Browsing by Author "Hains, David S."

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    3D Mapping Reveals a Complex and Transient Interstitial Matrix During Murine Kidney Development
    (Wolters Kluwer, 2021) Lipp, Sarah N.; Jacobson, Kathryn R.; Hains, David S.; Schwarderer, Andrew L.; Calve, Sarah; Pediatrics, School of Medicine
    ESKD is increasing in incidence and a limited number of organs are available for transplantation. Therefore, researchers have focused on understanding how cellular signaling influences kidney development to expand strategies to rebuild a kidney. However, the extracellular matrix (ECM), another critical component that biomechanically regulates nephrogenesis, has been largely neglected. Proteomics and 3D imaging of the murine kidney resolved previously undescribed dynamics of the interstitial matrix in the cortex and corticomedullary junction during development. Combined with cells and growth factors, scaffolds modeled after the composition and organization of the developmental ECM have the potential to improve engineered models of the kidney.
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    Association Between Continuous Kidney Replacement Therapy Clearance and Outcome in Pediatric Patients With Hyperammonemia Not Due to Inborn Error of Metabolism
    (Society of Critical Care Medicine​ and WFPICCS, 2022-07) Starr, Michelle C.; Cater, Daniel T.; Wilson, Amy C.; Wallace, Samantha; Bennett, William E.; Hains, David S.; Pediatrics, School of Medicine
    OBJECTIVES: To describe a single-center experience of pediatric patients with hyperammonemia not due to inborn errors of metabolism and determine the association between use of continuous kidney replacement therapy (CKRT) treatment and outcomes. DESIGN: Retrospective cohort study. SETTING: Tertiary-care children's hospital. PATIENTS: All children less than 21 years old admitted to the hospital with hyperammonemia defined as an elevated ammonia levels (>100 µmol/L) not due to inborn error of metabolism. INTERVENTIONS: None. MEASURES AND MAIN RESULTS: Of 135 children with hyperammonemia, the most common reason for admission was infection in 57 of 135 (42%), congenital heart disease in 20 of 135 (14%), and bone marrow transplantation in 10 of 135 (7%). The overall mortality was 61% (82 of 135), which increased with degree of hyperammonemia (17 of 23 [74%] in those with ammonia >250 µmol/L). After multivariable regression, hyperammonemia severity was not associated with mortality (aOR, 1.4; 95% CI, 0.92–2.1; p = 0.11). Of the 43 patients (32%) receiving CKRT, 21 were prescribed standard clearance and 22 high clearance. The most common indications for CKRT were fluid overload in 17 of 43 (42%) and acute kidney injury or uremia in 16 of 43 (37%). Mean CKRT duration was 13 days. There was no difference between standard and high clearance groups in risk of death (76% vs 86%; p = 0.39), cerebral edema on CT scan (19% vs 27%; p = 0.52), nor decrease in ammonia levels after 24 or 48 hours of CKRT (p = 0.20, p = 0.94). Among those receiving CKRT, we failed to find an association between high clearance and decreased risk of death in multivariable analysis (aOR, 1.2; 95% CI, 0.64–2.3; p = 0.55). CONCLUSIONS: In our single-center retrospective study, we failed to find an association between clearance on CKRT and improved survival nor decreased cerebral edema on head imaging. In fact, we failed to find an association between ammonia level and mortality, after controlling for illness severity.
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    Asymptomatic Bacteriuria versus Symptom Underreporting in Older Emergency Department Patients with Suspected Urinary Tract Infection
    (Wiley, 2020-11) Caterino, Jeffrey M.; Stephens, Julie A.; Camargo, Carlos A., Jr.; Wexler, Randell; Hebert, Courtney; Southerland, Lauren T.; Hunold, Katherine M.; Hains, David S.; Bischof, Jason J.; Wei, Lai; Wolfe, Alan J.; Schwaderer, Andrew; Pediatrics, School of Medicine
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    Asymptomatic Seroconversion of Immunoglobulins to SARS-CoV-2 in a Pediatric Dialysis Unit
    (American Medical Association, 2020-05-14) Hains, David S.; Schwaderer, Andrew L.; Carroll, Aaron E.; Starr, Michelle C.; Wilson, Amy C.; Amanat, Fatima; Krammer, Florian; Pediatrics, School of Medicine
    Dialysis units are at especially high risk of infectious disease transmission, and concern exists about spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Dialysis units in Wuhan, China, have reported high coronavirus disease 2019 (COVID-19) prevalence, due in part to unique exposure challenges that limit social distancing efforts, including open bay formats and rotating/multiple nursing assignments. This study describes SARS-CoV-2 seroconversion in patients and health care workers in a pediatric dialysis unit.
