Nephrology Commons^™

Advancing Ckd Diagnosis: Race-Free Egfr, Cystatin C, And Genetic Insights, Halah Tariq Albar

Saudi Toxicology Journal

Globally, the rates of chronic kidney disease (CKD) are increasing due to the increasing incidence of hypertension, obesity, and diabetes mellitus. Early detection and treatment of kidney disease are essential in improving health outcomes. Estimate glomerular filtration rate (eGFR) is used to diagnose, stage, and manage CKD. CKD biomarkers are broadly categorized into traditional (serum creatinine), emerging (cystatin C), and disease specific (Interleukin-6). The purpose of this narrative review is to synthesize the current evidence regarding the use of eGFR in diverse populations. The initial eGFR equations included race variables, which created a controversial debate about their relevancy and has …

A Novel “Stairstep” Approach To The Management Of Extreme Hypernatremia Using Continuous Kidney Replacement Therapy And Hypertonic Saline, Bahar Barani, Xuexin Lu, Darcy Weidemann, Judith Vansickle, Vimal Chadha, Nathan Beins

Posters

Hypernatremia is defined as a serum sodium greater than 145 mEq/L and is due to either a deficit of free water or excess sodium intake. Extreme hypernatremia (sodium level > 190 mEq/L) is immediately life–threatening with mortality rates > 60%. It is especially challenging to avoid complications, such as permanent neurological injury, respiratory failure, and profound electrolyte derangement, when children are in kidney failure. Established guidelines are lacking for correcting such extreme levels due to a paucity of information in the literature, although general recommendations are to decrease levels by no more than 10-12 mEq/L per day to prevent neurological complications. We …

Clinical Uptake Of An Antigen-Based Approach To Membranous Nephropathy: A Survey Of General Nephrologists And Glomerular Disease Experts., Eibhlin Goggins, Andrew Delaat, Bryce Barr, Jonathan Taliercio, Ali Mehdi, Georges Nakhoul, Brendan Bowman, Corey Cavanaugh

Ambulatory and Primary Care Articles

BACKGROUND: In recent years, there has been an emergence of new antigens discovered in membranous nephropathy (MN). Whether these antigens have impacted the approach to, and management of, MN patients undertaken by nephrologists is still unclear.

METHODS: We conducted a cross-sectional international survey pertaining to 13 antigens recently discovered in MN. The survey was distributed by the National Kidney Foundation, direct emails, and social media.

RESULT: PLA2R, THSD7A, NELL1, and EXT1/2 testing were readily available while the most common response for other antigen testing was 'Not Performed' or 'Unknown'. All respondents had tested for or treated PLA2R-positive MN. Of 79 …

The Role Of Serum Phosphate Control In Supporting Transplant Readiness In Patients On Dialysis, Laura A Williams, Stephen Z Fadem

Faculty, Staff and Students Publications

Chronic kidney disease affects over 36 million Americans, with more than 800,000 progressing to end-stage kidney disease (ESKD). Treatment with kidney transplantation offers superior survival, quality of life, and cost-effectiveness compared with dialysis, yet access remains limited. Hyperphosphatemia is a highly prevalent and modifiable complication of ESKD that contributes to cardiovascular disease, mineral bone disorder, and potential pulmonary dysfunction. Additionally, elevated serum phosphate has been linked to transplant graft failure and adverse post-transplant outcomes. Although normal phosphate levels are not formally required for transplant eligibility, they are frequently considered as part of transplant readiness assessments. Persistent gaps between clinical guideline …

Targeting Sting To Disrupt Macrophage-Mediated Adhesion In Encapsulating Peritoneal Sclerosis, Juan Sun, Yuxiang Sun, Dandan Guo, Huolin Ye, Qiang Huang, Hu Zhou, Canming Li, Mei Liao, Yujia You, Hongli Shang, Pan Zhou, Dongxuan Wu, Janusz Witowski, Zhaoyong Hu, Hui Peng

Faculty, Staff and Students Publications

Encapsulating peritoneal sclerosis (EPS) is a life-threatening fibrotic condition characterized by severe abdominal adhesions, chronic inflammation, and significant morbidity. The lack of effective treatments for EPS stems from a limited understanding of its underlying mechanisms. In this study, we developed a modified mouse model of PD-induced EPS and investigated the role of the STING signaling pathway in disease progression. Our findings reveal that STING activation in peritoneal mesothelial cells significantly increases the secretion of the macrophage chemokine CCL2, leading to enhanced macrophage infiltration and the formation of pathological adhesions. Notably, pharmacological inhibition of STING using the inhibitor H151 effectively reduced …

Cryptococcoid Sweet Syndrome Or Halogenoderma? Highlighting The Crucial Need For Serum Iodine Testing, Jacob R. Kilgore, Jonathan M. Joseph, Addie Walker, William Snider, Nicholas Culotta, Carson Bogatto, Aaron Coulon

School of Medicine Faculty Publications

No abstract provided.

