Clinical nephrology最新文献

{"title":"Metabolic testing in urinary diversion stone formers.","authors":"Arrsh Bajaj, Jane Li, Amy A Yau","doi":"10.5414/CN111532","DOIUrl":"10.5414/CN111532","url":null,"abstract":"","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":"143514852","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":"In Memoriam Hartmut H. Malluche.","authors":"Peter Sawaya","doi":"10.5414/CNP103157","DOIUrl":"https://doi.org/10.5414/CNP103157","url":null,"abstract":"","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390281","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":"Timing of magnesium supplementation in patients with nephrolithiasis: A randomized controlled trial.","authors":"Adam J Sharbaugh, Omar M Ayyash, Julie M Riley, Timothy D Averch, Michelle J Semins","doi":"10.5414/CN111168","DOIUrl":"10.5414/CN111168","url":null,"abstract":"<p><strong>Background: </strong>Urinary magnesium plays an important role in the prevention of calcium oxalate stone formation, but the role of magnesium supplementation has yet to be clearly defined. We examined the urinary biochemistry of patients taking magnesium supplementation with meals versus while fasting.</p><p><strong>Materials and methods: </strong>This was a single-institution, prospective, randomized controlled pilot study examining magnesium supplementation taken with meals versus while fasting in patients with a history of calcium oxalate stones and isolated hyperoxaluria. Patients were provided a controlled diet and randomized to take magnesium supplementation either fasting or with meals during a 7-day study period. A pre-intervention and post-intervention 24-hour urinalysis was completed for all patients.</p><p><strong>Results: </strong>Eight patients were enrolled with 4 patients randomized to each arm of magnesium supplementation. Those taking magnesium supplementation with meals experienced a median decrease of 17.8 mg/d in urinary oxalate, increase of 33.6 mg/d in urinary magnesium, and increase of 134.8 mg/d in urinary citrate from the pre- to the post-intervention 24-hour urinalysis. Those taking supplementation while fasting experienced an average decrease of 8.5 mg/d in urinary oxalate, increase of 21.8 mg/d in urinary magnesium, and increase of 116.6 mg/d of urinary citrate.</p><p><strong>Conclusion: </strong>Patients with a prior history of calcium oxalate stone formation and isolated hyperoxaluria who took magnesium supplementation with meals were found to have a more substantial improvement in urinary parameters on 24-hour urinalysis compared to those who took magnesium supplementation while fasting. Magnesium supplementation should be taken with meals if prescribed for the prevention of recurrent calcium oxalate nephrolithiasis.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143363968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and factors associated with renal insufficiency in patients with lung cancer: A cross-sectional study.","authors":"Guibao Ke, Yongzhang Huang, Ying Yu, Yonghua Peng, Zongshun Huang, Peilan Zhou, Ping Zhang, Xiaomin Yu, Qianglin Zeng, Xin Xu, Jie Xiao","doi":"10.5414/CN110961","DOIUrl":"10.5414/CN110961","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to determine the prevalence of renal insufficiency in patients with lung cancer and factors associated with its development.</p><p><strong>Materials and methods: </strong>All patients at the First Affiliated Hospital of Guangzhou Medical University from January 1 to December 31, 2016 who had lung cancer were included in this study. Baseline characteristics, including age, sex, clinical features, estimated glomerular filtration rate (eGFR), echocardiographic findings, electrocardiogram results, and biochemical indicators were collected retrospectively. eGFR was divided into three categories: ≥ 60, 45 - 59, and < 45 mL/min/1.73m². Renal insufficiency was defined as eGFR < 60 mL/min/1.73m². The prevalence of co-occurring lung cancer and renal insufficiency as well as factors associated with it were also studied.