Editor’s Note: We asked authors of Original Investigations to provide short plain-language summaries that would briefly summarize what inspired their study, the basic approach taken, what was learned, and why it matters. We hope our readers will find this valuable in helping them keep up with the latest research in the field of nephrology. Highlights from the August 2023 issue:
From the authors: In this observational study, we investigated the association of proton pump inhibitors with fatigue and health-related quality of life among kidney transplant recipients. Our data showed that proton pump inhibitors were independently associated with fatigue severity, severe fatigue, and lower physical and mental health-related quality of life. These associations were present among all individually assessed proton pump inhibitor types and were dose dependent. While we await future studies on this topic, proton pump inhibitor use might be an easily accessible target for alleviating fatigue and improving health-related quality of life among kidney transplant recipients.
Ultraprocessed Foods and Kidney Disease Progression, Mortality, and Cardiovascular Disease Risk in the CRIC Study by Valerie K. Sullivan et al
From the authors: Ultraprocessed foods are industrial formulations produced using ingredients and processes that are not commonly used in culinary preparations and contain few, if any, intact unprocessed foods. Ultraprocessed foods are widely consumed in the United States, and high intakes of such foods have been linked to cardiovascular disease, kidney disease, and mortality in the general population. In this study, we found that greater intake of ultraprocessed foods was associated with higher risk of kidney disease progression and mortality in adults with chronic kidney disease. Our findings suggest that patients with kidney disease may benefit from greater consumption of fresh, whole, and homemade or hand-prepared foods and fewer highly processed foods.
From the authors: Children with chronic kidney disease (CKD) have many treatment demands and experience many systemic effects. How CKD impacts the daily life of a child is poorly understood. We surveyed 212 children, adolescents, and younger adults with CKD and their parents over 24 months to assess the participants’ well-being over time. Among children, adolescents, and younger adults with CKD we found a very high and persistent burden of psychological distress that did not differ by degree of CKD or type of kidney disease. The participants with CKD endorsed greater impairment in fatigue and global health compared with healthy children, adolescents, and younger adults, and parent-reported sleep problems were associated with poorer patient-reported outcome (PRO) scores across all domains. These findings emphasize the importance of including PRO measures, including fatigue and sleep measures, into routine clinical care to optimize the lived experience of children with CKD.
From the authors: Heart disease and kidney disease are known to interact with each other. In this study, we examined whether cardiac abnormalities, as assessed by echocardiography, were linked to the subsequent progression of kidney disease among people living with chronic kidney disease (CKD). We found that people with abnormalities in heart structure and function had a greater risk of progression to advanced CKD that required kidney replacement therapy and had a faster rate of decline in kidney function. Our study indicates the potential role of abnormal heart structure and function in the progression of kidney disease among people living with CKD.
Case Report from the August 2023 issue:
Anaphylaxis From Ethylene Oxide–Sterilized Dialysis Tubing and Needles: A Case Report by Clarkson Crane et al [OPEN ACCESS]
Anaphylaxis and hypersensitivity reactions to dialysis equipment in patients undergoing maintenance hemodialysis (HD) have been well described. However, most reports are from the 1980s and describe reactions to dialyzers that were sterilized with ethylene oxide during the manufacturing process. In response to this, most commercial dialyzers are now sterilized with electron beam or steam sterilization. However, many other pieces of routine dialysis equipment, such as tubing and needles, continue to be sterilized with ethylene oxide. The authors report a case of anaphylaxis that initially presented as intradialytic hypotension and was ultimately attributed to an IgE-mediated allergy to ethylene oxide.
On the Cover: The word glomerulus derives from the Latin root, glomus, meaning “ball of yarn”. Glomerular diseases are complex and often considered challenging to understand, diagnose, and treat. Recent advancements in knowledge regarding the pathophysiology of glomerular diseases have improved their classification and catalyzed the development of novel diagnostic and therapeutic approaches for their management. The KDOQI commentary on the KDIGO 2021 Clinical Practice Guideline for the Management of Glomerular Diseases provides further insight and unravels the tangled strands of our knowledge on glomerular diseases.
The photograph “Confetti in a ball” by inger maaike is released on Flickr under the CC BY 2.0 license.
Special thanks to Editorial Intern Dilushi Wijayaratne for curating the cover image and drafting the cover blurb for this issue
This special collection highlights the top cited Original Investigations published in 2020 and 2021 that contributed to AJKD’s 2022 Impact Factor of 13.2, our highest IF yet. The editors would like to thank all the authors and reviewers who helped AJKD achieve this milestone..