Development of a Natural Language Processing Model for Extracting Kidney Biopsy Pathology Diagnoses.

Rationale & Objective: Kidney biopsy reports are in a nonindexed text format, and the diagnosis requires labor-intensive manual abstraction. Natural language processing (NLP) has not been rigorously tested for kidney biopsy diagnosis extraction. Our objective was to develop an accurate model to extract the biopsy diagnosis from free-text reports.

Clinical Phenotypes and Renal Outcomes in PLA2R-Associated Membranous Nephropathy: A Multi-Center Cohort Study with Unsupervised Cluster Analysis.

Background: Membranous nephropathy (MN) associated with phospholipase A2 receptor (PLA2R) antibodies is the most common cause of nephrotic syndrome in non-diabetic adult patients. This study investigated the relationship between clinical phenotypes and renal outcomes in this population, emphasizing the potential for phenotype-based treatment stratification.

Methods: We conducted a retrospective, multi-center cohort study of PLA2R-positive MN.

eGFR Inaccuracy in the Assessment of Living Kidney Transplant Donor Eligibility.

Background: Accurate glomerular filtration rate (GFR) estimation is crucial for evaluating living kidney donors, especially when measured GFR (mGFR) is unavailable. This study compares the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), full age spectrum (FAS), and European Kidney Function Consortium (EKFC) creatinine- and/or cystatin C-based estimated GFR (eGFR) equations against iohexol mGFR to determine the optimal equation for donor eligibility assessment in a US population.

Methods: 1210 kidney donor candidates were retrospectively analyzed, comparing eGFR equations based on creatinine, cystatin C, or both against iohexol mGFR.

The Clinical and Pathological Characteristics of Patients with Proliferative Glomerulonephritis with Monoclonal Immunoglobulin Deposits.

Introduction: Proliferative glomerulonephritis with monoclonal immunoglobin (Ig) deposits (PGNMID) is a rare form of kidney disease associated with low monoclonal protein detection rates and poor renal outcomes. The lack of effective therapy is partly due to limited data and understanding of its pathogenesis.

Methods: We conducted a retrospective analysis of 18 patients with PGNMID from the Cleveland Clinic Kidney Biopsy Epidemiology Project from January 2015 to March 2023.

Double Trouble in the Basement! A Case of PLA2R-Associated Membranous Nephropathy with Atypical Anti-Glomerular Basement Membrane Disease.

Introduction: Concurrent atypical anti-glomerular basement membrane (anti-GBM) disease with membranous nephropathy is a rare occurrence. Compared to typical anti-GBM disease, atypical anti-GBM disease is often seronegative, with a mild disease presentation and course. We present a case of concomitant of PLA2R-associated membranous nephropathy and atypical anti-GBM disease in a patient with cholangiocarcinoma.

The Clinical and Pathological Characteristics of Patients with Oxalate Nephropathy.

Key Points: Oxalate nephropathy is an underrecognized cause of CKD and ESKD. We present one of the largest native oxalate nephropathy cohorts to date from a tertiary care institution in the United States. Oxalate nephropathy has multiple etiologies and given its clinical course and poor prognosis, attention must be paid to screening for risk factors to guide prompt diagnosis and management.

Genetic Susceptibility to Chronic Kidney Disease: Links, Risks and Management.

Chronic kidney disease (CKD) is associated with significant morbidity and mortality worldwide. In recent years, our understanding of genetic causes of CKD has expanded significantly with several renal conditions having been identified. This review discusses the current landscape of genetic kidney disease and their potential treatment options.

The Cleveland Clinic Kidney Biopsy Epidemiological Project.

Background: The kidney biopsy is the gold standard for diagnosing glomerular diseases. Large-scale, epidemiologic studies describing the prevalence of kidney diseases are lacking, especially in the United States. We aimed to determine the spectrum of biopsy-proven kidney disease across the Cleveland Clinic enterprise.

Maintenance of Remission and Risk of Relapse in Myeloperoxidase-Positive ANCA-Associated Vasculitis with Kidney Involvement.

Background: The optimal strategy for remission-maintenance therapy in patients with myeloperoxidase-ANCA (MPO-ANCA)-associated vasculitis is not established. Defining parameters to guide maintenance therapy is required.

Methods: This was a retrospective cohort study of all patients with MPO-ANCA-associated vasculitis (microscopic with polyangiitis and granulomatosis with polyangiitis) and GN followed at the Mayo Clinic between 1996 and 2015.

Ketogenic-Diet Shake Containing -Associated Acute Interstitial Nephritis.

is a plant that has been used in traditional medicine for its anti-inflammatory, immunomodulatory, and immunostimulant properties. As a result, it can be found in several over-the-counter supplements worldwide. Acute interstitial nephritis (AIN) can be due to an offending medication, infection, or autoimmunity.

Lupus nephritis - An update on disparities affecting african americans.

Lupus Nephritis is a complex clinical manifestation of systemic lupus erythematosus (SLE) associated with significant morbidity and mortality. It disproportionately affects minorities, especially African Americans (AA) with higher rates of progression to end stage kidney disease. Several factors are implicated including genetic predisposition to both SLE and chronic kidney disease, social determinants of health such as income inequality, education disparities, social isolation/lack of support, health care access and affordability.

