Nephrology Commons^™

Beyond Appearances: A Case Report Of Mistaken Identity In Dialysis Access, Ephrem D. Demie, Shahin Owji, Mohammad Shafiq, Srikanth Raayasa

Gulf Coast Division GME Research Day 2025

No abstract provided.

Development Of A Continous Renal Replacement Therapy Protocol For A Midsize Community Hospital, Srinidhi Shyamkumar, Eric Riha, Crystal Ike, Rachel Wright, D Villareal, Justin Shanks, Damon Cao

Gulf Coast Division GME Research Day 2025

No abstract provided.

A Diagnostic Challenge—Tinu Syndrome, Sophia Lee, Md, Claire Kassakian, Md

Books, Presentations, Posters, Etc.

Introduction: •TINU Syndrome: Tubulointerstitial Nephritis and Uveitis  rare multi-system syndrome  has renal manifestations typical of acute interstitial nephritis (AIN), in addition to bilateral anterior uveitis  not well-understood •Thought to be an immune-mediated process, although mechanisms for disease remain unclear  Likely secondary to a combination of genetic predisposition and certain environmental exposures •Genetic predisposition:  specific HLA phenotypes  possibly an auto-antigen to modified C-reactive protein (mCRP) •Potential triggers:  Infections: tuberculosis, EBV, varicella zoster, chlamydia, toxoplasma  Medications: antibiotics (β-lactams, meropenem, azithromycin, levofloxacin), NSAIDs, goreisan (Chinese herb)  Endocrine diseases: hypoparathyroidism, hyperparathyroidism, rheumatoid arthritis, IgG4-related autoimmune …

Nutritional Management Of The Child With Chronic Kidney Disease And On Dialysis., Vanessa Shaw, Caroline Anderson, An Desloovere, Larry A. Greenbaum, Lyndsay Harshman, Christina L. Nelms, Pearl Pugh, Nonnie Polderman, José Renken-Terhaerdt, Evelien Snauwaert, Stella Stabouli, Jetta Tuokkola, Johan Vande Walle, Bradley A. Warady, Fabio Paglialonga, Rukshana Shroff

Manuscripts, Articles, Book Chapters and Other Papers

While it is widely accepted that the nutritional management of the infant with chronic kidney disease (CKD) is paramount to achieve normal growth and development, nutritional management is also of importance beyond 1 year of age, particularly in toddlers, to support the delayed infantile stage of growth that may extend to 2-3 years of age. Puberty is also a vulnerable period when nutritional needs are higher to support the expected growth spurt. Inadequate nutritional intake throughout childhood can result in failure to achieve full adult height potential, and there is an increased risk for abnormal neurodevelopment. Conversely, the rising prevalence …

The Management Of Dietary Fiber Intake In Children With Chronic Kidney Disease - Clinical Practice Recommendations From The Pediatric Renal Nutrition Taskforce., An Desloovere, Nonnie Polderman, José Renken-Terhaerdt, Vanessa Shaw, Caroline Anderson, Larry A. Greenbaum, Christina L. Nelms, Leila Qizalbash, Stella Stabouli, Jetta Tuokkola, Bradley A. Warady, Johan Vande Walle, Fabio Paglialonga, Rukshana Shroff, Evelien Snauwaert

Manuscripts, Articles, Book Chapters and Other Papers

The benefits of dietary fiber are widely accepted. Nevertheless, a substantial proportion of children fail to meet the recommended intake of dietary fiber. Achieving adequate fiber intake is especially challenging in children with chronic kidney disease (CKD). An international team of pediatric renal dietitians and pediatric nephrologists from the Pediatric Renal Nutrition Taskforce (PRNT) has developed clinical practice recommendations (CPRs) for the dietary intake of fiber in children and adolescents with CKD. In this CPR paper, we propose a definition of fiber, provide advice on the requirements and assessment of fiber intake, and offer practical guidance on optimizing dietary fiber …

Covid-19 Associated Worry And Emotional Distress In Youth And Young Adults With Chronic Kidney Disease., Joann Carlson, Erin M. Jones, Sharon Manne, Matthew B. Matheson, Lyndsay A. Harshman, Bradley A. Warady, Susan Furth, Stephen R. Hooper, Rebecca J. Johnson

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVE: The COVID-19 (C19) pandemic impacted youth mental/behavioral health with a 25% increase in prevalence of anxiety and depression worldwide. Little is known about the emotional impact of C19 for children with Chronic Kidney Disease (CKD). The purpose of the current study is to describe C19-related distress and worry among youth with CKD.

