Current Opinion in Nephrology and Hypertension最新文献_第9页

Global trends in hypertension prevalence, awareness, treatment, and control. 高血压流行、认识、治疗和控制的全球趋势。

IF 3.1 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2026-03-01 Epub Date: 2026-01-06 DOI: 10.1097/MNH.0000000000001151

Samantha S O'Connell, Paul K Whelton, Katherine T Mills

引用次数: 0

Implementing novel tools for enhancing diagnostic and therapeutic capacities to promote global public health and outcomes in kidney disease management and transplantation. 实施新工具，提高诊断和治疗能力，促进全球公共卫生和肾脏疾病管理和移植的结果。

IF 2.4 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2026-01-01 Epub Date: 2025-11-27 DOI: 10.1097/MNH.0000000000001136

Ekamol Tantisattamo, Ramy M Hanna, Kamyar Kalantar-Zadeh

引用次数: 0

Super high-flux membrane dialyzers and mortality in patients undergoing hemodialysis. 超高通量膜透析器与血液透析患者的死亡率。

IF 3.1 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2026-01-01 Epub Date: 2025-11-10 DOI: 10.1097/MNH.0000000000001134

Hiroyuki Takashima, Takashi Maruyama, Masanori Abe

{"title":"Super high-flux membrane dialyzers and mortality in patients undergoing hemodialysis.","authors":"Hiroyuki Takashima, Takashi Maruyama, Masanori Abe","doi":"10.1097/MNH.0000000000001134","DOIUrl":"10.1097/MNH.0000000000001134","url":null,"abstract":"Purpose of review: Synthetic high-flux membranes are currently the most widely used dialyzers worldwide. In Japan, super high-flux membranes have been in widespread use for some time, but in recent years, S-type dialyzer membranes have also been reported to improve prognosis. Today, super high-flux membranes with a larger pore size make it possible to remove large-molecule toxins, such as α 1 -microglobulin. This review focuses on the prognostic benefit of super high-flux and S-type dialyzer membranes.Recent findings: Until 2012, dialyzers in Japan were classified based on their β2-microglobulin (β2MG) clearance rate as type I (<10 ml/min), type II (≥10-30 ml/min), type III (≥30-50 ml/min), type IV (≥50-70), or type V (≥70 ml/min). It has been reported that type IV and V dialyzers are associated with a good prognosis. Dialyzers are now classified as type I-a, I-b, II-a, or II-b, based on a combination of β2MG clearance and the sieving coefficient for albumin. Moreover, the S-type dialyzer has been defined as having high biocompatibility, improving solute removal by adsorption, and having anti-inflammatory and antioxidant properties.Summary: Type IV and V dialyzers with a β2MG clearance rate of ≥50 ml/min are considered to improve the prognosis of patients on dialysis. According to the present classification, super high-flux membranes with a β2MG clearance rate of ≥70 ml/min and S-type membranes contribute to a more favorable prognosis.","PeriodicalId":10960,"journal":{"name":"Current Opinion in Nephrology and Hypertension","volume":" ","pages":"5-12"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145480547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Self-cannulation for home hemodialysis: a review of current practices and implementation approaches. 家庭血液透析的自我插管：当前实践和实施方法的回顾。

IF 3.1 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2026-01-01 Epub Date: 2025-10-14 DOI: 10.1097/MNH.0000000000001121

Maria C Bermudez, Osama El Shamy

引用次数: 0

Management of peritoneal dialysis in patients with obesity. 肥胖患者腹膜透析的处理。

IF 3.1 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2026-01-01 Epub Date: 2025-10-23 DOI: 10.1097/MNH.0000000000001124

