Inter-organ crosstalk: The kidney's role in systemic health and disease.

This review elucidates the critical role of inter-organ crosstalk in systemic health, focusing on the kidney's interactions with the heart, bone marrow, lung, liver, intestine, bone-vascular, and nervous system. These interactions are vital for maintaining physiological homeostasis and are mediated by hormones, cytokines, and metabolites. The kidney's role in these networks is pivotal, as dysfunction can exacerbate systemic diseases, highlighting the need for integrated therapeutic strategies.

Microbiota and kidney disease: the road ahead.

More than 850 million individuals worldwide, accounting for 10-15% of the adult population, are estimated to have chronic kidney disease. Each of these individuals is host to tens of trillions of microorganisms that are collectively referred to as microbiota - a dynamic ecosystem that both influences host health and is itself influenced by changes in the host. Available evidence supports the existence of functional connections between resident microorganisms and kidney health that are altered in the context of specific kidney diseases, including acute kidney injury, chronic kidney disease and renal stone disease.

The Association of Antiemetics Use With Incident Chronic Kidney Disease.

Objectives: Gastrointestinal symptoms can significantly impact patients' nutritional status. Effective management using antiemetics is crucial for maintaining adequate nutrition. However, the effect of antiemetics on long-term renal function remains unclear.

Sleep Patterns, Symptoms, and Mortality in Hemodialysis: A Prospective Cohort Study.

Rationale & Objective: While sleep disorders are common in patients treated with hemodialysis, the impact of sleep patterns on survival is not well defined. We thus examined the association of specific sleep patterns with mortality in this population.

Study Design: An observational cohort study.

Dietary Protein Intake Recommendations for Patients with Non-Dialysis-Dependent CKD: What Should Healthcare Providers Do?

Protein intake is crucial to maintain human health, and an adequate quantity and quality of dietary protein intake (DPI) is particularly important in patients with CKD. Both an insufficient amount of DPI ( i.e .

From niche to norm: a multiaction plan to close gaps and mainstream incremental hemodialysis.

Attention is increasingly turning toward the individualization of hemodialysis prescriptions through an incremental start. This approach prioritizes the patient's clinical needs over rigid metrics like dialysis urea depuration, begins with fewer sessions (1 or 2 per week), and gradually increases in frequency and/or duration based on the patient's evolving clinical condition. Clinical manifestations related to uremia are managed through a combination of residual kidney function, dialysis, dietary modification, and medications.

Declining Serum Albumin With Stable Body Mass Index: A Mortality Indicator in Predialysis Chronic Kidney Disease.

Objective: This study aimed to investigate changes in nutritional markers in patients with predialysis chronic kidney disease (CKD) and stable body mass index (BMI).

Methods: We analyzed data from a nationwide cohort of US Veterans with advanced CKD who transitioned to kidney replacement therapy from October 1, 2007, through March 31, 2015. We identified 20,164 U.

The humanistic burden of focal segmental glomerulosclerosis on patients and care-partners in the United States.

Purpose: This study cross-sectionally surveyed patients with primary focal segmental glomerulosclerosis (FSGS) and their caregivers/care-partners, in terms of physical and mental health-related quality of life (HRQoL) and work productivity.

Methods: HRQoL instruments, including the KDQoL-36 (with SF-12 v2), PedsQL (v4.0, parent proxy for children/adolescents), GAD-7 (anxiety), PHQ-9 (depression), and WPAI: SHP (work productivity), were used in the study.

The Association of Fibrate Use with Kidney Outcomes and Mortality.

Key Points: In this large national cohort of United States veterans followed over 14 years, fibrate was associated with a higher risk of incident CKD. Fibrate use was also associated with a lower risk of ESKD and all-cause mortality. Considering the potential long-term benefits, clinicians should not necessarily avoid fibrate use, with careful monitoring of kidney function.

The history and future of online hemodiafiltration and online solutions in North America.

Purpose Of Review: Online hemodiafiltration (OL-HDF) is a type of outpatient intermittent dialysis therapy using purified online dialysis fluid sourced from the city water supply. OL-HDF has been widely practiced in Europe and Japan, and its clinical effects have been reported for prevention of dialysis amyloidosis, inflammation, and dialysis hypotension.

