Clinical nephrology最新文献_第4页

Advances in biomarkers of IgA nephropathy. IgA肾病的生物标志物研究进展

IF 1 4区医学

Clinical nephrology Pub Date : 2026-01-01 DOI: 10.5414/CN111395

Hailang Wei, Fuhua Xie, Runxiu Wang

引用次数: 0

The incidence, risk factors, and outcomes of acute kidney injury after minor lower-limb amputations. 轻度下肢截肢后急性肾损伤的发生率、危险因素和结局。

IF 1 4区医学

Clinical nephrology Pub Date : 2026-01-01 DOI: 10.5414/CN111832

Stefanie Marie Agius, Deborah Balzan, Kevin Cassar, Jesmar Buttigieg

{"title":"The incidence, risk factors, and outcomes of acute kidney injury after minor lower-limb amputations.","authors":"Stefanie Marie Agius, Deborah Balzan, Kevin Cassar, Jesmar Buttigieg","doi":"10.5414/CN111832","DOIUrl":"10.5414/CN111832","url":null,"abstract":"Background and aims: Minor lower-limb amputations are limb and potentially life-saving procedures. However, they are associated with serious adverse events, including acute kidney injury (AKI).Materials and methods: We conducted a single-center retrospective study to determine the incidence of AKI after these procedures, identify risk factors, and assess impact on patient survival.Results: We included 201 patients. AKI occurred in 18.9% using AKIN criteria, and 24.9% using KDIGO criteria. Only 1 patient required temporary dialysis. Patients with AKI were older (73.0 ± 10.4 vs. 68.5 ± 11.8 years, p = 0.033), had a higher incidence of chronic kidney disease (CKD); estimated glomerular filtration rate (eGFR) < 45 mL/min/1.73m2 (39.5 vs. 14.7%, p = 0.001), and/or chronic obstructive pulmonary disease (COPD) (28.9 vs. 13.5% p = 0.028), and higher use of diuretics (68.4 vs. 49.1%, p = 0.049), fluoroquinolones (71.1 vs. 52.8% p = 0.047), and/or carbapenems (10.5 vs. 2.5%, p = 0.043) compared to patients without AKI. eGFR < 45 mL/min/1.73m2 (OR: 3.24, CI: 1.40 - 7.52, p = 0.006), use of fluoroquinolones (OR: 3.19, CI: 1.30 - 7.82, p = 0.012), and day-1 C-reactive protein (CRP) (OR: 1.01, CI: 1.00 - 1.01, p = 0.009) were established as independent risk factors for AKI. Cumulative survival was not significantly lower in patients with AKI (log rank: 0.02, p = 0.88).Conclusion: AKI is a potential complication following minor lower-limb amputations. Age, COPD, diuretics, fluoroquinolones, and carbapenems were associated with increased incidence of AKI. An eGFR < 45 mL/min/1.73m2, day-1 C-reactive protein, and fluoroquinolone use were identified as independent risk factors for AKI.","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":"39-47"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145336770","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 risk factors related to osteoporosis in maintenance hemodialysis patients. 维持性血液透析患者骨质疏松相关危险因素分析。

