International Journal of Nephrology最新文献

{"title":"Transitioning From Blind to Real-Time Ultrasound-Guided Kidney Biopsy in Children: Diagnostic Yield and Bleeding Outcomes in a Vietnamese Tertiary Referral Hospital, a Retrospective Cohort Study.","authors":"Binh Thanh Le, Tien Quoc Nguyen, Anh Xuan Nguyen, Cam Thao Nguyen, Tru Huy Vu, Dinh Quang Truong, Tien Minh Nguyen, Quang Duc Nguyen, Linh Ngoc Huynh, Khanh Ngoc Minh Nguyen, Tam Ngoc Minh Bui, Siyu Chen, Binbin Ji, Jackson Tan, Minh Cuong Duong","doi":"10.1155/ijne/7390086","DOIUrl":"10.1155/ijne/7390086","url":null,"abstract":"<p><strong>Background: </strong>Kidney biopsy is the gold standard for diagnosing renal parenchymal diseases, guiding treatment and assessing prognosis. Real-time ultrasound-guided biopsy is widely regarded as the preferred technique. However, the implementation may be affected by equipment availability, trained personnel and workflow constraints in resource-limited settings worldwide.</p><p><strong>Objective: </strong>This study compared the safety and effectiveness of real-time ultrasound-guided and blind kidney biopsy techniques in a paediatric tertiary referral hospital in Vietnam and examined the practical implications of transitioning to real-time ultrasound guidance.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted at the Nephro-Endocrinology Department, City Children's Hospital, Ho Chi Minh City, Vietnam, from May 2018 to April 2025. All native kidney biopsies performed during the study period were included. A standardised questionnaire was used to extract data from medical records, including demographics, biopsy techniques, glomerular yield, samples containing ≥ 10 and ≥ 25 glomeruli, and inadequate yield and complications, including macroscopic haematuria and major complications.</p><p><strong>Results: </strong>Among 221 participants (median age: 11 [IQR 7-13] years), 173 underwent real-time ultrasound-guided biopsy and 48 used the blind technique. The ultrasound-guided group had a significantly higher median glomerular count (<i>p</i> = 0.01) and greater proportion of samples with ≥ 10 (<i>p</i> < 0.001) and ≥ 25 glomeruli (<i>p</i> = 0.04). There were no significant differences in inadequate sample rates (<i>p</i> = 0.06), macroscopic haematuria (<i>p</i> = 0.63) or major complications (<i>p</i> = 0.60). Lower eGFR was independently associated with post-biopsy bleeding events, mainly macroscopic haematuria (AOR = 0.809 per 10 mL/min/1.73 m² increase, 95% CI 0.671-0.975, <i>p</i> = 0.03).</p><p><strong>Conclusion: </strong>In this Vietnamese paediatric tertiary referral setting, real-time ultrasound-guided biopsy provided superior tissue adequacy compared with the blind technique, without a detectable increase in macroscopic haematuria or major complications. Lower estimated glomerular filtration rate was associated with post-biopsy bleeding events in this cohort, mostly macroscopic haematuria rather than major bleeding.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2026 ","pages":"7390086"},"PeriodicalIF":1.9,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13424444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148653035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Profile and Outcome of Snake Bite-Associated Acute Kidney Injury: A Retrospective Study.","authors":"E Mahesh, Mohammed Yousuff, N Monika, Pooja Prabhu, M S Gireesh, R Rajashekar, V Hamsa","doi":"10.1155/ijne/6661125","DOIUrl":"10.1155/ijne/6661125","url":null,"abstract":"<p><strong>Background: </strong>Snakebite is a neglected tropical disease with a high burden in South Asia, particularly India. Acute kidney injury (AKI) is one of the most serious complications of snake envenomation, which has significant morbidity, mortality, and risk of chronic kidney disease (CKD). The present study aimed to evaluate the incidence, predictors, and outcomes of snakebite-associated AKI (SBE-AKI) in a tertiary care center.