Journal of the American Society of Nephrology : JASN




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This Month’s Highlights

doi : 10.1681/ASN.2021050662

JASN July 2021, 32 (7) i

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Too Little or Too Much? Extracellular Matrix Remodeling in Kidney Health and Disease

Sergi Clotet-Freixas and Ana Konvalinka

doi : 10.1681/ASN.2021050654

JASN July 2021, 32 (7) 1541-1543

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Primacy in Kidney Allocation: Does It Alleviate the Barriers to Transplantation?

John S. Gill, Catherine R. Butler and Neil R. Powe

doi : 10.1681/ASN.2021040474

JASN July 2021, 32 (7) 1544-1545

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New Kidney and Pancreas Allocation Policy: Moving to a Circle as the First Unit of Allocation

Ajay Israni, Andrew Wey, Bryn Thompson, Jon Miller, Vincent Casingal, Martha Pavlakis, Silke Niederhaus, Rachel Forbes, Amber Wilk, Warren McKinney, Raja Kandaswamy, Peter Stock and Jon Snyder

doi : 10.1681/ASN.2020121679

JASN July 2021, 32 (7) 1546-1550

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Role of Platelets in Chronic Kidney Disease

Nishank Jain, Adam L. Corken, Amudha Kumar, Clayton L. Davis, Jerry Ware and John M. Arthur

doi : 10.1681/ASN.2020121806

JASN July 2021, 32 (7) 1551-1558

Platelet-dependent mechanisms for excessive clotting and bleeding in CKD remain undefined. Moreover, platelets’ contribution to inflammation, and specifically to CKD, are equally elusive. To date, descriptions of changes in the functional properties of circulating platelets during CKD have provided confusing interpretations. Experimental approaches that can advance our understanding of platelet dysfunction in CKD are needed, and studies that provide mechanistic insights into the dynamic relationships between thrombosis, bleeding, and inflammation associated with CKD will be essential to improve clinical management and outcomes for this vulnerable population. This article summarizes existing literature characterizing platelets in CKD and identifies areas that need further investigation.

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Potential Therapeutic Targets for Cisplatin-Induced Kidney Injury: Lessons from Other Models of AKI and Fibrosis

Sophia M. Sears and Leah J. Siskind

doi : 10.1681/ASN.2020101455

JASN July 2021, 32 (7) 1559-1567

The effectiveness of cisplatin, a mainstay in the treatment of many solid organ cancers, is hindered by dose-limiting nephrotoxicity. Cisplatin causes AKI in 30% of patients. Patients who do not develop AKI by clinical standards during treatment are still at risk for long-term decline in kidney function and the development of CKD. The connection between AKI and CKD has become increasingly studied, with renal fibrosis a hallmark of CKD development. To prevent both the short- and long-term effects of cisplatin, researchers must use models that reflect both types of pathology. Although a lot is known about cisplatin-induced AKI, very little is known about the mechanisms by which repeated low levels of cisplatin lead to fibrosis development. In this review, strategies used in various rodent models to prevent kidney injury, its progression to fibrosis, or both, are examined to gain mechanistic insights and identify potential therapeutic targets for cisplatin-induced kidney pathologies. Reviewing the results from these models highlights the diverse and highly complex role of cell death, cell senescence, endoplasmic reticulum stress, autophagy, and immune cell activation in acute and chronic kidney injuries. The use of several models of kidney injury is needed for development of agents that will prevent all aspects of cisplatin-induced kidney injury.

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Epidemiology and Outcomes of COVID-19 in Home Dialysis Patients Compared with In-Center Dialysis Patients

Caroline M. Hsu, Daniel E. Weiner, Gideon Aweh, Page Salenger, Doug S. Johnson and Eduardo Lacson

doi : 10.1681/ASN.2020111653

JASN July 2021, 32 (7) 1569-1573

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SARS-CoV-2 Vaccine Acceptability in Patients on Hemodialysis: A Nationwide Survey

Pablo Garcia, Maria E. Montez-Rath, Heather Moore, Johnie Flotte, Chris Fults, Martha S. Block, Jialin Han, Mary Dittrich, Julie Parsonnet, Glenn M. Chertow, Geoffrey A. Block and Shuchi Anand

doi : 10.1681/ASN.2021010104

JASN July 2021, 32 (7) 1575-1581

Background Patients on dialysis are at increased risk for COVID-19–related complications. However, a substantial fraction of patients on dialysis belong to groups more likely to be hesitant about vaccination.

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Platelet Function in CKD: A Systematic Review and Meta-Analysis

Constance C.F.M.J. Baaten, Marieke Sternkopf, Tobias Henning, Nikolaus Marx, Joachim Jankowski and Heidi Noels

doi : 10.1681/ASN.2020101440

JASN July 2021, 32 (7) 1583-1598

Background Patients with CKD are at high risk for thrombotic and hemorrhagic complications. Abnormalities in platelet function are central to these complications, but reports on platelet function in relation to CKD are conflicting, and vary from decreased platelet reactivity to normal or increased platelet responsiveness. The direct effects of uremic toxins on platelet function have been described, with variable findings.

