Sex and gender as predictors for allograft and patient-relevant outcomes after kidney transplantation.

Background: Sex, as a biological construct, and gender, defined as the cultural attitudes and behaviours attributed by society, may be associated with allograft loss, death, cancer, and rejection. Other factors, such as recipient age and donor sex, may modify the association between sex/gender and post-transplant outcomes.

Objectives: We sought to evaluate the prognostic effects of recipient sex and, separately, gender as independent predictors of graft loss, death, cancer, and allograft rejection following kidney or simultaneous pancreas-kidney (SPK) transplantation.

Blood pressure in young Aboriginal and Torres Strait Islander people: analysis of baseline data from a prospective cohort study.

Objective: To assess the distribution of blood pressure levels and the prevalence of hypertension and pre-hypertension in young Indigenous people (10-24 years of age).

Study Design: Prospective cohort survey study (Next Generation: Youth Wellbeing Study); baseline data analysis.

Setting, Participants: Aboriginal and Torres Strait Islander people aged 10-24 years living in regional, remote, and urban communities in Central Australia, Western Australia, and New South Wales; recruitment: March 2018 - March 2020.

Serum and urine nucleic acid screening tests for BK polyomavirus-associated nephropathy in kidney and kidney-pancreas transplant recipients.

Background: BK polyomavirus-associated nephropathy (BKPyVAN) occurs when BK polyomavirus (BKPyV) affects a transplanted kidney, leading to an initial injury characterised by cytopathic damage, inflammation, and fibrosis. BKPyVAN may cause permanent loss of graft function and premature graft loss. Early detection gives clinicians an opportunity to intervene by timely reduction in immunosuppression to reduce adverse graft outcomes.

Perspectives of Caregivers on Access to Health Care for Children with CKD.

Introduction: Inequitable access to health care based on demographic factors such as ethnicity, socioeconomic status and geographical location has been consistently found in children with chronic kidney disease (CKD). However, little is known about the perspectives of caregivers on accessing health care. We described caregivers' perspectives on accessing health care for children with CKD from socioeconomically disadvantaged backgrounds and/or rural or remote areas.

Establishing a peritoneal dialysis technique survival core outcome measure: A standardised outcomes in nephrology-peritoneal dialysis consensus workshop report.

Background: Technique survival, also reported with negative connotations as technique failure or transfer from peritoneal dialysis to haemodialysis, has been identified by patients, caregivers and health professionals as a critically important outcome to be reported in all trials. However, there is wide variation in how peritoneal dialysis technique survival is defined, measured and reported, leading to difficulty in comparing or consolidating results.

Methods: We conducted an online international consensus workshop to establish a core outcome measure of technique survival.

Non-corticosteroid immunosuppressive medications for steroid-sensitive nephrotic syndrome in children.

Background: About 80% of children with steroid-sensitive nephrotic syndrome (SSNS) have relapses. Of these children, half will relapse frequently, and are at risk of adverse effects from corticosteroids. While non-corticosteroid immunosuppressive medications prolong periods of remission, they have significant potential adverse effects.

Using prediction models to improve care and communicate risk: updated modeling for children with IgA nephropathy.

Clinical risk prediction models are being generated at an increasing rate. One important component is the identification of groups for whom such models might require recalibration to retain their desired performance. To this end, an update of the postbiopsy International IgA Nephropathy Prediction Tool for children has been published in this issue of Kidney International.

Experiences of Social Isolation and Loneliness in Chronic Kidney Disease: A Secondary Qualitative Analysis.

Key Points: Loneliness and social isolation are increasingly recognized as global public health issues; however, little is known about the patient and caregiver experience in CKD. We used qualitative data to explore the experiences of loneliness and social isolation from the perspective of patients and caregivers.

Background: Many patients with CKD experience loneliness and social isolation, which are associated with a higher risk of mortality, morbidity, and poor mental health.

Corticosteroid therapy for nephrotic syndrome in children.

