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Recent Advances in Pathogenesis, Clinical Outcomes, and Treatment of Kidney...
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Recent Advances in Pathogenesis, Clinical Outcomes, and Treatment of Kidney Diseases

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Nephrology & Urology".

Deadline for manuscript submissions: closed (31 December 2023) | Viewed by 8607

Special Issue Editors

Dr. Charat Thongprayoon

E-Mail Website
Guest Editor
Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN, USA
Interests: artificial intelligence; machine Learning; nephrology; acute kidney injury; clinical nephrology; kidney transplantation
Special Issues, Collections and Topics in MDPI journals
Dr. Wisit Kaewput

E-Mail Website
Guest Editor
Department of Medicine, Phramongkutklao College of Medicine, Bangkok, Thailand
Interests: machine learning; kidney transplantation; observational studies; statistical analysis; epidemiology
Special Issues, Collections and Topics in MDPI journals
Dr. Wisit Cheungpasitporn

E-Mail Website
Guest Editor
Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic, Rochester, MN, USA
Interests: artificial Intelligence; machine learning; meta-analysis; acute kidney injury; clinical nephrology; kidney transplantation
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The kidney is a vital organ of our lives. Over-million deaths per year, however, are caused by kidney diseases and the mortality rate associated with kidney is still increasing. Nowadays, some kidney-related problems have been studied and investigated to be solved. Given that there are still lots of unknown and/or unclear kidney disease knowledge on pathogenesis, outcomes, and novel treatment of kidney diseases.

In this Special Issue, we are very honored to invite all of the researchers and clinicians who are interested in Nephrology, Hypertension, and Kidney Transplantation with these above aspects to advance knowledge in these important fields. Original investigations, review articles as well as short communications are especially welcome.

Potential topics include, but are not limited to, the following:

  • Pathophysiology and classification of kidney disease
  • Mechanism of glomerular impairment
  • Acquired glomerular disease triggered by immune mediated injury
  • Glomerular-inflammation recovery with a variable degree of fibrosis
  • Severity of tubulointerstitial injury with impairment of renal function
  • Epithelial-mesenchymal transition correlated with renal function
  • The reversibility of renal fibrosis
  • Chronic kidney disease and clinical outcomes
  • Consensus definitions of clinical trial outcomes for kidney failure
  • Determinants of outcomes of acute kidney injury: Clinical Predictors
  • Spectrum of severity in acute kidney diseases
  • Kidney stones: Mechanism of formation and pathogenesis
  • Diabetic kidney diseases: Update on clinical management
  • Polycystic kidney disease treatment and management
  • Recent advances in the management of autosomal dominant polycystic kidney disease
  • Recent treatment of acute pyelonephritis
  • Pathophysiology of renal cell carcinomas (RCCs)
  • Kidney Cancer: An overview of current therapeutic approaches
  • Current treatment approaches for amyloidosis-associated kidney disease
  • Treatment of steroid-sensitive nephrotic syndrome: new guideline

Dr. Charat Thongprayoon
Dr. Wisit Kaewput
Dr. Wisit Cheungpasitporn
Guest Editors

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. Journal of Clinical Medicine 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

  • acute kidney diseases
  • chronic kidney disease
  • polycystic kidney diseases
  • kidney stones
  • renal cell carcinoma
  • pyelonephritis
  • nephrology
  • hypertension
  • kidney transplantation
  • renal transplantation
  • transplantation

Published Papers (5 papers)