IF 1 4区医学

Clinical nephrology Pub Date : 2026-01-01 DOI: 10.5414/CN111686

Jinzhi Li, Yanping Hu, Yuting Yang, Dingyun Lin, Xinhua He, Lianying Hu, Yu Wang

{"title":"Analysis of risk factors related to osteoporosis in maintenance hemodialysis patients.","authors":"Jinzhi Li, Yanping Hu, Yuting Yang, Dingyun Lin, Xinhua He, Lianying Hu, Yu Wang","doi":"10.5414/CN111686","DOIUrl":"10.5414/CN111686","url":null,"abstract":"Introduction: This study is a retrospective analysis of patients undergoing maintenance hemodialysis (MHD) at our institution. The objective is to assess bone density and the prevalence of osteoporosis among these patients, as well as to analyze associated risk factors.Materials and methods: A total of 131 MHD patients undergoing regular dialysis treatment at our hemodialysis center from September 2022 to December 2023 were included, and bone mineral density (BMD) values of lumbar spine (L1 - L3) of the patients were measured using QCT. Data were analyzed using the SPSS computer software version 26.0 to assess the relationship between BMD and clinical biochemical parameters in end-stage renal disease patients.Results: We found that of the 131 patients included, 82 were males and 49 were females, with a male to female ratio of 1.67 : 1, age 56.92 ± 13.37 years, and dialysis age of 24 (12 - 60) months. In the overall population, 25 cases (19.1%) were osteoporotic, 45 cases (34.4%) had low bone mass, and 61 cases (46.56%) had normal bone mass. Regarding risk factors, BMD was significantly negatively correlated with age (β = -1.788, p < 0.001), hypertension (β = -21.605, p = 0.018) and significantly positively correlated with total iron-binding capacity (β = 0.803, p = 0.01). Further logistics regression showed that age, decreased total iron binding, calcium-phosphorus product, and intact parathyroid hormone (iPTH) ≥ 300 pg/mL were independent risk factors for osteoporosis in MHD patients.Conclusion: Abnormal BMD is prevalent in patients with MHD. Age, decreased total iron binding capacity, calcium-phosphorus product, and iPTH ≥ 300 pg/mL are independent risk factors for the development of osteoporosis in patients undergoing maintenance hemodialysis.","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":"1-11"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145480809","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

Prevalence and associated factors of hypertension and major adverse cardiovascular events in lupus nephritis in sub-Saharan Africans. 撒哈拉以南非洲地区狼疮性肾炎患者高血压和主要不良心血管事件的患病率及相关因素

IF 1 4区医学

Clinical nephrology Pub Date : 2026-01-01 DOI: 10.5414/CN111720

Mansour Mbengue, Mbéne Dieng Kébé, Jatt Tsahabayembi, Serigne Fall, Idrissa Sall, Cheikh M F Kitane, Niakhaleen Keita, Maria Faye, Ahmed Tall Lemrabott, El Hadji Fary Ka, Abdou Niang

{"title":"Prevalence and associated factors of hypertension and major adverse cardiovascular events in lupus nephritis in sub-Saharan Africans.","authors":"Mansour Mbengue, Mbéne Dieng Kébé, Jatt Tsahabayembi, Serigne Fall, Idrissa Sall, Cheikh M F Kitane, Niakhaleen Keita, Maria Faye, Ahmed Tall Lemrabott, El Hadji Fary Ka, Abdou Niang","doi":"10.5414/CN111720","DOIUrl":"10.5414/CN111720","url":null,"abstract":"Introduction: The prevalence of hypertension in lupus nephritis varies according to studies and can be as high as 74%. The aim of this study was to determine the prevalence of hypertension in lupus nephritis and to search for factors associated with hypertension and the occurrence of major adverse cardiovascular events (MACE).Materials and methods: This was a multicenter, retrospective, descriptive, and analytical study over a 10-year period from January 1, 2012, to December 31, 2022. It targeted patients followed for lupus nephritis confirmed by anatomo-pathological examination in three nephrology departments in Dakar. We compared hypertensive and non-hypertensive patients to identify hypertension-associated factors.Results: During the study period, 73 cases of lupus nephritis were collected. In the study population, the mean age was 33.90 years, with a sex ratio of 0.30. The prevalence of hypertension was 40.1%. 23 patients were class III, 25 class IV, and 19 class V. Among hypertensive patients, mean creatinine was 33.7 mg/L, and renal failure was present in 56.66% of patients. Mean proteinuria was 5.42 g/24h. Hypertension-associated factors were age (OR = 1.15, 95% CI: 1.05 - 2.25; p = 0.001), renal failure (OR = 12.872, 95% CI: 2.23 - 74.28; p = 0.004), and proliferative class (OR = 18.83, 95% CI: 1.91 - 185.25; p = 0.012). For the cardiovascular events, there were 3 cases of stroke, 0 cases of heart attack, and 0 cardiovascular deaths.Conclusion: Hypertension in lupus nephritis is common in our setting. Hypertension-associated factors were related to advanced age and severity of lupus nephritis. Long-term follow-up would be necessary to better detect cardiovascular events.","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":"12-18"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145336830","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

