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De novo and relapsing glomerulonephritis after COVID-19 vaccination: how much do we know?
Anthony T. P. Chan,Sydney C. W. Tang
doi : 10.1111/nep.14013
Volume 27, Issue 1 p. 5-6
Humoral and cellular immune response to severe acute respiratory syndrome coronavirus-2 vaccination in haemodialysis and kidney transplant patients
Joel Swai,Ming Gui,Mao Long,Zhu Wei,Zixuan Hu,Shaojun Liu
doi : 10.1111/nep.13974
Volume 27, Issue 1 p. 7-24
End-stage renal disease (ESRD) patients are amongst the vulnerable groups and thus prioritized in the Coronavirus disease-2019 vaccination programmes. However, this cohort was excluded from vaccine-trials and yet shares the same vaccination scheme with the general population. Here, we explore trends of immune response-proportions amongst ESRD patients on renal replacement therapy for up to 4?weeks post-vaccination completion with Pfizer/Moderna vaccines. From inception to 10 July 2021, we searched six online-databases for articles reporting humoral and cellular immune response proportions for up to 4?weeks post booster-vaccination. We pooled the responders' proportions by meta-analysis and conducted a meta-regression stratifying outcomes by significant confounders. Twenty-seven eligible studies reported 2789 ESRD patients. 1337, 1452 and 477 were on haemodialysis, received kidney transplantation, and healthy controls, respectively. Haemodialysis patients' proportions of humoral and cellular immune responses varied from 87.29% (80.77–93.81)–88.78% (86.76–90.80) and 62.86% (56.56, 69.17)–85.78% (78.99, 92.57), respectively, between first- and fourth-weeks. Kidney transplant patients' proportions of humoral and cellular immune responses ranged from 2.6% (0.06–13.48)–29.87% (27.68, 32.07) and 5.13% (0.63–17.3)–59.84% (54.57–65.10), respectively, between first- and fourth-weeks. All healthy controls maintained ?93% proportions of both responses throughout the follow-up. Study design and country of study influenced the pooled response proportions. Conclusively, haemodialysis and kidney transplant patients have lower proportions of humoral and cellular immune responses than healthy controls. However, haemodialysis patients' response proportions improve, reaching near healthy-control levels by the fourth week. Kidney transplant patients' lower responses' proportions also improve but remain significantly lower than healthy controls throughout four-weeks. The “one-size-fits-all” vaccination scheme might be inadequate for kidney transplant patients.
Association of body mass index with kidney function and mortality in high cardiovascular risk population: A nationwide prospective cohort study
Noppawit Aiumtrakul,Annop Kittithaworn,Ouppatham Supasyndh,Rungroj Krittayaphong,Arintaya Phrommintikul,Bancha Satirapoj
doi : 10.1111/nep.13970
Volume 27, Issue 1 p. 25-34
There is increasing awareness of the impact of obesity and underweight on cardiovascular (CV) disease, chronic kidney disease (CKD) and mortality. Abnormal body mass index (BMI) might be associated with worse clinical outcomes, including CKD progression, but limited evidence exists among Asian patients with high CV risk.
Treatment preferences for primary membranous nephropathy: Results of a multinational survey among nephrologists in the South Asia Pacific region
Bhadran Bose,Sunil V. Badve,David W. Johnson,Carmel Hawley,Vivekanand Jha,Donna Reidlinger,Chen Au Peh
doi : 10.1111/nep.13953
Volume 27, Issue 1 p. 35-43
There is no clear consensus on how best to treat primary membranous nephropathy (PMN). This study aimed to ascertain prevailing views among nephrologists on their choice of immunosuppressive agents to treat this disease.