Noninvasive Diagnosis of PLA2R-Associated Membranous Nephropathy: A Validation Study.

Background And Objectives: Kidney biopsy is the current gold standard to diagnose membranous nephropathy. Approximately 70%-80% of patients with primary membranous nephropathy have circulating anti-phospholipase A2 receptor antibodies. We previously demonstrated that in proteinuric patients with preserved eGFR and absence of associated conditions ( autoimmunity, malignancy, infection, drugs, and paraproteinemia), a positive anti-phospholipase A2 receptor antibody test by ELISA and immunofluorescence assay confirms the diagnosis of membranous nephropathy noninvasively.

Recurrent Glomerulonephritis in the Kidney Allograft.

Renal transplantation is the preferred form of renal replacement therapy in patients who develop end-stage kidney disease (ESKD). Among the diverse etiologies of ESKD, glomerulonephritis is the third most common cause, behind hypertensive and diabetic kidney disease. Although efforts to prolong graft survival have improved over time with the advent of novel immunosuppression, recurrent glomerulonephritis remains a major threat to renal allograft survival despite concomitant immunosuppression.

A Target Antigen-Based Approach to the Classification of Membranous Nephropathy.

Objective: To describe the clinical and pathological phenotype of membranous nephropathy (MN) associated with M-type-phospholipase-A-receptor (PLAR), thrombospondin-type-1-domain-containing-7A (THSD7A), semaphorin 3B (SEMA3B), neural-epidermal-growth-factor-like-1-protein (NELL-1), protocadherin 7 (PCDH7), exostosin 1/exostosin 2 (EXT1/EXT2) and neural cell adhesion molecule 1 (NCAM-1) as target antigens.

Methods: A retrospective cohort of 270 adult patients with biopsy-proven MN diagnosed between January 2015 and April 2020 was classified as PLAR-, THSD7A-, SEMA3B-, NELL-1-, PCDH7-, EXT1/EXT2-, NCAM-1-associated or septuple-negative MN using serologic tests, immunostaining, and/or mass spectrometry. Clinical, biochemical, pathologic, and follow-up data were systematically abstracted from the medical records, including disease activity of conditions traditionally associated with MN and occurring within 5 years of MN diagnosis.

New-onset atrial fibrillation in patients with acute kidney injury on continuous renal replacement therapy.

Purpose: The mortality of critically ill patients with acute kidney injury (AKI) who require continuous renal replacement therapy (CRRT) remains high. We assessed the incidence and predictors of new-onset atrial fibrillation (NOAF) in this population and its impact on outcomes.

Materials And Methods: This is a retrospective cohort study of adult intensive care units (ICU) patients who had AKI and received CRRT from December 2006 through November 2015 in a tertiary academic medical center.

Recurrence of DNAJB9-Positive Fibrillary Glomerulonephritis After Kidney Transplantation: A Case Series.

Rationale & Objective: Fibrillary glomerulonephritis (FGN) is a rare glomerular disease that often progresses to kidney failure requiring kidney replacement therapy. We have recently identified a novel biomarker of FGN, DnaJ homolog subfamily B member 9 (DNAJB9). In this study, we used sequential protocol allograft biopsies and DNAJB9 staining to help characterize a series of patients with native kidney FGN who underwent kidney transplantation.

The association of microhematuria with mesangial hypercellularity, endocapillary hypercellularity, crescent score and renal outcomes in immunoglobulin A nephropathy.

Background: Microhematuria is common in immunoglobulin A nephropathy (IgAN). However, current prognostication is based on proteinuria and mesangial hypercellularity, endocapillary hypercellularity, segmental sclerosis, tubulointerstitial fibrosis and crescent (MEST-C) scores.

Methods: In this retrospective study, we evaluated whether MEST-C score components are associated with the presence of microhematuria at biopsy and whether the degree of microhematuria during follow-up is associated with change in estimated glomerular filtration rate (eGFR), after adjusting for clinical and histological parameters.

Senolytics decrease senescent cells in humans: Preliminary report from a clinical trial of Dasatinib plus Quercetin in individuals with diabetic kidney disease.

Background: Senescent cells, which can release factors that cause inflammation and dysfunction, the senescence-associated secretory phenotype (SASP), accumulate with ageing and at etiological sites in multiple chronic diseases. Senolytics, including the combination of Dasatinib and Quercetin (D + Q), selectively eliminate senescent cells by transiently disabling pro-survival networks that defend them against their own apoptotic environment. In the first clinical trial of senolytics, D + Q improved physical function in patients with idiopathic pulmonary fibrosis (IPF), a fatal senescence-associated disease, but to date, no peer-reviewed study has directly demonstrated that senolytics decrease senescent cells in humans.

Noninvasive diagnosis of primary membranous nephropathy using phospholipase A2 receptor antibodies.

Kidney biopsy is the gold standard to diagnose membranous nephropathy (MN). Approximately 70%-80% of patients with primary MN have anti-phospholipase A2 receptor (PLA2R) antibodies. We hypothesized that PLA2R antibody testing without kidney biopsy may be a valid strategy to make a non-invasive diagnosis of MN in patients with a negative work-up for secondary causes.