</p><p><strong>Results: </strong>A total of 140 patients with a lung cancer diagnosis confirmed by pathologic examination were included. The prevalence of eGFR ≥ 60, 45 - 59, and < 45 mL/min/1.73m² categories was 77.14%, 12.14%, and 10.71%, respectively. The lung cancer subtypes were adenocarcinoma (102 cases (72.86%)), squamous cell carcinoma (23 cases (16.43%)), and small cell carcinoma (15 cases (10.71%)). Logistic regression analysis showed that age (odds ratio (OR), 5.522; 95% CI, 2.712 - 11.243; p < 0.001), proteinuria (OR, 4.832; 95% CI, 1.518 - 15.383; p = 0.008), and thyroid-specific transcription factor-1 (TTF-1) positivity (OR, 5.730; 95% CI, 1.509 - 21.754; p = 0.010) were independently associated with eGFR category < 60 mL/min/1.73m2. Age (OR, 2.372; 95% CI, 1.331 - 4.228; p = 0.003) and TTF-1 positivity (OR, 12.791; 95% CI, 3.394 - 49.575; p < 0.001) were independently associated with eGFR category 45 - 59 mL/min/1.73m². Finally, age (OR, 4.083; 95% CI, 1.979 - 8.426; p < 0.001), low albumin (OR, 9.05; 95% CI, 1.335 - 61.349; p = 0.024), and hyperuricemia (OR, 4.974; 95% CI, 1.22 - 20.282; p = 0.025) were independently associated with eGFR category < 45 mL/min/1.73m².</p><p><strong>Conclusion: </strong>Renal function is an important parameter to monitor in patients undergoing lung cancer treatment. The patient's age and presence of proteinuria, low albumin, hyperuricemia, and TTF-1 positivity in lung cancer are all independently associated with renal insufficiency in these patients. To ensure safe recovery and discharge after lung cancer treatment, factors associated with renal insufficiency should be recognized during treatment. Large-scale multicenter trials are warranted for further validation of these findings.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143363966","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 nonlinear correlation between total bilirubin and lumbar spine bone mineral density in patients receiving maintenance hemodialysis.","authors":"Na Zhao, Song-Tao Yang, Xiao-Fang Shen, Yue-Fei Xiao","doi":"10.5414/CN111473","DOIUrl":"10.5414/CN111473","url":null,"abstract":"<p><strong>Background: </strong>Patients receiving maintenance hemodialysis (MHD) are at increased risk of osteoporosis. The effects of bilirubin on bone metabolism vary among different disease populations. However, the relationship between total bilirubin (TBIL) and bone metabolism in MHD has not been investigated yet.</p><p><strong>Materials and methods: </strong>This cross-sectional study included 122 MHD patients aged ≥ 18 years who underwent regular hemodialysis at the Blood Purification Center of Aerospace Central Hospital from April 2021 to April 2023. Blood sampling and bone mineral density (BMD) examinations were conducted. Multivariate linear regression, restricted cubic spline and subgroup analyses were performed to evaluate the association between TBIL and BMD.</p><p><strong>Results: </strong>TBIL (correlation coefficient: 1.7 (0.17, 3.25); p = 0.04) was independently associated with BMD in the multivariate linear regression analysis. The results showed that BMD was nonlinearly related to TBIL in MHD patients, exhibiting a J shaped curve (p = 0.035). When plasma TBIL level < 0.64 mg/dL, there is an average increase of 5.3 (95% CI: 2.0 - 8.7; p = 0.002) g/cm² in BMD for every 1-unit increase in plasma TBIL level. The association between TBIL and BMD was not significant when the plasma TBIL level was ≥ 0.64 mg/dL.</p><p><strong>Conclusion: </strong>The relationship between TBIL and BMD in MHD patients is J-shaped, with an inflection point of 0.64 mg/dL.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142982633","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":"Treating primary membranous nephropathy with extremely high titer of anti-phospholipase A2 receptor antibodies: A case of failed treatment with very high-dose rituximab.","authors":"Jingshu Sun, Shengqin Wu, Fang Yin, Kunying Zhang, Jianying Wang","doi":"10.5414/CN111228","DOIUrl":"10.5414/CN111228","url":null,"abstract":"<p><p>Rituximab (RTX) is the anti-CD20 monoclonal antibody that has been used as the first-line therapy for primary membranous nephropathy (PMN) in recent years. However, the optimal dosing regimen and timing of RTX, or combination with other immunosuppressants, especially in patients with extremely high titers (> 1,000 RU/mL) of anti-PLA2R antibody (aPLA2R), are unclear at present. This report describes the case of a 70-year-old PMN patient with extremely high aPLA2R titer who failed to respond to very high doses of RTX. We also discuss the possible reasons for treatment failure.