Clinical Kidney Journal最新文献

{"title":"The use of budesonide in IgA pediatric patients with recurrent macroscopic hematuria: a single-center real-life experience.","authors":"Luigi Annicchiarico Petruzzelli, Oriana De Marco, Gabriele Malgieri, Eleonora Riccio, Antonio Pisani","doi":"10.1093/ckj/sfaf109","DOIUrl":"https://doi.org/10.1093/ckj/sfaf109","url":null,"abstract":"","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 5","pages":"sfaf109"},"PeriodicalIF":3.9,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143955250","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":"Potential and pitfalls of measuring circulating anti-nephrin autoantibodies in glomerular diseases.","authors":"Felicitas E Hengel, Tobias B Huber, Nicola M Tomas","doi":"10.1093/ckj/sfaf100","DOIUrl":"https://doi.org/10.1093/ckj/sfaf100","url":null,"abstract":"<p><p>Recent studies have identified autoantibodies targeting the podocyte protein nephrin in patients with primary podocytopathies such as minimal change disease, primary focal segmental glomerulosclerosis (FSGS), post-transplant recurrent FSGS and childhood idiopathic nephrotic syndrome. These antibodies bind nephrin and directly influence nephrin downstream signaling, with immense effect on the podocytes' cellular structure and function, substantially changing our understanding of antibody-mediated podocytopathies and disease classification. Their presence correlates with disease activity and holds great potential as a novel biomarker of anti-nephrin-associated podocytopathy. However, the detection of these potentially low-titre autoantibodies has proven challenging. In this review, we highlight and explain distinct detection methodologies with their advantages and disadvantages and discuss the potential of anti-nephrin autoantibodies as a novel biomarker in nephrotic syndrome for diagnosis, prognostication and therapeutic guidance in patients with nephrotic syndrome.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 5","pages":"sfaf100"},"PeriodicalIF":3.9,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984702","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":"Effects of super high-flux vitamin E-coated and medium cut-off dialyzers on uremic toxins removal and biocompatibility: the E-FLUX randomized controlled study.","authors":"Mohamed Belmouaz, Etienne Cogne, Florent Joly, Fabien Duthe, Estelle Desport, Cecile Martin, Thierry Hauet, Sebastien Giraud, Estelle Lemarie, Lisa Durocher, Frank Bridoux","doi":"10.1093/ckj/sfaf106","DOIUrl":"https://doi.org/10.1093/ckj/sfaf106","url":null,"abstract":"<p><strong>Background: </strong>Medium cut-off hemodialysis (MCO-HD) improves removal of middle molecules (MM) uremic toxins. The effects of the novel super high-flux vitamin E-coated (SHFVE) dialyzer on MM removal and biocompatibility parameters including inflammation and oxidative stress remain to be investigated.</p><p><strong>Methods: </strong>This non-inferiority cross-over prospective randomized study included 36 patients randomly assigned to receive either 3 months of MCO-HD followed by 3 months of SHFVE-HD, or vice versa. The primary endpoint was beta2-microglobulin reduction ratio (RR) after 3 months. Secondary endpoints were other MM RR and biocompatibility parameters.</p><p><strong>Results: </strong>SHFVE-HD provided non-inferior beta2-microglobulin RR as compared with MCO-HD {74.2% [95% confidence interval (CI) 71; 77] vs 73.3% (95% CI 71; 76) with a difference of 0.9% (95% CI -1.9%; 3.6), respectively}, with similar mean RR of prolactin, alpha1-microglobulin, vascular endothelial growth factor, and kappa and lambda free light chains. SHFVE-HD induced lower mean myoglobin RR compared with MCO-HD (55.5 ± 7.3 vs 60.2 ± 6.6%, <i>P </i>= 0.022). Myoglobin pre-dialysis levels were not significantly different [160 (118-199) vs 167 (167-240) µg/L, <i>P </i>= .08].Median pre-dialysis levels of interleukin-6 [0.8 (0-4.4) vs 1.7 (0.2-7.2) pg/mL, <i>P </i>= .032], asymmetric dimethylarginine (ADMA) [163 (122-260) vs 167 (133-270) ng/mL, <i>P </i>= .01), mean pre-dialysis serum soluble tumor necrosis factor receptor 1 (sTNFR1) levels (12.7 ± 3.5 vs 13.6 ± 3.6 ng/mL, <i>P </i>= .039) and mean post-dialysis oxidized low-density lipoprotein levels (54 ± 18 vs 63 ± 22 ng/mL, <i>P </i>= .01) decreased significantly with SHFVE-HD. SHFVE-HD induced a significantly lower median relative variation in blood leucocyte count 15 min after dialysis initiation [-3.5 (-6.8 to 1.6) vs -6.2 (-12.9 to -1.5) %, <i>P </i>= .009], encompassing both polymorphonuclear neutrophils and monocytes.