Clinical nephrology最新文献_第3页

Avacopan for ANCA-associated vasculitis: Beyond the 52-week treatment course. Avacopan治疗anca相关血管炎：超过52周疗程。

IF 1 4区医学

Clinical nephrology Pub Date : 2025-07-30 DOI: 10.5414/CN111775

Ella Eisinger, Abdallah S Geara, Bryan Chang, Preethi Reddivari, Julia Ford, Ora Gewurz-Singer, Duvuru Geetha

{"title":"Avacopan for ANCA-associated vasculitis: Beyond the 52-week treatment course.","authors":"Ella Eisinger, Abdallah S Geara, Bryan Chang, Preethi Reddivari, Julia Ford, Ora Gewurz-Singer, Duvuru Geetha","doi":"10.5414/CN111775","DOIUrl":"10.5414/CN111775","url":null,"abstract":"The landmark ADVOCATE trial, which lead to the approval of Avacopan (AVP) as adjunctive treatment of ANCA-associated vasculitis (AAV), treated patients with AVP for 52 weeks. In the real-world, some patients are prescribed AVP for a longer duration. In this study, we performed a multi-center retrospective cohort study of 15 adult patients with new and relapsing AAV treated with AVP for a duration of 52 weeks or longer. During a mean follow-up period of 96 (21) weeks, 1/15 patients experienced AAV flare, and none progressed to end-stage kidney disease. On last follow-up, the mean estimated glomerular filtration rate (eGFR) rise from baseline was 16 mL/min/1.73m2. Infections were the most reported adverse effects including 5 infections requiring hospitalization. No abnormal liver function tests were reported during these prolonged courses of AVP beyond 52 weeks. AVP therapy for AAV showed excellent remission rates with marked improvement of the eGFR at 26- and 52-weeks follow-up. By prolonging the treatment with AVP beyond 52 weeks, the improvement in eGFR was sustained during the additional AVP treatment period. Infection complications were the most observed adverse effects. Further data on the longer-term use of AVP is needed.","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144741359","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

Bidirectional two-sample Mendelian randomization analysis reveals a causal effect of chronic pain on chronic kidney diseases and renal function. 双向双样本孟德尔随机分析揭示了慢性疼痛对慢性肾脏疾病和肾功能的因果影响。

IF 1.1 4区医学

Clinical nephrology Pub Date : 2025-07-11 DOI: 10.5414/CN111662

Chengwei Wu, Qiankun Zhang, Zhenhua Wu

{"title":"Bidirectional two-sample Mendelian randomization analysis reveals a causal effect of chronic pain on chronic kidney diseases and renal function.","authors":"Chengwei Wu, Qiankun Zhang, Zhenhua Wu","doi":"10.5414/CN111662","DOIUrl":"10.5414/CN111662","url":null,"abstract":"Objective: A growing body of research has shown a connection between chronic pain and chronic kidney disease (CKD). However, it is unclear if these correlations point to a cause-and-effect link. Our goal is to investigate the causal link between renal function or CKD and chronic pain.Materials and methods: Using genome-wide association study (GWAS) datasets on these traits, we performed bidirectional two-sample Mendelian randomization (MR) analyses in this work to evaluate genetic linkages and possible causal links between chronic pain and CKD or renal function. The CKD Genetics Consortium provided the GWAS data for CKD symptoms, estimated creatinine-based glomerular filtration rate (eGFRcrea) and cystatin C-based GFR (eGFRcys). A sizable biomedical database of GWAS provided summary statistics for both chronic widespread musculoskeletal pain (CWP) and multisite chronic pain (MCP).Results: MR analysis revealed that MCP was significantly associated with an increased risk of CKD (OR = 1.52; 95% CI: 0.97 - 2.40; p = 0.037) and eGFRcys decline (OR = 0.97; 95% CI: 0.95 - 0.99; p = 0.014). The reliability of the MR analysis was demonstrated by sensitivity analysis. However, MR analysis did not find a significant association between CWP and CKD or renal function decline. Additionally, this study did not discover a link between renal function decline or CKD and chronic pain.Conclusion: Our research revealed a substantial correlation between MCP and a higher risk of CKD and renal function deterioration.","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607709","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

Exploring predictive models for intradialytic hypotension risk in maintenance hemodialysis patients: A systematic review. 探讨维持性血液透析患者分析性低血压风险的预测模型：一项系统综述。