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":"63-68"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142281353","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":"Nutritional and psychological sequelae of COVID-19 infection in maintenance hemodialysis patients.","authors":"Sara T Ibrahim, Basant M Talaat, Iman E ElGohary, Gihane I Khalil, Dalia A Maharem","doi":"10.5414/CN111369","DOIUrl":"10.5414/CN111369","url":null,"abstract":"<p><strong>Aim: </strong>The risk of infection with COVID-19 in hemodialysis (HD) patients is higher compared to the general population. Additionally, HD patients are at higher risk of developing post-COVID-19 infection sequelae. However, this has not been thoroughly investigated. Therefore, we aimed to study the impact of COVID-19 on nutritional status and psychological health in HD patients 6 months following recovery.</p><p><strong>Materials and methods: </strong>We recruited HD patients who were proven to be infected with COVID-19 and received treatment at two HD units in two institutions between April 2022 and December 2022. Additionally, we enrolled a group of age- and sex-matched HD patients who had not previously been infected with COVID-19 or received vaccination. Nutritional status was assessed using malnutrition inflammation score (MIS), while psychological health was assessed using online questionnaires. The Patient Health Questionnaire 9 (PHQ 9) was employed to assess symptoms of depression, the Generalized Anxiety Disorder 7 (GAD 7) was used to identify anxiety disorders, the Patient Health Questionnaire 15 (PHQ 15) was utilized to measure somatic symptoms, and the Insomnia Severity Index (ISI) was used to measure insomnia.</p><p><strong>Results: </strong>A total of 60 subjects (30 patients and 30 controls) were assessed in the study. We found statistically significant differences between patients and controls regarding the MIS (median score (interquartile range (IQR)); 11 (9 - 12) and 5.5 (5 - 7), respectively), PHQ 15 (median score (IQR); 17.5 (15 - 19) and 9 (6 - 11), respectively), PHQ 9 (median score (IQR); 17 (13 - 19) and 5 (7 - 8), respectively), GAD 7 (median score (IQR); 14 (11 - 16) and 6 (4 - 8), respectively), and ISI (median score (IQR); 20 (15 - 22) and 8 (7 - 11), respectively), with p < 0.001 for all scores.</p><p><strong>Conclusion: </strong>COVID-19 has long-term effects on the psychosocial health of HD patients and may lead to a higher incidence of malnutrition 6 months post recovery.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":"44-52"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307252","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":"Use of bisphosphonates in chronic kidney disease is associated with cardiovascular death.","authors":"Kathleen A Borghoff, Agnes E Ounda, Melissa L Swee, Saket Girotra, Amal A Shibli-Rahhal, Patrick Ten Eyck, Diana I Jalal, Anna J Jovanovich","doi":"10.5414/CN111428","DOIUrl":"10.5414/CN111428","url":null,"abstract":"<p><strong>Background and objectives: </strong>Chronic kidney disease (CKD) is associated with increased cardiovascular risk, which may be mediated by vascular calcification. Based on evidence that bisphosphonates inhibit vascular calcification, we hypothesized use of bisphosphonates in CKD would be associated with lower incident cardiovascular disease (CVD), CVD-related mortality, and all-cause mortality.</p><p><strong>Materials and methods: </strong>This was a longitudinal observational study including 2,593 Framingham Offspring participants. We used propensity score-adjusted Cox regression models to determine the association between bisphosphonate use and outcomes: time to incident CVD, time to CVD-related mortality, and time to all-cause mortality. The data were stratified by presence or absence of CKD, defined as estimated glomerular filtration rate < 60 mL/min/1.73m². The propensity score included age, sex, hypertension, smoking status, diabetes, total cholesterol, high-density lipoprotein, and self-reported history of fracture.</p><p><strong>Results: </strong>In unadjusted and propensity score-adjusted analyses, those with CKD using bisphosphonates had a trend toward increased incident CVD risk (adjusted hazard ratio (HR) 1.66 (95% CI, 93 - 2.97)) compared to those with CKD not using bisphosphonates. Those with CKD using bisphosphonates also had increased risk of cardiovascular mortality in the propensity score-adjusted model (adjusted HR 2.20 (95% CI, 1.12 - 4.32)). There was no significant association between bisphosphonate use and all-cause mortality in participants with CKD. Among individuals without CKD, bisphosphonate use was significantly associated with an increase in all-cause mortality in the propensity-score adjusted analysis (adjusted HR 1.59 (95% CI, 1.27 - 1.98)). However, there was no significant association between bisphosphonate use and incident CVD events (adjusted HR 0.85 95% CI, 0.63 - 1.16) or CVD-related death (adjusted HR 0.70 (95% CI 0.36 - 1.37) in those without CKD.