Clinical Kidney Journal最新文献

{"title":"Adult prognosis of childhood kidney replacement therapy: ERA Registry Figure of the Month.","authors":"Vianda S Stel, Alberto Ortiz, Anneke Kramer","doi":"10.1093/ckj/sfaf204","DOIUrl":"https://doi.org/10.1093/ckj/sfaf204","url":null,"abstract":"","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 6","pages":"sfaf204"},"PeriodicalIF":3.9,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12230547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144583256","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: Time-averaged concentration estimation of uraemic toxins with different removal kinetics: a novel approach based on intradialytic spent dialysate measurements.","authors":"","doi":"10.1093/ckj/sfaf207","DOIUrl":"https://doi.org/10.1093/ckj/sfaf207","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1093/ckj/sfac273.].</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 7","pages":"sfaf207"},"PeriodicalIF":3.9,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12225170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559414","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":"Heterogeneity of regional and national hospitalization burden of lupus nephritis and systemic lupus erythematous.","authors":"Alejandro Avello, Raúl Fernández-Prado, Daria Abasheva, Ignacio Mahillo, Miguel Ángel González-Gay, Catalina Martín-Cleary, José Miguel Arce-Obieta, María Vanessa Pérez-Gómez, Beatriz Fernández-Fernández, Alberto Ortiz","doi":"10.1093/ckj/sfaf162","DOIUrl":"10.1093/ckj/sfaf162","url":null,"abstract":"<p><strong>Background: </strong>Differences between regional healthcare systems in the in-hospital burden and care of systemic lupus erythematosus (SLE) and lupus nephritis (LN) are poorly characterized. Their analysis may provide benchmarking opportunities that improve the quality and sustainability of care.</p><p><strong>Methods: </strong>We retrospectively investigated the hospitalization burden of SLE and LN in 2019-2021 across Spanish regional healthcare systems using the Spanish National Hospital Discharge Records database (RAE-CMBD) and National Statistics Institute (INE) data.</p><p><strong>Results: </strong>Of 66 262 724 hospitalization episodes from 644 public and private hospitals, 10 781 had a primary diagnosis of SLE, of which 2481 (23%) were for LN. The mean annual nationwide hospitalization case incidence was 70.61 and 1.75 per 100 000 population for SLE and LN, respectively. Regional differences were large: 48.0-fold and 6.9-fold between regions with the highest and lowest incidence for SLE and LN, respectively. In multivariate analysis, net household income and percentage of foreign-born population were associated with the number of SLE and LN hospitalization episodes. Internal medicine managed 28% of SLE and 15% of LN hospitalizations, nephrology 14% and 56% and rheumatology 23% and 11%, respectively, but there were large regional differences. The mean SLE and LN stays were 8.85 and 6.92 days (5.47 and 5.41 for nephrology and 11.18 and 11.83 for internal medicine), respectively. The average all patient refined diagnosis related groups (APR-DRGs) cost per episode was €2408 for SLE and €3563 for LN. The average yearly costs were €167 985 per million population (pmp) for SLE hospitalizations (4.32-fold differences between regions) and €60 825 pmp for LN hospitalizations (4.20-fold differences between regions). Large differences between regions were observed in the cost burden pmp relative to household income (4.70-fold for LN and 4.13-fold for SLE).</p><p><strong>Conclusion: </strong>In real-world clinical practice, the burden of in-hospital care of LN and SLE is heterogeneous across and within regional healthcare systems, offering the opportunity to benchmark best practice, optimize care and improve outcomes.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 7","pages":"sfaf162"},"PeriodicalIF":3.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12230550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144583259","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 management of chronic kidney disease in primary care in Denmark: patient characteristics, treatment, follow-up, progression and referral.","authors":"","doi":"10.1093/ckj/sfaf177","DOIUrl":"https://doi.org/10.1093/ckj/sfaf177","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1093/ckj/sfae393.].</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 6","pages":"sfaf177"},"PeriodicalIF":3.