《美国肾脏病学杂志》是一份同行评审期刊，重点关注基础科学和临床研究中的及时主题。论文分为几个部分，包括：

The American Journal of Nephrology is a peer-reviewed academic journal that focuses on timely topics in basic science and clinical research. The articles are divided into several sections, including:

《美国肾脏病学杂志》是一份经过同行评审的学术期刊，专注于基础科学和临床研究中的重要主题。期刊中的论文分为多个部分，包括：

American Journal of Nephrology

Background: Fatigue, although common and associated with outcomes in dialysis-dependent chronic kidney disease (CKD), has not been studied in nondialysis chronic kidney disease  (CKD-ND) patients. Methods: In this longitudinal cohort of 266 outpatients with CKD-ND stages 2–5, we measured self-reported fatigue on 3 scales-Quick Inventory of Depression Symptomatology-Self Report (QIDS-SR16), Beck Depression Inventory-I (BDI-I), and short form 12 health survey (SF-12) questionnaires and evaluated the prespecified composite of progression to dialysis initiation, death, or hospitalization after 12 months. Logistic and linear regression assessed characteristics associated with fatigue. Survival analysis measured associations of fatigue with outcomes. Results: Mean age was 64.4 ± 12.0 years, and mean estimated glomerular filtration rate (eGFR) was 31.6 ± 16.7 mL/min/1.73 m2. Fatigue was common, with 69.2% reporting fatigue on QIDS-SR16 and 77.7% on BDI-I. Unemployment, comorbidities, use of antidepressant medications, and lower hemoglobin correlated with fatigue. There were 126 outcome events. Participants that reported any versus no fatigue on QIDS-SR16 were more likely to reach the composite, hazard ratio (HR) 1.70 (95% CI 1.11–2.59), which persisted after adjusting for demographics, comorbidities, substance abuse, hemoglobin, albumin, eGFR, and calcium-phosphorus product, HR 1.63 (1.05–2.55). Fatigue severity by the SF-12 was also associated with outcomes independent of demographics, comorbidities, and substance abuse, HR per unit increase 1.18 (1.03–1.35). No association was observed with fatigue on the BDI-I. Conclusion: Fatigue affected about 2/3 of CKD-ND patients and associated with unemployment, comorbidities, antidepressant medication use, and anemia. Fatigue measured by the QIDS-SR16 and SF-12 independently predicted outcomes in CKD patients. Eliciting the presence of fatigue may be a clinically significant prognostic assessment in CKD patients.

L. Parker Gregg

Nishank Jain

Thomas Carmody

Abu T. Minhajuddin

A. John Rush

Madhukar H. Trivedi

S. Susan Hedayati

Am J Nephrol

Fatigue in Nondialysis Chronic Kidney Disease: Correlates and Association with Kidney Outcomes

非透析慢性肾病中的疲劳：相关因素及其与肾病转归的关联

Background: Inflammation appears to be at the biological core of arteriovenous fistula (AVF) dysfunction, and the occurrence of AVF dysfunction is related to high death and disability in hemodialysis (HD) patients. Despite several studies on the correlations between AVF dysfunction and inflammatory indicators, how AVF dysfunction is related to the monocyte-to-lymphocyte ratio (MLR) is much unclear. We hypothesize that preoperative MLR is associated with AVF dysfunction in Chinese HD patients. Methods: In this single-center retrospective cohort study, totally 769 adult HD patients with a new AVF created between 2011 and 2019 were included. Association of preoperative MLR with AVF dysfunction (thrombosis or decrease of normal vessel diameter by &#x3e;50%, requiring either surgical revision or percutaneous transluminal angioplasty) was assessed by multivariable Cox proportional hazard regression. Results: The patients were aged 55.8 ± 12.2 years and were mostly males (55%). During the average 32-month follow-up (maximum 119 months), 223 (29.0%) patients had permanent vascular access dysfunction. In adjusted multivariable Cox proportional hazard regression analyses, the risk of AVF dysfunction was 4.32 times higher with 1 unit increase in MLR (hazard ratio [HR]: 5.32; 95% confidence interval [CI]: 3.1–9.11). Compared with patients with MLR &#x3c;0.28, HRs associated with an MLR of 0.28–0.41 and ≥0.41 are 1.54 (95% CI: 1.02–2.32) and 3.17 (2.18–4.62), respectively. Conclusions: A higher preoperative MLR is independently connected with a severer risk of AVF dysfunction in HD patients. Its clinical value should be determined in the future.