</p><p><strong>Methods: </strong>We retrospectively analyzed 325 patients with snakebite envenomation, admitted to our institution. Demographic, clinical, laboratory, and treatment variables were compared between patients with and without AKI. AKI was staged according to KDIGO criteria. Renal biopsy was performed selectively in patients with prolonged renal failure, dialysis dependence, delayed renal recovery, or suspicion of irreversible renal injury. Outcomes assessed included recovery, progression to CKD, and mortality.</p><p><strong>Results: </strong>Of the 325 patients, 79 (32.1%) developed AKI. Patients with AKI were significantly younger (mean age 34 vs. 45 years, <i>p</i> = 0.001). Delay in antisnake venom (ASV) administration (5 vs. 9 h, <i>p</i> = 0.001), need for inotropes (41.8% vs. 14.2%, <i>p</i> = 0.001), and mechanical ventilation (36.7% vs. 6.9%, <i>p</i> = 0.001) were strong predictors. Proteinuria was more frequent in AKI (80% vs. 32.5%). Among AKI patients, 57% had Stage 3 AKI; 39.2% required dialysis. Biopsy (<i>n</i> = 8) showed acute tubular necrosis in 37.5% and cortical necrosis in 25%. Outcomes included 77.2% recovery, 6.3% progression to CKD, and 16.5% mortality.</p><p><strong>Conclusion: </strong>SBE-AKI is a common and serious complication of snakebite. Delay in ASV administration, hemodynamic instability, proteinuria, advanced AKI stage, and cortical necrosis predict poor outcomes. Early ASV, timely dialysis, and long-term nephrology follow-up are essential to improve survival and reduce CKD progression.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2026 ","pages":"6661125"},"PeriodicalIF":1.9,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13373522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148470551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Point-of-Care Kidney Ultrasonography in Pediatric Nephrology: Current Evidence and Clinical Relevance.","authors":"Mahboube Bahroudi, Ali Asadifar, Mastaneh Moghtaderi","doi":"10.1155/ijne/7767952","DOIUrl":"10.1155/ijne/7767952","url":null,"abstract":"<p><p>Point-of-care ultrasonography (POCUS) has revolutionized pediatric healthcare by offering immediate, bedside diagnostic capabilities that enhance clinical decision-making and patient management. This comprehensive review examines the impact and necessity of POCUS in assessing renal conditions in children. By synthesizing current literature, clinical applications, diagnostic accuracy, and patient outcomes associated with POCUS, this paper highlights its essential role in pediatric nephrology. Additionally, the integration of POCUS into clinical practice, requisite training protocols, and future technological advancements are discussed. The review concludes that POCUS is an indispensable tool in pediatric kidney assessment, improving diagnostic precision, reducing the need for more invasive procedures, and enhancing overall patient outcomes.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2026 ","pages":"7767952"},"PeriodicalIF":1.9,"publicationDate":"2026-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13266088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148264341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Renal Resistive Index in Severe Preeclampsia: Correlation With Glomerular Filtration Rate and Diagnostic Accuracy for Acute Kidney Injury.","authors":"Jorge Luis Medina-Lopez, Olivia Aleida Cardoso-Navarrete, Job H Rodriguez-Guillen, Jose J Zaragoza, Jonathan S Chavez-Iñiguez","doi":"10.1155/ijne/9943930","DOIUrl":"10.1155/ijne/9943930","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate the diagnostic performance of renal resistive index (RRI) for predicting acute kidney injury (AKI) and glomerular filtration rate (GFR) in patients with severe preeclampsia.</p><p><strong>Methods: </strong>This observational study included 22 patients admitted with severe preeclampsia. RRI was measured at admission. AKI was defined and staged according to Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Receiver operating characteristic (ROC) curve analysis was used to assess RRI's ability to predict AKI and measured creatinine clearance.