Our faculty research broadens the knowledge of kidney disease.

Rates of Cardiac Rhythm Abnormalities in Patients with CKD and Diabetes

Nazem Akoum, Leila R. Zelnick, Ian H. de Boer, Irl B. Hirsch, Dace Trence, Connor Henry, Nicole Robinson, Nisha Bansal

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

Umeukeje EM, Young BA, Fullerton SM, Cavanaugh K, Owens D, Wilson JG, Burke W, Blacksher E.

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)

Maass C, Sorensen NB, Himmelfarb J, Kelly EJ, Stokes CL, Cirit M

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

Perkins BA, Bebu I, de Boer IH, Molitch M, Tamborlane W, Lorenzi G, Herman W, White NH, Pop-Busui R, Paterson AD, Orchard T, Cowie C, Lachin JM, and on behalf of the Diabetes Control and Complications Trial (DCCT)-Epidemiology of Diabetes Interventions and Complications (EDIC) Research Group

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.

Commentary on Risks of Living Kidney Donation: Current State of Knowledge on Core Outcomes Important to Donors

Bryan R. Kestenbaum, Stephen L. Seliger

In this evidence-based nephrology review, Lentine et al. discuss the growing evidence regarding short- and long-term risks of living kidney donation. Adopting a patient-centered approach to characterizing and prioritizing these risks, the authors identify four potential risk categories.

Integrated epigenomic profiling reveals endogenous retrovirus reactivation in renal cell carcinoma

Siebenthall, K.T.,  Miller, C.P.,  Vierstra, J.D.,  Mathieu, J.d,,  Tretiakova, M.,  Reynolds, A.,  Sandstrom, R.,  Rynes, E.,  Haugen, E.,  Johnson, A.,  Nelson, J.,  Bates, D.,  Diegel, M.,  Dunn, D.,  Frerker, M.,  Buckley, M.,  Kaul, R.,  Zheng, Y.,  Himmelfarb, J.,  Ruohola-Baker, H.,  Akilesh, S.

Transcriptional dysregulation drives cancer formation but the underlying mechanisms are still poorly understood. Renal cell carcinoma (RCC) is the most common malignant kidney tumor which canonically activates the hypoxia-inducible transcription factor (HIF) pathway. Despite intensive study, novel therapeutic strategies to target RCC have been difficult to develop. Since the RCC epigenome is relatively understudied, we sought to elucidate key mechanisms underpinning the tumor phenotype and its clinical behavior.

Evidence-based therapy for undocumented immigrants with ESRD

Haemodialysis options for undocumented immigrants with end-stage renal disease range from standard of care thrice-weekly treatments to emergency-only haemodialysis. This latter approach is associated with poor patient outcomes and high costs. The time has come for the nephrology community to demand an end to the practice of emergency-only haemodialysis.

A Conceptual Framework of Palliative Care across the Continuum of Advanced Kidney Disease

Lam DY, Scherer JS, Brown M, Grubbs V, Schell JO.

Kidney palliative care is a growing discipline within nephrology. Kidney palliative care specifically addresses the stress and burden of advanced kidney disease through the provision of expert symptom management, caregiver support, and advance care planning with the goal of optimizing quality of life for patients and families. The integration of palliative care principles is necessary to address the multidimensional impact of advanced kidney disease on patients. In particular, patients with advanced kidney disease have a high symptom burden and experience greater intensity of care at the end of life compared with other chronic serious illnesses.

Neighborhood Social Context and Kidney Function Over Time: The Multi-Ethnic Study of Atherosclerosis

Hicken MT, Katz R, Peralta CA, Crews DC, Kramer HJ

Although socioeconomic status has been associated with chronic kidney disease (CKD), little is known about its relationship to residential neighborhood context. Secondary analysis of the Multi-Ethnic Study of Atherosclerosis (MESA), a prospective cohort study designed to investigate the development and progression of subclinical cardiovascular disease.