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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.

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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.

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• 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.

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• 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.

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• 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.

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• 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.

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• 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.

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• 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.

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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.

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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.

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• 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.

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• 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.

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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.

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• 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.

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• 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.

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• 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.

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• A new study demonstrated that TRC101, a hydrochloric acid binder for the treatment of metabolic acidosis associated with chronic kidney disease, provided a rapid and sustained average increase in serum bicarbonate. • All adverse effects were mild or moderate.

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• 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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• From 2004 to 2016, VA patients had lower rates of transplantation compared with patients with Medicare or private insurance. • VA patients also had a higher rate of mortality on the waiting list compared with privately insured patients. • 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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• 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.

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The results of numerous high-impact clinical trials that could affect kidney-related medical care 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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• In an analysis of published studies, individuals who used proton pump inhibitors had a 33% increased relative risk of developing chronic kidney disease or kidney failure when compared with non-users. • Results from the analysis 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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• In white patients with chronic kidney disease, those with depressive symptoms had a higher risk of early death than those without depressive symptoms. This risk was much lower after accounting for use of anti-depressants, however. • In black patients, the presence of depressive symptoms was not linked to risk of death. • 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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• The American Society of Nephrology (ASN), the world’s largest organization of kidney health professionals, has elected Mark D. Okusa, MD, FASN, as the next ASN President. • Dr. Okusa officially assumes his role as ASN President during the society’s annual meeting, ASN Kidney Week 2017, the largest gathering of kidney care specialists in the world, and will begin his term on January 1, 2018.

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• In patients treated for hypertension, greater reductions in mean blood pressure were linked with reduced kidney function. • Results from the analysis 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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• In patients with chronic kidney disease, there was a dose-dependent inverse association between caffeine consumption and early death. • Results from the analysis 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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• In a recent analysis, African American patients were less likely to be wait-listed than White patients.  This difference was influenced by factors including age, comorbidities, socio-economic status, being on dialysis, having a living donor, transplant knowledge, and social support. • 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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• Among children with impaired kidney function, those with high blood pressure at night experienced a faster time to kidney failure than children with normal blood pressure. This decline was even more pronounced in patients with high blood pressure during both day and night when compared with children with normal blood pressure. • 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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• Insomnia was linked with increased risks of early death, rapid kidney function decline, and kidney failure in a group of US veterans. • 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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• A particular protein is found in abundance in the kidneys of patients with an aggressive form of kidney disease called fibrillary glomerulonephritis. The discovery may improve diagnosis, and eventually, treatment. • The protein was identified by two research groups, working independently.

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Two longtime advocates for the 40 million Americans affected by kidney diseases recently received national recognition from the American Society of Nephrology (ASN) during Kidney Week 2017 for ongoing efforts in the fight to end this serious public health crisis.

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Briefing will feature presentations of High-Impact Clinical Trials. Dr. Pascale Lane and Dr. Kelly Hyndman will moderate and provide context and expert commentary on the science presented.

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• Five leaders in the kidney health community are being honored by the American Society of Nephrology (ASN), the world’s largest organization of kidney disease specialists. • The award winners will be honored at ASN Kidney Week, the world’s premier nephrology meeting where more than 13,000 kidney health professionals from around the world will gather in New Orleans, LA from October 31–November 5.

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• In a recent analysis of individuals on dialysis for at least 10 years, those who then received a kidney transplant lived longer than those who stayed on dialysis. • Transplant recipients were at higher risk of death for 180 days after transplantation, however, and they did not derive survival benefit until 657 days after transplantation.

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• Keryx Biopharmaceuticals, Inc. has committed to contributing $1 million over five years to the ASN Foundation for Kidney Research Securing the Future Campaign • ASN has matched the donation to endow a Career Development Grant named for Joseph V. Bonventre, MD, PhD, FASN, Chief of the Division of Renal Medicine at Brigham and Women’s Hospital in Boston, MA

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The American Society of Nephrology (ASN), the world’s largest organization of kidney health professionals, released a new analysis of the future nephrology workforce, authored by George Washington University (GW) researchers. • GW details an improved job market for new nephrologists, although international medical graduates still face employment challenges. The report noted that lifestyle concerns are important to fellows and may be discouraging applicants to the specialty. More than 40 million Americans have kidney diseases, the 9th leading cause of death in the U.S.

