Clinical Kidney Journal最新文献

{"title":"Correction to: A clinical score to predict recovery in end-stage kidney disease due to acute kidney injury.","authors":"","doi":"10.1093/ckj/sfaf299","DOIUrl":"https://doi.org/10.1093/ckj/sfaf299","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1093/ckj/sfae085.].</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 9","pages":"sfaf299"},"PeriodicalIF":4.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12485600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathways to translation for nanomedicine in nephrology.","authors":"Zoe Schoales, Pratyusha Ghosh, Anastasiia Vasylaki, Edgar A Jaimes, Ryan Williams","doi":"10.1093/ckj/sfaf192","DOIUrl":"10.1093/ckj/sfaf192","url":null,"abstract":"<p><p>Kidney diseases are a substantial worldwide health burden, with high mortality and increasing incidence. Despite their prevalence, substantial gaps remain in the clinic in both diagnostics and therapeutics. Many novel treatments have failed in clinical trials or fallen out of use in the clinic due to side effects and poor efficacy, in large part due to poor therapeutic profiles in the kidney. Nanomedicines have begun to emerge as a potentially promising diagnostic or therapeutic delivery system. Based on their physicochemical properties, such as size, shape, surface chemistry, and so on, some nanotechnologies can target the kidneys. However, as of yet, no kidney-specific nanomedicines have reached clinical translation. While the field of renal nanomedicine is in its early stages and growing, some potential obstacles to translation include poor preclinical models, challenges in manufacturing scale-up, clinical trial design and the cost of translation. Here, we overview the current state of the kidney-targeting nanomedicine field and outline a potential framework for clinical translation. We focus on the paths of US Food and Drug Administration- approved nanomedicines and suggestions from other nanomedicine fields to inform our key considerations for translational success. We also highlight the importance of academic and clinical collaboration with industry and federal regulators. Several investigational technologies are just now at the cusp of scaling towards the clinic and we therefore aim to support this momentum for improving the lives of patients with kidney diseases.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 9","pages":"sfaf192"},"PeriodicalIF":4.6,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12461149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145184739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical applications and limitations of large language models in nephrology: a systematic review.","authors":"Zoe Unger, Shelly Soffer, Orly Efros, Lili Chan, Eyal Klang, Girish N Nadkarni","doi":"10.1093/ckj/sfaf243","DOIUrl":"10.1093/ckj/sfaf243","url":null,"abstract":"<p><strong>Background: </strong>Large language models (LLMs) have emerged as potential tools in healthcare. This systematic review evaluates the applications of text-generative conversational LLMs in nephrology, with particular attention to their reported advantages and limitations.</p><p><strong>Methods: </strong>A systematic search was performed in PubMed, Web of Science, Embase and the Cochrane Library in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Eligible studies assessed LLM applications in nephrology. PROSPERO registration number CRD42024550169.</p><p><strong>Results: </strong>Of 1070 records screened, 23 studies met inclusion criteria, addressing four clinical applications in nephrology. In patient education (<i>n</i> = 13), GPT-4 improved the readability of kidney donation information from a 10th to a 4th grade level (9.6 ± 1.9 to 4.30 ± 1.71) and Gemini provided the most accurate answers to chronic kidney disease questions (Global Quality Score 3.46 ± 0.55). Regarding workflow optimization (<i>n</i> = 7), GPT-4 achieved high accuracy (90-94%) in managing continuous renal replacement therapy alarms and improved diagnosis of diabetes insipidus using chain-of-thought and retrieval-augmented prompting. In renal dietary guidance (<i>n</i> = 2), Bard AI led in classifying phosphorus and oxalate content of foods (100% and 84%), while GPT-4 and Bing Chat were most accurate for potassium classification (81%). For laboratory data interpretation (<i>n</i> = 1), Copilot significantly outperformed ChatGPT and Gemini in simulated nephrology datasets (median scores 5/5 compared with 4/5 and 4/5; <i>P</i> < .01). TRIPOD-LLM assessment revealed frequent omissions in data handling, prompting strategies and transparency.</p><p><strong>Conclusions: </strong>While LLMs may enhance various aspects of nephrology practice, their widespread adoption remains premature. Input-quality dependence and limited external validation restrict generalizability. Further research is needed to confirm their real-world feasibility and ensure safe clinical integration.