Shweta Bansal, Rajeev Nararyan

{"title":"Management of peritoneal dialysis in patients with obesity.","authors":"Shweta Bansal, Rajeev Nararyan","doi":"10.1097/MNH.0000000000001124","DOIUrl":"10.1097/MNH.0000000000001124","url":null,"abstract":"Purpose of review: The healthcare system is increasingly burdened by the rising number of patients with end-stage kidney disease (ESKD), alongside a parallel surge in obesity. However, use of peritoneal dialysis in patients with obesity has been met with caution despite increasing recognition of advantages of home dialysis. This review addresses these concerns and outlines evidence-based guidelines for effective management.Recent findings: Contemporary analysis of peritoneal dialysis cohorts demonstrates that catheter-related complications are not higher in patients with obesity compared to normal weight using basic or advanced laparoscopic methods, and even percutaneously placed catheters can achieve good outcomes using technical advancements. A meticulously identified and well placed exit site facilitates infection free peritoneal dialysis delivery in patients with obesity. It is important to recognize that adipocytes have a significantly lower water content; therefore, adjusted body weight is proposed to estimate the volume of distribution and the clearance of small solutes more accurately. The practice of incremental dialysis and use of Icodextrin for long dwells help limit glucose exposure and manage related metabolic complications. Recent evidence does not support the notion that peritoneal dialysis modality alters the impact of obesity on likelihood of transplantation or overall survival.Summary: Obesity is associated with adverse outcomes in dialysis patients; however, these effects are comparable between hemodialysis and peritoneal dialysis, and are not more pronounced in peritoneal dialysis. With careful technical and clinical considerations, peritoneal dialysis therapy can be effectively delivered to patients with obesity without imposing undue burden. Therefore, obesity should not be viewed as a contraindication to peritoneal dialysis.","PeriodicalId":10960,"journal":{"name":"Current Opinion in Nephrology and Hypertension","volume":" ","pages":"101-107"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12672041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145353992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The obesity and lipid paradoxes in chronic kidney disease: mechanisms, interventions, and future directions. 慢性肾脏疾病中的肥胖和脂质悖论：机制、干预措施和未来方向。

IF 3.1 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2026-01-01 Epub Date: 2025-11-19 DOI: 10.1097/MNH.0000000000001131

Rina Takahashi, Yoshitsugu Obi, Kamyar Kalantar-Zadeh, Csaba P Kovesdy

{"title":"The obesity and lipid paradoxes in chronic kidney disease: mechanisms, interventions, and future directions.","authors":"Rina Takahashi, Yoshitsugu Obi, Kamyar Kalantar-Zadeh, Csaba P Kovesdy","doi":"10.1097/MNH.0000000000001131","DOIUrl":"10.1097/MNH.0000000000001131","url":null,"abstract":"Purpose of review: In patients with advanced chronic kidney disease (CKD), risk factor reversals occur where obesity and elevated LDL cholesterol paradoxically associate with improved survival. This review synthesizes recent advances in understanding these obesity and lipid paradoxes, integrating insights from body composition, inflammation, and metabolism.Recent findings: Observational studies have shown stage-specific survival advantages of obesity, mainly in hemodialysis populations and among patients with inflammation. The lipid paradox is also largely explained by the confounding effects of inflammation, which suppresses cholesterol levels. Beyond quantitative assessment, emerging evidence emphasizes that assessments of body composition and lipid quality are stronger predictors of clinical outcomes. For severely obese patients, integrative strategies using lifestyle, nutritional therapy, and pharmacologic agents may modulate inflammation, reducing the risk of protein-energy wasting. Weight loss from GLP-1 receptor agonists or bariatric surgery may improve kidney transplant eligibility but requires careful individual assessment to balance this benefit with the risk of malnutrition.Summary: The obesity and lipid paradoxes in CKD are not merely anomalies nor statistical fallacies to be adjusted for, but manifestations of CKD's distinct metabolic milieu. Their recognition highlights the need for individualized approaches beyond conventional risk factor modification. By integrating assessment of body composition, nutrition, and inflammation, precision nephrology can provide tailored interventions that improve prognosis.","PeriodicalId":10960,"journal":{"name":"Current Opinion in Nephrology and Hypertension","volume":" ","pages":"21-29"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145556396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

C3 glomerulopathy: advancements in diagnostics and therapeutics. C3肾小球病变：诊断和治疗的进展。

IF 3.1 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2026-01-01 Epub Date: 2025-11-07 DOI: 10.1097/MNH.0000000000001133

