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Caliskan Y, Lee B, Whelan AM, Abualrub F, Lentine KL, Jittirat A. Evaluation of Genetic Kidney Diseases in Living Donor Kidney Transplantation: Towards Precision Genomic Medicine in Donor Risk Assessment. CURRENT TRANSPLANTATION REPORTS 2022; 9:127-142. [DOI: 10.1007/s40472-021-00340-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Abstract
Purpose of Review
To provide a comprehensive update on the role of genetic testing for the evaluation of kidney transplant recipient and living donor candidates.
Recent Findings
The evaluation of candidates for living donor transplantation and their potential donors occurs within an ever-changing landscape impacted by new evidence and risk assessment techniques. Criteria that were once considered contraindications to living kidney donation are now viewed as standard of care, while new tools identify novel risk markers that were unrecognized in past decades. Recent work suggests that nearly 10% of a cohort of patients with chronic/end-stage kidney disease had an identifiable genetic etiology, many whose original cause of renal disease was either unknown or misdiagnosed. Some also had an incidentally found genetic variant, unrelated to their nephropathy, but medically actionable. These patterns illustrate the substantial potential for genetic testing to better guide the selection of living donors and recipients, but guidance on the proper application and interpretation of novel technologies is in its infancy. In this review, we examine the utility of genetic testing in various kidney conditions, and discuss risks and unresolved challenges. Suggested algorithms in the context of related and unrelated donation are offered.
Summary
Genetic testing is a rapidly evolving strategy for the evaluation of candidates for living donor transplantation and their potential donors that has potential to improve risk assessment and optimize the safety of donation.
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Fu SM, Wang H, Dai C, Sung SSJ, Gaskin F. Pathogenesis of proliferative lupus nephritis from a historical and personal perspective. Clin Immunol 2017; 185:51-58. [PMID: 27591148 PMCID: PMC5332347 DOI: 10.1016/j.clim.2016.07.024] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 07/25/2016] [Accepted: 07/26/2016] [Indexed: 01/27/2023]
Affiliation(s)
- Shu Man Fu
- Division of Rheumatology, The Center of Inflammation, Immunity and Regenerative Medicine and Division of Nephrology, Department of Medicine, University of Virginia, Charlottesville, VA, United States; Department of Microbiology, Immunology and Cancer Biology, University of Virginia, Charlottesville, VA, United States.
| | - Hongyang Wang
- Division of Rheumatology, The Center of Inflammation, Immunity and Regenerative Medicine and Division of Nephrology, Department of Medicine, University of Virginia, Charlottesville, VA, United States
| | - Chao Dai
- Division of Rheumatology, The Center of Inflammation, Immunity and Regenerative Medicine and Division of Nephrology, Department of Medicine, University of Virginia, Charlottesville, VA, United States
| | - Sun-Sang J Sung
- Division of Rheumatology, The Center of Inflammation, Immunity and Regenerative Medicine and Division of Nephrology, Department of Medicine, University of Virginia, Charlottesville, VA, United States
| | - Felicia Gaskin
- Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, VA, United States
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Capriolli TV, Visentainer JEL, Sell AM. Lack of association between Kidd blood group system and chronic kidney disease. Rev Bras Hematol Hemoter 2017; 39:301-305. [PMID: 29150101 PMCID: PMC5693269 DOI: 10.1016/j.bjhh.2017.05.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 05/29/2017] [Accepted: 05/30/2017] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND The Kidd blood group system has three antigens, Jka, Jkb and Jk3, found on red blood cells and on endothelial cells of the inner lining of blood vessels in the renal medulla. These are known as urea transporter B (UT-B). Researchers have found that individuals carrying the Jk(a-b-) or Jk-null (UT-B null) phenotypes have a lower urine-concentrating capability and risk of severe renal impairment. This study evaluated the distribution of the Kidd phenotypes in patients with chronic kidney disease and a possible association of Kidd antigens with the development of renal disease. METHODS Jka and Jkb antigens were phenotyped using the gel column agglutination test (ID-cards Bio-RAD) in 197 patients with chronic kidney disease and 444 blood donors, as the control group. The phenotype and antigen frequencies between patients and controls were evaluated using the Chi-square method with Yates correction and logistic regression after adjustments for gender and age. RESULTS No differences were observed between the Kidd phenotypes frequency distribution between patients with chronic kidney disease and blood donors [Jk(a-b+)=22.3% and 27.2%; Jk(a+b-)=30.5% and 24.3%; Jk(a+b+)=47.25% and 48.4%, respectively]. CONCLUSION The distribution of Kidd phenotypes found in the studied population is expected for Caucasians; Jka and Jkb antigens and phenotypes were not found to be related to susceptibility for chronic kidney disease.
