Our faculty research broadens the knowledge of kidney disease.
Updates in the management of heart failure for the chronic kidney disease patient
Heart failure is highly prevalent in patients with chronic kidney disease (CKD) and a leading cause of morbidity and mortality in this population. Heart failure therapies proven to benefit the general population may have different risk–benefit profiles in patients with concurrent CKD, plausibly because of the unique pathophysiology of heart failure in this population. The present review highlights recent advances in heart failure treatment as they apply to patients with CKD.
Association of serum uromodulin with mortality and cardiovascular disease in the elderly-the Cardiovascular Health Study
Uromodulin (UMOD) is released by renal tubular cells into the serum (sUMOD) and urine. Lower urine UMOD has been linked to mortality and cardiovascular disease but much less is known about sUMOD. We evaluated the association of sUMOD with these outcomes in community-dwelling older adults.
Urinary Concentration Ability: Time to Bring the Tubules to the Table
As a central homeostatic organ, the kidneys perform diverse physiologic functions beyond glomerular filtration, including synthesis of vital hormones, secretion of protein-bound organic solutes, and maintenance of salt and water balance. The “intact nephron hypothesis” postulates a progressive and proportionate decline in kidney functions across the spectrum of chronic kidney disease (CKD). However, several lines of evidence suggest contrasts between tubular and glomerular functions in the diseased state. For example...
Health-related quality of life in glomerular disease
There is scant literature describing the effect of glomerular disease on health-related quality of life (HRQOL). The Cure Glomerulonephropathy study (CureGN) is an international longitudinal cohort study of children and adults with four primary glomerular diseases (minimal change disease, focal segmental glomerulosclerosis, membranous nephropathy, and IgA nephropathy). HRQOL is systematically assessed using items from the Patient-Reported Outcomes Measurement Informative System (PROMIS).
Building Scaffolds to Rebuild Kidneys
The ability to promote a regenerative, rather than fibrotic, response to injury in the kidney could open up an important therapeutic possibility in patients with CKD. The paper by Lih et al. makes an important contribution to this topic by optimizing artificial scaffolds for kidney regeneration.The rationale behind this study is the observation that artificial scaffolds of porous materials have been widely studied for their ability to enhance tissue regeneration, but commonly used polyester scaffolds such as poly(lactic-co-glycolic acid) (PLGA) release acidic byproducts as they degrade, which can have the opposite effect. The authors therefore seek to optimize these scaffolds, drawing inspiration from two examples of well-studied biology: the ability of magnesium hydroxide to moderate stomach acidity in antacid formulations, and the ability of extracellular matrix preparations to suppress immune responses and promote healing.
Rates of Cardiac Rhythm Abnormalities in Patients with CKD and Diabetes
Follow the link to listen to the accompanying podcast. Cardiac arrhythmias increase mortality and morbidity in CKD. We evaluated the rates of subclinical arrhythmias in a population with type 2 diabetes and patients with moderate to severe CKD who were not on dialysis.
Peritoneal Dialysis Access Associated Infections
Infection is a significant driver of morbidity and mortality in patients with end-stage renal disease undergoing maintenance dialysis. This article reviews current knowledge with regards to prevention of PD-associated infections, and the diagnosis and management of exit site infections and peritonitis.
You Are Just Now Telling Us About This? African American Perspectives of Testing for Genetic Susceptibility to Kidney Disease
Variants of the APOL1 gene, which encodes apo L1, confer increased risk for CKD, ESKD, and reduced cadaveric kidney transplant survival, and likely contribute to kidney disease disparities among African American individuals in the United States. To date, few studies have gathered African Americans’ perspectives on APOL1 testing practices. In this Perspective, we describe the results of a study designed to gather informed input about the potential benefits and risks of APOL1 testing in routine patient care and in kidney transplant settings.
Translational assessment of drug-induced proximal tubule injury using a kidney microphysiological system (MPS)
Drug‐induced kidney injury (DIKI), a major cause of acute kidney injury (AKI), results in progressive kidney disease and is linked to increased mortality in hospitalized patients. Primary injury sites of DIKI are proximal tubules. Clinically, kidney injury molecule‐1 (KIM‐1), an established tubule‐specific biomarker, is monitored to assess the presence and progression of injury. The ability to accurately predict drug‐related nephrotoxicity pre‐clinically would reduce patient burden and drug attrition rates, yet state‐of‐the‐art in vitro and animal models fail to do so.
Risk Factors for Kidney Disease in Type 1 Diabetes
In type 1 diabetes (T1D), the course of microalbuminuria is unpredictable and timing of glomerular filtration rate (GFR) loss is uncertain. Thus, there is a need to identify the risk factors associated with the development of more advanced stages of kidney disease through large, long-term systematic analysis.