METHODS: C19 questionnaire adapted from the SARS-CoV-19 worry scale was completed for participants. Covariate data were collected at or prior to C19 questionnaire administration.Analyses examined rates of C19 emotional distress and worry and included logistic regression to identify associations with socioeconomic and disease-related covariates.

RESULTS: The sample …

Cerebral Or Renal? Cerebral Salt Wasting In The Absence Of Cerebral Disease, Arthika Sakthevel, Nathan Shekey, Ramalakshmi Santhanam, Mohamed Faris

South Atlantic Division GME Research Day 2025

No abstract provided.

Home Dialysis For Latinx Individuals Living With Kidney Failure: A Qualitative Study Of Interdisciplinary Dialysis Clinicians, Katherine Rizzolo, Rebeca Gonzalez Jauregui, Jade Teakell, Michel Chonchol, Sushrut S Waikar, Lilia Cervantes

Faculty, Staff and Student Publications

Key Points:

1. Individual-level advocacy to overcome structural barriers to home dialysis is key in improving home dialysis access for Latinx individuals.

2. Acknowledging patient influences on dialysis modality choice is critical for Latinx individuals with kidney failure.

3. Early, repeated education from a trusted source is important for Latinx individuals with kidney failure.

Background: Latinx individuals experience two times the incidence of kidney failure compared with non-Latinx individuals and are less likely to use home dialysis therapies. In this qualitative study, interdisciplinary home dialysis clinicians were interviewed to understand the key factors and strategies used by clinicians to improve home dialysis uptake …

Emerging Role Of Sh3bp2 As Regulator Of Immune And Nonimmune Cells In Nephrotic Syndrome., Tarak Srivastava, Mukut Sharma

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Minimal change disease (MCD) and focal segmental glomerulosclerosis (FSGS) are major forms of nephrotic syndrome that remain difficult to treat. MCD and FSGS have distinct but also overlapping clinical, histological, metabolic, and molecular features. Effective use of immunosuppressive drugs, activated immune cells, altered cytokine profiles, and upregulated signaling pathways suggest a link between immune dysfunction and nephrotic syndrome, but the exact mechanism of immunopathogenesis is unclear. Immune dysfunction is an area of ongoing research for identifying novel molecular targets for treating nephrotic syndrome. However, the available animal models do not directly address the role of immune dysfunction in nephrotic …

Key Considerations For Combination Therapy In Alzheimer’S Clinical Trials: Perspectives From An Expert Advisory Board Convened By The Alzheimer’S Drug Discovery Foundation, Jeffrey Cummings, Michael Gold, Mark Mintun, Michael Irizarry, Andrew Von Eschenbach, Suzanne Hendrix, Donald Berry, Cristina Sampaio, Kaycee Sink, Jaren Landen, Miia Kivipelto, Michael Grundman, Steven E Arnold, Allan Green, Katherine Partrick, Laura Nisenbaum, Aaron Burstein, Howard Fillit

Faculty, Staff and Student Publications

There is growing consensus in the Alzheimer's community that combination therapy will be needed to maximize therapeutic benefits through the course of the disease. However, combination therapy raises complex questions and decisions for study sponsors, from preclinical research through clinical trial design to regulatory, statistical, and operational considerations. In January 2024, the Alzheimer's Drug Discovery Foundation convened an expert advisory board to discuss the key considerations in each of these areas. Experts agreed on the need to prioritize a combination therapy approach that encompasses a wide range of targets associated with aging and the underlying biology of Alzheimer's disease. Progress …

Pengetahuan Dan Persepsi Keluarga Penderita Penyakit Ginjal Tahap Akhir (Pgta) Terhadap Transplantasi Ginjal Di Rs Hasan Sadikin Bandung, Rizqa Adinda Syakira, Helni Mariani, Rizky Andhika

Jurnal Penyakit Dalam Indonesia

Introduction. Kidney transplantation is the best kidney replacement therapy for End Stage Renal Disease (ESRD) patients. The gap between the number of donors and recipients remains a problem contributing to the low rate of kidney transplantation in Indonesia. The families of ESRD patients are the most recommended donor candidates. Knowledge and perception have a crucial role in the decision to donate organs, making it important to know the knowledge and perception of ESRD patients’ families towards kidney transplantation. This study aimed to describe the knowledge and perception of families of ESRD patients undergoing dialysis at Dr. Hasan Sadikin General …