</p><p><strong>Results: </strong>Of the 22 patients, 9 (40.9%) developed AKI. Patients who developed AKI had significantly higher admission RRI values compared to those who did not (mean 0.75 ± 0.19 vs. 0.45 ± 0.13, respectively; <i>p</i> < 0.001). The area under the ROC curve for RRI predicting AKI was 0.87 (95% CI, 0.65-0.97). In the multivariate linear regression analysis, RRI showed a borderline significant negative association with adjusted GFR (<i>β</i> = -112.67; <i>p</i> = 0.095), though the overall model was not statistically significant (<i>p</i> = 0.23).</p><p><strong>Conclusion: </strong>The RRI measured at ICU admission is a promising, noninvasive predictor of AKI in patients with severe preeclampsia, demonstrating good diagnostic accuracy with high specificity at an optimal cutoff.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2026 ","pages":"9943930"},"PeriodicalIF":1.9,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13240432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148198875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic Kidney Disease in Urban, Adult Sri Lankans: A Cohort Follow-Up Study.","authors":"Shamila De Silva, Dileepa Ediriweera, Madunil Niriella, Anuradhini Kasturiratne, Arunasalam Pathmeswaran, Norihiro Kato, Rajitha Wickramasinghe, H Janaka de Silva","doi":"10.1155/ijne/3236349","DOIUrl":"10.1155/ijne/3236349","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease (CKD) affects approximately 850 million adults worldwide, with its prevalence rising due to increasing rates of diabetes and hypertension in aging populations. This study aims to assess the prevalence and associated factors of CKD in an urban adult cohort in Sri Lanka, where such data are limited.</p><p><strong>Methods: </strong>We conducted a stratified random sampling of participants from Ragama, Sri Lanka, initially in 2007 (ages 35-64) and reassessed them in 2014. Data collection involved structured interviews, anthropometric measurements, and biochemical tests. CKD was evaluated in 2014 using the estimated glomerular filtration rate (eGFR) calculated via the CKD-EPI formula, defining CKD as eGFR < 60 mL/min/1.72 m² according to KDIGO/KDOQI guidelines. A follow-up in 2017 assessed all-cause and cardiovascular mortality and morbidity.</p><p><strong>Results: </strong>Of 2985 individuals recruited in 2007, 2148 (71.6%) participated in the 2014 follow-up; 2032 (94.6%) had complete data to assess CKD status in 2014. Mean age of the participants was 52.3 (SD 7.7) years; 57% were women. Age-adjusted prevalence of CKD was 3.03 (1.98-4.11) per 100 population in 2014; most were Stage 3A (67.2%), followed by Stage 3B (23%) and Stage 4 (9.8%). Older age (<i>p</i> < 0.001), male gender (<i>p</i> < 0.05), diabetes (<i>p</i> < 0.001), and hypertension (<i>p</i> < 0.001) at baseline were associated with CKD in 2014. No association was observed between CKD and all-cause or cardiovascular mortality or morbidity by 2017 (<i>p</i> > 0.05).</p><p><strong>Conclusions: </strong>Diabetes and hypertension are significant contributors to CKD prevalence, with most patients at Stage 3, where early detection and management can slow disease progression. CKD remains underrecognized in Sri Lanka, highlighting the need for extensive population-based studies to better understand this growing health issue better.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2026 ","pages":"3236349"},"PeriodicalIF":1.9,"publicationDate":"2026-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13175392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147963529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HLA Profiles of Patients With Chronic Kidney Disease in Central South Africa.","authors":"Walter Janse van Rensburg, Kirsten Lange, Feziwe Bisiwe, Jean Kloppers","doi":"10.1155/ijne/5519442","DOIUrl":"10.1155/ijne/5519442","url":null,"abstract":"<p><strong>Background: </strong>The human leucocyte antigen (HLA) complex has been associated with the susceptibility of several hundred human diseases, increasingly so with kidney disease. HLA data are under-represented in South Africa, and thus, their contribution to disease characterisation remains poorly understood. Therefore, there is a need for HLA typing studies among high-risk disease populations in our region.