</p><p><strong>Conclusion: </strong>Compared with MCO-HD, SHFVE-HD appears to provide similar MM RR and may be associated with improved biocompatibility parameters.</p><p><strong>Trial registration clinicaltrialsgov: </strong>NCT05610683. Data deposited at Centre de la recherche clinique CHU Poitiers.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 5","pages":"sfaf106"},"PeriodicalIF":3.9,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970019","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":"Estimating 24-hour urine phosphate excretion from spot urine.","authors":"Yongchao Li, Daniel G Fuster, Nasser A Dhayat, Harald Seeger, Alexander Ritter, Olivier Bonny, Gregoire Wuerzner, Thomas Ernandez, Stephan Segerer, Beat Roth, Isabel Rubio-Aliaga, Carsten A Wagner","doi":"10.1093/ckj/sfaf097","DOIUrl":"https://doi.org/10.1093/ckj/sfaf097","url":null,"abstract":"<p><strong>Background: </strong>24-hour urinary phosphate excretion (24hUrP) is indicative of intestinal phosphate absorption in steady-state conditions. Nevertheless, 24-hour urine collections are cumbersome and error-prone. Previous studies suggested that spot urine phosphate (uPi) could serve as a practical substitute to predict 24hUrP, however, these data originated only from patients with chronic kidney disease. Here, we investigated the validity of predictive equations using spot urine parameters to assess 24hUrP in a cohort with normal kidney function (eGFR >60 ml/min per 1.73 m²) including 761 kidney stone patients and 207 non-kidney stone formers as assessed by low-dose CT scans, the Swiss Kidney Stone Cohort (SKSC).</p><p><strong>Methods: </strong>Published equations for 24hUrP were tested in our cohort and a novel predictive equation was developed. Pearson correlation coefficients and Bland-Altman plots were used to assess the relationship between spot uPi and spot urine creatinine (uCr) and 24hUrP. Additionally, forward multivariate analysis was performed to predict uPi excretion.</p><p><strong>Results: </strong>Previously published equations provided less accurate prediction of 24hUrP from spot urine. Log-transformed 24hUrP with log-transformed spot uPi and creatinine yielded the best model fit. In addition, inclusion of age, sex, and BMI significantly improved prediction of 24hUrP. Compared with spot uPi and uCr alone (<i>r</i> ² = 0.0561, <i>P</i> < .001) the new equation predicted 24hUrP (<i>r</i> ² = 0.1820, <i>P</i> < .001) more accurately.</p><p><strong>Conclusions: </strong>Here, we present a new equation for predicting 24hUrP from spot urine samples of individuals with normal kidney function. This model has a moderate ability to explain 24hUrP variance but has the strength to use only parameters routinely collected in clinical settings such as spot urinary phosphate and creatinine, sex, BMI, and age.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 5","pages":"sfaf097"},"PeriodicalIF":3.9,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985620","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":"Malignancies and glomerulonephritis: when to suspect and when to screen?","authors":"Ahmet Murt, Ilay Berke, Annette Bruchfeld, Fernando Caravaca-Fontán, Jürgen Floege, Eleni Frangou, Safak Mirioglu, Sarah M Moran, Stefanie Steiger, Kate I Stevens, Onno Y K Teng, Andreas Kronbichler","doi":"10.1093/ckj/sfaf101","DOIUrl":"https://doi.org/10.1093/ckj/sfaf101","url":null,"abstract":"<p><p>Glomerular diseases may occur secondary to malignancies. Age-specific cancer screening is recommended for patients with glomerular diseases and may be extended based on the specific risk associated with the detected histopathologic pattern. Membranous nephropathy is the prototype of cancer-associated glomerulonephritis, with 10% of cases presenting with malignancy within a year from diagnosis. Among antigens that are expressed in patients with membranous nephropathy thrombospondin type 1 domain-containing 7A and neural epidermal growth factor-like-1 are often reported in patients with underlying malignancies. However, the risk of having a concurrent malignancy does not exceed 25%-30% when these antigens are expressed. While less frequent in other glomerulonephritides, co-occurrence of malignancy is reported in a substantial proportion of glomerular diseases including IgA nephropathy, podocytopathies with prominent podocyte foot process effacement such as minimal change disease as glomerular lesion pattern, amyloidosis, C3 glomerulopathy, monoclonal immunoglobulin deposition disease, or immune-complex-mediated glomerulonephritis. Treatment of malignancy-associated glomerulonephritis is usually directed