Our research broadens the knowledge of kidney disease.

Triglyceride-Rich Lipoproteins, Apolipoproteins, and Atherosclerotic Cardiovascular Events Among Patients with Diabetes Mellitus and End-Stage Renal Disease on Hemodialysis

Julio A Lamprea-Montealegre, Ronit Katz, Hubert Scharnagl, Günther Silbernagel, Winfried März, Christiane Drechsler, Cristoph Wanner, Ian H de Boer

In this observational post–hoc analysis of the “Die Deutsche Diabetes Dialyse Studie (4D study)” clinical trial8, we examined associations of triglycerides, VLDL–cholesterol (VLDL–C), and apolipoproteins B (Apo B) and C–III (Apo C–III) with ASCVD events among patients with type 2 diabetes and ESRD on HD.

Calculating estimated glomerular filtration rate without the race correction factor: Observations at a large academic medical system

Junyan Shi, Edwin G. Lindo, Geoffrey S. Baird, Bessie Young, Michael Ryan, J.  Ashley Jefferson, Rajnish Mehrotra, Patrick C. Mathias, Andrew N. Hoofnagle

Creatinine-based MDRD and CKD-EPI equations include a race correction factor, which results in higher eGFR in Black patients. We evaluated the impact on our patient population upon adoption of the CKD-EPI equation and the removal of the race correction factor from the equation. Retrospective analysis of blood creatinine results and respective eGFR values calculated by the MDRD or CKD-EPI equation without the race correction factor (CKD-EPINoRace) in a large academic medical system over a 20.5-month period.

An Introduction to Qualitative Inquiry

Many aspects of care for people with kidney disease cannot be meaningfully understood in numerical terms, and benefit from a qualitative approach to inquiry. Qualitative methodologies were originally developed in the social sciences, but are increasingly used in medical research to address questions related to people's lived experiences of illness and care, the meanings they attribute to these experiences, and how health care processes and systems function. In the nephrology literature, qualitative work has helped to identify those health outcomes that matter most to people with kidney disease and their families, which has informed the design and testing of clinical interventions. Other studies have shed light on complex health care processes, such as kidney transplant donation and medical decision making, helping to identify targets for process improvement. Qualitative work may also offer a view into the lives of people with kidney disease, which supports clinicians in better understanding, communicating with, and caring for this group.

DNAm-based signatures of accelerated aging and mortality in blood are associated with low renal function

Pamela R. Matías-García, Cavin K. Ward-Caviness, Laura M. Raffield, Xu Gao, Yan Zhang, Rory Wilson, Xīn Gào, Jana Nano, Andrew Bostom, Elena Colicino, Adolfo Correa, Brent Coull, Charles Eaton, Lifang Hou, Allan C. Just, Sonja Kunze, Leslie Lange, Ethan Lange, Xihong Lin, Simin Liu, Jamaji C. Nwanaji-Enwerem, Alex Reiner, Jincheng Shen, Ben Schöttker, Pantel Vokonas, Yinan Zheng, Bessie Young, Joel Schwartz, Steve Horvath, Ake Lu, Eric A. Whitsel, Wolfgang Koenig, Jerzy Adamski, Juliane Winkelmann, Hermann Brenner, Andrea A. Baccarelli, Christian Gieger, Annette Peters, Nora Franceschini, Melanie Waldenberger

The difference between an individual's chronological and DNA methylation predicted age (DNAmAge), termed DNAmAge acceleration (DNAmAA), can capture life-long environmental exposures and age-related physiological changes reflected in methylation status. Several studies have linked DNAmAA to morbidity and mortality, yet its relationship with kidney function has not been assessed. We evaluated the associations between seven DNAm aging and lifespan predictors (as well as GrimAge components) and five kidney traits (estimated glomerular filtration rate [eGFR], urine albumin-to-creatinine ratio [uACR], serum urate, microalbuminuria and chronic kidney disease [CKD]) in up to 9688 European, African American and Hispanic/Latino individuals from seven population-based studies.

Body mass index and chronic kidney disease outcomes after acute kidney injury: a prospective matched cohort study

Helen L. MacLaughlin, Mindy Pike, Nicholas M. Selby, Edward Siew, Vernon M. Chinchilli, Andrew Guide, Thomas G. Stewart, Jonathan Himmelfarb, Alan S. Go, Chirag R. Parikh, Nasrollah Ghahramani, James Kaufman, T. Alp Ikizler & Cassianne Robinson-Cohen for the ASSESS-AKI Study Investigators

Acute kidney injury (AKI) and obesity are independent risk factors for chronic kidney disease (CKD). This study aimed to determine if obesity modifies risk for CKD outcomes after AKI. This prospective multisite cohort study followed adult survivors after hospitalization, with or without AKI. The primary outcome was a combined CKD event of incident CKD, progression of CKD and kidney failure.