A Conceptual Framework To Assess The Health, Socioeconomic And Environmental Burden Of Chronic Kidney Disease, Charlotte Johnston-Webber, Isaac Bencomo-Bermudez, George Wharton, Robin Van Kessel, Salvatore Barone, Francisco Brotons Muntó, Steven Chadban, Juan Jose Garcia Sanchez, Janwillem Kocks, Kyra Obolensky, Petra Sandow, Neil Skolnik, Ming-Hui Zhao, Alexei Volaco, David Wheeler, Alistair Mcguire, Elias Mossialos

Department of Medicine Faculty Papers

Chronic kidney disease (CKD) is a global health challenge that affects patients, caregivers, healthcare systems, the environment and national economies. Despite its far-reaching impact, there is no framework to systematically evaluate national CKD prevention and management programmes or evaluate the societal burden of disease. This paper has two objectives: first, to introduce a comprehensive framework to assess national programmes, which recognises gaps and weaknesses and identifies feasible policy interventions to reduce overall CKD burden; second, to present some key challenges and success stories in delivering CKD services delivered in eight different country settings. A literature review informed an initial version …

Defining Renal Recovery In Patients With Hepatorenal Syndrome-Acute Kidney Injury: Experience From North American Studies, Muhammad A. Mujtaba, Hussien Elsiesy, Sara Faiz, Syed A. Hussain, Ann Kathleen N. Gamilla-Crudo, Aftab Karim, Mohammad I. Khan, Muhammad W. Khattak, Zunaira Zafar, Michael Kueht, Khurram Jamil

Jefferson Health - Northeast Papers (formerly Aria Health Papers)

INTRODUCTION: The degree of improvement in serum creatinine (SCr) has previously been suggested as a sensitive indicator of treatment response in patients with hepatorenal syndrome-acute kidney injury (HRS-AKI), while HRS reversal remains the primary endpoint in clinical trials.

METHODS: A total of ≥ 30% SCr improvement was analyzed as an exploratory prespecified endpoint in the CONFIRM trial. In this post hoc analysis, intent-to-treat population data from three Phase 3 studies (OT-0401, REVERSE, and CONFIRM) conducted in North America in patients with HRS-AKI were pooled to assess the incidence of > 30% improvement in SCr and its association with clinical outcomes.

RESULTS: …

Responding To The Workforce Crisis: Consensus Recommendations From The Second Workforce Summit Of The American Society Of Pediatric Nephrology., Danielle E. Soranno, Sandra Amaral, Isa Ashoor, Meredith A. Atkinson, Gina-Marie Barletta, Michael C. Braun, Joann Carlson, Caitlin Carter, Annabelle Chua, Vikas R. Dharnidharka, Keri Drake, Elif Erkan, Dan Feig, Stuart L. Goldstein, David Hains, Lyndsay A. Harshman, Elizabeth Ingulli, Alexander J. Kula, Mary Leonard, Sudha Mannemuddhu, Shina Menon, Zubin J. Modi, Marva Moxey-Mims, Arwa Nada, Victoria Norwood, Michelle C. Starr, Priya S. Verghese, Darcy K. Weidemann, Adam Weinstein, Jodi Smith

Manuscripts, Articles, Book Chapters and Other Papers

IMPORTANCE: Pediatric patients with complex medical problems benefit from pediatric sub-specialty care; however, a significant proportion of children live greater than 80 mi. away from pediatric sub-specialty care.

OBJECTIVE: To identify current knowledge gaps and outline concrete next steps to make progress on issues that have persistently challenged the pediatric nephrology workforce.

EVIDENCE REVIEW: Workforce Summit 2.0 employed the round table format and methodology for consensus building using adapted Delphi principles. Content domains were identified via input from the ASPN Workforce Committee, the ASPN's 2023 Strategic Plan survey, the ASPN's Pediatric Nephrology Division Directors survey, and ongoing feedback from ASPN …

The Use Of Sodium-Glucose Transport Protein 2 Inhibitors In The Treatment Of Lupus Nephritis: A Preliminary Systematic Review, Stephanie Nagy, Marc M. Kesselman

HCA-NSU MD Research Day

Objective: To analyze the nephroprotective effects of SGLT-2 inhibitors, traditionally an antidiabetic medication, on the progression and outcomes of lupus nephritis (LN). Background: Systemic lupus erythematosus is a prevalent autoimmune condition resulting from the loss of tolerance against self-antigens. Widespread inflammation affects all body systems, especially the kidneys, resulting in lupus nephritis within 3 years. Lupus nephritis is a type 3 hypersensitivity that occurs due to immune complex deposition leading to inflammation of the nephrons that can progress to end-stage renal disease and renal failure if not treated effectively. Methods: A search was conducted using OVID, CINHAL, Web of Science, …

Commentary: Obstructive Sleep Apnea In The Hemodialysis Population: Are Clinicians Putting Existing Scientific Evidence Into Practice?, Aleena Jamal, Som Singh, Fawad Qureshi

SKMC Student Presentations and Publications

No abstract provided.

