Skip to Main Content

Department of Kidney and Pancreas Health Center: Home

Library materials, subject guides, and useful resources compiled by KFSH&RC

About King Faisal Specialist Hospital & Research Center

King Faisal Specialist Hospital & Research Centre in Riyadh (KFSH&RC-R), is recognized internationally for its world-class facility, latest medical technology and equipment, experienced and professional doctors and health care providers, and excellent medical care. KFSH&RC-R opened in 1975 and is located close to Riyadh’s city center. The hospital has reached an international standard of excellence equivalent to that of leading global academic medical centers. KFSH&RC-R focuses primarily on research in the field of cancer, cardiovascular diseases, transplant immunology, genetics, molecular diagnostics, and proteomics. The facility has maintained the highest standards in specialized medical care in an integrated educational and research environment.

Welcome

Kidney, and Pancreas Health Center (KPHC)

Organ Transplant Center of Excellence (OTCoE)

The Kidney and Pancreas Health Center (KPHC) at King Faisal Hospital, Riyadh is a leading center in renal and pancreas transplantation, performing approximately 500 kidney transplants and 5–10 kidney-pancreas transplants annually. The center provides comprehensive follow-up care for over 5,000 transplant recipients through its outpatient services. Also serves as the primary renal consultation for solid organ transplant patients, the Transplant Nephrology team ensures expert management at every stage of the transplant journey. The Department library will ensure access to all departmental protocols, journal publications by department members and up-to-date access to transplant knowledge. King Faisal Hospital’s Transplant Nephrology, Kidney, and Pancreas Health Center remains committed to exceptional patient care, pioneering research, and the education of future leaders in transplantation medicine.

Scope of Services

Kidney and Kidney-Pancreas Transplantation

  • Preoperative evaluation and preparation of recipients and donors.
  • Immediate postoperative management, including immunosuppressive therapy and transplant induction.
  • Diagnosis and treatment of delayed graft function.
  • Post-transplant dialytic management.

Primary Renal Transplant Services

  • Management of rejection using immunosuppressive and adjunctive therapies (e.g., plasmapheresis).
  • Treatment of surgical and non-surgical complications, including acute and chronic graft dysfunction.
  • Diagnosis and management of infectious and non-infectious post-transplant complications.
  • Long-term follow-up addressing hematologic, cardiovascular, and metabolic concerns.
  • Training general nephrology fellows in transplant care.

Transplant Nephrology Consultation

  • Evaluation for combined kidney and multi-organ transplants.
  • Management of allograft dysfunction and immunosuppressive therapy in critically ill patients.
  • Coordination of immunosuppressive care for kidney transplant patients admitted to non-medicine services.

Outpatient Services

  • Develop diagnostic, consultative, therapeutic, and follow-up care plans.
  • Graft function evaluation, immunosuppressive therapy, and transplant-related complications.
  • Conduct comprehensive assessments of potential transplant recipients and living kidney donors.

Clinics

  • Staffed by transplant nephrologists, renal transplant fellows, and transplant coordinators.

Meetings and Conferences

  • Biweekly Selection Committee – Case discussions for transplant candidates.
  • Weekly Core Lecture – Updates in transplant nephrology.
  • Weekly Educational Lecture – Training sessions for fellows.