</p><p><strong>Methods: </strong>We recruited a total of 100 participants with biopsy-proven chronic kidney disease (CKD) attending a nephrology clinic in central South Africa. Exploratory analyses of demographic, clinical and serological characteristics were performed. High-resolution HLA typing was conducted using DNA microarray technology.</p><p><strong>Results: </strong>Among 100 participants, a large proportion had early-stage CKD based on glomerular filtration rate (GFR) category (CKD stage 1 and 2: 64%), yet many were classified as being at high or very high risk of disease progression to end-stage kidney disease (ESKD) according to the 'Kidney Disease: Improving Global Outcomes' (KDIGO) criteria. This risk was predominantly driven by severely increased proteinuria (proteinuria category A3: 41.8%) rather than reduced estimated GFR (eGFR). Hypertension was the most common comorbidity/complication, and roughly a fifth of the cohort were HIV positive. The most prevalent autoimmune serology was antinuclear antibody (ANA) positivity, occurring in the context of a high frequency of lupus nephritis (LN) in this cohort. We observed the following recurring set of HLA alleles in this CKD cohort, alongside specific clinical and/or serological features: HLA-A∗23:01; HLA-A∗68:02; HLA-B∗15:10; HLA-B∗44:03; HLA-DRB1∗03:01; HLADQB1∗02:01; HLA-DQB1∗02:02 and/or HLA-DPB1∗04:01.</p><p><strong>Conclusion: </strong>Our findings suggest that specific HLA alleles may be associated with CKD susceptibility and/or the increased risk of disease progression in this regional cohort, warranting further investigation into specific CKD-related immunological and molecular mechanisms to establish causality in larger studies. Furthermore, by increasing our global representation in population-specific reference panels, we can improve our understanding of South Africa's extensive genetic diversity.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2026 ","pages":"5519442"},"PeriodicalIF":1.9,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13155130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147868290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Spectrum and Temporal Trends of Glomerular Diseases in Saudi Arabia: A Systematic Review of Biopsy-Based Studies.","authors":"Manal E Alotaibi, Laila A Alharbi, Fahd Almalki, Waleed Alotaibi, Ibrahim Tawhari, Mutlaq Alotaibi","doi":"10.1155/ijne/3670670","DOIUrl":"10.1155/ijne/3670670","url":null,"abstract":"<p><strong>Purpose: </strong>This systematic review aims to synthesize data from biopsy-based studies to quantify the epidemiology, regional variations, and temporal trends of glomerular diseases (GDs) in Saudi Arabia.</p><p><strong>Methods: </strong>We conducted a systematic search using PubMed, MEDLINE, the Cochrane Library, and Google Scholar to identify relevant studies published up to January 1, 2025. Studies reporting native renal-biopsy data from Saudi Arabia, with histopathological confirmation of GD, were included. Data extraction followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and study quality was assessed using the Newcastle-Ottawa Scale.</p><p><strong>Results: </strong>Twelve studies (4066 patients) were included, representing all major regions of Saudi Arabia between 1989 and 2017. Primary GD accounted for 50%-80% of all biopsies, while secondary GD represented 18%-48%. Focal segmental glomerulosclerosis (FSGS) was the most common primary GD (15%-40% of cases), while lupus nephritis dominated secondary GD (55%-75%). Nephrotic syndrome was the principal indication for biopsy in all adult cohorts (40%-65%), particularly with minimal change disease (MCD), FSGS, and membranous glomerulonephritis (MGN) subtypes. Temporal trends revealed an increase in IgA nephropathy and diabetic nephropathy, with a decline in membranoproliferative glomerulonephritis. Notable regional variations were also identified. Progression to ESRD was observed in 25%-35% of crescentic and FSGS cases.</p><p><strong>Conclusion: </strong>This review highlights the evolving landscape of GDs in Saudi Arabia, emphasizing the need for early diagnosis, standardized biopsy protocols, and multidisciplinary management. A national renal biopsy registry is recommended to improve surveillance and research collaboration.