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11 pages, 930 KiB  
Article
Endocan as a Potential Marker for Predicting All-Cause Mortality in Hemodialysis Patients
by Jia-Hong Lin, Bang-Gee Hsu, Chih-Hsien Wang and Jen-Pi Tsai
J. Clin. Med. 2023, 12(23), 7427; https://doi.org/10.3390/jcm12237427 - 30 Nov 2023
Viewed by 699
Abstract
Endocan, a pro-inflammatory cytokine and pro-angiogenic factor, is a marker of endothelial dysfunction and has been proven to correlate with cardiovascular disease. In hemodialysis (HD) patients, cardiovascular disease is the major cause of mortality. Our study aimed to investigate the relationship between serum [...] Read more.
Endocan, a pro-inflammatory cytokine and pro-angiogenic factor, is a marker of endothelial dysfunction and has been proven to correlate with cardiovascular disease. In hemodialysis (HD) patients, cardiovascular disease is the major cause of mortality. Our study aimed to investigate the relationship between serum endocan and all causes of mortality in HD patients. A total of 103 patients, aged over 20 years old and undergoing HD for more than 3 months, were included and followed for 36 months. Mortality events, serum endocan, biochemical data, body mass index, systolic and diastolic blood pressure, baseline characteristics, and the use of antihypertensive and lipid-lowering drugs were recorded. In our study, a total of 26 deaths (25.2%) occurred. Hemodialysis patients with diabetes mellitus, older age, higher serum endocan, and lower creatinine and albumin levels had a higher risk of mortality. Adjusting for prognostic variables, HD patients with higher serum endocan (p = 0.010) and lower serum creatinine (p = 0.034) demonstrated significantly higher all-cause mortality. In our study, increased endocan and lower creatinine are associated with all-cause mortality in HD patients. Serum endocan levels could serve as a biomarker for a high mortality risk in HD patients. Full article
(This article belongs to the Special Issue Recent Advances in Pathogenesis, Clinical Outcomes, and Treatment of Kidney Diseases)
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11 pages, 876 KiB  
Article
Laboratory Diagnostic of Acute Kidney Injury and Its Progression: Risk of Underdiagnosis in Female and Elderly Patients
by Thea Sophie Kister, Maria Schmidt, Lara Heuft, Martin Federbusch, Michael Haase and Thorsten Kaiser
J. Clin. Med. 2023, 12(3), 1092; https://doi.org/10.3390/jcm12031092 - 30 Jan 2023
Cited by 5 | Viewed by 1842
Abstract
Acute kidney injury (AKI) is a common disease, with high morbidity and mortality rates. In this study, we investigated the potential influence of sex and age on laboratory diagnostics and outcomes. It is known that serum creatinine (SCr) has limitations as a laboratory [...] Read more.
Acute kidney injury (AKI) is a common disease, with high morbidity and mortality rates. In this study, we investigated the potential influence of sex and age on laboratory diagnostics and outcomes. It is known that serum creatinine (SCr) has limitations as a laboratory diagnostic parameter for AKI due to its dependence on muscle mass, which may lead to an incorrect or delayed diagnosis for certain patient groups, such as women and the elderly. Overall, 7592 cases with AKI, hospitalized at the University of Leipzig Medical Center (ULMC) between 1st January 2017 and 31st December 2019, were retrospectively analyzed. The diagnosis and staging of AKI were performed according to the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines, based on the level and dynamics of SCr. The impact of sex and age was analyzed by the recalculation of a female to male and an old to young SCr using the CKD-EPI equation. In our study cohort progressive AKI occurred in 19.2% of all cases (n = 1458). Female cases with AKI were underrepresented (40.4%), with a significantly lower first (−3.5 mL/min) and last eGFR (−2.7 mL/min) (p < 0.001). The highest incidence proportion of AKI was found in the [61–81) age group in female (49.5%) and male (52.7%) cases. Females with progressive AKI were underrepresented (p = 0.04). By defining and staging AKI on the basis of relative and absolute changes in the SCr level, it is more difficult for patients with low muscle mass and, thus, a lower baseline SCr