Shubham Dixit, Yongen Chang, Rebecca S Ahdoot, Ava Ham, Ramy M Hanna

{"title":"C3 glomerulopathy: advancements in diagnostics and therapeutics.","authors":"Shubham Dixit, Yongen Chang, Rebecca S Ahdoot, Ava Ham, Ramy M Hanna","doi":"10.1097/MNH.0000000000001133","DOIUrl":"10.1097/MNH.0000000000001133","url":null,"abstract":"Purpose of review: C3 glomerulopathy is a complex, relatively recently elucidated topic with many diagnostic and therapeutic developments over the last 10 years. The authors aim to update the general, glomerular disease, and transplant nephrology audience regarding these new discoveries.Recent findings: C3 glomerulopathy (C3G) includes a spectrum of disorders both etiologically, and morphologically, like dense deposit disease. Further developments in related glomerular pathologies like immune complex mediated membranoproliferative glomerulonephritis (ICMPGN), C3 monoclonal immunoglobulin deposition disease (C3-MIDD), and post infectious glomerulonephritis (PIGN) are emerging. Increases in molecular testing have revealed genetic links to alternative complement and acquired nephritic and anticomplement antibodies as playing an etiologic role. This alongside new pharmaceutical developments have moved the field forward significantly. There are also two new pivotal pharmacological agents approved by the United States Food and Drug Administration (USFDA). The new pharmacological pathways involve Factor B blockade (iptacopan) and C3 blockade (pegetacoplan).Summary: The new diagnostic, genetic, and molecular developments are discussed; changes in nomenclature and taxonomy are reviewed. Finally, landmark trials (such as the APPEAR-C3G and VALIANT, respectively) are reviewed to provide clinicians and clinician researchers with a timely update of new events in C3G.","PeriodicalId":10960,"journal":{"name":"Current Opinion in Nephrology and Hypertension","volume":" ","pages":"52-61"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145480575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Bringing medical education "home": the university health network and St. Michael's hospital home dialysis fellowship. 将医学教育“带回家”：大学健康网络和圣迈克尔医院家庭透析奖学金。

IF 3.1 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2026-01-01 Epub Date: 2025-10-03 DOI: 10.1097/MNH.0000000000001122

Wendy W Q Ye, Tushar Malavade, Joanne M Bargman, Christopher T Chan, Jeffrey Perl

{"title":"Bringing medical education \"home\": the university health network and St. Michael's hospital home dialysis fellowship.","authors":"Wendy W Q Ye, Tushar Malavade, Joanne M Bargman, Christopher T Chan, Jeffrey Perl","doi":"10.1097/MNH.0000000000001122","DOIUrl":"10.1097/MNH.0000000000001122","url":null,"abstract":"Purpose of review: Home dialysis remains variable and underused globally despite clinical and quality of life benefits for patients. Due to low patient volumes in many centers, it is challenging for nephrology trainees to gain adequate clinical exposure to achieve competency and comfort in patient management. In this review, we highlight the University of Toronto-affiliated University Health Network (UHN) and St. Michael's Hospital (SMH) Home Dialysis Fellowship as an educational model to improve competency and comfort in home dialysis.Recent findings: The UHN/SMH Home Dialysis Fellowship offers diverse clinical exposure with over 300 patients on peritoneal dialysis and home hemodialysis. Trainees achieve competency through repetitive exposure to a large volume of patients. The fellowship leverages continuity and longitudinal follow-up across all stages of a patient's chronic kidney disease journey. The program fosters interprofessional collaboration to develop comprehensive patient management plans. The attending physicians are leading world experts and support the varied trainee academic and career goals through mentorship and sponsorship.Summary: The UHN/SMH Home Dialysis Fellowship program combines evidence-based medical education principles with high volume, diverse, and complex patient populations to offer trainees an exceptional learning experience and the foundations to become the next generation of home dialysis experts.","PeriodicalId":10960,"journal":{"name":"Current Opinion in Nephrology and Hypertension","volume":" ","pages":"108-117"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145243868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

SLC26A1 directs sulfate homeostasis in health and disease. SLC26A1指导健康和疾病中的硫酸盐稳态。

