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2020 landmark papers in transplantation published in NDT: clinical research highlights in the area of kidney transplantation
Rainer Oberbauer
doi : 10.1093/ndt/gfab011
Volume 36, Issue 4, April 2021, Pages 569–571
NDT published 32 original research papers in the field of kidney transplantation in the year 2020. My selection of only eight featured transplant papers is owed to the restricted word count of editorials and is clearly subjective with a focus on findings with potential clinical impact. All other transplant papers in Volume 35 of NDT are also highly recommended and acknowledged.
At least 156 reasons to prioritize COVID-19 vaccination in patients receiving in-centre haemodialysis
Christian Combe, Alexander H Kirsch, Gaetano Alfano, Valerie A Luyckx, Rukshana Shroff ...
doi : 10.1093/ndt/gfab007
Volume 36, Issue 4, April 2021, Pages 571–574
A timely analysis and call to action by the Council of the ERA-EDTA and the European Renal Association COVID-19 Database (ERACODA) Working Group has recently highlighted the extremely high burden of coronavirus disease 2019 (COVID-19) infection in chronic kidney disease (CKD) patients, who, compared with patients suffering from other major disorders, are at the highest risk to develop severe COVID-19 and to die from it [1].
Is it time to abandon the nutrient-based renal diet model?
David E St-Jules, Denis Fouque
doi : 10.1093/ndt/gfaa257
Volume 36, Issue 4, April 2021, Pages 574–577
The traditional renal diet is logical, but perhaps not biological. In this issue of Nephrology Dialysis Transplantation, Gonzalez-Ortiz et al. present findings from cross-sectional analyses that add to the growing body of literature [1]. The analysis fails to support the theory that diet-related complications in hemodialysis (HD) patients are caused by diet-derived nutrient imbalances [2–4]. In particular, the renal dietary pattern for HD is designed to be low potassium, low phosphorus and high protein, with the understanding that this would help to prevent and treat hyperkalemia, hyperphosphatemia and protein–energy wasting (PEW), respectively [5].
Does the relationship between measured and prescribed dialysate sodium matter in the nephrology community?
Daniele Marcelli, Carlo Basile
doi : 10.1093/ndt/gfaa334
Volume 36, Issue 4, April 2021, Pages 577–580
Dialysate composition is one of the most fascinating topics in nephrology. Learning about the art and science of haemodialysates (regarding sodium, potassium, calcium, magnesium and bicarbonates) is one of the best ways to further our understanding of the pathophysiologic processes underlying the myriad of acid–base, fluid, electrolyte and blood pressure abnormalities in end-stage kidney disease [1].
Glomerular endothelial activation, C4d deposits and microangiopathy in immunoglobulin A nephropathy
Hern?n Trimarchi, Rosanna Coppo
doi : 10.1093/ndt/gfz241
Volume 36, Issue 4, April 2021, Pages 581–586
Immunoglobulin A nephropathy (IgAN) is considered as mesangiopathy since it initiates in the mesangium; however, other glomerular components are involved and the glomerular capillary wall offers the first contact to circulating macromolecular IgA1. Acute and active forms of IgAN are associated with endocapillary hypercellularity and vascular damage of various degrees, in severe cases with microangiopathy (MA) without or with thrombosis [thrombotic microangiopathy (TMA)].
BK polyomavirus—pathogen, paradigm and puzzle
Suman Krishna Kotla, Pradeep V Kadambi, Allen R Hendricks, Rebecca Rojas
doi : 10.1093/ndt/gfz273
Volume 36, Issue 4, April 2021, Pages 587–593
BK virus is a polyomavirus with seroprevalence rates of 80% in adults. Infection is usually acquired during childhood, and the virus is benign or pathologic depending on immune status. The virus reactivates in immunodeficiency states, mostly among transplant (either kidney or bone marrow) recipients.
C3 glomerulopathy
Jacob J E Koopman, Aiko P J de Vries, Ingeborg M Bajema
doi : 10.1093/ndt/gfz201
Volume 36, Issue 4, April 2021, Pages 594–596
C3 glomerulopathy is an umbrella term [1] that became used over the last decade to cover two entities: dense deposit disease and C3 glomerulonephritis—the latter covering a variety of renal manifestations that share a dominance for C3 deposits in the work-up of a renal biopsy.
Paediatric immune-mediated renal disease: an overview
Louise Oni
doi : 10.1093/ndt/gfz184
Volume 36, Issue 4, April 2021, Pages 596–598
Immune-mediated renal diseases are a broad group of conditions where a dysregulated autoimmune process is the predominant driving force behind the onset of renal inflammation and injury [1]. This concise review summarizes some of the diseases seen in childhood grouped into how they typically present. It is by no means exhaustive and focuses on key differences when compared with patients with adult-onset disease.
