Welcome to the Chronic Kidney Disease Insider Newsletter. If you are living with chronic kidney disease (CKD) on dialysis, have had a kidney transplant or are helping care for someone who is, this newsletter was created for you! The CKD Insider Newsletter provides actionable information for you and your family to help you manage your health in consultation with your doctor.
In this month’s CKD Insider:
Recent Clinical Trial Review: Kidney Retransplantation in Patients over 65
Detecting Rejection for Pancreas Kidney Transplant Recipient
Pediatric CKD Care (non-dialysis):
Considerations for transitioning to adult care
Takeaways from 2024 KDIGO Guidelines
Latest News from Kidney Organizations
AAKP Webinar Key Considerations: Support for Care Partners If A Loved One Transitions From Home to a Skilled Nursing Facility - Watch the Replay
The American Association of Kidney Patients (AAKP) and Concerto Renal Services recently hosted a webinar where they discussed best practices and solutions for care partners who have a loved one transitioning from home to a skilled nursing facility. Enhancing the care coordination can help ensure quality dialysis care.
Watch the replay here.
DPC Education Center is hosting live Q&A sessions with Healthcare Consultant
The Dialysis Patient Citizens (DPC) Education Center is dedicated to empowering kidney disease patients through education with continual collaboration from health professionals. DPC is led by a board of directors composed of end-stage renal disease (ESRD) patients. They have established a once monthly education call schedule where leading experts present on topics critical to people with CKD on those on dialysis. This month bring your kidney questions to Dr. Scantlebury, a former kidney surgeon and healthcare consultant. Learn valuable information about staying healthy while living with kidney disease.
Wednesday, April 2nd
12:30 - 1:00 PM EST
Live Q&A with Dr. Scantlebury
Wednesday April 16th
4:00 - 4:30 PM EST
Live Q&A with Dr. Scantlebury
AAKP: Healthline webinar on the critical role phosphorus plays in kidney health
In recognition of National Phosphorus Awareness Day on April 5th, the American Association of Kidney Patients (AAKP) is hosting a special HealthLine webinar about phosphorus and kidney disease with a registered dietitian, who will provide a clinical overview of phosphorus management. Learn practical tips through a live low-phosphorus cooking demonstration with a professional chef and hear directly from AAKP Ambassadors who will share their personal strategies for managing phosphorus intake, and the importance of being your own best advocate in accessing new treatments and making informed choices about your care plan.
Friday, April 4th
3:00 - 4:00 PM EST
Register here.
AAKP Annual Global Summit on Kidney Innovations Save the Date
The Decade of the Kidney™ at Midpoint: Opportunities and Barriers to Greater Innovation and Freedom from Disease and Disability will be presented by the partnership of American Association of Kidney Patients & George Washington University School of Medicine & Health Sciences.
May 22 – 23, 2025
Virtual Event
Register here.
Your Fun Tip of the Day
Explore the World from Your Seat: Shows & Nature Watching to Brighten Your Day
Tired of the same view? Check out these incredible shows that take you on epic journeys—exploring stunning landscapes, discovering unique animals and their habitats, and uncovering the hidden history and wonders of our world—all while you sit back and relax. Let these programs be your window to exploration!
Want to create your own nature-watching experience? A smart bird feeder with a camera lets you enjoy live bird visits from your phone while in dialysis. Watching birds come and go can bring a little joy to your day!
Suggested Shows & Experiences:
The Americas (Hosted by Tom Hanks)
Aerial Travel Documentaries (Smithsonian Channel)
Latest News for Kidney Transplant Community
Kidney Retransplantation Viable in Patients over 65
What it is: A retrospective study of 668 transplants performed in people 65+ years old found that retransplantation (repeat transplants) in patients over 65 are viable and preferable to long-term dialysis. With the exception of death, second transplants had similar outcomes to primary transplants. The study excluding people who received living donors and multi-organ transplants.
Why it's important: If you or a loved one are over age 65 and in need of transplant, this study can provide you both hope that you can still receive a transplant if you want one, and also provide evidence for discussion when speaking with your nephrologist.
Read more here.
AlloSure Kidney Testing for Detect Rejection for Simultaneous Pancreas-Kidney (SPK) Transplants
What it is: CareDx AlloSure is a test that can detect organ rejection following transplant by measuring DNA from the donor in the blood of the organ recipient, called donor-derived cell-free DNA (dd-cfDNA). AlloSure Kidney has expanded the indications and is now available for patients who have received a simultaneous pancreas-kidney transplantation (SPK). SPK transplants improve quality of life and survival for people with insulin-dependent diabetes and kidney disease but are at risk of rejection.
Why it’s important: If you have had a simultaneous pancreas and kidney transplant, the AlloSure Kidney test could help you and your physician detect kidney rejection and graft injury even when you might be feeling good. Ask your nephrologist if incorporating this test into your regular evaluations is appropriate for you.
Read more here. Additionally, AlloSure Heart is now available for pediatric heart transplant patients under 15.
Pediatric Chronic Kidney Disease Care (Non-Dialysis)
Transitioning to adult CKD care considerations
Transitioning to adult care has unique considerations. A useful guide was recently published in Kidney360. Here are a few key takeaways:
If possible, the transition should span several years.
Providers and caregivers should provide increasing autonomy for care decisions and management to the pediatric patient years prior to the transition to adult care.
In addition to assessing patient readiness for disease management, providers should prepare caregivers for the transition.
Because the cause of childhood CKD is often different than adults, including resulting from congenital abnormalities of the kidney and urinary tract (called CAKUT), disease progression differs. It’s important to have continuity between the pediatric and adult treatment providers.
For those with CAKUT, providers and patients may want to consider genetic testing and weigh risks as they reach reproductive age.
For more information and a complete guide, see Pediatric to Adult Nephrology Transition published this year in Kidney360 (click download link on the left to see full guide).
2024 KDIGO Guidelines for Caring for Pediatric Kidney Patients Review
Caring for children with CKD is not just a scaled version of adult care. The 2024 KDIGO Guidelines include specific recommendations for caring for pediatric kidney patients, which were recently summarized in JAMA Pediatrics. There are three key areas that differ from adult care: assessment of kidney function, disease trajectories, and navigating growth and development alongside kidney care.
Some key take aways for Pediatricians:
eGFR in children is typically calculated using the CKIDU25 or EKFC equation, with CKIDU25 being more accurate due to its diverse cohort. Certain populations require other equations, including those with low muscle mass due to neuromuscular conditions or malnutrition that should use a cystatin C-based eGFR equation.
Proteinuria should be assessed with a first-morning midstream sample to avoid orthostatic proteinuria (affecting 2–5% of adolescents). Exercise, menstruation, and infection can affect this measurement.
The new definition of low eGFR creatinine for children older than 2 is defined as less than 90 mL/min/1.73m2.
Disease cause often differs for pediatric patents compared to adults, including congenital anomalies. Disease progression is usually slower than in adults.
Care of an adolescent patient includes navigating normal developmental changes concurrent to kidney disease.
For the full guidelines and important information, see the full article here: KDIGO Guidelines – Key Points for Pediatricians.
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