Dual-Function Polyester Nanoparticles For Amplified Anti-Inflammatory Effects, Ingrid M Heyns, Abiodun T Wahab, Raghu Ganugula, David Sheikh-Hamad, M N V Ravi Kumar, Meenakshi Arora

Faculty, Staff and Students Publications

This study investigates a dual-acting drug delivery system using naringenin (NAR) as a folate receptor ligand to enhance intestinal uptake and encapsulated NAR for combating inflammation. The dual-acting systems were tested in vitro on cisplatin-induced human kidney-2 cells and in vivo in a mouse model of cisplatin-induced acute kidney injury (AKI). NAR-loaded passive nanoparticles [P2Ns(NAR)] and dual-acting systems [P2Ns-NAR(NAR)] showed notable advantages over unformulated NAR, reducing the required dose by up to 57 and 79%, respectively. These nanoparticles modulated immune responses, restored T cell function, and shifted macrophage polarization from proinflammatory M1 to tissue-repairing M2. In addition, P2Ns-NAR(NAR) alleviated AKI …

Drug Development Studies Supporting Zileuton As A Parenteral Adjuvant To Attenuate Antibiotic-Associated Nephrotoxicity, Cole S Hudson, James E Smith, Linh T Vuong, Nicholas S Teran, Nazanin Pouya, David Sheikh-Hamad, Xinli Liu, Shama Kajiji, Vincent H Tam

Faculty, Staff and Students Publications

Glycopeptide, polymyxin, and aminoglycoside antibiotics are among the most commonly used agents to treat drug-resistant bacterial infections; however, their clinical use is hindered by nephrotoxicity. We previously reported that zileuton has the potential to attenuate antibiotic-associated nephrotoxicity in an animal model. Here, we further report the development of a parenteral formulation and exploration of dosing strategies for zileuton. The solubility, stability, and multi-dose safety of two zileuton formulations were evaluated. Zileuton serum and renal tissue pharmacokinetics were evaluated after a single dose and compared to steady state after 10 days. Different dosing strategies of zileuton to attenuate vancomycin-, polymyxin B-, …

Exploring The Effect Of Social Determinants Of Health (Sdoh) Factors On The Time To Kidney Transplant Evaluation Completion For African American End Stage Renal Disease (Esrd) Patients, Kesha Levesque

MUSC Theses and Dissertations

Purpose – The purpose of this dissertation is to investigate the relationship between demographics and Social Determinants of Health (SDOH) variables on diagnostic testing time completion in patients being evaluated for kidney transplant waitlisting.

Aims - Compared to White Americans, African Americans who are eligible to receive a kidney transplant are less likely to complete the required testing in order to be placed on the kidney transplant waiting list which puts African Americans at risk for morbidity and mortality due to prolonged exposure to dialysis. The COVID-19 pandemic was directly associated with a decrease in the number of patients placed …

Therapeutic Potential Of Sglt2 Inhibitors In A Repeated Love Dose Cisplatin Model., Dianet C. Sanchez

Electronic Theses and Dissertations

Cisplatin is a potent chemotherapeutic, thirty percent of patients develop Acute Kidney Injury (AKI). These patients are ten times more likely to develop chronic kidney disease (CKD). Sodium-glucose-cotransporter-2-inhibitors (SGLT2i), FDA approved for diabetes, has shown protection in multiple mouse models of AKI-CKD. We hypothesize SGLT2i can protect the kidney in a model of repeated low dose cisplatin with/without cancer. B6:129 mice with/without lung adenocarcinoma (Lung-adeno) were treated daily with SGLT2i dapagliflozin (10mg/kg)/vehicle control. After seven days, weekly cisplatin (7mg/kg)/vehicle control was initiated for 3-4 weeks. Following final cisplatin dose, kidney function, injury, fibrosis, inflammation was assessed. SGLT2i treatment attenuated alterations …

Cholesterol Crystal Embolization Induced Kidney Disease, Shohan Pervaze, Shreya Mohandas, Pushkas Gopalan, Stephen A. Morse, Siddhartha Bajracharya, Landon A. Krone, Farshid Yazdi

School of Medicine Faculty Publications

Cholesterol crystal embolization (CCE) results from the release of cholesterol crystals from ruptured atherosclerotic plaques into circulation, resulting in the occlusion of small arteries and arterioles in various organs. Ischemia triggers a systemic inflammatory response resulting in vascular obstruction and organ dysfunction. Kidneys are often involved because of the proximity to the aorta and CCE in the kidneys can result in acute, sub-acute, or chronic kidney disease. There are many known risk factors for renal involvement of CCE, including iatrogenic and spontaneous causes. The pathophysiology of CCE includes complex pathways that lead to acute and chronic effects that can have …

