Clinical nephrology最新文献_第2页

Corrigendum for the article Clin Nephrol. 2025; 103: 1-4.

IF 1.1 4区医学

Clinical nephrology Pub Date : 2025-03-25 DOI: 10.5414/CN111423Cor

Fredrik Barth Brekke, Nanna von der Lippe, Ine Røed, Helga Gudmundsdottir, Martin Braaten, Espen Nordheim

引用次数: 0

Prediction and phenotyping of long COVID in kidney transplant recipients: A cross-sectional study.

IF 1.1 4区医学

Clinical nephrology Pub Date : 2025-03-25 DOI: 10.5414/CN111584

Ivan Zahradka, Vojtech Petr, Istvan Modos, Katarina Jakubov, Lukas Dolezal, Szabolcs Kalina, Ondrej Viklicky

{"title":"Prediction and phenotyping of long COVID in kidney transplant recipients: A cross-sectional study.","authors":"Ivan Zahradka, Vojtech Petr, Istvan Modos, Katarina Jakubov, Lukas Dolezal, Szabolcs Kalina, Ondrej Viklicky","doi":"10.5414/CN111584","DOIUrl":"10.5414/CN111584","url":null,"abstract":"Aims: The aim was to describe the epidemiology, phenotyping, and risk factors of long COVID (LC) in a well-defined cohort of kidney transplant recipients (KTRs) using a novel LC diagnostic method based on self-reported symptoms.Materials and methods: We conducted a cross-sectional study using an electronic survey to inquire about persisting symptoms following COVID-19. KTRs who survived COVID-19 up to February 8, 2023, were considered for inclusion, and 596 KTRs were enrolled. A brief 35-question screening questionnaire was used. A novel statistical approach based on the factor analysis method was used to make LC diagnosis and identify its clinical phenotypes.Results: LC was identified in 33.7% of KTRs who responded to the survey. Male sex (OR 0.69, 95% CI 0.48 - 1.0, p = 0.047), more severe COVID-19 (OR 2.48, 95% CI 1.58 - 3.92, p < 0.001), higher body mass index (OR 1.04, 95% CI 1.0 - 1.08, p = 0.031), and corticosteroids (OR 2.8, 95% CI 1.23 - 7.09, p = 0.02) were independently associated with LC development. Eight LC phenotypes were identified based on symptom clustering: fatigue (32.4% of all KTRs), psychiatric (15.9%), cardiovascular (6%), ophthalmic (13.8%), cognitive (17.8%), fibromyalgia-like (11.1%), integumental (10.6%), and malnutritional (6%). The rate of LC was similar in those who had COVID-19 less/more than a year since responding to the survey.Conclusion: A novel method for determining LC diagnosis and its phenotyping was used in a large cohort of KTRs, which showed that a third of KTRs who responded to the survey developed LC after COVID-19. This method may improve diagnosis and future research of LC.","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699877","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

Administering immunosuppressive drugs by feeding tube in kidney transplant recipients: Practical guide for nephrologists.

IF 1.1 4区医学

Clinical nephrology Pub Date : 2025-03-21 DOI: 10.5414/CN111661

Kai Ming Chow, Simon Wai Yin So

引用次数: 0

Prognostic outcomes and influencing factors of peritoneal dialysis-related peritonitis: A retrospective single-center study.

IF 1.1 4区医学

Clinical nephrology Pub Date : 2025-03-21 DOI: 10.5414/CN111367

Yan Wang, Yong-Chun Wang, Hong-Xia Zhang, Hui-Min Shi, Hong-Hong Xie, Shu-Hua Song, Li Wang, Xiao-Qin Ma, Cai-Ping Zhao, Mei Xu, Ya-Nan Chang, Na Tian, Meng-Hua Chen