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Affiliation(s)
| | | | - Ana Maria Sell
- Universidade Estadual de Maringá (UEM), Maringá, PR, Brazil.
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Hayek SS, Koh KH, Grams ME, Wei C, Ko YA, Li J, Samelko B, Lee H, Dande RR, Lee HW, Hahm E, Peev V, Tracy M, Tardi NJ, Gupta V, Altintas MM, Garborcauskas G, Stojanovic N, Winkler CA, Lipkowitz MS, Tin A, Inker LA, Levey AS, Zeier M, Freedman BI, Kopp JB, Skorecki K, Coresh J, Quyyumi AA, Sever S, Reiser J. A tripartite complex of suPAR, APOL1 risk variants and α vβ 3 integrin on podocytes mediates chronic kidney disease. Nat Med 2017; 23:945-953. [PMID: 28650456 PMCID: PMC6019326 DOI: 10.1038/nm.4362] [Citation(s) in RCA: 156] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 06/01/2017] [Indexed: 12/17/2022]
Abstract
Soluble urokinase plasminogen activator receptor (suPAR) independently predicts chronic kidney disease (CKD) incidence and progression. Apolipoprotein L1 (APOL1) gene variants G1 and G2, but not the reference allele (G0), are associated with an increased risk of CKD in individuals of recent African ancestry. Here we show in two large, unrelated cohorts that decline in kidney function associated with APOL1 risk variants was dependent on plasma suPAR levels: APOL1-related risk was attenuated in patients with lower suPAR, and strengthened in those with higher suPAR levels. Mechanistically, surface plasmon resonance studies identified high-affinity interactions between suPAR, APOL1 and αvβ3 integrin, whereby APOL1 protein variants G1 and G2 exhibited higher affinity for suPAR-activated avb3 integrin than APOL1 G0. APOL1 G1 or G2 augments αvβ3 integrin activation and causes proteinuria in mice in a suPAR-dependent manner. The synergy of circulating factor suPAR and APOL1 G1 or G2 on αvβ3 integrin activation is a mechanism for CKD.
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Affiliation(s)
- Salim S Hayek
- Emory Clinical Cardiovascular Research Institute, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Kwi Hye Koh
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Morgan E Grams
- Welch Center for Prevention and Johns Hopkins Bloomberg School of Public Health, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, Maryland, USA
| | - Changli Wei
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Yi-An Ko
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, Georgia, USA
| | - Jing Li
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Beata Samelko
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Hyun Lee
- Center for Biomolecular Science and Department of Medicinal Chemistry and Pharmacognosy, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Ranadheer R Dande
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Ha Won Lee
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Eunsil Hahm
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Vasil Peev
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Melissa Tracy
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Nicholas J Tardi
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Vineet Gupta
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Mehmet M Altintas
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Garrett Garborcauskas
- Harvard Medical School and Division of Nephrology, Massachusetts General Hospital, Charlestown, Massachusetts, USA
| | - Nikolina Stojanovic
- Harvard Medical School and Division of Nephrology, Massachusetts General Hospital, Charlestown, Massachusetts, USA
| | - Cheryl A Winkler
- Molecular Genetic Epidemiology Section, Basic Research Laboratory, Basic Science Program, NCI, Leidos Biomedical Research, Frederick National Laboratory, Frederick, Maryland, USA
| | - Michael S Lipkowitz
- Division of Nephrology and Hypertension, Georgetown University Medical Center, Washington, DC, USA
| | - Adrienne Tin
- Welch Center for Prevention and Johns Hopkins Bloomberg School of Public Health, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, Maryland, USA
| | - Lesley A Inker
- Division of Nephrology, Tufts Medical Center, Boston, Massachusetts, USA
| | - Andrew S Levey
- Division of Nephrology, Tufts Medical Center, Boston, Massachusetts, USA
| | - Martin Zeier
- Division of Nephrology, Ruprecht Karls University, Heidelberg, Germany
| | - Barry I Freedman
- Department of Internal Medicine, Section on Nephrology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Jeffrey B Kopp
