Clinical nephrology最新文献

{"title":"Advances in biomarkers of IgA nephropathy.","authors":"Hailang Wei, Fuhua Xie, Runxiu Wang","doi":"10.5414/CN111395","DOIUrl":"https://doi.org/10.5414/CN111395","url":null,"abstract":"<p><p>IgA nephropathy (IgAN) is the most common primary glomerular disease in the world; it is associated with the intestinal microbiota, diet, genetics, etc., and is mainly diagnosed by kidney biopsy. Patients with IgAN may develop end-stage renal disease (ESRD) within decades of diagnosis, placing an enormous burden on patients and society. Therefore, early prediction and effective measures are needed to prevent disease progression. To date, a large number of studies have explored biomarkers of IgAN progression. In this paper, IgAN biomarkers are discussed to guide the early diagnosis, prevention, and treatment of this disease.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145343833","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":"Renal manifestations of immune checkpoint inhibitors in the pediatric population.","authors":"Lydia Noh, Matthew Satariano, Jieji Hu, Elena Levtchenko, Rupesh Raina","doi":"10.5414/CN111756","DOIUrl":"https://doi.org/10.5414/CN111756","url":null,"abstract":"<p><strong>Background: </strong>Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment and have become an essential part of therapy, but their use is associated with immune-related adverse events (irAE). Specifically, nephrotoxicity is well documented in adult populations but data regarding irAEs are limited in pediatric populations. This review examines the renal manifestations of ICIs and relevant clinical measures and treatments.</p><p><strong>Materials and methods: </strong>A comprehensive review of existing literature was conducted to assess the incidence, pathophysiology, and management of ICI-associated renal injuries in pediatric and adult populations.</p><p><strong>Results: </strong>The most common renal irAE associated with ICIs is acute kidney injury; however, ICIs have been implicated in transplant rejection and electrolyte disturbances including hyponatremia, hyperkalemia, hypophosphatemia, and metabolic acidosis. Pediatric ICI manifestation patterns are similar to those in adults, but research suggests earlier onset compared to adults. Though corticosteroids are the primary treatment for irAEs, standardized pediatric management guidelines require further improvement.</p><p><strong>Conclusion: </strong>ICIs carry concerning risks in pediatric populations, yet research in this area is lacking. This warrants further research into the recognition, treatment, and prevention of renal irAEs, particularly for the improvement of long-term outcomes.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145343763","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":"The incidence, risk factors, and outcomes of acute kidney injury after minor lower-limb amputations.","authors":"Stefanie Marie Agius, Deborah Balzan, Kevin Cassar, Jesmar Buttigieg","doi":"10.5414/CN111832","DOIUrl":"10.5414/CN111832","url":null,"abstract":"<p><strong>Background and aims: </strong>Minor lower-limb amputations are limb and potentially life-saving procedures. However, they are associated with serious adverse events, including acute kidney injury (AKI).</p><p><strong>Materials and methods: </strong>We conducted a single-center retrospective study to determine the incidence of AKI after these procedures, identify risk factors, and assess impact on patient survival.</p><p><strong>Results: </strong>We included 201 patients. AKI occurred in 18.9% using AKIN criteria, and 24.9% using KDIGO criteria. Only 1 patient required temporary dialysis. Patients with AKI were older (73.0 ± 10.4 vs. 68.5 ± 11.8 years, p = 0.033), had a higher incidence of chronic kidney disease (CKD); estimated glomerular filtration rate (eGFR) < 45 mL/min/1.73m² (39.5 vs. 14.7%, p = 0.001), and/or chronic obstructive pulmonary disease (COPD) (28.9 vs. 13.5% p = 0.028), and higher use of diuretics (68.4 vs. 49.1%, p = 0.049), fluoroquinolones (71.1 vs. 52.8% p = 0.047), and/or carbapenems (10.5 vs. 2.5%, p = 0.043) compared to patients without AKI. eGFR < 45 mL/min/1.73m² (OR: 3.24, CI: 1.40 - 7.52, p = 0.006), use of fluoroquinolones (OR: 3.19, CI: 1.30 - 7.82, p = 0.012), and day-1 C-reactive protein (CRP) (OR: 1.01, CI: 1.00 - 1.01, p = 0.009) were established as independent risk factors for AKI. Cumulative survival was not significantly lower in patients with AKI (log rank: 0.02, p = 0.88).