NEWS

  • Do Fast Foods Contribute to Food Insecurity in the In-Center Hemodialysis Population?This link opens in a new window No abstract available Mar 11, 2025
  • The Cardiovascular–Kidney Connection in the Hispanic/Latino CommunityThis link opens in a new window No abstract available Mar 11, 2025
  • Do Overweight Status and Obesity Affect Progression to ESKD in Autosomal Dominant Polycystic Kidney Disease?This link opens in a new window No abstract available Mar 12, 2025
  • Extending Kidney Protective Therapy to Type 1 Diabetes: The Time is NowThis link opens in a new window No abstract available Mar 11, 2025
  • The Kinetics of Cystatin C and Serum Creatinine in AKIThis link opens in a new window Key Points Modeling shows that serum cystatin C can detect AKI 6–48 hours earlier than serum creatinine, regardless of baseline kidney function.Absolute value diagnostic cutoffs are more effective than percentage-based thresholds for AKI detection across different CKD stages. Background AKI is a common condition affecting a significant portion of hospitalized and critically ill patients. Current AKI diagnosis relies on serum creatinine (sCr), which has several recognized limitations that affect the timely detection and response to AKI management. Serum cystatin C (sCys) has characteristics that can overcome the limitations of sCr, but head-to-head comparisons of these biomarkers are difficult to study prospectively. A quantitative assessment of the kinetics of sCys and sCr during AKI is necessary to support clinical workflow implementation for AKI diagnosis and management. Methods A quantitative systems pharmacology model was developed using Matrix Laboratories and Simbiology (The MathWorks, Natick, MA), to simulate the concentration–time profiles of sCr and sCys under varying degrees of AKI across a spectrum of baseline kidney function. The model incorporated parameters from existing literature and used a contemporary sCr and sCys GFR equation to assess the time to reach AKI diagnostic criteria for both biomarkers. Results The model demonstrated that sCys achieves steady-state concentration and meets AKI diagnostic thresholds significantly faster than sCr, with an advantage of 6–48 hours, depending on CKD stage. sCys exhibited greater sensitivity in detecting GFR reductions, with the ability to detect AKI within 12–24 hours after AKI, compared with 12–72 hours for sCr. The study also identified that for sCys, absolute value diagnostic cutoffs are more effective than percentage-based thresholds and can provide consistent detection across different CKD stages. Conclusions sCys has superior kinetics for early AKI detection compared with sCr, making it a valuable addition to AKI diagnostic protocols, particularly in high-risk populations. Daily monitoring of sCys in patients at risk of AKI would facilitate more timely detection and potentially improve clinical outcomes. Future research should focus on validating sCys diagnostic criteria and integrating it with other biomarkers to enhance AKI management. Jan 30, 2025
  • Novel Dietary Inflammatory Score and Risk of Incident CKDThis link opens in a new window Key Points Inflammation is relevant for CKD. Dietary intake influences inflammation.In 9814 individuals, our study found that concordance to a proinflammatory diet was associated with greater risk of CKD.Our results suggest that clinicians should consider recommending reducing dietary patterns high in inflammatory potential. Background Inflammation contributes to the onset of CKD. Diet is a modifiable risk factor for CKD; however, it remains unknown if the inflammatory potential of the diet is prospectively associated with CKD risk in healthy individuals. Methods In 9814 participants (mean age: 60 years) free of CKD in the Atherosclerosis Risk in Communities Study at visit 3 (1993–1995), we developed a novel empirically derived, food-based, dietary inflammatory score (Comprehensive Dietary Inflammation Index [CDII]) from a random two-thirds sample (N=6,542, discovery) and validated in the remaining one-third sample (N=3,272, validation). Reduced rank regression with 13 inflammatory biomarkers as the response variables and 31 food groups as the independent variables was used to develop the CDII. Cox proportional hazards models were used to calculate hazard ratios and 95% confidence intervals and test the association between the CDII and incident CKD, adjusting for important