Genetic variation in targets of roxadustat and risk of common cancers: A Mendelian randomization analysis. 罗沙他靶基因变异与常见癌症风险：孟德尔随机化分析。

IF 1 4区医学

Clinical nephrology Pub Date : 2026-01-01 DOI: 10.5414/CN111790

Xiaona He, Hongxi Chen, Yue Qi, Wenjie Long, Yangang Zhou, Xin Ma

{"title":"Genetic variation in targets of roxadustat and risk of common cancers: A Mendelian randomization analysis.","authors":"Xiaona He, Hongxi Chen, Yue Qi, Wenjie Long, Yangang Zhou, Xin Ma","doi":"10.5414/CN111790","DOIUrl":"10.5414/CN111790","url":null,"abstract":"Background: Roxadustat is used for treating chronic kidney disease (CKD) patients, particularly those on hemodialysis with comorbid cancer. Some studies suggest a link between roxadustat and cancer progression, but the mechanisms remain unclear, highlighting the need for further investigation into potential causal links.Materials and methods: We employed a two-sample Mendelian randomization (MR) analysis to explore associations between genetic variations in Roxadustat targets and 14 cancer types. Single-nucleotide polymorphisms (SNPs) in the Egl-9 family hypoxia inducible factor 1 (EGLN1) and Egl-9 family hypoxia inducible factor 2 EGLN2 genes, related to hemoglobin levels, were chosen as instrumental variables. Analyses used inverse variance-weighted (IVW)-MR and summary data-based MR (SMR) approaches, assessing horizontal pleiotropy with Mendelian randomization Egger (MR-Egger) and Mendelian Randomization Pleiotropy RESidual Sum and Outlier (MR-PRESSO), and using the heterogeneity in dependent instrumental variables (HEIDI) test for SMR.Results: Summary statistics were derived from three UK studies involving 172,925 individuals. IVW-MR revealed a positive association between EGLN1 variants and breast cancer (OR = 1.644) and lung adenocarcinoma (OR = 2.117), while negative associations were found for malignant non-melanoma skin cancer and kidney cancer. SMR confirmed the links to breast cancer and a decrease in skin cancer risk. EGLN2 expression was positively associated with prostate and lung cancers and negatively with estrogen receptor (ER)- breast and brain cancers.Conclusion: Our findings support a potential causal relationship between the inhibition of EGLN1 and EGLN2 and the development of specific cancer types.","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":"26-38"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145444202","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

Thomas Willis (1621 - 1675): First steps into kidney function. 托马斯·威利斯（1621 - 1675）：研究肾脏功能的第一步。