</p><p><strong>Conclusion: </strong>AKI is a potential complication following minor lower-limb amputations. Age, COPD, diuretics, fluoroquinolones, and carbapenems were associated with increased incidence of AKI. An eGFR < 45 mL/min/1.73m², day-1 C-reactive protein, and fluoroquinolone use were identified as independent risk factors for AKI.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145336770","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":"Prevalence and associated factors of hypertension and major adverse cardiovascular events in lupus nephritis in sub-Saharan Africans.","authors":"Mansour Mbengue, Mbéne Dieng Kébé, Jatt Tsahabayembi, Serigne Fall, Idrissa Sall, Cheikh M F Kitane, Niakhaleen Keita, Maria Faye, Ahmed Tall Lemrabott, El Hadji Fary Ka, Abdou Niang","doi":"10.5414/CN111720","DOIUrl":"10.5414/CN111720","url":null,"abstract":"<p><strong>Introduction: </strong>The prevalence of hypertension in lupus nephritis varies according to studies and can be as high as 74%. The aim of this study was to determine the prevalence of hypertension in lupus nephritis and to search for factors associated with hypertension and the occurrence of major adverse cardiovascular events (MACE).</p><p><strong>Materials and methods: </strong>This was a multicenter, retrospective, descriptive, and analytical study over a 10-year period from January 1, 2012, to December 31, 2022. It targeted patients followed for lupus nephritis confirmed by anatomo-pathological examination in three nephrology departments in Dakar. We compared hypertensive and non-hypertensive patients to identify hypertension-associated factors.</p><p><strong>Results: </strong>During the study period, 73 cases of lupus nephritis were collected. In the study population, the mean age was 33.90 years, with a sex ratio of 0.30. The prevalence of hypertension was 40.1%. 23 patients were class III, 25 class IV, and 19 class V. Among hypertensive patients, mean creatinine was 33.7 mg/L, and renal failure was present in 56.66% of patients. Mean proteinuria was 5.42 g/24h. Hypertension-associated factors were age (OR = 1.15, 95% CI: 1.05 - 2.25; p = 0.001), renal failure (OR = 12.872, 95% CI: 2.23 - 74.28; p = 0.004), and proliferative class (OR = 18.83, 95% CI: 1.91 - 185.25; p = 0.012). For the cardiovascular events, there were 3 cases of stroke, 0 cases of heart attack, and 0 cardiovascular deaths.</p><p><strong>Conclusion: </strong>Hypertension in lupus nephritis is common in our setting. Hypertension-associated factors were related to advanced age and severity of lupus nephritis. Long-term follow-up would be necessary to better detect cardiovascular events.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145336830","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":"Utilizing artificial intelligence-assisted chest computed tomography to assess bone mineral density in patients requiring glucocorticoid therapy.","authors":"Ruigang Huang, Xian Wang, Yanhua Qiu, Weihua Lin, Lihao Wei, Jiguang Zhou, Chunhong Huang, Shanying Chen","doi":"10.5414/CN111750","DOIUrl":"10.5414/CN111750","url":null,"abstract":"<p><strong>Objectives: </strong>Utilizing artificial intelligence (AI)-assisted chest computed tomography (CT) to assess bone mineral density (BMD) in patients requiring long-term glucocorticoid (GC) therapy.</p><p><strong>Materials and methods: </strong>In this retrospective study, dual-energy X-ray absorptiometry (DXA) was used as the gold standard for BMD assessment. The area under the receiver operating characteristic curve (AUC) was used to test diagnostic accuracy. We combined opportunistic chest CT and AI to measure vertebral BMD.