1,721,116 research outputs found
Pseudo-AKI associated with targeted anti-cancer agents-the truth is in the eye of the filtration marker
No full textBesides true acute kidney injury (AKI), the occurrence of pseudo-AKI has been associated with several targeted agents. To improve the management of cancer patients treated with targeted agents, we need to be aware of this and use diagnostic approaches to differentiate between pseudo-AKI and AKI. In an article by Wijtvliet et al. in this issue of CKJ, tepotinib is added to the list of targeted agents associated with pseudo-AKI. In this editorial we discuss the current literature regarding pseudo-AKI and true AKI associated with targeted agents, and subsequently propose a management strategy to monitor kidney function in patients treated with targeted agents
Testing the functional reserve of the kidney before hematopoietic stem cell transplantation: doubt remains
No full textAcute kidney injury is a common and important complication following hematopoietic stem cell transplantation. In the nephrology community, acute kidney injury is no longer viewed as a simple temporary and potentially reversible decline in kidney clearance as acute kidney injury imposes a risk for immediate and future complications. Therefore, stratifying patients for the risk of acute kidney injury following stem cell transplantation would be very helpful to optimize peri-stem cell transplant management and could potentially improve outcomes in this patient population. In the current issue of CKJ, Mancianti et al. report on the testing of the kidney's functional reserve in patients planned for stem cell transplantation and demonstrate that stem cell transplant candidates with a preserved kidney response on a protein load had a higher chance of full kidney recovery after an episode of acute kidney injury. In this editorial, we discuss the kidney's functional reserve test and its limitations
Chemotherapy in patients with severely reduced glomerular filtration rate: challenges and a call for improvement
No full textPrognosis and Outcomes of Acute and Chronic Tubulointerstitial Nephritis
No full textTubulointerstitial nephritis (TIN) is a rare heterogenous kidney disease and outcomes depend upon many factors including patient characteristics, clinical presentation and histopathological features on kidney biopsy. When considering short-term kidney outcomes, about 20% of adult patients with acute TIN will require dialysis, although many will fully or partially recover without need for maintenance kidney replacement therapy. However, current evidence suggests that long-term kidney outcomes of patients with TIN are far less favorable than originally thought. Risk factors for adverse kidney outcomes include patient characteristics (e.g., older age, hypertension), a higher degree of proteinuria, recurrent acute TIN episodes and signs of disease chronicity or granulomatous interstitial nephritis on kidney biopsy. Pediatric patients have a better long-term prognosis, although a significant proportion of patients will develop CKD as well. In general, drug-induced acute TIN has a better prognosis when compared with autoimmune etiologies, particularly if the inciting drug is discontinued early in the disease course and re-exposure is avoided. Autoimmune etiologies frequently cause CKD, partially because they are associated with recurrent acute TIN episodes. In this review, we summarize the available data regarding prognosis and outcomes of acute and chronic TIN for various etiologies of TIN. (c) 2025 by the National Kidney Foundation, Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies
Kidney Transplantation in Patients With Monoclonal Gammopathy of Renal Significance
No full textMonoclonal gammopathy of renal significance (MGRS) defines disorders characterized by direct or indirect kidney injury caused by a monoclonal immunoglobulin produced by a B-cell or plasma-cell clone that does not meet current hematologic criteria for therapy. MGRS-associated kidney diseases are diverse and can result in the development of end stage kidney disease. The current paradigm states that the underlying hematologic condition should be treated and in deep remission before kidney transplantation can be performed because recurrence has been reported for all MGRS-associated kidney diseases. However, we suggest that decisions regarding kidney transplantation in MGRS patients should be individualized considering many factors such as the subtype of MGRS-associated kidney disease, patient age and comorbidity, presence and risk of extrarenal complications, estimated waiting time, the availability of a living kidney donor, and previous hematological treatment and response. Thus, kidney transplantation should be considered even in treatment-naive patients, with hematological treatment initiated after successful kidney transplantation.Financial Disclosure: Dr. Dispenzieri reports other from Alnylam, other from Intellia, other from Janssen, grants
from Takeda, grants from Pfizer, grants from Prothena, grants from Celgene, grants from Alnylam, grants from
Janssen, outside the submitted work; Dr. Gertz reports personal fees from reports personal fees from Ionis/Akcea,
