Advances in Nephrology

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: 31 May 2024 | Viewed by 8795

Special Issue Editor

Special Issue Information

Dear Colleagues,

Acute kidney injury (AKI) is a widespread, epidemic-level problem. AKI is becoming more common in hospitalized patients with acute illnesses and those undergoing major surgery, according to compelling evidence. AKI's consequences are severe, with an increased risk of short- and long-term mortality, incident CKD, and accelerated progression to end-stage renal disease (ESRD).

Chronic kidney disease (CKD) is a major component of noncommunicable chronic diseases, which have reached pandemic proportions and are the leading cause of morbidity and mortality worldwide. Patients with impaired renal function are at increased risk not only of kidney disease progression and the development of ESRD but also of cardiovascular disease and mortality. Unfortunately, CKD is underdiagnosed and undertreated, resulting in missed opportunities for clinical improvement. Early detection and appropriate interventions will improve patient care and prevent or delay progression to ESRD.

We welcome papers in this Special Issue that investigate novel biomarkers, pathophysiological mechanisms, and novel treatments in patients with AKI or CKD.

Prof. Dr. Marijn M. Speeckaert
Guest Editor

Manuscript Submission Information

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Published Papers (4 papers)

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Research

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13 pages, 2818 KiB  
Article
Ratio of Extracellular to Intracellular Water Is Associated with Permanent Catheter Patency Survival in Patients Receiving Maintenance Hemodialysis
by Moo-Jun Kim, Jae-Wan Jeon, Hae-Ri Kim, Hyerim Park, Suyeon Han, Yunkyeong Hwang, Heewon Park, Kyungho Park, Eu-Jin Lee, Young-Rok Ham, Ki-Ryang Na, Kang-Wook Lee and Dae-Eun Choi
Diagnostics 2023, 13(15), 2545; https://doi.org/10.3390/diagnostics13152545 - 31 Jul 2023
Cited by 1 | Viewed by 784
Abstract
Patients undergoing dialysis through a permanent catheter often experience infection or malfunction. However, few studies have clarified the predictors of permanent catheter patency survival in patients undergoing hemodialysis. We assessed the relationship between the parameters of body composition monitoring (BCM), determined before the [...] Read more.
Patients undergoing dialysis through a permanent catheter often experience infection or malfunction. However, few studies have clarified the predictors of permanent catheter patency survival in patients undergoing hemodialysis. We assessed the relationship between the parameters of body composition monitoring (BCM), determined before the initiation of dialysis, and the patency survival of the permanent catheters inserted in 179 patients who commenced hemodialysis between 14 January 2020 and 31 August 2021. The relationships between permanent catheter patency at 6 weeks and BCM parameters, laboratory tests, age, sex, comorbidities, and medications at baseline were studied using Kaplan–Meier survival curves. Permanent catheter patency was observed to be superior at high extracellular-to-intracellular (ECW/ICW) ratio (p < 0.005). After adjustment for covariates, the ECW/ICW ratio remained an independent factor associated with permanent catheter patency survival. When patients with non-patent catheters were subdivided into infection and malfunction groups, and the associations of BCM parameters were evaluated in those groups, the ECW/ICW ratio was not significantly associated with permanent catheter patency survival in the infection group (p = 0.327); instead, a significant association was found for the lean tissue index (p < 0.001). In the malfunction group, the ECW/ICW ratio remained significantly associated with permanent catheter patency survival (p < 0.001). Full article
(This article belongs to the Special Issue Advances in Nephrology)
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17 pages, 1110 KiB  
Article
Potential of Urine Biomarkers CHI3L1, NGAL, TIMP-2, IGFBP7, and Combinations as Complementary Diagnostic Tools for Acute Kidney Injury after Pediatric Cardiac Surgery: A Prospective Cohort Study
by Wim Vandenberghe, Jorien De Loor, Katrien Francois, Kristof Vandekerckhove, Ingrid Herck, Johan Vande Walle, Harlinde Peperstraete, Thierry Bové, Daniël De Wolf, Lieve Nuytinck, Jan J. De Waele, Evelyne Meyer and Eric A. J. Hoste
Diagnostics 2023, 13(6), 1047; https://doi.org/10.3390/diagnostics13061047 - 09 Mar 2023
Cited by 1 | Viewed by 1676
Abstract
Acute kidney injury (AKI) is common after pediatric cardiac surgery (CS). Several urine biomarkers have been validated to detect AKI earlier. The objective of this study was to evaluate urine CHI3L1, NGAL, TIMP-2, IGFBP7, and NephroCheck® as predictors for AKI ≥ 1 [...] Read more.
Acute kidney injury (AKI) is common after pediatric cardiac surgery (CS). Several urine biomarkers have been validated to detect AKI earlier. The objective of this study was to evaluate urine CHI3L1, NGAL, TIMP-2, IGFBP7, and NephroCheck® as predictors for AKI ≥ 1 in pediatric CS after 48 h and AKI ≥ 2 after 12 h. Pediatric patients (age < 18 year; body weight ≥ 2 kg) requiring CS were prospectively included. Urine CHI3L1, NGAL, TIMP-2, IGFBP7, and NephroCheck® were measured during surgery and intensive care unit (ICU) stay and corrected for urine dilution. One hundred and one pediatric patients were included. AKI ≥ 1 within 48 h after ICU admission occurred in 62.4% and AKI ≥ 2 within 12 h in 30.7%. All damage biomarkers predicted AKI ≥ 1 within 48 h after ICU admission, when corrected for urine dilution: CHI3L1 (AUC-ROC: 0.642 (95% CI, 0.535–0.741)), NGAL (0.765 (0.664–0.848)), TIMP-2 (0.778 (0.662–0.868)), IGFBP7 (0.796 (0.682–0.883)), NephroCheck® (0.734 (0.614–0.832)). Similarly, AKI ≥ 2 within 12 h was predicted by all damage biomarkers when corrected for urine dilution: uCHI3L1 (AUC-ROC: 0.686 (95% CI, 0.580–0.780)), NGAL (0.714 (0.609–0.804)), TIMP-2 (0.830 (0.722–0.909)), IGFBP7 (0.834 (0.725–0.912)), NephroCheck® (0.774 (0.658–0.865)). After pediatric cardiac surgery, the damage biomarkers urine CHI3L1, NGAL, TIMP-2, IGFBP7, and NephroCheck® reliably predict AKI after correction for urine dilution. Full article
(This article belongs to the Special Issue Advances in Nephrology)
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Review

