Clinical nephrology最新文献

{"title":"Development of autoimmune antibodies against human phospholipase A2 receptor and the application as diagnostic criteria for primary membranous nephropathy.","authors":"Shukun Wu, Yixing Zhai, Na Yang, Zhou Zhou, Yingchun Huang, Li Yang, Bing Lai, Guisen Li","doi":"10.5414/CN111747","DOIUrl":"https://doi.org/10.5414/CN111747","url":null,"abstract":"<p><strong>Introduction: </strong>Membranous nephropathy (MN) is a severe chronic kidney disease (CKD) with ~ 30% of patients progressing to end-stage renal disease within 10 years. Phospholipase A2 receptor (PLA2R) is one of the major target antigens of MN. Despite the importance of PLA2R antibodies in the pathogenesis, diagnosis, and prognosis of MN, anti-human PLA2R monoclonal antibodies have not been obtained. This lack hinders the measurement of chemical PLA2R antibody titers, which are critical for drug development.</p><p><strong>Purpose: </strong>The purpose of this study is to obtain standard anti-human PLA2R monoclonal antibodies by creating a phage antibody library to screen for antibodies.</p><p><strong>Materials and methods: </strong>Our study used CHO cells expressing the human PLA2R CysR-FnII-CTLD1 structural domain (CC1h) and obtained candidate antibodies by screening a human phage display library. These candidate antibodies were expressed in CHO cells, and their binding affinity for CC1h was determined by enzyme-linked immunosorbent assay (ELISA) and biological layer interferometry (BLI). In addition, we calibrated the representative antibody names of A13 and A13SP to obtain transforming factors using a commercial PLA2R antibody ELISA kit.</p><p><strong>Results: </strong>43 high-affinity candidate antibodies were obtained by screening human phage display libraries, and 9 groups of IgG antibodies and their IgG4SP subtype antibodies showed high affinity by CHO cell expression, ELISA, and BLI experiments, and we screened 1 group of antibodies with high protein expression levels and high affinity names of A13 and A13SP subtypes from these 9 antibodies. A few of the remaining 8 groups of antibodies and subtypes also showed high protein expression levels and high affinity, and these antibodies can also be used as alternative antibodies. In addition, we calibrated the representative antibody A13 using a commercial PLA2R antibody ELISA kit and obtained an average conversion factor of 1 RU = 70 ng, and we found that the standard curves of the A13 and A13SP subtype antibody groups exhibited a high concordance with that of the commercial PLA2R antibody ELISA kit, which was higher than that of the other alternative antibodies, and therefore this also indicates that the A13 and A13SP subtype antibodies are the most preferred antibody groups in our antibody library.</p><p><strong>Conclusion: </strong>The A13 and A13SP subtype antibodies showed high protein expression levels and high antibody affinity, and the standard curves showed high concordance with the commercial kits, and this conclusion suggests that the A13 and A13SP subtype antibodies can be used as standard antibodies in the ELISA kits for the quantitative detection of human PLA2R antibodies.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945115","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":"Angiotensin receptor-neprilysin inhibitor in the management of heart failure in patients with an episode of malignant hypertension and advanced kidney dysfunction: A case series and literature review.","authors":"Tomohiro Saito, Masahide Mizobuchi, Mitsuru Kawanishi, Kazuki Abe, Yuki Kajio, Risa Samejima, Yuuki Mima, Hirokazu Honda","doi":"10.5414/CN111487","DOIUrl":"10.5414/CN111487","url":null,"abstract":"<p><p>Although malignant hypertension (MH) treatment has significantly advanced with the introduction of modern antihypertensive agents, progression to end-stage renal disease remains a significant cause of morbidity and mortality. Additionally, the efficacy of sacubitril/valsartan, which is an angiotensin receptor-neprilysin inhibitor (ARNI), for patients with advanced kidney dysfunction and MH remains unknown. We report the cases of two patients with severe kidney and cardiac dysfunction who received uninterrupted antihypertensive treatment, including sacubitril/valsartan and experienced significant clinical improvement in proteinuria and renal function as well as left ventricular reverse remodeling. This report highlights the benefits of ARNI therapy for MH and its renoprotective effects.