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Deep Learning (DL) holds great promise to improve patient outcomes by improving the precision and speed of disease diagnosis and treatment recommendations. Given the efficacy of DL in image analysis, pathology will likely be one of the first medical fields transformed by DL. However, several challenges must be overcome before we can expect to see the use of DL transform the digital future of pathology.
Graft rejection is traditionally attributed to adaptive immune cells that recognize donor-specific alloantigens, with innate immunity having a secondary role. The finding that recipient natural killer cells are activated by the inability of graft endothelial cells to provide HLA-I-mediated inhibitory signals challenges this dogma and introduces the concept of innate rejection.
Kidneys from older donors might improve the quality of life and survival of patients with kidney failure, yet these organs are often underutilized. Re-framing discussions of organ acceptance from older donors and its benefits over dialysis, especially for older patients and those who cannot tolerate prolonged waiting for transplantation, is urgently needed.
Centenarians — who are a putative model of healthy longevity — often have a low risk of cardiovascular disease, despite an age-associated decline in kidney function. An understanding of the molecular and cellular underpinnings of health kidney ageing in centenarians may provide clues for the prevention or alleviation of the burden of kidney disease in older populations.
American Indian and Alaska Native peoples have low life expectancy and a disproportionate disease burden (including of chronic kidney disease), owing to inadequate education, poverty, discrimination and underfunding in the delivery of health services, and healthcare institutions’ lack of appreciation for cultural differences. These broad quality-of-life issues are rooted in economic adversity and poor social conditions.
The increasing prevalence of chronic kidney disease (CKD) is placing a growing burden on healthcare systems, which results in considerable economic and environmental challenges. Sustainable CKD care and optimization of patient outcomes requires a new approach to the organization of healthcare systems, in which home monitoring will have a pivotal role.
The use of cystatin C-inclusive equations will continue to propagate the unnecessary overdiagnosis of chronic kidney disease (CKD) in older people. Cystatin C is less biologically specific for CKD than is serum creatinine, inflates the risks of adverse outcomes compared to measured glomerular filtration rate, and does not establish chronicity at a single time point.
Kidney disease is strongly linked with cardiovascular diseases, hypertension, diabetes, infections and other health conditions, as well as social determinants of health and climate change. Consequently, a holistic approach to promote well-being, protect individual health and improve access to quality primary care will support kidney health.
Chronic kidney disease is a life-changing diagnosis for millions of people worldwide, as the risk of disease progression and kidney failure creates unbearable uncertainty and limits lifestyle. The devastating impact of advanced kidney disease must be acknowledged in the public health agenda to pave way for improved outcomes for patients at all stages of disease.
Clinical algorithms that are used to guide medical decision-making often include sex as a variable. However, binary considerations of sex and/or gender might introduce bias due to potentially inaccurate assumptions about sex and gender-specific physiology, hormones and exposures. An equity-focused approach to sex and gender is essential when using clinical algorithms to ensure health equity across populations.