Clinical nephrology最新文献

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Kidney function, bone health, and vascular calcifications in patients with CKD II - IV: A 2 - 3 year prospective study with bone biopsies. CKD II - IV患者的肾功能、骨骼健康和血管钙化:一项伴有骨活检的2 - 3年前瞻性研究
IF 1.1 4区 医学
Clinical nephrology Pub Date : 2025-02-01 DOI: 10.5414/CN111603
Hartmut H Malluche, Qi Qiao, Florence Lima, Jin Chen, Mohamed Issa, David Pienkowski
{"title":"Kidney function, bone health, and vascular calcifications in patients with CKD II - IV: A 2 - 3 year prospective study with bone biopsies.","authors":"Hartmut H Malluche, Qi Qiao, Florence Lima, Jin Chen, Mohamed Issa, David Pienkowski","doi":"10.5414/CN111603","DOIUrl":"10.5414/CN111603","url":null,"abstract":"<p><strong>Background: </strong>Patients with chronic kidney disease (CKD) have serum, bone, and vascular abnormalities presenting as chronic kidney disease-mineral bone disorder (CKD-MBD) syndrome. This study sought to identify the parameters with the greatest relative impact on progression of CKD-MBD abnormalities.</p><p><strong>Materials and methods: </strong>This prospective study measured 237 parameters including serum markers, clinical variables, dual-energy X-ray absorptiometry (DXA) measurements, vascular calcifications, and histomorphometric results from bone samples obtained at baseline and after 2 - 3 years. Relative impact of these parameters on kidney function, bone changes, and vascular calcification were assessed using machine learning, a subset of artificial intelligence analyses.</p><p><strong>Results: </strong>Baseline estimated glomerular filtration rate (eGFR) values ranged from 18 to 70 mL/min and declined in 52% of subjects by at least 3.3% annually during the study. These declines in eGFR were associated with changes in specific serum markers, bone quantity decreases, and bone quality alterations, but not with arterial calcifications. Arterial calcifications were associated with collagen crosslinking heterogeneity, serum phosphorus, diuretics and atorvastatin treatment, but not with kidney function. Baseline collagen crosslinking heterogeneity was an important factor impacting progression of coronary, but not aortic calcification. Baseline serum phosphorus was a factor primarily associated with progression of aortic calcification.</p><p><strong>Conclusion: </strong>Machine learning revealed specific bone and vascular abnormalities occurring early during loss of kidney function. Bone, vascular, blood, medication use, and other parameters were identified impacting the presence and progression of arterial calcification and altering bone quality and quantity in this understudied patient population. Serum phosphorus levels considered normal impacted progression of arterial calcification. Identification of these parameters and their relative importance enhances our understanding of CKD progression and should improve patient care.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":"71-85"},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142964045","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
Application of artificial intelligence and machine learning for risk stratification acute kidney injury among hematopoietic stem cell transplantation patients: PCRRT ICONIC AI Initiative Group Meeting Proceedings. 应用人工智能和机器学习对造血干细胞移植患者的急性肾损伤进行风险分层:PCRRT ICONIC人工智能倡议小组会议论文集。
IF 1.1 4区 医学
Clinical nephrology Pub Date : 2025-02-01 DOI: 10.5414/CN111421
Rupesh Raina, Kush Doshi, Pushan Aggarwal, Parker Kim, Jonathan Sasse, Sidharth Sethi, Carolyn Abitbol, Rolla Abu-Arja, Kianoush Kashani