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":"218-225"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198404","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 relationship between proteinuria and left ventricular hypertrophy in non-diabetic chronic glomerulonephritis patients.","authors":"Musa Ilker Durak, Beyza Algul Durak, Melahat Coban, Mine Sebnem Karakan","doi":"10.5414/CN111637","DOIUrl":"10.5414/CN111637","url":null,"abstract":"<p><strong>Aim: </strong>Chronic glomerulonephritis (GN) encompasses various disorders that lead to glomerular inflammation and damage through the interaction of environmental triggers such as immune-mediated mechanisms and infections. The aim of the study was to investigate the relationship between proteinuria and left ventricular hypertrophy (LVH) in non-diabetic chronic GN patients.</p><p><strong>Materials and methods: </strong>This study was conducted with 103 (62.4%) male and 62 (37.6%) female chronic GN patients with a mean age of 55.65 ± 15.81 years. Patients were compared with 90 healthy individuals of similar age and gender. Proteinuria levels were measured using 24-hour proteinuria quantification (24h QP). Left ventricular (LV) ejection fraction (LVEF), LV end-diastolic diameter (LVEDD), LV end-systolic diameter (LVESD), and LV mass index (LVMI) were calculated using echocardiography.</p><p><strong>Results: </strong>Proteinuria was determined to be ≥ 3.5 g/day in 54 (32.7%) of the patients. In patients, creatinine, LVMI, and LVH were significantly higher compared to healthy individuals. Patients with nephrotic proteinuria had higher LVMI and LVH compared to those with non-nephrotic proteinuria. A significant relationship was found between LVMI and LVH in patients with nephrotic proteinuria. In the univariate logistic regression analysis, an increase in LVH and LVMI values was found to be associated with an increase in nephrotic proteinuria levels.</p><p><strong>Conclusion: </strong>Increased development of LVH was observed in patients compared to healthy individuals. Significantly higher development of LVH was observed in those with nephrotic proteinuria compared to those without. A significant relationship was observed between nephrotic proteinuria and LVH as well as LVMI in patients with chronic GN.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":"170-177"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976588","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":"Malnutrition and short-term mortality in hospitalized general medical patients with acute kidney injury: A prospective observational study.","authors":"Vishal Choudhary, Surendran Deepanjali","doi":"10.5414/CN111715","DOIUrl":"10.5414/CN111715","url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury (AKI) is a common condition present at admission to hospital in a proportion of general medical patients and it contributes to mortality. Presence of associated malnutrition could worsen the prognosis. We aimed to study the prevalence of malnutrition in patients with community-acquired AKI requiring hospitalization and its association with short-term (in-hospital and 1-month post-discharge) mortality, admission to the intensive care unit (ICU) and length of hospitalization (LOH).</p><p><strong>Materials and methods: </strong>We did a prospective observational study including adult general medical patients who had AKI at admission; patients with chronic kidney disease were excluded. We calculated the Charlson Comorbidity Index (CCI) and Sequential Organ Failure Assessment Score (SOFA). Nutritional assessment was done using Subjective Global Assessment (SGA) and also Prognostic Nutritional Index (PNI). Clinical course and vital status at 1 month after discharge was noted. Predictors of mortality were identified using logistic regression.</p><p><strong>Results: </strong>We recruited 230 patients. The median (interquartile range (IQR)) age was 51 (40 - 64) years; 171 (74.3%) were males. Based on admission creatinine, 60 (26%) were in Kidney Disease Improving Global Outcomes (KDIGO) stage 1, 82 (35.6%) in stage 2, and 88 (38.3%) in stage 3. We found that 132 (57.4%) belonged to SGA category A, 77 (33.5%) to SGA B, and 21 (9.1%) to SGA C. The median (IQR) PNI was 36.3 (30 - 46.6). The short-term mortality was 59 (25.6%). Multivariable analysis showed that male sex (adjusted OR (aOR) (2.75 (1.08 - 6.98); p = 0.033), higher CCI (aOR 1.43 (1.18 - 1.74); p < 0.001), higher SOFA scores (aOR 1.36 (1.19 - 1.55); p < 0.001), and SGA C category (aOR 4.4 (1.39 - 14.03); p = 0.012) to be associated with mortality, while AKI due to underlying infections was associated with survival (aOR 0.38 (0.18 - 0.78); p = 0.008). There was no association of malnutrition with ICU admission or LOH. PNI did not predict mortality.