Membranous nephropathy gets a second serology, and it tracks proteinuria

The edition in brief

A thin day on the nephrology desk, and a short edition rather than a padded one. A meta-analysis of 19 studies, nine pooled, found that hypoalbuminaemia on admission after burn injury was associated with an odds ratio of 9.51 (95% CI 3.04-29.78) for in-hospital death and 2.83 (2.49-3.22, I² 0%) for acute kidney injury. A meta-analysis of 17 retrospective cohorts covering 2,986 children found a pooled acute kidney injury incidence of 30.7% (95% CI 25.0-36.3) after paediatric liver transplantation, with preoperative hepatic impairment, coagulation abnormality, intraoperative blood loss, transfusion burden and ischaemia-reperfusion injury among the contributing factors, though most individual associations rest on few studies. Laboratory and human work implicates platelet-derived growth factor receptor β in uraemic vascular calcification: uraemic dialysate raised receptor phosphorylation in murine aortas, inhibition with soluble receptor or imatinib reduced calcification and improved vascular elasticity, and arteries from patients with stage 5 chronic kidney disease showed the same receptor activation. A pearl covers the contrast-associated acute kidney injury conversation. The edition closes with a luciferase immunoprecipitation assay for anti-NELL1 antibodies, which showed 90% sensitivity and 100% specificity in a biopsy-proven validation cohort of 40 patients and whose titres tracked proteinuria in three longitudinally followed cases.