Clinical nephrology最新文献

Kidney health for all: Caring for people, protecting the planet. 人人享有肾脏健康：关爱人类，保护地球。

IF 1 4区医学

Clinical nephrology Pub Date : 2026-05-06 DOI: 10.5414/CNWKDEdi26

Raymond Vanholder, Dina Abdellatif, Augusto Cesar Soares Dos Santos, Ricardo Correa-Rotter, Natarajan Gopalakrishnan, Bill Wang, Stefanos Roumeliotis, Alessandro Balducci, Ágnes Haris, Manjusha Yadla, Li-Li Hsiao

{"title":"Kidney health for all: Caring for people, protecting the planet.","authors":"Raymond Vanholder, Dina Abdellatif, Augusto Cesar Soares Dos Santos, Ricardo Correa-Rotter, Natarajan Gopalakrishnan, Bill Wang, Stefanos Roumeliotis, Alessandro Balducci, Ágnes Haris, Manjusha Yadla, Li-Li Hsiao","doi":"10.5414/CNWKDEdi26","DOIUrl":"https://doi.org/10.5414/CNWKDEdi26","url":null,"abstract":"The current kidney care model - focused on late-stage disease and in-center hemodialysis - is unsustainable, because of costs, environmental burden, poor outcomes, and reduced quality of life. The 78th World Health Assembly's recognition of kidney disease as a serious health threat presents a critical opportunity to reshape kidney care. Aligned with this, the 2026 World Kidney Day theme, \"Kidney Health for All: Caring for People, Protecting the Planet\", calls for a systematic change. A sustainable model must prioritize early detection and prevention, reducing the need for kidney replacement therapy. Transplantation and home dialysis benefit people with kidney failure, environment and society. Dialysis itself must become more eco-friendly without compromising care quality, recognizing that planetary perturbations in turn affect kidney health. Conservative care should also be considered, particularly for elderly and frail patients, if the quality-of-life benefits outweigh the perspectives offered by dialysis. Achieving this shift requires coordinated action across all stakeholders; education and engagement of the public, policy makers and health professionals to raise awareness about the threat of kidney disease; and an urgent move toward patient-centered care.","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834590","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

Hb target achievement and associated predictors of roxadustat therapy across baseline anemia severities in maintenance hemodialysis: A single-center real-world retrospective cohort study. 维持性血液透析中罗沙司他治疗的基线贫血严重程度的Hb目标实现和相关预测因素：一项单中心现实世界回顾性队列研究

IF 1 4区医学

Clinical nephrology Pub Date : 2026-05-06 DOI: 10.5414/CN111997

Jiao Yuan, Yingsong Jiang

{"title":"Hb target achievement and associated predictors of roxadustat therapy across baseline anemia severities in maintenance hemodialysis: A single-center real-world retrospective cohort study.","authors":"Jiao Yuan, Yingsong Jiang","doi":"10.5414/CN111997","DOIUrl":"https://doi.org/10.5414/CN111997","url":null,"abstract":"Background: Anemia is common in maintenance hemodialysis (MHD). Therapy with erythropoiesis-stimulating agents (ESAs) may be limited by inflammation-related hyporesponsiveness and safety concerns. Real-world evidence on roxadustat across baseline anemia severities is limited.Materials and methods: In this single-center retrospective cohort, 300 MHD patients who switched from ESAs to roxadustat monotherapy were grouped by baseline hemoglobin (Hb): severe < 80 g/L (n = 82), moderate 80 - 99 g/L (n = 137), and mild 100 - 110 g/L (n = 81). The primary outcome was sustained Hb target achievement (100 - 120 g/L for ≥ 2 consecutive visits within 12 weeks without rescue therapy). Hb trajectories were assessed using linear mixed-effects models, and predictors of target achievement were identified by multivariable logistic regression with false discovery rate adjustment.Results: At 12 weeks, sustained Hb achievement increased with baseline Hb: 46.3% (severe), 64.2% (moderate), and 76.5% (mild) (q = 0.0012). Hb variability decreased across groups (time-weighted coefficients of variation 7.5, 6.1, and 5.2%; q = 0.008). Early Hb rise was fastest in severe anemia (+1.85 vs. +1.24 vs. +0.74 g/L/week over weeks 0 - 4; q = 0.028). Adverse events occurred in 47.7%, mostly grade 1 - 2, without between-group differences in serious events or discontinuation. Higher C-reactive protein (per 10 mg/L, OR 0.42; q = 0.012) and poor prior ESA response (OR 0.60; q = 0.013) predicted lower target attainment, whereas higher prealbumin (per 10 mg/L, OR 1.35; q = 0.004), IV iron (OR 1.52; q = 0.021), and ≥ 50% dose titration (OR 1.59; q = 0.019) predicted higher attainment.Conclusion: Roxadustat improved and stabilized Hb across anemia severities in MHD, with best control in milder anemia; inflammation, nutrition, prior ESA response, iron use, and dose titration influenced success.","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834612","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

