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":"Hydralazine-induced antineutrophil cytoplasmic antibody-associated glomerulonephritis.","authors":"Marrey Ruby Quizon, Whitney Li, Jonathan Zuckerman, Lili Tong, John Sy, Wei Ling Lau, Anna Jin, Joline Chen, Sohrab Tanavoli, Yongen Chang","doi":"10.1093/ckj/sfaf200","DOIUrl":"10.1093/ckj/sfaf200","url":null,"abstract":"","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 8","pages":"sfaf200"},"PeriodicalIF":4.6,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12343090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144834346","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":"Screening for latent tuberculosis infection in patients with chronic kidney disease: a review of evidence and current practice in the UK.","authors":"Joseph Sturman, Jyoti Baharani, Jed Ashman, Lorraine Harper, Adam F Cunningham, Martin Dedicoat, Matthew K O'Shea","doi":"10.1093/ckj/sfaf197","DOIUrl":"10.1093/ckj/sfaf197","url":null,"abstract":"<p><p>Tuberculosis (TB) and chronic kidney disease (CKD) represent an extant local and global syndemic, with TB incidence rates in the UK end-stage renal failure population far surpassing those of the general population in endemic countries. Patients with CKD generally have latent TB reactivation, rather than <i>de novo</i> infection, which presents with atypical, non-pulmonary presentations leading to late diagnosis, poorer outcomes and a high risk of widespread transmission through haemodialysis units. There is therefore a need to consider latent TB infection screening in the CKD population. However, there is widespread variation in local screening practices in the UK due to the challenge of diagnosing latent TB in CKD, and the absence of robust evidence-based guidelines. There is also concern that although a screening programme may have significant public health benefit, it may cause harm to the individual patient through adverse effects of treatment. In this review, we present the current evidence for latent TB infection screening in CKD, including the evidence of benefit and harm to the individual and the public. We also review current practices in the UK and present survey data from renal units in England demonstrating the diversity of policies currently in place. We advocate screening for latent TB in all CKD patients commencing dialysis and we highlight the pressing research questions that need to be urgently answered to help move towards a cohesive national policy to help drive evidence-based consistent care.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 7","pages":"sfaf197"},"PeriodicalIF":4.6,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12378438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945381","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":"Global genetic prevalence estimates of primary hyperoxaluria are greater than previously reported.","authors":"Giorgia Mandrile, Gill Rumsby, Veronica Sciannameo, Andrea G Cogal, Michelle Glover, John C Lieske, Peter C Harris","doi":"10.1093/ckj/sfaf194","DOIUrl":"10.1093/ckj/sfaf194","url":null,"abstract":"<p><strong>Background: </strong>Primary hyperoxaluria (PH), a rare autosomal recessive disease of oxalate accumulation in the kidneys, is caused by biallelic pathogenic changes in three known genes: <i>AGXT</i> (PH1), <i>GRHPR</i> (PH2) and <i>HOGA1</i> (PH3).</p><p><strong>Methods: </strong>To better understand the overall risk of developing clinical PH, we manually curated and classified PH genetic variants and calculated the estimated genetic prevalence overall and in five ethnic subpopulations using allelic frequencies from the population Genome Aggregation Database (gnomAD version 2.1.1).</p><p><strong>Results: </strong>Of the 651 identified PH variants, 273 were found in gnomAD 2.1.1 on the day of download and after reclassification, 208 were determined pathogenic (P) or likely pathogenic (LP) (<i>AGXT, n</i> = 94; <i>GRHPR, n</i> = 46; and <i>HOGA1, n</i> = 68) and a further 65 were classified as rare variants of uncertain significance (VUS). Using P and LP only, estimated carrier frequency was 1:229 for PH1, 1:465 for PH2 and 1:151 for PH3, while genetic prevalence was 1:209 357 for PH1, 1:863 028 for PH2 and 1:90 834 for PH3 (i.e. nearly 5, 1 and 11 per 1 million individuals, respectively). The highest carrier frequencies for <i>AGXT</i> pathogenic variants were in East Asians (1 in 146) and the European non-Finnish population (1 in 187); for <i>GRHPR</i>, South Asians (1 in 313) and the European non-Finnish population (1 in 413); and for <i>HOGA1</i>, Ashkenazi Jewish (1 in 38) and East Asians (1 in 100). The estimated risk of developing PH was ≈1:59 017.</p><p><strong>Conclusions: </strong>This careful benchmarking exercise indicates that a significant number of individuals at risk for PH symptoms remain undiagnosed. Since these numbers exceed known diagnosed cases of PH, improved screening and diagnosis of this underestimated disease is necessary.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 7","pages":"sfaf194"},"PeriodicalIF":4.6,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12378434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945301","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}