Clinical and Experimental Nephrology最新文献

{"title":"Characteristics of newly diagnosed systemic lupus erythematosus patients with or without kidney involvement: analysis of the National Database of Designated Intractable Diseases of Japan.","authors":"Hidekazu Ikeuchi, Tomonori Kimura, Ryuichi Sakate, Shoichi Maruyama, Yoshitaka Isaka, Ichiei Narita, Keiju Hiromura","doi":"10.1007/s10157-026-02870-5","DOIUrl":"https://doi.org/10.1007/s10157-026-02870-5","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to clarify the characteristics of newly diagnosed systemic lupus erythematosus (SLE) patients with or without kidney involvement in Japan.</p><p><strong>Methods: </strong>We used electronic data of SLE patients in the National Database of Designated Intractable Diseases of Japan who newly registered between 2015 and 2017. We analyzed patients within one year of disease onset. Kidney involvement was defined as any of the following: urinary protein ≥ 0.5 g/day, granular casts, a clinical diagnosis of nephrotic syndrome, acute or chronic renal failure, or rapidly progressive glomerulonephritis, an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m², lupus nephritis confirmed by renal biopsy, or hemodialysis.</p><p><strong>Results: </strong>Among 2315 SLE patients, 1088 (47.0%) had kidney involvement. Patients with kidney involvement more frequently exhibited symptoms such as pulmonary hemorrhage, pulmonary infarction and disturbance of consciousness, pericarditis, and hemolytic anemia whereas manifestations such as arthritis, aseptic meningitis, discoid rash, photosensitivity, and Raynaud's phenomenon were less common compared with those without kidney involvement. Anti-DNA antibody positivity was higher and complement levels (C3, C4, and CH50) were lower in patients with kidney involvement. In addition, concomitant glucocorticoid pulse therapy and immunosuppressive drugs were more frequently used in patients with kidney involvement.</p><p><strong>Conclusion: </strong>In this nationwide cohort, nearly half of newly diagnosed Japanese patients with SLE had kidney involvement and showed a distinct pattern of systemic manifestations, autoantibody profiles, and treatment intensity. These findings provide important insights into the epidemiology and pathophysiology of kidney involvement in SLE in Japan.</p>","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147721698","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":"Seasonal variation of salt intake in patients with chronic kidney disease correlates with that of systolic blood pressure in males in summer.","authors":"Naro Ohashi, Yuri Uchiyama, Yoshimichi Yamashiro, Sayaka Ishigaki, Shinsuke Isobe, Chiemi Ema, Takamitsu Sasaki, Masanori Sakakima, Naoki Ikegaya, Takamasa Iwakura, Tomoyuki Fujikura, Akihiko Kato, Akira Hishida, Hideo Yasuda","doi":"10.1007/s10157-026-02871-4","DOIUrl":"https://doi.org/10.1007/s10157-026-02871-4","url":null,"abstract":"<p><strong>Background: </strong>Blood pressure (BP) displays a higher seasonal variation in winter than in summer. However, evidence of seasonal variations in salt intake is limited. No study has evaluated the same individuals over time using daily urine collection. Further, there are no reports that demonstrates the relationship between BP and salt intake by sex on a seasonal basis.</p><p><strong>Methods: </strong>This study included 168 patients with chronic kidney disease (CKD) (mean 62.1 years, 93 males) over a 1-year period. We analyzed the seasonal variation between summer and winter in 147 patients with CKD for whom both summer and winter data were available. In addition, we evaluated 90 patients separately who were not taking medications that impact urinary sodium excretion.</p><p><strong>Results: </strong>In 147 patients, body weight, body mass index (BMI), BP, choline esterase (ChE), low-density lipoprotein (LDL) cholesterol, and salt intake were higher in winter in males, whereas only BP, albumin, ChE and LDL cholesterol were higher in winter in females. In the multiple regression analyses, systolic BP significantly and positively correlated with salt intake in males and this trend was more pronounced in summer. Contrarily, females did not show a correlation between systolic BP and salt intake in both summer and winter. Moreover, the 90 patients who were not taking medications that impact sodium excretion showed a similar relationship between systolic BP and salt intake.