A single-cell map for the transcriptomic signatures of peripheral blood mononuclear cells in end-stage renal disease
Ting Luo, Fengping Zheng, Kang Wang, Yong Xu, Huixuan Xu ...
doi : 10.1093/ndt/gfz227
Volume 36, Issue 4, April 2021, Pages 599–608
Immune aberrations in end-stage renal disease (ESRD) are characterized by systemic inflammation and immune deficiency. The mechanistic understanding of this phenomenon remains limited.
Circulating plasmablasts and high level of BAFF are hallmarks of minimal change nephrotic syndrome in adults
Julie Oniszczuk, Asma Beldi-Ferchiou, Etienne Audureau, Imane Azzaoui, Valérie Molinier-Frenkel ...
doi : 10.1093/ndt/gfaa279
Volume 36, Issue 4, April 2021, Pages 609–617
The recent success achieved with the use of B cell-depleting agents in some patients with minimal change nephrotic syndrome (MCNS) suggests an unexpected role for B lymphocytes in the pathogenesis of this immune-mediated glomerular disease. Nevertheless, no extensive B-cell phenotyping analysis has ever been performed in untreated adult patients soon after MCNS diagnosis.
The receptor activator of nuclear factor ?? ligand receptor leucine-rich repeat-containing G-protein-coupled receptor 4 contributes to parathyroid hormone-induced vascular calcification
Natalia Carrillo-L?pez, Laura Mart?nez-Arias, Cristina Alonso-Montes, Beatriz Mart?n-Carro, Julia Mart?n-V?rgala ...
doi : 10.1093/ndt/gfaa290
Volume 36, Issue 4, April 2021, Pages 618–631
In chronic kidney disease, serum phosphorus (P) elevations stimulate parathyroid hormone (PTH) production, causing severe alterations in the bone–vasculature axis. PTH is the main regulator of the receptor activator of nuclear factor ?B (RANK)/RANK ligand (RANKL)/osteoprotegerin (OPG) system, which is essential for bone maintenance and also plays an important role in vascular smooth muscle cell (VSMC) calcification.
Enteropeptidase inhibitor SCO-792 effectively prevents kidney function decline and fibrosis in a rat model of chronic kidney disease
Yuko Katayama, Jun Sugama, Tomohisa Suzuki, Yoshimasa Ishimura, Akihiro Kobayashi ...
doi : 10.1093/ndt/gfaa349
Volume 36, Issue 4, April 2021, Pages 631–640
Inhibiting enteropeptidase, a gut serine protease regulating protein digestion, suppresses food intake and ameliorates obesity and diabetes in mice. However, the effects of enteropeptidase inhibition on kidney parameters are largely unknown. Here, we evaluated the chronic effects of an enteropeptidase inhibitor, SCO-792, on kidney function, albuminuria and kidney pathology in spontaneously hypercholesterolaemic (SHC) rats, a rat chronic kidney disease (CKD) model.
Prevalence and correlates of physical activity across kidney disease stages: an observational multicentre study
Thomas J Wilkinson, Amy L Clarke, Daniel G D Nixon, Katherine L Hull, Yan Song ...
doi : 10.1093/ndt/gfz235
Volume 36, Issue 4, April 2021, Pages 641–649
People with chronic kidney disease (CKD) report high levels of physical inactivity, a major modifiable risk factor for morbidity and mortality. Understanding the biological, psychosocial and demographic causes of physical activity behaviour is essential for the development and improvement of potential health interventions and promotional initiatives. This study investigated the prevalence of physical inactivity and determined individual correlates of this behaviour in a large sample of patients across the spectrum of kidney disease.
The Australian Calciphylaxis Registry: reporting clinical features and outcomes of patients with calciphylaxis
Irene Ruderman, Nigel D Toussaint, Carmel M Hawley, Rathika Krishnasamy, Eugenia Pedagogos ...
doi : 10.1093/ndt/gfz256
Volume 36, Issue 4, April 2021, Pages 649–656
Calciphylaxis is a rare disease, predominantly affecting patients with chronic kidney disease (CKD) and associated with significant morbidity and mortality due to progressive cutaneous calcification, necrotic ulceration and infection. Clinical registries have been established to better understand the risk factors, optimal treatments and disease outcomes of calciphylaxis.
The Acute Kidney Outreach to Prevent Deterioration and Death trial: a large pilot study for a cluster-randomized trial
Mark E Thomas, Tarek S Abdelaziz, Gavin D Perkins, Alice J Sitch, Jyoti Baharani ...
doi : 10.1093/ndt/gfz246
Volume 36, Issue 4, April 2021, Pages 657–665
The Acute Kidney Outreach to Reduce Deterioration and Death trial was a large pilot study for a cluster-randomized trial of acute kidney injury (AKI) outreach.