IF 3.1 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2026-01-01 Epub Date: 2025-10-03 DOI: 10.1097/MNH.0000000000001123

Felix Pitzken, Anna Köttgen, Peter S Aronson, Felix Knauf

{"title":"SLC26A1 directs sulfate homeostasis in health and disease.","authors":"Felix Pitzken, Anna Köttgen, Peter S Aronson, Felix Knauf","doi":"10.1097/MNH.0000000000001123","DOIUrl":"10.1097/MNH.0000000000001123","url":null,"abstract":"Purpose of review: Sulfate is essential for the sulfation of proteoglycans to maintain cell function. The mechanisms regulating the 'ins and outs' of systemic sulfate balance remain incompletely understood. SLC26A1 is an anion exchanger expressed in the kidney. It has recently been identified as a key regulator of plasma sulfate homeostasis in humans. This review summarizes current insights into SLC26A1 function and its role in human diseases.Recent findings: Slc26a1-knockout mouse models exhibit reduced plasma sulfate and abnormal sulfate and oxalate homeostasis, accompanied by augmented susceptibility to acetaminophen-induced liver injury and kidney stone disease, although findings on oxalate homeostasis are inconsistent. In humans, rare and common SLC26A1 variants are associated with hyposulfatemia, musculoskeletal abnormalities, and, in some cases, nephrolithiasis. Functional assays confirm disrupted sulfate and oxalate transport of damaging variants. However, the knockout mouse models have been incompletely characterized, and few patients with damaging SLC26A1 variants have been characterized regarding sulfate and oxalate homeostasis and associated diseases.Summary: SLC26A1 emerges as a key regulator of sulfate homeostasis, with potential roles in hepatic detoxification, skeletal integrity, and kidney stone disease. Additional mouse models with tissue-specific gene deletion are needed to delineate the role of SLC26A1 in sulfate and oxalate homeostasis as well as disease pathogenesis. Identification of additional patients with damaging variants in SLC26A1 as well as larger population studies may help to elucidate causal relationships of SLC26A1 activity with clinical outcomes.","PeriodicalId":10960,"journal":{"name":"Current Opinion in Nephrology and Hypertension","volume":" ","pages":"126-132"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145243928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Peritoneal dialysis and heart failure. 腹膜透析和心力衰竭。

IF 3.1 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2026-01-01 Epub Date: 2025-10-14 DOI: 10.1097/MNH.0000000000001125

Caroline M Hsu, Daniel E Weiner, Wendy McCallum

{"title":"Peritoneal dialysis and heart failure.","authors":"Caroline M Hsu, Daniel E Weiner, Wendy McCallum","doi":"10.1097/MNH.0000000000001125","DOIUrl":"10.1097/MNH.0000000000001125","url":null,"abstract":"Purpose of review: Heart failure and chronic kidney disease are frequently comorbid, with both characterized by salt and water retention that lead to clinical deterioration. Peritoneal dialysis can effectively treat fluid overload and maintain euvolemia but remains underutilized. This review addresses the use of peritoneal dialysis in heart failure, including its potential advantages and also its challenges.Recent findings: The 2019 Advancing American Kidney Health initiative incentivized increased use of peritoneal dialysis in the United States. There is, therefore, growing recognition of peritoneal dialysis's appropriateness for heart failure, in that it can effectively remove volume, often with greater hemodynamic stability than intermittent hemodialysis. Peritoneal dialysis additionally avoids the risk of systemic bloodstream infection, which may be particularly high risk for patients with cardiac devices. System and logistic challenges remain for more widespread uptake of peritoneal dialysis in people with kidney failure and heart failure, including limited ability to urgently start peritoneal dialysis and clinician and hospital inexperience.Summary: Peritoneal dialysis is an effective therapy for heart failure in individuals with kidney failure but remains underutilized. Strategies for increased uptake include provider education and greater structural and logistic support, particularly in the inpatient setting.","PeriodicalId":10960,"journal":{"name":"Current Opinion in Nephrology and Hypertension","volume":" ","pages":"118-125"},"PeriodicalIF":3.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12820935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145336689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0