Clinical and Experimental Nephrology最新文献

{"title":"Correction: Age-specific trends in peritoneal dialysis use among incident dialysis patients in Japan.","authors":"Kenta Torigoe, Tomohisa Tsuyuki, Mineaki Kitamura, Tsutomu Sakurada, Tomoya Nishino","doi":"10.1007/s10157-026-02973-z","DOIUrl":"https://doi.org/10.1007/s10157-026-02973-z","url":null,"abstract":"","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149215115","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}

{"title":"Sex differences in the association between corrected serum calcium and sudden death in patients undergoing maintenance hemodialysis: ten-year outcomes of the Q-cohort study.","authors":"Hiroto Hiyamuta, Shunsuke Yamada, Rei Matsui, Masatomo Taniguchi, Kazuhiko Tsuruya, Toshiaki Nakano, Tetsuro Ago","doi":"10.1007/s10157-026-02964-0","DOIUrl":"https://doi.org/10.1007/s10157-026-02964-0","url":null,"abstract":"<p><strong>Background: </strong>Lower serum calcium (Ca) levels may increase arrhythmogenic vulnerability in patients undergoing hemodialysis, but whether this association differs by sex remains unclear. We examined the sex-specific association between corrected serum Ca and sudden death in a multicenter hemodialysis cohort.</p><p><strong>Methods: </strong>We analyzed 3,505 Japanese patients undergoing maintenance hemodialysis in the Q-Cohort Study. Baseline corrected serum Ca was evaluated as a 1-standard deviation (SD) increase and as low corrected serum Ca, primarily defined as < 8.4 mg/dL. The primary outcome was sudden death. Cox proportional hazards and Fine-Gray competing-risk models were used, with non-sudden death treated as a competing event. The primary analysis tested the interaction between corrected serum Ca and sex.</p><p><strong>Results: </strong>During follow-up, 227 sudden deaths occurred among 1,426 women and 2,079 men. Median corrected serum Ca was 9.4 mg/dL, and 211 patients had corrected serum Ca < 8.4 mg/dL. In the extended Cox model, higher corrected serum Ca was associated with lower sudden death risk in women (hazard ratio [HR] per 1-SD increase, 0.596; 95% confidence interval [CI], 0.464-0.766; P < 0.001), but not in men (HR, 1.04; 95% CI, 0.877-1.23; P = 0.663). The corrected serum Ca-by-male sex interaction was significant (HR, 1.74; 95% CI, 1.29-2.34; P < 0.001). Similar findings were observed in Fine-Gray models and sensitivity analyses.</p><p><strong>Conclusions: </strong>Lower corrected serum Ca was associated with higher sudden death risk primarily in women. Sex may modify the prognostic significance of corrected serum Ca for sudden death risk stratification.</p>","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149215105","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}

{"title":"Safety and efficacy of prednisolone, mizoribine and lisinopril combination therapy for severe childhood IgA nephropathy.","authors":"Yuko Shima, Hironobu Mukaiyama, Yu Tanaka, Wataru Shimabukuro, Hiroshi Kaito, Ryojiro Tanaka, Kandai Nozu, Kazumoto Iijima, Daisuke Tokuhara, Norishige Yoshikawa, Koichi Nakanishi","doi":"10.1007/s10157-026-02972-0","DOIUrl":"https://doi.org/10.1007/s10157-026-02972-0","url":null,"abstract":"<p><strong>Background: </strong>Angiotensin-converting enzyme inhibitors (ACEi), such as lisinopril, have long been used for childhood IgA nephropathy (cIgAN). A two-year regimen including prednisolone, mizoribine, warfarin, and dipyridamole was previously shown to be superior to prednisolone and mizoribine alone in achieving proteinuria remission. Because warfarin nephropathy has been reported and the cumulative prednisolone dose used in earlier regimens was substantial, we evaluated a new two-year regimen consisting of prednisolone, mizoribine, and lisinopril.</p><p><strong>Methods: </strong>Among 567 biopsy‑proven cIgAN cases treated between 1976 and 2022, 93 patients met the criteria for severe cIgAN. Of these, 77 received the previous regimen and 16 received the new regimen. Severe cIgAN was defined as diffuse mesangial proliferation and/or persistent heavy proteinuria (> 1 g/gCr). To adjust for baseline differences in proteinuria, eGFR, and C‑lesions, 1:1 propensity score matching was performed, yielding 15 matched pairs.</p><p><strong>Results: </strong>Baseline clinicopathological characteristics did not differ significantly between groups. Kaplan-Meier analysis showed that the new regimen was associated with a higher proteinuria remission rate during follow-up (log-rank p = 0.01) and a shorter time to remission (median 1.0 vs. 4.0 years, p = 0.03). Hematuria remission tended to be higher with the new regimen (80.0% vs. 46.7%). Proteinuria recurrence rates were comparable between groups.</p><p><strong>Conclusions: </strong>The two‑year regimen of prednisolone, mizoribine, and lisinopril was more effective in achieving earlier proteinuria remission and required a shorter duration of prednisolone exposure, with no significant difference in proteinuria recurrence compared with the previous regimen in children with severe cIgAN.</p>","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149215153","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}

