Our faculty research broadens the knowledge of kidney disease.

Are County Codes More Indicative of Kidney Health Than Genetic Codes?

Stanifer JW, Hall YN

Within the United States, striking disparities in life expectancy exist by race, ethnicity, socioeconomic status, and geography.1, 2 As with health disparities in chronic diseases such as end-stage renal disease (ESRD), life expectancy itself reflects diverse biological, social, economic, and geographic determinants. In the United States, lower income is strongly linked to premature mortality, and the differences in life expectancy across income groups appear to be increasing over time.

Krüppel-like factor 4 is a negative regulator of STAT3-induced glomerular epithelial cell proliferation

Estrada CC, Paladugu P, Guo Y, Pace J, Revelo MP, Salant DJ, Shankland SJ, D'Agati VD, Mehrotra A, Cardona S, Bialkowska AB, Yang VW, He JC, Mallipattu SK

Pathologic glomerular epithelial cell (GEC) hyperplasia is characteristic of both rapidly progressive glomerulonephritis (RPGN) and subtypes of focal segmental glomerulosclerosis (FSGS). Although initial podocyte injury resulting in activation of STAT3 signals GEC proliferation in both diseases, mechanisms regulating this are unknown. Here, we show that the loss of Krüppel-like factor 4 (KLF4), a zinc-finger transcription factor, enhances GEC proliferation in both RPGN and FSGS due to dysregulated STAT3 signaling.

Training Nephrology Fellows in Temporary Hemodialysis Catheters and Kidney Biopsies Is Not Needed and Should Not Be Required.

This opinion piece argues against the training of all nephrology fellows in the United States in our profession’s two major procedures: dialysis catheter insertion and percutaneous kidney biopsies. [...] regardless of who is placing the line or performing the kidney biopsy, nephrologists are integral in the care team because of the kidney, dialysis, and transplant expertise that only we can provide. In my mind, these two nephrology procedures are therefore not an essential part of what it means to be a nephrologist in 2018.

Glomerular disease augments kidney accumulation of synthetic anionic polymers

Liu GW, Prossnitz AN, Eng DG, Cheng Y, Subrahmanyam N, Pippin JW, Lamm RJ, Ngambenjawong C, Ghandehari H, Shankland SJ, Pun SH

Polymeric drug carriers can alter the pharmacokinetics of their drug cargoes, thereby improving drug therapeutic index and reducing side effects. Understanding and controlling polymer properties that drive tissue-specific accumulation is critical in engineering targeted drug delivery systems. For kidney disease applications, targeted drug delivery to renal cells that reside beyond the charge- and size-selective glomerular filtration barrier could have clinical potential.

Serum 25-Hydroxyvitamin D Concentrations Are Associated with Computed Tomography Markers of Subclinical Interstitial Lung Disease among Community-Dwelling Adults in the Multi-Ethnic Study of Atherosclerosis (MESA)

Kim SM, Zhao D, Podolanczuk AJ, Lutsey PL, Guallar E, Kawut SM, Barr RG, de Boer IH, Kestenbaum BR, Lederer DJ, Michos ED

Activated vitamin D has anti-inflammatory properties. 25-Hydroxyvitamin D [25(OH)D] deficiency might contribute to subclinical interstitial lung disease (ILD). We examined associations between serum 25(OH)D concentrations and subclinical ILD among middle-aged to older adults who were free of cardiovascular disease at baseline

Are we underestimating the quality of aviremic hepatitis C-positive kidneys? Time to reconsider

Sibulesky L, Kling CE, Blosser C, Johnson CK, Limaye AP, Bakthavatsalam R, Leca N, Perkins JD

Kidney Donor Risk Index (KDRI) introduced in 2009 included hepatitis C serologic but not viremic status of the donors. With nucleic acid amplification testing (NAT) now being mandatory, further evaluation of these donors is possible. We conducted a retrospective matched case-control analysis of adult deceased donor kidney transplants...

A wearable artificial kidney for patients with end-stage renal disease

Gura V, Rivara MB, Bieber S, Munshi R, Smith NC, Linke L, Kundzins J, Beizai M, Ezon C, Kessler L, Himmelfarb J

Stationary hemodialysis machines hinder mobility and limit activities of daily life during dialysis treatments. New hemodialysis technologies are needed to improve patient autonomy and enhance quality of life. We conducted a FDA-approved human trial of a wearable artificial kidney, a miniaturized, wearable hemodialysis machine, based on dialysate-regenerating sorbent technology. We aimed to determine the efficacy of the wearable artificial kidney in achieving solute, electrolyte, and volume homeostasis in up to 10 subjects over 24 hours.

Bioelectrical Impedance Analysis Measures and Clinical Outcomes in CKD

Bioelectrical impedance analysis (BIA) provides a noninvasive assessment of body composition. BIA measures of cell integrity (phase angle) and hydration (vector length) have been associated with mortality among patients receiving dialysis. Whether these measures are associated with clinical outcomes in patients with chronic kidney disease (CKD) is unknown.

GDF-15, Galectin 3, Soluble ST2, and Risk of Mortality and Cardiovascular Events in CKD

Tuegel C, Katz R, Alam M, Bhat Z, Bellovich K, de Boer I, Brosius F, Gadegbeku C, Gipson D, Hawkins J, Himmelfarb J, Ju W, Kestenbaum B, Kretzler M, Robinson-Cohen C, Steigerwalt S, Bansal N

Inflammation, cardiac remodeling, and fibrosis may explain in part the excess risk for cardiovascular disease (CVD) in patients with chronic kidney disease (CKD). Growth differentiation factor 15 (GDF-15), galectin 3 (Gal-3), and soluble ST2 (sST2) are possible biomarkers of these pathways in patients with CKD

Heroin Use Is Associated with AA-Type Kidney Amyloidosis in the Pacific Northwest

Arjun Sharma, Priyanka Govindan, Mirna Toukatly, Jack Healy, Connor Henry, Steve Senter, Behzad Najafian, Bryan Kestenbaum

AA-type kidney amyloidosis is classically associated with chronic autoimmune or inflammatory disorders. However, some urban centers have reported a high prevalence of injection drug use among patients with kidney AA amyloidosis. Previous reports lack control groups to quantify associations and most predate the opioid epidemic in the United States.