{"title":"Application of artificial intelligence and machine learning for risk stratification acute kidney injury among hematopoietic stem cell transplantation patients: PCRRT ICONIC AI Initiative Group Meeting Proceedings.","authors":"Rupesh Raina, Kush Doshi, Pushan Aggarwal, Parker Kim, Jonathan Sasse, Sidharth Sethi, Carolyn Abitbol, Rolla Abu-Arja, Kianoush Kashani","doi":"10.5414/CN111421","DOIUrl":"10.5414/CN111421","url":null,"abstract":"<p><p>Acute kidney injury (AKI) is a frequent, severe complication of hematopoietic stem cell transplantation (HSCT) and is associated with an increased risk of morbidity and mortality. Recent advances in artificial intelligence (AI) and machine learning (ML) have showcased their proficiency in predicting AKI, projecting disease progression, and accurately identifying underlying etiologies. This review examines the central aspects of AKI post-HSCT, veno-occlusive disease (VOD) in HSCT recipients, discusses present-day applications of artificial intelligence in AKI, and introduces a proposed ML framework for the early detection of AKI risk.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":"129-139"},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616145","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
Clinical factors associated with hospital mortality in critically ill adult COVID-19 patients with AKI requiring CRRT: A multicenter study. 需要进行 CRRT 的 COVID-19 重症成人 AKI 患者住院死亡率的相关临床因素:一项多中心研究。
IF 1.1 4区 医学
Clinical nephrology Pub Date : 2025-02-01 DOI: 10.5414/CN111404
Augusto Cama-Olivares, Ashutosh Tamhane, Victor Ortiz-Soriano, Douglas Farrell, Huei Hsun Wen, Tomonori Takeuchi, Patel Devansh, Francesco Galasso, Jin Chen, Lili Chan, Ashita J Tolwani, Girish N Nadkarni, Javier A Neyra
{"title":"Clinical factors associated with hospital mortality in critically ill adult COVID-19 patients with AKI requiring CRRT: A multicenter study.","authors":"Augusto Cama-Olivares, Ashutosh Tamhane, Victor Ortiz-Soriano, Douglas Farrell, Huei Hsun Wen, Tomonori Takeuchi, Patel Devansh, Francesco Galasso, Jin Chen, Lili Chan, Ashita J Tolwani, Girish N Nadkarni, Javier A Neyra","doi":"10.5414/CN111404","DOIUrl":"10.5414/CN111404","url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury (AKI) is a common complication of critically ill COVID-19 patients which is associated with adverse outcomes. We examined clinical factors associated with hospital mortality in critically ill adult COVID-19 patients with AKI who required continuous renal replacement therapy (CRRT).</p><p><strong>Materials and methods: </strong>We conducted a multicenter retrospective cohort study including data from two large academic medical centers. Adult (age ≥ 18 years) patients with AKI and requiring CRRT admitted from March 2020 to April 2021 were included in the study. Patients with end-stage kidney disease or renal transplantation were excluded. Multivariable Poisson regression analyses were used to identify clinical predictors of hospital mortality.</p><p><strong>Results: </strong>A total of 178 patients were included. Patients were predominantly men (68.2%), 13.1% were Black, and 57.9% White. Median hospital and ICU length of stay were 20 days and 14 days, respectively. Mechanical ventilation and extracorporeal membrane oxygenation were utilized in 97.2% and 17.4% of patients, respectively. Overall, 130 (73.0%) patients died in the hospital (mortality rate of 2.7 per 100 person-days). In multivariable analyses, SOFA score ≥ 12 at ICU admission (MRRadj = 1.88; 95% CI 1.17 - 3.01) was associated with increased risk of mortality, while Black race (MRRadj = 0.56; 95% CI 0.31 - 1.01) was associated with a decreased risk of mortality.</p><p><strong>Conclusion: </strong>More than two-thirds of critically ill adult COVID-19 patients with AKI requiring CRRT died during hospitalization. SOFA score ≥ 12 at ICU admission was an independent predictor of hospital mortality, and Black patients had a lower risk of mortality.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":"96-107"},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142674988","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
Peritoneal dialysis-related complication: Can diagnostic accuracy be achieved at low iodinated contrast media dose using dual-layer spectral detector CT? 腹膜透析相关并发症:使用双层光谱探测器 CT,能否在低碘造影剂剂量下实现诊断准确性?
