Although undocumented people are eligible for kidney transplant from a regulatory standpoint, undocumented individuals are often excluded from federal health insurance, leading to difficulty accessing kidney transplant. Menon et al. highlight lower mortality and graft failure rates for presumed undocumented immigrants compared with residents and citizens post-transplant. In this commentary, we emphasize

The pathogenic mechanisms of chronic kidney disease-induced osteoporosis are not well understood and might involve metabolic alterations and apoptosis of osteocytes. In this issue, Hsu et al. present experimental work in uremic mice and cultured mouse osteoblasts showing that impaired mitochondrial function and mitophagy in osteocytes contribute to chronic kidney disease-associated osteoporosis. They

Chronic kidney disease (CKD) has become a public health issue. Rapid urbanization in China has been intimately linked to shifts in the spectrum of CKD, particularly as regards CKD related to diabetes mellitus. By amalgamating diverse data streams and harnessing cutting-edge technologies, the China Kidney Disease Network aspires to evolve into a comprehensive surveillance framework for kidney diseases

INTRODUCTION Chronic active antibody-mediated rejection (AMR) is the leading cause of death-censored kidney allograft loss, with no proven treatments. While intravenous immunoglobulin (IVIG) has been used in certain cases, its efficacy is unknown. METHODS In this open-label multicenter randomized controlled trial (VIPAR), participants with biopsy-proven chronic active AMR, were assigned to six doses

INTRODUCTION Patients with metabolic syndrome and heart failure (HF) often have accompanying kidney dysfunction, which was recently defined as cardiovascular-kidney-metabolic (CKM) syndrome. Prior metabolomics profiling of metabolic syndrome patients identified a plasma branched chain amino acid (BCAA) signature, and BCAAs themselves are elevated in the myocardium of patients with HF, potentially due

BACKGROUND Visual scoring of tubular damage has limitations in capturing the full spectrum of structural changes and prognostic potential. Here, we investigated if computationally quantified tubular features can enhance prognostication and reveal spatial relationships with interstitial fibrosis. METHODS Deep-learning and image-analysis approaches were employed on 254/266 Periodic acid Schiff-stained

INTRODUCTION Monoclonal gammopathy of renal significance (MGRS) is increasingly recognized as an important causes of kidney failure. A kidney biopsy remains an important diagnostic measure. However, a kidney biopsy is not without risks. Here, we devised the Mayo MGRS Prediction Tool to assess the probability of finding MGRS in patients with chronic kidney disease with monoclonal gammopathy (MG). METHODS

Attention is increasingly turning toward the individualization of hemodialysis prescriptions through an incremental start. This approach prioritizes patient's clinical needs over rigid metrics like dialysis urea depuration, begins with fewer sessions (one or two per week), and gradually increases in frequency and/or duration based on patient's evolving clinical condition. Clinical manifestations related

INTRODUCTION Vascular calcification is prevalent in chronic kidney disease (CKD), but existing medical treatments fail to achieve satisfactory therapeutic effects. Vascular calcification is now recognized as an active multifactorial process involving diverse mechanisms. Alpha-ketoglutarate (AKG), an intermediate in tricarboxylic acid cycle, has been demonstrated to extend lifespan and ameliorate age-related

Thrombotic microangiopathy (TMA) is a complex condition involving endothelial damage and microvascular thrombi. The International Society of Nephrology’s HUS International Forum identified genetic variants as crucial for tailored therapies like plasma exchange and anti-complement therapy. Recent studies suggested that new pathogenic genes beyond complement, and coagulation pathways contribute to TMA

INTRODUCTION Women with preeclampsia often deliver preterm (under37 weeks gestation). Preterm birth is associated with an increased risk of offspring kidney disease, but whether preeclampsia is independently associated with kidney disease risk is unknown. Here, we conducted a register-based cohort study to explore associations between maternal preeclampsia and offspring kidney disease after accounting

INTRODUCTION Disease recurrence after kidney transplantation (KTx) remains a major challenge in patients with primary focal segmental glomerulosclerosis (pFSGS). Antibodies targeting the slit diaphragm protein nephrin have been identified in patients with early disease recurrence. Here, we describe monitoring and effective pre-transplant elimination of anti-nephrin antibodies in an adolescent with