</p><p><strong>Conclusion: </strong>Salt intake in patients with CKD was higher in winter. Furthermore, the correlation between systolic BP and salt intake was particularly pronounced in males in summer.</p>","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147716115","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":"Association of nutritional indicators with food and nutrient intake and bean consumption in hemodialysis patients: A retrospective cohort study with a one-year follow-up.","authors":"Anna Miyahira, Yoshinari Matsumoto, Akane Kizu, Daiki Habu","doi":"10.1007/s10157-026-02872-3","DOIUrl":"https://doi.org/10.1007/s10157-026-02872-3","url":null,"abstract":"<p><strong>Objective: </strong>Malnutrition in hemodialysis patients is a risk factor for mortality, and appropriate nutritional assessment and management are necessary to prevent malnutrition. This study aimed to examine the relationship between nutritional status and nutrient and food-group-specific intake status in hemodialysis patients.</p><p><strong>Methods: </strong>A total of 955 hemodialysis outpatients who attended one hospital were enrolled. Survey items included basic attributes, blood biochemical test results, dietary intake status, and nutritional assessment (NRI-JH; nutritional index for Japanese hemodialysis patients, the Nutritional Risk Index-Japanese Hemodialysis). Multinomial logistic regression was used to analyze changes in NRI-JH over one year as an outcome.</p><p><strong>Results: </strong>A total of 335 patients were included in the analysis. In the multinomial logistic regression analysis, bean intake above the 75th percentile of the population was associated with a significantly lower odds ratio of improvement in the NRI-JH over time (odds ratio: 0.36, 95% confidence interval: 0.14-0.88). In contrast, higher intake of seasonings and spices (Q2-Q4) was positively associated with improvement in NRI-JH. While moderate intake of fats and oils was positively associated with improved NRI-JH, no dose-response relationship was observed.</p><p><strong>Conclusion: </strong>Our findings suggest that excessive consumption of beans may not be advisable. Optimal intake levels require further investigation.</p>","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147716037","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":"Association between serum lactate dehydrogenase level and renal outcome in patients with advanced chronic kidney disease without diabetes mellitus.","authors":"Yoshihiro Nakamura, Shimon Kurasawa, Takahiro Imaizumi, Terumasa Hayashi, Ichiei Narita, Kenichiro Tanabe, Satoshi Morita, Yoshiharu Tsubakihara, Enyu Imai, Tadao Akizawa, Shoichi Maruyama","doi":"10.1007/s10157-026-02855-4","DOIUrl":"https://doi.org/10.1007/s10157-026-02855-4","url":null,"abstract":"<p><strong>Background: </strong>Higher serum lactate dehydrogenase (LDH) levels are associated with poor prognosis including renal outcome, all-cause and cardiovascular mortality in patients with diabetic kidney disease. However, this association remains unclear in patients with chronic kidney disease (CKD) without diabetes mellitus (DM).</p><p><strong>Methods: </strong>Using data from the PREDICT trial, which enrolled patients aged 20-85 years with an estimated glomerular filtration rate (eGFR) of 8-20 mL/min/1.73 m² and hemoglobin <10 g/dL due to renal anemia without DM, we investigated the association between serum LDH levels and study outcomes.</p><p><strong>Results: </strong>In total, 444 patients (median age, 73 years; 61% men; mean eGFR, 13.5 mL/min/1.73 m²) were divided into four quartiles according to serum LDH level: Q1, 78-169 U/L; Q2, 170-193 U/L; Q3, 194-224 U/L; Q4, 225-503 U/L. The median observation period for renal composite events and the composite of cardiovascular events or death were 562 and 637 days, respectively. In total, 206 (46%) patients experienced renal composite outcomes, and 45 (10%) patients experienced a composite of cardiovascular events or death. The multivariable analysis showed that the Q4 group had a higher risk of renal composite outcomes (adjusted hazard ratio [aHR], 2.07; 95% confidence interval [CI], 1.39-3.08) and the composite of cardiovascular events or death (aHR, 2.77; 95%CI, 1.21-6.32) compared with the Q1 group.