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 9","pages":"sfaf243"},"PeriodicalIF":4.6,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12461145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145184795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: The burden of acute kidney disease: an epidemiological review and importance of follow-up care.","authors":"","doi":"10.1093/ckj/sfaf277","DOIUrl":"https://doi.org/10.1093/ckj/sfaf277","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1093/ckj/sfaf169.].</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 9","pages":"sfaf277"},"PeriodicalIF":4.6,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145112053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: Decongestion in patients with advanced chronic kidney disease coexisting with heart failure.","authors":"","doi":"10.1093/ckj/sfaf288","DOIUrl":"https://doi.org/10.1093/ckj/sfaf288","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1093/ckj/sfaf185.].</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 9","pages":"sfaf288"},"PeriodicalIF":4.6,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145112063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: Spatially resolved transcriptomic profiling for glomerular and tubulointerstitial gene expression in C3 glomerulopathy.","authors":"","doi":"10.1093/ckj/sfaf257","DOIUrl":"https://doi.org/10.1093/ckj/sfaf257","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1093/ckj/sfaf139.].</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 9","pages":"sfaf257"},"PeriodicalIF":4.6,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145112055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel CT-based radiomics approach for kidney function evaluation in ADPKD: a pilot study.","authors":"Luca Calvaruso, Pierluigi Fulignati, Luigi Larosa, Huong Elena Tran, Claudio Votta, Carla Cipri, Luigi Natale, Viola D'Ambrosio, Giulia Condello, Pietro Manuel Ferraro, Francesco Pesce, Luca Boldrini, Giuseppe Grandaliano","doi":"10.1093/ckj/sfaf264","DOIUrl":"10.1093/ckj/sfaf264","url":null,"abstract":"<p><strong>Background: </strong>Management of autosomal dominant polycystic kidney disease (ADPKD) might take advantage of the use of new tools to predict risk of progression towards end-stage kidney disease (ESKD). The aim of this study is to explore the potential of radiomic features obtained from computed tomography (CT) scans for the prediction of kidney function decline over time of ADPKD patients.</p><p><strong>Methods: </strong>We retrospectively selected a cohort of 58 ADPKD patients who routinely underwent CT scan for total kidney volume (TKV) assessment from February 2020 to March 2021. An expert radiologist generated a region-of-interest segmentation for cystic kidneys from which we extracted 217 radiomic features. In a subgroup of 51 patients with at least three serum creatinine measurements, on the basis of estimated glomerular filtration rate we identified 26 rapid progressors to ESKD (>3 mL/min/1.73 m²/year), and we developed a radiomic model to discriminate rapid from non-rapid progressors. Area under the curve (AUC) of the receiver operating characteristic (ROC) and sensitivity were employed to evaluate models' performance.</p><p><strong>Results: </strong>The most statistically significant radiomic feature (<i>F_cm.corr</i>) (<i>P</i>-value = .04) associated with rapid progression showed an AUC (95% confidence interval) of 0.78 (0.65-0.90) and a sensitivity of 0.92 (0.78-0.98). On the contrary, the logistic regression model based on the height-adjusted TKV (ht-TKV) presented a lower AUC (95% confidence interval) of 0.65 (0.49-0.80), with a sensitivity 0.62 (0.42-0.78).</p><p><strong>Conclusions: </strong>We developed a model based on the radiomic feature <i>F_cm.corr</i> that was able to discriminate rapid progressors. Further validation studies on larger and external cohort are warranted to corroborate our findings and to confirm the role of radiomics in ADPKD management.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 9","pages":"sfaf264"},"PeriodicalIF":4.6,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dapagliflozin use in tolvaptan-treated patients with ADPKD: exploring renal outcomes in a retrospective study.","authors":"Ryunosuke Nakajima, Shun Minatoguchi, Ryosuke Umeda, Shigehisa Koide, Midori Hasegawa, Hiroki Hayashi, Naotake Tsuboi","doi":"10.1093/ckj/sfaf269","DOIUrl":"10.1093/ckj/sfaf269","url":null,"abstract":"<p><strong>Background: </strong>Despite the widespread use of sodium-glucose cotransporter 2 inhibitors (SGLT2i) in the management of chronic kidney disease, their role in autosomal dominant polycystic kidney disease (ADPKD) remains unclear.