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    Coronavirus disease 2019 (COVID-19) in two pediatric patients with kidney disease on chronic immunosuppression: A case series
    (Wiley, 2021-01) Rawson, Ashley; Wilson, Amy C.; Schwaderer, Andrew L.; Spiwak, Elizabeth; Johnston, Bethanne; Anderson, Shannon; Nailescu, Corina; Gupta, Sushil; Christenson, John C.; Hains, David S.; Starr, Michelle C.; Pediatrics, School of Medicine
    Coronavirus disease 2019 (COVID‐19) is a highly infectious disease caused by the severe acute respiratory syndrome coronavirus 2 virus (SARS‐CoV‐2). While children appear to experience less severe disease than adults, those with underlying conditions such as kidney disease may be more susceptible to infection. Limited data are present for children with kidney disease, and there are limited prior reports of pediatric hemodialysis patients with COVID‐19. This report describes the mild clinical disease course of COVID‐19 in two pediatric patients with chronic kidney disease, one on hemodialysis and both on chronic immunosuppression. We review treatment in these patients, as well as our measures to reduce transmission among our hemodialysis patients and staff.
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    DCHS1 DNA copy number loss associated with pediatric urinary tract infection risk
    (Sage, 2020-08) Qureshi, Aslam H.; Liang, Dong; Canas, Jorge; Hooks, Jenaya; Arrregui, Samuel W.; Saxena, Vijay; Rooney, Robert; Nolan, Vikki; Schwaderer, Andrew L.; Hains, David S.; Pediatrics, School of Medicine
    Urinary tract infections (UTI), associated with vesicoureteral reflux (VUR), can lead to chronic kidney disease. Genetic alterations in the innate immune defenses contribute to UTI risk. We investigated a novel gene, Dachsous Cadherin-Related 1 ( DCHS1), in children with UTI. We determined absolute DNA copy number (CN) of DCHS1 in children with UTI. In this case-control study, we utilized multiple complementary methods to determine the genomic CN of DCHS1. Children with ( n = 370) and without ( n = 71) VUR from two well-phenotyped clinical trials of UTI were copy-typed and compared to 491 healthy controls with no known history of VUR or UTI. Less than 1% of controls had a single copy of DCHS1, while 31% of children with UTI and no VUR and 7% of children with UTI and VUR had a single copy of the DCHS1 gene. Using immunostaining, we localized expression postnatally to the bladder and renal epithelia. Mice were also challenged with two uropathogenic Escherichia coli strains, and Dchs1 mRNA was quantified. This study represents the first report of DCHS1 in association with pediatric UTI. We hypothesize that its role in innate immunity is critical to lower urinary tract defense. Further investigation is required to determine the role of DCHS1 in innate immunity.
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    DCHS1 DNA copy number loss associated with pediatric urinary tract infection risk
    (SAGE, 2020-04-15) Qureshi, Aslam H.; Liang, Dong; Canas, Jorge; Hooks, Jenaya; Arrregui, Samuel W.; Saxena, Vijay; Rooney, Robert; Nolan, Vikki; Schwaderer, Andrew L.; Hains, David S.; Pediatrics, School of Medicine
    Urinary tract infections (UTI), associated with vesicoureteral reflux (VUR), can lead to chronic kidney disease. Genetic alterations in the innate immune defenses contribute to UTI risk. We investigated a novel gene, Dachsous Cadherin-Related 1 (DCHS1), in children with UTI. We determined absolute DNA copy number (CN) of DCHS1 in children with UTI. In this case-control study, we utilized multiple complementary methods to determine the genomic CN of DCHS1. Children with (n = 370) and without (n = 71) VUR from two well-phenotyped clinical trials of UTI were copy-typed and compared to 491 healthy controls with no known history of VUR or UTI. Less than 1% of controls had a single copy of DCHS1, while 31% of children with UTI and no VUR and 7% of children with UTI and VUR had a single copy of the DCHS1 gene. Using immunostaining, we localized expression postnatally to the bladder and renal epithelia. Mice were also challenged with two uropathogenic Escherichia coli strains, and Dchs1 mRNA was quantified. This study represents the first report of DCHS1 in association with pediatric UTI. We hypothesize that its role in innate immunity is critical to lower urinary tract defense. Further investigation is required to determine the role of DCHS1 in innate immunity.
