American Journal of Kidney Diseases

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AJKD, official journal of @kidney.org, is the leading source of information devoted to clinical nephrology research and practice. AJKD.org | AJKDblog.org | Organizer of #NephMadness @nephmadness.bsky.social

Fuel metabolism in the liver and other organs with prolonged starvation. Following depletion of glycogen stores, skeletal muscle–derived alanine and glutamine become the primary substrates supporting glucose homeostasis. In muscle, alanine transaminase catalyzes the transfer of an amino group from l-glutamate to pyruvate, forming α-ketoglutarate and l-alanine. The alanine is transported to the liver where its amino group contributes to urea synthesis; the resulting pyruvate enters gluconeogenesis through conversion to oxaloacetate. During early starvation, the small intestine is the principal site of glutamine metabolism. Active turnover of intestinal epithelial cells stimulates purine synthesis, creating a high demand for glutamine uptake. A by-product of intestinal glutamine metabolism is alanine, which enters the circulation and is taken up by the liver to support gluconeogenesis. With prolonged starvation, glutamine metabolism shifts to the kidney, where the generation of NH4+ prov
Integrative mechanisms for mitochondrial function assessment in CKD. This figure illustrates a comprehensive overview of mitochondrial evaluation techniques and alterations in CKD. Upper left panel: Functional imaging techniques including as examples qBOLD MRI114 and PET scan (18F-BDP-BF)71 other important readouts that can be enabled through imaging include tissue perfusion, oxygenation, TCA cycle flux, end-organ insulin resistance, mitochondrial respiration, and overall organ and mitochondrial health status.
Framework for meaningful engagement of patients in research. The framework (adapted from Harrison et al.)15 includes three distinct but inter-related elements of stakeholder engagement in research: research phases, foundational principles, and best practices. The framework elements are inter-related as shown by the arrows surrounding the figure. For example, the foundational engagement principles serve as the foundation for the best practices and are relevant to activities across the research continuum from design to dissemination.
Field pre- and post-test protocol for assessing physiological heat strain and renal responses in agricultural workers. Legend: This figure illustrates the field measurement protocol used to evaluate physiological heat strain and acute renal responses. Environmental heat exposure, including wet-bulb globe temperature (WBGT), and work metabolic rate were assessed during field activities.
Genomic Modifications in the Donor Pig. Abbreviations: GGTA1, alpha-1,3-galactosyltransferase 1; αGal, galactose-α-1,3-galactose; CMAH, cytidine monophospho-N-acetylneuraminic acid hydroxylase; Neu5Gc, N-glycolylneuraminic acid; B4GALNT2, beta-1,4-N-acetyl-galactosaminyltransferase 2; PERV, porcine endogenous retrovirus; CD46, cluster of differentiation 46; CD55, cluster of differentiation 55; THBD, thrombomodulin; PROCR, endothelial protein C receptor; CD47, cluster of differentiation 47; HMOX1, heme oxygenase 1; TNFAIP3, TNF alpha induced protein 3; PERV, Porcine Endogenous Retrovirus; CRISPR, clustered regularly interspaced short palindromic repeats; Cas9, CRISPR-associated protein 9.
Screen failure reasons according to trial and participant demographics (a) overall population (b) screen failures according to trial, and (c) screen failures according to demographics
Cumulative incidence of kidney outcomes after inverse probability of treatment weighting. Time expressed in months (30-day intervals). Abbreviations: CKD, chronic kidney disease.
Time course of clinical parameters and representative kidney biopsy images. Trends of hemoglobin (Hb) and platelet count (A); creatinine and uric acid (B); AST (aspartate transaminase), ALT (alanine transaminase), and LDH (lactate dehydrogenase) (C); over a 7-month follow-up, from the first hospital admission at 34 weeks’ gestation (25 days before the delivery) to 190 days after delivery. Arrows indicate key clinical events: delivery (day 0), administration of fresh frozen plasma (FFP, +2 days), red blood cell transfusions (PRBCs, +3 days and +12 days), and kidney biopsy (+15 days). Triangles represent the timings of proteinuria measurements (yellow: higher than normal range; red: nephrotic range proteinuria.