Personalized Medicine in Kidney Disease

A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Personalized Therapy and Drug Delivery".

Deadline for manuscript submissions: closed (23 June 2023) | Viewed by 15413

Special Issue Editors


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Guest Editor
Unit of Nephrology and Dialysis, Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy
Interests: clinical nephrology; chronic kidney disease; glomerulonephritis; diabetic kidney disease; thrombotic microangiopathies; hypertensive disorders of pregnancy; vitamin D
Special Issues, Collections and Topics in MDPI journals

E-Mail Website
Guest Editor
Unit of Nephrology and Dialysis, Department of Clinical and Experimental Medicine, University of Messina, Via Consolare Valeria, 98125 Messina, Italy
Interests: clinical nephrology; chronic kidney disease; glomerulonephritis; diabetic kidney disease; hypertension; thrombotic microangiopathies; renal tubular acidosis; acute kidney injury; dialysis; vitamin D; vascular access
Special Issues, Collections and Topics in MDPI journals

E-Mail Website
Guest Editor
Unit of Nephrology and Dialysis, Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy
Interests: clinical nephrology; chronic kidney disease; glomerulonephritis; diabetic kidney disease; hypertension; thrombotic microangiopathies; renal tubular acidosis; acute kidney injury; dialysis; vitamin D; vascular access

Special Issue Information

Dear Colleagues,

Chronic kidney diseases represent a real challenge for clinicians, who may take charge of patients at high risk of developing chronic and likely invalidating impairment of renal function.

In particular, hypertensive kidney disease and diabetic kidney disease represent emergencies that negatively affect the population’s quality of life worldwide. Even these frequent diseases need a personalized approach for all individuals, guaranteeing a patient-centered treatment strategy with a tailored therapy, to date reserved for rarer syndromes.

Recent advances in technology have enabled a better comprehension of pathophysiology mechanisms, laying the foundation for developing new and more specific therapies. Therefore, the importance of a “precision medicine” approach, borrowed from oncology, is growing in all medical fields, to cure the patient more than the disease.

Concerning kidney diseases, this strategy has not only been applied in onconephrology, but it has been successfully translated in the treatment of glomerulonephritis and autoimmune and autoinflammatory diseases. At the same time, recent evidence has demonstrated the relevant impact of customized nutrition programs on preserving renal function with reduced salt and protein intake or even plant-based diets, chosen according to patients’ habits or wishes. Finally, renal replacement therapies, required in advanced stages of chronic kidney disease, can also be personalized in line with the patients’ needs to ensure the best possible quality of life for them.

This Special Issue of the Journal of Personalized Medicine aims to publish papers on tailored medicine and its challenges in all the nephrological settings, as it represents one of the key features of a successful therapeutic alliance between clinicians and patients.

Dr. Rossella Siligato
Dr. Guido Gembillo
Prof. Dr. Domenico Santoro
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 Personalized Medicine is an international peer-reviewed open access monthly 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

  • chronic kidney disease
  • diabetic kidney disease
  • hypertension
  • rare diseases
  • glomerulonephritis
  • thrombotic microangiopathies
  • renal tubular acidosis
  • acute kidney injury
  • vascular access
  • personalized dialysis

Published Papers (6 papers)

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Editorial

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7 pages, 214 KiB  
Editorial
Personalized Medicine in Kidney Disease
by Guido Gembillo, Rossella Siligato and Domenico Santoro
J. Pers. Med. 2023, 13(10), 1501; https://doi.org/10.3390/jpm13101501 - 16 Oct 2023
Viewed by 1260
Abstract
The Special Issue “Personalized Medicine in Kidney Disease” is focused on the importance of customized medicine in nephrology as it represents one of the main characteristics of successful therapeutic results [...] Full article
(This article belongs to the Special Issue Personalized Medicine in Kidney Disease)