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    DEFA1A3 DNA gene-dosage regulates the kidney innate immune response during upper urinary tract infection
    (Cold Spring Harbor Laboratory, 2024-04-05) Canas, Jorge J.; Arregui, Samuel W.; Zhang, Shaobo; Knox, Taylor; Calvert, Christi; Saxena, Vijay; Schwaderer, Andrew L.; Hains, David S.; Pediatrics, School of Medicine
    Antimicrobial peptides (AMPs) are host defense effectors with potent neutralizing and immunomodulatory functions against invasive pathogens. The AMPs α-Defensin 1-3/DEFA1A3 participate in innate immune responses and influence patient outcomes in various diseases. DNA copy-number variations in DEFA1A3 have been associated with severity and outcomes in infectious diseases including urinary tract infections (UTIs). Specifically, children with lower DNA copy numbers were more susceptible to UTIs. The mechanism of action by which α-Defensin 1-3/DEFA1A3 copy-number variations lead to UTI susceptibility remains to be explored. In this study, we use a previously characterized transgenic knock-in of the human DEFA1A3 gene mouse to dissect α-Defensin 1-3 gene dose-dependent antimicrobial and immunomodulatory roles during uropathogenic Escherichia coli (UPEC) UTI. We elucidate the relationship between kidney neutrophil- and collecting duct intercalated cell-derived α-Defensin 1-3/DEFA1A3 expression and UTI. We further describe cooperative effects between α-Defensin 1-3 and other AMPs that potentiate the neutralizing activity against UPEC. Cumulatively, we demonstrate that DEFA1A3 directly protects against UPEC meanwhile impacting pro-inflammatory innate immune responses in a gene dosage-dependent manner.
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    Deleted in malignant brain tumor 1 genetic variation confers urinary tract infection risk in children and mice
    (Wiley, 2021-07) Hains, David S.; Polley, Shamik; Liang, Dong; Saxena, Vijay; Arregui, Samuel; Ketz, John; Barr-Beare, Evan; Rawson, Ashley; Spencer, John D.; Cohen, Ariel; Hansen, Pernille L.; Tuttolomondo, Martina; Casella, Cinzia; Ditzel, Henrik J.; Cohen, Daniel; Hollox, Edward J.; Schwaderer, Andrew L.; Pediatrics, School of Medicine
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    Developing a Research Mentorship Program: The American Society of Pediatric Nephrology's Experience
    (Frontiers, 2019-04-24) Vasylyeva, Tetyana L.; Díaz-González de Ferris, María E.; Hains, David S.; Ho, Jacqueline; Harshman, Lyndsay A.; Reidy, Kimberly J.; Brady, Tammy M.; Okamura, Daryl M.; Samsonov, Dmitry V.; Wenderfer, Scott E.; Hartung, Erum A.; Pediatrics, School of Medicine
    Background: Most pediatric nephrologists work in academia. Mentor-mentee relationships provide support and guidance for successful research career. Mentorship program implementation is valuable in medical fields for providing research opportunities to young faculty. Methods: The American Society of Pediatric Nephrology (ASPN) established a research mentorship program to (a) assist with matching of appropriate mentor-mentee dyads and (b) establish metrics for desirable mentor-mentee outcomes with two independent components: (1) the grants review workshop, a short-term program providing mentor feedback on grant proposals, and (2) the longitudinal program, establishing long-term mentor-mentee relationships. Regular surveys of both mentors and mentees were reviewed to evaluate and refine the program. Results: Twelve mentees and 17 mentors participated in the grant review workshop and 19 mentees were matched to mentors in the longitudinal program. A review of NIH RePORTER data indicated that since 2014, 13 NIH grants have been awarded. Mentees in the longitudinal program reported that the program helped most with identifying an outside mentor, improving grant research content, and with general career development. Mentors perceived themselves to be most helpful in assisting with overall career plans. Email communications were preferred over phone or face-to-face communications. Mentees endorsed strong interest in staying in touch with their mentors and 100% of mentors expressed their willingness to serve in the future. Conclusion: This mentorship program was initiated and supported by a relatively small medical society and has shown early success in cultivating mentoring relationships for a future generation of clinician-scientists.