Proteomic Analysis Identifies Dysregulated Proteins in Albuminuria: A South African Pilot Study.

Albuminuria may precede decreases in the glomerular filtration rate (GFR) and both tests are insensitive predictors of early stages of kidney disease. Our aim was to characterise the urinary proteome in black African individuals with albuminuria and well-preserved GFR from South Africa. This case-controlled study compared the urinary proteomes of 52 normoalbuminuric (urine albumin: creatinine ratio (uACR) < 3 mg/mmol) and 56 albuminuric (uACR ≥ 3 mg/mmol) adults of black African ethnicity.

A machine learning approach towards assessing consistency and reproducibility: an application to graft survival across three kidney transplantation eras.

Background: In South Africa, between 1966 and 2014, there were three kidney transplant eras defined by evolving access to certain immunosuppressive therapies defined as (before availability of cyclosporine), (when cyclosporine became available), and (availability of tacrolimus and mycophenolic acid). As such, factors influencing kidney graft failure may vary across these eras. Therefore, evaluating the consistency and reproducibility of models developed to study these variations using machine learning (ML) algorithms could enhance our understanding of post-transplant graft survival dynamics across these three eras.

Cystatin C should be routinely available for estimating kidney function.

Purpose Of Review: In this report, we summarize why the availability of cystatin C is important across a variety of clinical scenarios, the recent literature on when, why and in whom cystatin C testing should be considered, and how nephrologists can take practical steps to incorporate cystatin C testing into their practice.

Recent Findings: Large intra-individual discrepancies between estimated glomerular filtration rate by creatinine (eGFRcr) and estimated glomerular filtration rate by creatinine eGFRcys (known as eGFRdiff) are observed in at least 1 in 4 people. These differences are seen more commonly among more vulnerable individuals: older adults, females, non-White individuals and those living with multiple medical conditions.

Proteomic insights into the pathophysiology of hypertension-associated albuminuria: Pilot study in a South African cohort.

Background: Hypertension is an important public health priority with a high prevalence in Africa. It is also an independent risk factor for kidney outcomes. We aimed to identify potential proteins and pathways involved in hypertension-associated albuminuria by assessing urinary proteomic profiles in black South African participants with combined hypertension and albuminuria compared to those who have neither condition.

Alternative creatinine-based GFR estimates in United States populations-similar performance, same gaps-is it time to move on?

This study evaluated performance of the European Kidney Function Consortium (EKFC) equation in a US cohort, comparing population-specific (EKFCPS) with race-free (EKFCRF) Q values (median normal creatinine). Both EKFCPS and EKFCRF equations showed less bias than the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) 2021 equation. The percentage of estimated glomerular filtration rate (GFR) within 30% of measured GFR was similar for CKD-EPI 2021 (79.

The impact of diabetes and hypertension on renal allograft survival- A single center study.

Background: To determine the impact of pre-transplant diabetes mellitus (DM) and post-transplant hypertension (HT) at 1 year on renal allograft survival in all adult first kidney-only (FKO) transplant recipients at a single transplant center in Johannesburg, South Africa.

Materials And Methods: A retrospective review was conducted of all adult FKO transplant procedures at the Charlotte Maxeke Johannesburg Academic Hospital transplant unit between 1966 and 2013.

Results: During the stipulated timeframe, 1685 adult FKO transplant procedures were performed.

Forgotten but not gone in rural South Africa: Urinary schistosomiasis and implications for chronic kidney disease screening in endemic countries.

Urinary schistosomiasis caused by infection with ( ) remains endemic in Africa and is associated with haematuria and albuminuria/proteinuria. Kidney Disease Improving Global Outcomes clinical guidelines recommend evaluating proteinuria/albuminuria and glomerular filtration rate for chronic kidney disease (CKD) diagnosis. The guidelines are informed by population data outside of Africa but have been adopted in many African countries with little validation.

The African Liver Tissue Biorepository Consortium: Capacitating Population-Appropriate Drug Metabolism, Pharmacokinetics, and Pharmacogenetics Research in Drug Discovery and Development.

Pharmaceutical companies subject all new molecular entities to a series of in vitro metabolic characterizations that guide the selection and/or design of compounds predicted to have favorable pharmacokinetic properties in humans. Current drug metabolism research is based on liver tissue predominantly obtained from people of European origin, with limited access to tissue from people of African origin. Given the interindividual and interpopulation genomic variability in genes encoding drug-metabolizing enzymes, efficacy and safety of some drugs are poorly predicted for African populations.

Genome-wide association analysis of cystatin-C kidney function in continental Africa.