toward treatment of the underlying malignancy with combinations of surgery, chemotherapy, and/or radiotherapy. Moreover, relapse of the malignancy may result in recurrence of glomerulonephritis. Refractoriness of glomerulonephritis to initial therapy may be due to an occult primary malignancy that was not diagnosed during initial cancer screening. In such a scenario a step-up diagnostic approach is recommended. In addition, re-screening may be sensible for relapsing patients who carry higher risks for cancer including patients of older age and those with a smoking history. This review focuses on the description of malignancies in the context of glomerular diseases and provides practical guidance on screening.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 5","pages":"sfaf101"},"PeriodicalIF":3.9,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12062743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977499","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":"Fibrinogen-to-albumin ratio is associated with the prognosis of patients with septic acute kidney injury.","authors":"Liying Zhan, Ying Zhang, Yuxin Zhang, Jingdi Chen, Handong Zou, Lu Wang, Mengmeng Guo, Raojuan Huang, Yaqi Sun, Hang Gao, Jing Xu, Ru Xiong, Wei Wu","doi":"10.1093/ckj/sfaf095","DOIUrl":"https://doi.org/10.1093/ckj/sfaf095","url":null,"abstract":"<p><strong>Background: </strong>The fibrinogen-to-albumin ratio (FAR), a novel inflammatory biomarker, is strongly associated with the incidence of sepsis. Nonetheless, there is a lack of research regarding the FAR and prognosis in individuals with septic acute kidney injury (SAKI). The aim of this study was to assess the correlation between the FAR upon intensive care unit (ICU) admission and overall mortality in patients with SAKI.</p><p><strong>Methods: </strong>All patient information was retrieved from the Medical Information Mart for Intensive Care-IV (MIMIC-IV) database. All patients were divided into four distinct categories according to the FAR. The primary endpoints for this study were the 30-day and 365-day all-cause death rates, whereas the secondary endpoints were the 60-day, 90-day and 180-day all-cause death rates. The FAR was quartile, and the Kaplan-Meier curve was used to evaluate the outcomes across the groups. To evaluate the correlation between the FAR and outcomes, we used a Cox proportional hazards regression model and restricted cubic splines (RCSs).</p><p><strong>Results: </strong>Among the 6208 participants, the average age was 65 years, with 3659 (58.94%) identified as male. Patients exhibiting elevated FAR values demonstrated an increased risk of all-cause mortality at 30, 60, 90, 180 and 365 days, as evidenced by the Kaplan-Meier curves (log-rank <i>P</i> < .001). SAKI patients with elevated FAR values had a greater risk of all-cause mortality at 30, 60, 90, 180 and 365 days than did those with lower FAR values, as demonstrated by Cox proportional hazards regression analysis. With inflection points at 35.14 for 30-day mortality and 34.8 for 365-day mortality, the RCS analysis revealed that the FAR and all-cause mortality were related in an inverted N-type pattern. In instances where FAR levels were below 35.14 mg/g, a reduction of 1 unit in the FAR correlated with a 6.5% increase in the risk of 30-day all-cause mortality [hazard ratio (HR) 0.935; 95% confidence interval (CI) 0.923, 0.948]. In instances where FAR levels were below 34.8 mg/g, a reduction of 1 unit in the FAR correlated with a 6.2% increase in the risk of 365-day all-cause mortality (HR 0.938; 95% CI 0.927, 0.949).</p><p><strong>Conclusion: </strong>In severely ill patients with SAKI, elevated FAR levels are strongly correlated with an increased risk of all-cause mortality at 30, 60, 90, 180 and 365 days. FAR may serve as a reliable metric for assessing and managing patients with SAKI in the ICU.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 4","pages":"sfaf095"},"PeriodicalIF":3.9,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035531/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966840","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":"Low serum free IL-18 is a novel potential marker for predicting infectious events in patients at dialysis initiation.","authors":"Takashi Tawara-Iida, Joichi Usui, Itaru Ebihara, Takashi Ishizu, Masaki Kobayashi, Yoshitaka Maeda, Hiroaki Kobayashi, Kunihiro Yamagata","doi":"10.1093/ckj/sfaf094","DOIUrl":"https://doi.org/10.1093/ckj/sfaf094","url":null,"abstract":"<p><strong>Background: </strong>Compared to the general population, individuals who are undergoing hemodialysis are at a higher risk of contracting severe infectious diseases, and their mortality rate from infectious diseases is also higher. We investigated the serum free interleukin-18 [free state of interleukin-18 (IL-18)] concentration as a prognostic factor for hemodialysis patients' infection risk.