</p><p><strong>Results: </strong>We analyzed results of 249 chest CT-DXA pairs from 235 patients requiring GC therapy. Prevalence of osteopenia and osteoporosis was 28.51% and 22.13%, respectively. The average of thoracic 11 (T11) and T12 vertebral BMD measured by AI (AI-BMD) was 154.83 mg/cm³ and 147.56 mg/cm³, respectively. AUC of AI-BMD for osteopenia/osteoporosis was 0.867 (95% confidence interval (CI): 0.823, 0.911) at T11 and 0.844 (95% CI: 0.795, 0.893) at T12. No significant differences in AUC between T11 and T12 were found in the cohort. 80 pairs of chest CT-DXA scans were performed among patients with long-term GC therapy. AUC of AI-BMD for osteopenia/osteoporosis were excellent in patients with long-term and initiating GC therapy. There were no significant differences in AUC among the two subgroups.</p><p><strong>Conclusion: </strong>We found that AI-assisted chest CT is a convenient diagnostic tool for BMD assessment. AUC of AI-BMD for osteopenia/osteoporosis at T11 and T12 is excellent in patients requiring long-term GC therapy. By using AI-assisted opportunistic chest CT, patients can receive BMD assessments without the extra burden.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145336851","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":"Thomas Willis (1621 - 1675): First steps into kidney function.","authors":"Livia Ann Frost, Garabed Eknoyan","doi":"10.5414/CN111802","DOIUrl":"10.5414/CN111802","url":null,"abstract":"<p><p>This review analyzes the pivotal but underrecognized contribution of Thomas Willis (1621 - 1675) to the foundations of kidney function in the 17^th century. By comparing his early work <i>De Urinis</i> (1659), which interpreted urinary diagnosis through humoral traditions, with his subsequent <i>Pharmaceutice Rationalis</i> (1674 - 1675) we document a paradigm shift: progress from considering the kidney a passive filter to proposing it as an active regulatory organ that balanced urinary salts through tubular function. Building on the cardiac pump and blood circulation model of William Harvey and the tubular structure of the kidney of Lorenzo Bellini, Willis rejected the Galenic physiology that the kidney attracted blood because it was in its nature to do so in favor of a mechanical model of \"straining or percolation\" driven by the force of circulating blood. Willis also considered diabetes a blood disorder rather than a kidney disease, noting that diabetic urine differed from imbibed fluids being sweet \"as it were imbued with Honey or Sugar\". These conceptual advances - developed without microscopic evidence or chemical analysis - reveal a remarkable inductive reasoning. Documented by subsequent observations, Willis' work established three critical principles: the blood-clearing function of the kidney depends on circulatory dynamics, tubules modify urine composition, and urinary changes reflect systemic physiology rather than just renal pathology. His renal model, though incomplete, provided the first systematic framework for homeostasis that would be developed in the 19^th century. His writings clearly mark the initial but fundamental first steps in the evolution of our current understanding of kidney function.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145336801","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":"Feasibility of nephrology electronic consults in an inner-city population.","authors":"Ewalola Ayo Ijaduola, Alexander Quarshie, Chamberlain Obialo","doi":"10.5414/CN111771","DOIUrl":"10.5414/CN111771","url":null,"abstract":"<p><strong>Background: </strong>In the United States (U.S.), economically disadvantaged populations have reduced access to subspecialty care. To improve accessibility to nephrology care early in the clinical course of chronic kidney disease (CKD), we designed a feasibility pilot study for electronic consults (eCons).</p><p><strong>Materials and methods: </strong>This retrospective cohort study evaluated eCons referral patterns, patient demographics, comorbidities, and rates of in-person visits following eCons. Our suggested referral criteria included CKD stages 1 - 3a with a urine albumin-creatinine ratio (UACR) < 300 mg/g, resistant hypertension, abnormal kidney imaging or urine sediment, electrolyte abnormalities, and nephrolithiasis.</p><p><strong>Results: </strong>A total of 103 patients completed eCons over a 12-month period. 