Shouliang Hu

Dan Wang

Tean Ma

Fanli Yuan

Yong Zhang

Xiaoli Gao

Qingfeng Lei

Junzhang Cheng

Association between Preoperative Monocyte-to-Lymphocyte Ratio and Late Arteriovenous Fistula Dysfunction in Hemodialysis Patients: A Cohort Study

术前单核细胞/淋巴细胞比值与血液透析患者晚期动静脉瘘功能障碍的关联：一项队列研究

&lt;b&gt;&lt;i&gt;Introduction:&lt;/i&gt;&lt;/b&gt; The current prevalence of chronic kidney disease (CKD) is substantial, and CKD individuals face a heightened risk of mortality, encompassing both all-cause and cause-specific outcomes. The current study aims to investigate the potential impact of adhering to Life’s Essential 8 (LE8) on reducing mortality among CKD individuals. &lt;b&gt;&lt;i&gt;Methods:&lt;/i&gt;&lt;/b&gt; Using the National Health and Nutrition Survey (NHANES) data from 2005 to 2018, we analyzed 22,420 US adults (≥20 years old). CKD is defined by urinary albumin-to-creatinine ratio (≥30 mg/g or 3 mg/mmol) and estimated glomerular filtration rate (&amp;lt;60 mL/min/1.73 m&lt;sup&gt;2&lt;/sup&gt;). The components of LE8, including diet, physical activity (PA), nicotine exposure, sleep, body mass index, blood lipids, blood glucose, and blood pressure (BP), were measured and given a score of 0–100. The total LE8 score was the unweighted average of all components and was divided into low cardiovascular health (CVH) (0–49), moderate CVH (50–79), and high CVH (80–100). A Cox proportional hazards regression model was used to explore the associations of LE8 with all-cause, cardiovascular disease (CVD), and cancer mortality, which were followed prospectively by the National Center for Health Statistics until December 31, 2019. &lt;b&gt;&lt;i&gt;Results:&lt;/i&gt;&lt;/b&gt; In the overall population, individuals with moderate CVH had a 47% lower risk of CKD, while high CVH was linked to a 55% lower risk compared to low CVH. During a median follow-up of 7.58 years, CKD individuals had a 93% higher all-cause mortality rate and a 149% higher CVD mortality rate compared to those without CKD. Among the CKD individuals, every 10-point increase in the LE8 score was associated with reduced risks of 17% for all-cause mortality (especially PA, nicotine exposure, blood glucose, and BP), 18% for CVD mortality (especially PA), and 12% for cancer mortality (especially PA and sleep health). In additional and sensitivity analysis, the results remained significant after further consideration of potential confounding of renal function. Additionally, LE8 demonstrated superior risk stratification for CVD mortality among CKD patients compared with LS7. Interaction was observed between LE8 and age, education level, marital status, and drinking status. &lt;b&gt;&lt;i&gt;Conclusion:&lt;/i&gt;&lt;/b&gt; The current study demonstrates that adherence to higher LE8 levels within CKD individuals is associated with a reduced risk of both all-cause and cause-specific mortality.

