Clinical Kidney Journal最新文献

{"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":"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}

{"title":"Considering the utility of urinary amino acids for early identification of non-diabetic chronic kidney disease.","authors":"Henry H L Wu, David Cantor, Fei Chi, Long The Nguyen, Rajkumar Chinnadurai, Carol A Pollock, Sonia Saad","doi":"10.1093/ckj/sfaf198","DOIUrl":"10.1093/ckj/sfaf198","url":null,"abstract":"","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 7","pages":"sfaf198"},"PeriodicalIF":3.9,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12264485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648757","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 CALCIPHYX trial and its impact on calciphylaxis treatment: what's next?","authors":"Marieta Theodorakopoulou, Björn Meijers","doi":"10.1093/ckj/sfaf193","DOIUrl":"10.1093/ckj/sfaf193","url":null,"abstract":"","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 7","pages":"sfaf193"},"PeriodicalIF":3.9,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559418","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 renal denervation on glucose metabolism in hypertensive patients with and without chronic kidney disease.","authors":"Venera Bytyqi, Dennis Kannenkeril, Axel Schmid, Kristina Striepe, Agnes Bosch, Marina V Karg, Mario Schiffer, Michael Uder, Roland E Schmieder","doi":"10.1093/ckj/sfaf184","DOIUrl":"10.1093/ckj/sfaf184","url":null,"abstract":"<p><strong>Backgroun: </strong>Sympathetic overactivation is associated with numerous pathologies, including arterial hypertension, diabetes, metabolic syndrome and chronic kidney disease (CKD). Renal denervation (RDN) has emerged as an adjacent therapy for the management of hypertension. By modulating sympathetic activity in the whole body, RDN has shown conflicting results regarding insulin secretion and glucose homeostasis. The aim of this study is to analyse the impact of RDN on glycaemic control in patients with CKD.</p><p><strong>Methods: </strong>A total of 155 hypertensive patients with (<i>n</i> = 45) or without CKD (<i>n</i> = 110) were included in this post hoc analysis. All patients underwent radiofrequency-, ultrasound- or alcohol injection-based RDN. Fasting plasma glucose (FPG) and haemoglobin A1c levels were measured at baseline, 3 months and 6 months after RDN in parallel with the office and 24-h ambulatory blood pressure. CKD was defined either by clinical diagnosis, an estimated glomerular filtration rate (eGFR) of 15-59 ml/min/1.73 m² and/or A2/A3 albuminuria in hypertensive patients, repeatedly confirmed, or several of these criteria.</p><p><strong>Results: </strong>In the total study cohort, FPG decreased by 5.1 ± 29.1 mg/dl (<i>P</i> = .032) and by 7.9 ± 32.7 mg/dl (<i>P</i> = .003) at 3 and 6 months after RDN, respectively. The change in FPG levels was related to the change in 24-h systolic BP (<i>r</i> = 0.286, <i>P</i> = .008) 3 months after RDN. Among patients with CKD, FPG levels decreased by 13.5 ± 43.5 mg/dl at 3 months (<i>P</i> = .043) and by 17.1 ± 45.2 mg/dl at 6 months (<i>P</i> = .015) following RDN. These reductions were greater compared with the non-CKD group (<i>P</i> = .021 and <i>P</i> = .024, respectively). After excluding patients on oral antidiabetic or insulin therapy, patients with CKD (but not those without CKD) exhibited a reduction in FPG levels of 6.7 ± 15.3 mg/dl (<i>P</i> = .043) at 6 months post-RDN. No significant changes were observed in eGFR in either group.</p><p><strong>Conclusion: </strong>We observed that FPG levels improved to a greater extent in hypertensive patients with CKD after RDN. Thus RDN may have a broader therapeutic impact beyond blood pressure reduction in CKD patients.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 7","pages":"sfaf184"},"PeriodicalIF":3.9,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12231565/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144583258","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 erythropoiesis-stimulating agent types on malignancy in hemodialysis patients.","authors":"Seok Hui Kang, Yu Jeong Lim, Bo Yeon Kim, Ji Young Choi, Jun Young Do","doi":"10.1093/ckj/sfaf148","DOIUrl":"10.1093/ckj/sfaf148","url":null,"abstract":"<p><strong>Background: </strong>Since erythropoiesis-stimulating agent (ESA) types vary in their affinity for receptors, investigating their association with malignancies could offer valuable insights. This study aims to evaluate the effect of ESA types on malignancy incidence in hemodialysis (HD) patients.</p><p><strong>Methods: </strong>The Health Insurance Review and Assessment Service has operated a nationwide HD quality assessment program to address the high medical costs and mortality rates among HD patients. This retrospective study analyzed data from 33 960 HD patients, who underwent fourth and fifth HD quality assessments. Participants were divided into three groups: short-, intermediate- and long-acting groups. The onset of any malignancy was defined as the date of the first diagnosis based on International Classification of Diseases, Tenth Revision codes for the 12 most common malignancies. Patient survival was assessed for those with a first diagnosis of any malignancy during follow-up.