Prognostic values of left ventricular mass index in chronic kidney disease patients
Giovanni Tripepi, Graziella D’Arrigo, Francesca Mallamaci, Gerard London, Navdeep Tangri ...
doi : 10.1093/ndt/gfz254
Volume 36, Issue 4, April 2021, Pages 665–672
Left ventricular hypertrophy is causally implicated in the high risk of death and heart failure (HF) in chronic kidney disease (CKD) patients. Whether the left ventricular mass index (LVMI) adds meaningful predictive power for mortality and de novo HF to simple risk models has not been tested in the CKD population.
Urinary chloride concentration and progression of chronic kidney disease: results from the KoreaN cohort study for Outcomes in patients With Chronic Kidney Disease
Young Su Joo, Jinseok Kim, Cheol Ho Park, Hae-Ryong Yun, Jung Tak Park ...
doi : 10.1093/ndt/gfz247
Volume 36, Issue 4, April 2021, Pages 673–680
Urinary chloride is regulated by kidney transport channels, and high urinary chloride concentration in the distal tubules can trigger tubuloglomerular feedback. However, little attention has been paid to urinary chloride as a biomarker of clinical outcomes. Here, we studied the relationship between urinary chloride concentration and chronic kidney disease (CKD) progression.
Nutritional status, hyperkalaemia and attainment of energy/protein intake targets in haemodialysis patients following plant-based diets: a longitudinal cohort study
Ailema Gonz?lez-Ortiz, Hong Xu, Samuel Ramos-Acevedo, Carla M Avesani, Bengt Lindholm ...
doi : 10.1093/ndt/gfaa194
Volume 36, Issue 4, April 2021, Pages 681–688
Patients undergoing haemodialysis (HD) are often discouraged from eating fruits and vegetables because of fears of hyperkalaemia and undernutrition, yet evidence to support these claims is scarce. We here explore the association between adherence to a healthy plant-based diet with serum potassium, surrogates of nutritional status and attainment of energy/protein intake targets in HD patients.
Effect of comorbidities on survival in patients >80?years of age at onset of renal replacement therapy: data from the ERA-EDTA Registry
Jaakko Helve, Anneke Kramer, Jose Maria Abad Diez, Nuria Aresté-Fosalba, Mustafa Arici ...
doi : 10.1093/ndt/gfaa278
Volume 36, Issue 4, April 2021, Pages 688–694
The number of elderly patients on renal replacement therapy (RRT) is increasing. The survival and quality of life of these patients may be lower if they have multiple comorbidities at the onset of RRT. The aim of this study was to explore whether the effect of comorbidities on survival is similar in elderly RRT patients compared with younger ones.
Relationship between measured and prescribed dialysate sodium in haemodialysis: a systematic review and meta-analysis
Jack Kit-Chung Ng, , Brendan Smyth, , Mark R Marshall, , Amy Kang, , Jule Pinter ...
doi : 10.1093/ndt/gfaa287
Volume 36, Issue 4, April 2021, Pages 695–703
Dialysate sodium (DNa) prescription policy differs between haemodialysis (HD) units, and the optimal DNa remains uncertain. We sought to summarize the evidence on the agreement between prescribed and delivered DNa, and whether the relationship varied according to prescribed DNa.
Association of lactate dehydrogenase with mortality in incident hemodialysis patients
Soh Young Ryu, Carola-Ellen Kleine, Jui-Ting Hsiung, Christina Park, Connie M Rhee ...
doi : 10.1093/ndt/gfaa277
Volume 36, Issue 4, April 2021, Pages 704–712
Lactate dehydrogenase (LDH) plays a role in the glucose metabolism of the human body. Higher LDH levels have been linked to mortality in various cancer types; however, the relationship between LDH and survival in incident hemodialysis (HD) patients has not yet been examined. We hypothesized that higher LDH level is associated with higher death risk in these patients.
The effect of increasing dialysate magnesium on calciprotein particles, inflammation and bone markers: post hoc analysis from a randomized controlled clinical trial
Iain Bressendorff, Ditte Hansen, Andreas Pasch, Stephen G Holt, Morten Schou ...
doi : 10.1093/ndt/gfz234
Volume 36, Issue 4, April 2021, Pages 713–721
The formation of calciprotein particles (CPPs) may be an important component of the humoral defences against ectopic calcification. Although magnesium (Mg) has been shown to delay the transition of amorphous calcium-/phosphate-containing primary CPP (CPP-1) to crystalline apatite-containing secondary CPP (CPP-2) ex vivo, effects on the endogenous CPP pool are unknown.
Effects of bisphosphonates on long-term kidney transplantation outcomes
Seung Hwan Song, Hoon Young Choi, Ha Yan Kim, Chung Mo Nam, Hyeon Joo Jeong ...
doi : 10.1093/ndt/gfaa371
Volume 36, Issue 4, April 2021, Pages 722–729
Bisphosphonates are administered to post-transplantation patients with mineral and bone disorders; however, the association between bisphosphonate therapy and long-term renal graft survival remains unclear.
