BACKGROUND Potential impairment of exercise capacity is prevalent even in patients undergoing hemodialysis without frailty. Cardiopulmonary exercise testing (CPET) can detect physiological reserves such as cardiopulmonary, muscle, and autonomic function. We hypothesized that these indices could accurately determine the prognosis of patients on hemodialysis and analyzed them based on their relationship

BACKGROUND Acute kidney injury (AKI) increases the risk for chronic kidney disease (CKD). We aimed to identify combinations of clinical variables and biomarkers that predict long-term kidney disease risk after AKI. METHODS We analyzed data from a prospective cohort of 723 hospitalized patients with AKI in the Assessment, Serial Evaluation, and Subsequent Sequelae of AKI (ASSESS-AKI) Study. Using machine

Sexual dimorphism plays an important role in the pathogenesis and progression of chronic kidney disease (CKD). Men with CKD often exhibit faster kidney function decline, leading to higher rates of kidney failure and mortality compared to women. Studies suggest that sex hormones may influence this apparent dimorphism, although the mechanisms underlying these influences remain poorly understood. In this

BACKGROUND The Southeastern United States (US) has among the lowest rates of kidney transplantation nationally and has documented racial and socioeconomic disparities in transplant access. We assessed the effectiveness and implementation of a multi-component intervention aimed at increasing access and reducing disparities in access to early transplant steps in Georgia (GA), North Carolina (NC), and

ing/waitlist mortality, considering intentionality and frailty. Methods: We leveraged data on body mass index (BMI), weight loss intentionality, (one-year pre-evaluation and at evaluation), and frailty (four-component Physical Frailty Phenotype at evaluation) for 1,361 candidates (895 listed) with obesity (BMI≥30kg/m2) enrolled in a prospective multi-center cohort study. We estimated the association

An abstract is unavailable. This article is available as a PDF only.

An abstract is unavailable. This article is available as a PDF only.

Health Centers (CHCs) for affordable ambulatory care. Methods: We conducted a retrospective cohort study of 139,275 adults aged 18-64 years who were enrolled in Medicaid or uninsured at time of end-stage kidney disease (ESKD) onset during 2016-2020. We examined whether CHC penetration of the state-level low-income population was associated with ESKD incidence, process measures reflective of pre-ESKD

ebate over payments to donors is discussed with particular emphasis on the national and international ramifications of such payments, the impact on normative “altruistic” donation, and the nature of the relationship between the doctor and the patient in the donor work up process. A way forward is proposed through the promotion of “Financial Neutrality” and expanded efforts to prevent chronic kidney

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d continuous ambulatory peritoneal dialysis (CAPD), automated peritoneal dialysis (APD) and home hemodialysis (HD) with in-center HD patients. Methods: We included 968 patients who entered dialysis in the Helsinki-Uusimaa healthcare district in Finland from 2004 to 2017, of whom 162 were on CAPD, 229 on APD, 145 on home HD and 432 on in-center HD at day 90 from the start of dialysis. MACE was defined

. Methods: We conducted a new user, active comparator cohort study in a United States-based commercial claims database spanning 2013 through 2020 to quantify the comparative risk of fracture associated with select DOACs (apixaban or rivaroxaban) versus warfarin. Individuals were required to have International Classification of Diseases diagnosis codes for CKD (stages 3-5) and atrial fibrillation during

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e P4P) for patients with diabetes or hypertension. These tests must be performed annually by general practitioners (GPs), but are not sufficiently performed, although drug therapies depend on them. We wanted to understand the practice of urinary protein screening assays by means of a qualitative study on the experience of GPs in a French region, with a view to developing facilitating strategies. Methods:

d the first cardiovascular and bleeding events using Korean nationwide cohort data. Methods: Among individuals aged 40–79 years with an estimated glomerular filtration rate between 15 and 59 mL/min/1.73 m2 who underwent routine health examinations between 2011 and 2016, 15,861 individuals who were newly prescribed aspirin at a dose of 100 mg/day were matched with 79,305 aspirin non-users by propensity

atient-reported outcomes in people with non–dialysis-dependent CKD is needed. Background Cardiovascular disease is the leading cause of death in people with CKD. Coronary revascularization can improve cardiac function and prognosis in people with ischemic heart disease; however, in people with CKD, there is concern that potential harms could outweigh benefits of revascularization. Evidence on the balance

bisphosphonates associates with lower incidence of non-vertebral fractures after kidney transplantation. Methods: We conducted a retrospective review for all Southern California Kaiser Permanente kidney transplant recipients with osteoporosis transplanted between 2000 and 2019. Baseline variables were collected. Those prescribed an oral bisphosphonate were compared to those who were not. The primary

