Why creatinine can mislead, PD peritonitis benchmarks, and AKI risk on hormone therapy

The edition in brief

Five findings for nephrologists. An editorial explains that an African-ancestry-specific variant at the GATM locus raises creatine synthesis and serum creatinine without changing measured kidney function, accounting for part of the residual bias in creatinine-based eGFR and strengthening the case for cystatin C confirmation. A systematic review of over 132,000 peritoneal dialysis patients across 37 countries found a global peritonitis rate of 0.31 episodes per patient-year, with wide regional variation (0.21 to 0.99) and 10 countries exceeding the ISPD benchmark of 0.40, mostly Gram-positive organisms. A commentary on the GOAL trial notes that a single outpatient comprehensive geriatric assessment did not improve goal attainment in older people with CKD and frailty, pointing to the need for better-integrated models. A pearl covers using cystatin C to clarify kidney function when creatinine misleads. The practice-changer is a meta-analysis of 72,980 prostate cancer patients linking androgen deprivation therapy to higher odds of acute kidney injury (odds ratio 1.34), most clearly with GnRH agonists, supporting renal monitoring.