Serum Syndecan-1 Is Associated With Kidney And Cardiovascular Outcomes In Idiopathic Nephrotic Syndrome., Colin Bauer, Arshia Anand, Christine Sethna, Jonathan Troost, Tarak Srivastava, Imtiazul Islam, Audrey Fetsko, Julie A. Dougherty, William E. Smoyer, Richard J. Johnson, Gabriel Cara-Fuentes

Manuscripts, Articles, Book Chapters and Other Papers

INTRODUCTION: Idiopathic nephrotic syndrome (INS) is associated with important kidney and cardiovascular morbidities. We tested the hypothesis that serum syndecan-1, a marker of endothelial glycocalyx injury, can help identify patients at risk for unfavorable kidney and cardiovascular outcomes.

METHODS: We included 348 children and adults with INS (n = 35 unbiopsied, n = 141 minimal change disease [MCD] and n = 172 focal segmental glomerulosclerosis [FSGS]) from the Nephrotic Syndrome Study Network (NEPTUNE) cohort and 34 healthy participants (n = 22 adults, n = 12 children). We measured baseline serum syndecan-1 levels using an enzyme-linked immunosorbent assay and …

An Unusual Presentation Of Iga Vasculitis And Iga Nephropathy: A Case Report, Mark A. Colantonio, Nicholas Condiles, Alan P. Lim, Khaled Shawwa

Journal of Community Hospital Internal Medicine Perspectives

Immunoglobulin A (IgA) nephropathy is the most common glomerulonephritis worldwide. While IgA nephropathy mainly presents with renal manifestations, systemic symptoms associated with vasculitis are uncommon. Oftentimes, creatinine is used as a serum marker for renal dysfunction; however, it may not always be sensitive, especially in patients with low muscle mass. In such cases, cystatin C may prove to be a better indicator of renal function. Here, we present a case of IgA nephropathy with a normal serum creatinine and elevated cystatin C, highlighting the utility of cystatin C in the setting of a normal creatinine and high suspicion for renal …

Effectiveness Of Allopurinol On Uric Acid And Pediatric Chronic Kidney Disease Severity In The Chronic Kidney Disease In Children Study., Derek K. Ng, Matthew B. Matheson, George J. Schwartz, Katherine E. Kurgansky, Bradley A. Warady, Susan L. Furth

Manuscripts, Articles, Book Chapters and Other Papers

RATIONALE & OBJECTIVE: Clinical trials have shown that serum uric acid reduction does not slow chronic kidney disease (CKD) progression in adults, but it is uncertain whether these findings apply to children.

STUDY DESIGN: An observational cohort study.

SETTING & POPULATION: The Chronic Kidney Disease in Children cohort with participants who initiated allopurinol with a comparison group matched on age, sex, uric acid, CKD diagnosis, estimated glomerular filtration rate (eGFR), and proteinuria.

EXPOSURE: Allopurinol initiation.

OUTCOMES: Uric acid, eGFR, and proteinuria before and after initiation, and longitudinal changes over time.

ANALYTICAL APPROACH: Allopurinol initiators were matched to noninitiators at a …

Covid-19 Vaccine-Induced Rhabdomyolysis In A 53-Year-Old Woman, Akash Hazari, Jack Chien, Daniel Nunez

HCA Healthcare Journal of Medicine

Introduction

COVID-19-induced rhabdomyolysis is a common complication in COVID-19 infection. However, only a handful of cases have been reported showing links between COVID-19 vaccine and rhabdomyolysis.

Case Presentation

We present the case of a 53-year-old woman, who recently received COVID-19 vaccine and presented to the hospital with progressive extremity weakness. Common reasons for rhabdomyolysis were ruled out as possibility and the patient was found to have rhabdomyolysis induced from COVID-19 vaccine.

Conclusion

Even though COVID-19 vaccine-induced rhabdomyolysis is rare, it should be considered in the differential diagnosis with patients presenting with neuromuscular complaints and a recent COVID-19 vaccine.

Peran Prediktif Il-6, Il-10, Dan Tnf-Α Plasma Terhadap Gagal Ginjal Akut Pada Pasien Dengan Covid-19 Derajat Sedang Dan Berat, Dewi Gathmyr, Maruhum Bonar H Bonar, Adityo Susilo, Kuntjoro Harimurti, Ginova Nainggolan, Alvin Tagor, Hamzah Shatri, Cosmas Rinaldi Adithya Lesmana, Zulkifli Amin

Jurnal Penyakit Dalam Indonesia

Introduction. Acute kidney injury (AKI) is associated with higher mortality rate in COVID-19 patients due to inflammation and immune dysregulation. This study aimed to correlate serum levels of IL-6, IL-10, and TNF-α with serum creatinine changes and their roles to predict incidence of acute kidney injury (AKI) in patients with moderate and severe COVID-19.

