Clinical Kidney Journal最新文献

{"title":"Causal effects of obesity on estimated glomerular filtration rate: a Mendelian randomization and image data analysis study.","authors":"Patrik Ene, Maria K Svensson, Robin Strand, Joel Kullberg, Håkan Ahlström, Anders Larsson, Lars Lind","doi":"10.1093/ckj/sfaf116","DOIUrl":"https://doi.org/10.1093/ckj/sfaf116","url":null,"abstract":"<p><strong>Background: </strong>Obesity has been associated with onset and progression of chronic kidney disease (CKD) but causal relationship remains uncertain. This study investigated how obesity causally affects estimated glomerular filtration rate.</p><p><strong>Methods: </strong>Cross-sectional and magnetic resonance imaging (MRI) data analyses were performed within the Prospective Investigation of Obesity, Energy, and Metabolism (POEM) study (502 participants, all aged 50 years). Additionally Mendelian randomization was performed using published summary data. Outcomes were creatinine- and cystatin C-based eGFR. Body mass index (BMI) and waist circumference (WC) were used as exposure variables in the cross-sectional and Mendelian randomization analyses. In the imaging data analyses, eGFR was regressed non-parametrically on tissue volume for each 3D voxel and visualized as a correlation \"Imiomics\" map.</p><p><strong>Results: </strong>Negative correlations were shown between cystatin C-based eGFR and BMI [beta = -0.190 (95% CI: -0.280 to -0.100)] and WC [beta = -0.160 (95% CI: -0.250 to -0.060)] in an adjusted model. In contrast, a positive association was found for creatinine-based eGFR [BMI beta = 1.20 (95% CI: 0.030 to 0.210) and WC beta = 0.160 (95% CI: 0.070 to 0.260)]. Similar patterns were found using MRI analysis (Imiomics map). Mendelian randomization implied a negative causal effect of obesity-related measures on cystatin C-based eGFR [BMI beta = -0.031 (95% CI: -0.037 to -0.026) and WC beta = -0.038 (95% CI: -0.045 to -0.031)], but no statistically significant effect was found for creatinine-based eGFR.</p><p><strong>Conclusion: </strong>This study suggests a causal negative effect of obesity on cystatin C-based, but not creatinine-based eGFR. These findings warrant further research regarding estimations of kidney function when assessing obesity and CKD.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 5","pages":"sfaf116"},"PeriodicalIF":3.9,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976899","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":"CKD-associated pruritus in haemodialysis: a road map for diagnosis and treatment.","authors":"Joerg Latus, Antoine Lanot, Sonja Ständer, Emilio Sanchez-Alvarez, Filippo Aucella, Gil Yosipovitch","doi":"10.1093/ckj/sfaf096","DOIUrl":"10.1093/ckj/sfaf096","url":null,"abstract":"<p><p>Of the wide range of symptoms affecting patients with chronic kidney disease (CKD) on haemodialysis, CKD-associated pruritus is one of the most common and burdensome, occurring at moderate-to-severe intensity in 31%-40% of patients, significantly impacting multiple aspects of quality of life, and associated with increased healthcare utilization. Despite the distressing nature of this symptom, clinicians frequently underestimate its prevalence and it is under-reported by patients who may be unaware of the availability of effective treatment options. The identification and management of CKD-associated pruritus should form an essential aspect of patient-centred care; however, patients with CKD may have multiple causes of chronic itch including those of dermatological, systemic, neuropathic and psychogenic origin, and CKD-associated pruritus must be distinguished from these. Together with its highly variable presentation in patients on haemodialysis, the range of potential causes of itch makes differential diagnosis of CKD-associated pruritus challenging. The presence of bilaterally symmetrical and non-dermatomally distributed itching, commonly affecting the back, limbs, chest and head is characteristic of CKD-associated pruritus, although approximately 50% of patients report generalized pruritus. Secondary skin lesions (including excoriation, crusts, impetigo, lichenifications and prurigo also seen in dermatological conditions) may or may not be observed, and xerosis (dry skin) that may exacerbate itching is common. Here, we provide a pragmatic approach to the identification and differential diagnosis of chronic itching in CKD-associated pruritus with the aim of supporting the effective management of this highly distressing symptom in clinical practice.