Research

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17 pages, 3205 KiB  
Article
Independent Prognostic and Predictive Role of Interstitial Macrophages in Kidney Biopsies of IgA Nephropathy Patients
by Francesca Bianca Aiello, Franco Oreste Ranelletti, Marcella Liberatore, Paolo Felaco, Graziano De Luca, Alessia Lamolinara, Francesco Paolo Schena and Mario Bonomini
J. Pers. Med. 2023, 13(6), 935; https://doi.org/10.3390/jpm13060935 - 31 May 2023
Cited by 1 | Viewed by 1221
Abstract
A relevant percentage of IgAN patients experience a progressive decline in kidney function. According to the KDIGO guidelines, proteinuria and eGFR are the only validated prognostic markers. The role of interstitial macrophages in kidney biopsies of IgAN patients and the outcome of patients [...] Read more.
A relevant percentage of IgAN patients experience a progressive decline in kidney function. According to the KDIGO guidelines, proteinuria and eGFR are the only validated prognostic markers. The role of interstitial macrophages in kidney biopsies of IgAN patients and the outcome of patients treated with renin–angiotensin system inhibitors (RASBs) alone or combined with glucocorticoids were evaluated. Clinical and laboratory records (age, gender, hypertension, hematuria, proteinuria, eGFR, serum creatinine, and therapy), MEST-C parameters of the Oxford classification, C4d deposition, peritubular capillaries, and glomerular and interstitial macrophages in 47 IgAN patients undergoing kidney biopsy consecutively between 2003 and 2016 were examined. A high number of interstitial macrophages significantly correlated with peritubular capillary rarefaction and impairment of kidney function. Cox’s multivariable regression analysis revealed that a value > 19.5 macrophages/HPF behaved as an independent marker of an unfavorable outcome. Patients exhibiting > 19.5 macrophages/HPF treated at the time of diagnosis with RASBs combined with methylprednisolone had an estimated probability of a favorable outcome higher than patients treated with RASBs alone. Thus, a value > 19.5 macrophages/HPF in IgAN biopsies can predict an unfavorable outcome and endorse a well-timed administration of glucocorticoids. Studies evaluating urine biomarkers associated with peritubular capillary rarefaction in patients with marked macrophage infiltration may help personalized treatment decisions. Full article
(This article belongs to the Special Issue Personalized Medicine in Kidney Disease)
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14 pages, 1907 KiB  
Article
Kidney Function Trajectory within Six Months after Acute Kidney Injury Inpatient Care and Subsequent Adverse Kidney Outcomes: A Retrospective Cohort Study
by You-Lin Tain, Chien-Liang Liu, Hsiao-Ching Kuo and Chien-Ning Hsu
J. Pers. Med. 2022, 12(10), 1606; https://doi.org/10.3390/jpm12101606 - 29 Sep 2022
Cited by 4 | Viewed by 1367
Abstract
Timing and extent of kidney function recovery after an acute kidney injury (AKI) episode are associated with chronic kidney disease onset and progression. This study aimed to categorize AKI recovery patterns within 6 months after index hospital discharge and associate them with kidney [...] Read more.
Timing and extent of kidney function recovery after an acute kidney injury (AKI) episode are associated with chronic kidney disease onset and progression. This study aimed to categorize AKI recovery patterns within 6 months after index hospital discharge and associate them with kidney outcomes. This was a retrospective cohort study of 234,867 patients, hospitalized between 2010 and 2017, and classified as AKI or no AKI. Kidney function recovery from pre-hospitalization baseline within 1.5× serum creatinine (SCr) were evaluated at 3 and 6 months after hospital discharge and categorized as persistent non-recovery (PNR: SCr not recovered at 3 and 6 months), non-recovery (NR: SCr not recovered at 6 months), and recovery (SCr recovered at 6 months). A composite of incident chronic kidney disease, kidney replacement therapy, and estimated glomerular filtration rate reduction >30% from baseline and <15 mL/min/1.73 m2 was evaluated. Of 14,673 AKI surviving patients, 10.18% had PNR and 14.33% showed NR. Compared with no AKI, PNR and NR of AKI were associated with an increased risk of composite adverse outcomes (adjusted subdistribution hazard ratio (SHR) 4.55; 95% CI, 4.05–5.11; SHR, 3.54; 95% CI, 3.18–3.94, respectively). Patients with NR showed a greater risk of adverse outcomes than those with non-rapid recovery at 3 months after hospital discharge. The AKI recovery pattern within 6 months following inpatient care revealed an increasing continuum of risk of long-term adverse kidney outcomes. Risk stratification and a kidney function monitoring plan at discharge are needed to improve post-AKI care. Full article