Background: Chronic kidney disease is becoming more prevalent in Africa, and its genetic determinants are poorly understood. Creatinine-based estimated glomerular filtration rate (eGFR) is commonly used to estimate kidney function, modelling the excretion of the endogenous biomarker (creatinine). However, eGFR based on creatinine has been shown to inadequately detect individuals with low kidney function in Sub-Saharan Africa, with eGFR based on cystatin-C (eGFRcys) exhibiting significantly superior performance.

Disparities in the Prevalence of Osteoporosis and Osteopenia in Men and Women Living in Sub-Saharan Africa, the UK, and the USA.

Purpose: To review the rising prevalence of osteopenia and osteoporosis in sub-Saharan Africa and the challenges this poses to governments and healthcare services. Using existing studies, we compare the prevalence of osteopenia and osteoporosis in men and women from sub-Saharan Africa to US and UK cohorts. Context-specific disparities in healthcare are discussed particularly the challenges in diagnosis and treatment of osteoporosis.

Screening for Kidney Disease in Low- and Middle-Income Countries.

Kidney disease is the 10th leading cause of death worldwide and disproportionately increases morbidity and mortality for people residing in low- and middle-income countries (LMICs). Considering the high burden of chronic kidney disease (CKD) on patients, society, and health care systems, strategies to improve screening for CKD need to be prioritized. With appropriate interventions, screening could prevent progression of early stages of CKD and, ultimately, reduce the need for kidney replacement therapy.

The causal effects of lipid traits on kidney function in Africans: bidirectional and multivariable Mendelian-randomization study.

Background: Observational studies have investigated the effect of serum lipids on kidney function, but these findings are limited by confounding, reverse causation and have reported conflicting results. Mendelian randomization (MR) studies address this confounding problem. However, they have been conducted mostly in European ancestry individuals.

Identifying the prevalence and correlates of multimorbidity in middle-aged men and women: a cross-sectional population-based study in four African countries.

Objectives: To determine the prevalence of multimorbidity, to identify which chronic conditions cluster together and to identify factors associated with a greater risk for multimorbidity in sub-Saharan Africa (SSA).

Design: Cross-sectional, multicentre, population-based study.

Setting: Six urban and rural communities in four sub-Saharan African countries.

Kidney dysfunction: prevalence and associated risk factors in a community-based study from the North West Province of South Africa.

Background: Globally, the World Health Organization ranks chronic kidney disease (CKD) as one of the top 10 causes of mortality. In South Africa, where noncommunicable diseases have become leading causes of mortality, the true population prevalence of CKD is unknown and associated risk factors remain understudied. This study aimed to describe the prevalence of kidney dysfunction and associated risk factors in a community from the North West province of South Africa.

Estimating population level 24-h sodium excretion using spot urine samples in older adults in rural South Africa.

Background: South Africa has introduced regulations to reduce sodium in processed foods. Assessing salt consumption with 24-h urine collection is logistically challenging and expensive. We assess the accuracy of using spot urine samples to estimate 24-h urine sodium (24hrUNa) excretion at the population level in a cohort of older adults in rural South Africa.

Chronic kidney disease (CKD) and associated risk in rural South Africa: a population-based cohort study.

In Africa, true prevalence of chronic kidney disease (CKD) is unknown, and associated clinical and genetic risk factors remain understudied. This population-based cohort study aimed to investigate CKD prevalence and associated risk factors in rural South Africa. A total 2021 adults aged 20-79 years were recruited between 2017-2018 from the Agincourt Health and Socio-Demographic Surveillance System in Bushbuckridge, Mpumalanga, South Africa.

Emphasising Organisational Routine: A Qualitative Study of Patient and Health Professional Experiences of Inpatient Oncology Care.

Background: Although the experience of hospitalisation for cancer management has been widely researched, such research from the African sub-continent is limited.

Objective: This study explored experiences of patient care in a tertiary, inpatient oncology setting in urban South Africa, from the point of view of patients and health professionals.

Methods: In-depth interviews and focus groups were conducted with participants.

Coronavirus Host Genomics Study: South Africa (COVIGen-SA).

Host genetic factors are known to modify the susceptibility, severity, and outcomes of COVID-19 and vary across populations. However, continental Africans are yet to be adequately represented in such studies despite the importance of genetic factors in understanding Africa's response to the pandemic. We describe the development of a research resource for coronavirus host genomics studies in South Africa known as COVIGen-SA-a multicollaborator strategic partnership designed to provide harmonised demographic, clinical, and genetic information specific to Black South Africans with COVID-19.