- Kidney Disease Section, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland, USA
| | - Karl Skorecki
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Rambam Health Care Campus, Haifa, Israel
| | - Josef Coresh
- Welch Center for Prevention and Johns Hopkins Bloomberg School of Public Health, Epidemiology and Clinical Research, Johns Hopkins University, Baltimore, Maryland, USA
| | - Arshed A Quyyumi
- Emory Clinical Cardiovascular Research Institute, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Sanja Sever
- Harvard Medical School and Division of Nephrology, Massachusetts General Hospital, Charlestown, Massachusetts, USA
| | - Jochen Reiser
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
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Roveran Genga K, Lo C, Cirstea M, Zhou G, Walley KR, Russell JA, Levin A, Boyd JH. Two-year follow-up of patients with septic shock presenting with low HDL: the effect upon acute kidney injury, death and estimated glomerular filtration rate. J Intern Med 2017; 281:518-529. [PMID: 28317295 DOI: 10.1111/joim.12601] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Sepsis is associated with decreased levels of high-density lipoprotein (HDL) cholesterol. HDL has anti-inflammatory properties, and the use of Apo A-I mimetic peptides is associated with renal function improvement in animal models of sepsis. However, it is not known whether decreased HDL level results in impaired renal function in human sepsis. We investigated whether low levels of HDL conferred an increased risk of sepsis-associated acute kidney injury (AKI) or long-term decreased estimated glomerular filtration rate (eGFR) after sepsis. METHODS HDL concentration (mg dL-1 ) was measured in plasma samples from 180 patients with septic shock at admission to the Emergency Department (ED). We divided the patients using median HDL as a cut-off value and assessed the frequency of sepsis-associated AKI and long-term decreased eGFR after sepsis. Univariate and multivariate analyses were performed. RESULTS Patients with low HDL had a significantly greater frequency of KDIGO 2 or 3 sepsis-associated AKI [39/90 (43.3%) vs. 12/90 (13.3%), P < 0.001] and decreased long-term eGFR [24/58 (41.4%) vs. 11/57 (19.3%), P = 0.018] compared to those with high HDL. The adjusted OR for sepsis-associated AKI and decreased eGFR after sepsis in the lower HDL group was 2.80 (95% CI 1.08-7.25, P = 0.033) and 5.45 (95% CI 1.57-18.93, P = 0.008), respectively. CONCLUSION Low HDL levels during sepsis are associated with increased risk of sepsis-associated AKI, and/or subsequent decreased eGFR. These results suggest that HDL may be involved and/or may be a marker of kidney injury during and after sepsis.
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Affiliation(s)
- K Roveran Genga
- Centre for Heart Lung Innovation, University of British Columbia, Vancouver, BC, Canada
| | - C Lo
- Centre for Heart Lung Innovation, University of British Columbia, Vancouver, BC, Canada
| | - M Cirstea
- Centre for Heart Lung Innovation, University of British Columbia, Vancouver, BC, Canada
| | - G Zhou
- Centre for Heart Lung Innovation, University of British Columbia, Vancouver, BC, Canada
| | - K R Walley
- Centre for Heart Lung Innovation, University of British Columbia, Vancouver, BC, Canada
| | - J A Russell
- Centre for Heart Lung Innovation, University of British Columbia, Vancouver, BC, Canada
| | - A Levin
- Centre for Heart Lung Innovation, University of British Columbia, Vancouver, BC, Canada
| | - J H Boyd
- Centre for Heart Lung Innovation, University of British Columbia, Vancouver, BC, Canada
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Fu Y, Zhu JY, Richman A, Zhang Y, Xie X, Das JR, Li J, Ray PE, Han Z. APOL1-G1 in Nephrocytes Induces Hypertrophy and Accelerates Cell Death. J Am Soc Nephrol 2016; 28:1106-1116. [PMID: 27864430 DOI: 10.1681/asn.2016050550] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 10/09/2016] [Indexed: 01/17/2023] Open
Abstract