(This article belongs to the Special Issue Personalized Medicine in Kidney Disease)
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12 pages, 2705 KiB  
Article
The Role of Plasma Interleukin-6 Levels on Atherosclerotic Cardiovascular Disease and Cardiovascular Mortality Risk Scores in Javanese Patients with Chronic Kidney Disease
by Hendri Susilo, Mochammad Thaha, Budi Susetyo Pikir, Mochamad Yusuf Alsagaff, Satriyo Dwi Suryantoro, Citrawati Dyah Kencono Wungu, Nando Reza Pratama, Cennikon Pakpahan and Delvac Oceandy
J. Pers. Med. 2022, 12(7), 1122; https://doi.org/10.3390/jpm12071122 - 10 Jul 2022
Cited by 7 | Viewed by 1811
Abstract
Interleukin-6 (IL-6) has been identified as an important pro-inflammatory factor involved in mediating the severity of chronic kidney disease (CKD). This study sought to determine the effect of plasma IL-6 levels on atherosclerotic cardiovascular disease (ASCVD) and cardiovascular mortality risk scores in Javanese [...] Read more.
Interleukin-6 (IL-6) has been identified as an important pro-inflammatory factor involved in mediating the severity of chronic kidney disease (CKD). This study sought to determine the effect of plasma IL-6 levels on atherosclerotic cardiovascular disease (ASCVD) and cardiovascular mortality risk scores in Javanese CKD patients. We also analyzed the frequency of IL-6 G174C single nucleotide polymorphism (SNP) in the population. This study was a cross-sectional study involving seventy-three patients of Javanese ethnic origin with stable chronic kidney disease. We assessed the ASCVD risk score, cardiovascular mortality score, genotyping of IL-6 G174C SNP, and plasma IL-6 levels in these patients. The genotype distribution and allele frequencies of the IL-6 G174C SNP were predominated by the G genotype/allele (GG: 97.26%, GC: 1.37%, CC: 1.37%, G-allele: 97.95%, and C-allele: 2.05%). Despite the fact that plasma IL-6 levels did not directly affect cardiovascular mortality risk, further analysis revealed its direct effect on the ASCVD risk score (path coefficient = 0.184, p = 0.043, 95% CI = 0.018–0.380), which in turn affected cardiovascular mortality risk (path coefficient = 0.851, p = <0.01, 95% CI = 0.714–0.925). In conclusion, plasma IL-6 levels play important roles on ASCVD risk and cardiovascular mortality risk in Javanese patients with CKD. Full article
(This article belongs to the Special Issue Personalized Medicine in Kidney Disease)
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15 pages, 6005 KiB  
Article
Renoprotective Effect of Vardenafil and Avanafil in Contrast-Induced Nephropathy: Emerging Evidence from an Animal Model
by Ioannis-Erineos Zisis, Georgios Georgiadis, Anca Oana Docea, Daniela Calina, Liliana Cercelaru, John Tsiaoussis, Georgios Lazopoulos, Nikolaos Sofikitis, Aristidis Tsatsakis and Charalampos Mamoulakis
J. Pers. Med. 2022, 12(5), 670; https://doi.org/10.3390/jpm12050670 - 22 Apr 2022
Cited by 8 | Viewed by 1917
Abstract
The potential renoprotective effects of vardenafil (VAR) have been evaluated in a very limited number of studies using acute kidney injury animal models other than contrast-induced nephropathy (CIN) with promising results, while avanafil (AVA) has not been evaluated in this respect before. The [...] Read more.
The potential renoprotective effects of vardenafil (VAR) have been evaluated in a very limited number of studies using acute kidney injury animal models other than contrast-induced nephropathy (CIN) with promising results, while avanafil (AVA) has not been evaluated in this respect before. The purpose of this study was to evaluate for the first time the potential renoprotective effect of VAR and AVA in a rat model of CIN. Twenty-five male Wistar rats were equally assigned into five groups: control, CIN, CIN+N-acetyl cysteine (NAC) (100 mg/kg/day) as a positive control, CIN+VAR (10 mg/kg/day) and CIN+AVA (50 mg/kg/day). CIN was induced by dehydration, inhibition of prostaglandin and nitric oxide synthesis as well as exposure to the contrast medium (CM). Serum Cr (sCr) levels were measured at 24 and 48 h after CIN induction. At 48 h of CM exposure, animals were sacrificed. Matrix metalloproteinase (MMP) 2 (MMP-2) and MMP-9, kidney injury molecule 1 (KIM-1) and cystatin-C (Cys-C) were measured on renal tissue. Histopathological findings were evaluated on kidney tissue. All treatment groups had close to normal kidney appearance. sCr levels subsided in all treatment groups compared to CIN group at 48 h following CIN induction. A significant decline in the levels of MMP-2, MMP-9, KIM-1 and Cys-C compared to CIN group was observed. These results provide emerging evidence that VAR and AVA may have the potential to prevent CIN. Full article
(This article belongs to the Special Issue Personalized Medicine in Kidney Disease)
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Review

