International Journal of Nephrology and Renovascular Disease最新文献

{"title":"Identification and Management of CKD-Associated Pruritus: Current Insights.","authors":"Tomasz Skrzypczak, Anna Skrzypczak, Piotr Nockowski, Jacek C Szepietowski","doi":"10.2147/IJNRD.S499798","DOIUrl":"10.2147/IJNRD.S499798","url":null,"abstract":"<p><p>Chronic kidney disease-associated pruritus (CKD-aP) is a frequent and distressing problem for individuals with chronic kidney disease (CKD) and end-stage renal disease. It affects around 20% of those with CKD and 40% of those with end-stage renal disease. Despite its clear association with poorer psychosocial and medical outcomes, it is often underreported by patients and frequently remains unnoticed by healthcare providers. This is likely due to uncertainty regarding its diagnosis and treatment. Most commonly, CKD-aP could be screened with questionnaires like the KDQoL-36 and WI-NRS, chosen for their simplicity and ease of use. Prior treatment studies of CKD-aP were mostly limited by noncontrolled design and small sample size. First CKD-aP medication - difelikefalin a powerful, new therapeutic option was approved by Federal Drug Administration (FDA) in 2021 and European Medicines Agency (EMA) in 2022. Recent expert opinions, clinical trials and metanalysis identified difelikefalin and gabapentinoids as medications of choice in treatment of CKD-aP. All these findings improved current understanding and management of this condition.</p>","PeriodicalId":14181,"journal":{"name":"International Journal of Nephrology and Renovascular Disease","volume":"17 ","pages":"339-354"},"PeriodicalIF":2.1,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11693948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921650","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":"Pediatric Acute Lobar Nephronia: A Case Series and Literature Review.","authors":"Kfir Lavi, Adi Klein, Noy Shtein, Vered Schichter Konfino, Vered Nir","doi":"10.2147/IJNRD.S491182","DOIUrl":"10.2147/IJNRD.S491182","url":null,"abstract":"<p><strong>Introduction: </strong>Acute lobar nephronia (ALN) is a focal renal infection without liquefaction, historically regarded as rare in the pediatric population, yet recent literature suggests it may be under-diagnosed, which may result in the formation of renal abscess and future renal scarring.</p><p><strong>Methods: </strong>The clinical presentation, investigations, treatment and long-term outcomes of 5 patients diagnosed with ALN was described and literature review was conducted by reviewing publications in PubMed using the keywords \"acute lobar nephronia\" and \"pediatric\".</p><p><strong>Results: </strong>Three patients were males, aged 1 to 11 years. The primary complaint in all cases was fever, accompanied by significantly elevated inflammatory markers. Upon presentation, none of the patients exhibited pyuria on urinalysis, and all had sterile blood and urine cultures. Diagnosis was based on CT scans for three patients and renal sonography for two. Main findings included hyperechogenic renal parenchyma, and hypodense localized parenchyma. Treatment consisted of broad-spectrum intravenous antibiotics, administered for 7 to 12 days and additional 1 week course with amoxicillin-clavulanate, resulting in similar defervescence times across all patients. None of the patients demonstrated recurrence and none had renal pathology upon repeated renal sonography and upon DMSA scintigraphy.</p><p><strong>Discussion: </strong>Clinical suspicion for ALN should arise in cases of abdominal pain and markedly increased inflammatory markers. It\"s crucial to note that the absence of pyuria and negative culture results should not exclude ALN diagnosis, underscoring the need for a high index of suspicion in the pediatric population.</p>","PeriodicalId":14181,"journal":{"name":"International Journal of Nephrology and Renovascular Disease","volume":"17 ","pages":"333-337"},"PeriodicalIF":2.1,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11662641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876865","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":"Causal Relationships Between Gut Microbiota, Metabolites, and Diabetic Nephropathy: Insights from a Two-Sample Mendelian Randomization Analysis.","authors":"Xixi Song, Jingqiu Cui, Shiwei Li, Bo Huang","doi":"10.2147/IJNRD.S489074","DOIUrl":"10.2147/IJNRD.S489074","url":null,"abstract":"<p><strong>Background: </strong> Previous studies have established a correlation between gut microbiota, metabolites, and diabetic nephropathy (DN). However, the inherent limitations of observational studies, including reverse causality and confounding factors, made this relationship uncertain.