Clinical and Experimental Nephrology最新文献_第10页

Advancing large language models in nephrology: bridging the gap in image interpretation. 推进肾脏病学的大型语言模型：弥补图像解读方面的差距。

IF 2.2 4区医学

Clinical and Experimental Nephrology Pub Date : 2025-01-01 Epub Date: 2024-10-28 DOI: 10.1007/s10157-024-02581-9

Shunsuke Koga

引用次数: 0

Association of hyperphosphatemia with renal prognosis in patients with autosomal dominant polycystic kidney disease. 常染色体显性多囊肾患者的高磷血症与肾脏预后的关系。

IF 2.2 4区医学

Clinical and Experimental Nephrology Pub Date : 2025-01-01 Epub Date: 2024-09-25 DOI: 10.1007/s10157-024-02568-6

Kosaku Nitta, Hiroshi Kataoka, Shun Manabe, Shiho Makabe, Taro Akihisa, Yusuke Ushio, Momoko Seki, Ken Tsuchiya, Junichi Hoshino, Toshio Mochizuki

{"title":"Association of hyperphosphatemia with renal prognosis in patients with autosomal dominant polycystic kidney disease.","authors":"Kosaku Nitta, Hiroshi Kataoka, Shun Manabe, Shiho Makabe, Taro Akihisa, Yusuke Ushio, Momoko Seki, Ken Tsuchiya, Junichi Hoshino, Toshio Mochizuki","doi":"10.1007/s10157-024-02568-6","DOIUrl":"10.1007/s10157-024-02568-6","url":null,"abstract":"Background: Serum phosphate (P) levels are generally lower in autosomal dominant polycystic kidney disease (ADPKD) than in other kidney disorders, potentially masking the clinical significance of hyperphosphatemia. This study aimed to determine if serum P levels can predict renal outcomes in ADPKD patients.Methods: We included 235 patients with ADPKD who were not taking drugs to treat hyperphosphatemia. Survival analysis was performed for the renal outcome of a 50% reduction in estimated glomerular filtration rate or initiation of renal replacement therapy.Results: Multivariable Cox regression analyses revealed that serum P (1 mg/dL increase, HR = 2.03, P < 0.0001) was a significant risk factor for kidney disease progression. Similarly, hyperphosphatemia (P > 3.5 mg/dL, HR = 2.05; P > 4.0 mg/dL, HR = 1.90; P > 4.5 mg/dL, HR = 2.78; P > 5.0 mg/dL, HR = 27.22) was significantly associated with renal prognosis. Kaplan-Meier analysis showed significantly lower kidney survival rates in patients with P > 3.5 mg/dL than in those without hyperphosphatemia (log-rank test, P < 0.0001), and similar Kaplan-Meier analysis results were found for P > 4.0 mg/dL, P > 4.5 mg/dL, and P > 5.0 mg/dL. The 2 year kidney survival rate for ADPKD patients with P > 3.5 mg/dL was 66.7% overall and 41.4% in those with stage 4-5 CKD. For patients with P > 4.0 mg/dL, the survival rate dropped to 46.8% overall and 28.2% in those with stage 4-5 CKD, indicating a very poor prognosis.Conclusion: Hyperphosphatemia was associated with renal prognosis in patients with ADPKD. In these patients, attention should be paid to even mild serum P elevation of > 3.5 or > 4.0 mg/dL.","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":"75-82"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Marked vascular calcification in a patient on hemodialysis. 一名血液透析患者的血管明显钙化。

IF 2.2 4区医学

Clinical and Experimental Nephrology Pub Date : 2025-01-01 Epub Date: 2024-08-22 DOI: 10.1007/s10157-024-02547-x

Kazuho Oe, Yohei Koyashiki, Shin-Ichi Takeda

引用次数: 0

A review of the genetic background in complicated WT1-related disorders. 复杂 WT1 相关疾病的遗传背景综述。

IF 2.2 4区医学

Clinical and Experimental Nephrology Pub Date : 2025-01-01 Epub Date: 2024-07-13 DOI: 10.1007/s10157-024-02539-x