98% self-identified as African Americans, and 2% as Caucasians. The rates of subsequent in-person visits for patients with CKD stages 2, 3a, 3b, 4, and 5 were 5/9 (56%), 8/28 (29%), 34/38 (90%), 11/14 (79%), and 9/9 (100%), respectively. Among the 103 patients, 40 (39%) had macroalbuminuria (UACR > 300 mg/g), and 51 (50%) had diabetes mellitus. The rates of subsequent in-person visits for patients with macroalbuminuria and diabetes mellitus were 87.5% and 76%, respectively. Patients with macroalbuminuria had greater odds of subsequent in-person visits than did those without macroalbuminuria, adjusted for age and sex (AOR, 6.15; 95% confidence interval (CI), 2.08 - 18.16; p = 0.001). Patients with diabetes mellitus were also more likely to have subsequent in-person visits than were those without diabetes mellitus (OR, 2.38; 95% CI, 1.02 - 5.57; p = 0.04).</p><p><strong>Conclusion: </strong>Electronic consultations are beneficial in the early CKD stages and in patients without diabetes or macroalbuminuria. In addition, both macroalbuminuria and diabetes influence the need for subsequent in-person evaluation.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145336803","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":"The causal association of colorectal cancer on the risk of membranous nephropathy: A Mendelian randomization study.","authors":"Zhanxin Zhu, Jin Zhao, Yunlong Qin, Jinguo Yuan, Yumeng Zhang, Anjing Wang, Mei Han, Qiao Zheng, Xiaoxuan Ning, Shiren Sun","doi":"10.5414/CN111557","DOIUrl":"10.5414/CN111557","url":null,"abstract":"<p><strong>Background: </strong>Studies have suggested that colorectal cancer (CRC) and membranous nephropathy (MN) could be associated with each other. However, the existing conventional research methods fail to establish a conclusive relationship between the two conditions.</p><p><strong>Materials and methods: </strong>The genome-wide association data for CRC and MN were obtained from previously published genome-wide association studies (GWAS). Inverse variance weighted (IVW), weighted median, weighted mode, and Mendelian randomization (MR)-Egger regression, were employed to analyze the data. Sensitivity analyses were conducted using the heterogeneity test, pleiotropic test, and leave-one-out test. Additionally, a reverse MR analysis was conducted to evaluate any potential reverse causal effects.</p><p><strong>Results: </strong>The IVW analysis provided strong evidence supporting a causal link between CRC and MN (odds ratio (OR), 1.485; 95% confidence interval (CI), 1.131 - 1.951, p = 0.004). Similar findings were obtained from the weighted median analysis (OR, 1.515; 95% CI, 1.120 - 2.051, p = 0.007) and the weighted mode (OR, 1.572; 95% CI, 0.996 - 2.480, p = 0.084). The MR-Egger regression results indicated that the presence of horizontal pleiotropy was unlikely to bias the findings (intercept, -0.047; p = 0.611). MR-Egger regression did not show any causal association between CRC and MN (OR, 2.075; 95% CI, 0.584 - 7.373, p = 0.292). Reverse MR analysis suggested that MN is not a causative factor for CRC. Cochran's Q test, the funnel plot, and leave-one-out sensitivity analysis demonstrated the robustness of the MR study.</p><p><strong>Conclusion: </strong>Based on the genetic evidence obtained from this MR study, it can be concluded that CRC may serve as a risk factor for the development of MN. These findings will facilitate a future understanding of the mechanisms underlying MN.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145291139","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":"Nephrotic syndrome as the first symptom in Alport syndrome children.","authors":"Ying Bao, Pei Qian, MengYang Li, YanHui Cheng, Yili Wang","doi":"10.5414/CN111767","DOIUrl":"10.5414/CN111767","url":null,"abstract":"<p><strong>Background: </strong>Alport syndrome is a hereditary disorder of type IV collagen characterized by progressive kidney failure. Most childhood cases present with glomerular hematuria and varying degrees of proteinuria.</p><p><strong>Materials and methods: </strong>We conducted a retrospective study of 7 individuals from 6 families who presented with nephrotic syndrome as the first symptom and were ultimately diagnosed with Alport syndrome and referred to a tertiary pediatric nephrology service between 2016 and 2022.