{"title":"Donor kidney volume relative to recipient body size and longitudinal graft function in living donor kidney transplantation.","authors":"Shunta Hori, Mitsuru Tomizawa, Kuniaki Inoue, Akira Tachibana, Yuki Oda, Kenta Onishi, Yosuke Morizawa, Daisuke Gotoh, Yasushi Nakai, Makito Miyake, Tatsuo Yoneda","doi":"10.1007/s10157-026-02967-x","DOIUrl":"https://doi.org/10.1007/s10157-026-02967-x","url":null,"abstract":"<p><strong>Background: </strong>Donor nephron mass and recipient metabolic demand may influence graft outcomes after kidney transplantation. However, the clinical significance of kidney volume-based size mismatch remains unclear. We evaluated the association between donor kidney volume relative to recipient body size and short- and long-term graft function after living donor kidney transplantation (LDKT).</p><p><strong>Methods: </strong>We retrospectively analyzed 170 LDKT recipients. Donor kidney volume (DKV) was quantified using preoperative computed tomography and indexed to recipient body surface area (DKV/RBSA). The primary outcome was 12-month eGFR < 30 mL/min/1.73 m². Multivariable regression assessed 12-month graft function, and the incremental value of DKV/RBSA was compared with conventional mismatch indices. Longitudinal eGFR was analyzed using a linear mixed-effects model.</p><p><strong>Results: </strong>Impaired graft function occurred in 27 recipients (15.9%). DKV/RBSA was not associated with the primary binary outcome (OR 0.85 per 10 mL/m²; P = 0.208) but was independently associated with continuous 12-month eGFR (β = 1.94 per 10 mL/m²; P < 0.001). Adding DKV/RBSA increased the adjusted R² from 0.123 to 0.190, representing the largest increase among the mismatch indices examined. Higher DKV/RBSA remained associated with eGFR through 10 years (β = 1.37 per 10 mL/m²; P = 0.004), with no significant time interaction (P = 0.194).</p><p><strong>Conclusions: </strong>Higher DKV/RBSA was associated with better continuous and longitudinal graft function but not with the prespecified binary outcome. CT-derived DKV/RBSA may provide complementary information on donor-recipient size matching, although external validation is required before clinical application.</p>","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164311","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}