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Activation of Sympathetic Signaling in Macrophages Blocks Systemic Inflammation and Protects against Renal Ischemia-Reperfusion Injury

Sho Hasegawa, Tsuyoshi Inoue, Yasuna Nakamura, Daichi Fukaya, Rie Uni, Chia-Hsien Wu, Rie Fujii, Wachirasek Peerapanyasut, Akashi Taguchi, Takahide Kohro, Shintaro Yamada, Mikako Katagiri, Toshiyuki Ko, Seitaro Nomura, Atsuko Nakanishi Ozeki, Etsuo A. Susaki, Hiroki R. Ueda, Nobuyoshi Akimitsu, Youichiro Wada, Issei Komuro, Masaomi Nangaku and Reiko Inagi

doi : 10.1681/ASN.2020121723

JASN July 2021, 32 (7) 1599-1615

Background The sympathetic nervous system regulates immune cell dynamics. However, the detailed role of sympathetic signaling in inflammatory diseases is still unclear because it varies according to the disease situation and responsible cell types. This study focused on identifying the functions of sympathetic signaling in macrophages in LPS-induced sepsis and renal ischemia-reperfusion injury (IRI).

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Empagliflozin Inhibits Proximal Tubule NHE3 Activity, Preserves GFR, and Restores Euvolemia in Nondiabetic Rats with Induced Heart Failure

Fl?vio A. Borges-J?nior, Dan?bia Silva dos Santos, Acaris Benetti, Juliano Z. Polidoro, Aline C.T. Wisnivesky, Renato O. Crajoinas, Ednei L. Antônio, Leonardo Jensen, Bruno Caramelli, Gerhard Malnic, Paulo J. Tucci and Adriana C.C. Girardi

doi : 10.1681/ASN.2020071029

JASN July 2021, 32 (7) 1616-1629

Background SGLT2 inhibitors reduce the risk of heart failure (HF) mortality and morbidity, regardless of the presence or absence of diabetes, but the mechanisms underlying this benefit remain unclear. Experiments with nondiabetic HF rats tested the hypothesis that the SGLT2 inhibitor empagliflozin (EMPA) inhibits proximal tubule (PT) NHE3 activity and improves renal salt and water handling.

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Anti Human CX3CR1 VHH Molecule Attenuates Venous Neointimal Hyperplasia of Arteriovenous Fistula in Mouse Model

Sanjay Misra, Sreenivasulu Kilari, Binxia Yang, Amit Sharma, Chih-Cheng Wu, Roberto I. Vazquez-Padron and John Broadwater

doi : 10.1681/ASN.2020101458

JASN July 2021, 32 (7) 1630-1648

Background Fractalkine receptor 1 (CX3CR1) mediates macrophage infiltration and accumulation, causing venous neointimal hyperplasia (VNH)/venous stenosis (VS) in arteriovenous fistula (AVF). The effect of blocking CX3CR1 using an anti–human variable VHH molecule (hCX3CR1 VHH, BI 655088) on VNH/VS was determined using a humanized mouse in which the human CX3CR1 (hCX3CR1) gene was knocked in (KI).

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3D Mapping Reveals a Complex and Transient Interstitial Matrix During Murine Kidney Development

Sarah N. Lipp, Kathryn R. Jacobson, David S. Hains, Andrew L. Schwarderer and Sarah Calve

doi : 10.1681/ASN.2020081204

JASN July 2021, 32 (7) 1649-1665

Background The extracellular matrix (ECM) is a network of proteins and glycosaminoglycans that provides structural and biochemical cues to cells. In the kidney, the ECM is critical for nephrogenesis; however, the dynamics of ECM composition and how it relates to 3D structure during development is unknown.

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Serine Protease HTRA1 as a Novel Target Antigen in Primary Membranous Nephropathy

Laith Farah Al-Rabadi, Tiffany Caza, Claire Trivin-Avillach, Aylin R. Rodan, Nicole Andeen, Norifumi Hayashi, Brandi Williams, Monica P. Revelo, Fred Clayton, Jo Abraham, Edwin Lin, Willisa Liou, Chang-Jiang Zou, Nirupama Ramkumar, Tim Cummins, Daniel W. Wilkey, Issa Kawalit, Christian Herzog, Aaron Storey, Rick Edmondson, Ronald Sjoberg, Tianxin Yang, Jeremy Chien, Michael Merchant, John Arthur, Jon Klein, Chris Larsen and Laurence H. Beck

doi : 10.1681/ASN.2020101395

JASN July 2021, 32 (7) 1666-1681

Background Identification of target antigens PLA2R, THSD7A, NELL1, or Semaphorin-3B can explain the majority of cases of primary membranous nephropathy (MN). However, target antigens remain unidentified in 15%–20% of patients.