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 5","pages":"sfaf096"},"PeriodicalIF":3.9,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076531","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":"Does nighttime hypertension predict long-term kidney outcomes in patients with IgA nephropathy?","authors":"Takumi Ikeda, Kotaro Haruhara, Takaya Sasaki, Hirokazu Marumoto, Eisuke Kubo, Nobuo Tsuboi, Takashi Yokoo","doi":"10.1093/ckj/sfaf085","DOIUrl":"https://doi.org/10.1093/ckj/sfaf085","url":null,"abstract":"","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 5","pages":"sfaf085"},"PeriodicalIF":3.9,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12044330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968345","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":"Development, Rasch analysis and validation of the kidney symptom burden questionnaire (KSB-Q).","authors":"Derek Kyte, Benjamin R Fletcher, Mike Horton, Sarah Damery, Olalekan Lee Aiyegbusi, Nicola Anderson, Andrew Bissell, Melanie Calvert, Paul Cockwell, James Ferguson, Muirne C S Paap, Chris Sidey-Gibbons, Neil Turner, Rav Verdi, Anita Slade","doi":"10.1093/ckj/sfaf112","DOIUrl":"https://doi.org/10.1093/ckj/sfaf112","url":null,"abstract":"<p><strong>Background: </strong>Increasingly, patient-reported outcome measures (PROMs) are used to monitor chronic kidney disease (CKD) symptoms in routine clinical practice. However, such symptom measurement currently requires completion of multiple, often lengthy, PROMs, which may lead to questionnaire fatigue, lower levels of completion, and missing data. Moreover, many CKD-specific PROMs lack evidence of important measurement properties and few were developed using contemporary psychometric methods. The study objective was to develop and validate a short-form kidney symptom burden questionnaire (KSB-Q).</p><p><strong>Methods: </strong>A cross-sectional item pool survey was distributed to adults (≥18 years) with CKD stages 3-5 [including individuals not receiving kidney replacement therapy (KRT), those receiving dialysis and those with a functioning kidney transplant] in England (Birmingham, London, Sheffield, and Nottingham) from March to September 2022. Rasch measurement was used to assess the psychometric properties of the item pool. Cognitive debriefing interviews were conducted to evaluate content validity.</p><p><strong>Results: </strong>In total, 419/1464 participants responded (29% response rate), with 28% receiving dialysis and 30% in receipt of a kidney transplant. Rasch analysis indicated that nine items, one for each of nine symptom domains (fatigue, pain, memory/concentration, poor sleep, skin problems, gastrointestinal problems, dizziness, restless legs, and shortness of breath), formed a PROM with strong psychometric properties (including statistically acceptable reliability, test-retest reliability, and validity). Cognitive debriefing and survey responses confirmed content validity encompassing relevance, comprehensiveness, and clarity.</p><p><strong>Conclusions: </strong>The KSB-Q is a nine-item PROM measuring somatic symptoms. The KSB-Q demonstrates strong psychometric properties in patients with CKD stages 3-5, including those not receiving KRT, individuals receiving dialysis, and those with a functioning kidney transplant.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 5","pages":"sfaf112"},"PeriodicalIF":3.9,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966845","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":"ERA Registry Figure of the month Expected remaining years of life for dialysis and kidney transplant patients.","authors":"Vianda S Stel, Alberto Ortiz, Anneke Kramer","doi":"10.1093/ckj/sfaf091","DOIUrl":"https://doi.org/10.1093/ckj/sfaf091","url":null,"abstract":"","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 4","pages":"sfaf091"},"PeriodicalIF":3.9,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12015465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962472","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":"Donor-derived