Hongyu Chen

Haoxian Tang

Jingtao Huang

Nan Luo

Xuan Zhang

Xin Wang

Life’s Essential 8 and Mortality in US Adults with Chronic Kidney Disease

美国慢性肾病成年人的生命必需8项与死亡率

Increased uric acid levels are associated with kidney dysfunction. We tested the hypothesis that uric acid level predicts future development of chronic kidney disease (CKD) in the general population.For this study, we enrolled 7,078 consecutive subjects with normal estimated glomerular filtration rates (eGFR; ≥60 ml/min/1.73 m(2)) who visited our hospital for a yearly health checkup (age: 52.8 ± 10.7 years; female: 35.8%). Subjects underwent a routine physical examination and laboratory assessment of cardiovascular disease risk factors at enrollment, and were followed up for 1,694 days (median) with the endpoint being the development of CKD (eGFR <60 ml/min/1.73 m(2)). The impact of uric acid and other cardiovascular risk factors at baseline on the future development of CKD were assessed.During the follow-up period, 417 male (9.2%) and 151 female subjects (6.0%) developed CKD. Univariate logistic regression analysis revealed a significant association between the onset of CKD and age, male gender, body mass index, blood pressure, fasting plasma glucose, dyslipidemia and uric acid. Multiple logistic regression analysis revealed that new-onset CKD was independently correlated with the baseline uric acid level after adjustment for possible factors. Subanalysis showed similar results in subjects with normal uric acid levels (male: ≤7.0 mg/dl; female: ≤6.0 mg/dl; n = 6,223).Uric acid is an independent predictor of future development of CKD. Whether preventing an increase in uric acid levels reduces the incidence of CKD must be clarified by prospective follow-up studies.

Hiroo Sonoda

Hiroyuki Takase

Yasuaki Dohi

Genjiro Kimura

Uric Acid Levels Predict Future Development of Chronic Kidney Disease

尿酸水平预测慢性肾脏疾病的未来发展

Introduction: Understanding the molecular signals associated with the progression of kidney disease is vital for risk stratification and targeted treatment. Recent advances in RNA-sequencing technique has enabled us to characterize extracellular transcriptome profiles for precision diagnostics. Method: We evaluated the plasma mRNA profile of participants exhibiting slow (n=119) and fast (n=119) decline in estimated glomerular filtration rate (eGFR) among the Chronic Renal Insufficiency Cohort (CRIC) in a nested case control study. The two groups were matched for age, sex, race, baseline eGFR, proteinuria and diabetes status. The next generation sequencing data was analyzed using edgeR to identify differentially expressed genes (DEGs) and Ingenuity Pathway Analysis (IPA) was done to identify the associated pathways. We also compared the top plasma DEGs with gene expression in microdissected human CKD kidney. Results: We identified fragments from ~28,000 annotated genes, of which 783 transcripts exhibited differential expression between slow and fast CKD progressors. Among 629 protein coding genes, 469 were overexpressed in slow progressors, while 157 showed increased expression in fast progressors. Expression of GLI2, CUX1, NOTCH1 and LRP1 transcripts were amplified in slow progressors. Pathway analysis linked these differentially expressed genes to WNT/β-catenin signaling, IL-12 signaling and production in macrophages, Netrin-1 Signaling and Epithelial-Mesenchymal Transition pathways. Many of the plasma differentially expressed genes were also upregulated in microdissected human CKD kidney. Conclusion: Warranting further validation, circulating levels of aberrantly expressed transcripts hold potential to be used as biomarkers for fast CKD progression.

Anvesha Srivastava

Mark Maienschein-Cline

Richard L. Amdur

Katalin Susztak

Jeffrey Burnett Kopp

Haiming Cao

Divya Shankaranarayanan

Yoosif Abdalla

Ana Pabalan

Michael Gombert

Dominic Raj

Plasma transcriptome profile associated with CKD progression

与慢性肾脏病进展相关的血浆转录组特征

The kidney is a frequent target of SARS-CoV-2, potentially developing lesions in glomeruli, vessels, and tubulointerstitium in response to this infection. Herein we present the analysis of the first large Latin American cohort of adult patients undergoing kidney biopsy due to COVID-19-associated kidney disorders. This retrospective, multicenter, national study was based on the collection of information on demographics, comorbidities, laboratory data, kidney histology, therapy, and therapeutic response. Patients diagnosed with collapsing glomerulopathy (CG) were genotyped for APOL1. Our cohort included 94 patients, most male (62.8%). The median age was 44 (33-52) years and 50% of them were previously hypertensive. The time between COVID-19 diagnosis and kidney biopsy was 30 (15-60) days. Most patients had decreased kidney function at diagnosis, 43.5% required dialysis upon diagnosis, 77.6% received immunosuppression, and 2/3 achieved a clinical remission. CG was the most common kidney involvement (18 cases), reproducing previous findings. Focal Segmental Glomerulosclerosis (FSGS), Thrombotic Microangiopathy (TMA) and IgA Nephropathy were also frequent, with 10 cases each. FSGS and Minimal Change Disease (MCD) were associated with the best cumulative kidney survival; none started dialysis. In contrast, patients with TMA/C3 glomerulopathy presented a poor kidney prognosis, with more than half progressing to kidney replacement therapy. A novel and striking finding of our study, therefore, was the association of FSGS and MCD with the best kidney outcome among all COVID-19-related histological patterns. Moreover, the overall distribution of histological profiles showed significant particularities in the analyzed patient cohort, the most important being the higher frequency of TMA cases.