confounders. Results The CDII included eight food groups (four proinflammatory and four anti-inflammatory), with a higher score representing a more proinflammatory diet. In the validation sample, the CDII was positively correlated with most proinflammatory proteins (C-reactive protein, interferon-γ, IL-8, IL-6, and monocyte chemoattractant protein-1) and negatively correlated with adiponectin. However, the CDII was positively associated with one anti-inflammatory protein (transforming growth factor-β). Over a median follow-up of 19 years (mean follow-up of 18 years), 3293 participants developed CKD. A diet that was the most versus least concordant with the CDII (quartile 4 versus quartile 1) had 28% greater risk of incident CKD (hazard ratio, 1.28; 95% confidence interval, 1.15 to 1.43; P trend < 0.001). Conclusions A novel diet score, representing its inflammatory potential, was associated with a higher risk of developing CKD. Reducing consumption of proinflammatory diet may be a strategy to prevent CKD. Feb 16, 2025
  • Validation of the Beck Depression Inventory in US Hispanic Patients with CKDThis link opens in a new window Key Points The Beck Depression Inventory is a valid instrument to screen for depressive symptoms in Hispanic adults with CKD.Using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders Fourth Edition Disorders as the gold standard, a Beck Depression Inventory of ≥16 was found to be the optimal screening cutoff in Hispanic adults with nondialysis CKD or ESKD. Background Depression is common in patients with CKD. Self-report scales, including the Beck Depression Inventory (BDI), have been evaluated in non-Hispanic adults with CKD for screening of depressive symptoms. However, the BDI has not been validated in Hispanic adults with CKD. Methods We investigated the screening characteristics of the BDI in 248 Hispanic adults (164 with CKD and 84 with ESKD) enrolled in the Hispanic Chronic Renal Insufficiency Cohort Study. Two trained study personnel administered the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders Fourth Edition Disorders, which served as the gold-standard measure for the diagnosis of major depression. Results Among the 164 participants with CKD, the mean (SD) age was 61 (0.8) years, 37% were female, 77% spoke primarily Spanish, mean (SD) eGFR was 37 (1.3) ml/min per 1.73 m2, and median (interquartile range) proteinuria was 0.4 (0.1–2.0) g/g. Using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders Fourth Edition Disorders, 24 (15%) were classified as having current major depressive disorder. The best cutoff BDI score to identify current major depression disorder on the basis of the receiver-operating characteristic curve was 16. Sensitivity was 88%, specificity was 84%, positive predictive value was 49%, and negative predictive value was 98%. Similar results were found in participants with ESKD. Conclusions A BDI score of ≥16 was sensitive and specific for identifying major depression in US Hispanic adults with CKD and ESKD, which is a higher cutoff than reported for non-Hispanic patients with CKD. These differences in psychometric properties should be considered in future research and clinical practice. Feb 16, 2025
  • Life's Essential 8, Cardiovascular Health, and CKD Progression among Hispanic/Latino Adults: The Hispanic Community Health Study/Study of Latinos StudyThis link opens in a new window Key Points In US Hispanic/Latino adults with CKD, better cardiovascular health is associated with slower eGFR declines and improvements in albumin-to-creatinine ratio over 6 years.These findings support the implementation of a heart healthy lifestyle to delay CKD progression among US Hispanic/Latino adults. Background The primary cause of death in CKD is cardiovascular disease. Life's essential 8 (LE8) is an established measure of cardiovascular health (CVH). Our objective was to examine the relationship between CVH (LE8 score) and CKD progression among Hispanic/Latino adults, an understudied but growing population. Methods The Hispanic Community Health Study/Study of Latinos is a longitudinal cohort of Hispanic/Latino adults aged 18–74 years from four cities in the United States, examined at visit 1 (V1, 2008–2011) and visit 2 (2014–2017). At V1, participants underwent a comprehensive assessment of health behaviors (diet, physical activity, nicotine exposure, and sleep health) and clinical measurements (body mass index, blood