</p><p><strong>Conclusion: </strong>Contrary to our hypothesis, bisphosphonate use was associated with a trend toward increased incident CVD and a two-fold higher risk of CVD mortality in CKD.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":"5-11"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The incidence and prevalence of immunoglobulin A nephropathy in the United States.","authors":"Marc DeCongelio, Sarah N Ali, Martina Furegato, Sandipan Bhattacharjee, Ancilla W Fernandes","doi":"10.5414/CN111489","DOIUrl":"10.5414/CN111489","url":null,"abstract":"<p><strong>Aims: </strong>Reliable national estimates for the incidence and prevalence of immunoglobulin A nephropathy (IgAN) in the United States (U.S.) are needed. We performed a national survey with pathologists and used insurance claims data to estimate IgAN frequency nationwide.</p><p><strong>Materials and methods: </strong>An online survey with pathologists was conducted between November and December 2021 to obtain data on the number and types of biopsies evaluated and the proportion with IgAN confirmed. Biopsy data were extrapolated to two different claims databases to estimate incidence and prevalence. Results were validated against a separate dataset of electronic health records.</p><p><strong>Results: </strong>A total of 43 pathologists from across U.S. regions reported evaluating a mean of 169 kidney biopsies (standard deviation 179.1) in the past 12 months. Of the 7,267 total biopsies evaluated, 632 (8.7%) were IgAN. Based on the respective claims databases, annual incidence rates of 2.1 and 2.2 per 100,000 and prevalence rates of 59.9 and 62.7 per 100,000 were estimated. Results from the validation dataset were similar, with an incidence of 1.9 per 100,000 and prevalence of 54.2 per 100,000.</p><p><strong>Conclusion: </strong>This study estimated incidence and prevalence of IgAN. Extrapolating the findings to the U.S. population for 2021, total prevalence was 198,887 - 208,184 persons.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":"19-25"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11659967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spontaneous remission of de novo membranous nephropathy in post-allogeneic hematopoietic stem cell transplantation patients: A report of two cases.","authors":"Wai Lun Will Pak, Ann Jakubowski, Miguel-Angel Perales, Claudia Michelle Brauer Obrador, Steven Salvatore, Surya Seshan, Ilya Glezerman","doi":"10.5414/CN111431","DOIUrl":"10.5414/CN111431","url":null,"abstract":"<p><p>Membranous nephropathy (MN) is one of the most common de novo glomerular diseases developing in patients after allogeneic hematopoietic stem cell transplantation (HSCT). Most authors have used immunosuppression for its treatment to target the underlying immune-mediated processes, akin to graft-versus-host disease, but the optimal management is currently unclear. Limited reports in the literature described the use of a conservative approach with success, particularly in cases with lower risks of progression, such as non-nephrotic-range proteinuria or early reduction of proteinuria by 6 months. We report two cases of post-HSCT MN with moderate risk features, namely prolonged durations of nephrotic-range proteinuria, that spontaneously resolved with conservative treatment. Patient 1 was of advanced age and in an immunocompromised state, while patient 2 was in need of a greater graft-versus-disease effect from the donor's immune system, which necessitated a balance between the risk of immunosuppression and the risk of progressive kidney function loss. These cases demonstrated that conservative treatment can be a reasonable approach in selected patients with post-HSCT MN, including those with moderate risk.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":"370-374"},"PeriodicalIF":1.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141999509","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}