Temporal trends in living kidney donation in France between 2007 and 2017
François Gaillard, Lola Jacquemont, Veena Roberts, Laetitia Albano, Julien Allard ...
doi : 10.1093/ndt/gfz229
Volume 36, Issue 4, April 2021, Pages 730–738
Long-term studies have demonstrated a slight increased risk for end-stage renal disease (ESRD) for living kidney donors (LKD). In France, living kidney donation doubled within the past 10?years. We investigated the change in characteristics of LKD between 2007 and 2017 and the adequacy of follow-up.
Glucocorticoid-free treatment of severe ANCA-associated vasculitis
Tariq E Farrah, Maria Prendecki, Robert W Hunter, Rashmi Lahiri, Thomas D Cairns ...
doi : 10.1093/ndt/gfaa310
Volume 36, Issue 4, April 2021, Pages 739–742
Anti-neutrophil cytoplasm antibody (ANCA)-associated vasculitis (AAV) is a rare, small-vessel vasculitis with a peak in incidence in the seventh and eighth decades [1]. Previous studies have shown that older age and poorer performance status are associated with worse outcomes likely as a consequence of the disease and its treatment [2, 3]. Also, best practice for elderly patients is unclear, as they are underrepresented in randomized controlled trials of induction immunosuppression in AAV; mean participant ages in the CYCLOPS, RAVE, MYCYC and PEXIVAS trials were 57, 53, 60 and 63?years, respectively [4–7].
Ionized and not total magnesium as a discriminating biomarker for hypomagnesaemia in continuous venovenous haemofiltration patients
Tim J A Hutten, Maaike A Sikma, Ron H Stokwielder, Marjon Wesseling, Imo E Hoefer ...
doi : 10.1093/ndt/gfaa330
Volume 36, Issue 4, April 2021, Pages 742–743
Magnesium is the second most abundant intracellular cation and plays an essential role as a cofactor in hundreds of enzymatic reactions [1]. In plasma, ~70% of magnesium exists as the bioactive ionized form and is maintained within a narrow range [2]. Magnesium dysregulation mainly impacts neuromuscular and cardiovascular function and can even result in seizures and coma. Hypomagnesaemia is a common phenomenon occurring in 12% of hospitalized patients and up to 65% of critically ill patients [3, 4]. Hypomagnesaemia in critically ill patients is associated with a higher risk of ventilator support, sepsis and mortality [5–7].
Regional anticoagulation with calcium-free dialysate containing citrate in chronic haemodialysis patients
Violaine Scarfoglière, Mickaël Bobot, Cavaille Guilhem, Dammar Bouchouareb, Philippe Brunet ...
doi : 10.1093/ndt/gfaa365
Volume 36, Issue 4, April 2021, Pages 745–746
The intermittent haemodialysis technique requires extracorporeal circuit anticoagulation to prevent clotting while minimizing the risk of bleeding complications. Heparin is currently the most commonly used anticoagulant, with a wide patient-to-patient variability. A chronic dialysis patient is likely to present periodic higher risk of bleeding requiring a temporary adjustment of the anticoagulation. Some patients have permanently high bleeding risk that necessitates an alternative method of anticoagulation.
The association of calcium oxalate deposition in kidney allografts with graft and patient survival
Ragnar Palsson, Anil K Chandraker, Gary C Curhan, Helmut G Rennke, Gearoid M McMahon ...
doi : 10.1093/ndt/gfy364
Volume 36, Issue 4, April 2021, Page 747
The association of calcium oxalate deposition in kidney allografts with graft and patient survival, Nephrol Dial Transplant 2018; gfy271. doi:10.1093/ndt/gfy271
Current approaches to middle molecule removal: room for innovation
Ikuto Masakane, Kenji Sakurai
doi : 10.1093/ndt/gfy384
Volume 36, Issue 4, April 2021, Page 747
Current approaches to middle molecule removal: room for innovation, Nephrology Dialysis Transplantation, Volume 33, Issue suppl_3, 1 October 2018, Pages iii12–iii21, https://doi.org/10.1093/ndt/gfy224
Validation of echocardiographic criteria for the clinical diagnosis of heart failure in chronic kidney disease
Kathrin Untersteller, Sarah Seiler-Mu?ler, Francesca Mallamaci, Danilo Fliser, Gérard M London ...
doi : 10.1093/ndt/gfy408
Volume 36, Issue 4, April 2021, Page 748
Validation of echocardiographic criteria for the clinical diagnosis of heart failure in chronic kidney disease, Nephrol Dial Transplant 2018; gfx197. doi: 10.1093/ndt/gfx197