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42 pages, 2355 KiB  
Review
Unveiling the Hidden Power of Uromodulin: A Promising Potential Biomarker for Kidney Diseases
by Raïsa Thielemans, Reinhart Speeckaert, Charlotte Delrue, Sander De Bruyne, Matthijs Oyaert and Marijn M. Speeckaert
Diagnostics 2023, 13(19), 3077; https://doi.org/10.3390/diagnostics13193077 - 28 Sep 2023
Cited by 2 | Viewed by 3068
Abstract
Uromodulin, also known as Tamm-Horsfall protein, represents the predominant urinary protein in healthy individuals. Over the years, studies have revealed compelling associations between urinary and serum concentrations of uromodulin and various parameters, encompassing kidney function, graft survival, cardiovascular disease, glucose metabolism, and overall [...] Read more.
Uromodulin, also known as Tamm-Horsfall protein, represents the predominant urinary protein in healthy individuals. Over the years, studies have revealed compelling associations between urinary and serum concentrations of uromodulin and various parameters, encompassing kidney function, graft survival, cardiovascular disease, glucose metabolism, and overall mortality. Consequently, there has been a growing interest in uromodulin as a novel and effective biomarker with potential applications in diverse clinical settings. Reduced urinary uromodulin levels have been linked to an elevated risk of acute kidney injury (AKI) following cardiac surgery. In the context of chronic kidney disease (CKD) of different etiologies, urinary uromodulin levels tend to decrease significantly and are strongly correlated with variations in estimated glomerular filtration rate. The presence of uromodulin in the serum, attributable to basolateral epithelial cell leakage in the thick ascending limb, has been observed. This serum uromodulin level is closely associated with kidney function and histological severity, suggesting its potential as a biomarker capable of reflecting disease severity across a spectrum of kidney disorders. The UMOD gene has emerged as a prominent locus linked to kidney function parameters and CKD risk within the general population. Extensive research in multiple disciplines has underscored the biological significance of the top UMOD gene variants, which have also been associated with hypertension and kidney stones, thus highlighting the diverse and significant impact of uromodulin on kidney-related conditions. UMOD gene mutations are implicated in uromodulin-associated kidney disease, while polymorphisms in the UMOD gene show a significant association with CKD. In conclusion, uromodulin holds great promise as an informative biomarker, providing valuable insights into kidney function and disease progression in various clinical scenarios. The identification of UMOD gene variants further strengthens its relevance as a potential target for better understanding kidney-related pathologies and devising novel therapeutic strategies. Future investigations into the roles of uromodulin and regulatory mechanisms are likely to yield even more profound implications for kidney disease diagnosis, risk assessment, and management. Full article
(This article belongs to the Special Issue Advances in Nephrology)
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27 pages, 1369 KiB  
Review
Urinary Extracellular Vesicles in Chronic Kidney Disease: From Bench to Bedside?
by Charlotte Delrue, Sander De Bruyne, Reinhart Speeckaert and Marijn M. Speeckaert
Diagnostics 2023, 13(3), 443; https://doi.org/10.3390/diagnostics13030443 - 26 Jan 2023
Cited by 11 | Viewed by 2429
Abstract
Extracellular vesicles are a diverse group of particles that include exosomes, microvesicles, and apoptotic bodies and are defined by size, composition, site of origin, and density. They incorporate various bioactive molecules from their cell of origin during formation, such as soluble proteins, membrane [...] Read more.
Extracellular vesicles are a diverse group of particles that include exosomes, microvesicles, and apoptotic bodies and are defined by size, composition, site of origin, and density. They incorporate various bioactive molecules from their cell of origin during formation, such as soluble proteins, membrane receptors, nucleic acids (mRNAs and miRNAs), and lipids, which can then be transferred to target cells. Extracellular vesicles/exosomes have been extensively studied as a critical factor in pathophysiological processes of human diseases. Urinary extracellular vesicles could be a promising liquid biopsy for determining the pattern and/or severity of kidney histologic injury. The signature of urinary extracellular vesicles may pave the way for noninvasive methods to supplement existing testing methods for diagnosing kidney diseases. We discuss the potential role of urinary extracellular vesicles in various chronic kidney diseases in this review, highlighting open questions and discussing the potential for future research. Full article
(This article belongs to the Special Issue Advances in Nephrology)
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