Systemic effects of metabolic acidosis. 代谢性酸中毒的全身效应。

IF 1 4区医学

Clinical nephrology Pub Date : 2026-05-01 DOI: 10.5414/CN111953

Raymond Chen, Caitlin Kumala, Lynh Vu, Biff F Palmer

{"title":"Systemic effects of metabolic acidosis.","authors":"Raymond Chen, Caitlin Kumala, Lynh Vu, Biff F Palmer","doi":"10.5414/CN111953","DOIUrl":"10.5414/CN111953","url":null,"abstract":"Metabolic acidosis is a primary reduction in serum bicarbonate concentration and a consequent decrease in blood pH, which has profound implications for systemic physiology. This literature review synthesizes the current evidence of metabolic acidosis's effect on cardiovascular, vascular, pulmonary, gastrointestinal, endocrine, musculoskeletal, renal, and metabolic systems. Cardiovascular effects include impaired cardiac contractility, altered ion exchange currents, and decreased β-adrenergic response. Vascular response is dependent on vessel size, promoting vasodilation in large arteries and vasoconstriction in small vessels via NO and Ca2+-dependent pathways. Pulmonary adaptations include hyperventilation, altered hemoglobin-oxygen affinity via the Bohr effect, and increased pulmonary vascular resistance. Gastrointestinal effects include activation of acid-sensitive neuronal pathways causing increased mucus gel thickness, HCO3- secretion, and mucosal blood flow. Endocrine effects include growth hormone resistance, decreased thyroid hormone secretion, and negative shifts in Ca2+-PO4- balance. Renal effects include predisposition to calcium-oxalate stones and acceleration of chronic kidney disease through inflammatory mechanisms. Overall, this review aims to explore the physiological effects of metabolic acidosis, highlighting mechanism contributing to organ dysfunction.","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":"341-351"},"PeriodicalIF":1.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147282462","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

Impact of immune marker-based microinflammation on dialysis efficacy in diabetic nephropathy patients: Development of an early prediction model. 基于免疫标志物的微炎症对糖尿病肾病患者透析疗效的影响：早期预测模型的建立

IF 1 4区医学

Clinical nephrology Pub Date : 2026-05-01 DOI: 10.5414/CN111843

Meiyang Zhou, Haole Huang, Canxin Zhou

{"title":"Impact of immune marker-based microinflammation on dialysis efficacy in diabetic nephropathy patients: Development of an early prediction model.","authors":"Meiyang Zhou, Haole Huang, Canxin Zhou","doi":"10.5414/CN111843","DOIUrl":"10.5414/CN111843","url":null,"abstract":"Background: Peritoneal dialysis (PD) is widely used for treating end-stage renal disease (ESRD) in diabetic nephropathy patients. Suboptimal dialysis outcomes are often linked to chronic microinflammation, yet predictive models integrating immune markers remain limited.Materials and methods: In this prospective cohort study, 236 diabetic nephropathy patients undergoing PD were categorized into high-inflammation (HI) and microinflammation (MI) groups based on serum levels of CRP, IL-6, and TNF-α. Clinical and biochemical data - including Kt/V, infection rates, and survival - were collected. Logistic regression was applied to identify predictors of poor dialysis outcomes and construct a predictive model.Results: The HI group showed significantly lower dialysis efficiency (Kt/V < 1.5), increased peritonitis and catheter infections, and reduced survival. Elevated CRP, IL-6, and TNF-α levels were observed alongside higher creatinine, urea nitrogen, fasting glucose, lipids, and notable electrolyte and acid-base imbalances. Logistic regression identified CRP, IL-6, TNF-α, Kt/V, infection rates, and selected biochemical markers as independent predictors of poor outcomes. The resulting predictive model yielded an AUC of 0.87, demonstrating strong discriminative power.Conclusion: Microinflammation is a key determinant of dialysis efficacy in diabetic nephropathy patients receiving PD. The proposed model, based on inflammatory and dialysis-related parameters, offers a promising approach for early risk stratification and personalized treatment. Further validation may enhance long-term management and survival outcomes in this population.","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":"308-317"},"PeriodicalIF":1.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147371978","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

