Our faculty research broadens the knowledge of kidney disease.

Initial skin cancer screening for solid organ transplant recipients in the United States: Delphi method development of expert consensus guidelines

Crow LD, Jambusaria-Pahlajani A, Chung CL, Baran DA, Lowenstein SE, Abdelmalek M, Ahmed RL, Anadkat MJ, Arcasoy SM, Berg D, Bibee KP, Billingsley E, Black WH, Blalock TW, Bleicher M, Brennan DC, Brodland DG, Brown MR, Carroll BT, Carucci JA, Chang TW, Chaux G, Cusack CA, Dilling DF, Doyle A, Emtiazjoo AM, Ferguson NH, Fosko SW, Fox MC, Goral S, Gray AL, Griffin JR, Hachem RR, Hall SA, Hanlon AM, Hayes D Jr, Hickey GW, Holtz J, Hopkins RS, Hu J, Huang CC, Brian Jiang SI, Kapnadak SG, Kraus ES, Lease ED, Leca N, Lee JC, Leitenberger JJ, Lim MA, Longo MI, Malik SM, Mallea JM, Menter A, Myers SA, Neuburg M, Nijhawan RI, Norman DJ, Otley CC, Paek SY, Parulekar AD, Patel MJ, Patel VA, Patton TJ, Pugliano-Mauro M, Ranganna K, Ravichandran AK, Redenius R, Roll GR, Samie FH, Shin T, Singer JP, Singh P, Soon SL, Soriano T, Squires R, Stasko T, Stein JA, Taler SJ, Terrault NA, Thomas CP, Tokman S, Tomic R, Twigg AR, Wigger MA, Zeitouni NC, Arron ST

Skin cancer is the most common malignancy affecting solid organ transplant recipients (SOTR). SOTR have a significantly increased risk for developing both melanoma and nonmelanoma skin cancers as compared to the general population. An understanding of the risk factors and trends in post‐transplant skin cancer is required to accurately risk stratify SOTR and create targeted screening guidelines. Until appropriate outcomes data to further inform guidelines becomes available, we have developed an expert consensus guideline using a multidisciplinary Delphi panel. To complete the Delphi, experts answered questionnaires, and after each round of questions, the facilitator provided an anonymized summary of the experts’ responses from the previous round, as well as the reasons provided for their judgments. Experts revised their responses in subsequent surveys in light of the replies of other members of the panel. The goal of this process was to decrease the range of the answers until the group converged on a consensus answer. The process was stopped after a predefined stop criterion of three rounds.

Association of High-Density Lipoprotein Particles and High-Density Lipoprotein Apolipoprotein C-III Content With Cardiovascular Disease Risk According to Kidney Function: The Multi-Ethnic Study of Atherosclerosis

Julio A. Lamprea‐Montealegre, Robyn L. McClelland, James D. Otvos, Samia Mora, Manja Koch, Majken K. Jensen, Ian H. de Boer

Chronic kidney disease is associated with structural and compositional abnormalities in high‐density lipoprotein particles (HDLp). We examined associations of HDLp size, particle subfractions, and apolipoprotein C‐III content with incident cardiovascular disease (CVD) events across categories of estimated glomerular filtration rate (eGFR).

Apolipoprotein B, Triglyceride-Rich Lipoproteins, and Risk of Cardiovascular Events in Persons with CKD

Julio Alejandro Lamprea-Montealegre, Natalie Staplin, William G. Herrington, Richard Haynes, Jonathan Emberson, Colin Baigent, Ian H. de Boer and on behalf of the SHARP Collaborative Group

Triglyceride-rich lipoproteins may contribute to the high cardiovascular risk of patients with CKD. This study evaluated associations of apo-B and markers of triglyceride-rich lipoproteins with cardiovascular events in people with CKD.

Serial Fibroblast Growth Factor 23 Measurements and Risk of Requirement for Kidney Replacement Therapy: The CRIC (Chronic Renal Insufficiency Cohort) Study

Rupal Mehta, Xuan Cai, Jung wha Lee, Dawei Xie, Xue Wang, Julia Scialla, Amanda H. Anderson, Jon Taliercio, Mirela Dobre, Jing Chen, Michael Fischer, Mary Leonard, James Lash. Chi-yuan Hsu, Ian H. de Boer, Harold I. Feldman, Myles Wolf, Tamara Isakova, on behalf of the CRIC Study Investigators: Lawrence J. Appel, Alan S. Go, Jiang He, Panduranga S. Rao, Mahboob Rahman, Raymond R.Townsend

Studies using a single measurement of fibroblast growth factor 23 (FGF-23) suggest that elevated FGF-23 levels are associated with increased risk for requirement for kidney replacement therapy (KRT) in patients with chronic kidney disease. However, the data do not account for changes in FGF-23 levels as kidney disease progresses. We evaluated the association between serial FGF-23 levels and risk for requiring KRT...