IF 1.1 4区医学

Clinical nephrology Pub Date : 2025-07-02 DOI: 10.5414/CN111658

Xiaoping Wen, Kexin Zheng, Luyin Han, Qin Yan, Miao Cao

{"title":"Exploring predictive models for intradialytic hypotension risk in maintenance hemodialysis patients: A systematic review.","authors":"Xiaoping Wen, Kexin Zheng, Luyin Han, Qin Yan, Miao Cao","doi":"10.5414/CN111658","DOIUrl":"10.5414/CN111658","url":null,"abstract":"Background: This systematic review evaluates existing risk prediction models for intradialytic hypotension (IDH) in maintenance hemodialysis (MHD) patients, aiming to inform the development of high-quality predictive tools for clinical use.Materials and methods: Retrieve studies on the construction of predictive models for IDH risk in patients undergoing maintenance hemodialysis in CNKI and other databases. The search time frame is from the establishment of the databases to November 13, 2024. Two researchers independently screened the literature and extracted data according to the Predictive Model Study Data Extraction Form and bias risk assessment tools. The bias risk and applicability of the included literature were evaluated.Results: A total of 21 studies were included, with 16 undergoing internal validation, and 8 reporting calibration. IDH incidence ranged from 7.3 to 51.0%. The overall applicability of the studies included in the research is good, but the overall risk of bias is high, mainly due to unreasonable sample size, lack of performance evaluation, and single-center studies.Conclusion: The research on predictive models for IDH risk in patients undergoing maintenance hemodialysis is still in its early stages. The included studies exhibit an overall high risk of bias, and there is a lack of clinical application. In the future, it may be beneficial to utilize interpretable machine learning methods to construct predictive models with good performance and simplicity, aiming for practical clinical applications.","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144539242","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

The association between anemia and mortality in hemodialysis patients is inconsistent in different blood glucose levels. 血液透析患者贫血与死亡率之间的关系在不同血糖水平下是不一致的。

IF 1.1 4区医学

Clinical nephrology Pub Date : 2025-07-02 DOI: 10.5414/CN111415

Xiaobing Yin, Shoumei Wang, Yan Jiang, Guimei Wang, Xiang Li, Jian Yang, Jinbao Li, Jincheng Xiao, Yan Shi

{"title":"The association between anemia and mortality in hemodialysis patients is inconsistent in different blood glucose levels.","authors":"Xiaobing Yin, Shoumei Wang, Yan Jiang, Guimei Wang, Xiang Li, Jian Yang, Jinbao Li, Jincheng Xiao, Yan Shi","doi":"10.5414/CN111415","DOIUrl":"10.5414/CN111415","url":null,"abstract":"Aims: To evaluate if the association between anemia and mortality is affected by blood glucose levels in hemodialysis patients.Materials and methods: A total of 818 consecutive patients who started hemodialysis between January 2013 and December 2016 were included in this study, followed until December 2022. Patients were categorized into five HbA1c groups (< 5%, 5 - 5.9%, 6 - 6.9%, 7 - 7.9%, and ≥ 8%) and six hemoglobin (Hb) groups (< 9, 9 - 10, 10 - 11, 11 - 12, 12 - 13, and > 13 g/dL). Kaplan-Meier survival analysis and multivariate Cox regression were performed to evaluate the association between Hb levels and all-cause mortality, adjusting for confounders.Results: There were 310 (37.9%) deaths during a maximum follow-up of 120 months. Lower Hb levels were significantly associated with increased mortality risk (p for trend < 0.01). However, subgroup analysis revealed a significant interaction between Hb and HbA1c levels (p for interaction < 0.01). In patients with HbA1c < 5% and 5 - 5.9%, lower Hb levels (< 11 g/dL) were associated with a higher risk of mortality (p for trend < 0.05). In contrast, in patients with HbA1c ≥ 6%, Hb levels were not significantly associated with mortality risk (p for trend > 0.05).Conclusion: The association between anemia and mortality in hemodialysis patients varies across HbA1c levels. Lower Hb levels were associated with increased mortality risk in patients with HbA1c < 6%, whereas this association was not observed in those with HbA1c ≥ 6%.","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144539244","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

Comparison of clinicopathological characteristics and medium-term kidney outcomes in adults with mixed class III/IV with class V and pure proliferative lupus nephritis in a developing country. 发展中国家成人混合型III/IV型与V型和纯增殖性狼疮性肾炎的临床病理特征和中期肾脏结局的比较

