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Chronic kidney disease (CKD) is a growing concern in aging populations. CKD is characterized by two hallmark symptoms: a decline in the glomerular filtration rate (GFR) and albuminuria. Early changes in kidney function are notoriously underdiagnosed, suggesting the need for new noninvasive diagnostic and prognostic biomarkers of CKD. Thus, analysis of urinary extracellular vesicles (uEVs) may broaden the diagnostic options for CKD. EVs are a heterogeneous group of particles, enclosed by a lipid bilayer, which differ in size, biogenesis, and function. EVs can be readily recovered from the urine (urinary EVs, uEVs), where they are derived from various cells of the kidney, bladder, prostate, and utero-vaginal tract. Within the kidney, EVs are released by almost all cell types, including but not limited to podocytes, cells of the proximal and distal tubules, the collecting duct, and the loop of Henle. In addition to specific markers of parental cells, uEVs carry mRNAs, miRNAs, and proteins. Thus, analysis of uEVs may provide insights into the content and composition of the specific cells from which they are released, leading to the identification of new diagnostic and prognostic biomarkers for kidney diseases of different etiologies. This review provides an overview of kidney disease-related changes in uEV size and concentration and covers the potential of uEVs as new biomarkers for various types of kidney disease.
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http://dx.doi.org/10.1093/ckj/sfaf189 | DOI Listing |
J Am Soc Nephrol
September 2025
Department of Biochemistry and Molecular Biology, Mayo Clinic, Rochester, MN, USA.
Background: Genetic modifiers are believed to play an important role in the onset and severity of polycystic kidney disease (PKD), but identifying these modifiers has been challenging due to the lack of effective methodologies.
Methods: We generated zebrafish mutants of IFT140, a skeletal ciliopathy gene and newly identified autosomal dominant PKD (ADPKD) gene, to examine skeletal development and kidney cyst formation in larval and juvenile mutants. Additionally, we utilized ift140 crispants, generated through efficient microhomology-mediated end joining (MMEJ)-based genome editing, to compare phenotypes with mutants and conduct a pilot genetic modifier screen.
JCI Insight
September 2025
Division of Nephrology, Boston University Chobanian & Avedisian School of Medicine, Boston, United States of America.
Background: Active vitamin D metabolites, including 25-hydroxyvitamin D (25D) and 1,25-dihydroxyvitamin D (1,25D), have potent immunomodulatory effects that attenuate acute kidney injury (AKI) in animal models.
Methods: We conducted a phase 2, randomized, double-blind, multiple-dose, 3-arm clinical trial comparing oral calcifediol (25D), calcitriol (1,25D), and placebo among 150 critically ill adult patients at high-risk of moderate-to-severe AKI. The primary endpoint was a hierarchical composite of death, kidney replacement therapy (KRT), and kidney injury (baseline-adjusted mean change in serum creatinine), each assessed within 7 days following enrollment using a rank-based procedure.
Clin J Am Soc Nephrol
September 2025
University College London Great Ormond Street Hospital for Children and Institute of Child Health, London, UK.
Background: Experience with icodextrin use in children on long-term peritoneal dialysis is limited. We describe international icodextrin prescription practices and their impact on clinical outcomes: ultrafiltration, blood pressure control, residual kidney function (RKF), technique and patient survival.
Methods: We included patients under 21 years enrolled in the International Pediatric Peritoneal Dialysis Network (IPPN) between 2007 and 2024, on automated PD with a daytime dwell.
Clin J Am Soc Nephrol
September 2025
Division of Nephrology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland USA.
Socioeconomic, environmental and lifestyle factors shape kidney health. Among the social determinants of health, access to healthy foods is particularly significant. As a basic need, food is integral to an individual's identity, culture, and health.
View Article and Find Full Text PDFClin J Am Soc Nephrol
September 2025
Kidney Division, Peking University First Hospital, Peking University Institute of Nephrology; Key Laboratory of Kidney Disease, Ministry of Health of China; Key Laboratory of Chronic Kidney Disease Prevention and Treatment (Peking University), Ministry of Education, China.
Background: The Therapeutic Effects of Steroids in IgA Nephropathy Global (TESTING) trial demonstrated that glucocorticoid therapy reduced proteinuria and improved kidney outcomes in patients with Immunoglobulin A Nephropathy (IgAN). Galactose-deficient IgA1 (Gd-IgA1) plays a central role in IgAN pathogenesis by promoting immune complex formation. However, the effects of glucocorticoid on pathogenic IgA levels remain unclear.
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