Journal of the American Society of Nephrology
Top medRxiv preprints most likely to be published in this journal, ranked by match strength.
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BackgroundThe extent to which achieving multiple metabolic treatment targets confers sustained cardiorenal protection across all stages of cardiovascular - kidney - metabolic (CKM) syndrome remains uncertain. MethodsThis multicenter retrospective cohort study used data from the China Renal Data System (CRDS). Participants were classified into CKM stages 1-4. Metabolic target achievement was defined as simultaneous control of blood pressure (BP<130/80 mmHg), fasting blood glucose (FBG<5.6 mmol/L...
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Individuals with chronic kidney disease (CKD) have higher rates of hip fracture and post-fracture mortality. Although they may develop age-related osteoporosis similar to those without CKD, they may also exhibit CKD-related metabolic bone disease (MBD), characterized by low, high, or mixed turnover at similar levels of bone mineral density (BMD). Because BMD does not provide information about turnover status, clinical decision-making is challenging. This study evaluated the associations between ...
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BackgroundProgression into more severe stages of chronic kidney disease (CKD) based on estimated glomerular filtration rate (eGFR) and albuminuria are associated with increased risk of end-stage renal failure, cardiovascular diseases, and mortality. Vesicles in the urine are cell-derived particles containing constituents of the cells of origin. Little is known about the prognostic capacity of urinary vesicles for CKD progression. PurposeTo evaluate the association between components of urinary ...
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IntroductionThere remains considerable debate as to the cause of the epidemic of Mesoamerican Nephropathy (MeN). We have previously reported early loss of estimated glomerular filtration rate (eGFR) as a surrogate for disease onset in a population-representative cohort study of young-adults at risk of disease from Northwest Nicaragua. Using a nested case-control approach we analysed urine and serum proteins surrounding this timepoint with the aim of gaining insight into the primary disease aetio...
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BackgroundThe Kidney Precision Medicine Project (KPMP) consortium aims to redefine chronic kidney disease (CKD) by integrating clinical, pathological, and molecular tissue data from kidney biopsies. Here, we demonstrate how biopsy data in CKD can clarify disease etiology and contribute to understandings of disease pathophysiology and clinical prognosis. MethodsThe KPMP is obtaining research kidney biopsies from individuals with CKD (defined as an estimated glomerular filtration rate [eGFR] < 60...
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Acute kidney injury (AKI) and chronic kidney disease (CKD) are two interconnected clinical conditions, both defined by degree of functional impairment, but with heterogeneous clinical trajectories. Using new transcriptomic technologies, recent studies have described the cellular diversity in the healthy and injured kidney at the single cell level. Here, we used single nucleus transcriptomics to investigate the molecular diversity and commonalities in kidney biopsies from over 150 participants wi...
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IntroductionGenomic testing is reshaping nephrology practice, yet the structure, outcomes, and implementation of kidney genetics services remain poorly characterized. MethodsWe conducted a two-part scoping study comprising (i) a literature review (JBI methodology, PRISMA-ScR compliant; OSF registration doi.org/10.17605/OSF.IO/N32VA) of English-language publications (2000-2025) describing kidney genetics services and outcomes, and (ii) an international stakeholder consultation of clinic leads to...
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BackgroundImmune checkpoint inhibitor (ICI)-associated acute interstitial nephritis (ICI-AIN) has emerged as a common cause of acute kidney injury (AKI). However, acute tubular necrosis (ATN) may present with similar clinical features yet requires fundamentally different management. Robust data on the prevalence of ATN among patients with suspected ICI-AIN are limited. The aim of this study was to determine the prevalence of ATN in patients with suspected ICI-AIN and to estimate the risk of diag...
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Background and objectivesDiagnostic disclosure practices for autosomal dominant polycystic kidney disease (ADPKD) vary and may influence patient experience and linkage to nephrology care. We characterized patient-reported diagnostic pathways, perceived timing, and disclosure experiences in the PK-DIAG survey. Design, setting, participants, and measurementsCross-sectional web-based survey in France (February 2019-August 2024) among adults with self-reported ADPKD, disseminated via patient organi...
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BackgroundKidney disease refers to a broad range of disorders that impair renal structure and function. Among these, chronic kidney disease (CKD) is the most prevalent worldwide, affecting approximately 10% of the global adult population. While large-scale omics studies have identified numerous molecular associations with kidney function and disease, these insights often remain isolated within individual data layers, hindering a systems-level understanding of the functional interplay between gen...
