Journal of the American Society of Nephrology : JASN
Audio Summaries

Fibroblast COX-2 Expression in the Development of Progressive Kidney Fibrosis

Aug 6, 2026

The authors investigate the role of fibroblast COX-2 expression in the development of progressive kidney fibrosis, particularly its interaction with macrophages. They find that selective deletion of COX-2 in fibroblasts leads to increased kidney fibrosis and a proinflammatory macrophage phenotype, suggesting that COX-2 plays a protective role against fibrosis by modulating macrophage activity during chronic kidney injury.

Medicare Advantage and Access to Living Donor Kidney Transplantation among Older Patients Receiving Dialysis

Aug 5, 2026

The authors aimed to investigate the impact of Medicare Advantage enrollment on access to living donor kidney transplantation among older patients receiving dialysis. Their findings reveal that Medicare Advantage is associated with a lower likelihood of waitlisting for transplantation and a reduced incidence of living donor kidney transplantation, although it does not affect the rates of deceased donor transplantation. This suggests potential barriers in access to living donor options for beneficiaries enrolled in Medicare Advantage compared to those in Traditional Medicare.

A Vagal-Renal-Splenic Reflex Suppresses Renal Sympathetic Nerve Activity and Preserves Kidney Function After Ischemic Injury

Aug 5, 2026

The authors investigate whether afferent vagus nerve stimulation (aVNS) can mitigate ischemic acute kidney injury (AKI) by modulating renal sympathetic nerve activity (RSNA) through central autonomic circuits and splenic neuroimmune signaling. Their findings demonstrate that aVNS effectively suppresses RSNA, preserves kidney function, and requires splenic involvement for optimal protective effects after ischemic injury. This study suggests a potential therapeutic approach for AKI by targeting vagal-autonomic pathways.

Impaired Metabolic Remodeling Characterizes Injured Niches during Post-ischemic Kidney Repair

Aug 3, 2026

The authors investigate how the tissue microenvironment affects the transition from acute kidney injury to chronic kidney disease, specifically focusing on the metabolic characteristics of injured niches. Using a multimodal spatial omics approach, they identify distinct metabolic abnormalities in both failed-repair and seemingly healthy proximal tubule cells within injured areas, highlighting defects in oxidative phosphorylation and fatty acid β-oxidation that extend beyond visibly damaged cells. This study underscores the importance of the metabolic landscape in kidney repair processes following ischemia-reperfusion injury.

Hypertension Management in Pregnancy and Postpartum

Aug 3, 2026

The authors examine the management of hypertensive disorders during pregnancy and the postpartum period, highlighting the critical role of nephrologists in identifying and addressing renal complications that may arise. They aim to underscore the importance of postpartum care as a vital opportunity to initiate interventions that can prevent long-term cardiovascular and renal issues in women affected by these conditions. The review discusses the pathophysiology, diagnosis, and management strategies for hypertensive disorders throughout the peripartum continuum.

Immune Checkpoint Inhibitor-Associated Acute Kidney Injury: A Report from the 34th Acute Disease Quality Initiative (ADQI) Consensus Conference

Jul 31, 2026

The authors aimed to address the challenges associated with immune checkpoint inhibitor-associated acute kidney injury (ICI-AKI), including its epidemiology, diagnosis, management, and implications for immunosuppression and ICI rechallenge. Through a consensus conference, they developed statements highlighting that ICI-AKI affects up to 20% of patients receiving ICIs, with acute tubulointerstitial nephritis being the most common pathology, and emphasized the need for individualized management strategies and further research to improve outcomes.

Glucocorticoid-Modulated Molecular Signatures and Prediction of Treatment Efficacy in IgA Nephropathy

Jul 31, 2026

The authors aimed to identify glucocorticoid-modulated proteins that could predict treatment efficacy in patients with IgA nephropathy undergoing glucocorticoid therapy. Through proteomic analysis of serum samples from a randomized controlled trial, they identified 302 proteins associated with treatment response and developed a predictive model that significantly outperformed traditional clinical variables. This study highlights the potential for using specific protein biomarkers to better stratify patients for glucocorticoid treatment.

Health-Related Quality of Life in Clinical Trials of CKD Progression: A Scoping Review

Jul 29, 2026

This scoping review investigates the effects of pharmacological interventions on health-related quality of life (HRQoL) in clinical trials for chronic kidney disease (CKD) progression. The authors found that while some trials reported significant improvements in HRQoL, these effects were inconsistent, instrument-dependent, and primarily observed in physical health domains. They emphasize the need for future studies to utilize kidney-specific HRQoL instruments and comprehensively report findings across various domains to enhance interpretability.

HLA Matching in US Kidney Transplantation Over Three Decades: Trends, Disparities, and Clinical Implications

Jul 29, 2026

This study investigates how HLA matching in kidney transplantation in the US has changed over the past three decades, particularly in relation to evolving allocation policies and donor demographics. The authors found a significant decline in the proportion of well-matched transplants, especially among children and racial minorities, and while HLA matching is still associated with better graft survival, the benefits have diminished in recent years.

Anti-podocin and Anti-KIRREL1 Antibodies and Steroid Resistance, FSGS, and Disease Recurrence after Transplantation in Autoimmune Podocytopathies

Jul 23, 2026

This study investigates the clinical implications of anti-podocin and anti-KIRREL1 antibodies in patients with autoimmune podocytopathies, particularly their association with steroid resistance, focal segmental glomerulosclerosis (FSGS), and disease recurrence after kidney transplantation. The authors found that these antibodies correlate with poorer outcomes, including steroid resistance and higher rates of post-transplant recurrence, while isolated anti-nephrin antibodies were linked to better prognoses. Overall, the research highlights the importance of identifying specific autoantibodies to predict disease progression and treatment responses in affected patients.