China Nagano, Kandai Nozu

{"title":"A review of the genetic background in complicated WT1-related disorders.","authors":"China Nagano, Kandai Nozu","doi":"10.1007/s10157-024-02539-x","DOIUrl":"10.1007/s10157-024-02539-x","url":null,"abstract":"The Wilms tumor 1 (WT1) gene was first identified in 1990 as a strong candidate for conferring a predisposition to Wilms tumor. The WT1 protein has four zinc finger structures (DNA binding domain) at the C-terminus, which bind to transcriptional regulatory sequences on DNA, and acts as a transcription factor. WT1 is expressed during kidney development and regulates differentiation, and is also expressed in glomerular epithelial cells after birth to maintain the structure of podocytes. WT1-related disorders are a group of conditions associated with an aberrant or absent copy of the WT1 gene. This group of conditions encompasses a wide phenotypic spectrum that includes Denys-Drash syndrome (DDS), Frasier syndrome (FS), Wilms-aniridia-genitourinary-mental retardation syndrome, and isolated manifestations of nephropathy or Wilms tumor. The genotype-phenotype correlation is becoming clearer: patients with missense variants in DNA binding sites including C2H2 sites manifest DDS and develop early-onset and rapidly developing end-stage kidney disease. A deeper understanding of the genotype-phenotype correlation has also been obtained in DDS, but no such correlation has been observed in FS. The incidence of Wilms tumor is higher in patients with DDS and exon-truncating variants than in those with non-truncating variants. Here, we briefly describe the genetic background of this highly complicated WT1-related disorders.","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":"1-9"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11807054/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141603320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Straightforward and immediate ultrasound-guided kidney biopsy using a guide needle technique to get adequate tissue with reduced procedural time. 使用导针技术，在超声波引导下进行直接、即时的肾脏活组织检查，以获取足够的组织并缩短手术时间。

IF 2.2 4区医学

Clinical and Experimental Nephrology Pub Date : 2025-01-01 Epub Date: 2024-08-22 DOI: 10.1007/s10157-024-02544-0

Hiroaki Komatsu, Tomohisa Yamashita, Arata Osanami, Chikako Akazawa, Kota Endo, Shun Tsugawa, Ayumu Kimura, Daisuke Miyamori, Koki Abe, Satoko Takahashi, Yufu Gocho, Masayuki Koyama, Tatsuya Sato, Marenao Tanaka, Norihito Moniwa, Masato Furuhashi

{"title":"Straightforward and immediate ultrasound-guided kidney biopsy using a guide needle technique to get adequate tissue with reduced procedural time.","authors":"Hiroaki Komatsu, Tomohisa Yamashita, Arata Osanami, Chikako Akazawa, Kota Endo, Shun Tsugawa, Ayumu Kimura, Daisuke Miyamori, Koki Abe, Satoko Takahashi, Yufu Gocho, Masayuki Koyama, Tatsuya Sato, Marenao Tanaka, Norihito Moniwa, Masato Furuhashi","doi":"10.1007/s10157-024-02544-0","DOIUrl":"10.1007/s10157-024-02544-0","url":null,"abstract":"Background: A streamlined and effective renal biopsy technique is essential for all nephrologists, particularly those who are less experienced, such as residents. Herein, we report the efficacy of a Straightforward and Immediate ultrasound-guided kidney biopsy using a Guide Needle (SIGN) technique, which allows operators to insert a biopsy gun through a guide needle placed into the fascia of the posterior abdominal wall.Methods: A retrospective cross-sectional study was conducted at a nephrology training institution to compare the time spent on the procedure and the number of glomeruli obtained between a group using the SIGN (n = 81) and a group using the conventional ultrasound-guided kidney biopsy technique with a needle guide device (n = 143).Results: The median procedure time in the SIGN group (2 min, interquartile range [IQR]: 1-3 min) was significantly shorter than that in the conventional group (3 min, IQR: 2-4 min) (P < 0.001). Multivariable linear regression and logistic regression analyses adjusted for covariates, including operators (board-certificated nephrologists or nephrology residents), showed that the use of the SIGN technique was independently associated with a high number of glomeruli obtained and a procedure time above 2 min as the median value (odds ratio: 0.17, 95% confidence interval CI 0.09-0.34). The prevalence of complications was comparable between the two groups (P = 0.681).Conclusion: The SIGN technique reduces the procedure time and obtains adequate biopsy tissue regardless of the operator's experience. SIGN can be applied in nephrology training programs and used as a standard biopsy technique.","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":"57-66"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11807059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142016577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Exposure and outcomes of aortic valve change in patients initiating dialysis. 开始透析的患者主动脉瓣变化的风险和结果。

IF 2.2 4区医学

Clinical and Experimental Nephrology Pub Date : 2025-01-01 Epub Date: 2024-08-22 DOI: 10.1007/s10157-024-02548-w

Mineaki Kitamura, Hiroshi Yamashita, Atsushi Sawase, Masayoshi Takeno, Koji Maemura, Hiroshi Mukae, Tomoya Nishino