</p><p><strong>Conclusions: </strong>Higher LDH levels are associated with higher risk of renal complications and composite of cardiovascular events or death in patients with advanced CKD without DM.</p>","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147688393","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":"Morphological characteristics of the renal lesion in TAFRO syndrome and POEMS syndrome: a retrospective and multicenter study.","authors":"Naoko Masuzawa, Yuko Ono, Hiroko Kakita, Wako Yumura, Akinori Hashiguchi","doi":"10.1007/s10157-026-02864-3","DOIUrl":"https://doi.org/10.1007/s10157-026-02864-3","url":null,"abstract":"<p><strong>Background: </strong>TAFRO syndrome (TAFRO) and POEMS syndrome (POEMS) are rare systemic inflammatory diseases with significant clinical, histological, and immunological overlaps with idiopathic multicentric Castleman disease (iMCD). While a high incidence of renal symptoms is observed in TAFRO and POEMS, the specific histopathological differences in their renal manifestations are not fully understood.</p><p><strong>Methods: </strong>This retrospective, multicenter study was conducted by the Japanese Renal Pathology Society (JRPS). Eighteen patients with TAFRO (n = 7), POEMS (n = 6), and iMCD (n = 5) were registered by members of the JRPS, and their clinicopathological findings were analyzed. Morphological examinations were performed using light, fluorescence, and electron microscopy. Immunohistochemical studies and semi-quantitative scoring systems have been used for detailed assessment of glomerular lesions.</p><p><strong>Results: </strong>Clinical data indicated that the time from disease onset to biopsy was significantly shorter in TAFRO patients than POEMS patients. Although immunosuppressive therapy induced improvement in all TAFRO patients, some POEMS patients exhibited a poor renal prognosis. Glomerular endothelial injury was observed in both the TAFRO and POEMS; however, the characteristics differed: the former displayed endotheliosis, whereas the latter exhibited membranoproliferative glomerulonephritis (MPGN)-pattern injury. Laminated short-linear structures of the subendothelial space were observed in both the TAFRO and POEMS using electron microscopy.</p><p><strong>Conclusions: </strong>Morphological characteristics of the process of renal glomerular damage and repair in TAFRO and POEMS were revealed. The differences in endotheliosis and MPGN-pattern injury in these diseases may reflect differences in the timing of renal biopsy and the clinical course.</p>","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147670635","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":"eGFR slope improvement with SGLT2 inhibitors is not statistically associated with changes in urinary protein in Japanese CKD patients: a single-center real-world analysis.","authors":"Shogo Kuwagata, Masami Chin-Kanasaki, Aki Yamada, Tomonori Sakae, Nahomi Ishimoto, Yoshimi Imamura-Uehara, Sho Sugahara, Kosuke Yamahara, Mako Yasuda-Yamahara, Yuki Tanaka-Sasaki, Itsuko Miyazawa, Shinji Kume","doi":"10.1007/s10157-026-02860-7","DOIUrl":"https://doi.org/10.1007/s10157-026-02860-7","url":null,"abstract":"<p><strong>Background: </strong>SGLT2 inhibitors reduce urinary protein and slow eGFR decline in clinical trials. However, real-world evidence on within-patient changes in eGFR slope before and after treatment initiation, and their relationship to changes in urinary protein, remains limited. This study was designed to address these concerns.</p><p><strong>Methods: </strong>This retrospective study included 90 Japanese CKD patients who initiated dapagliflozin and had ≥ 5 eGFR measurements during both the 12-month periods before and after initiation. The treatment effect was defined as the ΔeGFR slope (post-minus pre-initiation slope). Clinical factors associated with ΔeGFR slope were assessed using multivariable regression.</p><p><strong>Results: </strong>The mean eGFR slope significantly improved from - 5.12 ± 5.93 to 1.59 ± 5.27 mL/min/1.73 m²/year (p < 0.0001). Urinary protein decreased modestly without statistical significance (median 0.65 - 0.55 g/gCr, p = 0.155). Significant improvements in eGFR slope were observed regardless of baseline urinary protein level or the reduction rate. Multivariable analysis revealed that a reduction in serum uric acid (β =  - 0.26, p < 0.001), but not urinary protein, was independently associated with the ΔeGFR slope.