How to Best Protect Kidneys for Transplantation-Mechanistic Target

Global trends of delayed graft function in kidney transplantation from 2013 to 2023: a bibliometric analysis

Delayed graft function (DGF) is an early complication after kidney transplantation. The literature on DGF has experienced substantial growth. However, there is a lack of bibliometric analysis of DGF. This study aimed to analyze the scientific outputs of DGF and explore its hotspots from 2013 to 2023 by using CiteSpace and VOSviewer. The 2058 pieces of literature collected in the Web of Science Core Collection (WOSCC) from 1 January 2013 to 31 December 2023 were visually analyzed in terms of the annual number of publications, authors, countries, journals, literature co-citations, and keyword clustering by using CiteSpace and VOSviewer. We found that the number of papers published in the past ten years showed a trend of first increasing and then decreasing; 2021 was the year with the most posts. The largest number of papers was published by the University of California System, and the largest number of papers was published by the United States. The top five keyword frequency rankings are: 'delayed graft function', 'kidney transplantation', 'renal transplantation', 'survival', and 'recipients'. These emerging trends include 'brain death donors', 'blood absence re-injection injuries', 'tacrolimus', 'older donors and recipients', and 'artificial intelligence and DGF'. In summary, this study reveals the authors and institutions that could be cooperated with and discusses the research hotspots in the past ten years. It provides a reference and direction for future research and application of DGF.

Kidney/Aorta Ratio for Renal Morphometric Determination in Swine Subjected to Acute Kidney Injury Using an Optimized Surgical Model

This research aims to establish an experimental surgical model for access to the renal pedicle and kidney and to determine renal length measurement via the kidney/aorta ratio (K/AO) using ultrasound. Fifteen swine underwent ventral median celiotomy with a supraumbilical transverse incision to access the right and left renal pedicles and induce renal ischemia-reperfusion injury (IRR). The kidneys were evaluated using ultrasonography to standardize renal length, aortic diameter, and the K/AO. Assessment was performed at 2 time points: 1 h before and 24 h after the surgery to induce IRR. Blood and urine samples were collected to assess renal function. Histologic evaluation of kidney fragments was also conducted. The proposed abdominal cavity access method proved to be highly efficient for exposing the right and left renal pedicles and inducing IRR. Serum levels of urea, creatinine, calcium, and phosphorus, as well as levels of the urinary protein/urinary creatinine ratio and urinary GGT, did not show significant differences. Acute kidney injury was confirmed through histopathology. The mean lengths of the right and left kidneys were 82.63 and 87.64 mm, respectively. The values of the right and left K/AO were 9.81 and 10.38, respectively. There was no statistically significant difference in the K/AO ratio before and after IRR. The proposed surgical model allowed surgical intervention on the renal pedicles without intra- or postoperative complications. Furthermore, the K/AO could be measured through ultrasonography, establishing a reference for healthy animals.

Serum Glucocorticoid-Regulated Kinase-1 in Ischemia-Reperfusion Injury: Blessing or Curse

The family of serum-glucocorticoid-regulated kinase (SGK) consists of three paralogs, SGK-1, SGK-2, and SGK-3, with SGK-1 being the better studied. Indeed, recognition of the role of SGK-1 in regulation of cell survival and proliferation has led to introduction of a number of small-molecule inhibitors for some types of cancer. In addition, SGK-1 regulates major physiologic effects, such as renal solute transport, and contributes to the pathogenesis of non-neoplastic conditions involving major organs including the heart and the kidney. These observations raise the prospect for therapeutic modulation of SGK-1 to reduce the burden of such diseases as myocardial infarction and acute kidney injury. Following a brief description of the structure and function of SGK family of proteins, the present review is primarily focused on our current understanding of the role of SGK-1 in pathologies related to ischemia-reperfusion injury involving several organs (e.g., heart, kidney). The essential role of the mitochondrial permeability transition pore in cell death coupled with the pro-survival function of SGK-1 raise the prospect that its therapeutic modulation could beneficially impact conditions associated with ischemia-reperfusion injury. SIGNIFICANCE STATEMENT: Since the discovery of serum glucocorticoid-regulated kinase (SGK)-1, extensive research has unraveled its role in cancer biology and, thus, its therapeutic targeting. Increasingly, it is also becoming clear that SGK-1 is a major determinant of the outcome of ischemia-reperfusion injury to various organs. Thus, evaluation of existing information should help identify gaps in our current knowledge and also determine whether and how its therapeutic modulation could impact the outcome of ischemia-reperfusion injury.