IF 1 4区医学

Clinical nephrology Pub Date : 2026-01-01 DOI: 10.5414/CN111802

Livia Ann Frost, Garabed Eknoyan

{"title":"Thomas Willis (1621 - 1675): First steps into kidney function.","authors":"Livia Ann Frost, Garabed Eknoyan","doi":"10.5414/CN111802","DOIUrl":"10.5414/CN111802","url":null,"abstract":"This review analyzes the pivotal but underrecognized contribution of Thomas Willis (1621 - 1675) to the foundations of kidney function in the 17th century. By comparing his early work De Urinis (1659), which interpreted urinary diagnosis through humoral traditions, with his subsequent Pharmaceutice Rationalis (1674 - 1675) we document a paradigm shift: progress from considering the kidney a passive filter to proposing it as an active regulatory organ that balanced urinary salts through tubular function. Building on the cardiac pump and blood circulation model of William Harvey and the tubular structure of the kidney of Lorenzo Bellini, Willis rejected the Galenic physiology that the kidney attracted blood because it was in its nature to do so in favor of a mechanical model of \"straining or percolation\" driven by the force of circulating blood. Willis also considered diabetes a blood disorder rather than a kidney disease, noting that diabetic urine differed from imbibed fluids being sweet \"as it were imbued with Honey or Sugar\". These conceptual advances - developed without microscopic evidence or chemical analysis - reveal a remarkable inductive reasoning. Documented by subsequent observations, Willis' work established three critical principles: the blood-clearing function of the kidney depends on circulatory dynamics, tubules modify urine composition, and urinary changes reflect systemic physiology rather than just renal pathology. His renal model, though incomplete, provided the first systematic framework for homeostasis that would be developed in the 19th century. His writings clearly mark the initial but fundamental first steps in the evolution of our current understanding of kidney function.","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":"74-81"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145336801","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; 103: 200-212. 临床尼弗罗尔。2025；103: 200 - 212。

IF 1 4区医学

Clinical nephrology Pub Date : 2026-01-01 DOI: 10.5414/CN111509Cor

Chen-Li Li, Yu-Qian Jiang, Wei Pan, Yan-Li Yang

引用次数: 0

Renal manifestations of immune checkpoint inhibitors in the pediatric population. 免疫检查点抑制剂在儿科人群中的肾脏表现。

IF 1 4区医学

Clinical nephrology Pub Date : 2026-01-01 DOI: 10.5414/CN111756

Lydia Noh, Matthew Satariano, Jieji Hu, Elena Levtchenko, Rupesh Raina

{"title":"Renal manifestations of immune checkpoint inhibitors in the pediatric population.","authors":"Lydia Noh, Matthew Satariano, Jieji Hu, Elena Levtchenko, Rupesh Raina","doi":"10.5414/CN111756","DOIUrl":"10.5414/CN111756","url":null,"abstract":"Background: Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment and have become an essential part of therapy, but their use is associated with immune-related adverse events (irAE). Specifically, nephrotoxicity is well documented in adult populations but data regarding irAEs are limited in pediatric populations. This review examines the renal manifestations of ICIs and relevant clinical measures and treatments.Materials and methods: A comprehensive review of existing literature was conducted to assess the incidence, pathophysiology, and management of ICI-associated renal injuries in pediatric and adult populations.Results: The most common renal irAE associated with ICIs is acute kidney injury; however, ICIs have been implicated in transplant rejection and electrolyte disturbances including hyponatremia, hyperkalemia, hypophosphatemia, and metabolic acidosis. Pediatric ICI manifestation patterns are similar to those in adults, but research suggests earlier onset compared to adults. Though corticosteroids are the primary treatment for irAEs, standardized pediatric management guidelines require further improvement.Conclusion: ICIs carry concerning risks in pediatric populations, yet research in this area is lacking. This warrants further research into the recognition, treatment, and prevention of renal irAEs, particularly for the improvement of long-term outcomes.","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":"56-73"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145343763","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

Feasibility of nephrology electronic consults in an inner-city population. 肾病电子会诊在市中心人群中的可行性。