lipids, blood glucose, and BP) used to estimate an LE8 score (range: 0–100). We included 1284 participants with CKD at V1, defined as eGFR <60 ml/min per 1.73 m2 and/or urine albumin-to-creatinine ratio (ACR) ≥30 mg/g. Change in eGFR and log(ACR) was defined as the difference in each measure between V1 and visit 2. To estimate the association between LE8 score with change in eGFR and log(ACR), we used linear regression models adjusted for follow-up time and demographic, socioeconomic, and clinical factors. All analyses accounted for Hispanic Community Health Study/Study of Latinos complex survey design. Results Among 1284 Hispanic/Latino participants with CKD at V1, the mean age was 48.6 years (SEM: 0.8), 57.2% were women, and the mean LE8 score was 61.1 (SEM: 0.7). Over an average of 6 years of follow-up, eGFR declined by 5.8 ml/min per 1.73 m2 and log(ACR) declined by 0.60. From multivariable adjusted models, for each 10-unit higher LE8 score, eGFR was lower by 0.97 ml/min per 1.73 m2 less (95% confidence interval, −1.93 to −0.02) and log(ACR) was lower by an additional 0.15 (95% confidence interval, 0.05 to 0.25). Conclusions Among diverse US Hispanic/Latino adults with CKD, higher LE8 score (better CVH) was associated with a slower decline in eGFR and lower albuminuria over 6 years. Feb 27, 2025
  • Bridging the Gap: Assessing Nephrology Transition Practices in Pediatric and Adult Medical CentersThis link opens in a new window Key Points Despite recommendations, many nephrology programs lack a structured transition clinic or transition protocol for young adults.There is a lack of coordination between partnered adult and pediatric programs to establish formal transition practices.Adult nephrology programs generally perceive a lower need for health care transition practices compared to pediatric nephrology programs. Background The transition from pediatric to adult care can be challenging for young adults living with kidney disease. The International Society of Nephrology recommends establishing a transition process for this vulnerable population. The prevalence of nephrology transition clinics and protocols in academic medical centers, however, is currently unknown. Methods General nephrology and transplant nephrology programs were surveyed at both pediatric and adult medical centers to explore the current state of nephrology transition practices. Programs without transition clinics were asked to identify obstacles preventing the establishment of a transition clinic. Results Overall, there were 488 programs targeted for survey distribution. There were 188 survey responses with an overall response rate of 39%. Only 20% of programs had a transition clinic, and 32% of programs reported neither having an established transition clinic nor a transition protocol. Adult programs were more likely to lack an established transition clinic or protocol compared with pediatric programs (42% versus 20%, P = 0.001). Of partnered pediatric and adult programs that both responded to the survey, 51% were discordant in their transition practices. For the 150 programs without a transition clinic, there were 119 comments regarding obstacles to the establishment of such a clinic. Resource and financial obstacles were mentioned most frequently (50% of comments). Adult programs were more likely to mention no perceived need or obstacles compared with pediatric programs (17% versus 4%, P = 0.04). Conclusions Despite guidelines recommending pediatric to adult transition programs for young adults with kidney disease, transition clinics remain uncommon. Although there are many cited barriers to the establishment of a nephrology transition clinic, our study highlights the lack of coordination and cooperation between adult and pediatric centers, which may stem from a lack of perceived need or interest from adult nephrology programs. Feb 4, 2025
