparison of host endothelial, epithelial and inflammatory response in ICU patients with and without COVID-19: a prospective observational cohort study
Analyses of blood biomarkers involved in the host response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral infection can reveal distinct biological pathways and inform development and testing of therapeutics for COVID-19. Our objective was to evaluate host endothelial, epithelial and inflammatory biomarkers in COVID-19.