Corrigendum for the article Clin Nephrol. 2025; 104: 318-327. 临床尼弗罗尔。2025；104: 318 - 327。

IF 1 4区医学

Clinical nephrology Pub Date : 2026-05-01 DOI: 10.5414/CN111702Cor

Ci Sun, Haixia Zhang, Ying Lu, Sheng Feng, Kai Song, Weiwei Li

引用次数: 0

Clinical relevance of transplant renal vein stenosis in the early post-operative period. 移植肾静脉术后早期狭窄的临床意义。

IF 1 4区医学

Clinical nephrology Pub Date : 2026-05-01 DOI: 10.5414/CN111945

Fu-Shun Pan, Gang Huang, Rong-Hai Deng, Ming Liu

{"title":"Clinical relevance of transplant renal vein stenosis in the early post-operative period.","authors":"Fu-Shun Pan, Gang Huang, Rong-Hai Deng, Ming Liu","doi":"10.5414/CN111945","DOIUrl":"10.5414/CN111945","url":null,"abstract":"Aims: To evaluate the progression of transplant renal vein stenosis (TRVS) in the early post-operative period and its impact on clinical outcomes.Materials and methods: This prospective study enrolled 23 consecutive patients with TRVS detected by contrast-enhanced ultrasound (CEUS). Duplex ultrasound (DUS) was performed on days 1, 30, and 90 after transplantation. The DUS measurements included peak velocity (PV) of stenosis and peak velocity ratio of stenosis to pre-stenosis (PV-ratio). The differences in DUS measurements across different timepoints were evaluated by linear mixed-effects model.Results: The mean serum creatinine (SCr) levels at days 30 and 90 were 131 (range, 46 - 196) μmol/L, and 103 (range, 70 - 136) μmol/L, respectively. Two TRVS cases were caused by mural thrombi, the remaining 21 cases were free of any surgical complications. The mean TRVS-PV at days 1, 30, and 90 were 335 ± 92, 221 ± 86, and 134 ± 59 cm/s, respectively. The mean PV-ratio at days 1, 30, and 90 were 9.3 ± 5.0, 3.5 ± 1.9, and 2.0 ± 1.3, respectively. Linear mixed-effects model revealed a significant main effect of timepoint on SCr, TRVS-PV, and PV-ratio (p < 0.01 for all), exhibiting a gradually declining trend. There was no significant main effect of timepoint on arterial parameters.Conclusion: TRVS unrelated to thrombotic causes in the early post-operative period is a transient finding not correlating with short-term outcome.","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":"325-332"},"PeriodicalIF":1.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147372024","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

Fibronectin glomerulopathy caused by genetic FN1 mutation: A case report and literature review. FN1基因突变致纤维连接蛋白肾小球病1例并文献复习。