  • Overweight Status, Obesity, and Progression to ESKD in Patients with Autosomal Dominant Polycystic Kidney DiseaseThis link opens in a new window Key Points Higher body mass index increased risk of progression to ESKD in patients with early-stage autosomal dominant polycystic kidney disease.Higher body mass index did not increase the risk of progression to ESKD in patients with late-stage autosomal dominant polycystic kidney disease. Background Prior research has linked higher body mass index (BMI) and greater visceral adiposity with more rapid progression of early-stage autosomal dominant polycystic kidney disease (ADPKD). We now evaluate the association between overweight and obesity in patients with early- and late-stage ADPKD with progression to ESKD. Methods Participants with early-stage ADPKD (study A; N=556; eGFR: 91±17 ml/min per 1.73 m2) and late-stage ADPKD (study B; N=483; eGFR: 48±12 ml/min per 1.73 m2) who participated in the Halt Progression of Polycystic Kidney Disease (HALT) polycystic kidney disease trials were categorized by BMI as normal weight (18.5–24.9 kg/m2; ref; n=357), overweight (25.0–29.9 kg/m2; n=384), or obese (≥30 kg/m2; n=298). Kaplan–Meier survival analysis and multivariate Cox proportional hazard models were used to determine the association of baseline BMI as a continuous and categorical variable with risk of ESKD (according to the United States Renal Data System) over a median (interquartile range) follow-up period of 12.2 (7.5–13.3; study A) and 7.3 (5.1–11.7; study B) years (primary outcome). All-cause mortality (National Death Index) was also considered as a competing risk (Fine and Gray method). Results The number of ESKD events was greater with overweight (n=24) and obesity (n=23) in HALT study A versus normal weight (n=12) but not in HALT study B (normal weight: n=89, overweight: n=102, obese: n=92). In fully adjusted models, higher BMI was associated with risk of progression to ESKD in study A (hazard ratio [HR (95% confidence interval)], 1.09 [1.03 to 1.15] per unit higher BMI) but not in study B (HR, 0.98 [0.96 to 1.00]). Obesity was associated with increased risk of ESKD (HR, 2.71 [1.22 to 6.02] versus normal weight) in study A only. Results were similar when considering death as a competing risk. Conclusions Higher BMI, particularly obesity, increased the risk of progression to ESKD in patients with early-stage ADPKD but not in those with late-stage ADPKD. Feb 18, 2025
  • Modeling Cardiorenal Protection with Sodium-Glucose Cotransporter 2 Inhibition in Type 1 Diabetes: An Analysis of DEPICT-1 and DEPICT-2This link opens in a new window Key Points Risk modelling analysis of DEPICT trials show that dapagliflozin reduced estimated cardiovascular and kidney disease risk in T1D persons.Greatest reduction in estimated ESKD risk was accompanied by an expected rise in eGFR, after 4 weeks post drug discontinuation.Dedicated outcome trials with SGLT2 inhibitors are warranted in T1D persons with CKD or CVD for best determination of efficacy and risks. Background Sodium-glucose cotransporter-2 (SGLT2) inhibitors improve glycemia and reduce insulin requirements in type 1 diabetes (T1D) and type 2 diabetes. Although SGLT2 inhibitors lower cardiovascular disease (CVD) and ESKD risk in type 2 diabetes, no dedicated cardiorenal outcome trials in T1D have been conducted to date. Using validated risk prediction models, this study evaluated the effect of SGLT2 inhibition on estimated CVD and ESKD risk in a T1D cohort. Methods Demographics, medical history, and biomarkers were extracted from 1473 participants with T1D enrolled in the Dapagliflozin Evaluation in Patients with Inadequately Controlled Type -1 and -2 trials. Data at baseline, 24, 52, and 56 weeks (4 weeks after drug cessation) were used to estimate 10-year CVD and 5-year ESKD risk using the Steno T1 Risk Engine (SRE) and Scottish Diabetes Research Network (SDRN) risk prediction models. Risk reduction was determined on the basis of relative change in risk from baseline between participants receiving dapagliflozin (pooled 5 and 10 mg) versus placebo. Subgroup analyses were conducted by age, sex, diabetes duration, CVD risk, and CKD status at baseline. Results The relative change in 10-year estimated CVD risk (SRE: –6.50% [–8.04% to –4.95%] and SDRN: –6.77% [–8.40% to –5.13%]; all P < 0.001) and 5-year ESKD risk (SRE: –4.48% [–7.68% to –1.28%]; P = 0.006) were lower at the end of 24 weeks of dapagliflozin treatment compared with placebo. Furthermore, the greatest relative change in 5-year ESKD risk was observed at week 56 (SRE: –12.84% [–16.65% to –9.03%]; P < 0.001), in conjunction with an expected rise in eGFR after drug washout. Subgroup analysis revealed larger relative lowering in 10-year CVD risk in those with CKD compared with those without (SRE: –11.3% versus –5.9%, and SDRN: –11.9% versus –6.1%, respectively; all Pinteraction < 0.02). Conclusions Dapagliflozin improves estimated CVD and ESKD risk in participants with T1D, emphasizing the need for cardiorenal outcome trials in people living with T1D. Feb 6, 2025