People of African ancestry carrying certain APOL1 mutant alleles are at elevated risk of developing renal diseases. However, the mechanisms underlying APOL1-associated renal diseases are unknown. Because the APOL1 gene is unique to humans and some primates, new animal models are needed to understand the function of APOL1 in vivo We generated transgenic Drosophila fly lines expressing the human APOL1 wild type allele (G0) or the predominant APOL1 risk allele (G1) in different tissues. Ubiquitous expression of APOL1 G0 or G1 in Drosophila induced lethal phenotypes, and G1 was more toxic than was G0. Selective expression of the APOL1 G0 or G1 transgene in nephrocytes, fly cells homologous to mammalian podocytes, induced increased endocytic activity and accumulation of hemolymph proteins, dextran particles, and silver nitrate. As transgenic flies with either allele aged, nephrocyte function declined, cell size increased, and nephrocytes died prematurely. Compared with G0-expressing cells, however, G1-expressing cells showed more dramatic phenotypes, resembling those observed in cultured mammalian podocytes overexpressing APOL1-G1. Expressing the G0 or G1 APOL1 transgene in nephrocytes also impaired the acidification of organelles. We conclude that expression of an APOL1 transgene initially enhances nephrocyte function, causing hypertrophy and subsequent cell death. This new Drosophila model uncovers a novel mechanism by which upregulated expression of APOL1-G1 could precipitate renal disease in humans. Furthermore, this model may facilitate the identification of APOL1-interacting molecules that could serve as new drug targets to treat APOL1-associated renal diseases.
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Affiliation(s)
- Yulong Fu
- Center for Cancer and Immunology Research, Washington, DC
| | - Jun-Yi Zhu
- Center for Cancer and Immunology Research, Washington, DC
| | - Adam Richman
- Center for Cancer and Immunology Research, Washington, DC
| | - Yi Zhang
- Center for Cancer and Immunology Research, Washington, DC.,Center for Genetic Medicine Research, Washington, DC
| | - Xuefang Xie
- Center for Genetic Medicine Research, Washington, DC
| | - Jharna R Das
- Center for Genetic Medicine Research, Washington, DC.,Division of Nephrology, Children's National Health Systems, Washington, DC; and.,Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Jinliang Li
- Center for Genetic Medicine Research, Washington, DC.,Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Patricio E Ray
- Center for Genetic Medicine Research, Washington, DC.,Division of Nephrology, Children's National Health Systems, Washington, DC; and.,Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Zhe Han
- Center for Cancer and Immunology Research, Washington, DC; .,Department of Pediatrics, The George Washington University School of Medicine and Health Sciences, Washington, DC
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Dettmar AK, Oh J. Infection-Related Focal Segmental Glomerulosclerosis in Children. BIOMED RESEARCH INTERNATIONAL 2016; 2016:7351964. [PMID: 27294131 PMCID: PMC4886048 DOI: 10.1155/2016/7351964] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/25/2015] [Revised: 04/07/2016] [Accepted: 04/21/2016] [Indexed: 01/16/2023]
Abstract
Focal segmental glomerulosclerosis (FSGS) is the most common cause of steroid resistant nephrotic syndrome in children. It describes a unique histological picture of glomerular damage resulting from several causes. In the majority of patients the causing agent is still unknown, but in some cases viral association is evident. In adults, the most established FSGS causing virus is the human immune-deficiency virus, which is related to a collapsing variant of FSGS. Nevertheless, other viruses are also suspected for causing a collapsing or noncollapsing variant, for example, hepatitis B virus, parvovirus B19, and Cytomegalovirus. Although the systemic infection mechanism is different for these viruses, there are similarities in the pathomechanism for the induction of FSGS. As the podocyte is the key structure in the pathogenesis of FSGS, a direct infection of these cells or immediate damage through the virus or viral components has to be considered. Although viral infections are a very rare cause for FSGS in children, the treating pediatric nephrologist has to be aware of a possible underlying infection, as this has a relevant impact on therapy and prognosis.
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Affiliation(s)
- Anne Katrin Dettmar
- Department of Pediatric Nephrology, University Children's Medical Clinic, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Jun Oh
- Department of Pediatric Nephrology, University Children's Medical Clinic, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
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