Our research broadens the knowledge of kidney disease.

Read up-to-date Nephrology faculty research on Pubmed with the link below

University of Washington Nephrology Faculty Research on Pubmed

We are committed to conducting path-breaking research in order to improve the lives of people with kidney diseases. Our faculty consistently publish new research in nationally recognized journals.


A selection of recent papers:

 

Association of Clonal Hematopoiesis of Indeterminate Potential with Worse Kidney Function and Anemia in Two Cohorts of Patients with Advanced Chronic Kidney Disease

Vlasschaert C, McNaughton A, Chong M, Cook E, Hopman W, Kestenbaum B, Robinson-Cohen C, Garland J, Moran S, Paré G, Clase C, Tang M, Levin A, Holden R, Rauh M, Lanktree M.

Background: Clonal hematopoiesis of indeterminate potential (CHIP) is an inflammatory premalignant disorder resulting from acquired genetic mutations in hematopoietic stem cells. This condition is common in aging populations and associated with cardiovascular morbidity and overall mortality, but its role in chronic kidney disease (CKD) is unknown. Methods: We performed targeted sequencing to detect CHIP mutations in two independent cohorts of 87 and 85 adults with an eGFR<60 ml/min per 1.73m2. We also assessed kidney function, hematologic, and mineral bone disease parameters cross-sectionally at baseline, and collected creatinine measurements over the following 5-year period.

Comparative Effectiveness of Dialysis Modality on Laboratory Parameters of Mineral Metabolism

Soohoo M, Obi Y, Rivara MB, Adams SV, Lau WL, Rhee CM, Kovesdy CP, Kalantar-Zadeh K, Arah OA, Mehrotra R, Streja E

Introduction: Chronic kidney disease-mineral and bone disorders (CKD-MBD) are prevalent in patients undergoing maintenance dialysis. Yet, there is limited and mixed evidence on the effects of different dialysis modalities involving longer treatment times or higher frequencies on CKD-MBD markers. Methods: This cohort study used data from 132,523 incident dialysis patients treated with any of the following modalities: conventional thrice-weekly in-center hemodialysis, nocturnal in-center hemodialysis (NICHD), home hemodialysis (HHD), or peritoneal dialysis (PD) from 2007 to 2011.

Prediction of Incident Heart Failure in CKD: The CRIC Study

Leila R. Zelnick, Michael G. Shlipak, Elsayed Z. Soliman, Amanda Anderson, Robert Christenson, Mayank Kansal, Rajat Deo, Jiang He, Bernard G. Jaar, Matthew R. Weir, Panduranga Rao, Debbie L. Cohen, Jordana B. Cohen, Harold I. Feldman, Alan Go, Nisha Bansal, on behalf ofCRIC Study Investigators

Heart failure (HF) is common in chronic kidney disease (CKD); identifying patients with CKD at high risk for HF may guide clinical care. We assessed the prognostic value of cardiac biomarkers and echocardiographic variables for 10-year HF prediction compared with a published clinical HF prediction equation in a cohort of participants with CKD.

Cystatin C- and Creatinine-Based Glomerular Filtration Rate Estimation Differences and Muscle Quantity and Functional Status in Older Adults: The Health, Aging, and Body Composition Study

O. Alison Potok, Joachim H. Ixm Michael G. Shlipak, Nisha Bansal, Ronit Katz, Stephen B. Kritchevsky, Dena E Rifkin

The difference in the estimated glomerular filtration rate based on cystatin C and that based on creatinine (eGFRDiff) is known to be associated with frailty and mortality. Creatinine is influenced by muscle mass, more so than cystatin C; we aimed to determine whether eGFRDiff is associated with muscle quantity and to what extent muscle quantity explains the relationship between eGFRDiff and poor functional status.

Kidney Tubular Injury Biomarkers and Secretory Function in Acute Decompensated Heart Failure

Alexander J. Kula, David K. Prince, Bryan R. Kestenbaum, Song Li, Kevin D. O’Brien, Nisha Bansal

The assessment of kidney function is a critical component of care for patients admitted for acute decompensated heart failure. A valid measurement of kidney function is needed to guide diuretics and other key therapies. However, serum creatinine level, the traditional marker of kidney function, does not comprehensively capture the multidimensional processes of the kidneys. Relying on changes in the serum creatinine levels in patients with acute decompensated heart failure may be problematic for several reasons.