</p><p><strong>Methods: </strong>In this study, we compiled summary statistics from a genome-wide association study (GWAS) conducted on gut microbiota, metabolites, and DN. We employed a two-sample Mendelian randomization (MR) approach, utilizing inverse variance weighted (IVW), MR-Egger, weighted median, and weighted mode methods.</p><p><strong>Results: </strong> We detected the protective nature of genetically predicted representatives from the family Bacteroidaceae (OR: 0.716, 95% CI: 0.516-0.995, <i>p</i> = 0.046), family Victivallaceae (OR: 0.871, 95% CI: 0.772-0.982, <i>p</i> = 0.026), genus Bacteroides (OR: 0.716, 95% CI: 0.516-0.995, <i>p</i> = 0.046), genus Coprococcus 2 (OR: 0.745, 95% CI: 0.576-0.963, <i>p</i> = 0.025), and genus Lactococcus (OR: 0.851, 95% CI: 0.730-0.992, <i>p</i> = 0.039) against the development of DN. Conversely, we identified a positive correlation between the incidence of DN and entities, such as Phylum Bacteroidetes (OR: 1.427, 95% CI: 1.085-1.875, <i>p</i> = 0.011), class Bacteroidia (OR: 1.304, 95% CI: 1.036-1.641,<i>p</i> = 0.024), order Bacteroidales (OR: 1.304, 95% CI: 1.035-1.641, <i>p</i> = 0.028), genus Catenibacterium (OR: 1.312, 95% CI: 1.079-1.594, <i>p</i> = 0.006), genus Lachnoclostridium (OR: 1.434, 95% CI: 1.129-1.821, <i>p</i> = 0.003), and genus Parasutterella (OR: 1.270, 95% CI: 1.070-1.510, <i>p</i> = 0.006). In our analysis, none of the gut metabolites demonstrated a causal relationship with DN.</p><p><strong>Conclusion: </strong> Our results substantiated the potential causal association between specific gut microbiota and DN. Therefore, our study offers novel insight into the mechanisms underlying DN. This finding provides a theoretical foundation for the future development of targeted strategies for the prevention and treatment of DN.</p>","PeriodicalId":14181,"journal":{"name":"International Journal of Nephrology and Renovascular Disease","volume":"17 ","pages":"319-332"},"PeriodicalIF":2.1,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11645948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142828318","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":"Value of Shear Wave Elastography in the Evaluation of Chronic Kidney Disease.","authors":"Shivarajkumar K Lakshmana, Prakashini Koteshwar, Tanushree Kamath","doi":"10.2147/IJNRD.S480501","DOIUrl":"10.2147/IJNRD.S480501","url":null,"abstract":"<p><strong>Purpose and motivation: </strong>Chronic kidney disease (CKD) is a major global public health problem with eventual progression to end-stage renal disease which tends to increase kidney stiffness. Shear wave elastography (SWE) is a recently developed ultrasound based technique which can be used to assess tissue stiffness noninvasively. The aim of this study was to evaluate the potential diagnostic value of SWE to assess renal parenchymal stiffness in CKD and its correlation with estimated glomerular filtration rate (eGFR), which may be used as a marker for detecting and staging CKD.</p><p><strong>Materials and methods: </strong>The study protocol was approved by the Institutional ethics Committee at Kasturba medical college, Manipal and written informed consent was obtained from all participants. The study included 93 control subjects and 108 patients with CKD. SWE imaging was performed to assess renal cortical stiffness, as measured by the Young's modulus (YM). Correlations between SWE and conventional ultrasound parameters with age, serum creatinine, eGFR and serum urea were analysed using Pearson's correlation coefficient (p ≤ 0.05) and receiver operating characteristic (ROC) curves were derived.</p><p><strong>Results: </strong>The diagnostic performance of SWE correlated with serum creatinine levels and eGFR. We found a statistically significant difference in kidney stiffness values between healthy individuals and CKD patients. The Spearman correlation coefficient revealed moderate negative linear correlation between the YM measurements and eGFR. We obtained a YM measurement cut-off value of 4.43 kPa, a value less than or equal to this suggested a no diseased kidney. This yielded sensitivity and specificity of 92.6% and 80.6%, respectively, with an AUROC of 0.92.</p><p><strong>Conclusion: </strong>Our results demonstrated that shear wave elastography may provide a low-cost, non-invasive method for the morphological assessment and progression of the disease status in chronic kidney disease patients with CKD.