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2026 ","pages":"3670670"},"PeriodicalIF":1.9,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13106946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic Kidney Disease and Superimposed Acute Kidney Injury: Greater Impact of Acute Insults on Outcomes.","authors":"Mariana Wernersbach Chagas, Dayana Bitencourt Dias, Welder Zamoner, Daniela Ponce","doi":"10.1155/ijne/1353892","DOIUrl":"10.1155/ijne/1353892","url":null,"abstract":"<p><strong>Introduction: </strong>Acute kidney injury (AKI) and chronic kidney disease (CKD) are widely correlated. However, the risk factors associated with outcomes of AKI in CKD patients have not been widely studied to date.</p><p><strong>Objectives: </strong>To identify factors associated with outcomes of death and need for kidney support therapy (KST) in patients with CKD who present with AKI during hospital stay.</p><p><strong>Methods: </strong>Retrospective cohort conducted from July 2018 to June 2022 that included patients with CKD and superimposed AKI. Sociodemographic data related to CKD, AKI, and the progression of patients to outcomes as death and KST were collected. The results were discussed with a significance level of <i>p</i> < 0.05.</p><p><strong>Results: </strong>A total of 327 patients were included. The patients had a mean age of 68.6 ± 11.4 years, the majority were men, and the most prevalent comorbidities were hypertension (81.7%) and cardiovascular disease (61.5%). The mean creatinine was 1.85 ± 0.74 mg/dL. The main etiology of CKD was undetermined (26.6%) and of AKI was septic (45.3%). Patients were hospitalized mainly for infectious or cardiovascular causes (22.3% each). Overall mortality was 29.1%, and the need for KST was 35.2%. In the intensive care unit (ICU), 73.2% required dialysis and 74.4% died, reaching 85.7% in those with KST. CKD staging was not associated with any of the primary outcomes. The risk factors for KST were obesity, ATN-ISS score, and creatinine elevation greater than three times the baseline. The risk factors for death were ATN-ISS score, undetermined CKD, septic AKI, ICU admission, and KST.</p><p><strong>Conclusions: </strong>Mortality and need for KST in CKD patients admitted to the ICU and who develop AKI are high. Variables related to AKI were more relevant than those related to CKD for clinical outcomes.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2026 ","pages":"1353892"},"PeriodicalIF":1.9,"publicationDate":"2026-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12789637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145951999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interaction Effect of Depression and Hypertension on Nephrotoxicity Among Persons Living With HIV: A Cross-Sectional Study.","authors":"John Tetteh, Naana Agyeman, Swithin M Swaray, Kwasi Torpey, Elijah Paintsil, Alfred Edwin Yawson, Duah Dwomoh","doi":"10.1155/ijne/8421994","DOIUrl":"10.1155/ijne/8421994","url":null,"abstract":"<p><strong>Background: </strong>The goal of antiretroviral therapy will not be achieved without addressing Human Immunodeficiency Virus (HIV) comorbidities, including depression, hypertension, and nephrotoxicity among people living with HIV (PLWH). This study was conducted to assess the interaction effect of depression and hypertension on nephrotoxicity among PLWH.</p><p><strong>Methods: </strong>The study employed a cross-sectional study design. Data were collected from May to June 2022. The main outcome was nephrotoxicity, while depression and hypertension were considered as exposure factors. Confounders were identified through the directed acyclic graph and were controlled using the propensity score matching procedure. We estimated the causal association from the interactions by using weighted logistic regression.