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144539258","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":"Effect of changes in potassium intake on blood pressure: a dose-response meta-analysis of randomized clinical trials (2000-2024).","authors":"Maelys Granal, Victoria Sourd, Michel Burnier, Jean Pierre Fauvel, Arthur Gougeon","doi":"10.1093/ckj/sfaf173","DOIUrl":"10.1093/ckj/sfaf173","url":null,"abstract":"<p><strong>Background: </strong>Over the past three decades, the prevalence of hypertension in adults has doubled worldwide, surging from 650 million to 1.3 billion cases between 1990 and 2019. Sodium reduction is a cornerstone of non-pharmacological strategies for managing hypertension. However, recent guidelines increasingly emphasize the importance of boosting potassium intake, supported by robust evidence of its cardiovascular benefits. Despite this, the precise dose-dependent effects of potassium on blood pressure (BP) remain inadequately defined.</p><p><strong>Methods: </strong>We conducted a systematic review of randomized controlled trials (RCTs) published between 2000 and 2024 to evaluate the impact of potassium supplementation alone-assessed solely via 24-h urinary potassium excretion-on BP. A dose-response meta-analysis was performed using linear, quadratic, and one-stage cubic spline regression models. Subgroup analyses were carried out based on subjects with or without hypertension.</p><p><strong>Results: </strong>Our meta-analysis included 10 RCTs, comprising 4 studies on subjects without hypertension and 6 studies on subjects with hypertension. The dose-response relationship varied according to BP status. In subjects without hypertension, potassium supplementation had a modest negative linear effect on BP. In contrast, subjects with hypertension exhibited a markedly higher reduction in BP. Specifically, a 50 mmol/day increase in urinary potassium excretion was associated with a 0.5 mmHg reduction in systolic BP (SBP) and a 0.12 mmHg reduction in diastolic BP (DBP) in subjects without hypertension, and a 5.3 mmHg reduction in SBP and a 3.62 mmHg reduction in DBP in subjects with hypertension.</p><p><strong>Conclusion: </strong>This meta-analysis highlights the dose-response relationship between potassium supplementation and BP reduction, particularly in subjects with hypertension. While the findings offer valuable insights for refining dietary guidelines, caution is warranted due to the limited number of RCTs included in the analysis.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 7","pages":"sfaf173"},"PeriodicalIF":3.9,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559416","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":"Efficacy and safety of obinutuzumab in active lupus nephritis.","authors":"Corina-Daniela Ene, Annette Bruchfeld","doi":"10.1093/ckj/sfaf161","DOIUrl":"10.1093/ckj/sfaf161","url":null,"abstract":"","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 7","pages":"sfaf161"},"PeriodicalIF":3.9,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12214873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559417","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: Recognition of intraglomerular histological features with deep learning in protocol transplant biopsies and their association with kidney function and prognosis.","authors":"","doi":"10.1093/ckj/sfaf178","DOIUrl":"https://doi.org/10.1093/ckj/sfaf178","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1093/ckj/sfae019.].</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 6","pages":"sfaf178"},"PeriodicalIF":3.9,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144495017","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":"Reflections on our role as patient representatives for <i>CKJ</i>.","authors":"Takamasa Iwakura, Brooke M Huuskes","doi":"10.1093/ckj/sfaf202","DOIUrl":"https://doi.org/10.1093/ckj/sfaf202","url":null,"abstract":"","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 7","pages":"sfaf202"},"PeriodicalIF":3.9,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12241847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607711","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":"Major complications of percutaneous native and transplant kidney biopsy: a complete 10-year national prospective cohort study.","authors":"Colin C Geddes, Samira Bell, Kate Buck, Bryan Conway, Vishal Dey, Robert Hunter, Nicola Joss, Michael Kelly, Joe Lakey, Steve Marjoribanks, Wendy Metcalfe, Shona Methven, Lisa Norman, Kate Stevens, Graham Stewart, Jamie Traynor, David Walbaum, Wan Wong, Emily McQuarrie","doi":"10.1093/ckj/sfaf196","DOIUrl":"https://doi.org/10.1093/ckj/sfaf196","url":null,"abstract":"<p><strong>Background: </strong>Previous reports of incidence of major complications (MC) of kidney biopsy vary depending on definitions of MC, single or multicentre analysis, and prospective or retrospective data collection. We aimed to provide accurate, unbiased information about the incidence of MC by analysing 10-year data from a prospective national renal biopsy registry.