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The impact of socioeconomic status on AKI incidence and survival

Social deprivation is associated with higher incidence of AKI and poorer survival even after adjusting for the higher presence of comorbidities.

A new study explored the socioeconomic gradient of the incidence and mortality of AKI, after adjusting for important mediators such as comorbidities. Authors linked primary care and laboratory data from two large acute hospitals in the south of England, sourced from the Care and Health Information Analytics database of 580 940 adults. Results showed that the annual incidence rate of first AKI was 1726/100 000 (1.7%). The risk of AKI was higher in the most deprived compared with the least deprived areas after controlling for age, sex, comorbidities and prescribed medication. Adjusted risk of mortality post first AKI was higher in the most deprived areas.

Find the paper in the CKJ here

3 September 2019/by ERA

Current state and pitfalls of B-cell therapy in lupus nephritis

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In a recently published NDT article, the authors reviewed the current experience with B-cell therapy in LN and highlighted the pitfalls that may have limited their success.

Systemic lupus erythematosus (SLE) is an autoimmune multisystem disease that commonly affects the kidneys characterized by persistent autoantibody production that targets a multitude of self-antigens. B-cells, plasmablasts and plasma cells, as the source of these autoantibodies, play a major role in the development of lupus nephritis (LN), and are therefore promising therapeutic targets. To date, however, randomized clinical trials of B-cell therapies in LN have not lived up to expectations, whereas uncontrolled cohort and observational studies of B-cell antagonists have been more promising.
In a recently published NDT article, the authors reviewed the current experience with B-cell therapy in LN and highlighted the pitfalls that may have limited their success.

Find an NDT review here

2 September 2019/by ERA

Long term outcomes following acute rejection in kidney transplant recipients

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The authors of a new study examined the association of AR within 6 months of kidney transplant with long-term outcomes of transplant recipients, using data from the ANZDATA Registry between 1997 and 2017.

Declining rates of acute rejection (AR) and the very high rate of 1-year graft survival among patients with AR has led some clinicians and researchers to reconsider the importance of AR as a primary outcome in clinical trials or in patients. The authors of a new study examined the association of AR within 6 months of kidney transplant with long-term outcomes of transplant recipients, using data from the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry between 1997 and 2017. Recipients with early AR were more likely to experience graft loss attributed to chronic allograft nephropathy and recurrent AR. Recipients with early AR were also more likely to die from cardiovascular disease or cancer. AR, therefore, remains an important short-term outcome in kidney transplantation with significant long-term effects.

Find out more here

1 September 2019/by ERA