</p><p><strong>Methods: </strong>The Ibaraki Dialysis Initiation Cohort (iDIC) study is a multicenter prospective cohort investigation of patients undergoing a new initiation of dialysis in a local region of Japan. We performed a survival analysis of several events requiring hospitalization and compared the Kaplan-Meier curves of the \"low\" and \"high\" serum free IL-18 concentration groups. To adjust for confounding factors, we also performed a Cox proportional hazards analysis.</p><p><strong>Results: </strong>We analyzed the serum free IL-18 concentration of samples from 295 patients randomly selected from the blood sample bank of the iDIC study. The mean free IL-18 concentration was 8.7 ± 5.3 pmol/l. The cumulative incidence of infectious events was significantly higher in the low free IL-18 group (<6.0 pmol/l, log-rank test <i>P </i>< .01). The Cox proportional hazards analysis revealed that low serum free IL-18 (<6.0 pmol/l) was an independent factor associated with the development of infectious events. Total IL-18 and IL-18BP (binding protein) showed no association with infectious events.</p><p><strong>Conclusion: </strong>A low serum free IL-18 concentration in the dialysis initiation period is a potential marker for predicting the development of severe infection in these patients.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 5","pages":"sfaf094"},"PeriodicalIF":3.9,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12044333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995592","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":"10 tips for providing kidney care to persons in prison.","authors":"Mukesh Kumar, Madelena Stauss, Philip Taylor, Laura Maursetter, Alexander Woywodt","doi":"10.1093/ckj/sfaf090","DOIUrl":"https://doi.org/10.1093/ckj/sfaf090","url":null,"abstract":"<p><p>Chronic kidney disease (CKD) is prevalent in prisons and most nephrologists see persons in prison in various clinical settings. These encounters are often fraught with challenges around logistics and communication with healthcare providers staffing the prison. Preplanning clinic visits along with education for teams can improve care and ease concerns. Access to virtual consultations in prisons is variable despite it being shown to considerably improve access to care. Access to patient information material is another area for improvement, given that persons in prison are not usually allowed internet access. Another issue is handover of care when persons in prison are transferred between facilities or when they re-enter the community after release from prison. Providing care to persons in prison with established kidney failure is typically challenging, although nephrologists do provide dialysis in prisons. Data are sparse regarding access to transplantation, and the situation differs between countries, but persons in prison face challenges when accessing transplantation and posttransplant care. Palliative care for persons in prison with CKD who decide against dialysis or where dialysis seems incongruent with goals is not always available. Persons in prison are at a higher-than-average risk of CKD and nephrologists can impact outcomes by focusing on modifying these risk factors during clinical encounters. Departments and institutions should work on communication with their prisons and with structured approaches to improve renal care for this unique and vulnerable population. We suggest that nephrologists share the 10 tips with their teams and become advocates for patients with CKD in prison.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 5","pages":"sfaf090"},"PeriodicalIF":3.9,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977525","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":"Monitoring serum potassium concentration in patients with severe hyperkalemia: the role of bloodless artificial intelligence-enabled electrocardiography.","authors":"Chien-Chou Chen, Chin Lin, Ding-Jie Lee, Chin-Sheng Lin, Sy-Jou Chen, Chih-Chien Sung, Yu-Juei Hsu, Shih-Hua Lin","doi":"10.1093/ckj/sfaf092","DOIUrl":"https://doi.org/10.1093/ckj/sfaf092","url":null,"abstract":"<p><strong>Background: </strong>Severe hyperkalemia is a life-threatening emergency requiring prompt management and close surveillance. Although artificial intelligence-enabled electrocardiography (AI-ECG) has been developed to rapidly detect hyperkalemia, its application to monitor potassium (K⁺) levels remains unassessed. This study aimed to evaluate the effectiveness of AI-ECG for monitoring K⁺ levels in patients with severe hyperkalemia.