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Diagnostics
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Current Issues on Kidney Diseases Diagnosis and Management
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Current Issues on Kidney Diseases Diagnosis and Management

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Clinical Laboratory Medicine".

Deadline for manuscript submissions: closed (31 March 2023) | Viewed by 13662

Special Issue Editor

Prof. Dr. Luis Yu

E-Mail Website
Guest Editor
Nephrology Division, School of Medicine, University of São Paulo, São Paulo 01246-903, SP, Brazil
Interests: AKI; dialysis; glomerulopathies; education

Special Issue Information

Dear Colleagues,

The kidneys are very important in mantaining fluid homeostasis and filtrate wastes from the body. It is estimated that around 10% of the world’s population is living with chronic kidney disease (CKD). This morbid and mortal condition affects people of all ages and races. In addition, CKD varies according to regions and countries around the globe; however, it is specially ominous in disadvantaged populations, where socio-economic factors and poor and limited access to medical care may further aggravate the CKD burden.

Many kidney diseases and morbid conditions may lead to acute kidney injury (AKI) and/or CKD. Several renal diseases, such as glomerulopathies, polycistic kidney disease, post-infectious glomerulonephritis, vasculitis, and renal involvement in systemic diseases, along with arterial hypertension, diabetes, and obesity, may cause temporary or definite renal impairment.

For this reason, this Special Issue wishes to gather relevant scientific information that would enlarge our knowledge and improve the diagnosis and management of kidney diseases and renal involvement in systemic diseases and morbid conditions.

Prof. Dr. Luis Yu
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • kidney diseases
  • renal involvement
  • AKI
  • CKD
  • glomerulopathies
  • diagnosis
  • treatment
  • dialysis
  • epidemiology
  • nephritic syndrome
  • nephrotic syndrome
  • biomarkers
  • urinalysis
  • oliguria
  • poliuria
  • electrolytes
  • acid-base balance

Published Papers (5 papers)