Precil Diego Miranda de Menezes Neves

Stanley Almeida Araujo

David Campos Wanderley

Andressa Monteiro Sodré

Marcos Adriano Garcia Campos

Elieser Hitoshi Watanabe

Denise Maria Avancini Costa Malheiros

Lívia Barreira Cavalcante

Felipe Lourenço Ledesma

Karla Cristina Petruccelli Israel

Flávia Lara Barcelos Barcelos

Laila Lopes de Farias Pinho

Fabrício Augusto Marques Barbosa

Silvana Maria Carvalho Miranda

Márcio Dantas

Welluma Lomarques de Mendonça Britto

Jenaine Oliveira Paixão

Rafael Lage Madeira

Felipe Leite Guedes

Weverton Machado Luchi

Américo Lourenço Cuvello-Neto

Igor Denizarde Bacelar Marques

Jose Bruno Almeida

Rafael Fernandes Vanderlei Vasco

Antonio Monteiro

Francisco Rasiah Ladchumananandasivam

Antônio Augusto Lima Teixeira Júnior

Orlando Vieira Gomes

Rodrigo Hagemann

Oreste Angelo Ferra-Neto

Ricardo Ferreira Santos

Denise Maria do Nascimento Costa

Epitácio Rafael Luz-Neto

Leandro de Castro Bahia Alvarenga Soares

Rebecca Souza Mubarac

Kellen Micheline Alves Henrique Costa

Rafael Weissheimer

Christiany Moreira Almeida

Barbara Antunes Bruno da Silva

Leandro Santos Miranda

Leandro Rodrigues Iannuzzi

Gilson Masahiro Murata

Irene de Lourdes Noronha

Natalino Salgado Filho

Luiz Onuchic

Gyl Eanes de Barros Silva

Minimal Change Disease and Focal Segmental Glomerulosclerosis are associated with good kidney prognosis and Thrombotic Microangiopathy with poor kidney survival in patients with COVID-19-associated nephropathies

微小病变病和局灶节段性肾小球硬化与COVID-19相关肾病患者良好的肾脏预后相关，而血栓性微血管病与不良的肾脏存活率相关

Background Roxadustat, a hypoxia-inducible factor prolyl hydroxylase inhibitor used in renal anemia treatment, has been associated with thyroid hormone suppression. This study investigated the patterns of thyroid profile changes following roxadustat administration and their clinical implications. Methods In this retrospective study (2019-2023) at Shenzhen Second People's Hospital, patients were categorized based on TSH reduction during follow-up (≥50% decrease vs&lt;50% decrease). Thyroid profiles, clinical symptoms, and laboratory indicators were analyzed. Quality of life was assessed using EQ-5D-3L and ThyPRO questionnaires. Complementary animal experiments were conducted to verify the effects of roxadustat on thyroid function. Results A total of 118 patients were finally enrolled in our study. Among patients with initially normal thyroid function, 31 developed euthyroid sick syndrome post-roxadustat treatment. Treatment significantly decreased T3, FT3, FT4, and TSH levels, with TSH showing marked reduction within the first 10 weeks. Contrastingly, animal models exhibited decreased T3 but increased TSH levels, regardless of renal status. Blood lipid levels decreased in all patients, particularly in those with substantial TSH reduction. Despite thyroid alterations, quality of life scores remained unchanged between roxadustat-treated and untreated patients, with no overt clinical symptoms in either humans or animals. Conclusions While roxadustat induces significant thyroid hormone suppression in patients, these alterations rarely manifest as clinical symptoms. Euthyroid sick syndrome is the predominant thyroid dysfunction pattern observed. Regular thyroid function monitoring is recommended during roxadustat therapy, particularly during the initial treatment phase when TSH changes are most pronounced.

