ICYMI: Highlights From Kidney Week 2023

Our top coverage of American Society of Nephrology (ASN) Kidney Week 2023 highlighted discussions on the challenges of medication dose adjustments in chronic kidney disease (CKD), the potential of a bioartificial kidney to transform end-stage kidney disease care, the impact of disparities in LGBTQ+ health care on kidney outcomes, the agnostic nature of biomarkers in kidney disease progression to underlying diabetes, and emerging technologies in nephrology such as the STARgraft AV Graft and the "kidney on a chip" model for disease simulation and drug discovery. CKD is a common condition among people with both type 1 and type 2 diabetes, with 1 in 3 adults with diabetes also having CKD.

Here are the ASN Kidney Week 2023 highlights. Click here to catch up on all of our coverage from the conference.

5. Dose Adjustment Considerations in Patients With Chronic Kidney Disease: Dr Linda Awdishu

In the context of CKD, Linda Awdishu, PharmD, FASN, discussed the challenges in balancing the benefits and risks of medications, emphasizing the importance of evaluating and potentially adjusting drug doses for patients with kidney disease. Awdishu highlighted the need for coordination with other specialists who may have prescribed certain drugs, especially when considering dose adjustments that could impact the efficacy and tolerability of medications like antidepressants. The risk assessment process involves careful evaluation of adverse events and collaboration with specialty providers to ensure comprehensive and tailored patient care.

Watch the interview here.

4. A Bioartificial Kidney Would Reduce Transplant Wait Times, Costs for Patients on Dialysis

Shuvo Roy, PhD, professor of bioengineering at the University of California San Francisco, discussed the potential of a bioartificial kidney to revolutionize care for patients with end-stage kidney disease. Roy, who is leading the development of the first implantable bioartificial kidney, highlighted the device's ability to serve as a mass-produced, universal donor kidney, eliminating the need for strict organ transplant criteria and type matching. The bioartificial kidney demonstrated the possibility of avoiding lifelong immunosuppression drugs, reducing costs, minimizing adverse effects, and providing a more robust response to infections for patients compared with traditional transplant methods or dialysis. Roy suggested that the bioartificial kidney could be covered by insurance, including Medicare, and potentially be more cost-effective than dialysis and transplantation.

Read the full article and Q&A here.

3. Multiple Barriers Impact Kidney Care Disparities in LGBTQ+ Individuals

Presenters at Kidney Week 2023 focused on LGBTQ+ health care disparities and their impact on kidney outcomes, emphasizing the need for better data. Factors driving disparities include social determinants, legal and insurance inequity, limited access, safety concerns, and stigma. Mistrust in the health system, stemming from discrimination and fear, has contributed to challenges, with transgender adults less likely to receive flu shots or attend routine doctor visits. The LGBTQ+ community faces higher risk factors for CKD, such as smoking and obesity, highlighting the importance of considering intersectionality for patient care and improving data collection to address health disparities.

Read the full article here.

2. Biomarkers of Kidney Disease Progression Have “Transcendent Signals” Across Subtypes, Says Dr Steven Coca

Biomarkers of kidney disease progression appear to be agnostic to underlying diabetes, with most markers assessing kidney health or injury regardless of diabetes presence, according to Steven Coca, DO, MS, professor of medicine at the Icahn School of Medicine at Mount Sinai. While some studies show markers to be slightly stronger in those with diabetes—such as soluble tumor necrosis factor receptors, kidney injury molecule-1, urinary epidermal growth factor, urinary monocyte chemoattractant protein-1, uromodulin, and others—they generally demonstrate prognostic significance in both type 1 and type 2 diabetes, as well as in nondiabetic CKD. The data suggest the potential for markers to be applicable in various clinical scenarios and patient subtypes.

Watch the interview here.

1. Bioengineered Human Kidney and Graft Technology Among New Innovations Highlighted at ASN Kidney Week 2023

Presenters highlighted emerging technologies in nephrology, with Monnie Wasse, MD, MPH, discussing innovations in dialysis access. She presented advances such as the STARgraft AV Graft, TRUE AVC (acellular vascular conduit), and percutaneous/endovascular arteriovenous fistulas, emphasizing their benefits in improving vein access and addressing obstruction issues. Jonathan Himmelfarb, MD, discussed the "kidney on a chip" model, showcasing its role in disease simulation, drug discovery, and clinical trials. The bioengineered human kidney model allows researchers to study human genetics, simulate diseases like polycystic kidney disease and COVID-19 infection, and explore the effects of aging on kidney function.

Read the full article here.