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Research

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19 pages, 2566 KiB  
Article
SDS Electrophoresis on Gradient Polyacrylamide Gels as a Semiquantitative Tool for the Evaluation of Proteinuria
by Paulina Mazur, Paulina Dumnicka, Joanna Tisończyk, Anna Ząbek-Adamska and Ryszard Drożdż
Diagnostics 2023, 13(9), 1513; https://doi.org/10.3390/diagnostics13091513 - 23 Apr 2023
Cited by 2 | Viewed by 4024
Abstract
Proteinuria is an important sign of kidney diseases. Different protein patterns in urine associated with glomerular, tubular and overload proteinuria may be differentiated using the immunochemical detection of indicator proteins or via urinary proteins electrophoresis. Our aim was to characterize sodium dodecyl sulphate–polyacrylamide [...] Read more.
Proteinuria is an important sign of kidney diseases. Different protein patterns in urine associated with glomerular, tubular and overload proteinuria may be differentiated using the immunochemical detection of indicator proteins or via urinary proteins electrophoresis. Our aim was to characterize sodium dodecyl sulphate–polyacrylamide gel electrophoresis (SDS-PAGE) using commercially available 4–20% gradient gels as a method to detect and differentiate proteinuria. Our laboratory-based study used excess urine samples collected for routine diagnostic purposes from adult patients of a tertiary-care hospital, including patients with albumin/creatinine < 30 mg/g and patients with dipstick proteinuria. The limit of albumin detection was estimated to be 3 mg/L. In 93 samples with albumin/creatinine < 30 mg/g, an albumin fraction was detected in 87% of samples with a minimum albumin concentration of 2.11 mg/L. The separation of 300 urine samples of patients with proteinuria revealed distinct protein patterns differentiated using the molecular weights of the detected proteins: glomerular (albumin and higher molecular weights) and two types of tubular proteinuria (“upper” ≥20 kDa and “lower” with lower molecular weights). These patterns were associated with different values of the glomerular filtration rate (median 66, 71 and 31 mL/min/1.72 m2, respectively, p = 0.004) and different proportions of multiple myeloma and nephrological diagnoses. As confirmed using tandem mass spectrometry and western blot, the SDS-PAGE protein fractions contained indicator proteins including immunoglobulin G, transferrin (glomerular proteinuria), α1-microglobulin, retinol-binding protein, neutrophil gelatinase-associated lipocalin, cystatin C, and β2-microglobulin (tubular), immunoglobulin light chain, myoglobin, and lysozyme (overflow). SDS-PAGE separation of urine proteins on commercially available 4–20% gradient gels is a reliable technique to diagnose proteinuria and differentiate between its main clinically relevant types. Full article
(This article belongs to the Special Issue Current Issues on Kidney Diseases Diagnosis and Management)
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10 pages, 1474 KiB  
Article
A Cross-Sectional Study on the Prevalence and Risk Stratification of Chronic Kidney Disease in Cardiological Patients in São Paulo, Brazil
by Farid Samaan, Bruna Bronhara Damiani, Gianna Mastroianni Kirsztajn and Ricardo Sesso
Diagnostics 2023, 13(6), 1146; https://doi.org/10.3390/diagnostics13061146 - 16 Mar 2023
Cited by 2 | Viewed by 1413
Abstract
Chronic kidney disease (CKD) provides a worse prognosis for patients with heart disease. In Latin America, studies that analyzed the prevalence and risk stratification of CKD in this population are scarce. We aimed to evaluate CKD prevalence and risk categories in patients of [...] Read more.
Chronic kidney disease (CKD) provides a worse prognosis for patients with heart disease. In Latin America, studies that analyzed the prevalence and risk stratification of CKD in this population are scarce. We aimed to evaluate CKD prevalence and risk categories in patients of a public referral cardiology hospital in São Paulo, Brazil. This was a cross-sectional study based on a laboratory database. Outpatient serum creatinine and proteinuria results performed between 1 January 2021 and 31 December 2021 were analyzed. CKD was defined by estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 and proteinuria, by the albumin/creatinine ratio in a spot urine sample (UACR) >30 mg/g. A total of 36,651 adults were identified with serum creatinine levels (median age 72.4 [IQR, 51.0–73.6] years, 51% male). Among them, 51.9% had UACR dosage (71.5% with UACR < 30 mg/g, 22.6%, between 30–300 mg/g, and 5.9% with UACR > 300 mg/g). The prevalence of CKD was 30.9% (15.3% stage 3a, 10.2% stage 3b, 3.6% stage 4, and 1.7% stage 5), and the distribution of patients in the risk categories of the disease was: 52.0% with low-risk, 23.5%, moderate risk, 13.0%, high risk, and 11.2%, very high. In an outpatient setting, the prevalence of CKD in cardiological patients was almost three times (31%) that of the general population; about half of the individuals evaluated (48%) were not screened for an important risk marker (proteinuria), and approximately a quarter of these patients (24%) were in the high or very high CKD risk categories. Full article
(This article belongs to the Special Issue Current Issues on Kidney Diseases Diagnosis and Management)
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10 pages, 1066 KiB  
Article
Urinary CD80 and Serum suPAR as Biomarkers of Glomerular Disease among Adults in Brazil
by Renata de Cássia Zen, Wagner Vasques Dominguez, Ivone Braga, Luciene Machado dos Reis, Lectícia Barbosa Jorge, Luis Yu, Viktoria Woronik and Cristiane Bitencourt Dias
Diagnostics 2023, 13(2), 203; https://doi.org/10.3390/diagnostics13020203 - 5 Jan 2023
Cited by 2 | Viewed by 1264
Abstract
Introduction: Urinary CD80 has been shown to have good specificity for minimal change disease (MCD) in children. However, the investigation of circulating factors such as soluble urokinase plasminogen activator receptor (suPAR) as biomarkers of focal segmental glomerulosclerosis (FSGS) is quite controversial. The objective [...] Read more.
Introduction: Urinary CD80 has been shown to have good specificity for minimal change disease (MCD) in children. However, the investigation of circulating factors such as soluble urokinase plasminogen activator receptor (suPAR) as biomarkers of focal segmental glomerulosclerosis (FSGS) is quite controversial. The objective of this study was to determine whether urinary CD80 and serum suPAR can be used for the diagnosis of MCD and FSGS, respectively, in the adult population of Brazil. We also attempted to determine whether those biomarkers assess the response to immunosuppressive treatment. Methods: This was a prospective study in which urine and blood samples were collected for analysis of CD80 and suPAR, respectively, only in the moment of renal biopsy, from patients undergoing to diagnostic renal biopsy. At and six months after biopsy, we analyzed serum creatinine, serum albumin, and proteinuria in order to evaluate the use of the CD80 and suPAR collected in diagnosis as markers of response to immunosuppressive treatment. In healthy controls were collected urinary CD80 and proteinuria, serum suPAR, and creatinine. Results: The results of 70 renal biopsies were grouped, by diagnosis, as follows: FSGS (n = 18); membranous nephropathy (n = 14); MCD (n = 5); and other glomerulopathies (n = 33). There was no significant difference among the groups in terms of the urinary CD80 levels, and serum suPAR was not significantly higher in the FSGS group, as would have been expected. Urinary CD80 correlated positively with nephrotic syndrome, regardless of the type of glomerular disease. Neither biomarker correlated with proteinuria at six months after biopsy. Conclusion: In adults, urinary CD80 can serve as a marker of nephrotic syndrome but is not specific for MCD, whereas serum suPAR does not appear to be useful as a diagnostic or treatment response marker. Full article
(This article belongs to the Special Issue Current Issues on Kidney Diseases Diagnosis and Management)
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12 pages, 2100 KiB  
Article
Impact of an Electronic Alert in Combination with a Care Bundle on the Outcomes of Acute Kidney Injury
by Ana Carolina Nakamura Tome, Rodrigo José Ramalho, Karise Fernandes dos Santos, Bianca Ponte, Helga Agostinho, Mauricio Nassau Machado, Marcelo Barreto Lopes, Mario Abbud-Filho and Emerson Quintino de Lima
Diagnostics 2022, 12(12), 3121; https://doi.org/10.3390/diagnostics12123121 - 10 Dec 2022
Cited by 3 | Viewed by 2217
Abstract
Early diagnosis is essential for the appropriate management of acute kidney injury (AKI). We evaluated the impact of an electronic AKI alert together with a care bundle on the progression and mortality of AKI. This was a single-center prospective study that included AKI [...] Read more.
Early diagnosis is essential for the appropriate management of acute kidney injury (AKI). We evaluated the impact of an electronic AKI alert together with a care bundle on the progression and mortality of AKI. This was a single-center prospective study that included AKI patients aged ≥ 18 years, whereas those in palliative care, nephrology, and transplantation departments were excluded. An AKI alert was issued in electronic medical records and a care bundle was suggested. A series of classes were administered to the multidisciplinary teams by nephrologists, and a clinical pharmacist audited prescriptions. Patients were categorized into pre-alert and post-alert groups. The baseline characteristics were comparable between the pre-alert (n = 1613) and post-alert (n = 1561) groups. The 30-day mortality rate was 33.6% in the entire cohort and was lower in the post-alert group (30.5% vs. 36.7%; p < 0.001). Age, pulmonary disease, malignancy, and ICU admission were associated with an increase in 30-day mortality. The electronic AKI alert together with a care bundle and a multidisciplinary education program was associated with a reduction in 30-day mortality in patients with AKI. Full article
(This article belongs to the Special Issue Current Issues on Kidney Diseases Diagnosis and Management)
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Review