{"title":"Albuminuria and hematologic profiles across eGFR categories in U.S. adults: NHANES 2001-2018 with detailed iron-biomarker analysis.","authors":"Yoshitaka Furuto","doi":"10.1007/s10157-026-02962-2","DOIUrl":"https://doi.org/10.1007/s10157-026-02962-2","url":null,"abstract":"<p><strong>Background: </strong>Albuminuria and estimated glomerular filtration rate (eGFR) are complementary dimensions of kidney disease, but the hematologic phenotype of albuminuria beyond reduced filtration is incompletely defined.</p><p><strong>Methods: </strong>We analyzed adults aged ≥20 years in nine National Health and Nutrition Examination Survey (NHANES) cycles (2001-2018). The primary outcome was hemoglobin; secondary outcomes were anemia, red-cell indices, and serum iron. UACR was modeled per doubling and by KDIGO A1-A3 categories using survey-weighted models adjusted for eGFR and clinical covariates. Ferritin, transferrin saturation (TSAT), iron-binding measures, and soluble transferrin receptor (sTfR) were examined in 2017-2018.</p><p><strong>Results: </strong>Among 42,634 participants, 40,705 entered the primary model. The prespecified primary hypothesis was not supported: UACR was not significantly associated with mean hemoglobin (beta per doubling, -0.008 g/dL; 95% confidence interval [CI], -0.020 to 0.004). UACR was associated with secondary anemia (odds ratio [OR] per doubling, 1.112; 95% CI, 1.078-1.147; A2 vs A1, OR 1.332; A3 vs A1, OR 1.855). RDW, MCV, MCH, and serum iron differences were small; sTfR showed a small exploratory association. Ferritin- and TSAT-based phenotypes were not significantly associated with UACR.</p><p><strong>Conclusions: </strong>The prespecified mean-hemoglobin hypothesis was not supported. Higher UACR was associated with threshold-defined anemia as a secondary outcome, while small red-cell and iron-marker differences did not establish conventional absolute iron deficiency or imply changes in anemia management.</p>","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149165257","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}

{"title":"Stress hyperglycemia ratio as a predictor of in-hospital mortality in patients with acute kidney injury: a retrospective cohort study.","authors":"Jichao Zhang, Jing Liu, Yuanyuan Li, Wentao Ma, Ying Ma, Shenmin Li, Jing Yang","doi":"10.1007/s10157-026-02953-3","DOIUrl":"https://doi.org/10.1007/s10157-026-02953-3","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the relationship between the stress hyperglycemia ratio (SHR) and the risk of in-hospital mortality in patients with acute kidney injury (AKI), and to evaluate its predictive performance.</p><p><strong>Methods: </strong>A retrospective cohort study used the Medical Information Mart for Intensive Care (MIMIC-IV) and MIMIC-III databases. SHR was defined as the ratio of admission blood glucose to estimated average glucose. Restricted cubic spline regression analyzed the nonlinear relationship between SHR and in-hospital mortality. Multivariate logistic regression and subgroup analyses were applied to validate the robustness of the association. Receiver operating characteristic (ROC) curve analysis was employed to evaluate the predictive performance of SHR.</p><p><strong>Results: </strong>Among 2180 patients, in-hospital mortality was 18.8% (263/1,398) in MIMIC-IV and 19.8% (155/782) in MIMIC-III. SHR showed a U-shaped relationship with in-hospital mortality, where SHR > 1.19 or < 0.50 significantly increased death risk (P < 0.05). The overall pattern was consistent across subgroup and sensitivity analyses. ROC curve analysis demonstrated that SHR had better predictive performance than conventional severity and comorbidity scores for hospital mortality in AKI patients. The highly consistent results from both databases indicate reliability.</p><p><strong>Conclusion: </strong>SHR is an independent predictor of in-hospital mortality in AKI patients. By distinguishing the extreme low-SHR range from the intermediate lowest-risk range, this study further characterized the bidirectional nonlinear risk pattern, facilitating early identification of high-risk patients for risk stratification.</p>","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164369","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}

{"title":"List of referees.","authors":"","doi":"10.1007/s10157-026-02971-1","DOIUrl":"https://doi.org/10.1007/s10157-026-02971-1","url":null,"abstract":"","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149147324","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}