Association of serum and urinary uromodulin and their correlates in older adults-The Cardiovascular Health Study

Dominik Steubl, Petra Buzkova, Joachim H. Ix, Prasad Devarajan, Michael R. Bennett, Paolo H. M. Chaves, Michael G. Shlipak, Nisha Bansal, Mark J. Sarnak, Pranav S. Garimella

Uromodulin is released into serum (sUMOD) and urine (uUMOD) exclusively by renal tubular cells. Both sUMOD and uUMOD are correlated with estimated glomerular filtration rate (eGFR), and associated with mortality and cardiovascular disease (CVD). However, no study to our knowledge has measured both sUMOD and uUMOD in the same population, thus the relationship of sUMOD with uUMOD with one another, and their respective correlates have not been evaluated simultaneously.

Clinical Characteristics of and Risk Factors for Chronic Kidney Disease Among Adults and Children: An Analysis of the CURE-CKD Registry

Katherine R. Tuttle, Radica Z. Alicic, O. Kenrik Duru, Cami R. Jones, Kenn B. Daratha, Susanne B. Nicholas, Sterling M. McPherson, Joshua J. Neumiller, Douglas S. Bell, Carol M. Mangione, Keith C. Norris

What are the clinical characteristics of and major risk factors for chronic kidney disease among patients in 2 large US health care systems? In this cohort study of the Center for Kidney Research, Education, and Hope (CURE-CKD) registry, more than 2.6 million adults and children had chronic kidney disease or were at risk. Albuminuria or proteinuria was tested in approximately one-eighth of adults with chronic kidney disease, renin-angiotensin system inhibitors were prescribed to one-fifth, and nonsteroidal anti-inflammatory agents or proton pump inhibitors were prescribed to more than one-third. Despite common occurrence of chronic kidney disease, rates of identification and use of kidney protective agents were low, while use of potential nephrotoxins was widespread.

The landscape of diabetic kidney disease transformed

After nearly two decades, a new therapeutic agent, canagliflozin, received regulatory approval to prevent loss of kidney function, end-stage kidney disease, hospitalization for heart failure and cardiovascular death in patients with diabetic kidney disease. Nonetheless, the residual risk of kidney disease progression and complications remains high, underlining the importance of ongoing therapeutic development.

Utilizing centralized biorepository samples for biomarkers of cystic fibrosis lung disease severity

Scott D. Sagela, Brandie D. Wagner, Assem Ziady, Tom Kelley, John P. Clancy, Monica Narvaez-Rivase, Joseph Pilewski, Elizabeth Joseloff, Wei Shah, Leila Zelnick, Kenneth D.R.Setchelle, Sonya L. Heltshe, Marianne S. Muhlebach

Circulating biomarkers reflective of lung disease activity and severity have the potential to improve patient care and accelerate drug development in CF. The objective of this study was to leverage banked specimens to test the hypothesis that blood-based biomarkers discriminate CF children segregated by lung disease severity.

Fibrillary Glomerulonephritis Clinicopathologic Features and Atypical Cases from a Multi-Institutional Cohort

Nicole K. Andeen, Megan L. Troxell, Maziar Riazy, Rupali S. Avasare, Jessica Lapasia, J. Ashley Jefferson, Shreeram Akilesh, Behzad Najafian, Roberto F. Nicosia, Charles E. Alpers and Kelly D. Smith

Fibrillary GN has been defined as an immune complex-mediated GN with amyloid-like fibrils larger than amyloid which are IgG positive and Congo red negative. With discovery of DNAJB9 as a highly sensitive and specific marker for fibrillary GN, the specificity of the morphologic criteria for establishing the diagnosis of fibrillary GN has come into question. We sought to (1) determine anatomic characteristics that best define fibrillary GN and (2) identify clinical and pathologic features that predict outcomes.

Transforming Care for Patients and Providers - Perspective from Nonprofit Providers

Suzanne Watnick and Jeffrey Silberzweig

As Chief Medical Officers of not-for-profit organizations, we often find ourselves addressing the needs of many stakeholders, focusing on patient care as our central mission and figuring how to achieve this with resources available. Along with our nephrologist colleagues and our dialysis organizations’ leadership and staff, we seek to provide the best possible care for our patients. This discussion will focus on the potential consequences of the AAKH initiative for our patients, nephrologists, and dialysis organizations.