IF 1 4区医学

Clinical nephrology Pub Date : 2026-05-01 DOI: 10.5414/CN111907

Bairu Shi, Yang Xia, Kejia Li, Long Jin, Xian Sun, Hui Yu

{"title":"Fibronectin glomerulopathy caused by genetic FN1 mutation: A case report and literature review.","authors":"Bairu Shi, Yang Xia, Kejia Li, Long Jin, Xian Sun, Hui Yu","doi":"10.5414/CN111907","DOIUrl":"10.5414/CN111907","url":null,"abstract":"Background: Fibronectin glomerulopathy (FGP), also known as fibronectin deposition glomerulopathy (GFND), is a rare hereditary autosomal dominant glomerular disease. Its clinical manifestations are proteinuria, hematuria, hypertension, and hyperkalemic distal renal tubular acidosis, which often progresses slowly to end-stage renal disease.Case description: We report a 21-year-old woman with fibronectin glomerulopathy who underwent renal puncture at the age of 10. The pathology was considered to be thrombotic microangiopathy, and it was not treated regularly. This time, renal puncture was performed again due to proteinuria combined with elevated serum creatinine. Light microscopy showed severe mesangial matrix hyperplasia of glomeruli with dense deposition and foam cell aggregation in capillary loops. Fibrinogen immunostaining was positive. Electron microscope showed severe hyperplasia of mesangial matrix, and a large amount of electron-dense matter deposited in mesangial area. Perfect genetic testing suggested that the FN1 gene was heterozygous for NM_212482.4 (c.2918A>G), that is, Y973C mutation. Therefore, she was diagnosed with fibronectin glomerulopathy and was given sacubitril valsartan sodium tablets 200 mg b.i.d. orally.Conclusion: We report a case of a patient with fibronectin glomerulopathy and review the literature of this disease. The disease often has insidious onset, and fibronectin deposition is a typical pathological change that can result. The disease slowly progresses to end-stage renal disease. At present, there is no specific treatment. It is advocated to use reninangiotensin-aldosterone system blockers to strictly control blood pressure and proteinuria, and the overall prognosis is poor. Genetic testing techniques may be helpful in early diagnosis of the disease.","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":"352-359"},"PeriodicalIF":1.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146123935","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

Real world, retrospective experience of glucagon-like peptide-1 receptor agonists in kidney transplant recipients: A single-center case series. 真实世界，回顾胰高血糖素样肽-1受体激动剂在肾移植受者中的应用：单中心病例系列。

IF 1 4区医学

Clinical nephrology Pub Date : 2026-05-01 DOI: 10.5414/CN111893

Priyamvada Singh, Melissa McGowan, Lauren Von Stein, Johanna Papanikolla, Annelise Nolan, Hannah Lingren, Noah Jagielski, Navdeep Singh, Shumei Meng, Todd Pesavento

{"title":"Real world, retrospective experience of glucagon-like peptide-1 receptor agonists in kidney transplant recipients: A single-center case series.","authors":"Priyamvada Singh, Melissa McGowan, Lauren Von Stein, Johanna Papanikolla, Annelise Nolan, Hannah Lingren, Noah Jagielski, Navdeep Singh, Shumei Meng, Todd Pesavento","doi":"10.5414/CN111893","DOIUrl":"10.5414/CN111893","url":null,"abstract":"We conducted a retrospective chart review of adult kidney transplant recipients (KTxR) with type 2 diabetes treated with a glucagon-like peptide-1 receptor agonist (GLP-1RA). A total of 211, 207, 161, and 92 KTxR were followed for 6, 12, 36, and 60 months, respectively. Over 5 years, we observed statistically significant reductions in the primary endpoints of weight, HbA1c, and major adverse cardiovascular events (MACE). The mean weight reduction was as follows: 1.17 kg at 6 months (p < 0.006), 1.2 kg at 12 months (p < 0.03), 3.7 kg at 36 months (p < 0.0001), and 4.1 kg at 60 months (p = 0.001) compared to baseline. The HbA1c levels showed reductions of 0.6 mmol/mol at 6 months (p < 0.0001), 0.5 mmol/mol at 12 months (p = 0.0004), 0.3 mmol/mol at 36 months (p = 0.04), and 0.35 mmol/mol at 60 months (p = 0.35). MACE rates fell from 45.5% at GLP-1RA initiation to 18.9% during follow-up (OR 3.6 (2.3 - 5.6), p < 0.0001). Insulin requirements decreased from 50 to 27 units over 5 years. Kidney function reduces over time in KTx, likely secondary to hemodynamic or vascular-mediated risk factors, chronic immunosuppressive agents, treatment for rejections, and solitary transplanted kidney. In our study, estimated glomerular filtration rate (eGFR) not only stayed stable but also showed a trend towards improvement (eGFR improved from 50 to 53 mL/min/1.73m2). Further prospective randomized trials are needed to assess GLP-1RA efficacy and safety in KTxR.","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":"318-324"},"PeriodicalIF":1.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147466788","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

Relationship of serum α-Klotho with diabetic kidney disease and mortality in diabetes: A population-based observational study. 血清α-Klotho与糖尿病肾病和糖尿病死亡率的关系：一项基于人群的观察性研究

IF 1 4区医学

Clinical nephrology Pub Date : 2026-05-01 DOI: 10.5414/CN111769

Liling Zhang, Di Fan, Tingting Zhu, Lei Geng, Linwang Gan, Santao Ou, Defeng Yin, Yong Xu