{"title":"Prognostic outcomes and influencing factors of peritoneal dialysis-related peritonitis: A retrospective single-center study.","authors":"Yan Wang, Yong-Chun Wang, Hong-Xia Zhang, Hui-Min Shi, Hong-Hong Xie, Shu-Hua Song, Li Wang, Xiao-Qin Ma, Cai-Ping Zhao, Mei Xu, Ya-Nan Chang, Na Tian, Meng-Hua Chen","doi":"10.5414/CN111367","DOIUrl":"10.5414/CN111367","url":null,"abstract":"Background: This study aims to elucidate the determinants contributing to the onset of peritonitis in individuals undergoing peritoneal dialysis (PD), thereby establishing a clinical foundation for diminishing the prevalence of PD-associated peritonitis.Materials and methods: A retrospective examination was conducted on the clinical records of 485 cases diagnosed with PD peritonitis at the General Hospital of Ningxia Medical University over a decade (2010 - 2020). Data scrutinized included demographic details, underlying diseases, duration of dialysis, etiology of infection, economic background, predisposing factors, and bacterial pathogens.Results: The analysis identified surgical or gynecological interventions and gastrointestinal infections from contaminated food as predominant precursors to PD-related peritonitis. Prognostically, patients with gastrointestinal infections linked to contaminated food intake and those with viral afflictions fared worse compared to their counterparts in the recovery cohort. The principal infectious agents were identified as Gram-positive cocci. Notable disparities in gender, duration of dialysis treatment, and antecedent peritonitis episodes were observed between those who recovered and those who did not. Binary logistic regression pinpointed extended duration of dialysis and bacterial etiology as independent prognostic indicators for adverse outcomes in PD peritonitis patients.Conclusion: The study concludes that both protracted dialysis treatment and bacterial etiology serve as independent prognostic determinants for PD-related peritonitis outcomes.","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673310","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

Trends and surgical outcomes in laparoscopic and open peritoneal dialysis catheter insertion.

IF 1.1 4区医学

Clinical nephrology Pub Date : 2025-03-03 DOI: 10.5414/CN111497

Ankur D Shah, Susie L Hu, Anvitha Rangan, Adena J Osband, Christina A Raker

{"title":"Trends and surgical outcomes in laparoscopic and open peritoneal dialysis catheter insertion.","authors":"Ankur D Shah, Susie L Hu, Anvitha Rangan, Adena J Osband, Christina A Raker","doi":"10.5414/CN111497","DOIUrl":"10.5414/CN111497","url":null,"abstract":"Background: Peritoneal dialysis (PD) catheters can be inserted via open or laparoscopic techniques. Recent guidelines suggest advanced laparoscopic insertion for suitable patients, due to known catheter-related benefits, but surgical outcomes literature is lacking.Materials and methods: We analyzed 11,731 PD catheter insertions from 2013 - 2018 in the National Surgical Quality Improvement Program database, including preoperative characteristics, operative details, and 30-day outcomes. Trends over time and factors associated with approach were assessed. Logistic regression examined the association between approach and postoperative mortality, complications, and length of stay.Results: Laparoscopic PD catheter insertions increased from 76.1 to 87% of cases over the study period (p < 0.0001). Compared to laparoscopic procedures, open insertions were performed in older patients (58.8 vs. 58.1 years) with higher comorbidity. After adjustment, odds of 30-day mortality (OR 1.16, 95% CI 0.72 - 1.89), surgical site infections (OR 1.18, 95% CI 0.84 - 1.66), and other complications were similar between groups, although length of stay > 7 days remained modestly higher for open procedures (OR 1.43, 95% CI 1.03 - 1.99).Conclusion: Use of laparoscopic PD catheter insertion has steadily increased from 2013 - 2018. After accounting for confounders, laparoscopic and open techniques had comparable early morbidity and mortality. These real-world data indicate increasing adoption of laparoscopic insertion as the predominant approach for PD access creation.","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540412","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

A national survey of pediatric nephrologists on the treatment of steroid-resistant nephrotic syndrome.