IF 1 4区医学

Clinical nephrology Pub Date : 2026-01-01 DOI: 10.5414/CN111771

Ewalola Ayo Ijaduola, Alexander Quarshie, Chamberlain Obialo

{"title":"Feasibility of nephrology electronic consults in an inner-city population.","authors":"Ewalola Ayo Ijaduola, Alexander Quarshie, Chamberlain Obialo","doi":"10.5414/CN111771","DOIUrl":"10.5414/CN111771","url":null,"abstract":"Background: In the United States (U.S.), economically disadvantaged populations have reduced access to subspecialty care. To improve accessibility to nephrology care early in the clinical course of chronic kidney disease (CKD), we designed a feasibility pilot study for electronic consults (eCons).Materials and methods: This retrospective cohort study evaluated eCons referral patterns, patient demographics, comorbidities, and rates of in-person visits following eCons. Our suggested referral criteria included CKD stages 1 - 3a with a urine albumin-creatinine ratio (UACR) < 300 mg/g, resistant hypertension, abnormal kidney imaging or urine sediment, electrolyte abnormalities, and nephrolithiasis.Results: A total of 103 patients completed eCons over a 12-month period. 98% self-identified as African Americans, and 2% as Caucasians. The rates of subsequent in-person visits for patients with CKD stages 2, 3a, 3b, 4, and 5 were 5/9 (56%), 8/28 (29%), 34/38 (90%), 11/14 (79%), and 9/9 (100%), respectively. Among the 103 patients, 40 (39%) had macroalbuminuria (UACR > 300 mg/g), and 51 (50%) had diabetes mellitus. The rates of subsequent in-person visits for patients with macroalbuminuria and diabetes mellitus were 87.5% and 76%, respectively. Patients with macroalbuminuria had greater odds of subsequent in-person visits than did those without macroalbuminuria, adjusted for age and sex (AOR, 6.15; 95% confidence interval (CI), 2.08 - 18.16; p = 0.001). Patients with diabetes mellitus were also more likely to have subsequent in-person visits than were those without diabetes mellitus (OR, 2.38; 95% CI, 1.02 - 5.57; p = 0.04).Conclusion: Electronic consultations are beneficial in the early CKD stages and in patients without diabetes or macroalbuminuria. In addition, both macroalbuminuria and diabetes influence the need for subsequent in-person evaluation.","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":"19-25"},"PeriodicalIF":1.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145336803","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

Rituximab for double-positive anti-GBM antibody and ANCA-associated glomerulonephritis: The first reported case in Asia and literature review. 利妥昔单抗治疗双阳性抗gbm抗体和anca相关性肾小球肾炎：亚洲首例报道病例和文献综述。

IF 1 4区医学

Clinical nephrology Pub Date : 2025-12-01 DOI: 10.5414/CN111588

Chang-Ying Chen, Ying-Ren Chen, Wei-Ren Lin, Wei-Hung Lin

{"title":"Rituximab for double-positive anti-GBM antibody and ANCA-associated glomerulonephritis: The first reported case in Asia and literature review.","authors":"Chang-Ying Chen, Ying-Ren Chen, Wei-Ren Lin, Wei-Hung Lin","doi":"10.5414/CN111588","DOIUrl":"10.5414/CN111588","url":null,"abstract":"Background: Double-positive patients exhibit both anti-glomerular basement membrane antibody and anti-neutrophil cytoplasmic antibody. Its initial treatment includes induction cyclophosphamide, glucocorticoids, and plasmapheresis, followed by maintenance therapy similar to that for anti-neutrophil cytoplasmic antibody-associated vasculitis. However, some patients suffer from refractoriness and intolerance to cyclophosphamide, creating an unmet need for second-line therapy. Moreover, no guidance has been provided on the choice of immunosuppressant agents for maintenance therapy.Case presentation: A 55-year-old Asian woman presented with post-prandial vomiting and a persistent high fever for 1 month. She was diagnosed as a double-positive patient after developing rapidly progressive glomerulonephritis, with a creatinine level of 332 μmol/L. She received induction therapy with cyclophosphamide, glucocorticoids, and plasmapheresis soon after diagnosis. However, worsening renal function and severe nausea and vomiting occurred after 3 monthly doses of cyclophosphamide. Four weekly doses of re-induction rituximab at 375 mg/m2, followed by maintenance rituximab 500 mg every 6 months, were administered. The patient had a stable creatinine level of 208 μmol/L 17 months after diagnosis.Conclusion: Rituximab may be a viable alternative as an induction therapy for double-positive patients when first-line cyclophosphamide is not effective or is not tolerated. Moreover, rituximab may be an effective maintenance therapy for double-positive patients. This case study demonstrates not only the efficacy of rituximab in double-positive patients but also reports the first Asian case of the disorder treated successfully with rituximab.","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":"434-439"},"PeriodicalIF":1.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079686","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