</p><p><strong>Conclusion: </strong>About 10% of patients with community-acquired AKI had severe malnutrition, and it independently predicts mortality. Male sex, higher CCI, and higher SOFA scores were also associated with mortality. AKI associated with infections has a better prognosis.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":"191-199"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967980","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, associated factors, and prognosis of acute kidney injury in critically ill patients with COVID-19 in sub-Saharan Africa: A retrospective single-center study.","authors":"Mansour Mbengue, Abdelhakh Achafi, Ibrahima Gaye, Jatt Tshabayembi, Fatou Ndiaye, Cheikh M F Kitane, Abdou Niang","doi":"10.5414/CN111607","DOIUrl":"10.5414/CN111607","url":null,"abstract":"<p><strong>Introduction: </strong>Acute kidney injury (AKI) constitutes a complication frequently encountered in patients with severe forms of COVID-19. The aim of this study was to evaluate the prevalence of acute kidney injury and to describe its associated factors.</p><p><strong>Materials and methods: </strong>This was a retrospective, descriptive, analytical study over a period of 18 months at Dalal Jamm Hospital in Dakar. We included all patients admitted to the intensive care unit for the treatment of COVID-19. AKI was defined according to KDIGO 2012.</p><p><strong>Results: </strong>During the study period, we collected 170 files. The mean age was 59.38 ± 14.81 years, and 40.6% were women. Hypertension and diabetes mellitus were the most frequently found comorbidities, respectively, in 37.65% and 31.18% of cases. AKI was present in 50 (29.4%) patients. Acute tubular injury was found in 44% of cases. Hemodialysis was performed in 10% of cases, and the indications were hyperkalemia (100%), and uremic encephalopathy (40%). Death occurred in 62.36% of cases. Recovery of renal function during hospitalization was noted in 16% of patients. In multivariable analysis, the factors associated with AKI were obesity (p = 0.020; adjusted odds ratio (aOR) = 7.406; 95% CI = 2.25 - 37.11) and non-renal Sequential Organ Failure Assessment (SOFA) (p = 0.001; aOR = 5.851; 95% CI = 3.04 - 11.2). AKI was an independently associated factor with death (p = 0.002; aOR = 4.510; 95% CI = 2.51 - 9.52).</p><p><strong>Conclusion: </strong>AKI is common during COVID-19. AKI is correlated with the severity of the disease and the presence of comorbidities. AKI is independently associated with increased risk of death in COVID-19.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":"200-206"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144539243","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 manifestations and prognosis of immune-mediated membranous nephropathy concurrent with other glomerulonephritides: A retrospective Chinese cohort analysis.","authors":"Zhe Li, Shuhua Zhu, Ke Zuo, Dacheng Chen, Weibo Le, Feng Xu, Xia Wang","doi":"10.5414/CN111627","DOIUrl":"10.5414/CN111627","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to analyze the clinical and prognostic differences in immune-mediated membranous nephropathy (MN) concurrent with other forms of glomerulonephritis.</p><p><strong>Materials and methods: </strong>A retrospective cohort study at Jinling Hospital from 2015 to 2023 included patients with PLA2R antibody levels ≥ 14RU/mL who underwent renal biopsy. Those with immune-mediated MN and concurrent glomerulonephritides were compared to a control group with isolated MN diagnosed in 2015.</p><p><strong>Results: </strong>Concurrent glomerulonephritis was found in 5.53% of the MN cohort, including 61 patients with IgA nephropathy (IgAN-MN), 49 with diabetic nephropathy (DN-MN), and 131 with focal segmental glomerulosclerosis (FSGS-MN). Compared to the control group, those with IgAN-MN showed increased severity of glomerular injury yet had a reduced degree of interstitial fibrosis. The DN-MN group exhibited intensified glomerular damage; however, no significant difference was observed in the extent of tubulointerstitial damage. Additionally, the FSGS-MN group displayed more severe damage to both glomerular and tubulointerstitial structures. Both the DN-MN group and the FSGS-MN group exhibited a significantly lower complete remission rate compared to the control group. The renal endpoint event rates were 29.51% for IgAN-MN, 46.94% for DN-MN, and 33.59% for FSGS-MN, which were all significantly higher than the 18.99% rate in the control group.