personal fees from Alnylam, personal fees from Prothena, personal fees from Sanofi, personal fees from Janssen,
grants and personal fees from Spectrum, personal fees from Annexon, personal fees from Appellis, personal fees
from Amgen, personal fees from Medscape, personal fees from Physicians Education Resource, personal fees
for Data Safety Monitoring board from Abbvie, and Celgene personal fees from Research to Practice, Speaker
fees from Johnson and Johnson; Speaker fees from Medscape, Speaker fees DAVA oncology; Advisory Board for
Pharmacyclics Advisory Board for Proclara outside the submitted work; Development of educational materials
for i3Health, outside the submitted work; Dr. Kapoor reports grants from Amgen, Takeda, GSK, Sanofi, AbbVie,
personal fees from Cellectar, Pharmacyclics, Karyopharm, Sanofi, GSK, outside the submitted work; Dr. Kumar
reports grants and other from Abbvie, grants and other from Celgene, grants and other from Janssen, grants
and other from Takeda, grants and other from Adaptive, grants and other from KITE, grants and other from
Medimmune/Astra Zeneca, grants from Merck, grants from Novartis, grants from Roche, grants from Sanofi, other
from Oncopeptides, outside the submitted work; Dr. Leung reports other from Takeda, other from AbbVie, personal
fees from Aduro, outside the submitted work; Dr. Murray has a patent Patents on the Use of Mass Spec for plasma
cell diseases licensed to The Binding Site
Diagnosis and management of immune checkpoint inhibitor-associated acute kidney injury
No full textImmune checkpoint inhibitors are increasingly used as anti-cancer treatments; however, their use can be associated with the development of immune-related adverse events, including acute kidney injury. This Review describes the symptoms, biochemical signs and possible underlying mechanisms of immune checkpoint inhibitor-associated acute kidney injury, and proposes an approach to its diagnosis and management. Since their introduction into clinical practice a decade ago, immune checkpoint inhibitors (ICIs) have had an overwhelming impact on cancer treatment. Use of these agents in oncology continues to grow; however, the increased use of these agents has been associated with a parallel increase in ICI-associated immune-related adverse events, which can affect virtually any organ, including the kidneys. ICI-associated acute kidney injury (ICI-AKI) occurs in 2-5% of patients treated with ICIs. Its occurrence can have important consequences, including the temporary or permanent discontinuation of ICIs or other concomitant anticancer therapies and the need for prolonged treatment with corticosteroids. Various mechanisms have been proposed to underlie the development of ICI-AKI, including loss of tolerance to self-antigens, reactivation of drug-specific effector T cells, and the production of kidney-specific autoantibodies. ICI-AKI most commonly manifests as acute tubulo-interstitial nephritis on kidney biopsy and generally shows a favourable response to early initiation of corticosteroids, with complete or partial remission achieved in most patients. The evaluation of patients with suspected ICI-AKI requires careful diagnostic work-up and kidney biopsy for patients with moderate-to-severe ICI-AKI to ensure accurate diagnosis and inform appropriate treatment.B.S. is a senior clinical investigator of The Research Foundation Flanders (F.W.O. 1842919N) and receives funding from the Foundation against Cancer (Stichting tegen Kanker; C/2020/1380). D.E.L. is funded by National Institutes of Health grants R01HL144566, R01DK125786 and R01DK126685. M.J.S. is funded by Fondo de Investigación Sanitaria-FEDER, ISCIII, PI17/00257, REDINREN, RD16/0009/0030 and EIN2020-112338. We would like to thank Albert Herelixka, University Hospitals Leuven, Belgium, for drawing the figures included in the original submission of this manuscript
Combined creatinine/cystatin C equations for estimation of GFR in patients with cancer: the future is now!
No full textRevisiting the role of acute kidney injury in patients on immune checkpoint inhibitors: a good prognosis renal event with a significant impact on survival
No full textIn the last decade, immune checkpoint inhibitors (ICI) have become a cornerstone in the treatment of a wide range of malignancies. It is well established that ICI are associated with multiple immune-related adverse events, a spectrum of autoimmune toxicities, that can also affect the kidney. In this issue of Clinical Kidney Journal, Kanbay et al. report the first meta-analysis and systematic review evaluating the impact of ICI-related acute kidney injury (ICI-AKI) on long-term kidney and patient outcomes (including mortality). The authors report a high incidence of ICI-AKI (mostly mild AKI episodes) with high rates of recovery resulting in a good kidney outcomes. However, the occurrence of ICI-AKI has a significant impact on mortality in ICI-treated patients probably related to temporary or definitive cessation of ICI. Additional studies are needed to establish the safety of ICI re-challenging in patients with ICI-AKI, and to determine the optimal treatment strategy for them
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
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