From Infection To Encapsulation; A Case Report On Encapsulating Peritoneal Sclerosis, Clinical Challenges And Management, Sidra Memon Md, Jacob Seth Psomiadis Md, Syed Uzair Mahmood, Jennifer Hoffman Md

Advances in Clinical Medical Research and Healthcare Delivery

Encapsulating Peritoneal Sclerosis (EPS) is a rare but deadly sequlae of peritoneal dialysis resulting in intraperitoneal inflammation and fibrosis. The disease itself can present in a variety of ways and is associated with significant morbidity and mortality. Here we present the case of a man in his 50's with a history of chronic peritoneal aspergillus as well as end-stage renal disease on peritoneal dialysis that had multiple admissions for abdominal fluid collections as well as bowel obstruction. After a multidisciplinary approach, the patient was diagnosed with encapsulating peritoneal sclerosis and then started the recommended therapy of tamoxifen and prednisone.

First Interim Results From Fine-Real: A Prospective, Non-Interventional, Phase 4 Study Providing Insights Into The Use And Safety Of Finerenone In A Routine Clinical Settingfirst Interim Results From Fine-Real: A Prospective, Non-Interventional, Phase 4 Study Providing Insights Into The Use And Safety Of Finerenone In A Routine Clinical Setting, Susanne B Nicholas, Ricardo Correa-Rotter, Nihar R Desai, Lixin Guo, Sankar D Navaneethan, Kevin M Pantalone, Christoph Wanner, Stefanie Hamacher, Samuel T Fatoba, Andrea Horvat-Broecker, Antonio Garreta-Rufas, Alain Gay, Martin Merz, David C Wheeler

Center for Medical Ethics and Health Policy Staff Publications

Background: Finerenone, a selective non-steroidal mineralocorticoid receptor antagonist, improves kidney and cardiovascular outcomes in patients with chronic kidney disease (CKD) associated with type 2 diabetes (T2D). The FINE-REAL study (NCT05348733) aims to evaluate the characteristics and treatment patterns of participants treated with finerenone in clinical practice.

Methods: FINE-REAL is a prospective, single-arm, non-interventional study of patients initiated on finerenone as part of their routine care in accordance with country-approved labels. The study, initiated in June 2022, is expected to be completed by January 2028. The cutoff for this pre-specified interim analysis was June 13, 2023.

Results: Participants were …

Evaluation Of Short-Term Complications In Laparoscopic Peritoneal Dialysis Catheter Placement - A Single Tertiary Center Experience, Cristina Raluca Iorga, Iuliana Andreiana, Simona Hildegrad Stancu, Traian Constantin, Victor Strambu, Cristian Iorga

Journal of Mind and Medical Sciences

Background. Peritoneal dialysis is a form of kidney function replacement that is not as widespread as hemodialysis. However, it has recognized advantages, such as preservation of residual renal function, lack of vascular access, and the ability to be performed at home. On the other hand, it requires the correct insertion of a peritoneal dialysis (PD) catheter and maintaining its patency. Methods. We conducted a retrospective study of 126 patients with end-stage renal disease who underwent laparoscopic Tenckhoff catheter placement for peritoneal dialysis between January 2016 and December 2022. The study analyzed the frequency and type of complications registered within three …

Transjugular Random Renal Biopsy: A Review, Katelyn Gill, Dan F. Laney Iv, Hector Ferral

School of Medicine Faculty Publications

Random renal biopsy is considered the gold standard for the diagnosis of systemic renal disorders. Percutaneous biopsy remains a safe option for most patients; however, the percutaneous approach may be considered too risky in approximately 5-10% of patients. In these high-risk patients, transjugular renal biopsy (TJRB) may represent an underutilized alternative. TJRB is a technically difficult procedure with a learning curve of approximately 10 cases. When performed properly, TJRB is a safe alternative to percutaneous biopsy in patients with renal failure or who are at high risk of bleeding. This article aims to provide a comprehensive review of the indications, …