Improvement of kidney function in patients with chronic kidney disease and severe obesity after bariatric surgery: A systematic review and meta-analysis
Yung Lee,Sama Anvari,Megan M. Chu,Olivia Lovrics,Adree Khondker,Roshan Malhan,Ishan Aditya,Aristithes G. Doumouras,Michael Walsh,Dennis Hong
doi : 10.1111/nep.13958
Volume 27, Issue 1 p. 44-56
The general management for chronic kidney disease (CKD) includes treating reversible causes, including obesity, which may be both a driver and comorbidity for CKD. Bariatric surgery has been shown to reduce the likelihood of CKD progression and improve kidney function in observational studies. We performed a systematic review and meta-analysis of patients with at least stage 3 CKD and obesity receiving bariatric surgery. We searched Embase, MEDLINE, CENTRAL and identified eligible studies reporting on kidney function outcomes in included patients before and after bariatric surgery with comparison to a medical intervention control if available. Risk of bias was assessed with the Newcastle-Ottawa Risk of Bias score. Nineteen studies were included for synthesis. Bariatric surgery showed improved eGFR with a mean difference (MD) of 11.64 (95%CI: 5.84 to 17.45, I2 = 66%) ml/min/1.73m2 and reduced SCr with MD of ?0.24 (95%CI ?0.21 to ?0.39, I2 = 0%) mg/dl after bariatric surgery. There was no significant difference in the relative risk (RR) of having CKD stage 3 after bariatric surgery, with a RR of ?1.13 (95%CI: ?0.83 to ?2.07, I2 = 13%), but there was reduced likelihood of having uACR >30?mg/g or above with a RR of ?3.03 (95%CI: ?1.44 to ?6.40, I2 = 91%). Bariatric surgery may be associated with improved kidney function with the reduction of BMI and may be a safe treatment option for patients with CKD. Future studies with more robust reporting are required to determine the feasibility of bariatric surgery for the treatment of CKD.
Association of central arterial blood pressure and left ventricular hypertrophy in patients with chronic kidney disease
Ruyi Cai,Lina Shao,Yifan Zhu,Yueming Liu,Jinshi Zhang,Qiang He
doi : 10.1111/nep.13967
Volume 27, Issue 1 p. 57-65
In the general population, central arterial blood pressure has proved to be more closely related to left ventricular hypertrophy (LVH) than brachial arterial blood pressure. We aimed to investigate whether this relationship was true in patients with chronic kidney disease (CKD).
Diastolic and systolic left ventricular dysfunction and mortality in chronic kidney disease patients on haemodialysis
Jose J. G. De Lima,Thiago A. Macedo,Luis Henrique W. Gowdak,Elias David-Neto,Luiz A. Bortolotto
doi : 10.1111/nep.13960
Volume 27, Issue 1 p. 66-73
Left ventricular diastolic dysfunction (LVDD) and LV systolic dysfunction (LVSD) are prevalent in CKD, but their prognostic relevance is debatable.
Incremental peritoneal dialysis is a safe and feasible prescription in incident patients with preserved residual kidney function
Louis L. Huang,Jia Y. Mah,Jennifer Howard,Matthew A. Roberts,Lawrence P. McMahon
doi : 10.1111/nep.13962
Volume 27, Issue 1 p. 74-81
Incremental peritoneal dialysis (PD) is recommended as a component of high-quality care by the international society for PD; however, its feasibility and clinical outcomes have not been widely reported. The aim of this study is to describe our experience with incremental PD.
Sofosbuvir plus velpatasvir combination for the treatment of chronic hepatitis C in patients with end stage renal disease on renal replacement therapy: A systematic review and meta-analysis
Arka De,Akash Roy,Nipun Verma,Saurabh Mishra,Madhumita Premkumar,Sunil Taneja,Virendra Singh,Ajay Duseja
doi : 10.1111/nep.13968
Volume 27, Issue 1 p. 82-89
Sofosbuvir (SOF) and velpatasvir (VEL) is a pan-genotypic regimen for the treatment of Hepatitis C virus (HCV) infection. The data on the efficacy and safety of this regimen is end-stage renal disease (ESRD) is scanty. This systematic review and meta-analysis was done to ascertain the efficacy and safety of SOF and VEL in patients with chronic Hepatitis C (CHC) and ESRD on renal replacement therapy (RRT).
Metabolic acidosis in the initial 6 months after renal transplantation: A prospective study
Kristin George,Ashish Datt Upadhyay,Arun Kumar Subbiah,Raj Kanwar Yadav,Sandeep Mahajan,Dipankar Bhowmik,Sanjay Kumar Agarwal,Soumita Bagchi
doi : 10.1111/nep.13954
Volume 27, Issue 1 p. 90-96
There is limited information about the incidence of metabolic acidosis (MA) after renal transplantation. This single centre prospective study aimed to delineate the incidence and risk factors of MA in the first 6 months after renal transplantation (RTX).