</p>","PeriodicalId":14181,"journal":{"name":"International Journal of Nephrology and Renovascular Disease","volume":"17 ","pages":"307-317"},"PeriodicalIF":2.1,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11634788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142817607","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":"Chorea in Hemodialysis Patients: Report of Two Cases.","authors":"Xiaoxia Chen, Yafeng Zhang, Yue Zhou","doi":"10.2147/IJNRD.S490816","DOIUrl":"10.2147/IJNRD.S490816","url":null,"abstract":"<p><strong>Background: </strong>Chorea is rare in maintenance dialysis patients but seriously affects the quality of life, and there are few previous reports of this condition. We report two patients undergoing regular hemodialysis for end-stage renal disease, both of whom presented with progressively intensified involuntary limb movements, but originating from different etiologies.</p><p><strong>Case presentation: </strong>We report two patients undergoing regular hemodialysis for end-stage renal disease who presented with progressively intensified involuntary limb movements. Treatment with sedatives alone proved ineffective in both cases. Through differential diagnosis, one patient was diagnosed with diabetic striatopathy and managed with intensive glycemic control, while the other was found to have uremic metabolic encephalopathy and treated with a combination of hemodialysis and hemoperfusion. Subsequently the patients' symptoms improved significantly.</p><p><strong>Conclusion: </strong>Choreiform movements in hemodialysis patients arise from a variety of etiologies. These two cases suggested the susceptibility to the onset of chorea in the early stage of maintenance hemodialysis.</p>","PeriodicalId":14181,"journal":{"name":"International Journal of Nephrology and Renovascular Disease","volume":"17 ","pages":"301-306"},"PeriodicalIF":2.1,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11616423/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780251","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":"Associated Factors for Chronic Kidney Disease in Patients with Diabetes Mellitus 2: Retrospective Study.","authors":"Evelyn Del Socorro Goicochea-Rios, Irma Luz Yupari-Azabache, Nélida Milly Otiniano, Néstor Iván Gómez Goicochea","doi":"10.2147/IJNRD.S489891","DOIUrl":"https://doi.org/10.2147/IJNRD.S489891","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic kidney disease affects the quality of life of people with diabetes mellitus, increases cardiovascular risk, and has high social costs.</p><p><strong>Objective: </strong>To determine associated factors for chronic kidney disease in people with diabetes mellitus type 2.</p><p><strong>Material and methods: </strong>Retrospective cohort study with 371 patients evaluated in primary care for diabetes mellitus. Information on age, sex, disease duration, comorbidity and laboratory results was obtained. Patients of both sexes attended between 2022 and 2024 were included. Patients with other renal diseases or referrals were excluded. Logistic regression analysis was performed to identify associated factors.</p><p><strong>Results: </strong>Males (p = 0.014), age >60 years, (p = 0.01) uncontrolled diabetes (HbA1C >7.99%±1.84) and disease duration over 20 years (p = 0.02) are associated factors for chronic kidney disease (CKD). HbA1c had significant differences between those with and those without CKD. The most frequent comorbidities are arterial hypertension (70%), dyslipidemia (43%), overweight/obesity (44%) and anemia (31%). CKD stage G2 is the most frequent (45%). One hundred percent of patients in G1 and G2 CKD stages have an elevated microalbuminuria/creatinuria rate, and 13% of patients between G3a and G4 stages have this rate within normal values. Most patients receive nephroprotection with ARA II and ACEIs.</p><p><strong>Conclusion: </strong>It is important to screen for kidney disease in patients with diabetes mellitus type 2 who are male, over 60 years of age, with uncontrolled HbA1c and prolonged disease duration, as well as to treat comorbidities and nephroprotection regardless of the stage of chronic kidney disease.