An abstract is unavailable.

rogates in APOL1 kidney disease. Background Surrogate end points for the clinical outcome of kidney failure have been accepted by the US Food and Drug Administration. However, they have not been specifically evaluated in Apolipoprotein L1 (APOL1)-associated kidney disease. Methods This random-effects meta-analysis included Black participants in the Atherosclerosis Risk in Communities study (N=3071)

An abstract is unavailable.

An abstract is unavailable.

with insulin response and coincided with persistently greater glucagon levels to oral glucose tolerance testing in CKD.Disruption in the incretin system and glucagon dynamics may contribute to metabolic complications in moderate-to-severe CKD. Background Incretins are regulators of insulin secretion and glucose homeostasis metabolized by dipeptidyl peptidase-4 (DPP-4). CKD may modify incretin release

ere measured by OLINK proteomics platform at baseline and after a median interval of 3-4 years in 106 individuals with type 1 and 77 with type 2 diabetes in two case-control studies. During 10-year follow-up, 31 and 26 individuals, respectively, developed rapid KF. RESULTS: Deltas for 40 proteins predicted rapid KF in both studies. All were better predictors than delta urine albumin-creatinine ratio

listing transplanted January 1st, 2010, to May 31st, 2022 (N=9,178) were included from the Scientific Registry of Transplant Recipients. Recipients were stratified into three groups according to Material Community Deprivation Index score, with greater score representing higher neighborhood socioeconomic deprivation. Outcomes were modeled using multivariable logistic regression and Cox proportional

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ondiabetic renal failure 1 and 2 trials.The CKD Epidemiology Collaboration 2009 and 2021 and European Kidney Function Consortium equations show no significant bias and sufficient accuracy in moderate-to-severe proteinuria. Background Creatinine-based GFR formulas introduce a substantial bias in GFR estimations in patients with frank nephrotic syndrome. The bias and accuracy of creatinine-based GFR

proteins predictive of time to rapid eGFR decline.Seven proteins were predictive of all three outcomes (SEM4A, PSB3, dihydroxyphenylalanine decarboxylase, C1RL1, T132A, pyruvate carboxylase, and C1-esterase inhibitor) and have been implicated in immune regulatory mechanisms, metabolic dysregulation, proteostasis, and cellular signaling pathways.Elastic net Cox proportional hazards model identified

Background: The optimal criteria to select individuals with type 1 diabetes mellitus (T1D) and albuminuric or normoalbuminuric diabetic kidney disease (DKD), who are at risk of rapid kidney function decline, for clinical trials are unclear. Methods: This study analyzed data from the Preventing Early Renal Loss in Diabetes (PERL) clinical trial, which investigated whether allopurinol slowed kidney function

it. We assessed perspectives of AA hemodialysis patients on unique factors impacting dialysis adherence, and use of motivational interviewing, an evidence-based intervention, to improve these factors, dialysis adherence, and outcomes in AAs. Methods: Self-identified AA hemodialysis patients (N=22) watched a brief video describing motivational interviewing and then completed a semi-structured interview

n patients with CKD and albuminuria, with and without type 2 diabetes. Methods: In this post-hoc analysis of the DAPA-CKD trial, 4304 adult patients with CKD were randomized to dapagliflozin 10mg or placebo as adjunct to maximally tolerated renin-angiotensin-system (RAAS) inhibitors. The primary endpoint was a composite of sustained ≥50% decline in estimated glomerular filtration rate, kidney failure

nt waitlisting practices. Background Despite the mortality benefit of kidney transplantation over dialysis, only 13% of patients with ESKD are on the transplant waitlist. Given the low rates of transplant waitlisting in the United States, Medicare launched the ESRD Treatment Choices (ETC) model in 2021, the largest mandatory trial of payment incentives in kidney disease, which randomized 30% of health

ization or change in health. Background The long-term follow-up of living kidney donors is highly variable in Canada. Methods We surveyed perspectives on postdonation follow-up among 685 living donors in the two largest transplant programs in Canada (43% survey response rate). The anonymous survey was informed by semistructured interviews with 12 living kidney donors. The survey was developed on the

l Data System (42%) compared with the National Death Index (22%). Background Cause-specific mortality data from the United States Renal Data System (USRDS) form the basis for identifying cardiovascular disease (CVD), specifically sudden cardiac death (SCD), as the leading cause of death for patients on dialysis. Death certificate data from the National Death Index (NDI) is the epidemiological standard

An abstract is unavailable.