IF 1.1 4区医学

Clinical nephrology Pub Date : 2025-07-02 DOI: 10.5414/CN111721

Tabassum Elahi, Saima Ahmed, Muhammed Mubarak, Ejaz Ahmed

{"title":"Comparison of clinicopathological characteristics and medium-term kidney outcomes in adults with mixed class III/IV with class V and pure proliferative lupus nephritis in a developing country.","authors":"Tabassum Elahi, Saima Ahmed, Muhammed Mubarak, Ejaz Ahmed","doi":"10.5414/CN111721","DOIUrl":"10.5414/CN111721","url":null,"abstract":"Objective: To compare clinicopathological characteristics and medium-term outcomes in patients with pure proliferative lupus nephritis (PPLN) or co-existence of proliferative lupus nephritis (PLN) with class V, termed mixed PLN (MPLN) in terms of remission, requirement of kidney replacement therapy (KRT), and patient survival.Materials and methods: A retrospective analysis was conducted on biopsy-proven PLN cases diagnosed between 1998 and 2018, at the Sindh Institute of Urology and Transplantation (SIUT), and followed at the kidney clinic for a minimum of 5 years. All patients were sub-classified as PPLN (class III or IV alone), and MPLN (class III+V or class IV+V) based on the 2003 International Society of Nephrology/Renal Pathology Society (ISN/RPS) classification system. The clinicopathological findings and medium-term kidney outcomes of the two groups were compared.Results: In total, 207 patients with PLN were identified: 152 (73.43%) with PPLN and 55 (26.57%) with MPLN. The cohort was predominantly female (88.9%), with a mean age of 26.63 ± 8.61 years. MPLN patients had a significantly greater degree of nephrotic-range proteinuria (4.46 ± 3.87 vs. 3.20 ± 2.77, p = 0.048) with predominant diffuse proliferative pattern (94.54 vs. 69.73%, p < 0.001). Remission rates were slightly lower in MPLN (81.8 vs. 88.1%, p > 0.05), and more MPLN patients progressed to end-stage kidney disease (ESKD) (21.8 vs. 17.1%, p = 0.18) and experienced increased mortality (14.5 vs. 13.1%, p = 0.36). Five-year kidney survival was 63.63% in MPLN versus 69.73% in PPLN (log-rank: p = 0.39), though it was not statistically significant.Conclusion: No statistically significant differences were found between histological categories of PLN in terms of remission, progression to ESKD, or mortality.","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144539241","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

Association between ARMC5 mutation with bilateral macronodular adrenal hyperplasia and primary aldosteronism: A case report. ARMC5突变与双侧肾上腺大结节性增生和原发性醛固酮增多症的关系：1例报告。

IF 1.1 4区医学

Clinical nephrology Pub Date : 2025-07-01 DOI: 10.5414/CN111653

Xin-Yi Tian, Hong-Rui An, Guo-Xue Qi, Rui-Tao Wu, Fu Ma, Meng Zhang, Fang Chen, Xiang-Bin Xin

{"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":"Background: Mutations in the ARMC5 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 ARMC5 mutations in certain PA cases; however, it remains unclear whether BMAH associated with ARMC5 mutations can directly contribute to PA.Case description: 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 ARMC5 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 ARMC5 mutations with BMAH rather than ACA, in conjunction with imaging findings and a history of meningioma, supports a diagnosis of ARMC5 mutation-associated BMAH.Conclusion: This case suggests that ARMC5 mutation-associated BMAH may contribute to the development of PA, expanding the understanding of the genetic underpinnings of PA in BMAH.","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}

引用次数: 0

A case of constrictive pericarditis diagnosed for hypotension occurring after two years on hemodialysis. 缩窄性心包炎1例诊断为低血压后发生两年的血液透析。

IF 1.1 4区医学

Clinical nephrology Pub Date : 2025-07-01 DOI: 10.5414/CN111602

Kana Shirai, Daisuke Uchida, Hiroo Kawarazaki

引用次数: 0

BK virus nephropathy in a native kidney of a lung transplant patient: A case report and literature review. 肺移植患者原生肾中的BK病毒肾病：1例报告并文献复习。

IF 1.1 4区医学

Clinical nephrology Pub Date : 2025-06-18 DOI: 10.5414/CN111596

Mercedes Galloway, John Sousou, Tarek Ahmad Zaho, Xu Zeng, Alaa S Awad, Charles W Heilig