</p><p><strong>Methods: </strong>This retrospective study was performed at an emergency department of a single medical center over 2.5 years. Patients with severe hyperkalemia defined as Lab-K⁺ ≥6.5 mmol/l with matched ECG-K⁺ ≥5.5 mmol/l were included. ECG-K⁺ was quantified by ECG12Net analysis of the AI-ECG system. The following paired ECG-K⁺ and Lab-K⁺ were measured at least twice, almost simultaneously, during and after K⁺-lowering therapy in 1 day. Clinical characteristics, pertinent intervention, and laboratory data were analyzed.</p><p><strong>Results: </strong>Seventy-six patients fulfilling the inclusion criteria exhibited initial Lab-K⁺ 7.4 ± 0.7 and ECG-K⁺ 6.8 ± 0.5 mmol/l. Most of them had chronic kidney disease (CKD) or were on chronic hemodialysis (HD). The followed Lab-K⁺ and ECG-K⁺ measured with a mean time difference of 11.4 ± 5.6 minutes significantly declined in parallel both in patients treated medically (<i>n</i> = 39) and with HD (<i>n</i> = 37). However, there was greater decrement in Lab-K⁺ (mean 7.3 to 4.1) than ECG-K⁺ (mean 6.6 to 5.0) shortly after HD. Three patients with persistent ECG-K⁺ hyperkalemia despite normalized Lab-K⁺ exhibited concomitant acute cardiovascular comorbidities.</p><p><strong>Conclusions: </strong>AI-ECG for K⁺ prediction may help monitor K⁺ level for severe hyperkalemia and reveal more severe cardiac disorders in the patients with persistent AI-ECG hyperkalemia.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 4","pages":"sfaf092"},"PeriodicalIF":3.9,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12032525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143982688","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":"Increasing the adoption of home dialysis through improved advanced kidney care patient education: a call for action.","authors":"Ulrika Hahn Lundström, Gert Meeus, Tommy Aronsen, Anne-Lorraine Clause, Jeanette Finderup, Patrik J Finne, Jan Dominik Kampmann, Jacek Lange, Kate McCarthy, Rita Nohra, Tomasz Stompòr, Eleri Wood, Monika Lichodziejewska-Niemierko, Stefan H Jacobson","doi":"10.1093/ckj/sfaf087","DOIUrl":"https://doi.org/10.1093/ckj/sfaf087","url":null,"abstract":"<p><strong>Background: </strong>Home dialysis modalities have several advantages yet remain underused in Europe. A minority of people with kidney failure opt for home dialysis, although many more could be suitable. To improve home dialysis uptake, advanced kidney care patient education is essential. The aim was to examine the association of national guidelines for advanced kidney care patient education with home dialysis prevalence and incidence across Europe.</p><p><strong>Methods: </strong>This call for action followed a consensus meeting in Copenhagen, Denmark, in June 2023. The participating professionals had extensive experience in advanced kidney care and home dialysis. We used data from the European Renal Association registry 2021 to examine the association of available national guidelines for advanced kidney care education with home dialysis prevalence and incidence in Europe.</p><p><strong>Results: </strong>In the European dialysis population, home dialysis prevalence is 10.5% and incidence is 13.3%. The organization of advanced kidney care and patient education differ. The availability of national guidelines for advanced kidney care patient education is associated with home dialysis uptake. The prevalence of home dialysis is significantly higher in countries with versus without national guidelines [20.9 versus 7.9%; odds ratio 1.398 (confidence interval 1.115-1.754), <i>P</i> = .004].</p><p><strong>Conclusion: </strong>Home dialysis prevalence and incidence vary in Europe. The availability of national guidelines for advanced kidney care patient education for professionals is associated with a higher prevalence and incidence of home dialysis. Coordinated action is needed to support advanced kidney care patient education as part of nephrology care to improve kidney care, in order to ensure that the right patient is on the right modality and increase access to home dialysis.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 4","pages":"sfaf087"},"PeriodicalIF":3.9,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11986811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981382","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}