membranous nephropathy.","authors":"Ramyangshu Chakraborty, Michael Sheaff, Muhammad Magdi Yaqoob","doi":"10.1093/ckj/sfaf122","DOIUrl":"10.1093/ckj/sfaf122","url":null,"abstract":"","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 5","pages":"sfaf122"},"PeriodicalIF":3.9,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12099867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141616","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":"Urinary TWEAK reflects disease activity in ANCA-associated vasculitis.","authors":"Ásta Dögg Jónasdóttir, Peter Hemmingsson, Angelina Schwarz, Magnus Söderberg, Annika Wernerson, Abdul Rashid Qureshi, Aleksandra Antovic, Iva Gunnarsson, Annette Bruchfeld","doi":"10.1093/ckj/sfaf086","DOIUrl":"10.1093/ckj/sfaf086","url":null,"abstract":"<p><strong>Background: </strong>The aim of the study was to investigate urinary and serum tumour necrosis factor (TNF)-like weak inducer of apoptosis (TWEAK) as potential biomarkers in a longitudinal cohort of patients with ANCA-associated vasculitis (AAV).</p><p><strong>Methods: </strong>Patients with active AAV were included in the study. The Birmingham Vasculitis Score 2003 (BVAS) was used for assessment of disease activity and C-reactive protein (CRP), creatinine, albuminuria, and serum (s) and urinary (u) TWEAK levels were measured at baseline and 6-month follow-up. sTWEAK was measured in population-based controls for comparison. Kidney biopsies from AAV patients were stained for TWEAK and its receptor fibroblast growth factor-inducible 14 (Fn14) using immunohistochemistry (IHC).</p><p><strong>Results: </strong>sTWEAK was measured in 74 patients and uTWEAK in 69 patients, 42 of whom had kidney involvement. uTWEAK-to-creatinine ratio (uTWEAK/Cr) was significantly higher at baseline compared with follow-up (median 7.21 vs 4.94 ng/mmol, <i>P</i> < .0001). Patients with kidney involvement had higher uTWEAK/Cr levels compared with those without (<i>P</i> = .03). A correlation was found between uTWEAK/Cr and BVAS (<i>P</i> = .006), albuminuria (<i>P</i> = .022) and crescentic changes (<i>P</i> = .03). sTWEAK levels were higher in patients at inclusion than at follow-up (<i>P</i> = .009) but no difference was found when comparing patients and controls, nor did sTWEAK correlate with BVAS. IHC staining showed a clear expression of TWEAK but a fainter pattern of Fn14 in kidney biopsies from AAV patients.</p><p><strong>Conclusions: </strong>uTWEAK/Cr correlated with BVAS, albuminuria and number of crescents in active AAV and may be a useful biomarker in assessing disease activity in patients with AAV, whereas sTWEAK level is not.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 5","pages":"sfaf086"},"PeriodicalIF":3.9,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12121554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180941","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":"Fatigue across different chronic kidney disease populations: experiences and needs of patients.","authors":"Eline Schade van Westrum, Ellen K Hoogeveen, Birit F P Broekman, Carl E H Siegert, Dirry Keurhorst, Coby Annema, Marc H Hemmelder, Willem Jan W Bos, Friedo W Dekker, Yvette Meuleman","doi":"10.1093/ckj/sfaf118","DOIUrl":"10.1093/ckj/sfaf118","url":null,"abstract":"<p><strong>Background: </strong>Fatigue is a common symptom of chronic kidney disease (CKD). Predominantly qualitative research among dialysis patients has contributed to our knowledge about CKD patients' fatigue experiences and perceptions. This nationwide survey study aimed to explore in different CKD populations: (i) patients' experienced fatigue burden, its impact on daily life, and presumed causes of fatigue; and (ii) patients' experiences and needs regarding support, discussion, and treatment of fatigue.</p><p><strong>Methods: </strong>A survey assessing patients' fatigue experiences and needs was constructed in co-creation with the Dutch Kidney Patients Association. Descriptive statistics were used to summarize results and stratified by CKD populations [CKD without kidney replacement therapy (KRT), receiving dialysis, after kidney transplantation (KTx)], gender, and age.