• Kidney failure patients undergoing hemodialysis are vulnerable to infectious threats, many of which may be life-threatening and spread to others in dialysis facilities • New articles provide important information on infections and their prevention in patients undergoing hemodialysis and transmission in dialysis facilities.
Highlight • In a study of Black Americans who participated in focus group sessions, certain participant factors—such as knowledge of kidney disease and spiritual and cultural influences—and logistical factors—such as convenience and awareness of scheduling—were identified as barriers that may prevent Black Americans from being screened for kidney disease.
Highlights • Between 2005 and 2015, the unadjusted rate of living kidney donation in the United States was 30.1 and 19.3 per million population in women and men, respectively. • After adjusting for differences in age, race, the incidence of kidney failure, and geographic factors, the incidence of donation was 44% higher in women. • Over time, the incidence of donation was stable in women but declined in men. The decline was most marked in men from lower income groups.
In celebration of the World Kidney Day 2018’s theme of "Kidneys & Women’s Health: Include, Value, Empower," the American Society of Nephrology (ASN) is highlighting several articles in its journals, Clinical Journal of the American Society of Nephrology (CJASN) and Journal of the American Society of Nephrology (JASN), that are focused on women's kidney health.
• In a group of older patients undergoing hemodialysis, cerebral blood flow declined by 10%, from before the start to the end of hemodialysis. • Cerebral blood flow declined in all brain regions that were examined, including the frontal, parietal, temporal, and occipital lobes; cerebellum; and thalamus.
• An analysis of published studies indicates that children with chronic kidney disease may have lower intellectual functioning compared than children in the general population. • Compared with children with mild-to-moderate stage kidney disease and with kidney transplants, children on dialysis had the lowest IQ scores. • Deficits were evident for attention, memory, and executive function domains.
• Three new research articles compare human and mouse kidney development to identify shared and novel features. • The studies provide new detailed molecular data to guide future research. • The studies revealed deep conservation of certain processes, but also significant differences in gene expression during kidney development, as well as in the timing, scale, organization, and molecular profile of key cell types and cell structures.
• In generally healthy older men, slightly lower sodium levels in the blood were related to both cognitive impairment and declines in cognitive function over time. • Additional studies are needed to determine whether correction of lower serum sodium may influence cognition in older adults.
• A new method is useful for assessing how well individual dialysis facilities are referring patients for kidney transplantation. • When the method was applied to dialysis facilities in Georgia, researchers found that most of the variation in referrals for transplantation were due to characteristics within the dialysis facilities rather than patient characteristics.
• Among working-aged adults who started dialysis between 1996 and 2013, employment was low throughout the study period at 23-24%, and 38% of patients who were employed 6 months prior to being diagnosed with kidney failure stopped working by the time they initiated dialysis. After accounting for differences in patients over time, the probability of employment in kidney failure patients increased slightly over time.
Kidney specialists face increasing work demands, high rates of burnout, and declining interest in nephrology as a career. A group of articles publishing in an upcoming issue of the Clinical Journal of the American Society of Nephrology (CJASN) sheds light on how that these factors threaten to reduce job satisfaction and impair the delivery of high-quality care to patients with kidney diseases.
In an effort to provide patients the opportunity to share practical health consumer perspectives, the Clinical Journal of the American Society of Nephrology (CJASN) is including Patient Voice editorials that will accompany certain journal articles. In the first editorial, Paul T. Conway, a past recipient of the ASN President’s medal, highlights 2 CJASN articles that focus on patient comprehension of how treatments align with their individual interests.
• In a trial of kidney transplant recipients with late antibody-mediated rejection, treatment with bortezomib, a type of proteasome inhibitor, failed to improve the function of transplanted kidneys and prevent immunologic tissue injury. • Bortezomib treatment was also linked with gastrointestinal and hematologic toxicity.
• In the United States, the excess risk of kidney failure–related death decreased by 12% to 27% over any 5-year interval between 1995 and 2013. • Decreases in excess mortality over time were observed for all ages and both during treatment with dialysis and during time with a functioning kidney transplant.
Around 17% of American adults have chronic kidney disease (CKD), and the rate of prevalence is higher for US Veterans. CKD, if not treated appropriately, can ultimately lead to kidney failure requiring either dialysis or a transplant.
• In an analysis of pairs of kidneys from the same donor in which 1 kidney was used but the other was discarded, the kidneys that were used tended to perform well. • The majority of discarded kidneys could have potentially been transplanted with good outcomes.
• New research indicates that the role of dendritic cells in kidney inflammation is more complex than previously thought. Different types of dendritic cells communicate with each other to control the magnitude of the immune response. • The findings may lead to a better understanding of various types of kidney disease.
• In tissue samples from patients who received kidney transplants without the need for chronic immunosuppression, researchers found increased expression of many genes associated with the regulation of certain immune cells. • The findings provide an improved understanding of transplant organ acceptance and rejection.
• In young women, a history of kidney stones was associated with metabolic and hypertensive complications. • Results from the study will be presented at ASN Kidney Week 2017 October 31–November 5 at the Ernest N. Morial Convention Center in New Orleans, LA.
• The estimated global burden of chronic kidney disease attributable to fine particulate matter is more than 10.7 million cases per year. • Results from the study will be presented at ASN Kidney Week 2017 October 31–November 5 at the Ernest N. Morial Convention Center in New Orleans, LA.
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