  • Current State and Future Direction of Vascular Access Training in the United StatesThis link opens in a new window Key Points Hands-on training is crucial for vascular access training.A multidisciplinary approach to vascular access training is paramount.Creation of a multifaceted vascular access curriculum is needed in all training programs. Background This study seeks to provide insights into the current state of vascular access education in adult nephrology fellowship programs in the United States and to identify areas for improvement. Methods A total of 63 adult nephrology programs and 71 second-year adult nephrology fellows were randomly selected for participation in a roundtable. Virtual roundtable discussions preceded by a survey were conducted to gather information on the delivery of vascular access education. Descriptive statistics were used for analysis. Results Among the respondents invited to the roundtable discussions, 42 individuals (30 faculty and 12 fellows) completed the survey, while 21 individuals (13 faculty and eight fellows) also participated in the roundtable discussion. Of these respondents, most (67%) didactic lectures on vascular access in fellowship programs were delivered by general nephrologists, with 57% provided by interventional nephrologists, 36% by surgeons, and 17% by interventional radiologists (respondents were able to select multiple disciplines). The respondents reported limited exposure to proceduralists, including interventional nephrologists and vascular access surgeons during fellowship training. Faculty and fellows were less comfortable with physical examination skills related to vascular access, particularly in using point-of-care ultrasound and interpreting vascular imaging as compared with naming and identification of vascular access. Both groups emphasized the importance of hands-on modalities in vascular access education. Conclusion Roundtable discussions highlighted the need for enhanced hands-on training, multidisciplinary collaboration, and standardized curricula in vascular access education. Recommendations were formulated in alignment with the three levels of competency outlined by the American Society of Nephrology Task Force on the Future of Nephrology, aiming to address gaps and improve the quality of vascular access education in nephrology fellowship programs. This study underscores the importance and need for a comprehensive vascular access education in nephrology fellowship training. By implementing the identified recommendations, programs can better prepare fellows to manage vascular access-related challenges in clinical practice. Feb 18, 2025
  • Food Insecurity and Risk of Hospitalization among Adults Receiving In-Center HemodialysisThis link opens in a new window Key Points Food insecurity was not associated with all-cause hospitalization but was associated with fluid or electrolyte-related hospitalization.Younger adults receiving hemodialysis may be more susceptible to food insecurity and should be a priority subpopulation for related interventions.Participants reporting food insecurity were more likely to miss dialysis treatments, suggesting food insecurity may affect outcomes through adherence. Background Food insecurity is common among people receiving in-center hemodialysis and living in residentially segregated communities. Food insecurity is associated with hospitalization in other chronic diseases but is understudied in the adult dialysis population. Methods We examined the association of food insecurity with all-cause hospitalization risk among adults receiving in-center hemodialysis. From February through December 2021, we conducted a prospective cohort study of adults at 17 dialysis facilities in Maryland, Washington DC, and Virginia. Participants completed a food insecurity survey at baseline and were monitored through their dialysis facility electronic medical record for 6 months. We censored participants upon change in dialysis modality, kidney transplantation, transfer to a nonparticipating dialysis facility, loss to follow-up, death, or end of the study follow-up period. Results We enrolled 322 participants. Of the 288 participants with survey and clinical record data, 61 (22%) reported food insecurity in the previous year and 91 (32%) experienced an all-cause hospitalization. Thirty-nine (13%) participants were censored