Our faculty research broadens the knowledge of kidney disease.

CD44 impacts glomerular parietal epithelial cell changes in the aged mouse kidney

Hiroko Hamatani, Diana G. Eng, Keiju Hiromura, Jeffrey W. Pippin, Stuart J. Shankland

CD44 contributes to the activation of glomerular parietal epithelial cells (PECs). Although CD44 expression is higher in PECs of healthy aged mice, the biological role of CD44 in PECs in this context remains unclear. Accordingly, young (4 months) and aged (24 months) CD44−/− mice were compared to age‐matched CD44+/+ mice, both aged in a nonstressed environment.

Renaissance needed in conservative management of patients with ESKD

The need for a conservative option as an alternative to dialysis persists and has driven resurgent efforts to develop contemporary models of conservative care.

Distinct Functional Requirements for Podocalyxin in Immature and Mature Podocytes Reveal Mechanisms of Human Kidney Disease

Ido Refaeli, Michael R. Hughes, Alvin Ka-Wai Wong, Mei Lin Z. Bissonnette, Calvin D. Roskelley, A. Wayne Vogl, Sean J. Barbour, Benjamin S. Freedman, Kelly M. McNagny 

Dominant and recessive mutations in podocalyxin (PODXL) are associated with human kidney disease. Interestingly, some PODXL mutations manifest as anuria while others are associated with proteinuric kidney disease. PODXL heterozygosity is associated with adult-onset kidney disease and podocalyxin shedding into the urine is a common biomarker of a variety nephrotic syndromes. It is unknown, however, how various lesions in PODXL contribute to these disparate disease pathologies.

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.