IF 1.1 4区医学

Clinical nephrology Pub Date : 2025-03-03 DOI: 10.5414/CN111620

Ankana Daga, Gia J Oh, Avram Z Traum

{"title":"A national survey of pediatric nephrologists on the treatment of steroid-resistant nephrotic syndrome.","authors":"Ankana Daga, Gia J Oh, Avram Z Traum","doi":"10.5414/CN111620","DOIUrl":"10.5414/CN111620","url":null,"abstract":"Aim: Steroid-resistant nephrotic syndrome (SRNS) in children is a common acquired cause of kidney failure. The treatment practices vary widely. With this web-based survey, we aim to report common medication and follow-up practices by pediatric nephrologists in the USA who treat children with SRNS.Materials and methods: This survey was conducted via the Pediatric Nephrology Research Consortium (PNRC) and sent to 190 members of the PNRC between April 2017 and September 2018.Results: 127 (67%) of the 190 member pediatric nephrologists of the PNRC responded to the survey. 46.5% of respondents were 35 - 44 years of age. Median number of years since fellowship training was 11.5 Definition of SRNS varied by number of weeks of resistance to steroids with 40% respondents using a 6-week cut-off, with others using a 4-week (28%) or 8-week (31%) cut-off. The majority (83%) of respondents use calcineurin inhibitors (CNI) as their first-line agent for steroid-resistant nephrotic syndrome. The majority (88%) of respondents use CNI if focal segmental glomerulosclerosis (FSGS) is present on the biopsy, while 63% of respondents use CNI if minimal change disease is present on the biopsy. There is significant variability in length of treatment with CNI for assessing response. The weaning schedule for CNI and steroids varies from weaning within weeks to months. 49% of respondents use rituximab if there is no response to CNI, and 29% use mycophenolate. Genetic testing in SRNS patients is pursued by most respondents.Conclusion: This survey result highlights the common use of CNI in SRNS and various treatment approaches by a sizeable number of pediatric nephrologists in the USA.","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540291","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

Causal effects of chronic kidney diseases, renal function, and dialysis on sarcopenia: Insights from a Mendelian randomization study.

IF 1.1 4区医学

Clinical nephrology Pub Date : 2025-02-27 DOI: 10.5414/CN111600

Yehui Zhu, Zhenzhong Chen, Qiankun Zhang, Feijun Liu

{"title":"Causal effects of chronic kidney diseases, renal function, and dialysis on sarcopenia: Insights from a Mendelian randomization study.","authors":"Yehui Zhu, Zhenzhong Chen, Qiankun Zhang, Feijun Liu","doi":"10.5414/CN111600","DOIUrl":"10.5414/CN111600","url":null,"abstract":"Objective: Sarcopenia is prevalent among patients with chronic kidney diseases (CKD) with or without dialysis. This research aims to explore the causal effects of CKD, renal function, and dialysis on sarcopenia.Materials and methods: Instrumental variables including CKD, estimated creatinine-based glomerular filtration rate (eGFRcrea), estimated cystatin C-based GFR (eGFRcys), and dialysis were identified from a comprehensive genome-wide association study (GWAS). Sarcopenia-related traits, including appendicular lean mass (ALM), hand grip strength (HGS; left/right), low HGS (age 60 and above), and usual walking pace (UWP), were obtained from a meta-analysis of GWAS. Analysis was conducted using the two-sample Mendelian randomization (MR) method.Results: MR analysis demonstrated that eGFRcrea was significantly associated with a risk of low HGS (OR = 3.33; 95% CI: 1.93 - 5.74; p < 0.001), ALM (OR = 0.32; 95% CI: 0.21 - 0.48; p < 0.001), HGS (left) (OR = 0.64; 95% CI: 0.55 - 0.74; p < 0.001), and HGS (right) (OR = 0.61; 95% CI: 0.52 - 0.71; p < 0.001). The Inverse-Variance-Weighting (IVW) analysis also revealed that dialysis was significantly associated with low HGS (OR = 1.07; 95% CI: 1.02 - 1.11; p = 0.0018). Sensitivity analysis indicated that the MR analysis was reliable. However, IVW analysis revealed that eGFRcys and CKD were not significantly associated with sarcopenia.Conclusion: Our study suggests a causal effect of decline eGFRcrea and dialysis on sarcopenia.","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514734","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

Unraveling hypertension through mineralocorticoid receptor activation in Cushing's syndrome: A case report.

