Our faculty research broadens the knowledge of kidney disease.

Kidney Function in Patients With Type 2 Diabetes After Vitamin D Supplementation-Reply

Ian H. de Boer, Leila R. Zelnick, JoAnn E. Manson

In Reply - Dr Peiris suggests that 25(OH)D concentrations, adherence, or vitamin D3 dose may have limited testing the effects of vitamin D3 on change in eGFR in our study.

Twice-Weekly Hemodialysis Is an Option for Many Patients in Times of Dialysis Unit Stress

Timothy W. Meyer, Thomas H. Hostetter, Suzanne Watnick

Considerable data suggest that two hemodialysis treatments per week are not much inferior to three treatments per week, and a change made in the face of the pandemic would likely be relatively short term. Thrice-weekly treatment was adopted as standard by the University of Washington program in the 1960s because patients developed neuropathy while receiving long nocturnal treatment dialysis twice weekly. It remains standard in the United States, and the 2015 Update of the Kidney Disease Outcomes Quality Initiative Clinical Practice Guideline left in place the 2006 recommendation that twice-weekly treatment be restricted to patients having a residual urea clearance of >2 ml/min.

Feasibility of Connecting Regional Research Programs to National Multisite Trials Emanating From the CTSA Trial Innovation Network

Laurie Hassell, Charlie Gregor, Ann Melvin, Christopher Goss, Robert H. Coker, Cindi Laukes, Sandra Albritton, Jeannine Brant, Paul Amoroso, Nichole Whitener, Katherine R. Tuttle

A collaborative research model was developed and tested to enable regional healthcare systems to join multisite clinical trials emanating from the Clinical and Translational Science Award (CTSA) Trial Innovation Network (TIN) by the Institute of Translational Health Sciences at the University of Washington and the Northwest Participant and Clinical Interactions (NW PCI) Network. The NW PCI is a collaborative group of regional research programs located at medical centers, healthcare systems, and universities across Washington, Wyoming, Alaska, Montana, and Idaho. This article describes the purpose, development, barriers, and initial experience with feasibility assessment for TIN-supported studies in the NW PCI.

Glycemic Monitoring and Management in Advanced Chronic Kidney Disease

Rodolfo J Galindo, Roy W Beck, Maria F Scioscia, Guillermo E Umpierrez, Katherine R Tuttle

Glucose and insulin metabolism in patients with diabetes are profoundly altered by advanced chronic kidney disease. Risk of hypoglycemia is increased by failure of kidney gluconeogenesis, impaired insulin clearance by the kidney, defective insulin degradation due to uremia, increased erythrocyte glucose uptake during hemodialysis, impaired counter-regulatory hormone responses (cortisol, growth hormone), nutritional deprivation and variability of exposure to oral anti-hyperglycemic agents and exogenous insulin.

Counterpoint: Twice-Weekly Hemodialysis Should Be an Approach of Last Resort Even in Times of Dialysis Unit Stress

The data comparing outcomes with twice- and thrice-weekly hemodialysis are extremely limited, and they are simply insufficient to conclude that the two regimens are equivalent. The evidence and data are derived from observational studies from the United States and China. In the United States, twice-weekly hemodialysis is used by <5% of patients, and it is often reserved for otherwise healthy individuals with significant residual kidney function.

Nomenclature for Kidney Function and Disease: Report of a Kidney Disease: Improving Global Outcomes (KDIGO) Consensus Conference

Andrew S Levey, Kai-Uwe Eckardt, Nijsje M Dorman, Stacy L Christiansen, Ewout J Hoorn, Julie R Ingelfinger, Lesley A Inker, Adeera Levin, Rajnish Mehrotra, Paul M Palevsky, Mark A Perazella, Allison Tong, Susan J Allison, Detlef Bockenhauer, Josephine P Briggs, Jonathan S Bromberg, Andrew Davenport, Harold I Feldman, Denis Fouque, Ron T Gansevoort, John S Gill, Eddie L Greene, Brenda R Hemmelgarn, Matthias Kretzler, Mark Lambi, Pascale H Lane, Joseph Laycock, Shari E Leventhal, Michael Mittelman, Patricia Morrissey, Marlies Ostermann, Lesley Rees, Pierre Ronco, Franz Schaefer, Jennifer St Clair Russell, Caroline Vinck, Stephen B Walsh, Daniel E Weiner, Michael Cheung, Michel Jadoul, Wolfgang C Winkelmayer

In June 2019, Kidney Disease: Improving Global Outcomes (KDIGO) convened a Consensus Conference with the goal of standardizing and refining the nomenclature used in the English language to describe kidney function and disease, and of developing a glossary that could be used in scientific publications. Guiding principles of the conference were that the revised nomenclature should be patient-centered, precise, and consistent with nomenclature used in the KDIGO guidelines.

Contemporary Patterns in Kidney Graft Survival From Donors After Circulatory Death in the United States

Catherine R. Butler, James D. Perkins, Christopher K. Johnson, Christopher D. Blosser, Iris De Castro, Nicolae Leca, Lena Sibulesky

Kidney transplants from donors after circulatory death (DCD) make up an increasing proportion of all deceased donor kidney transplants in the United States (US). However, DCD grafts are considered to be of lower quality than kidneys from donors after brain death (DBD). It is unclear whether graft survival is different for these two types of donor kidneys.

Serum Aldosterone Concentration, Blood Pressure, and Coronary Artery Calcium: The Multi-Ethnic Study of Atherosclerosis

Kosuke Inoue, Deena Goldwater, Matthew Allison, Teresa Seeman, Bryan R. Kestenbaum, Karol E. Watson

Aldosterone is a steroid hormone regulating fluid and electrolyte homeostasis and is known to increase the risk of atherosclerosis. In this study, we examined the associations of serum aldosterone concentrations with subclinical atherosclerosis and all-cause mortality. This study included 948 adults aged 46 to 88 years from the MESA (Multi-Ethnic Study of Atherosclerosis) with measurements of serum aldosterone and plasma renin activity and not taking antihypertensive medications.

Metabolomic Markers of Kidney Function Decline in Patients With Diabetes: Evidence From the Chronic Renal Insufficiency Cohort (CRIC) Study

Brian Kwan, Tobias Fuhrer, Jing Zhang, Manjula Darshi, Benjamin Van Espen, Daniel Montemayor, Ian H de Boer, Mirela Dobre, Chi-Yuan Hsu, Tanika N Kelly, Dominic S Raj, Panduranga S Rao, Santosh L Saraf, Julia Scialla, Sushrut S Waikar, Kumar Sharma, Loki Natarajan, CRIC Study Investigators

Biomarkers that provide reliable evidence of future diabetic kidney disease (DKD) are needed to improve disease management. In a cross-sectional study, we previously identified 13 urine metabolites that had levels reduced in DKD compared with healthy controls. We evaluated associations of these 13 metabolites with future DKD progression.

Level and Change in N-terminal Pro B-type Natriuretic Peptide and Kidney Function and Survival to Age 90

Astrid D Häberle, Mary L Biggs, Mary Cushman, Bruce M Psaty, Anne B Newman, Michael G Shlipak, John Gottdiener, Chenkai Wu, Julius M Gardin, Nisha Bansal, Michelle C Odden

Many traditional cardiovascular risk factors do not predict survival to very old age. Studies have shown associations of estimated glomerular filtration rate (eGFR) and N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) with cardiovascular disease and mortality in older populations. This study aimed to evaluate the associations of the level and change in eGFR and NT-pro-BNP with longevity to age 90 years.