Hello everyone 😊
Here is the monthly renal research bulletin for May 2024. Lots of excellent work has been done locally!
Local accomplishments
BEAM-KIDs
Congratulations to Dr Yadav who has become the site principal investigator for the BEAM-KIDs. Click here to learn more about the trial design.
Kidney transplantation in anuric children but no lower urinary tract disease
Well done to Sam Williamson who has co-authored the above project with Shuman Haq from Southampton. We look forward to seeing it at ESPN!
A Review of Cystatin C in the Paediatric Population – Biomolecules
Congratulations to David Kent, one of our ST2 doctors, who has co-authored the above publication!
And finally well done to Roger who has also had an abstract accepted for ESPN
Research from around the web
Highlights 💡
Adult transplant recipients were converted to a belatacept based immunosuppression regimen after developing CNI intolerance at any point post-transplant in two French transplant centers. Conversion to belatacept was associated with lower risk of graft failure and acceptable safety outcomes compared to matched patients maintained on CNI’s.
Other Interesting Papers and Oddities 🧐
CKD
Dyslipidaemia was present in 72% with CKD mostly affecting trigylcerides, but affecting all lipid fractions. Statistical modelling found it to be significantly associated with other cardiovascular risk factors.
Sleep disorders such as sleep apnoea, restless legs syndrome and insomnia are common and burdensome in CKD. Restless legs treatment options may include cool dialysate, iron supplementation and gabapentin. CBT for insomnia can be effective. Sleep apnoea is associated with accelerated decline in eGFR. Hypervolaemia in kidney failure may lead to sleep apnoea which can be ameliorated by intensification of ultrafiltration.
Transplantation
In response to increased demand for donor organs researchers have been exploring methods of preserving metabolically active kidneys to enable reconditioning, repair and regeneration of deceased donor organs. They have shown that kidneys can be preserved for up to 4 days when perfused with a cell-free perfusate supplemented with TCA cycle intermediates at 25 degrees Celsius.
AKI
Thinking of recent clinical events. Could biomarkers help us prepare patients for the need of renal replacement therapy? Urinary CCL14 has excellent predictive value for renal non-recovery in sepsis associated AKI
Stones
Among 5637 patients with urinary abnormalities pharmacological treatment resulted in 19% lower risk of recurrent stone disease within 12-36 months after the initial urine collection. Effectiveness diminished over longer follow-up periods and did not reach significance beyond 36 months. When examining specific urinary abnormalities only alkali therapy for hypocitraturia was associated with a significantly lower recurrence risk (HR 0.74, p = 0.03). We do not currently test for hypocitraturia … but should we?