</p><p><strong>Results: </strong>The study involved 416 PLWH with ages ranging from 19 to 80 years (mean standard deviation was 49.32 ± 10.43 years). The majority (79.09%) of the participants involved were females. The prevalence of depression, hypertension, and nephrotoxicity was 21.87% (95% CI = 18.15-26.12), 36.30% (31.80-41.05), and 33.65% (29.26-38.35), respectively. Among participants with both depression and hypertension, analysis showed a substantial increase in the odds of nephrotoxicity. The proportion of the combined effect due to interaction was approximately 71% (63-77), and the excess risk due to interaction was positive (RERI = 1.87; 1.46-2.28). On the multiplicative scale, when both depression and hypertension are present, the risk of nephrotoxicity tripled (effect = 3.42; 2.70-4.14). Having depression raises the likelihood of nephrotoxicity by 55% (aOR = 1.55; 1.35-1.76) among PLWH with hypertension. Among PLWH with depression, the odds of nephrotoxicity increased by over twofold due to hypertension (aOR = 2.12; 1.83-2.42).</p><p><strong>Conclusion: </strong>The presence of both depression and hypertension raises the likelihood of nephrotoxicity much more than either condition alone. The findings revealed a synergistic effect, highlighting the need for integrated care that addresses both mental health and cardiovascular risks in HIV treatment.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2025 ","pages":"8421994"},"PeriodicalIF":1.9,"publicationDate":"2025-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12754264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145889067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Evolving Experience and Outcomes of Pediatric Kidney Transplant in Abu Dhabi, UAE (2010-2024).","authors":"Ela Beyyumi, Watfa Al Dhaheri, Niaz Ahmad, Muhammad Badar Zaman, Eihab Al Khasawneh","doi":"10.1155/ijne/5188212","DOIUrl":"10.1155/ijne/5188212","url":null,"abstract":"<p><strong>Background: </strong>Kidney transplant is acknowledged as the treatment of choice for end-stage renal disease (ESRD). This study reports on the outcome of pediatric renal transplant at a tertiary hospital in Abu Dhabi.</p><p><strong>Methods: </strong>It is a retrospective study of all pediatric renal transplants performed at a single designated pediatric center between February 2010 and February 2024, including children aged 1-16 years.</p><p><strong>Results: </strong>Sixty-nine (44% female) pediatric renal transplants were performed, 36 from living-related donors and 33 from deceased donors. The mean age at transplant and last follow-up were 9.8 ± 3.6 years and 13.8 ± 4.7 years, respectively. ESRD etiologies included congenital anomalies of the kidney and urinary tract (39%), nephronophthisis (19%), glomerulonephritis (13%), and other causes (29%). Thirteen (19%) children underwent a preemptive transplant, whereas 56 (81%) were on dialysis at transplant. Thirty-one (45%) children had graft rejection: 16 (23%) in the first year, 9 (13%) in years 2-5, and 6 (9%) thereafter. Donor-specific antibodies (DSAs) were detected in 19 (28%) children; 17 (25%) of those had graft rejection with anti-DR or anti-DQ alloantibodies. Fourteen children had DSA-negative graft rejection. Of those, eight had cell-mediated rejection, and six had mixed rejection. Predictors of rejection were positive DSA (<i>p</i> = < 0.0001) and two DR mismatches (<i>p</i> = 0.029); three graft losses occurred. The prevalence of EBV, CMV, and BKV infection in the first year was 43%, 39%, and 33%, respectively, falling to 38%, 18%, and 12% in the subsequent years. Thirty-four (49%) children had at least one episode of culture-positive urinary tract infection. The 1-year and 5-year patient survival rates were 100% and 96.6%, and the corresponding graft survival rates were 98.1% and 89.7%, respectively.</p><p><strong>Conclusion: </strong>The outcome of pediatric kidney transplants in Abu Dhabi over 14 years shows patient and graft survival comparable to published data. Acute graft rejection remains a major challenge with the presence of DSA and biallelic HLA-DR mismatch as independent predictors for rejection. Optimizing donor selection, immunosuppression, and closer surveillance are vital.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2025 ","pages":"5188212"},"PeriodicalIF":1.9,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12752876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145878387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}