IF 1.1 4区 医学
Clinical nephrology Pub Date : 2025-02-01 DOI: 10.5414/CN111478
Jiao Bai, Yu Zhang, Fang Wang, Linwang Gan, Dongmei Zhao, Jian Shu
{"title":"Peritoneal dialysis-related complication: Can diagnostic accuracy be achieved at low iodinated contrast media dose using dual-layer spectral detector CT?","authors":"Jiao Bai, Yu Zhang, Fang Wang, Linwang Gan, Dongmei Zhao, Jian Shu","doi":"10.5414/CN111478","DOIUrl":"10.5414/CN111478","url":null,"abstract":"<p><strong>Introduction: </strong>Computed tomography peritoneography (CTp) is pivotal for evaluating peritoneal dialysis (PD)-related complications, yet it comes with drawbacks, specifically exposure to iodinated contrast media (ICM). This study aimed to explore the feasibility of reducing ICM dosage utilizing spectral detector CT (SDCT).</p><p><strong>Materials and methods: </strong>35 rabbits were strategically divided into 7 groups (A - G) according to the ICM concentration ratio in the injection protocol, with respective doses of 10, 15, 20, 25, 30, 40, and 50 mL/2L. The CTp injection protocol involved a 300-mL mixture of non-ionic ICM omnipaque (350 mgI/mL) and peritoneal dialysate (1.5% lactate, 2 L), followed by scans using dual-layer SDCT. Virtual monoenergetic images (VMIs) at 4 distinct energy levels (40 - 70 keV, in 10-keV steps), iodine maps (IMs), and effective atomic number (Zeff) maps were subsequently reconstructed. Both quantitative and qualitative image assessments were conducted, and the parameters from these analyses were compared across images from groups A - G and traditional 50 mL/2L 120-kVp images. In post-determination of the optimal concentration and reconstructions, we illustrated their applications in patients with suspected PD-related complications.</p><p><strong>Results: </strong>The quantitative image quality (IQ) of 15 mL/2L VMIs at 40 keV surpassed that of the 50 mL/2L 120-kVp images (p < 0.05). Furthermore, the diagnostic performance utilizing 15 mL/2L VMIs40 keV, when combined with IMs and Zeff maps, was found to be optimal.</p><p><strong>Conclusion: </strong>The employment of SDCT in CTp allows for a substantial reduction in the ICM dose by 70%, compared to the benchmark concentration of 50 mL/2L, without compromising diagnostic precision.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":"108-115"},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142674978","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 hemodialysis patient unable to walk - brown tumor as the culprit: Case report and review of the literature. 1例血液透析患者不能行走——棕色肿瘤为罪魁祸首:病例报告及文献复习。
IF 1.1 4区 医学
Clinical nephrology Pub Date : 2025-02-01 DOI: 10.5414/CN111469
Guangyan Nie, Ting Bao, Deguang Wang, Xuerong Wang
{"title":"A hemodialysis patient unable to walk - brown tumor as the culprit: Case report and review of the literature.","authors":"Guangyan Nie, Ting Bao, Deguang Wang, Xuerong Wang","doi":"10.5414/CN111469","DOIUrl":"10.5414/CN111469","url":null,"abstract":"<p><strong>Introduction: </strong>Brown tumors are benign lesions caused by hyperparathyroidism and characterized by increased osteoclast activity and mass effect, which can lead to paraplegia when the spine is involved. Secondary hyperparathyroidism is common in patients on long-term hemodialysis therapy.</p><p><strong>Case report: </strong>We report the case of a 48-year-old man on regular dialysis who presented with leg weakness as well as back pain and was diagnosed with secondary hyperparathyroidism and thoracic spine tumor. Since the spinal cord was compressed, T12 mass excision combined with spinal canal decompression was performed under general anesthesia. Post-operative pathology demonstrated abundant fibrovascular tissue and osteoclast-like multinucleated giant cells with hemorrhage and hemosiderin pigment deposition. The patient was diagnosed with brown tumor. Following operation, the patient recovered well. He remains on regular hemodialysis with follow-ups and unaffected activities 10 years later.</p><p><strong>Discussion: </strong>In dialysis patients with combined spinal tumors, brown tumors should be considered. For patients presenting with symptoms of spinal cord compression, surgical resection can lead to a favorable prognosis.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":"148-156"},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142779507","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 protective powers of L-theanine against drug-induced kidney damage. 左旋茶氨酸对药物性肾损伤的保护作用
IF 1.1 4区 医学
Clinical nephrology Pub Date : 2025-02-01 DOI: 10.5414/CN111549
Yahya Altinkaynak, Elizaveta Burenkova, Akcan Buket