Patient-reported outcomes in hemodialysis vascular access: A call to action

Karen Woo, Robert Fuld, Amanda Grandinetti, Jeffrey Lawson, Terry Litchfield, Mark Ohan, John Devin Peipert, Matthew B Rivara, Glenda Roberts, Prabir Roy-Chaudhury, Margo Underwood, Robert J Nordyke

The limited implementation of PROs in clinical trials, patient registries, quality measurement, and other research settings has significantly constrained the patient voice in evaluation of vascular access outcomes and vascular access decision-making. To address these issues, the Kidney Health Initiative, a public-private partnership between the American Society of Nephrology and the U.S. Food and Drug Administration, assembled an interdisciplinary workgroup to enhance uptake of access-related PROs The workgroup provided recommendations for actions to promote the widespread utilization of vascular access-related PRO measures in five categories: (1) development of vascular access-specific PRO measures, (2) ensuring comprehensive assessment when using vascular access PRO measures, (3) ensuring accessibility and applicability of vascular access PRO measures to all end stage kidney disease populations, (4) establishing universal guidelines and accepted vascular access PRO measures, and (5) engaging stakeholders across all facets.

Associations of Microvascular Complications With the Risk of Cardiovascular Disease in Type 1 Diabetes

Rose Gubitosi-Klug, Xiaoyu Gao, Rodica Pop-Busui, Ian H. de Boer, Neill White, Lloyd P. Aiello, Ryan Miller, Jerry Palmer, William Tamborlane, Amisha Wallia, Mikhail Kosiborod, John M. Lachin, Ionut Bebu the DCCT/EDIC Research Group

We examined whether the presence of microvascular complications was associated with increased subsequent risk of cardiovascular disease (CVD) among participants with type 1 diabetes in the Diabetes Control and Complications Trial and Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study followed for >35 years.

Chronic Kidney Disease in Diabetes: Guidelines from KDIGO

Kamlesh Khunti, Ian H de Boer, Peter Rossing

The Kidney Disease: Improving Global Outcomes (KDIGO) group, an international organization dedicated to nephrology clinical practice guidelines, has developed a new guideline for management of diabetes with CKD. Team-Based Care: People with diabetes and CKD have high risks of CKD progression, cardiovascular disease (CVD), and mortality, which can be reduced with a comprehensive approach to lifestyle and risk factor management in combination with appropriate pharmacotherapy. Optimal care includes primary care, cardiology, nephrology, endocrinology, psychology, nutrition, and disease management nursing support.

Time-Updated Changes in Estimated GFR and Proteinuria and Major Adverse Cardiac Events: Findings from the Chronic Renal Insufficiency Cohort (CRIC) Study

Jordana B Cohen, Wei Yang, Liang Li, Xiaoming Zhang, Zihe Zheng, Paula Orlandi, Nisha Bansal, Rajat Deo, James P Lash, Mahboob Rahman, Jiang He, Tariq Shafi, Jing Chen, Debbie L Cohen, Kunihiro Matsushita, Michael G Shlipak, Myles Wolf, Alan S Go, Harold I Feldman, CRIC Study Investigators

Rationale and objective: Evaluating repeated measures of estimated glomerular filtration rate (eGFR) and urine protein-to-creatinine ratio (UPCR) over time may enhance our ability to understand the association between changes in kidney parameters and cardiovascular disease risk. Study design: Prospective cohort study. Setting and participants: Annual visit data from 2,438 participants in the Chronic Renal Insufficiency Cohort. Exposures: Average and slope of eGFR and UPCR in time-updated, one-year exposure windows.

3D Cell Culture Models: Drug Pharmacokinetics, Safety Assessment, and Regulatory Consideration

Hongbing Wang, Paul C. Brown, Edwin C.Y. Chow, Lorna Ewart, Stephen S. Ferguson, Suzanne Fitzpatrick, Benjamin S. Freedman, Grace L. Guo, William Hedrich, Scott Heyward, James Hickman, Nina Isoherranen, Albert P. Li, Qi Liu, Shannon M. Mumenthaler, James Polli, William R Proctor, Alexandre Ribeiro, Jian-Ying Wang, Ronald L Wange, Shiew-Mei Huang

This article reviews the current application and challenges of 3D culture systems in drug PK, safety and efficacy assessment, and provides a focused discussion and regulatory perspectives on the liver-, intestine-, kidney- and neuron-based 3D cellular models.