{"title":"Exposure and outcomes of aortic valve change in patients initiating dialysis.","authors":"Mineaki Kitamura, Hiroshi Yamashita, Atsushi Sawase, Masayoshi Takeno, Koji Maemura, Hiroshi Mukae, Tomoya Nishino","doi":"10.1007/s10157-024-02548-w","DOIUrl":"10.1007/s10157-024-02548-w","url":null,"abstract":"Background: Aortic stenosis (AS) and aortic valve calcification (AVC) are occasionally observed in patients receiving maintenance dialysis. However, their prevalence and factors associated with them in patients undergoing dialysis remain unknown. We aimed to elucidate the aortic valve status at the time of dialysis initiation and patient prognosis based on aortic valve status.Methods: We analyzed 289 patients initiating dialysis (hemodialysis: peritoneal dialysis = 275:14) between 2016 and 2023. \"AS and/or AVC\" was detected using echocardiography. AS was defined as a maximum transaortic velocity > 2.0 m/s. Statistical analyses including multivariable logistic regression and Cox regression were used to assess the association between patient characteristics and survival outcomes.Results: Aortic valve changes were observed in 121 (42%) patients, among which 33 (11%) met the AS criteria. The mean age of patients in the AS, AVC without AS, and control groups was 79.1 ± 8.9, 75.9 ± 9.2, and 68.3 ± 12.9, respectively (P < 0.001). Multivariable logistic regression models showed that only age was associated with aortic valve changes (P < 0.001). Age and other important factor-adjusted multivariable Cox regression models showed that AS was an independent risk factor for death after dialysis initiation (hazard ratio (HR): 1.95, 95% confidence interval (CI): 1.06 - 3.59, P = 0.04). However, aortic valve changes (\"AS and/or AVC\") were not a risk factor for death (HR: 1.51, 95% CI 0.95 - 2.39, P = 0.08).Conclusions: With the growing older population undergoing dialysis, aortic valve changes should be closely monitored. Particularly, AS is crucial because of its impact on patient prognosis.","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":"91-98"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142016573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Tubulointerstitial nephritis associated with proton pump inhibitors: are we sufficiently aware of the problem? 与质子泵抑制剂相关的肾小管间质性肾炎：我们是否充分认识到了这个问题？

IF 2.2 4区医学

Clinical and Experimental Nephrology Pub Date : 2025-01-01 Epub Date: 2024-08-07 DOI: 10.1007/s10157-024-02542-2

Naoko Nakaosa, Nobuo Tsuboi, Keita Hirano, Masato Ikeda, Takashi Yokoo

引用次数: 0

Effect of age, sex, and chronic kidney disease on urinary creatinine excretion in Japanese patients. 日本患者的年龄、性别和慢性肾病对尿肌酐排泄的影响

IF 2.2 4区医学

Clinical and Experimental Nephrology Pub Date : 2025-01-01 Epub Date: 2024-09-27 DOI: 10.1007/s10157-024-02569-5

Shigehiro Yasui, Taro Horino, Keita Mitani, Yoshio Terada, Yoshiyasu Okuhara, Yutaka Hatakeyama

{"title":"Effect of age, sex, and chronic kidney disease on urinary creatinine excretion in Japanese patients.","authors":"Shigehiro Yasui, Taro Horino, Keita Mitani, Yoshio Terada, Yoshiyasu Okuhara, Yutaka Hatakeyama","doi":"10.1007/s10157-024-02569-5","DOIUrl":"10.1007/s10157-024-02569-5","url":null,"abstract":"Background: Urinary creatinine levels are used to estimate the excretion rates of certain analytes from the respective analyte-to-creatinine ratios. We clarified the influence of age and sex on estimated daily urinary creatinine excretion (eUCrE) based on the urinary creatinine level and daily urine volume.Methods: All inpatients aged ≥ 18 years who attended the Kochi Medical School Hospital with serum and urinary creatinine measurement results were enrolled. Serum and urinary creatinine concentrations were extracted from the database and fluctuations with sex and age were investigated. The eUCrE was calculated for patients with early morning spot urine protein excretion (UPE), and daily urine volume was measured on the same day.Results: Overall, 643 participants (322 men, 321 women) were enrolled. The eUCrE levels of men and women aged 18 - 64 and 18 - 44 years, respectively, significantly exceeded 1 g/day. Those of women aged 65-74 and ≥ 75 years were significantly lower than 1 g/day. Each age group was further categorised into Groups A (patients with eGFR ≥ 30 mL/min/1.73 m2 and UPE < 0.5 g/gCr), B (eGFR ≥ 30 mL/min/1.73 m2 and UPE ≥ 0.5 g/gCr), and C (eGFR < 30 mL/min/1.73 m2 and UPE ≥ 0.5 g/gCr). The eUCrE levels were the highest in Group A, followed by Groups B and C.Conclusion: This study revealed age-, sex-, and renal function-related biases in adjusted values using urinary biomarkers, including proteinuria and creatinine ratio.","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":"83-90"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Research progress on the pathogenesis of AKI complicated by ECMO. ECMO 并发 AKI 的发病机制研究进展。