{"title":"Long-term eGFR decline in polycythemia vera compared with secondary polycythemia: a retrospective longitudinal cohort study.","authors":"Davut Eren, Kerim Erer, Berna Talaslıoğlu Yeşiltepe, Ramazan Önalan, Rasim Şahin, Koray Uludağ, Sümeyra Koyuncu, Mustafa Demir, Serdal Korkmaz","doi":"10.1007/s10157-026-02957-z","DOIUrl":"https://doi.org/10.1007/s10157-026-02957-z","url":null,"abstract":"<p><strong>Background: </strong>Polycythemia vera (PV) and secondary polycythemia are clinical conditions characterized by erythrocytosis, but their biological basis and clinical course differ. Whether this difference is reflected in long-term kidney function is not well defined. We aimed to compare longitudinal estimated glomerular filtration rate (eGFR) trajectories and kidney function loss in patients with PV and secondary polycythemia.</p><p><strong>Methods: </strong>In this retrospective, single-center cohort, adult patients with PV or secondary polycythemia were evaluated from baseline through 4 years. Repeated eGFR measurements were examined using a linear mixed-effects model; the group-time interaction was the primary inferential test, with adjustment for age, sex, diabetes mellitus, hypertension, coronary artery disease, and baseline chronic kidney disease.</p><p><strong>Results: </strong>The cohort included 1,616 patients: 258 with PV and 1,358 with secondary polycythemia. The global group-time interaction indicated different eGFR trajectories (p = 0.049). The adjusted PV-secondary polycythemia eGFR contrast was small at baseline but indicated lower eGFR in PV by the fourth year (- 3.86 mL/min/1.73 m²; 95% CI, - 6.39 to - 1.33; Holm-corrected p = 0.014). The fourth-year contrast remained in the same direction in most sensitivity analyses.</p><p><strong>Conclusion: </strong>PV was associated with a late and modest eGFR separation compared with secondary polycythemia. These findings support consideration of kidney function monitoring in selected patients with PV and prospective assessment of factors influencing renal progression.</p>","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104848","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}

{"title":"Age-specific trends in peritoneal dialysis use among incident dialysis patients in Japan.","authors":"Kenta Torigoe, Tomohisa Tsuyuki, Mineaki Kitamura, Tsutomu Sakurada, Tomoya Nishino","doi":"10.1007/s10157-026-02961-3","DOIUrl":"10.1007/s10157-026-02961-3","url":null,"abstract":"","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104535","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}

{"title":"Diagnostic accuracy of doppler-derived renal ultrasound parameters for predicting acute kidney injury after cardiac surgery: a systematic review and meta-analysis.","authors":"Laura Esperanza Jiménez Gómez, Cándida Díaz-Brochero, Daniela Patiño Hernández, Sergio Velasco Malagón, Juan Daniel Caicedo-Ruiz, Daniel Martin, Luis Carlos Triana Moreno","doi":"10.1007/s10157-026-02931-9","DOIUrl":"https://doi.org/10.1007/s10157-026-02931-9","url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury (AKI) is a frequent and clinically significant complication following cardiac surgery. Doppler-derived renal ultrasound parameters-including the renal resistive index (RRI), semiquantitative power Doppler ultrasound (PDU) scales, and intrarenal venous flow (IRVF)-have been proposed as early, noninvasive predictors of postoperative AKI, but their diagnostic accuracy in this setting remains uncertain.</p><p><strong>Methods: </strong>We conducted a systematic review of diagnostic test accuracy studies evaluating RRI, PDU, or IRVF for predicting AKI within 7 days after cardiac surgery in adult intensive care unit patients. MEDLINE, Embase, Cochrane CENTRAL, Scopus, Web of Science, and clinical trial registries were searched through June 2025. Sensitivity, specificity, diagnostic odds ratio (DOR), and area under the receiver operating characteristic curve (AUC) were extracted or calculated. Meta-analysis was performed for RRI using hierarchical bivariate models; IRVF and PDU were summarized descriptively due to limited studies and heterogeneity.</p><p><strong>Results: </strong>Fourteen studies comprising 1,204 patients were included (12 RRI, 3 IRVF, 1 PDU). RRI thresholds between 0.71 and 0.74 demonstrated the highest diagnostic performance (AUC range 0.72-0.93). IRVF showed modest discrimination (AUC 0.62-0.66). Evidence for PDU was limited to one study. Substantial clinical and methodological heterogeneity was observed and overall certainty of evidence ranged from low to moderate.</p><p><strong>Conclusions: </strong>Among Doppler-derived renal ultrasound parameters, RRI appears to have the most consistent diagnostic accuracy for predicting AKI after cardiac surgery. However, methodological heterogeneity, the limited number of studies, and the low-to-moderate certainty of the evidence preclude definitive clinical recommendations. Prospective multicenter validation studies with standardized protocols and prespecified thresholds are warranted.</p>","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104595","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}