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IntroductionGenome-wide association studies (GWAS) for kidney function have mainly focused on creatinine-based glomerular filtration rate (eGFRcrea), which is affected by variation in muscle mass. Moreover, the genetic basis of the sexual dimorphism of chronic kidney disease is underexplored. MethodsWe performed a GWA meta-analysis for creatinine clearance (CrCl), a muscle mass-independent kidney function phenotype, in 58,976 individuals of European descent from the Lifelines Cohort Study. Res...
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IntroductionThe global prevalence of chronic kidney disease (CKD) is rising and initial studies suggest that diets predominantly based on greater inclusion of plant foods may be associated with lower CKD risk. As population-based studies are lacking, we investigated the association between habitual plant-based diets and CKD in the UK Biobank cohort. MethodsThe UK Biobank is a large prospective cohort study of participants aged 40-69 years. Habitual diet was assessed using a baseline food freque...
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IntroductionPatients with type 2 diabetes mellitus (T2DM) are at increased risk of coronary artery disease and frequently undergo coronary angiography or percutaneous coronary intervention. Although risk factors for post-contrast acute kidney injury (PC-AKI) are well defined, effective preventive strategies remain limited. MethodsThis multicenter observational cohort study included 975 patients aged 18-75 years who underwent coronary angiography and/or percutaneous coronary intervention with io...
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BackgroundRising kidney discard rates and uncertainty around accepting higher risk donor kidneys highlight the need for decision support tools that integrate donor and recipient factors and communicate risk in ways that are understandable and usable at the time of offer. Conventional indices (e.g., KDPI/KDRI) provide population level signals but do not deliver individualized, cognitively accessible information aligned with real time clinical workflows. ObjectiveTo describe how key transplant st...
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Rationale & ObjectiveCompetency-based medical education emphasizes observable skills rather than time-based training. Entrustable Professional Activities (EPA) transform competencies into distinct, assessable clinical tasks but have not yet been systematically developed for U.S nephrology fellowships. We aimed to create and achieve consensus on a set of nephrology-specific EPAs and align them with Accreditation Council for Graduate Medical Education (ACGME) competency standards. Study DesignA c...
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BackgroundCardiovascular-kidney-metabolic (CKM) syndrome is staged to reflect increasing cardiometabolic risk. Substantial heterogeneity exists within stage 2, which includes individuals with metabolic risk factors or chronic kidney disease (CKD) without established cardiovascular disease and affect nearly half of US adults. This study aimed to develop and validate a sex-specific, clinically pragmatic model to subdivide CKM stage 2 into lower-risk (stage 2a) and higher-risk (stage 2b) subgroups ...
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Congenital anomalies of the kidney and urinary tract (CAKUT) are the leading cause of pediatric kidney failure, but predicting individual progression remains challenging. This multicenter study developed and validated POCC, a machine learning model for predicting kidney failure risk at 1, 3, and 5 years post-diagnosis in CAKUT patients. Two versions were created using data from 2,249 children. The general model achieved internal AUCs of 0.93-0.99 and external AUCs of 0.90-0.98 and 0.81- 0.90 in ...
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Annual immunisation against both COVID-19 and seasonal influenza is now becoming standard of care, particularly ahead of anticipated winter waves. These vaccines may be co-administered on the same day or sequentially on separate days. Data on immunogenicity and the impact of consecutive vaccinations on spike-specific humoral and cellular immunity in dialysis patients remain limited. In this real-world observational study, SARS-CoV-2-specific immune responses were evaluated in dialysis patients ...
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BackgroundSnakebite is a neglected tropical disease with a high burden in South Asia, particularly India. Acute kidney injury (AKI) is one of the most serious complications of snake envenomation, which has significant morbidity, mortality and risk of chronic kidney disease (CKD). The present study aimed to evaluate the incidence, predictors, and outcomes of snakebite-associated AKI (SBE-AKI) in a tertiary care centre. MethodsWe retrospectively analysed 325 patients with snakebite envenomation, ...
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BackgroundPatient activation, defined as the knowledge, skills, and confidence to manage ones health, is associated with better outcomes in chronic disease. However, evidence on interventions that improve activation in people with end-stage kidney disease on hemodialysis remains limited. Methods and analysisThis single-centre, prospective, participant-blinded, randomised controlled trial conducted with adults undergoing chronic hemodialysis in an acute dialysis unit tests the hypothesis that ad...