</p><p><strong>Methods: </strong>This observational study evaluated the efficacy of the SGLT2i dapagliflozin in patients with ADPKD receiving tolvaptan. The primary outcome was the chronic estimated glomerular filtration rate (eGFR) slope, modeled using a multivariable linear mixed-effect model; a within-group analysis was also performed using an interrupted time series approach.</p><p><strong>Results: </strong>A total of 48 patients receiving tolvaptan were analyzed (24 patients in the control group vs 24 patients in the dapagliflozin group). The mean follow-up duration was 649 ± 363 days across all patients. The chronic eGFR slope was -2.30 [95% confidence interval (CI) -3.47, -1.13] in the control group and -1.72 (95% CI -3.48, -0.03) mL/min/1.73 m² per year in the dapagliflozin group (<i>P</i> = .595). In within-group analysis using an interrupted time series approach, the chronic eGFR slope changed from -2.34 (95% CI -3.39, -1.30) to -1.14 (95% CI -2.68, 0.40) mL/min/1.73 m² per year following dapagliflozin initiation (<i>P</i> = .191). No serious adverse events were observed during the follow-up period.</p><p><strong>Conclusions: </strong>Although no statistically significant differences were observed, both between- and within-group analyses showed a numerically slower decline in eGFR with dapagliflozin. Importantly, no evidence of harm was observed. These findings may contribute to ongoing discussions regarding the potential role of SGLT2i in ADPKD.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 9","pages":"sfaf269"},"PeriodicalIF":4.6,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12461144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145184780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kidney interstitial edema as the central pathophysiological mechanism of NSAKI: a call for reappraisal.","authors":"Osamu Uemura","doi":"10.1093/ckj/sfaf271","DOIUrl":"10.1093/ckj/sfaf271","url":null,"abstract":"","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 9","pages":"sfaf271"},"PeriodicalIF":4.6,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12461143/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145184733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drivers of hospital costs in ANCA-associated vasculitis patients with long-term follow-up-a real-world cost analysis.","authors":"Jolijn R van Leeuwen, Frouzan H Soltani, Wilbert B van den Hout, Ton J Rabelink, Y K Onno Teng","doi":"10.1093/ckj/sfaf267","DOIUrl":"10.1093/ckj/sfaf267","url":null,"abstract":"<p><strong>Background: </strong>Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a potentially life-threatening, systemic autoimmune disease with a high risk for relapse and treatment-related toxicity, making AAV a high-costs illness. This study aimed to identify clinical insights for clinicians on considering this costs burden.</p><p><strong>Methods: </strong>We conducted a detailed, retrospective, single-centre, activity-based cost-analysis and identified clinical variables associated with increased costs. We analysed real-world costs incurred by the hospital between January 2018 and December 2019, omitting the outpatient pharmacy expenditures. Our cohort included both incident and prevalent AAV patients with at least 6 months of follow-up since diagnosis, indicating survival beyond initial diagnosis.</p><p><strong>Results: </strong>For 180 AAV patients with a median follow-up of 1.8 years the average hospital costs incurred amounted to €9887 per patient year, with inpatient care being the primary cost driver (32%). Merely 15% of costs were attributable to patients experiencing relapse (<i>N</i> = 14/180, 8%). More importantly, 71% of costs were attributable to patients experiencing infections (<i>N</i> = 77/180, 43%). Likewise, 60% of costs were attributable to patients with multi-comorbidity (<i>N</i> = 65/180, 36%). Infections and multi-comorbidity were both strongly associated with corticosteroid (CS) use. Regression and sensitivity analyses suggest that a reduction of infections, comorbidities and maintenance treatment with CS will reduce hospital costs.</p><p><strong>Conclusion: </strong>This real-world cost analysis demonstrates that the burden of infections and comorbidities, both related to CS use, is higher than that of relapses on hospital costs in AAV patients. Thus, this study implicates clinicians considering hospital costs should focus on reducing CS and achieving CS-free remission to prevent infections and comorbidities.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 9","pages":"sfaf267"},"PeriodicalIF":4.6,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12448927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145112074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}