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Emerging Issues in Immune Mechanism of Kidney Diseases

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A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Molecular and Translational Medicine".

Deadline for manuscript submissions: closed (31 July 2023) | Viewed by 4961

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Special Issue Editor

Dr. Yawen Chuang

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Guest Editor

Division of Nephrology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
Interests: polycystic kidney disease; transplant; dialysis; acute kidney injury; chronic kidney disease; glomerulonephritis; regenerative medicine; mitochondria

Special Issue Information

Dear Colleagues,

With the medical understanding of the immune mechanism of transplantation, the vigorous development of immunosuppressants (anti-rejection drugs), and the accumulation of experience in transplantation, the treatment experience of kidney transplantation has progressed to a very mature level. In the past ten years, with the advancement of immunosuppressants, kidney transplantation is the best treatment mode for patients with end-stage renal failure, which not only improves the quality of life, but also significantly improves the survival rate of patients. Histocompatibility and immunogenetics are important to kidney transplantation. The main complications of kidney transplantation include rejection, infection, malignancy, metabolic complications and drug toxicity.

This special issue focuses on basic and translational research in immune mechanism of kidney transplantation, including regenerative medicine, tissue injury, repair, and inflammation, histocompatibility and immunogenetics, rejection, infection, cancer, drugs and pharmacology.

Dr. Yawen Chuang
Guest Editor

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Keywords

kidney transplantation
rejection
infection
cancer
histocompatibility
pharmacology
stem cell
exosome
regenerative medicine
drug toxicity

Published Papers (3 papers)

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Research

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12 pages, 1145 KiB

Open AccessArticle

Combination of Sarcopenia and Hypoalbuminemia Is a Poor Prognostic Factor in Surgically Treated Nonmetastatic Renal Cell Carcinoma

by Tomoyuki Makino, Kouji Izumi, Hiroaki Iwamoto, Suguru Kadomoto and Atsushi Mizokami

Biomedicines 2023, 11(6), 1604; https://doi.org/10.3390/biomedicines11061604 - 01 Jun 2023

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Abstract

Purpose: The purpose of this study is to observe how preoperative sarcopenia and hypoalbuminemia affect the oncological outcome of nonmetastatic renal cell carcinoma (RCC) after partial or radical nephrectomy. Methods: This study retrospectively analyzes 288 Japanese patients with nonmetastatic RCC who underwent radical treatment at Kanazawa University Hospital between October 2007 and December 2018. Relationships between sarcopenia as indicated by the psoas muscle mass index and hypoalbuminemia (albumin ≤ 3.5 g/dL) with overall survival (OS) and metastasis-free survival (MFS) were determined. Results: The study found that 110 (38.2%) of the 288 patients were sarcopenic and 29 (10.1%) had hypoalbuminemia. The combination of sarcopenia and hypoalbuminemia was associated with a shorter OS and MFS (p for trend = 0.0007 and <0.0001, respectively), according to Kaplan–Meier curves. The concurrent presence of sarcopenia and hypoalbuminemia were found to be significant and independent predictors of poor MFS (hazard ratio (HR), 2.96; 95% confidence interval (95% CI), 1.05–8.39; p = 0.041) and poor OS (HR, 6.87; 95% CI, 1.75–26.94; p = 0.006), respectively. Conclusions: In Japanese patients with surgically treated nonmetastatic RCC, combined preoperative sarcopenia and hypoalbuminemia was a significant predictor of poor survival. Full article

(This article belongs to the Special Issue Emerging Issues in Immune Mechanism of Kidney Diseases)

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16 pages, 2094 KiB

Open AccessArticle

Bacterial Urinary Tract Infection and Early Asymptomatic Bacteriuria in Kidney Transplantation Still Negatively Affect Kidney Transplant Outcomes in the Era of Modern Immunosuppression and Cotrimoxazole Prophylaxis

by Chayanan Santithanmakorn, Jakapat Vanichanan, Natavudh Townamchai, Kamonwan Jutivorakool, Salin Wattanatorn, Methee Sutherasan, Julin Opanuruk, Stephen J. Kerr, Kearkiat Praditpornsilpa, Yingyos Avihingsanon and Suwasin Udomkarnjananun

Biomedicines 2022, 10(11), 2984; https://doi.org/10.3390/biomedicines10112984 - 20 Nov 2022

Cited by 2 | Viewed by 1735

Abstract

Risk factors and consequences of urinary tract infection (UTI) post-kidney transplant have been variously reported by studies that were heterogenous in immunosuppressants and prophylactic protocols. We aimed to clarify the risks and consequences of UTI in kidney transplant recipients with post-transplantation cotrimoxazole prophylaxis in the context of modern immunosuppression. This retrospective cohort included kidney transplant recipients receiving tacrolimus, mycophenolate, prednisolone, and cotrimoxazole for bacterial UTI prophylaxis. Recipients were categorized into non-UTI and UTI groups. Asymptomatic bacteriuria (ASB) was screened in the first 3 months and was evaluated for association with UTI. Of 348 kidney transplant recipients, 129 were in the UTI group and 219 in the non-UTI group. UTI risk factors were female sex, body mass index ≥ 25 kg/m², human leukocyte antigen mismatch, and panel reactive antibody ≥ 50%. Recipients with recurrent UTI had inferior allograft function compared with non-UTI recipients. Patient survival was significantly lower in recipients with UTI in the first post-transplant month. Higher degree of immunosuppressions was associated with recurrent UTI and drug-resistant organisms. In conclusion, UTI continues to negatively affect graft function and survival of kidney transplant recipients. Treating ASB in the first 3 months did not reduce the UTI incidence in the first transplantation year. Full article

(This article belongs to the Special Issue Emerging Issues in Immune Mechanism of Kidney Diseases)

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Review

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16 pages, 3192 KiB

Open AccessReview

Pathological Approach to Kidney Allograft Infection

by Suwasin Udomkarnjananun and Kroonpong Iampenkhae

Biomedicines 2023, 11(7), 1902; https://doi.org/10.3390/biomedicines11071902 - 05 Jul 2023

Viewed by 1720

Abstract

Infectious agents can pose a significant challenge in kidney transplantation, as they have the potential to cause direct infections in the transplanted kidney. These infections can lead to a decline in kidney function and reduce the longevity of the transplanted kidney. Common post-transplant allograft infections include bacterial pyelonephritis and the BK virus infection, while adenovirus, JC virus, and cytomegalovirus are less frequent but can also lead to significant allograft dysfunctions. The histopathological features of these infections are characterized by the infiltration of inflammatory cells in the kidney interstitial area and the presence of viral nuclear inclusions or cytopathic changes in the renal tubular epithelial cells. The confirmation of causative organisms can be achieved by immunohistochemical staining or the visualization of viral particles using electron microscopic examination. However, these methods typically require a longer turnaround time and are not readily available in developing countries, unlike standard hematoxylin-eosin staining. Notably, the differential diagnosis of interstitial inflammation in kidney allografts almost always includes T cell-mediated rejection, which has a different treatment approach than allograft infections. The aim of this review was to prompt clinicians to identify diverse pathological alterations as observed in kidney allograft biopsies, thereby facilitating further investigations and the management of suspected kidney allograft infections. Full article

(This article belongs to the Special Issue Emerging Issues in Immune Mechanism of Kidney Diseases)

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