{"title":"The protective powers of L-theanine against drug-induced kidney damage.","authors":"Yahya Altinkaynak, Elizaveta Burenkova, Akcan Buket","doi":"10.5414/CN111549","DOIUrl":"10.5414/CN111549","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Drug-induced kidney damage (DIKD) is a significant medical concern linked to many drugs, including nonsteroidal anti-inflammatory drugs, antibiotics, and chemotherapy agents, due to its complex pathophysiology. L-theanine, a tea leaf amino acid, is explored for its protective effects against DIKD, considering its cognitive and calming benefits.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;In the theoretical part of the article, the role of L-theanine in combating DIKD is reviewed, highlighting its ability to mitigate oxidative stress and inflammation by neutralizing reactive oxygen species, enhancing antioxidant defenses, and modulating anti-inflammatory pathways. L-theanine's influence on cell signaling and its synergy with other nephroprotective agents are discussed. The practical part describes an experimental study using a murine model, where 60 male C57BL/6 mice were divided into four groups: a control group, a nephrotoxic group treated with cisplatin, and two treatment groups that received L-theanine either before or after cisplatin administration. Serum biomarkers (creatinine and blood urea nitrogen (BUN)), histopathological kidney damage scores, and oxidative stress markers (malondialdehyde (MDA) and superoxide dismutase (SOD)) were measured.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Evidence from the murine study indicates that L-theanine protects against DIKD through antioxidative, anti-inflammatory, and anti-apoptotic mechanisms, potentially enhancing its synergy with other nephroprotective agents. In the nephrotoxic group (N), serum creatinine and BUN levels were significantly elevated, while pre-treatment with L-theanine (LTP) reduced these levels to 1.2 ± 0.3 mg/dL and 34 ± 4 mg/dL, respectively. Histopathological analysis revealed severe tubular necrosis in the N group (score: 3.8 ± 0.3), which was significantly reduced in the LTP group (1.6 ± 0.4). Oxidative stress markers, such as MDA, were markedly lowered in the LTP group compared to the N group, with corresponding increases in SOD activity, indicating enhanced antioxidant defense. These findings underscore L-theanine's potential in preserving renal health amidst pharmacotherapy-induced toxicity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;L-theanine emerges as a promising nephroprotective agent, particularly in the context of increasing incidence of DIKD and the associated challenges in clinical management. The practical findings from this study in a murine model provide compelling evidence that L-theanine significantly reduces serum biomarkers of renal injury, attenuates tubular necrosis, and mitigates oxidative stress, with pronounced effects observed when administered as a pre-treatment. While these results are promising, the predominance of preclinical data underscores the need for rigorous human studies to validate L-theanine's efficacy and safety in the prevention of drug-related renal injuries. Such research is crucial for advancing renal protection strate","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":"116-128"},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142738560","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
B cell-driven reduced-dose rituximab as induction therapy for 2 patients with ANCA-associated renal vasculitis: A case series. B细胞驱动的小剂量利妥昔单抗诱导治疗2例anca相关性肾血管炎:病例系列
IF 1.1 4区 医学
Clinical nephrology Pub Date : 2025-02-01 DOI: 10.5414/CN111372
Qinglian Wang, Simeng Wang, Xiang Liu, Fajuan Cheng, Ying Xu
{"title":"B cell-driven reduced-dose rituximab as induction therapy for 2 patients with ANCA-associated renal vasculitis: A case series.","authors":"Qinglian Wang, Simeng Wang, Xiang Liu, Fajuan Cheng, Ying Xu","doi":"10.5414/CN111372","DOIUrl":"10.5414/CN111372","url":null,"abstract":"<p><strong>Objective: </strong>Antineutrophil cytoplasmic antibody (ANCA) associated vasculitis (AAV), a multisystem autoimmune disorder, deteriorates small vessels. Kidney involvement occurs in most affected patients and is the most common cause of rapidly progressive glomerulonephritis (RPGN). Rituximab (RTX), an anti-CD20 antibody, has been used in the induction and maintenance therapy of AAV as a non-inferior alternative to cyclophosphamide. Administration of 4 once-weekly doses of 375 mg/m<sup>2</sup> is the common dose in remission induction therapy, referred to as a conventional regimen. Recently, it was shown that the cumulative complete remission (CR) rates did not differ between low-dose RTX (2 once-weekly doses of 375 mg/m<sup>2</sup>) and the conventional RTX regimen. We aimed to explore the effect of the B cell-driven RTX dosing regimen.