Donor-derived Cell-free DNA Complements De Novo Class II DSA in Detecting Late Alloimmune Injury Post Kidney Transplantation

Butiu M, Obrisca B, Sibulesky L, Bakthavatsalam R, Smith KD, Gimferrer I, Warner P, Ismail G, Leca N

We sought to evaluate the association between de novo donor-specific antibodies (dnDSAs) class and their mean fluorescence intensity (MFI) with donor-derived cell-free DNA (dd-cfDNA), aiming to further clarify the biomarker utility of these noninvasive tests in relation to renal allograft function and histology. The study included kidney transplant recipients (n = 171) who underwent surveillance testing with DSA and dd-cfDNA as part of their clinical care between September 2017 and December 2019 at our center.

Trends over time in the risk of adverse outcomes among patients with SARS-CoV-2 infection

Ioannou GN, O'Hare AM, Berry K, Fan VS, Crothers K, Eastment MC, Locke E, Green P, Shah JA, Dominitz JA

Background: We aimed to describe trends in adverse outcomes among patients who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) between February and September 2020 within a national healthcare system. Methods: We identified enrollees in the national United States Veterans Affairs healthcare system who tested positive for SARS-CoV-2 between 28 February 2020 and 30 September 2020 (n = 55 952), with follow-up extending to 19 November 2020. We determined trends over time in incidence of the following outcomes that occurred within 30 days of testing positive: hospitalization, intensive care unit (ICU) admission, mechanical ventilation, and death.

Patient Information Items Needed to Guide the Allocation of Scarce Life-Sustaining Resources: A Delphi Study of Multidisciplinary Experts

Gray MM, Butler CR, Webster LB, Tonelli MR, Sakata VL, Diekema DS.

Plans for allocation of scarce life-sustaining resources during the coronavirus disease 2019 (COVID-19) pandemic often include triage teams, but operational details are lacking, including what patient information is needed to make triage decisions. A Delphi study among Washington state disaster preparedness experts was performed to develop a list of patient information items needed for triage team decision-making during the COVID-19 pandemic. Experts proposed and rated their agreement with candidate information items during asynchronous Delphi rounds. Consensus was defined as ≥80% agreement. Qualitative analysis was used to describe considerations arising in this deliberation. A timed simulation was performed to evaluate feasibility of data collection from the electronic health record.

Risk Prediction Models for Atherosclerotic Cardiovascular Disease in Patients with Chronic Kidney Disease: The CRIC Study

Bundy JD, Rahman M, Matsushita K, Jaeger BC, Cohen JB, Chen J, Deo R, Dobre MA, Feldman HI, Flack J, Kallem RR, Lash JP, Seliger S, Shafi T, Weiner SJ, Wolf M, Yang W, Allen NB, Bansal N, He J; CRIC Study Investigators

Patients with CKD are typically considered to be at high risk for atherosclerotic cardiovascular disease, but CKD is a heterogeneous condition and there are no validated atherosclerotic cardiovascular disease risk stratification tools for this population. Our analysis of 2604 participants in the Chronic Renal Insufficiency Cohort study found that newly developed risk prediction models, using clinically available variables and novel biomarkers, improved discrimination, calibration, and reclassification of nonevents compared with the traditional American College of Cardiology/American Heart Association pooled cohort equations developed for the general population. The new equations may improve risk stratification in patients with CKD and improve shared decision making for preventive therapy to reduce atherosclerotic cardiovascular disease incidence and mortality.

How the University of Washington implemented a change in Estimated Glomerular Filtration Rate (eGFR) reporting

Naomi T. Nkinsi and Bessie A. Young

Chronic kidney disease (CKD) disproportionately affects those of minoritized race and ethnicity. Lack of access to care and social determinants of health are most likely the largest drivers of increased risk. To improve and simplify the way we calculate kidney function, estimates of glomerular filtration rate (eGFR) were developed based on data provided from large cohort studies where relatively few Black individuals were enrolled in earlier studies. This article provides a brief history of race and racism in medicine and describes the transition from the clinical use of eGFR with the race variable to reporting eGFR without a race at the University of Washington (UW), the steps involved, and actions are taken.