An abstract is unavailable.

k by cardiopulmonary exercise testing can detect decrements in cardiovascular function during early stages of kidney function decline that may not be captured using resting left ventricular geometric indices alone. Background Traditional diagnostic tools that assess resting cardiac function and structure fail to accurately reflect cardiovascular alterations in patients with CKD. This study sought to

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ferent populations. Methods: We conducted a meta-analysis of randomized controlled trials that tested GLP-1 RA treatment vs. placebo in individuals with type 2 diabetes (T2D) or with overweight/obesity status, with or without CKD, with kidney events reported as primary or secondary endpoints. The primary outcome was the occurrence of worsening kidney function, defined as either a doubling of serum

ersus external (e.g., dietary) factors to UA stone propensity is challenging due to uncontrolled diets in outpatients in previously published studies. Methods: This compilation of metabolic studies with body composition examined by dual-energy X-ray absorptiometry (DXA) scan, and blood and urine biochemistry collected under a controlled metabolic diet was conducted across three distinct populations:

tus in this population are needed. Background Pruritus is common in hemodialysis patients. Less is known about the prevalence and outcomes of pruritus among patients receiving peritoneal dialysis (PD). Herein, we describe the prevalence of pruritus and its associations with patient-reported outcomes (PROs) and mortality/transfer to hemodialysis. Methods We analyzed a multicenter, international cohort

large diverse patient population in the United States. Methods: A cross-sectional study (2010-2021) was performed within an integrated health system in patients (age ≥18yrs) with biopsy-proven FSGS. Among biopsies with FSGS as the first diagnosis on pathology report, chart reviews were performed to determine primary FSGS, defined as podocyte foot process effacement ≥80% on electron microscopy. The

ts not waitlisted for transplant and with the highest predicted 5-year survival, there was a deficit of screening compared with waitlisted patients. Background The Choosing Wisely campaign suggests an individualized approach to cancer screening among patients receiving dialysis. We aimed to evaluate breast and prostate cancer screening among patients receiving maintenance hemodialysis by kidney transplant

ansporter 2 inhibitor therapy compared favorably with glucagon-like peptide-1 receptor agonists for kidney disease outcomes. Background CKD is a serious diabetes-related complication. While guidelines recommend use of sodium-glucose cotransporter 2 inhibitor (SGLT2i) and glucagon-like peptide-1 receptor agonist (GLP-1RA) therapies to mitigate cardiorenal risk in high-risk patients, the benefit of early

most switching to cinacalcet.These findings have US policy implications not only for etelcalcetide and parathyroid hormone but also for future development of innovative therapies in dialysis. Background Calcimimetics, including intravenous etelcalcetide and oral cinacalcet, are often prescribed to hemodialysis patients to prevent complications of elevated parathyroid hormone (PTH) levels. In January

An abstract is unavailable.

An abstract is unavailable. This article is available as a PDF only.

tor receptor were each individually associated with mortality, independent of baseline kidney measures. Background Several plasma biomarkers of kidney health have been associated with CKD progression in persons with diabetes, but their associations with mortality risk have been largely unexplored. Methods In a random sample of 594 participants with diabetes and creatinine-based eGFR <60 ml/min per

inine ratio (UACR). This enables the cost-effectiveness analysis of empagliflozin in subgroups stratified by these two parameters. Methods: A cost-utility analysis using the Markov model was performed to evaluate the cost-effectiveness of adding empagliflozin to the standard treatment for CKD in Japan over 20 years of observation. Each cohort with the initial eGFR (≥45 but <60 ml/min per 1.73 m2, ≥30

he effect of donation on future pregnancies and of pregnancy-related complications on postdonation outcomes. In February 2023, the American Society of Transplantation Women's Health Community of Practice held a virtual Controversies Conference on reproductive health, contraception, and pregnancy after transplantation and living donation. Experts in the field presented the available data. Smaller breakout