Background: In nephrotic syndrome, protein leaks from the blood into the urine through the glomeruli, resulting in hypoproteinaemia and generalised oedema. While most children with nephrotic syndrome respond to corticosteroids, 80% experience a relapsing course. Corticosteroids have reduced the death rate to around 3%; however, corticosteroids have well-recognised potentially serious adverse events such as obesity, poor growth, hypertension, diabetes mellitus, osteoporosis, cataracts, glaucoma and behavioural disturbances.

Patient, Parental, and Health Professional Perspectives on Growth in Children With CKD.

Rationale & Objective: Growth failure is a common problem among children with chronic kidney disease (CKD). Reduced height is associated with psychosocial burden, social stigma, and impaired quality of life. This study describes the aspects of growth impairment that are most impactful from the perspectives of children with CKD, their parents, and health professionals.

The cultural safety of research reports on primary healthcare use by Indigenous Peoples: a systematic review.

Introduction: Community-driven research in primary healthcare (PHC) may reduce the chronic disease burden in Indigenous peoples. This systematic review assessed the cultural safety of reports of research on PHC use by Indigenous peoples from four countries with similar colonial histories.

Methods: Medline, CINAHL and Embase were all systematically searched from 1st January 2002 to 4th April 2023.

Causal Relationship Between Kidney Function and Cancer Risk: A Mendelian Randomization Study.

Rationale & Objective: Patients treated with kidney replacement therapy experience a 1.5- to 2-fold increased risk of cancer and cancer mortality compared with the general population. Whether this excess risk extends to people with earlier stage chronic kidney disease and whether reduced kidney function is causally related to cancer is unclear.

Antihypertensive treatment for kidney transplant recipients.

Background: The comparative effects of specific blood pressure (BP) lowering treatments on patient-important outcomes following kidney transplantation are uncertain. Our 2009 Cochrane review found that calcium channel blockers (CCBs) improved graft function and prevented graft loss, while the evidence for other BP-lowering treatments was limited. This is an update of the 2009 Cochrane review.

On the efficacy of facial masks to suppress the spreading of pathogen-carrying saliva particles during human respiratory events: Insights gained via high-fidelity numerical modeling.

Respiratory fluid dynamics is integral to comprehending the transmission of infectious diseases and the effectiveness of interventions such as face masks and social distancing. In this research, we present our recent studies that investigate respiratory particle transport via high-fidelity large eddy simulation coupled with the Lagrangian particle tracking method. Based on our numerical simulation results for human respiratory events with and without face masks, we demonstrate that facial masks could significantly suppress particle spreading.

Nanopores map the acid-base properties of a single site in a single DNA molecule.

Nanopores are increasingly powerful tools for single molecule sensing, in particular, for sequencing DNA, RNA and peptides. This success has spurred efforts to sequence non-canonical nucleic acid bases and amino acids. While canonical DNA and RNA bases have pKas far from neutral, certain non-canonical bases, natural RNA modifications, and amino acids are known to have pKas near neutral pHs at which nanopore sequencing is typically performed.

Metformin for preventing the progression of chronic kidney disease.

Background: Metformin has been used in the management of diabetes for decades. It is an effective, low-cost intervention with a well-established safety profile. Emerging evidence suggests that metformin targets a number of pathways that lead to chronic kidney damage, and long-term use may, therefore, slow the rate of kidney function decline and chronic kidney disease (CKD) progression.

Hypertension and Cardiovascular Risk Among Children with Chronic Kidney Disease.

Purpose Of Review: Cardiovascular disease is the most common cause of mortality across the lifespan of children with chronic kidney disease (CKD). Hypertension is a common and important contributor, but other factors such as obesity, dyslipidemia and mineral bone disease play a role. This narrative review focusses on studies published in the past five years that have investigated hypertension and cardiovascular risk among children with CKD.

Socioeconomic Position and Health Among Children and Adolescents With CKD Across the Life-Course.

Children and adolescents in families of lower socioeconomic position (SEP) experience an inequitable burden of reduced access to healthcare and poorer health. For children living with chronic kidney disease (CKD), disadvantaged SEP may exacerbate their considerable disease burden. Across the life-course, CKD may also compromise the SEP of families and young people, leading to accumulating health and socioeconomic disadvantage.