</p><p><strong>Conclusions: </strong>Dapagliflozin significantly improves the eGFR slope, which was not statistically associated with urinary protein changes in this cohort, in routine clinical practice. These findings underscore the clinical value of eGFR slope-based evaluation for monitoring individualized therapeutic responses.</p>","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147670931","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":"Correction: Trajectories of kidney function over 10 years in patients with chronic kidney disease: a 10 year follow-up of FROM-J study.","authors":"Reiko Okubo, Masahide Kondo, Chie Saito, Hirayasu Kai, Ryoya Tsunoda, Akihiko Kato, Shoichi Maruyama, Jun Wada, Takashi Wada, Ichiei Narita, Kunihiro Yamagata","doi":"10.1007/s10157-026-02857-2","DOIUrl":"https://doi.org/10.1007/s10157-026-02857-2","url":null,"abstract":"","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147670912","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":"Glucocorticoid dose at discharge and the risk of infectious complications and rehospitalization in renal diseases.","authors":"Kensei Yahata, Koichi Seta, Keisuke Osaki, Akihiro Yoshimoto, Chiharu Kinoshita, Keiichi Kaneko, Motoko Yanagita, Hisako Hirashima, Naohiro Toda, Akira Ishii, Takeshi Matsubara, Tatsuo Tsukamoto, Daisuke Hirai, Fumiki Yoshihara, Naoki Sakane","doi":"10.1007/s10157-026-02868-z","DOIUrl":"https://doi.org/10.1007/s10157-026-02868-z","url":null,"abstract":"<p><strong>Background: </strong>Glucocorticoids have diverse adverse effects, particularly infections that may be severe or opportunistic. Therefore, glucocorticoids are often initiated during hospitalization; however, the optimal glucocorticoid dose at discharge remains uncertain. This study examined whether the discharge dose of glucocorticoids influences infection onset and rehospitalization in patients with renal disease.</p><p><strong>Methods: </strong>This was a multicenter retrospective cohort study conducted at eight hospitals from 2013 to 2023. Adults initiated on oral prednisolone ≥ 30 mg/day during hospitalization for renal disease were included. The primary outcome was infection within 30 days of discharge; secondary outcomes were rehospitalization for infection and unplanned rehospitalization for any cause. Logistic regression analyses were performed to evaluate primary and secondary outcomes, using glucocorticoid dose and other potential confounding factors as explanatory variables.</p><p><strong>Results: </strong>Among 684 patients, 24 (3.5%) developed infections within 30 days, including 17 bacterial (11 pneumonia), 5 fungal, and 2 cytomegalovirus infections; 17 patients (2.5%) required rehospitalization for infection. Overall, 51 patients (7.4%) had unplanned rehospitalization, most often for edema control, primary-disease relapse, or dehydration/electrolyte imbalance. In multivariate logistic regression analysis, oral glucocorticoid dose at discharge was not significantly associated with the primary outcome. No significant differences in infection onset or rehospitalization outcomes were observed across categories of oral glucocorticoid dose at discharge, and similar results were obtained regardless of the cutoff values or categorization strategy used.</p><p><strong>Conclusion: </strong>Higher discharge doses of oral glucocorticoids did not increase infection or rehospitalization rates. Discharge timing should therefore be individualized based on overall patient risk rather than glucocorticoid dose alone.</p>","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147670990","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":"Associations of exercise habits with physical function and emergency dialysis start in patients with end-stage renal disease before dialysis initiation.","authors":"Yuma Hirano, Tomoya Yamaguchi, Tomoya Omura, Yi Deng, Ruki Yamashita, Katsuya Yamauchi","doi":"10.1007/s10157-026-02869-y","DOIUrl":"https://doi.org/10.1007/s10157-026-02869-y","url":null,"abstract":"<p><strong>Background: </strong>In chronic kidney disease (CKD), declining physical function predicts adverse outcomes at dialysis initiation, highlighting the importance of promoting regular exercise habits. However, exercise is frequently discouraged immediately before dialysis initiation because of concerns regarding volume overload and hemodynamic instability. Evidence regarding the effectiveness and safety of habitual exercise during this period remains limited. This study examined associations between exercise habits, physical function, and emergency dialysis initiation among patients with end-stage renal disease (ESRD).