Wangyang Li

Tao Cao

Guangluan Huang

Jianying Guo

Tangkun Zhu

Haofei Hu

Huiwei Huang

Xueting Liu

Liling Wu

Jia Chen

Dongli Qi

Tie Chen

Qijun Wan

Yuan Cheng

Effects of roxadustat on thyroid profiles in patients and animals with chronic kidney disease

罗沙司他对慢性肾病患者和动物甲状腺指标的影响

Introduction: Idiopathic membranous nephropathy (iMN) has become one of the most prevalent primary glomerular diseases, with a marked increase in prevalence over the past two decades in northern China. Fine particulate matter (PM2.5) is considered to be associated with this rising prevalence. In this study, we aim to evaluate the trends of iMN in relation to improved air quality and conduct a cross-sectional study in Hebei province (northern China, near Beijing) to investigate the role of gene-environment interactions in its development. Methods: This study established two cohorts. Cohort 1 included 22,937 pathology reports from Peking University First Hospital (2002-2021) to assess iMN prevalence. Cohort 2 comprised 5,635 iMN patients from 11 cities in Hebei Province (2009-2013). DNA samples from 374 iMN patients and 1,259 controls were genotyped for SNPs rs4664608 (PLA2R1) and rs2187668 (HLA-DQA1). Patients were stratified by air pollution risk levels. The annual percentage change (APC) and average annual percentage change (AAPC) were estimated using a join-point regression model. Gene-environment interactions were analyzed using logistic regression and epinet-calculation. Results: In Cohort 1, 5,586 patients with iMN were identified, representing 24.3% of the 22,937 patients from 2002 to 2021. The general population showed a significant increase in iMN proportion with an APC of +12.7% per year from 2002 to 2014 (95% CI: 10.3 to 17.5, p &lt; 0.001), followed by a decline with an APC of -5.6% per year from 2014 to 2021 (95% CI: -9.6 to -2.6, p &lt; 0.001).In Hebei Province, the iMN frequency rose significantly with an APC of +17.6% per year from 2002 to 2016 (95% CI: 14.5 to 28.6, p &lt; 0.001), peaking at 60%, and then declined with an APC of -5.5% per year from 2016 to 2021 (95% CI: -13.1 to -1.2, p = 0.02). Cohort 2 highlighted significant regional variation in iMN incidence across Hebei Province. Geographic exposure to pollution was identified as an independent risk factor for iMN (RR 1.49, 95% CI 1.38–1.56, p&lt;0.001). Gene-environment interaction analysis revealed that patients with risk alleles in the PLA2R1 gene and exposure to risk environments had a markedly increased risk of developing iMN (OR=38.72, 95% CI 11.95-125.46, p&lt;0.01). Conclusion: The annual growth rate of iMN in northern China appears to be slowing down. Gene-environment interactions may have contributed to the previously observed increase in iMN prevalence.

Wanyin Hou

Sufang Shi

Zhe Yan

Maodong Liu

Gengxin Guo

Yujing Zhang

Yun Dong

Junjie Gao

Fuyun Sun

Guicai Hu

Zhaoxia Zheng

Liping Duan

Haisong Zhang

Bing Liu

Shaomei Li

Sumin Jiao

Jinwei Wang

Zhao Cui

Suxia Wang

Ying Li

Shuxia Fu

Minghui Zhao

Trends and the Role of Gene-Environment Interactions in Idiopathic Membranous Nephropathy in Northern China