to be diagnosed by an absolute SCr increase. AKIN1 and AKIN3 can be diagnosed by a relative or absolute change in SCr. In females, both stages were less frequently detected by an absolute criterion alone (AKIN1 ♀ 20.2%, ♂ 29.5%, p < 0.001; AKIN3 ♀ 13.4%, ♂ 15.2%, p < 0.001). A recalculated SCr for females (as males) and males (as young males) displayed the expected increase in AKI occurrence and severity with age and, in general, in females. Our study illustrates how SCr, as the sole parameter for the diagnosis and staging of AKI, bears the risk of underdiagnosis of patient groups with low muscle mass, such as women and the elderly. A sex- and age-adapted approach might offer advantages. Full article
(This article belongs to the Special Issue Recent Advances in Pathogenesis, Clinical Outcomes, and Treatment of Kidney Diseases)
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13 pages, 6878 KiB  
Article
Protective Effects of Orexin A in a Murine Model of Cisplatin-Induced Acute Kidney Injury
by Jungmin Jo, Jung-Yeon Kim and Jaechan Leem
J. Clin. Med. 2022, 11(23), 7196; https://doi.org/10.3390/jcm11237196 - 03 Dec 2022
Cited by 5 | Viewed by 1344
Abstract
Cisplatin is a chemotherapeutic agent widely used in the treatment of various cancers, but its application is often limited due to complications such as acute kidney injury (AKI). Orexins are hypothalamic neuropeptides that modulate the sleep-wake cycle, neuroendocrine function, and the autonomic nervous [...] Read more.
Cisplatin is a chemotherapeutic agent widely used in the treatment of various cancers, but its application is often limited due to complications such as acute kidney injury (AKI). Orexins are hypothalamic neuropeptides that modulate the sleep-wake cycle, neuroendocrine function, and the autonomic nervous system. Emerging evidence suggests that orexin A (OXA) has anti-inflammatory and neuroprotective effects in animal models of neuroinflammatory diseases of the central nervous system. However, the effect of OXA on kidney diseases has not been examined. Here, we investigated whether OXA has a protective effect in a murine model of cisplatin-induced AKI. Intraperitoneal administration of OXA ameliorated renal dysfunction, and histological abnormalities in mice injected with cisplatin. OXA inhibited cisplatin-induced oxidative stress through the modulation of prooxidant and antioxidant enzymes. This peptide reduced apoptotic cell death by inhibiting the p53-mediated pathway in mice injected with cisplatin. OXA also alleviated cisplatin-induced cytokine production and macrophage infiltration into injured kidneys. Taken together, these results showed that OXA ameliorates cisplatin-induced AKI via antioxidant, anti-apoptotic, and anti-inflammatory actions. This peptide could be a potential therapeutic agent for cisplatin-induced AKI. Full article
(This article belongs to the Special Issue Recent Advances in Pathogenesis, Clinical Outcomes, and Treatment of Kidney Diseases)
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16 pages, 4070 KiB  
Article
Explainable Preoperative Automated Machine Learning Prediction Model for Cardiac Surgery-Associated Acute Kidney Injury
by Charat Thongprayoon, Pattharawin Pattharanitima, Andrea G. Kattah, Michael A. Mao, Mira T. Keddis, John J. Dillon, Wisit Kaewput, Supawit Tangpanithandee, Pajaree Krisanapan, Fawad Qureshi and Wisit Cheungpasitporn
J. Clin. Med. 2022, 11(21), 6264; https://doi.org/10.3390/jcm11216264 - 24 Oct 2022
Cited by 7 | Viewed by 2141
Abstract
Background: We aimed to develop and validate an automated machine learning (autoML) prediction model for cardiac surgery-associated acute kidney injury (CSA-AKI). Methods: Using 69 preoperative variables, we developed several models to predict post-operative AKI in adult patients undergoing cardiac surgery. Models included autoML [...] Read more.