</p><p><strong>Methods: </strong>This cross-sectional study included patients with ESRD who initiated hemodialysis at the Hamamatsu University Hospital between August 2022 and April 2025. Exercise habits were assessed using the stages-of-change model, with action or maintenance stages indicating habitual exercise. The outcomes were Short Physical Performance Battery (SPPB) scores at dialysis initiation and emergency dialysis initiation. Associations with SPPB were analyzed using ordinal logistic regression, and associations with emergency initiation were analyzed using modified Poisson regression with robust variance.</p><p><strong>Results: </strong>Among 124 patients, 27 (21.8%) had exercise habits. Exercise habits were associated with higher SPPB categories (odds ratio [OR], 5.88; 95% confidence interval [CI] 1.66-20.81; p = 0.008). Emergency dialysis initiation occurred in 27.4% of patients (14.8% vs 30.9%) and was not significantly associated with exercise habits (risk ratios, 0.37; 95% CI 0.12-1.09; p = 0.071).</p><p><strong>Conclusions: </strong>Among patients with ESRD, immediately before dialysis initiation, exercise habits were associated with better physical function but were not significantly associated with emergency dialysis initiation.</p>","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147662242","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":"Effects of individual sodium-glucose cotransporter-2 inhibitors on all-cause mortality in patients with diabetic kidney disease.","authors":"Hiroki Nobayashi, Michihiro Satoh, Takuo Hirose, Shingo Nakayama, Yutaro Iwabe, Takahito Yagihashi, Hideaki Hashimoto, Takahisa Murakami, Kouji Okada, Takefumi Mori, Hirohito Metoki","doi":"10.1007/s10157-026-02865-2","DOIUrl":"https://doi.org/10.1007/s10157-026-02865-2","url":null,"abstract":"<p><strong>Background: </strong>Evidence on the drug effect of sodium-glucose cotransporter-2 inhibitors (SGLT2is) on mortality in patients with diabetic kidney disease (DKD) remains limited. We analyzed patients with DKD newly prescribed SGLT2is using large-scale Asian real-world data.</p><p><strong>Methods: </strong>We utilized commercially available databases provided by DeSC Healthcare, Inc., between 2014 and 2023. All-cause mortality was compared across five pairs of new users of SGLT2is-canagliflozin, empagliflozin, ipragliflozin, luseogliflozin, or tofogliflozin-each versus dapagliflozin, using a target trial emulation framework with propensity score matching.</p><p><strong>Results: </strong>Among 12,308 patients with DKD, 1,553 new users of canagliflozin, 2,948 of empagliflozin, 1,672 of ipragliflozin, 931 of luseogliflozin, and 955 of tofogliflozin were matched 1:1 with corresponding new users of dapagliflozin. The mean age of participants ranged from 72.2 to 75.4 years, and 67.4-72.2% were men. During a median follow-up period of 1.12-1.96 years, the incidence of all-cause mortality among new users of SGLT2 inhibitors ranged from 32.3 to 46.2 for dapagliflozin, and was 28.8 for canagliflozin, 38.8 for empagliflozin, 33.4 for ipragliflozin, 33.8 for luseogliflozin, and 25.7 for tofogliflozin, per 1,000 person-years. Both the cumulative incidence and hazard ratios for all-cause mortality were comparable among new users of each SGLT2i compared with dapagliflozin (all log-rank P > 0.05; 95% CIs included 1).</p><p><strong>Conclusions: </strong>Comparable effects of SGLT2is on all-cause mortality risk were observed in patients with DKD using the Asian real-world data. This apparent class effect on all-cause mortality suggests that different agents may confer comparable short-term mortality benefits when selected according to patient characteristics.</p>","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147653929","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}