</p><p><strong>Conclusion: </strong>Patients with MN who test positive for serum Anti-PLA2R antibodies may present with other forms of glomerulonephritis. The prognostic outcomes of MN in the presence of concurrent IgAN, DN, or FSGS are notably poorer than those of isolated MN. Renal biopsy is valuable for definitive diagnosis and prognostic evaluation.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":"207-217"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198407","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 chronic kidney disease-associated pruritus on quality of life in hemodialysis and non-dialysis patients: A cross-sectional study.","authors":"Abdullah Ucar, Mevlut Tamer Dincer, Safak Mirioglu, Siddik Keskin, Cebrail Karaca","doi":"10.5414/CN111649","DOIUrl":"10.5414/CN111649","url":null,"abstract":"<p><strong>Aims: </strong>Chronic kidney disease-associated pruritus (CKD-aP) is a common and distressing symptom, particularly in hemodialysis (HD) patients, significantly impacting their quality of life. This study aimed to investigate the effects of CKD-aP frequency and severity on quality of life in both HD and non-HD stage 3 - 5 CKD patients.</p><p><strong>Materials and methods: </strong>This cross-sectional case-control study was conducted from January to May 2024. Pruritus was assessed using the 5-D itch scale, and quality of life was evaluated with the World Health Organization Quality of Life Scale-Short Form (WHOQoL-BREF) questionnaire. Correlations between pruritus severity and patient characteristics were analyzed.</p><p><strong>Results: </strong>The study involved 169 patients, comprising 80 non-HD stage 3 - 5 CKD patients and 89 HD patients, with a mean age of 55.2 ± 16.7 years. Pruritus was significantly more prevalent in the HD group than in the non-HD group (61.8 vs. 41.3%, p = 0.008). HD patients had more pruritic body areas and higher 5-D itch scale scores (0 (0 - 8.5) vs. 0 (0 - 3.75), p = 0.002; 9.3 (8.0 - 14.8) vs. 8.0 (8.0 - 10.3), p = 0.003). In the HD group, pruritus was associated with lower quality of life in the psychological health, social relationships, and environment domains of the WHOQoL-BREF questionnaire (50.0 (35.4 - 58.3)% vs. 54.2 (42.7 - 66.7)%, p = 0.027; 50.0 (33.3 - 58.3)% vs. 50.0 (41.6 - 66.7)%, p = 0.046; 53.1 (40.6 - 65.5)% vs. 56.3 (50.0 - 68.8)%, p = 0.026, respectively). Pruritus also correlated with lower hemoglobin levels, higher serum creatinine levels, and poorer overall quality of life in both groups, with female sex and erythropoiesis-stimulating agent use as significant contributing factors.</p><p><strong>Conclusion: </strong>Pruritus significantly impairs the quality of life in HD patients.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":"178-190"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109977","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":"Central blood volume and cardiac output index predict all-cause and cardiovascular mortality in chronic hemodialysis patients.","authors":"Chung-Kuan Wu, Li-Juan Lin, Chew-Teng Kor, Chia Lin Wu","doi":"10.5414/CN111484","DOIUrl":"10.5414/CN111484","url":null,"abstract":"<p><strong>Background: </strong>This study investigated the effect of central blood volume (CBV) and cardiac output index (COI) on the all-cause and cardiovascular mortality in chronic hemodialysis (CHD) patients.</p><p><strong>Materials and methods: </strong>Adult CHD patients with functional arteriovenous access at the hemodialysis center of a medical center between January 1, 2003, and December 31, 2014, were recruited in this retrospective observational study. The primary and secondary endpoints were all-cause and cardiovascular mortality. Cumulative incidences of all-cause and cardiovascular mortality during the follow-up period were estimated and compared using the Kaplan-Meier method and log-rank test. Logistic regression and Cox proportional hazards models were used to calculate odds and hazard ratios.