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Kidney Failure: Diagnosis and Treatment of Acute and Chronic Conditions

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Special Issue Editor

Prof. Dr. Nikolina Basic-Jukic

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Guest Editor

Department of Nephrology, Hypertension, Dialysis and Transplantation, University Hospital Center Zagreb, Zagreb, Croatia
Interests: kidney transplantation; dialysis; hemodialysis; chronic renal failure; hypertension; clinical nephrology; acute kidney injury; immunoadsorption and apheresis

Special Issue Information

Dear Colleagues,

This Special Issue is dedicated to advancing the understanding and management of kidney failure, addressing both acute and chronic conditions within the realm of clinical medicine. Our primary aim is to provide a comprehensive overview of the current research status, emphasizing the core problems faced in the diagnosis and treatment of kidney failure, as well as the different methods of renal replacement therapies and their complications. We seek to explore innovative approaches, share clinical insights, and catalyze the translation of research findings into effective medical interventions. By focusing on both acute and chronic contexts, our goal is to contribute to improved patient outcomes and enhance the overall quality of care in nephrology.

The scope of this Special Issue encompasses a broad spectrum of topics related to kidney failure, spanning from diagnostic strategies to therapeutic interventions. We invite research articles and reviews addressing issues such as biomarkers for early detection, advancements in imaging techniques, novel treatment modalities, and the integration of precision medicine. Additionally, discussions on the challenges of managing both acute and chronic kidney conditions, including complications and comorbidities, are encouraged. We aim to create a platform for interdisciplinary collaboration, bringing together clinicians, researchers, and healthcare professionals to explore holistic approaches to kidney failure care.

Prof. Dr. Nikolina Basic-Jukic
Guest Editor

Manuscript Submission Information

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

kidney failure
renal dysfunction
hyponatremia
peritoneal dialysis
hemodialysis
renal transplantation
immunoadsorption
plasma exchange

Published Papers (2 papers)

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Research

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12 pages, 475 KiB

Open AccessArticle

Immunomodulatory Effect of COVID-19 on HLA-Antibody Profile in Renal Transplant Recipients

by Marina Kljajic, Zoran Sabljic, Ivana Juric, Vesna Furic Cunko, Renata Zunec, Marija Burek Kamenaric, Bojan Jelakovic and Nikolina Basic-Jukic

J. Clin. Med. 2024, 13(8), 2383; https://doi.org/10.3390/jcm13082383 - 19 Apr 2024

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Abstract

Background/Objectives: The novel coronavirus disease 2019 (COVID-19) has led to significant morbidity and mortality among kidney transplant recipients. SARS-CoV-2 has been hypothesized to cause an unusual immunological dysregulation triggering alloimmunity and leading to graft rejection. Methods: This prospective observational cohort study assessed 321 kidney transplant recipients who had COVID-19 infection. After the infection, patients’ sera were tested for the presence of anti-HLA de novo DSA and non-DSA specificities. Logistic regression analysis and a stepwise multivariable logistic regression analysis were used to analyze the independent risk factors associated with the development of antibodies, adjusting for known confounders. The variables evaluated were acute COVID-19 characteristics (i.e., presentation, and need for hospitalization), demographic characteristics (i.e., age, gender, and primary renal disease), clinical characteristics (i.e., various comorbidities), and post-COVID-19 sequelae. Results: Anti-HLA de novo DSA developed in 18.7% of patients, while anti-HLA class I and class II non-DSA antibodies developed de novo in 84 (26.3%) and 83 (25.9%) patients, respectively. The development of DSA, HLA-DQ, and HLA-DR antibodies was predicted by the history of graft rejection. Obesity appeared to be protective against the emergence of de novo DSA. De novo DSA and HLA-DR antibody formation was positively linked with intravenous immunoglobulin use, CMV-hyperimmune globulin use, and decreased doses of immunosuppression during acute infection. Better allograft function during the acute disease was a protective factor against the formation of HLA-DQ and HLA-DR antibodies. Positive predictors of de novo DSA development were graft biopsy and the reactivation of EBV after infection. Conclusions: These findings suggest that the SARS-CoV-2 virus has an immunomodulatory effect and may be associated with an increased mortality in this population. Full article

(This article belongs to the Special Issue Kidney Failure: Diagnosis and Treatment of Acute and Chronic Conditions)

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Review

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10 pages, 214 KiB

Open AccessReview

JC Virus in Kidney Transplant Population: Are We Cautious Enough?

by Mirha Pjanic, Mirna Aleckovic-Halilovic and Nikolina Basic-Jukic

J. Clin. Med. 2024, 13(8), 2217; https://doi.org/10.3390/jcm13082217 - 11 Apr 2024

Viewed by 632

Abstract

The John Cunningham virus (JCV) is a polyomavirus that usually infects people at a young age and does not cause any symptoms in immunocompetent individuals. However, in immunocompromised individuals, such as kidney transplant recipients, JCV can cause severe and potentially fatal disease. Unfortunately, JCV has not been researched as extensively as the BK virus and is not mentioned in relevant kidney transplant guidelines. This lack of attention to JCV can lead to less consideration in kidney transplant patients’ care. Surveillance using locally available diagnostic methods is of the utmost importance. The presence of JCV can be diagnosed with urine decoy cells, viruria, or viremia verified by the PCR method. A low threshold for considering JCV as a possible cause of any neurological or renal dysfunction in kidney transplant recipients must be maintained. In such cases, kidney and brain biopsy are indicated. Maintaining the appropriate immunosuppression while avoiding over-immunosuppression to prevent JCV disease is crucial, and the approach should be individual, according to overall immunological risk. We hypothesize that the presence of the JCV can indicate overt immunosuppression and identify kidney transplant recipients more prone to opportunistic infections and diseases, including some malignancies. To explore that, future observational studies are needed. Full article

(This article belongs to the Special Issue Kidney Failure: Diagnosis and Treatment of Acute and Chronic Conditions)

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