{"title":"Relationship of serum α-Klotho with diabetic kidney disease and mortality in diabetes: A population-based observational study.","authors":"Liling Zhang, Di Fan, Tingting Zhu, Lei Geng, Linwang Gan, Santao Ou, Defeng Yin, Yong Xu","doi":"10.5414/CN111769","DOIUrl":"10.5414/CN111769","url":null,"abstract":"This study aimed to investigate the associations between serum α-Klotho levels and diabetic kidney disease (DKD), as well as all-cause mortality among individuals with diabetes. We included participants from the National Health and Nutrition Examination Survey (NHANES) between 2007 and 2016. Multivariable logistic regression and Cox proportional hazards models were used to evaluate the relationships of serum α-Klotho with DKD and mortality, respectively. Restricted cubic splines were applied to examine potential nonlinear associations. Subgroup analyses were performed to assess the robustness of the findings. A total of 3,098 participants were enrolled. The fully adjusted odds ratio (95% confidence interval (CI)) for the association between serum α-Klotho and DKD was 0.47 (0.33, 0.67; p < 0.001). Similarly, the hazard ratio for all-cause mortality was 0.61 (0.36, 0.96; p = 0.043). Restricted cubic spline analyses revealed nonlinear relationships between serum α-Klotho and both DKD and all-cause mortality. Kaplan-Meier curves indicated that participants in the lower quartiles of serum α-Klotho had significantly reduced survival probabilities. After Bonferroni correction, subgroup analyses showed no significant interactions between serum α-Klotho and all-cause mortality across populations. In conclusion, serum α-Klotho is significantly associated with DKD and all-cause mortality in diabetes.","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":"297-307"},"PeriodicalIF":1.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147372010","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

Real-world outcomes of denosumab treatment in patients undergoing hemodialysis for osteoporosis: A 3-year observational study. 地诺单抗治疗骨质疏松症血液透析患者的实际结果：一项为期3年的观察性研究

IF 1 4区医学

Clinical nephrology Pub Date : 2026-05-01 DOI: 10.5414/CN111917

Jung Soon Kim, Jin Taek Kim, Hong Il Lim, Hyo-Jeong Kim, Kyong Yeun Jung, Hoonsung Choi, Jung Ah Lim, So Young Lee

{"title":"Real-world outcomes of denosumab treatment in patients undergoing hemodialysis for osteoporosis: A 3-year observational study.","authors":"Jung Soon Kim, Jin Taek Kim, Hong Il Lim, Hyo-Jeong Kim, Kyong Yeun Jung, Hoonsung Choi, Jung Ah Lim, So Young Lee","doi":"10.5414/CN111917","DOIUrl":"10.5414/CN111917","url":null,"abstract":"Objective: The safety and efficacy of denosumab in patients undergoing hemodialysis for osteoporosis remain underexplored. Therefore, guidelines are unclear regarding whether denosumab can be safely used in these patients. This study aimed to present the experience of denosumab treatment in a small cohort of patients for up to 3 years.Materials and methods: This study evaluated the effects of denosumab on bone metabolism in 12 patients with end-stage kidney disease (ESKD) and osteoporosis undergoing long-term hemodialysis in an observational cohort setting. These patients were maintained on high doses of calcium carbonate (1,250 mg/day) and vitamin D (1,000 IU/day) supplementation during denosumab treatment to prevent hypocalcemia. Eleven patients with ESKD undergoing hemodialysis who did not receive osteoporosis treatment were followed for the same period as a control group. Changes in biochemical markers, bone mineral density (BMD), and clinical outcomes were analyzed over a 3-year follow-up period.Results: The results revealed no significant differences in lumbar spine BMD but indicated a trend toward high femoral BMD values in the denosumab treatment group at the 2- and 3-year follow-up points. However, 2 patients experienced severe hypocalcemia. Most cases of denosumab discontinuation were due to a lack of BMD improvement.Conclusion: These findings highlight the potential of denosumab in managing osteoporosis in patients undergoing hemodialysis but also underscore the need for careful monitoring of calcium levels to mitigate adverse effects. Therefore, adequate calcium replacement is required to prevent severe hypocalcemia. This study provides valuable real-world evidence to guide therapeutic strategies for improving bone health in patients with ESKD.","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":"333-340"},"PeriodicalIF":1.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146103788","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