Journal of the American Society of Nephrology : JASN
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Purine Metabolism Regulates the Severity of APOL1 Nephropathy

May 8, 2026

This study investigates how purine metabolism influences the severity of nephropathy associated with high-risk APOL1 genotypes in African Americans. The authors found that impaired purine biosynthesis and subsequent ATP depletion are significant factors in disease progression, and that supplementation with the purine precursor AICAr can alleviate cellular injury and reduce albuminuria in models of APOL1 nephropathy. These findings suggest that targeting purine metabolism may offer therapeutic potential for managing APOL1-related kidney disease.

Microvascular Inflammation in Kidney Transplantation

May 7, 2026

The authors aimed to determine the independent prognostic significance of microvascular inflammation, specifically glomerulitis and peritubular capillaritis (g+ptc≥2), in kidney transplant recipients, particularly in the absence of donor-specific anti-HLA antibodies (DSA). Their study found that while g+ptc≥2 was associated with higher rates of death-censored allograft loss, it did not independently predict worse outcomes when accounting for concurrent T-cell-mediated rejection (TCMR) and de novo DSA events. This suggests that g+ptc≥2 alone may not be a reliable indicator of long-term graft survival in the context of modern immunosuppressive therapy.

Gestational Ketosis Compromises Nephron Endowment and Long-Term Kidney Function in Offspring

May 6, 2026

The authors investigate the impact of maternal ketosis, induced by a ketogenic diet or β-hydroxybutyrate supplementation, on fetal kidney development and long-term kidney function in offspring. Their findings reveal that maternal ketosis leads to a significant reduction in nephron number and impaired kidney function in offspring, attributed to disrupted nephrogenesis through the suppression of c-Myc signaling and activation of inflammatory pathways in nephron progenitor cells.

Integrating Genomics and Proteomics to Identify Causal Proteins and Biologic Pathways for Incident Atrial Fibrillation in CKD

May 1, 2026

The authors aimed to identify causal proteins and biological pathways linking chronic kidney disease (CKD) to incident atrial fibrillation (AF) and to develop a predictive model for AF risk in CKD patients. Through the analysis of plasma proteins in two cohorts, they discovered three proteins (NELL1, CILP2, and MMP12) associated with AF and found significant overlap in pathways related to both AF and left atrial enlargement. Additionally, they created a multi-protein risk score for AF that demonstrated comparable predictive performance to existing clinical risk models.

Normalization of nCounter Gene Expression Data Alters Molecular Diagnostics in Kidney Transplantation

Apr 23, 2026

The authors aimed to determine how different normalization methods for nCounter gene expression data affect the diagnostic performance of molecular profiling in kidney transplantation, specifically for antibody-mediated rejection (AMR) and T cell-mediated rejection (TCMR). They evaluated ten normalization techniques across multiple cohorts and found that while most methods improved gene count stability and diagnostic accuracy, complex methods like RCRNorm and RUVSeq negatively impacted performance. Ultimately, simpler normalization approaches consistently provided better outcomes for B-HOT-based diagnostics.

eGFR Discordance and its Association with Outcomes following Allogeneic Hematopoietic Stem Cell Transplantation and Adoptive T-Cell Therapies

Apr 21, 2026

The authors aimed to investigate the relationship between discordance in estimated glomerular filtration rate (eGFR) measurements based on serum creatinine and cystatin C, and the occurrence of acute kidney injury (AKI) and mortality following allogeneic hematopoietic stem cell transplantation (HSCT) and adoptive T-cell therapies. Their findings indicated that eGFR discordance was associated with higher odds of AKI or death in both patient cohorts; however, these associations diminished after adjusting for eGFR values. Additionally, eGFR discordance correlated with slower platelet engraftment and prolonged cytopenia in the respective treatments.

Computational Frontiers in Arteriovenous Fistula Maturation: A Review of Fluid Dynamics and Machine Learning Models

Apr 17, 2026

This review investigates the mechanisms behind the high failure rates of arteriovenous (AV) fistula maturation in hemodialysis patients, which can reach up to 60%. The authors explore the potential of computational fluid dynamics (CFD) and machine learning (ML) models to better understand hemodynamic conditions and predict clinical outcomes, while highlighting the need for larger, more diverse datasets and external validation to enhance the clinical applicability of these models.

Medications Influencing Serum Cystatin C Independent of Measured Glomerular Filtration Rate

Apr 17, 2026

The authors aimed to determine whether certain medications influence serum cystatin C levels independently of measured glomerular filtration rate (mGFR) and to assess the impact of these medications on cystatin C-based estimated GFR (eGFRcys) compared to creatinine-based estimates. They found that systemic glucocorticoids, opioids, and loop diuretics were associated with increased cystatin C levels, particularly glucocorticoids at higher doses, while other medications showed no significant effects. Additionally, eGFRcys underestimated mGFR more in users of these medications, whereas the combined eGFRcr-cys provided the most accurate GFR estimates.

Cell-Specific Roles of Angiopoietin-2 in CKD

Apr 14, 2026

The authors investigate the distinct roles of endothelial cell- and tubular epithelial cell-derived angiopoietin-2 in the pathogenesis of chronic kidney disease (CKD). They find that while global deletion of angiopoietin-2 preserves kidney function and reduces inflammation and fibrosis, endothelial-specific deletion primarily mitigates early inflammatory responses, and tubular epithelial-specific deletion is more effective in limiting progressive injury and advanced fibrosis. This study highlights the complex, cell-specific contributions of angiopoietin-2 in CKD progression.

Comparative Effectiveness of Different Influenza Vaccine Formulations among Patients Undergoing Maintenance Hemodialysis

Apr 13, 2026

The authors aimed to compare the effectiveness of different influenza vaccine formulations in preventing influenza-related outcomes among older adults undergoing maintenance hemodialysis. Their study found that high-dose and cell culture-based vaccines offered modestly increased protection against influenza and related hospitalizations compared to the standard-dose vaccine, while the effects of adjuvanted and recombinant vaccines were less clear. Overall, the findings suggest that certain enhanced vaccine formulations may be beneficial for this vulnerable population.