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12 pages, 628 KiB  
Review
Renal Biomarkers in Cardiovascular Patients with Acute Kidney Injury: A Case Report and Literature Review
by Rolando Claure-Del Granado and Jonathan S. Chávez-Íñiguez
Diagnostics 2023, 13(11), 1922; https://doi.org/10.3390/diagnostics13111922 - 31 May 2023
Viewed by 3764
Abstract
Biomarkers have become important tools in the diagnosis and management of cardiorenal syndrome (CRS), a complex condition characterized by dysfunction in both the cardiovascular and renal systems. Biomarkers can help identify the presence and severity of CRS, predict its progression and outcomes, and [...] Read more.
Biomarkers have become important tools in the diagnosis and management of cardiorenal syndrome (CRS), a complex condition characterized by dysfunction in both the cardiovascular and renal systems. Biomarkers can help identify the presence and severity of CRS, predict its progression and outcomes, and facilitate personalized treatment options. Several biomarkers, including natriuretic peptides, troponins, and inflammatory markers, have been extensively studied in CRS, and have shown promising results in improving diagnosis and prognosis. In addition, emerging biomarkers, such as kidney injury molecule-1 and neutrophil gelatinase-associated lipocalin, offer potential for early detection and intervention of CRS. However, the use of biomarkers in CRS is still in its infancy, and further research is needed to establish their utility in routine clinical practice. This review highlights the role of biomarkers in the diagnosis, prognosis, and management of CRS, and discusses their potential as valuable clinical tools for personalized medicine in the future. Full article
(This article belongs to the Special Issue Current Issues on Kidney Diseases Diagnosis and Management)
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