Our faculty research broadens the knowledge of kidney disease.

The Kidney Accelerator: Innovation Wanted, Nephrologists Needed

Innovation in nephrology is long overdue. The most impactful innovations in our field arguably arrived half a century ago with the invention of maintenance dialysis and novel federal funding policies, providing life-sustaining therapy to those with kidney failure. In the interim, we saw important advances, including the introduction of erythropoietin and improved immunosuppressants. However, we continue to reward kidney failure with a life on dialysis for many, while thousands die every year on the kidney transplant waitlist. Where are the novel ways to improve life with kidney disease, and where is the hope for a cure?

Long-term exposure to ambient air pollution and renal function in African Americans: the Jackson Heart Study

Weaver AM, Wang Y, Wellenius GA, Young B, Boyle LD, Hickson DA, Diamantidis CJ

Renal dysfunction is prevalent in the US among African Americans. Air pollution is associated with renal dysfunction in mostly white American populations, but has not been studied among African Americans. We evaluated cross-sectional associations between 1-year and 3-year fine particulate matter (PM2.5) and ozone (O3) concentrations, and renal function among 5090 African American participants in the Jackson Heart Study.

Characterization of Glomerular Sox9+ Cells in Anti-Glomerular Basement Membrane Nephritis in the Rat

Prochnicki A, Amann K, Wegner M, Sock E, Pfister E, Shankland S, Pippin J, Daniel C

Mechanisms of glomerular crescent formation and podocyte repair processes are still unclear. Therefore, we investigated the expression of the transcription factor Sox9 as a potential marker of a subpopulation of parietal epithelial cells (PECs) with potential regenerative properties. Glomerular Sox9 expression was characterized in detail in a rat anti-glomerular basement membrane (GBM) nephritis model using immunofluorescence and confocal laser scanning microscopy.

Reconstructing the Human Renal Vascular-Tubular Unit In Vitro

Rayner SG, Phong KT, Xue J, Lih D, Shankland SJ, Kelly EJ, Himmelfarb J, Zheng Y

Engineered human kidney-on-a-chip platforms show tremendous promise for disease modeling and drug screening. Outstanding challenges exist, however, in reconstructing the complex architecture, cellular make-up, and matrix composition necessary for the proper modeling of kidney function. Herein, the first fully tunable human kidney-on-a-chip platform is reported that allows the reconstruction of the native architecture of the renal endothelial-epithelial exchange interface using entirely cell-remodelable matrix and patient-derived kidney cells.

Cardiovascular Events after New-Onset Atrial Fibrillation in Adults with CKD: Results from the Chronic Renal Insufficiency Cohort (CRIC) Study

Nisha Bansal, Dawei Xie, Daohang Sha, Lawrence J. Appel, Rajat Deo, Harold I. Feldman, Jiang He, Kenneth Jamerson, John W. Kusek, Steven Messe, Sankar D. Navaneethan, Mahboob Rahman, Ana Catherine Ricardo, Elsayed Z. Soliman, Raymond Townsend and Alan S. Go

Atrial fibrillation (AF), the most common sustained arrhythmia in CKD, is associated with poor clinical outcomes in both patients without CKD and patients with dialysis-treated ESRD. However, less is known about AF-associated outcomes in patients with CKD who do not require dialysis.

Association of Medicaid Expansion With 1-Year Mortality Among Patients With End-Stage Renal Disease

Shailender Swaminathan, Benjamin D. Sommers, Rebecca Thorsness, Rajnish Mehrotra, Yoojin Lee, Amal N. Trivedi

In this observational study of 236,246 nonelderly patients with end-stage renal disease initiating dialysis comparing mortality between the preexpansion period and the postexpansion period, the change in 1-year mortality among patients in Medicaid expansion states compared with those in nonexpansion states was −0.8% vs −0.2%, a difference that was statistically significant. Among patients with end-stage renal disease initiating dialysis, the ACA Medicaid expansion was associated with significant improvements in 1-year survival.

Advanced dialysis fellowship

Munshi R, Winrow RM, Wu JS, Treit K, Bieber SD

End‐stage renal disease (ESRD) requiring dialysis or transplantation once thought to be an orphan disease now affects over 400,000 patients in the United States.Currently, renal transplantation offers the best option for renal replacement therapy. However, majority of patients with ESRD are treated by dialysis. Significant advancements have been made in dialysis technology since chronic dialysis became a viable option in 1960.

Recurrent Polyuria

Arora N, Durvasula R

To recognize fellowship programs’ educational mission, AJKD is using its popular Quiz feature to highlight Nephrology Fellowship programs when an author is a Nephrology Fellow. To participate, Fellowship Program Directors mentor fellows in submitting prospective Quizzes; those that are selected for publication include a brief description of the fellowship program from the Director. For “Recurrent Polyuria,” the first author is Nayan Arora, a Nephrology Fellow at the University of Washington.

Prevalence of Hypertension and Cardiovascular Risk According to Blood Pressure Thresholds Used for Diagnosis

Lamprea-Montealegre JA, Zelnick LR, Hall YN, Bansal N, de Boer IH

We sought to estimate the prevalence of hypertension and characteristics of hypertensive adults in the United States according to blood pressure (BP) thresholds used for diagnosis and estimate their associated cardiovascular disease risk.

Technology Transfer of the Microphysiological Systems: A Case Study of the Human Proximal Tubule Tissue Chip

Sakolish C, Weber EJ, Kelly EJ, Himmelfarb J, Mouneimne R, Grimm FA, House JS, Wade T, Han A, Chiu WA, Rusyn I

Tissue chips are promising new technology, they have the potential to serve as a valuable tool in biomedical research, as well as pharmaceutical development with regards to testing for efficacy and safety. The principal goals of this study were to validate a previously established proximal tubule tissue chip model in an independent laboratory and to extend its utility to testing of nephrotoxic compounds.