Background: We aimed to develop and validate an automated machine learning (autoML) prediction model for cardiac surgery-associated acute kidney injury (CSA-AKI). Methods: Using 69 preoperative variables, we developed several models to predict post-operative AKI in adult patients undergoing cardiac surgery. Models included autoML and non-autoML types, including decision tree (DT), random forest (RF), extreme gradient boosting (XGBoost), and artificial neural network (ANN), as well as a logistic regression prediction model. We then compared model performance using area under the receiver operating characteristic curve (AUROC) and assessed model calibration using Brier score on the independent testing dataset. Results: The incidence of CSA-AKI was 36%. Stacked ensemble autoML had the highest predictive performance among autoML models, and was chosen for comparison with other non-autoML and multivariable logistic regression models. The autoML had the highest AUROC (0.79), followed by RF (0.78), XGBoost (0.77), multivariable logistic regression (0.77), ANN (0.75), and DT (0.64). The autoML had comparable AUROC with RF and outperformed the other models. The autoML was well-calibrated. The Brier score for autoML, RF, DT, XGBoost, ANN, and multivariable logistic regression was 0.18, 0.18, 0.21, 0.19, 0.19, and 0.18, respectively. We applied SHAP and LIME algorithms to our autoML prediction model to extract an explanation of the variables that drive patient-specific predictions of CSA-AKI. Conclusion: We were able to present a preoperative autoML prediction model for CSA-AKI that provided high predictive performance that was comparable to RF and superior to other ML and multivariable logistic regression models. The novel approaches of the proposed explainable preoperative autoML prediction model for CSA-AKI may guide clinicians in advancing individualized medicine plans for patients under cardiac surgery. Full article
(This article belongs to the Special Issue Recent Advances in Pathogenesis, Clinical Outcomes, and Treatment of Kidney Diseases)
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6 pages, 231 KiB  
Brief Report
Dapaglifozin on Albuminuria in Chronic Kidney Disease Patients with FabrY Disease: The DEFY Study Design and Protocol
by Yuri Battaglia, Francesca Bulighin, Luigi Zerbinati, Nicola Vitturi, Giacomo Marchi and Gianni Carraro
J. Clin. Med. 2023, 12(11), 3689; https://doi.org/10.3390/jcm12113689 - 26 May 2023
Cited by 3 | Viewed by 1440
Abstract
Fabry disease (FD) is a rare genetic disorder caused by a deficiency in the α-galactosidase A enzyme, which results in the globotriaosylceramide accumulation in many organs, including the kidneys. Nephropathy is a major FD complication that can progress to end-stage renal disease if [...] Read more.
Fabry disease (FD) is a rare genetic disorder caused by a deficiency in the α-galactosidase A enzyme, which results in the globotriaosylceramide accumulation in many organs, including the kidneys. Nephropathy is a major FD complication that can progress to end-stage renal disease if not treated early. Although enzyme replacement therapy and chaperone therapy are effective, other treatments such as ACE inhibitors and angiotensin receptor blockers can also provide nephroprotective effects when renal damage is also established. Recently, SGLT2 inhibitors have been approved as innovative drugs for treating chronic kidney disease. Thus, we plan a multicenter observational prospective cohort study to assess the effect of Dapagliflozin, a SGLT2 inhibitor, in FD patients with chronic kidney disease (CKD) stages 1–3. The objectives are to evaluate the effect of Dapagliflozin primarily on albuminuria and secondarily on kidney disease progression and clinical FD stability. Thirdly, any association between SGT2i and cardiac pathology, exercise capacity, kidney and inflammatory biomarkers, quality of life, and psychosocial factors will also be evaluated. The inclusion criteria are age ≥ 18; CKD stages 1–3; and albuminuria despite stable treatment with ERT/Migalastat and ACEi/ARB. The exclusion criteria are immunosuppressive therapy, type 1 diabetes, eGFR < 30 mL/min/1.73 m2, and recurrent UTIs. Baseline, 12-month, and 24-month visits will be scheduled to collect demographic, clinical, biochemical, and urinary data. Additionally, an exercise capacity and psychosocial assessment will be performed. The study could provide new insights into using SGLT2 inhibitors for treating kidney manifestations in Fabry disease. Full article
(This article belongs to the Special Issue Recent Advances in Pathogenesis, Clinical Outcomes, and Treatment of Kidney Diseases)
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