before the end of the study period. Food insecurity was not a significant predictor of all-cause hospitalization in the full sample (adjusted hazard ratio [aHR], 1.06; 95% confidence interval [CI], 0.63 to 1.8). In exploratory analyses, all-cause hospitalization risk differed among younger and older participants reporting food insecurity, suggesting effect modification by age group (<55 years: aHR, 2.00; 95% CI, 0.91 to 4.42; ≥55 years: aHR, 0.63; 95% CI, 0.28 to 1.41; P value for interaction, 0.06). The risk of fluid or electrolyte-related hospitalizations among participants reporting food insecurity was three-fold higher than participants who were food secure (aHR, 3.04; 95% CI, 1.16 to 7.96). Conclusions In a cohort of adults receiving in-center hemodialysis, food insecurity was not associated with all-cause hospitalization but was associated with fluid or electrolyte-related hospitalization. Younger adults receiving in-center hemodialysis may be more susceptible to consequences of food insecurity. Feb 25, 2025
  • New Index Demonstrates Association between Social Vulnerability, Environmental Burden, and Kidney Failure Risk among Individuals with Glomerular DiseaseThis link opens in a new window Key Points More tools are needed to explore upstream drivers of racial and ethnic disparities in kidney disease outcomes.The Centers for Disease Control and Prevention Environmental Justice Index is a new tool which characterizes cumulative social and environmental burden at the census tract level.This study is the first application of the Environmental Justice Index to understanding glomerular disease outcomes. Background The Centers for Disease Control and Prevention Environmental Justice Index Social-Environmental Ranking (EJI-SER) combines a Social Vulnerability Module with an Environmental Burden Module to characterize cumulative environmental and social burden at the census tract level. This analysis evaluates the association between EJI-SER and kidney outcomes in patients with glomerular disease (GD). Methods Cure Glomerulopathy is an observational cohort study of adults and children with biopsy-proven GD. EJI-SER is a percentile ranking by census tract, with a higher score indicating a more severe burden. Associations between EJI-SER and its components with kidney failure (initiation of KRT, transplant, or two eGFRs <15 ml/min per 1.73 m2) and longitudinal eGFR were tested using multivariable Cox regression and linear mixed models, respectively, adjusted for demographics, histologic diagnosis, eGFR and urine protein to creatinine ratio at enrollment, and time from biopsy to enrollment. Results Among 1149 participants with census tract data, the median (interquartile range [IQR]) follow-up was 5.4 (3.0–7.0) years, the median (IQR) age at biopsy was 24 (10–48), and self-identified racial distribution was 5% Asian, 18% Black, and 70% White. Median (IQR) EJI-SER was 0.49 (0.26–0.75). EJI-SER scores in the lowest two quartiles were associated with a lower hazard of kidney failure compared with the highest quartile (adjusted hazard ratio [95% confidence interval], 0.62 [0.36 to 1.08] and 0.43 [0.25 to 0.76] for EJI-SER 0%–25% and >25%–50% versus >75%, respectively) and higher eGFR at enrolllment (adjusted mean 90.1 versus 87.1 ml/min per 1.73 m2 for 0%–25% versus >75%, P = 0.08). Conclusions As captured by EJI-SER, higher environmental and social burdens are associated with lower eGFR and a higher risk of kidney failure in the Cure Glomerulopathy cohort. This first use of the EJI-SER in GD demonstrates the need for additional investigation into social drivers of disparities in GD and policies and resources that address these structural inequities. Jan 16, 2025
  • Effect of Race on Transplantation in Autosomal Dominant Polycystic Kidney DiseaseThis link opens in a new window Key Points Despite overall superior outcomes, transplant outcomes of patients with autosomal dominant polycystic kidney disease are heavily influenced by race.Access to living donor and preemptive transplantation partly explains these racial disparities.Favorable Expected Post-Transplant Survival scores suggest that promoting equity would result in improved survival for patients with ADPKD. Background Autosomal dominant polycystic kidney disease (ADPKD) is the most common genetic cause of ESKD and occurs without racial predilection. In general, non-White patients with ESKD have less access to transplantation, especially