</p>","PeriodicalId":14181,"journal":{"name":"International Journal of Nephrology and Renovascular Disease","volume":"17 ","pages":"289-300"},"PeriodicalIF":2.1,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11611510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768717","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":"Risk Factors of Pulmonary Hypertension in Patients on Hemodialysis; Mitral Regurgitation is a Classic Cause of Secondary Pulmonary Hypertension [Letter].","authors":"Abdulrahman Naser","doi":"10.2147/IJNRD.S503952","DOIUrl":"10.2147/IJNRD.S503952","url":null,"abstract":"","PeriodicalId":14181,"journal":{"name":"International Journal of Nephrology and Renovascular Disease","volume":"17 ","pages":"287-288"},"PeriodicalIF":2.1,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11571995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142666974","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":"Serum Methotrexate Level Predicts Acute Kidney Injury After High-Dose Methotrexate: A Case Report and Single-Center Experience.","authors":"Pao-Wen Yen, Hsing-Yu Lin, Chien-Chih Wu, Tai-Chung Huang, Shang-Ju Wu, Szu-Yu Pan, Kuan-Yu Hung","doi":"10.2147/IJNRD.S487368","DOIUrl":"https://doi.org/10.2147/IJNRD.S487368","url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury (AKI) is a serious complication following high-dose methotrexate (HD-MTX) treatment, despite established preventive measures. This study presents a case report and a retrospective review of patients treated with HD-MTX, aiming to identify risk factors for AKI and propose a modified treatment protocol.</p><p><strong>Methods: </strong>We report a case of a 43-year-old man with diffuse large B-cell lymphoma who developed severe AKI after HD-MTX therapy. Additionally, a retrospective review of 70 patients receiving HD-MTX at our institution was conducted to identify predictors of AKI. Serum methotrexate levels were analyzed to determine their significance in predicting AKI.</p><p><strong>Results: </strong>The index patient developed methotrexate intoxication and severe AKI despite receiving standard prophylactic measures, requiring temporary hemodialysis. The retrospective review identified serum methotrexate levels as a significant predictor of AKI (OR 11.84, 95% CI: 2.62-53.53, p = 0.001). Higher initial serum methotrexate levels correlated with the development of AKI.</p><p><strong>Conclusion: </strong>Timely measurement of serum methotrexate levels is crucial in managing and preventing AKI in patients undergoing HD-MTX therapy. Based on our findings, we propose a modified HD-MTX treatment protocol to reduce the incidence of AKI. This includes earlier serum methotrexate level monitoring and adjustments in urine alkalization and leucovorin dosing strategies.</p>","PeriodicalId":14181,"journal":{"name":"International Journal of Nephrology and Renovascular Disease","volume":"17 ","pages":"277-285"},"PeriodicalIF":2.1,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11549911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620481","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":"Decarbonisation of Kidney Care in the United Arab Emirates: A Roadmap to an Environmentally Sustainable Care [Letter].","authors":"Elanda Fikri","doi":"10.2147/IJNRD.S502317","DOIUrl":"10.2147/IJNRD.S502317","url":null,"abstract":"","PeriodicalId":14181,"journal":{"name":"International Journal of Nephrology and Renovascular Disease","volume":"17 ","pages":"275-276"},"PeriodicalIF":2.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11537191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583005","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":"Different Dosage Regimens of Rituximab in Primary Membranous Nephropathy Treatment: A Systematic Review.","authors":"Yi Yu, Ricong Xu, Zhijian Li, Qijun Wan","doi":"10.2147/IJNRD.S489455","DOIUrl":"10.2147/IJNRD.S489455","url":null,"abstract":"<p><p>Primary membranous nephropathy (PMN) is one of the prevalent pathological types of adult primary nephrotic syndrome. Pathogenic autoantibodies targeting podocyte antigens such as phospholipase A2 receptor (PLA2R) lead to the disease. Patients frequently experience notable adverse effects when treated with conventional immunosuppressive therapies. Rituximab (RTX), a mouse/human monoclonal antibody, selectively depletes B cells and leads to a decrease in the antibody levels in the circulation, which helps to alleviate membranous nephropathy. Various RTX dosage regimens have been applied globally in the PMN treatment with satisfactory effects. Nevertheless, the optimal dosage of RTX has yet to be determined. This article reviews the application of different doses of RTX in the management of PMN so far.</p>","PeriodicalId":14181,"journal":{"name":"International Journal of Nephrology and Renovascular Disease","volume":"17 ","pages":"265-273"},"PeriodicalIF":2.1,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11531282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568834","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}