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23 pages, 843 KiB  
Review
Lung Dysfunction and Chronic Kidney Disease: A Complex Network of Multiple Interactions
by Guido Gembillo, Sebastiano Calimeri, Valeria Tranchida, Salvatore Silipigni, Davide Vella, Domenico Ferrara, Claudia Spinella, Domenico Santoro and Luca Visconti
J. Pers. Med. 2023, 13(2), 286; https://doi.org/10.3390/jpm13020286 - 03 Feb 2023
Cited by 6 | Viewed by 6619
Abstract
Chronic kidney disease (CKD) is a progressive disease that affects > 10% of the total population worldwide or >800 million people. CKD poses a particularly heavy burden in low- and middle-income countries, which are least able to cope with its consequences. It has [...] Read more.
Chronic kidney disease (CKD) is a progressive disease that affects > 10% of the total population worldwide or >800 million people. CKD poses a particularly heavy burden in low- and middle-income countries, which are least able to cope with its consequences. It has become one of the leading causes of death worldwide and is one of the few non-communicable diseases where the number of related deaths has increased over the last two decades. The high number of people affected, and the significant negative impact of CKD should be a reason to increase efforts to improve prevention and treatment. The interaction of lung and kidney leads to highly complex and difficult clinical scenarios. CKD significantly affects the physiology of the lung by altering fluid homeostasis, acid-base balance and vascular tone. In the lung, haemodynamic disturbances lead to the development of alterations in ventilatory control, pulmonary congestion, capillary stress failure and pulmonary vascular disease. In the kidney, haemodynamic disturbances lead to sodium and water retention and the deterioration of renal function. In this article, we would like to draw attention to the importance of harmonising the definitions of clinical events in pneumology and renal medicine. We would also like to highlight the need for pulmonary function tests in routine clinical practise for the management of patients with CKD, in order to find new concepts for pathophysiological based disease-specific management strategies. Full article
(This article belongs to the Special Issue Personalized Medicine in Kidney Disease)
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