{"title":"BK virus nephropathy in a native kidney of a lung transplant patient: A case report and literature review.","authors":"Mercedes Galloway, John Sousou, Tarek Ahmad Zaho, Xu Zeng, Alaa S Awad, Charles W Heilig","doi":"10.5414/CN111596","DOIUrl":"10.5414/CN111596","url":null,"abstract":"Background: BK virus nephropathy (BKVN) in native kidneys following lung transplantation is an exceptionally rare occurrence. This case report highlights a unique instance where BKVN developed in a patient's native kidney post lung transplantation, emphasizing its rarity and the importance of considering BKVN in differential diagnoses for patients presenting with acute kidney injury (AKI) after such transplants.Case presentation: A 67-year-old male patient who had undergone bilateral lung transplantation 3 years prior presented with worsening creatinine levels following an angiogram. The patient's history included no exposure to toxic medications or other known triggers for kidney disease. The worsening renal function was initially investigated through an angiogram, which was followed by the onset of hematuria and a progressive rise in creatinine levels. To determine the cause of the AKI, a kidney biopsy was performed. The biopsy of the left kidney revealed polyoma nephropathy. Confirmatory tests, including positive staining for simian virus 40 (SV40), confirmed the diagnosis of BKVN in the patient's native kidney.Conclusion: The occurrence of BKVN in the native kidney following lung transplantation is a rare phenomenon. This case underscores the necessity of considering BKVN in the differential diagnosis of AKI in patients with a history of lung transplantation. Early recognition and diagnosis are crucial for appropriate management and potential modification of immunosuppressive therapy to prevent further kidney damage.","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316038","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

Diet quality, unprocessed plant-based foods, and vascular function in adults with CKD: Secondary analysis of a pilot randomized clinical trial. 饮食质量、未加工的植物性食物和成人CKD的血管功能：一项试点随机临床试验的二次分析

IF 1.1 4区医学

Clinical nephrology Pub Date : 2025-06-18 DOI: 10.5414/CN111683

Luis Perez, Taylor Struemph, Sridharan Raghavan, Zhiying You, Gregory G Schwartz, Kristen L Nowak, Michel Chonchol, Anna Jovanovich

{"title":"Diet quality, unprocessed plant-based foods, and vascular function in adults with CKD: Secondary analysis of a pilot randomized clinical trial.","authors":"Luis Perez, Taylor Struemph, Sridharan Raghavan, Zhiying You, Gregory G Schwartz, Kristen L Nowak, Michel Chonchol, Anna Jovanovich","doi":"10.5414/CN111683","DOIUrl":"10.5414/CN111683","url":null,"abstract":"Objective: Chronic kidney disease (CKD) is prevalent among Veterans and is strongly associated with cardiovascular disease (CVD) and mortality. Fruit and vegetable intake may help manage CKD and CVD. However, the relationships of dietary intake of kidney-impacting nutrients from plant-based foods with vascular function, oxidation, and inflammation in CKD is uncertain.Materials and methods: We conducted a post-hoc analysis of the Phosphate Lowering in CKD Trial evaluating the association of unprocessed, plant-based energy and nutrient intake with pulse wave velocity (PWV), flow meditated dilation (FMD), and markers of oxidative stress and inflammation. Participants had stage 3b - 4 CKD and serum phosphorus of 2.8 - 5.5 mg/dL. Linear regression models were adjusted for age, sex, body mass index, blood pressure, diabetes, CVD, and kidney function.Results: Participants (n = 42) were aged 66 ± 7 years with estimated glomerular filtration rate 36.2 ± 10.1 mL/min/1.73m2; 88% were male. Diets comprised large proportions of animal and processed foods. Higher daily intake of unprocessed plant-based energy, potassium, phosphorus, and protein were each significantly associated with lower PWV in fully adjusted models: -1.11 cm/s (95% CI: -1.98, -0.25 cm/s), -0.49 cm/s (95% CI: -0.86, -0.12 cm/s), -312.4 cm/s (95% CI: -514.5, -110.3 cm/s), and -280.3 cm/s (95% CI: -484.4, -76.2 cm/s), respectively. However, unprocessed, plant-based nutrient intakes were not associated with FMD or markers of oxidation or inflammation.Conclusion: Despite overall low diet quality, higher consumption of unprocessed, plant-based energy and nutrients was associated with lower arterial stiffness. Future studies are needed to explore these associations in larger cohorts with CKD and the effects of diet quality interventions.","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316039","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

Resolution of acute kidney injury following intensive dialysis for oxalate nephropathy. 草酸肾病强化透析后急性肾损伤的解决。

IF 1.1 4区医学

Clinical nephrology Pub Date : 2025-06-02 DOI: 10.5414/CN111664

John R Roth, Alessia Buglioni, Neera K Dahl

引用次数: 0