</p><p><strong>Results: </strong>The short-, intermediate- and long-acting groups comprised 26 006, 6448 and 1506 patients, respectively (over ∼75 months of follow-up). The 5-year malignancy-free rates were 88.4%, 88.2% and 87.0% for short-, intermediate- and long-acting groups, respectively (<i>P</i> = .024 for short/intermediate-acting vs long-acting group). Univariable and multivariable analyses showed higher malignancy risk in the long-acting group, especially in males, older individuals and those on higher ESA doses. We performed analyses using a balanced cohort after propensity score weighting. The balanced cohort also confirmed higher malignancy risk in the long-acting group, while survival rates remained unaffected by ESA type.</p><p><strong>Conclusion: </strong>Our population-based cohort study reveals an association between long-acting ESAs use and the incidence of any malignancy, with a particularly strong influence on high-dose users. This suggests that avoiding long-acting ESAs may be advisable for patients at high risk of malignancy.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 6","pages":"sfaf148"},"PeriodicalIF":3.9,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12199780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505042","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":"Terlipressin for sinusoidal obstruction syndrome-associated acute kidney injury: a novel application.","authors":"Callie J Meath, Bindu Simon, Rohtesh S Mehta, Partow Kebriaei, Jamie S Lin","doi":"10.1093/ckj/sfaf188","DOIUrl":"10.1093/ckj/sfaf188","url":null,"abstract":"<p><p>Sinusoidal obstruction syndrome (SOS) is a life-threatening complication of hematopoietic cell transplantation that can lead to multiorgan failure, including acute kidney injury (AKI) due to hepatorenal syndrome (HRS)-like physiology. Current supportive measures often fail in preserving renal function, and dialysis is associated with high mortality risk. Terlipressin, a vasopressin analog approved for HRS in cirrhosis, has not been previously described for SOS-AKI. We report the first detailed case of terlipressin improving renal function, restoring diuretic responsiveness, and preventing dialysis in a patient with SOS, highlighting its potential as a therapeutic option for SOS-related renal failure.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 7","pages":"sfaf188"},"PeriodicalIF":3.9,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12259277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636432","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":"Loop diuretics in anuric hemodialysis patients for the clearance of protein-bound uremic toxins.","authors":"Didier Sánchez-Ospina, Maria Romero-Cote, Lucia Criado-Bellido, Maria Isabel Saez-Calero, Badawi Hijazi-Prieto, Sandra Delgado-Cuesta, Francisco Herrera-Gómez, Maddalen Mujika-Marticorena, Emilio Gonzalez-Parra, Maria Jesus Izquierdo-Ortiz, Sebastián Mas-Fontao","doi":"10.1093/ckj/sfaf195","DOIUrl":"10.1093/ckj/sfaf195","url":null,"abstract":"<p><strong>Background: </strong>In chronic kidney disease, the accumulation of protein-bound uremic toxins (PBUTs), such as hippuric acid (HA), p-cresyl sulfate (PCS) and indoxyl sulfate (IS), contributes to systemic toxicity and organ dysfunction. These toxins bind to plasma proteins, primarily albumin, rendering them resistant to clearance by conventional dialysis. This study hypothesizes that loop diuretics, particularly torasemide and furosemide, can displace PBUTs from their albumin-binding sites, increasing their free fraction and enhancing their removal during hemodialysis.</p><p><strong>Methods: </strong>This pilot multicenter crossover study included 17 anuric hemodialysis patients recruited from two hospitals. Participants underwent sequential treatment with furosemide and torasemide, each phase separated by a 1-week washout period. Plasma concentrations of HA, PCS and IS were measured pre- and post-dialysis during baseline (no diuretics) and diuretic treatment phases using high-performance liquid chromatography coupled with tandem mass spectrometry. Changes in pre- and post-dialysis toxin levels were evaluated across treatment phases. Repeated measures analysis of variance assessed the effect of each diuretic treatment on toxin levels and clearance rates.</p><p><strong>Results: </strong>Both loop diuretics increased the free fraction and clearance of PBUTs compared with baseline. Torasemide demonstrated higher efficacy in enhancing the clearance of HA (76.8%) compared with furosemide (63.2%) and baseline (57.3%). For PCS, furosemide achieved greater reductions (66.3%) than torasemide (61.8%) and baseline (24%). Indoxyl sulfate clearance increased significantly with both diuretics (59.1% for furosemide and 58.8% for torasemide) compared with baseline (26.2%).</p><p><strong>Conclusion: </strong>This study demonstrates that loop diuretics, especially torasemide, can enhance the clearance of PBUTs during hemodialysis. Their use mobilizes PBUTs from tissue stores and increases their dialyzability. These findings warrant further investigation in larger, long-term studies to validate the efficacy and clinical benefits of this approach.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 7","pages":"sfaf195"},"PeriodicalIF":3.9,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12264483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144648759","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}