Methods. This prospective cohort study was conducted among patients with moderate to severe COVID-19 in Pertamina Central Hospital Jakarta, Indonesia during November 2020 to January 2021. All serum levels of cytokines (IL-6, IL-10, and TNF-α) and creatinine were collected on the first day and …

Hydration Status And Acute Kidney Injury Biomarkers In Ncaa Female Soccer Athletes During Preseason Conditioning, Daniel E Newmire, Erica M Filep, Jordan B Wainwright, Heather E Webb, Darryn S Willoughby

Faculty, Staff and Students Publications

Exercise training in extreme temperatures concurrent with hypohydration status may potentiate the development of acute kidney injury (AKI) in young, healthy persons.

Background/Objectives: It is unknown how repeated training bouts in ambient higher temperatures and humidity may influence measures of AKI. The purpose of this study was to investigate hydration status and renal biomarkers related to AKI in NCAA Division I female soccer athletes during preseason conditioning.

Methods: A convenience sample of n = 21 athletes were recruited (mean ± SEM; age: 19.3 ± 0.25 y; height: 169.6 ± 1.36 cm; mass: 68.43 ± 2.46 kg; lean body …

Preoperative Dialysis Dose And Postoperative Outcomes In Patients Receiving Maintenance Hemodialysis, Vikram Fielding-Singh, Matthew W Vanneman, Arden M Morris, Wolfgang C Winkelmayer, Louise Y Sun, Pavel S Roshanov, Maria Montez-Rath, Glenn M Chertow, Eugene Lin

Faculty, Staff and Students Publications

Background: Little is known about preoperative hemodialysis dosing for patients with end-stage kidney disease. We assessed whether changes in preoperative hemodialysis dose (compared to and controlling for baseline dose) are associated with postoperative mortality in patients receiving maintenance hemodialysis.

Methods: We identified fee-for-service Medicare beneficiaries receiving hemodialysis for end-stage kidney disease who underwent surgical procedures between January 1, 2011, and November 30, 2020. Follow-up ended December 31, 2020. The primary exposure was preoperative change in Kt/Vurea, defined as the difference between the Kt/Vurea in the hemodialysis session proximal to the procedure and the mean Kt/Vurea for the preceding 180 days. …

Antibiotic Lock Therapy Fpr Dialysis Catheters: Implementation At An Urban Hospital, Erik Enquist, Hilary Klastae, Mary Jo Kelly

2025 Swedish FISH (Fostering Interdisciplinary Solutions in Healthcare) Conference

No abstract provided.

Cardiovascular And Thromboembolic Events In Children And Adults With Glomerular Disease: Findings From The Cure Glomerulonephropathy (Curegn) Network., Shikha Wadhwani, Sarah A. Mansfield, Abigail R. Smith, Bruce M. Robinson, Eman Abdelghani, Amira Al-Uzri, Isa F. Ashoor, Sharon M. Bartosh, Aftab S. Chishti, Salim S. Hayek, Michelle A. Hladunewich, Bryce A. Kerlin, Siddharth S. Madapoosi, Laura H. Mariani, Amy K. Mottl, Michelle N. Rheault, Michelle M. O'Shaughnessy, Christopher John Sperati, Tarak Srivastava, David T. Selewski, Chia-Shi Wang, Craig S. Wong, Donald J. Weaver, Myda Khalid, Glomerulonephropathy (Curegn) Study Consortium

Manuscripts, Articles, Book Chapters and Other Papers

RATIONALE & OBJECTIVE: Cardiovascular (CV) and thromboembolic (TE) events are known complications of glomerular disease (GD), but their incidence and risk factors are poorly characterized. This analysis describes CV and TE outcomes in the Cure GlomeruloNephropathy (CureGN) Network.

STUDY DESIGN: Prospective cohort study.

SETTING & PARTICIPANTS: CureGN is a prospective cohort study of children and adults with biopsy-proven minimal change disease (MCD), focal segmental glomerulosclerosis (FSGS), membranous nephropathy (MN), or IgA nephropathy (IgAN)/vasculitis (IgAV). Data from 2,545 children and adults (23% MCD, 23% MN, 25% FSGS, 29% IgAN/IgAV) was analyzed.

EXPOSURE: Estimated glomerular filtration rate (eGFR), proteinuria, serum albumin, tobacco …