</p><p><strong>Results: </strong>A high fatigue burden was found across all CKD populations (<i>n</i> = 414;144 CKD without KRT/39 dialysis/231 KTx): fatigue was often experienced (94.7%), present for >6 months (90.3%), in the top three most burdensome symptoms (86.3%), and presumed causes were multifactorial. Younger patients were limited in more life domains than elderly. Some patients (32.1%) never or rarely discussed fatigue with their physician, did not receive treatment (67.8%), or felt the advice/treatment(s) insufficiently managed their fatigue (58.6%). More women and 18-50-year-old patients reported insufficient social support. Patients desired acknowledgement and more information about treatments and coping strategies for (consequences of) fatigue.</p><p><strong>Conclusion: </strong>High fatigue burdens and insufficient support are experienced across all CKD populations, gender, and age groups. To address patients' unfulfilled needs, it is important to structurally measure and discuss fatigue in routine nephrology care, strengthen social support, and provide patient-centred multidisciplinary symptom management.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 5","pages":"sfaf118"},"PeriodicalIF":3.9,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12209799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144539255","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 importance of identifying new and putative target antigens associated with membranous nephropathy: evidence from a Sardinian cohort.","authors":"Nicola Lepori, Andrea Angioi, Benjamin Madden, Matteo Floris, Gianfranca Cabiddu, Doloretta Piras, Paola Bianco, Roberta Mascia, Daniela Onnis, Fernando C Fervenza, Sanjeev Sethi, Antonello Pani","doi":"10.1093/ckj/sfaf115","DOIUrl":"10.1093/ckj/sfaf115","url":null,"abstract":"<p><strong>Background: </strong>Membranous nephropathy (MN) is a leading cause of nephrotic syndrome (NS). Since the identification of anti-phospholipase A2 receptor (anti-PLA2R) antibodies in 2009, the use of laser microdissection and tandem mass spectrometry (LMD/MS) has allowed the discovery of several target antigens in MN.</p><p><strong>Methods: </strong>In this retrospective cohort study, adult patients evaluated at the Division of Nephrology at Brotzu Hospital (Cagliari, Italy) with biopsy-proven MN and a negative serological test for anti-PLA2R antibody underwent LMD/MS, performed at the Department of Laboratory Medicine and Pathology of Mayo Clinic (Rochester, MN, USA).</p><p><strong>Results: </strong>Twenty-four cases of biopsy-proven MN were available for antigen detection by LMD/MS studies. High total spectral counts of PLA2R were detected in 12 out of 24 (50%) cases. In addition, high spectral counts of THSD7A and NELL1 were detected in two cases each, and EXT1/EXT2 and NCAM1 in one case each. Five putative antigens have been detected: SULF1, PGLYRP, HYAL1, THBS and SEZ6L2.</p><p><strong>Conclusions: </strong>Our study highlights at least two interesting considerations. First, the determination of PLA2R on renal tissue in the diagnosis of PLA2R-associated MN is emphasized since 50% of our cases were falsely diagnosed with PLA2R-negative MN based on the serum anti-PLA2R antibodies determination. Second, our study shows six patients with MN likely associated with putative antigens, two of them showing new antigens never described before in literature (HYAL1 and THBS1). This high prevalence of putative antigens in our cohort is not easily explainable and paves the way for evaluating specific factors in the Sardinian population that could explain this evidence.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 7","pages":"sfaf115"},"PeriodicalIF":3.9,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12214870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559419","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":"Patient's View on: \"Changes in body composition and handgrip strength during dapagliflozin administration in patients with chronic kidney disease\".","authors":"Takamasa Iwakura","doi":"10.1093/ckj/sfaf121","DOIUrl":"https://doi.org/10.1093/ckj/sfaf121","url":null,"abstract":"","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 4","pages":"sfaf121"},"PeriodicalIF":3.9,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12051860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977152","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}