Nephrology

A CMS health-equity incentive for dialysis facilities reduced financial penalties for facilities that serve patients with more social risk factors but did not narrow disparities in clinical outcomes.

In this trial of the aldosterone synthase inhibitor lorundrostat in participants with uncontrolled hypertension, lorundrostat was associated with greater reductions in blood pressure than placebo.

In this trial, obinutuzumab, a humanized type II anti-CD20 monoclonal antibody, plus standard therapy provided significantly better renal responses than standard therapy alone in patients with lupus nephritis.

B cells play a key role in the pathogenesis of lupus nephritis, yet in the Lupus Nephritis Assessment with Rituximab (LUNAR) trial, rituximab therapy did not improve clinical outcomes after 1 year of treatment.¹ The success of anti-CD19 chimeric antigen receptor T cells in selected patients with refractory...

A 32-year-old woman was admitted with flank pain, fever, and hypoxemia. Imaging showed multifocal pulmonary opacities, pulmonary embolism, and renal vein thromboses. A diagnosis was made.

In this randomized, placebo-controlled trial involving patients with giant-cell arteritis, the oral Janus kinase inhibitor upadacitinib (15 mg) significantly improved remission of disease, with less glucocorticoid use.

In this trial, patients with type 2 diabetes had a lower incidence of major cardiovascular outcomes with a systolic blood-pressure target of less than 120 mm Hg than with a target of less than 140 mm Hg.

In a trial involving 135 participants with IgG4-related disease, inebilizumab was associated with significantly lower flare risk and greater likelihood of complete remission than placebo at 1 year.

In this audio interview, Editor-in-Chief Eric Rubin and Deputy Editor Jane Leopold discuss research being presented at the 2024 American Heart Association Scientific Sessions. . . .

Elevated blood pressure mediates much of the organ toxicity affecting persons with type 2 diabetes. The management of hypertension occupies as much clinical attention as that of dysglycemia, yet the recommended blood-pressure target in type 2 diabetes remains controversial. The Systolic Blood Pressure Intervention Trial (SPRINT; 9361 participants), which excluded...

IgG4-related disease is an increasingly recognized fibroinflammatory condition with protean manifestations. The disorder is characterized by inflammatory mass lesions that can involve many different organs and organ systems — including the pancreas and biliary tract, orbital structures, salivary and lacrimal glands, lungs, retroperitoneum, and kidneys — and can also cause...

A 72-year-old woman with type 2 diabetes had somnolence after a urologic procedure for bladder cancer. She had respiratory acidosis and anion-gap metabolic acidosis. A diagnosis was made.

This feature about a woman with diabetic ketoacidosis offers a case vignette accompanied by two essays, one supporting the use of balanced crystalloid fluids for fluid resuscitation and the other recommending the use of isotonic saline.

Chronic kidney disease affects 14% of the U.S. population¹ and is associated with an extraordinarily high risk of poor outcomes, including progression to end-stage kidney disease, cardiovascular events, and death.² Finally, after decades of therapeutic stagnation, a recent explosion of new therapies has revolutionized treatment options...

Two years of empagliflozin slowed kidney disease progression and reduced cardiovascular risk. In this post-trial study, empagliflozin had additional cardiorenal benefits after discontinuation.

Antibody-mediated rejection is an important determinant of allograft survival. Our understanding of antibody-mediated rejection has increased dramatically since the era when only hyperacute antibody-mediated rejection was known. Subacute, acute, and slowly progressive antibody-mediated rejection were subsequently recognized. Many aspects regarding the diagnosis and grading of allograft rejection have been developed...

Kidney-transplant microvascular inflammation has a varied clinical presentation. This study of more than 16,000 biopsy specimens supports the recognition of additional rejection phenotypes to standardize diagnostics.

This report describes the transplantation of a gene-edited porcine kidney in a hemodialysis-dependent man with long-standing diabetes, advanced vasculopathy, and marked dialysis-access challenges.

My journey as a pediatric nephrologist began with a laboratory elective in 1968, the year Drs. Jean Berger and Nicole Hinglais described the presence of IgA in the mesangium in certain patients with hematuria, subsequently called Berger’s disease. In those days, it was largely considered to be a benign condition....

In a prespecified interim analysis of a phase 3, randomized, controlled trial, the selective endothelin type A receptor antagonist atrasentan reduced proteinuria in patients with IgA nephropathy, without apparent safety issues.