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A Rare Autosomal Dominant Variant in Regulator of Calcineurin Type 1 (RCAN1) Gene Confers Enhanced Calcineurin Activity and May Cause FSGS

Brandon M. Lane, Susan Murray, Katherine Benson, Agnieszka Bierzynska, Megan Chryst-Stangl, Liming Wang, Guanghong Wu, Gianpiero Cavalleri, Brendan Doyle, Neil Fennelly, Anthony Dorman, Shane Conlon, Virginia Vega-Warner, Damian Fermin, Poornima Vijayan, Mohammad Azfar Qureshi, Shirlee Shril, Moumita Barua, Friedhelm Hildebrandt, Martin Pollak, David Howell, Matthew G. Sampson, Moin Saleem, Peter J. Conlon, Robert Spurney and Rasheed Gbadegesin

doi : 10.1681/ASN.2020081234

JASN July 2021, 32 (7) 1682-1695

Background Podocyte dysfunction is the main pathologic mechanism driving the development of FSGS and other morphologic types of steroid-resistant nephrotic syndrome (SRNS). Despite significant progress, the genetic causes of most cases of SRNS have yet to be identified.

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Autonomous Calcium Signaling in Human and Zebrafish Podocytes Controls Kidney Filtration Barrier Morphogenesis

Lydia Djenoune, Ritu Tomar, Aude Dorison, Irene Ghobrial, Heiko Schenk, Jan Hegermann, Lynne Beverly-Staggs, Alejandro Hidalgo-Gonzalez, Melissa H. Little and Iain A. Drummond

doi : 10.1681/ASN.2020101525

JASN July 2021, 32 (7) 1697-1712

Background Podocytes are critical to maintaining the glomerular filtration barrier, and mutations in nephrotic syndrome genes are known to affect podocyte calcium signaling. However, the role of calcium signaling during podocyte development remains unknown.

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Identification of an Altered Matrix Signature in Kidney Aging and Disease

Michael J. Randles, Franziska Lausecker, Qingyang Kong, Hani Suleiman, Graeme Reid, Maria Kolatsi-Joannou, Bernard Davenport, Pinyuan Tian, Sara Falcone, Paul Potter, Tom Van Agtmael, Jill T. Norman, David A. Long, Martin J. Humphries, Jeffrey H. Miner and Rachel Lennon

doi : 10.1681/ASN.2020101442

JASN July 2021, 32 (7) 1713-1732

Background Accumulation of extracellular matrix in organs and tissues is a feature of both aging and disease. In the kidney, glomerulosclerosis and tubulointerstitial fibrosis accompany the decline in function, which current therapies cannot address, leading to organ failure. Although histologic and ultrastructural patterns of excess matrix form the basis of human disease classifications, a comprehensive molecular resolution of abnormal matrix is lacking.

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Patients with High Priority for Kidney Transplant Who Are Not Given Expedited Placement on the Transplant Waiting List Represent Lost Opportunities

Jesse D. Schold, Anne M. Huml, Emilio D. Poggio, John R. Sedor, Syed A. Husain, Kristin L. King and Sumit Mohan

doi : 10.1681/ASN.2020081146

JASN July 2021, 32 (7) 1733-1746

Background Kidney transplantation is associated with the best outcomes for most patients with ESKD. The national Kidney Allocation System prioritizes patients with Estimated Post-Transplant Survival (EPTS) scores in the top 20% for expedited access to optimal deceased donor kidneys.

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Plasma Proteomics of Renal Function: A Transethnic Meta-Analysis and Mendelian Randomization Study

Pamela R. Mat?as-Garc?a, Rory Wilson, Qi Guo, Shaza B. Zaghlool, James M. Eales, Xiaoguang Xu, Fadi J. Charchar, John Dormer, Haifa Maalmi, Pascal Schlosser, Mohamed A. Elhadad, Jana Nano, Sapna Sharma, Annette Peters, Alessia Fornoni, Dennis O. Mook-Kanamori, Juliane Winkelmann, John Danesh, Emanuele Di Angelantonio, Willem H. Ouwehand, Nicholas A. Watkins, David J. Roberts, Agnese Petrera, Johannes Graumann, Wolfgang Koenig, Kristian Hveem, Christian Jonasson, Anna K?ttgen, Adam Butterworth, Marco Prunotto, Stefanie M. Hauck, Christian Herder, Karsten Suhre, Christian Gieger, Maciej Tomaszewski, Alexander Teumer, Melanie Waldenberger and Human Kidney Tissue Resource

doi : 10.1681/ASN.2020071070

JASN July 2021, 32 (7) 1747-1763

Background Studies on the relationship between renal function and the human plasma proteome have identified several potential biomarkers. However, investigations have been conducted largely in European populations, and causality of the associations between plasma proteins and kidney function has never been addressed.