In recent years, there have been significant changes in the lifestyle and dietary habits of the population characterized by an increased intake of high-calorie food and a sedentary lifestyle without physical activity. The increased prevalence of overweight and obesity has led to metabolic dysfunction and related complications, such as cardiovascular disease and chronic kidney disease. The purpose of

Podocytes are terminally differentiated cells of the kidney filtration barrier. Their network of interdigitating foot processes embraces the glomerular capillaries and are likely remodeled by cleavage of podocyte surface proteins. The metalloproteinase ADAM10 is a major regulator of such surface protein shedding and was recently implicated in the pathophysiology of antibody-mediated podocyte injury

Nephrin, the key structural protein of the slit diaphragm, is encoded by NPHS1. Pathogenic variants in this gene are the primary cause of congenital nephrotic syndrome. About 400 variants have been described but functional characterization in vitro is very limited.

Human pluripotent stem cells hold inherent properties, allowing researchers to recapitulate key morphogenetic processes. These characteristics, coupled with bioengineering techniques, have led to the definition of early procedures to derive organ-like cell cultures, the so-called organoids. With regard to kidney organoids, challenges stand ahead, such as the need to enhance cellular composition, maturation

The spectrum of kidney lesions associated with monoclonal gammopathy has significantly expanded over the past 2 decades, with description of new entities and variants of old entities. Pathologic diagnosis is challenging because of lesional complexity, heterogeneity, and reliance on electron microscopy and ancillary techniques. A lack of precise pathologic definitions and uniform terminology has hampered

Chronic Kidney Disease (CKD) is marked by progressive tubulointerstitial fibrosis (TIF), a pathological feature insufficiently addressed by existing therapies.

While mesangial IgA deposition is the pathognomonic feature of IgA nephropathy (IgAN), the extent of mesangial IgA accumulation does not correlate with the future risk of kidney failure. This has led to the search for other serum factors that may influence clinical outcome. The emergence of microRNAs (miRs) as negative regulators of gene expression and the increasingly recognized role of extracellular

The efficacy and safety of finerenone (a nonsteroidal mineralocorticoid receptor antagonist) versus placebo were assessed according to different changes in estimated glomerular filtration rate (eGFR) using data from FIDELITY, a pooled individual-level analysis of two clinical trials.

Proteinase 3 (PR3) is a major autoantigen in patients with anti-neutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis (AAV). Here, we performed a proof-of-principle study using ex vivo CRISPR-Cas9 guided gene editing to eliminate the PR3 autoantigen as an alternative to suppressing the autoimmune response to PR3.

Antibody-mediated rejection (ABMR) after allogeneic kidney transplantation is a substantial clinical problem for which there are no specific treatments. High endothelial venules (HEV) are specialized veins which are normally present only in lymph nodes (LN) facilitating immune cell entry. Here, we show that kidneys undergoing rejection develop HEV-like structures derived from host cells.

Proximal tubular epithelial cells with different DNA contents emerge after acute kidney injury (AKI). However, their heterogeneity and roles in the acute kidney injury-to-chronic kidney disease (AKI-to-CKD) transition remain incompletely understood.

Chronic kidney disease is associated with excessive cardiovascular mortality, which is promoted by the phosphaturic hormone fibroblast growth factor 23 (FGF23). Increased FGF23 levels result in left ventricular hypertrophy via activation of the FGF receptor 4 activation. Fuchs et al. now demonstrate, using bioengineered cardiobundles, neonatal rat ventricular myocytes, and mice with chronic kidney

The Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guideline for the Management of Glomerular Diseases was last updated and published in 2021. KDIGO continues to be committed to the nephrology community to provide periodic updates, based on new developments for each of the glomerular diseases. For children with nephrotic syndrome, the updated guideline now contains a treatment

Primary focal segmental glomerulosclerosis is a glomerular disorder associated with a high risk of recurrence after transplantation. Compelling evidence supports the existence of circulating permeability factors whose identity remains elusive. In the current issue of Kidney International, Gupta et al. propose that kidney organoid can respond to these factors in patients with focal segmental glomerulosclerosis