Oral/oesophageal candidiasis is a risk factor for severe infection after kidney transplantation
Tetsuya Abe,Kenta Futamura,Norihiko Goto,Kiyomi Ohara,Taiki Ogasa,Toshihide Tomosugi,Manabu Okada,Takahisa Hiramitsu,Shunji Narumi,Yoshihiko Watarai
doi : 10.1111/nep.13959
Volume 27, Issue 1 p. 97-103
Bacterial and fungal infections are serious, life-threatening conditions after kidney transplantation. The development of oral/oesophageal candidiasis after kidney transplantation is not a reported risk factor for subsequent severe infection. This study was performed to investigate the relationship between oral/oesophageal candidiasis after kidney transplantation and the development of subsequent infection requiring hospitalization.
Presence of galectin-3 in peritoneal dialysate. Does it have a role in the peritoneal membrane inflammatory process?
Yael Einbinder,Ayala Siboni,Shirley Zaidenstein,Keren Cohen-Hagai,Sydney Benchetrit,Tali Zitman-Gal
doi : 10.1111/nep.13981
Volume 27, Issue 1 p. 104-108
Peritoneal dialysis (PD) causes structural and functional changes in the peritoneal membrane, which are attributed to local inflammatory process. This study assessed the presence of galectin-3 (Gal-3), a known inflammatory modulator, in dialysate effluent and correlated its levels with markers of inflammatory process. Gal-3 levels in serum and dialysate effluent were measured in prevalent PD patients on morning visits (n =?27) or during peritoneal equilibration tests (PET, n =?16), it association with clinical and laboratory parameters, including dialysate/plasma creatinine (D/P creatinine) and interleukin-6 (IL-6) levels was analysed. Gal-3 levels in dialysate effluent correlated with D/P creatinine (0.663, p =?0.005) and dialysate effluent IL-6 levels (0.674, p =?0.002), but not with serum Gal-3 levels or dialysis vintage. Patients who were high transporters had higher Gal-3 levels in dialysate effluent, as compared to lower transporters. In multivariate regression analysis, dialysate IL-6 level was the strongest predictor of dialysate Gal-3 levels. This study found Gal-3 in dialysate effluent correlated with D/P creatinine and dialysate IL-6 levels. These findings may imply that Gal-3 has a role in the intraperitoneal inflammatory process. However, this needs to be investigated further.
Relapsed ANCA associated vasculitis following Oxford AstraZeneca ChAdOx1-S COVID-19 vaccination: A case series of two patients
Rachel David,Paul Hanna,Kenneth Lee,Angus Ritchie
doi : 10.1111/nep.13993
Volume 27, Issue 1 p. 109-110
Gross haematuria after mRNA COVID-19 vaccination in two patients with histological and clinical diagnosis of IgA nephropathy
Wai Kei Lo,Kwok Wah Chan
doi : 10.1111/nep.13992
Volume 27, Issue 1 p. 110-111
A 28?years old lady with history of microscopic haematuria for 5?years underwent a pre-scheduled kidney biopsy for suspected IgA nephropathy. Her renal function was normal with proteinuria 0.11?g/day. 3?weeks prior to biopsy, she received her second dose of mRNA COVID-19 vaccine (Pfizer-BioNTech BNT162b2) and developed painless gross hematuria 3 h later. Serum creatinine level was mildly elevated from 58 to 72??mol/L. Urine protein creatinine ratio increased from 20 to 320?mg/mmol. Her anti-nuclear antibody (ANA) turned from negative to positive with a titre of 1: 640, but anti-dsDNA remained negative. Her C3 and C4 levels were normal. 5?days later, her serum creatinine level fell to 54??mol/L and hematuria subsided spontaneously. 3?weeks later, her urine protein creatinine ratio fell to 34?mg/mmol and ANA became negative. Kidney biopsy confirmed IgA nephropathy with Oxford classification M1E0S0T0-C0 without features suggestive of lupus nephritis.
Report of two cases of minimal change disease following vaccination for COVID -19
Krishoban Baskaran,Adrienne Wai Seung Cohen,Nethmi Weerasinghe,Eswari Vilayur
doi : 10.1111/nep.13995
Volume 27, Issue 1 p. 111-112