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Diagnosis, Education, and Care of Patients with APOL1-Associated Nephropathy: A Delphi Consensus and Systematic Review

Barry I. Freedman, Wylie Burke, Jasmin Divers, Lucy Eberhard, Crystal A. Gadegbeku, Rasheed Gbadegesin, Michael E. Hall, Tiffany Jones-Smith, Richard Knight, Jeffrey B. Kopp, Csaba P. Kovesdy, Keith C. Norris, Opeyemi A. Olabisi, Glenda V. Roberts, John R. Sedor and Erika Blacksher

doi : 10.1681/ASN.2020101399

JASN July 2021, 32 (7) 1765-1778

Background APOL1 variants contribute to the markedly higher incidence of ESKD in Blacks compared with Whites. Genetic testing for these variants in patients with African ancestry who have nephropathy is uncommon, and no specific treatment or management protocol for APOL1-associated nephropathy currently exists.

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Phase 3 Randomized Study Comparing Vadadustat with Darbepoetin Alfa for Anemia in Japanese Patients with Nondialysis-Dependent CKD

Masaomi Nangaku, Kazuoki Kondo, Yoshimasa Kokado, Kiichiro Ueta, Genki Kaneko, Tsubasa Tandai, Yutaka Kawaguchi and Yasuhiro Komatsu

doi : 10.1681/ASN.2020091311

JASN July 2021, 32 (7) 1779-1790

Background Standard care for treating anemia in patients with CKD includes use of erythropoiesis-stimulating agents, which sometimes involves increased risks of cardiovascular morbidity and mortality. Previous studies in patients with anemia and nondialysis-dependent CKD (NDD-CKD) found significantly elevated hemoglobin levels with use of vadadustat, an oral hypoxia-inducible factor prolyl hydroxylase inhibitor, compared with placebo.

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Effects of a Knowledge-Translation Intervention on Early Dialysis Initiation: A Cluster Randomized Trial

Navdeep Tangri, Amit X. Garg, Thomas W. Ferguson, Stephanie Dixon, Claudio Rigatto, Selina Allu, Elaine Chau, Paul Komenda, David Naimark, Gihad E. Nesrallah, Steven D. Soroka, Monica Beaulieu, Ahsan Alam, S. Joseph Kim, Manish M. Sood and Braden Manns

doi : 10.1681/ASN.2020091254

JASN July 2021, 32 (7) 1791-1800

Background The Initiating Dialysis Early and Late (IDEAL) trial, published in 2009, found no clinically measurable benefit with respect to risk of mortality or early complications with early dialysis initiation versus deferred dialysis start. After these findings, guidelines recommended an intent-to-defer approach to dialysis initiation, with the goal of deferring it until clinical symptoms arise.

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The Effect of Tolvaptan on BP in Polycystic Kidney Disease: A Post Hoc Analysis of the TEMPO 3:4 Trial

Judith E. Heida, Ron T. Gansevoort, Vicente E. Torres, Olivier Devuyst, Ronald D. Perrone, Jennifer Lee, Hui Li, John Ouyang and Arlene B. Chapman

doi : 10.1681/ASN.2020101512

JASN July 2021, 32 (7) 1801-1812

Background The V2 receptor antagonist tolvaptan is prescribed to patients with autosomal dominant polycystic kidney disease to slow disease progression. Tolvaptan may alter BP via various acute and chronic effects.

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Cardiac and Noncardiac Determinants of Exercise Capacity in CKD

Shanmugakumar Chinnappa, Nigel Lewis, Omer Baldo, Ming-Chieh Shih, Yu-Kang Tu and Andrew Mooney

doi : 10.1681/ASN.2020091319

JASN July 2021, 32 (7) 1813-1822

Background Impaired exercise capacity is a significant symptom of CKD and is associated with poor survival. Furthermore, there is a growing interest in applying exercise as a diagnostic tool or as therapy in CKD. However, an in-depth understanding of exercise physiology in CKD is still lacking.

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High Incidence of Circuit Clotting in Critically Ill COVID-19 Patients Treated with Renal Replacement Therapy

Eloïse Grenon and Emmanuel Canet

doi : 10.1681/ASN.2021040528

JASN July 2021, 32 (7) 1823-1824

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Utility of Phosphate Binder Equivalent Dose Concept

Manjunath Kulkarni

doi : 10.1681/ASN.2021040440

JASN July 2021, 32 (7) 1824

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Authors’ Reply

Pablo E. Pergola, David P. Rosenbaum, Yang Yang and Glenn M. Chertow

doi : 10.1681/ASN.2021050606

JASN July 2021, 32 (7) 1824-1825

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