</p><p><strong>Results: </strong>A total of 390 CHD patients were enrolled, including 34 patients with early mortality. The early mortality group had a higher CBV than the survival group. CBV and COI were independently associated with all-cause and cardiovascular mortality. Low COI (< 3 L/min/m²) and high CBV (≥ 1.25 L) independently predicted long-term all-cause and cardiovascular mortality. The highest risks of all-cause and cardiovascular mortality were observed in patients with low COI and high CBV, followed by high COI and high CBV and then low COI and low CBV. Mortality was the lowest in those with high COI and low CBV.</p><p><strong>Conclusion: </strong>CBV and COI are important factors for predicting death in CHD patients. Those with low COI and high CBV had the worst outcomes.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":"108-119"},"PeriodicalIF":1.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966788","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 ARMC5 mutation with bilateral macronodular adrenal hyperplasia and primary aldosteronism: A case report.","authors":"Xin-Yi Tian, Hong-Rui An, Guo-Xue Qi, Rui-Tao Wu, Fu Ma, Meng Zhang, Fang Chen, Xiang-Bin Xin","doi":"10.5414/CN111653","DOIUrl":"10.5414/CN111653","url":null,"abstract":"<p><strong>Background: </strong>Mutations in the <i>ARMC5</i> gene are generally associated with bilateral macronodular adrenal hyperplasia (BMAH), whereas primary aldosteronism (PA) is most commonly linked to adrenal cortical adenomas (ACA). Recent studies have identified <i>ARMC5</i> mutations in certain PA cases; however, it remains unclear whether BMAH associated with <i>ARMC5</i> mutations can directly contribute to PA.</p><p><strong>Case description: </strong>A patient undergoing evaluation for secondary hypertension was diagnosed with BMAH, an elevated aldosterone/renin ratio (ARR) suggestive of PA, and subclinical Cushing's syndrome (SCS). Adrenal venous sampling (AVS) indicated left-sided dominance. Genetic testing confirmed <i>ARMC5</i> mutations in the patient and their son. A subsequent partial left adrenalectomy identified a golden-yellow adrenal tumor, which pathological analysis classified as an ACA. However, given the overlapping histological and clinical features of bilateral multifocal ACA and BMAH, the histological findings were reconsidered. The association of <i>ARMC5</i> mutations with BMAH rather than ACA, in conjunction with imaging findings and a history of meningioma, supports a diagnosis of <i>ARMC5</i> mutation-associated BMAH.</p><p><strong>Conclusion: </strong>This case suggests that <i>ARMC5</i> mutation-associated BMAH may contribute to the development of PA, expanding the understanding of the genetic underpinnings of PA in BMAH.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":"78-86"},"PeriodicalIF":1.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962302","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":"A case of constrictive pericarditis diagnosed for hypotension occurring after two years on hemodialysis.","authors":"Kana Shirai, Daisuke Uchida, Hiroo Kawarazaki","doi":"10.5414/CN111602","DOIUrl":"10.5414/CN111602","url":null,"abstract":"<p><p>One of the most frequently encountered dialysis-related complications is hemodialysis-associated hypotension. In this case, we encountered a patient with a 2-year history of dialysis, where the cause of hemodialysis-associated hypotension was constrictive pericarditis (CP). CP is a rare condition, and diagnosis is often challenging, making early detection and treatment crucial for patient outcomes. At the time, despite clinical signs of right heart failure, echocardiographic findings did not suggest heart failure, making the diagnosis difficult. Based on physical findings, further investigation into conditions causing right heart failure revealed pericardial thickening, leading to suspicion of CP. A right heart catheterization confirmed the diagnosis of CP, and the patient underwent pericardiectomy, which resulted in an improvement in dialysis-related complications. This case underscores the importance of considering CP as a potential cause of dialysis-related complications and highlights the need for a comprehensive diagnostic approach grounded in physical examination.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":"72-77"},"PeriodicalIF":1.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976586","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}