IF 1.1 4区医学

Clinical nephrology Pub Date : 2025-02-27 DOI: 10.5414/CN111430

Holly Thomson, Sydney Westphal, Musab S Hommos

{"title":"Unraveling hypertension through mineralocorticoid receptor activation in Cushing's syndrome: A case report.","authors":"Holly Thomson, Sydney Westphal, Musab S Hommos","doi":"10.5414/CN111430","DOIUrl":"10.5414/CN111430","url":null,"abstract":"Background: Cushing's syndrome is a rare cause of secondary hypertension. There are several mechanisms reported as contributing factors for blood pressure elevation in hypercortisolism patients. This case highlights the central role of mineralocorticoid receptors' activation by the excess cortisol in the development of hypertension.Case presentation: A 45-year-old male presented with several months of cushingoid features and refractory hypertension on maximum doses of five antihypertensive drugs, not including a mineralocorticoid receptor blocker. Workup for other causes of secondary hypertension revealed sleep apnea but was otherwise negative. Further evaluation revealed a carcinoid lung tumor as the cause of Cushing's syndrome with its ectopic production of adrenocorticotropic hormone (ACTH). Prior to the resection of this tumor, the addition of eplerenone, a mineralocorticoid receptor blocker, resulted in significant improvement in blood pressure within 4 weeks, highlighting that cortisol activation of mineralocorticoid receptors is one of the main mechanisms of hypertension in this patient with hypercortisolism.Conclusion: In hypercortisolism patients, some excess cortisol escapes deactivation by the 11β-hydroxysteroid dehydrogenase 2 enzyme in the kidney and directly activates mineralocorticoid receptors. Recent literature suggests that specific patient populations have subtle elevations in cortisol levels, and cortisol's effect on end-organ damage follows a spectrum from high-normal cortisol to overt hypercortisolism. Other data suggest a decline in 11β-hydroxysteroid dehydrogenase 2 enzyme activity with age. Additional research is needed to further define the role of cortisol- mineralocorticoid receptor interaction in hypertension among patients without overt hypercortisolism but with high-normal cortisol or low 11β-hydroxysteroid dehydrogenase 2 enzymatic activity.","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514854","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

Analysis of causes and risk factors for early withdrawal from peritoneal dialysis therapy and development of a prediction nomogram.

IF 1.1 4区医学

Clinical nephrology Pub Date : 2025-02-27 DOI: 10.5414/CN111479

Ci Sun, Yusheng Xu, Sheng Feng, Kai Song, Zhi Wang, Weiwei Li

{"title":"Analysis of causes and risk factors for early withdrawal from peritoneal dialysis therapy and development of a prediction nomogram.","authors":"Ci Sun, Yusheng Xu, Sheng Feng, Kai Song, Zhi Wang, Weiwei Li","doi":"10.5414/CN111479","DOIUrl":"10.5414/CN111479","url":null,"abstract":"Objective: This study aimed to explore the causes and risk factors for early withdrawal from treatment in patients starting peritoneal dialysis (PD) and establish a prediction model.Materials and methods: A single-center retrospective cohort study was conducted on 1,037 patients who received PD therapy at the Second Affiliated Hospital of Soochow University from January 2010 to June 2023. Demographic characteristics and laboratory examinations of the patients were collected. Binary logistic regression analysis was performed to identify risk factors for early withdrawal from PD therapy, establish a prediction model, and assess its calibration curve.Results: In total, 84 (8.1%) of 1,037 patients withdrew early from PD therapy within the first 6 months. Primary reasons for early withdrawal included death (63.1%), conversion to hemodialysis (HD) (28.6%), and kidney transplantation (8.3%). Logistic regression analysis showed that advanced age (OR = 1.033, 95% CI: 1.014 - 1.052, p = 0.001), combined with systemic vasculitis (OR = 4.347, 95% CI: 1.455 - 12.984, p = 0.008), cardiovascular disease (OR = 1.644, 95% CI: 1.002 - 2.699, p = 0.049), and hypoalbuminemia (OR = 0.957, 95% CI: 0.919 - 0.997, p = 0.037) increased the risk of early withdrawal from PD therapy. The statistically significant parameters were included to establish a prediction model, the C-index was 0.711 (95% CI: 0.650 - 0.770).Conclusion: The main causes of early PD withdrawal were death and conversion to HD. The main causes of death were cardiovascular diseases and infection; the main causes of conversion to HD were dialysate leakage and catheter dysfunction. Advanced age, systemic vasculitis, combined with cardiovascular disease, and hypoalbuminemia increased the risk of early withdrawal from PD therapy.","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514763","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

Metabolic testing in urinary diversion stone formers.

IF 1.1 4区医学

Clinical nephrology Pub Date : 2025-02-27 DOI: 10.5414/CN111532

Arrsh Bajaj, Jane Li, Amy A Yau

引用次数: 0