living donor transplantation. We examined long-term outcomes of patients with ADPKD-ESKD by self-reported race, with attention to the trajectory of Estimated Post-Transplant Survival (EPTS) scores over time. Methods United Network for Organ Sharing Standard Transplant Analysis and Research files were used to identify 32,611 ADPKD transplant recipients between January 2000 and December 2022. EPTS scores were calculated from the date of waitlisting until transplantation occurred. Cumulative incidences of living and deceased transplantation were calculated and plotted. Cox models were made for graft failure and death, and a subdistribution hazards model for graft failure accounted for death as a competing outcome, with adjustment for patient, donor, and transplant factors. Results Compared with White patients with ADPKD, all other groups had more dialysis years, more delayed graft function, and fewer living and preemptive transplants; mean EPTS scores were lower in Black and Hispanic patients at each time point on the waitlist. However, EPTS scores at the time of transplant was less likely to be <20% in Black and Hispanic patients because of longer waiting time. Black patients had a significantly higher risk of graft failure with death as competing risk compared with White patients. Asian and Hispanic patients had similar graft survivals but better patient survival compared with White patients. Conclusions Waitlist experience, allograft quality, and post-transplant outcomes of patients with ADPKD are influenced by patient race. Jan 27, 2025
  • Trends in Timing of Preemptive Kidney Transplantation and Association with Allograft and Survival Outcomes in ChildrenThis link opens in a new window Key Points Preemptive kidney transplant is occurring at higher levels of eGFR in US children over time.Higher level of eGFR at the time of transplant is not associated with patient or allograft survival.Implications of the observed trend of performing preemptive kidney transplant at higher eGFR on the long-term health of children deserve further study. Background There has been a recent trend toward starting dialysis at higher eGFRs in children, with no identified survival benefits. We aimed to determine whether there are similar trends in the timing of preemptive kidney transplant and whether higher eGFR (≥15 ml/min per 1.73 m2) at preemptive kidney transplant was associated with clinical outcomes among US children. Methods We performed a retrospective cohort study of 1514 children in the United States Renal Data System who received a preemptive kidney transplant between 2006 and 2019. In primary analysis, we examined the association between calendar year and eGFR (ml/min per 1.73 m2) at the time of preemptive kidney transplant, categorized as higher (eGFR ≥15) versus lower (eGFR <15) using logistic regressions. The relationship between eGFR at preemptive kidney transplant and graft failure or death was assessed using Cox proportional hazards and Fine–Gray models. Results We found a temporal trend in eGFR at preemptive kidney transplant in children; every 5-year increase in calendar period was associated with 55% higher odds (95% confidence interval, 1.35 to 1.79) of receiving a preemptive kidney transplant at higher eGFR. There was no association between preemptive kidney transplant at higher (versus lower) eGFR and risk of allograft failure or death (hazard ratio, 1.12; 95% confidence interval, 0.87 to 1.43) over a median follow-up of 5.7 years. Conclusions There has been a trend toward preemptive kidney transplant at higher eGFR over time in children. Receipt of a preemptive kidney transplant at higher eGFR was not associated with allograft or patient survival. Implications of these trends deserve further study. Feb 16, 2025
  • Risk of Surgical Site Infections after Tooth Extraction in CKD: A Retrospective Real-World Study in JapanThis link opens in a new window No abstract available Oct 22, 2024
  • Health Equity and Artificial Intelligence in NephrologyThis link opens in a new window No abstract available Jan 27, 2025
  • IgG4-Related Kidney DiseaseThis link opens in a new window No abstract available Feb 18, 2025
  • Cover ImageThis link opens in a new window No abstract available Mar 31, 2025
WebsiteThis link opens in a new window  |  FeedThis link opens in a new window

MGH Kidney Pancreas Transplant

Department Representative

Kidney & Pancreas Health Center Protocols