中国北方特发性膜性肾病的趋势及基因-环境相互作用的作用

Introduction The early diagnosis and appropriate treatment of monogenic glomerular diseases can reduce kidney failure, avoid unnecessary investigations such as kidney biopsies and ineffective treatment with immunosuppressants, guide transplant decisions, and inform the genetic risks of their family members. Yet, genetic testing for kidney disease is under-utilized in Singapore. We aimed to implement a nephrologist-led genetic service and evaluate the acceptance, adoption, utility and cost-effectiveness of genetic testing for monogenic glomerular disease in Singapore. Methods We will perform a prospective, multi-center, Type II hybrid effectiveness-implementation study with a post design to evaluate both implementation and clinical outcomes of nephrologist-led genetic testing for suspected genetic glomerular kidney diseases. The multi-disciplinary implementation team will train "genetic nephrologists" to provide pre- and post-test counselling, order targeted exome panel sequencing for suspected glomerular kidney diseases (persistent microscopic haematuria and/or albuminuria or proteinuria in the absence of known causes; steroid-resistant primary nephrotic syndrome; apparent familial IgA nephropathy; or chronic kidney disease with no apparent cause) and interpret genetic test results; create workflows for patient referral, evaluation and management, and discuss genetic results at regular genomic board meetings. The outcomes are acceptance, appropriateness and adoption among patients and nephrologists, utility (proportion of patients who received genetic testing and have a confirmed diagnosis of genetic glomerular disease) and cost-effectiveness. Conclusion This study will create and evaluate a nephrologist-led genetic service, develop an efficient variant curation process and inform future recommendations on the optimal referral and genetic testing strategy for monogenic glomerular disease in Singapore. This will facilitate the future mainstreaming of genetic testing that will enable precision medicine in kidney care.

Cynthia Lim

Ru Sin Lim

Jason Choo

Esther Huimin Leow

Gek Cher Chan

Yaochun Zhang

Jun Li Ng

Hui-Lin Chin

Ee Shien Tan

Jeannette Goh

Naline Gandhi

Yong Hong Ng

Mya Than

Indra Ganesan

Siew Le Chong

Celeste Yap

Sing Ming Chao

Breana Cham

Sylvia Kam

Jiin Ying Lim

Irene Mok

Hui Zhuan Tan

Jia Liang Kwek

Tung Lin Lee

Ziyin Wang

Su Mein Goh

Regina Lim

See Cheng Yeo

Boon Wee Teo

Yi Da

David Matchar

Kar Hui Ng

Clinical implementation of Nephrologist-led Genomic Testing for Glomerular Diseases in Singapore: Rationale and Protocol

新加坡肾病专家主导的肾小球疾病基因检测的临床应用：原理与方案

Abbreviation	Am J Nephrol
Journal Impact	4.21
Quartiles(Global)	UROLOGY & NEPHROLOGY(Q1)

ISSN	0250-8095, 1421-9670
h-index	103

Publication Information	Publisher: S. Karger AG，Publishing cycle: Bimonthly，Journal Type: journal，Open Access Journals: No
Basic data	Year of publication: 1981，Proportion of original research papers: 93.67%，Self Citation Rate:2.30%， Gold OA Rate: 30.31%
Average review cycle	网友分享经验：偏慢,4-8周
Average recruitment ratio	网友分享经验：容易

American Journal of Nephrology

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Fatigue in Nondialysis Chronic Kidney Disease: Correlates and Association with Kidney Outcomes

Association between Preoperative Monocyte-to-Lymphocyte Ratio and Late Arteriovenous Fistula Dysfunction in Hemodialysis Patients: A Cohort Study

Life’s Essential 8 and Mortality in US Adults with Chronic Kidney Disease

Uric Acid Levels Predict Future Development of Chronic Kidney Disease

Plasma transcriptome profile associated with CKD progression

Plasma transcriptome profile associated with CKD progression

Minimal Change Disease and Focal Segmental Glomerulosclerosis are associated with good kidney prognosis and Thrombotic Microangiopathy with poor kidney survival in patients with COVID-19-associated nephropathies

Effects of roxadustat on thyroid profiles in patients and animals with chronic kidney disease

Trends and the Role of Gene-Environment Interactions in Idiopathic Membranous Nephropathy in Northern China

Clinical implementation of Nephrologist-led Genomic Testing for Glomerular Diseases in Singapore: Rationale and Protocol