</p><p><strong>Case reports: </strong>Herein, we reported B cell-driven reduced-dose RTX therapies in a 71-year-old male de novo patient (case 1) and a 60-year-old female patient (case 2). Case 1, de novo diagnosed based on kidney biopsy, received 3 once-semimonthly doses of 300 mg RTX as induction therapy. Case 2, who was clinically diagnosed with ANCA-associated renal vasculitis 4 years before receiving treatment at our hospital, accepted 4 once-monthly doses of 300 mg RTX as induction therapy. Further dosages were dependent on peripheral CD19+ B-cell levels.</p><p><strong>Results: </strong>During the course of treatment, peripheral B-cell counts of both patients turned 0, and symptoms of both patients improved, complete remission occurred in case 1, with a Birmingham vasculitis activity score (BVAS) of 0.</p><p><strong>Conclusion: </strong>B cell-driven reduced-dose RTX might be also effective in induction therapy for AAV. Further study is warranted to confirm the efficacy, safety, and risk of relapse of a reduced-dose RTX regimen.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":"140-147"},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142779509","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
Correlation between indole-3-acetic acid and left ventricular hypertrophy in hemodialysis patients. 血液透析患者吲哚-3-乙酸与左心室肥厚之间的相关性。
IF 1.1 4区 医学
Clinical nephrology Pub Date : 2025-02-01 DOI: 10.5414/CN111299
Zhihua Lu, Wei Su, Ping Fan, Jiangtao Zhu, Cheng Chen
{"title":"Correlation between indole-3-acetic acid and left ventricular hypertrophy in hemodialysis patients.","authors":"Zhihua Lu, Wei Su, Ping Fan, Jiangtao Zhu, Cheng Chen","doi":"10.5414/CN111299","DOIUrl":"10.5414/CN111299","url":null,"abstract":"<p><strong>Background: </strong>Among hemodialysis patients, left ventricular hypertrophy (LVH) is a prevalent cardiac abnormality. The uremic toxin indole-3-acetic acid (IAA) is elevated in uremia patients, but the connection between IAA and LVH in individuals undergoing hemodialysis remains uncertain. Hence, the objective of this research was to examine the correlation between blood IAA levels and LVH in individuals undergoing hemodialysis.</p><p><strong>Materials and methods: </strong>In total, 205 individuals undergoing hemodialysis were chosen and categorized into two groups, with (143 patients) and without LVH (62 patients). Patient clinical data were collected, and serum creatinine, calcium, phosphorus, hemoglobin, and IAA levels were measured.</p><p><strong>Results: </strong>Compared to the non-LVH group, the LVH group had higher IAA and serum phosphorus but lower hemoglobin. The serum IAA concentration was positively correlated with both left ventricular mass (LVM) and left ventricular mass index (LVMI) but negatively correlated with both left ventricular ejection fraction (LVEF) and the ratio of left ventricular transmitral early peak flow velocity to left ventricular transmitral late peak flow velocity (E/A). Logistic regression analysis indicated that increased IAA levels are a risk factor for LVH and are not influenced by other factors. In addition, we exposed primary neonatal cultured mouse cardiomyocytes to varying concentrations of IAA in a controlled environment. Cardiomyocyte hypertrophy was induced by IAA in a concentration-dependent manner.</p><p><strong>Conclusion: </strong>Serum IAA is correlated with alterations in both the function and structure of the left ventricle. The serum IAA concentration is an independent risk factor for LVH. IAA may be a novel biomarker of LVH in hemodialysis patients.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":"86-95"},"PeriodicalIF":1.1,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616147","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
Treating primary membranous nephropathy with extremely high titer of anti-phospholipase A2 receptor antibodies: A case of failed treatment with very high-dose rituximab. 治疗抗磷脂酶A2受体抗体滴度极高的原发性膜性肾病:一个使用超大剂量利妥昔单抗治疗失败的病例。
IF 1.1 4区 医学
Clinical nephrology Pub Date : 2025-01-01 DOI: 10.5414/CN111228
Jingshu Sun, Shengqin Wu, Fang Yin, Kunying Zhang, Jianying Wang
{"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}
引用次数: 0
Nutritional and psychological sequelae of COVID-19 infection in maintenance hemodialysis patients. 维持性血液透析患者感染 COVID-19 后的营养和心理后遗症。
IF 1.1 4区 医学
Clinical nephrology Pub Date : 2025-01-01 DOI: 10.5414/CN111369
Sara T Ibrahim, Basant M Talaat, Iman E ElGohary, Gihane I Khalil, Dalia A Maharem
{"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}
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