</p><p><strong>Methods: </strong>The Scottish Renal Biopsy Registry has prospectively collected data on all native and transplant kidney biopsies undertaken in the nine adult renal centres in Scotland since 2014. Nephrologists from each centre report demographics, operator, coded indication, coded diagnosis and coded MC.</p><p><strong>Results: </strong>A total of 8476 biopsies were reported in the 10 years between 2014 and 2023 (6167 native, 2309 transplant). The overall incidences of MC following native and transplant kidney biopsy were 2.1% and 1.4%, respectively (<i>P </i>< .001). The most common MC of native kidney biopsy was the requirement for 'arteriography with embolization' (0.63% of biopsies) and the most common MC of transplant biopsy was 'blood transfusion only' (0.30%). Nine deaths (0.15%) and no nephrectomies were attributed to native biopsy, and one death and one nephrectomy were attributed to transplant biopsy. MC were more common in women than men (2.2 vs 1.5%; <i>P </i>= .01). MC incidence was identical for biopsies performed by nephrologists (<i>n</i> = 5373) and radiologists (<i>n</i> = 2709). A positive association between quartile of serum creatinine at the time of native biopsy and incidence of MC diminished when acute kidney injury as indication for biopsy was excluded. Transplant biopsies >10 years after transplant had a higher risk of MC (3.4%).</p><p><strong>Conclusion: </strong>MC of kidney biopsy in the modern era remain rare. This registry analysis provides accurate estimates of risk based on unbiased national data. The increased incidence of MC in women merits further study.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 7","pages":"sfaf196"},"PeriodicalIF":3.9,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12259278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636431","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":"The efficacy and safety of kappa opioid receptor (KOR) agonists in patients with uraemic pruritus: a systematic review and network meta-analysis.","authors":"Hanqi Yang, Ming Pei, Jingbo Zhai, Zijun Zhou, Yunze Xing, Qiumei Lan, Yixin Zhu, Xuchen Wang, Bo Yang","doi":"10.1093/ckj/sfaf131","DOIUrl":"10.1093/ckj/sfaf131","url":null,"abstract":"<p><strong>Background: </strong>Uraemic pruritus (UP) is an increasingly significant health burden. However, current treatments are often unsatisfactory and associated with numerous adverse reactions. Recently, several large randomized controlled trials (RCTs) have confirmed that kappa opioid receptor (KOR) agonists, which target the endogenous opioid system, are effective in controlling symptoms. We compared the efficacy and safety of currently available KOR agonists for the treatment of UP.</p><p><strong>Methods: </strong>We conducted a systematic review and network meta-analysis (NMA) of RCTs to assess the efficacy and safety of KOR agonists in patients with UP. The primary outcomes were pruritus-related scales and adverse events. Two independent reviewers evaluated RCTs for eligibility and extracted relevant data, with discrepancies resolved by consensus or a third reviewer. We utilized a fixed effects model within a Bayesian framework for the NMA. Dichotomous variables were presented as risk ratios (RRs) and continuous variables were merged using standardized mean differences. Statistical analyses were performed using R 4.2.3 and JAGS 4.3.0. The risk of bias was assessed using the RoB 2 tool and the certainty of findings was rated according to Grading of Recommendations Assessment, Development and Evaluation criteria. The study protocol was registered on PROSPERO (CRD42020169955).</p><p><strong>Results: </strong>Ten studies with 2483 participants were included. Concerning the primary endpoints, difelikefalin at doses of 0.25 µg/kg, 0.5 µg/kg, 1.0 µg/kg and 1.5 µg/kg, nalfurafine at 2.5 µg and 5 µg and nalbuphine at 120 mg were significantly effective in reducing itching severity compared with placebo. For the secondary endpoint, all four doses of difelikefalin were associated with higher rates of adverse events compared with placebo, while other interventions showed rates comparable to those of placebo and did not present statistically significant differences.</p><p><strong>Conclusion: </strong>In summary, difelikefalin at doses of 0.25 µg/kg and 0.5 µg/kg, along with nalfurafine at 0.25 µg/kg and 0.5 µg/kg, can be considered recommended therapeutic options for UP treatment.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 6","pages":"sfaf131"},"PeriodicalIF":3.9,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188196/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144495019","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}