</p><p><strong>Results: </strong>At first presentation, all patients had hematuria, nephrotic-range proteinuria, and hypoproteinemia. Their mean age at first presentation was 8.9 ± 2.1 years, and kidney biopsies revealed focal segmental glomerulosclerosis in all patients. In 4 cases, steroids and/or immunosuppressants were used inappropriately before the final diagnosis of Alport syndrome. Meanwhile, whole-exome sequencing found 6 different variants, including 4 in <i>COL4A5</i> and 1 compound heterozygous variant in <i>COL4A3</i>. Among them, 85.7% were severe variants, and 2 variants were not previously reported. The median follow-up duration was 4.4 (IQR, 2.4 - 8.0) years. All patients who received renin-angiotensin-aldosterone system (RAAS) blockers treatment exhibited varying degrees of reduction in proteinuria. However, 2 of them had decline in kidney function and chronic kidney failure, respectively.</p><p><strong>Conclusion: </strong>Alport syndrome with severe gene variants may present with nephrotic syndrome earlier and more obviously. Attention should be paid to the differential diagnosis of Alport syndrome in patients with nephrotic syndrome and hematuria, particularly to those who respond poorly to steroid therapy or have a family history of hematuria.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145249972","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":"Clinical and pathological features of IgA nephropathy patients with thyroid dysfunction: A retrospective cohort study.","authors":"Dan Wen, Longzhu Li, Xiujuan Liu, Yan Zhou, Ying Zeng, Qing Deng, Xin Yang, Siyi Liu, Yu Wang, Qinkai Chen, Jinlei Lv","doi":"10.5414/CN111744","DOIUrl":"10.5414/CN111744","url":null,"abstract":"<p><strong>Objective: </strong>This study investigates the clinical characteristics, pathological features, and risk factors of thyroid dysfunction in patients with immunglobulin A (IgA) nephropathy to facilitate early intervention and improve prognosis.</p><p><strong>Materials and methods: </strong>A total of 415 patients diagnosed with IgA nephropathy by renal biopsy between June 2019 and December 2021 were included. Thyroid function was evaluated for the first time during hospitalization, and clinical and pathological data were analyzed. Comparisons were made between patients with normal and abnormal thyroid function, and logistic regression analysis was used to identify independent risk factors for thyroid dysfunction.</p><p><strong>Results: </strong>There were 136 patients with thyroid dysfunction. Patients with thyroid dysfunction had significantly higher diastolic blood pressure (DBP), mean arterial pressure (MAP), serum creatinine (SCR), blood urea nitrogen (BUN), total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), complement component (C4), erythrocyte sedimentation rate (ESR), and 24-hour proteinuria (24hUP) but lower red blood cell (RBC), hemoglobin (Hb), albumin (Alb), IgG, IgA, and estimated glomerular filtration rate (eGFR) (all p < 0.05). These patients also exhibited a higher prevalence of T1+2 lesions and advanced chronic kidney disease (CKD) stages (3 - 5). Furthermore, thyroid dysfunction was associated with increased proteinuria severity and CKD progression. Thyroid-stimulating hormone (TSH) levels were positively correlated with age, mean arterial pressure, lipid levels, and 24hUP, whereas free triiodothyronine (FT3) and free thyroxine (FT4) levels were inversely correlated with these parameters. Logistic regression analysis identified elevated 24hUP (OR = 1.207, 95% CI: 1.117 - 1.305, p < 0.001) and eGFR < 60 mL/min/1.73m2 (OR = 2.330, 95% CI: 1.262 - 4.302, p = 0.007) as independent risk factors for thyroid dysfunction.</p><p><strong>Conclusion: </strong>Thyroid dysfunction is common among IgAN patients and is associated with more severe clinical and pathological features, such as increased proteinuria and advanced CKD stages. These findings underscore the importance of monitoring thyroid function and implementing targeted interventions to improve outcomes in IgA nephropathy patients.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145249936","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}