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• In a study of hospitalized patients in Canada, the mildest forms of acute kidney injury (AKI) resulted in adjusted costs that were 1.2 to 1.3 times greater than those for patients without AKI. • More severe AKI were associated with costs that were 1.8 to 2.5 times greater. • The incremental cost of AKI in Canada was estimated to be more than $200 million (Canadian dollars) per year.

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• Compared with healthy peers, young adults with kidney failure needing renal replacement therapy had lower quality of life, worse for dialysis patients compared with transplant patients. • Young adults on renal replacement therapy were more likely to be unemployed and to live in the family home, and they were less likely to be married or have a partner.

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Patient perspectives are often not considered by researchers and health care providers when making decisions that are inevitably going to influence the health and well-being of patients.

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• Most surveyed Canadian kidney specialists recommended follow-up kidney evaluations for the majority of patients hospitalized with acute kidney injury. • Real-world practice showed that only a minority of such patients in Alberta currently receive follow-up with a kidney specialist.

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• From 2008-2015, the number of kidneys donated after circulatory death that were obtained by the country’s 58 donor service areas varied substantially. • The outcomes associated with these organs were generally excellent. • The use of these organs could be increased if “cold ischemia times” are limited.

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• Among hemodialysis patients admitted to the hospital, nearly a quarter of admissions were followed by an unplanned readmission within 30 days. • Most readmissions were for a diagnosis different than the one for the initial hospitalization. • A small proportion of patients accounted for a disproportionate number of readmissions.

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American Society of Nephrology (ASN) President Eleanor D. Lederer, MD, FASN, released the following statement today regarding the US Senate’s consideration of the Graham-Cassidy health care proposal:

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• From 2006 to 2010, almost two thirds of US dialysis patients received at least one opioid prescription every year and >20% received chronic prescriptions. • More than 25% of dialysis patients using opioids received doses exceeding recommendations • Use of opioid medications was linked with higher risks of early death, discontinuation of dialysis, and the need for hospitalization in dialysis patients.

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• In a study of US veterans, researchers found a linear relationship between air pollution levels and risk of experiencing kidney function decline and of developing kidney disease or kidney failure.

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Washington, DC (September 20, 2017)—The world’s largest gathering of kidney health professionals will join forces in New Orleans from October 31–November 5, 2017, and serve as a major forum for the dissemination of advances in basic, clinical, and translational research as well as advances in clinical practice to the basic science and clinical community during the American Society of Nephrology’s Kidney Week 2017.

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Advocates from the American Society of Nephrology (ASN) and the 21 other health care organizations listed below are meeting with their representatives and senators today. They will urge Congress to continue its historic support of research funding for the National Institutes of Health (NIH) and to cosponsor and pass the Living Donor Protection Act (H.R. 1270), no-cost legislation to eliminate barriers to living donation and increase access to transplants.

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• In individuals with chronic kidney disease, high sleep fragmentation was associated with an elevated risk of developing kidney failure. • Higher sleep fragmentation and shorter sleep duration were each linked with steeper declines in kidney function over time. • Subjectively measured daytime sleepiness was associated with an increased risk of early death from any cause.

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• In patients with chronic kidney disease and Hepatitis C virus infection, sofosbuvir-based direct-acting antiviral therapy was safe and effective. • Patients with stage 3 kidney disease who were cured of infection experienced an improvement in their kidney function following treatment.

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• A particular receptor in kidney cells plays an important role in obesity-induced fat accumulation, dysfunction, injury, inflammation, and scarring in the kidney. • The receptor acts through a certain signaling pathway. • Targeting this receptor or the signaling pathway may help protect the kidneys of individuals who develop obesity.