Recent Findings: A randomized controlled trial of all-cause mortality in postdilution OL-HDF and high-flux hemodialysis groups with replacement fluid volumes >23 l/session (CONVINCE study) reported a lower risk of all-cause mortality with OL-HDF compared to conventional hemodialysis.

Ethnicity, Patient Satisfaction, and Clinical Outcomes among Israeli Dialysis Recipients.

Key Points: Growing interest in health-related quality of life underscores the need to explore patient satisfaction among diverse dialysis populations. In this study, patient ethnicity in Israel showed no significant effect on satisfaction, mortality, or transplantation outcomes. Dialysis vintage and patient age were key predictors of satisfaction and survival, highlighting areas for targeted interventions.

The Association of Niacin Use with Kidney Outcomes and Mortality.

Introduction: Niacin is a non-statin lipid-lowering therapy that has been shown to lower triglycerides and improve other risk factors for renal outcomes. Despite these favorable data, the effect of niacin on long-term kidney outcomes remains unclear. The aim of this study was to examine the associations of niacin therapies with incident chronic kidney disease (CKD), end-stage renal disease (ESRD), and death in patients with estimated glomerular filtration rate (eGFR) of at least 60 mL/min/1.

Consensus Report on the Use of Continuous Glucose Monitoring in Chronic Kidney Disease and Diabetes.

This report represents the conclusions of 15 experts in nephrology and endocrinology, based on their knowledge of key studies and evidence in the field, on the role of continuous glucose monitors (CGMs) in patients with diabetes and chronic kidney disease (CKD), including those receiving dialysis. The experts discussed issues related to CGM accuracy, indications, education, clinical outcomes, quality of life, research gaps, and barriers to dissemination. Three main goals of management for patients with CKD and diabetes were identified: (1) greater use of CGMs for better glycemic monitoring and management, (2) further research evaluating the accuracy, feasibility, outcomes, and potential value of CGMs in patients with end-stage kidney disease (ESKD) on hemodialysis, and (3) equitable access to CGM technology for patients with CKD.

Incremental hemodialysis transition in veterans and nonveterans with kidney failure.

Purpose Of Review: Initiation of hemodialysis treatment with a thrice-weekly prescription is currently the standard of care irrespective of patients' residual kidney function (RKF), comorbidities, and preferences.

Recent Findings: Each year ∼12 000 Veterans with advanced kidney disease progress to end-stage kidney disease (ESKD) requiring dialysis and comprise greater than 10% of the US incident ESKD population. Dialysis is costly and is associated with impaired health-related quality of life (HRQOL) and high mortality risk, especially in the first year of treatment.

Practicing health equity in kidney care by establishing improved access to timely disease management and kidney replacement therapy options: from providers to patients.

Purpose Of Review: The aim of this article is to review the current understanding of disparities in healthcare experienced by people living with kidney disease and emerging approaches to address root causes. Health equity for any disease state is an aspirational goal commonly sought out by the medical community, but all too often lacking the understanding and support required to improve the outcomes of people with complex conditions such as chronic kidney disease (CKD).

Recent Findings: The main themes of the literature covered in this article include a review of the structural drivers of healthcare outcomes, a description of research in the fields of health literacy and patient activation for patients with CKD, and an analysis of the examples of healthcare disparities in CKD patients that include involuntary discharges from dialysis facilities as well as the toll taken from dialysis populations during natural disasters.

The humanistic burden of immunoglobulin A nephropathy on patients and care-partners in the United States.

Purpose: This cross-sectional survey study quantified the humanistic burden of immunoglobulin A nephropathy (IgAN), in terms of physical and mental health-related quality of life (HRQoL) and work productivity, among adults with primary IgAN and their care-partners.

Methods: HRQoL was assessed (01/31/22 - 05/31/23) with validated tools including the KDQoL-36 (with SF-12), GAD-7 (anxiety), PHQ-9 (depression), and WPAI: SHP (work productivity). Participant characteristics and total/domain scores were summarized; selected outcomes were compared to an external, kidney disease-free cohort.