Our faculty research broadens the knowledge of kidney disease.

Longitudinal Evolution of Markers of Mineral Metabolism in Patients With CKD: The Chronic Renal Insufficiency Cohort (CRIC) Study

Tamara Isakova, Xuan Cai, Jungwha Lee, Rupal Mehta, Xiaoming Zhang, Wei Yang, Lisa Nessel, Amanda Hyre Anderson, Joan Lo, Anna Porter, Julie Wright Nunes, Lavinia Negrea, Lee Hamm, Edward Horwitz, Jing Chen, Julia J. Scialla, Ian H. de Boer, Mary B. Leonard, Harold I. Feldman, Myles Wolf, on behalf of the CRIC Study Investigators

The pathogenesis of disordered mineral metabolism in chronic kidney disease (CKD) is largely informed by cross-sectional studies of humans and longitudinal animal studies. We sought to characterize the longitudinal evolution of disordered mineral metabolism during the course of CKD.

Ethical Concerns in the Care of Patients with Advanced Kidney Disease: a National Retrospective Study, 2000–2011

Catherine R. Butler, Elizabeth K. Vig, Ann M. O’Hare, Chuan-Fen Liu, Paul L. Hebert. Susan P.Y. Wong

Understanding ethical concerns that arise in the care of patients with advanced kidney disease may help identify opportunities to support medical decision-making. The objective is to describe the clinical contexts and types of ethical concerns that arise in the care of patients with advanced kidney disease.

Tissue Chips in Space—Challenges and Opportunities

Catherine K. Yeung,  Paul Koenig,  Stefanie Countryman,  Kenneth E. Thummel,  Jonathan Himmelfarb,  Edward J. Kelly

The microgravity environment results in a multitude of physiological changes associated with aging and altered organ function. Deployment of microphysiological systems, also known as “tissue chips” to the International Space Station United States National Laboratory, will allow the study of these changes at the cellular/molecular level. The goal of these studies is to expand understanding of age‐related conditions to improve human health on earth.

Vitamin D Metabolic Ratio and Risks of Death and CKD Progression

Bansal, N., Katz, R., Appel, L., Denburg, M., Feldman, H., Go, A.S., He, J., Hoofnagle, A., Isakova, T., Kestenbaum, B., Kusek, J., Lash, J., Leonard, M., Rahman, M., Robinson-Cohen, C., Wolf, M., Xie, D., Zelnick, L., de Boer, I.H., Appel, L., Feldman, H., Kusek, J.W., Lash, J.P., Rao, P.S., Townsend, R.R., CRIC Study Investigators

Assessment of impaired vitamin D metabolism is limited by lack of functional measures. CYP24A1-mediated vitamin D clearance, calculated as the ratio of serum 24,25-dihydroxyvitamin D3 to 25-hydroxyvitamin D3 (the vitamin D metabolic ratio, VDMR), is induced by 1,25-dihydroxyvitamin D and may assess tissue-level activity. We tested associations of the VDMR with risks of death and progression to end-stage renal disease (ESRD) in patients with chronic kidney disease (CKD).

Differential Expression of Parietal Epithelial Cell and Podocyte Extracellular Matrix Proteins in Focal Segmental Glomerulosclerosis and Diabetic Nephropathy

Gek Cher Chan, Diana G. Eng, Jeffrey H. Miner, Charles E. Alpers, Kelly L Hudkins, Anthony Chang, Jeffrey W. Pippin, Stuart J Shankland

This study aimed to define individual ECM protein isoform expression by PECs in both experimental and human focal segmental glomerulosclerosis (FSGS) and diabetic nephropathy (DN), and to determine if changes were CD44-dependent.

Association of Family Ratings of Quality of End-of-Life Care With Stopping Dialysis Treatment and Receipt of Hospice Services

Claire A. Richards, Paul L. Hebert, Chuan-Fen Liu, Mary Ersek, Melissa W. Wachterman, Leslie L. Taylor, Lynn F. Reinke, Ann M. O’Hare

In this survey study of family members of patients with end-stage renal disease who were undergoing maintenance dialysis, the adjusted predicted probability of family rating the quality of end-of-life care as excellent was higher for patients who stopped dialysis before death than for patients who did not stop dialysis.

Genetics and ESKD Disparities in African Americans

Ebele M. Umeukeje, Bessie A.Young

African Americans have a 2- to 4-fold greater incidence of end-stage kidney disease (ESKD) than whites, which has long raised the possibility of a genetic cause for this disparity. Recent advances in genetic studies have shown a causal association of polymorphisms at the apolipoprotein L1 gene (APOL1) with the markedly increased risk for the nondiabetic component of the overall disparity in ESKD in African Americans.

Physician Judgment and Circulating Biomarkers Predict 28-Day Mortality in Emergency Department Patients

Daniel Henning; Pavan Bhatraju; Nicholas Johnson; Susanna Kosamo; Nathan Shapiro; Leila Zelnick; W. Liles; Mark Wurfel

OBJECTIVES: To determine whether biomarkers of endothelial activation and inflammation provide added value for prediction of in-hospital mortality within 28 days when combined with physician judgment in critically ill emergency department patients.

Alterations of Proximal Tubular Secretion in Autosomal Dominant Polycystic Kidney Disease

Ke Wang, Leila R. Zelnick, Yan Chen, Andrew N. Hoofnagle, Terry Watnick, Stephen Seliger, Bryan Kestenbaum

In autosomal dominant polycystic kidney disease (ADPKD), the GFR often remains normal despite significant nephron loss. Proximal tubular secretory clearance may be reduced in ADPKD before detectable changes in GFR.

Experiences of US Nephrologists in the Delivery of Conservative Care to Patients With Advanced Kidney Disease: A National Qualitative Study

Susan P.Y. Wong, Saritha Boyapati, Ruth A. Engelberg, Bjorg Thorsteinsdottir, Janelle S. Taylor, Ann M. O’Hare

This is a national qualitative study of nephrologist experiences and approaches to providing conservative care to patients who choose not to start maintenance dialysis. Nephrologists interviewed in this study describe a person-centered approach to care and being creative in improvising a care infrastructure for patients within health systems where dialysis is the default. The findings highlight the need to build the cultural and clinical infrastructure to support patients who do not wish to receive dialysis.