Recent Advances in Diagnosis and Treatment of Kidney Diseases: 2nd Edition

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

Deadline for manuscript submissions: 31 January 2025 | Viewed by 1449

Special Issue Editor


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Guest Editor
Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
Interests: renal development; kidney fibrosis; acute kidney injury; chronic kidney disease; regeneration; dialysis
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Special Issue Information

Dear Colleagues,

Chronic kidney disease (CKD) is a global public health problem with a huge economic cost on healthcare systems worldwide. Since the early diagnosis and treatment of CKD may delay or prevent progression to advanced kidney disease, the advent of reliable biomarkers detecting the early stages of kidney diseases, monitoring disease progression and prognostic values, as well as novel therapies for kidney diseases, is required. Over the last decade, a number of advances have been made in the diagnosis and treatment of CKD and its variety of etiologies, including diabetic kidney disease, glomerulonephritis and polycystic kidney diseases. Regarding the treatment of CKD, beneficial effects of sodium–glucose cotransporter 2 (SGLT2) inhibitor on CKD patients have been demonstrated, and other promising drug candidates have been reported. In addition, research for renal replacement therapies of hemodialysis, peritoneal dialysis and renal regeneration is also progressing.

This Special Issue aims to improve our knowledge of recent advances in the diagnosis and treatment of kidney diseases. The scope covers a wide range of kidney diseases, including diabetic kidney disease, glomerulonephritis and polycystic kidney diseases. In this Special Issue, original research and reviews that offer suggestions for the better diagnosis and treatment of kidney diseases are welcome.

Dr. Kenji Tsuji
Guest Editor

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Keywords

  • chronic kidney disease
  • diabetic kidney disease
  • glomerulonephritis
  • polycystic kidney diseases
  • renal pathology
  • biomarker
  • kidney regeneration
  • hemodialysis
  • peritoneal dialysis
  • diagnosis

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Published Papers (2 papers)

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Research

16 pages, 484 KiB  
Article
Fatty Acid β-Oxidation May Be Associated with the Erythropoietin Resistance Index in Stable Patients Undergoing Haemodialysis
by Shuhei Kidoguchi, Kunio Torii, Toshiharu Okada, Tomoko Yamano, Nanami Iwamura, Kyoko Miyagi, Tadashi Toyama, Masayuki Iwano, Ryoichi Miyazaki, Yosuke Shigematsu and Hideki Kimura
Diagnostics 2024, 14(20), 2295; https://doi.org/10.3390/diagnostics14202295 - 16 Oct 2024
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Abstract
Background/Objectives: Lipid metabolism and adiponectin modulate erythropoiesis in vitro and in general population studies and may also affect responsiveness to erythropoietin in patients undergoing haemodialysis (HD). However, little is known about the impact of lipid-associated biomarkers on reticulocyte production and erythropoietin resistance index [...] Read more.
Background/Objectives: Lipid metabolism and adiponectin modulate erythropoiesis in vitro and in general population studies and may also affect responsiveness to erythropoietin in patients undergoing haemodialysis (HD). However, little is known about the impact of lipid-associated biomarkers on reticulocyte production and erythropoietin resistance index (ERI) in patients undergoing HD. Therefore, we aimed to investigate their impacts in 167 stable patients undergoing HD. Methods: Pre-dialysis blood samples were collected and analysed for reticulocyte counts and serum lipid profiles by routine analyses and serum carnitine profiles (C0–C18) by LC-MS/MS. ERI was calculated as erythropoietin dose/kg/week normalized for haemoglobin levels. Results: The independent positive determinants of reticulocyte count were log [Triglyceride (TG)] and logC18:1. A large proportion of longer-chain acylcarnitines was positively correlated with reticulocyte counts, possibly resulting from the accumulation of acylcarnitines in mitochondria undergoing fateful exocytosis from reticulocytes. These results indicate a possible association between reticulocyte formation and reduced β-oxidation, which occurs during the peripheral phase of erythroblast enucleation. Total cholesterol (TC) and log [C2/(C16 + C18:1)] as a putative marker of β-oxidation efficiency were negative independent determinants of ERI. Moreover, acyl chain length had a significantly positive impact on the correlation coefficients of individual acylcarnitines with ERI, suggesting that enhanced β-oxidation may be associated with reduced ERI. Finally, adiponectin had no independent association with reticulocyte counts or ERI despite its negative association with HDL-C levels. Conclusions: Enhanced fatty acid β-oxidation and higher TC levels may be associated with lower ERI, whereas higher TG levels and longer acylcarnitines may be related to the latest production of reticulocytes in stable patients undergoing HD. Full article
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16 pages, 1214 KiB  
Article
Early CYP3A5 Genotype-Based Adjustment of Tacrolimus Dosage Reduces Risk of De Novo Donor-Specific HLA Antibodies and Rejection among CYP3A5-Expressing Renal Transplant Patients
by Kristina Schönfelder, Birte Möhlendick, Ute Eisenberger, Andreas Kribben, Winfried Siffert, Falko M. Heinemann, Anja Gäckler, Benjamin Wilde and Justa Friebus-Kardash
Diagnostics 2024, 14(19), 2202; https://doi.org/10.3390/diagnostics14192202 - 2 Oct 2024
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Abstract
Background/Objectives: Our previous retrospective single-center cohort study found, at 3-year follow-up, a trend toward low tacrolimus trough levels and an increased risk of de novo donor-specific anti-HLA antibodies (DSAs) and of antibody-mediated rejection (ABMR) in CYP3A5-expressing patients. Determining CYP3A5-expression status immediately after renal [...] Read more.
Background/Objectives: Our previous retrospective single-center cohort study found, at 3-year follow-up, a trend toward low tacrolimus trough levels and an increased risk of de novo donor-specific anti-HLA antibodies (DSAs) and of antibody-mediated rejection (ABMR) in CYP3A5-expressing patients. Determining CYP3A5-expression status immediately after renal transplant would allow early genotype-based dosage adjustment of tacrolimus and might prevent the occurrence of de novo DSAs and ABMR, improving transplant outcome. Methods: 160 renal allograft recipients who underwent renal transplant at the University Hospital Essen between May 2019 and May 2022 were genotyped for the CYP3A5 rs776746 polymorphism within the first two weeks after transplant, and genotype-based dose adjustment of tacrolimus was performed for the follow-up of 2 years. Results: CYP3A5 expression was detected in 33 (21%) of the 160 patients. Tacrolimus trough levels were similar in CYP3A5 expressers and nonexpressers over the entire 2-year follow-up period. However, we observed a trend toward slightly higher tacrolimus trough levels in CYP3A5 expressers, who, as expected, required tacrolimus dosages twice as high as did nonexpressers during follow-up. Calcineurin inhibitor (CNI) nephrotoxicity-free survival rates were comparable between CYP3A5 expressers and nonexpressers (p = 0.49). Rejection-free survival rates (p = 0.89), de novo anti-HLA antibody-free survival rates (p = 0.57) and de novo DSA-free survival rates (p = 0.61) did not differ between the two groups. Conclusions: Early detection of CYP3A5-expression status and resultant genotype-based adjustment of tacrolimus dosage after renal transplant protected patients from transplant rejection and de novo DSA formation and was not associated with increased incidence of CNI toxicity among CYP3A5 expressers. Full article
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