IF 2.2 4区医学

Clinical and Experimental Nephrology Pub Date : 2025-01-01 Epub Date: 2024-09-28 DOI: 10.1007/s10157-024-02559-7

Keke Sun, Congcong Yao, Guowu Xu, Jinxiang Wang, Songtao Shou, Heng Jin

{"title":"Research progress on the pathogenesis of AKI complicated by ECMO.","authors":"Keke Sun, Congcong Yao, Guowu Xu, Jinxiang Wang, Songtao Shou, Heng Jin","doi":"10.1007/s10157-024-02559-7","DOIUrl":"10.1007/s10157-024-02559-7","url":null,"abstract":"Background: Extracorporeal membrane oxygenation (ECMO) stands as a pivotal intervention for patients grappling with cardiopulmonary insufficiency. However, alongside its therapeutic benefits, ECMO carries the risk of complications, with acute kidney injury (AKI) emerging as a significant concern. The precise pathophysiological underpinnings of AKI in the context of ECMO remain incompletely elucidated.Methods: A comprehensive literature review was conducted to explore the epidemiology and pathophysiological mechanisms underlying the utilization of ECMO in the management of AKI.Results: ECMO initiates a multifaceted cascade of inflammatory reactions, encompassing complement activation, endothelial dysfunction, white blood cell activation, and cytokine release. Furthermore, factors such as renal hypoperfusion, ischemia-reperfusion injury, hemolysis, and fluid overload exacerbate AKI. Specifically, veno-arterial ECMO (VA-ECMO) may directly induce renal hypoperfusion, whereas veno-venous ECMO (VV-ECMO) predominantly impacts pulmonary function, indirectly influencing renal function.Conclusion: While ECMO offers significant therapeutic advantages, AKI persists as a potentially fatal complication. A thorough comprehension of the pathogenesis underlying ECMO-associated AKI is imperative for effective prevention and management strategies. Moreover, additional research is warranted to delineate the incidence of AKI secondary to ECMO and to refine clinical approaches accordingly.","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":"10-20"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11807062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Children and adolescents with severe motor and intellectual disabilities who underwent kidney transplantation. 接受肾移植的严重运动和智力残疾儿童和青少年。

IF 2.2 4区医学

Clinical and Experimental Nephrology Pub Date : 2025-01-01 Epub Date: 2024-08-22 DOI: 10.1007/s10157-024-02550-2

Ryo Nakatani, Kenichiro Miura, Taro Ando, Aya Kato, Yoko Shirai, Kiyonobu Ishizuka, Yuki Miyauchi, Daisuke Ogino, Yuko Akioka, Hideki Ishida, Motoshi Hattori

{"title":"Children and adolescents with severe motor and intellectual disabilities who underwent kidney transplantation.","authors":"Ryo Nakatani, Kenichiro Miura, Taro Ando, Aya Kato, Yoko Shirai, Kiyonobu Ishizuka, Yuki Miyauchi, Daisuke Ogino, Yuko Akioka, Hideki Ishida, Motoshi Hattori","doi":"10.1007/s10157-024-02550-2","DOIUrl":"10.1007/s10157-024-02550-2","url":null,"abstract":"Background: Kidney transplantation (KT) in children and adolescents with severe motor and intellectual disabilities (SMID) has been a topic of controversy. A multicenter study in Japan showed that KT was not contraindicated for children with multiple handicaps, but no consensus has been reached on KT for patients with SMID. This study aimed to determine whether KT is a viable treatment option for children and adolescents with SMID.Methods: A single-center, retrospective study was conducted on children and adolescents with SMID who underwent KT. SMID was defined based on Oshima's classification. Clinical information was collected through a review of medical records.Results: Of 453 children and adolescents who underwent KT between 1983 and 2023 in our institution, six (1.3%) patients with SMID were identified. One patient received KT twice. All patients underwent living KT. Five patients used medical devices, including gastrostomy and a ventriculoperitoneal shunt, prior to KT. Perioperative complications, including hemothorax related to central venous catheter insertion, ventilator-associated pneumonia, and common iliac artery thrombosis requiring graftectomy, occurred in three patients. One patient required vesicostomy owing to refractory urinary tract infection. There was no significant difference in the graft survival rate between patients with SMID and those without SMID. One patient developed graft failure and died after selecting conservative kidney management.Conclusion: Our study showed a favorable graft survival in children and adolescents with SMID who underwent KT. Although careful perioperative management and continued medical care are required, KT may be a viable option for these patients.","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":"99-104"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142016572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0