International Journal of Nephrology and Renovascular Disease最新文献

{"title":"The Association of Pre-Transplant Mixed Lymphocyte Reaction (MLR) with the Function of the Kidney Allograft and Antibody Response.","authors":"Farahnoosh Farnood, Alireza Mardomi, Yalda Rahbar Saadat, Amir Vahedi, Kowsar Fathalizadeh, Mohammadreza Ardalan, Sepideh Zununi Vahed","doi":"10.2147/IJNRD.S580439","DOIUrl":"10.2147/IJNRD.S580439","url":null,"abstract":"<p><strong>Aim: </strong>The mixed lymphocyte reaction (MLR) is a critical assay for evaluating immunological compatibility between donors and recipients prior to transplantation.</p><p><strong>Purpose: </strong>This prospective study aimed to evaluate the association of the renal allograft function with outcomes of the pre-transplant carboxyfluorescein diacetate succinimidyl ester (CFSE)-MLR assay and the levels of donor-specific antibodies (DSAs).</p><p><strong>Patients and methods: </strong>The study included 14 live donors and non-sensitized recipient pairs. Peripheral blood samples were collected from donor and recipient pairs, and then peripheral blood mononuclear cells (PBMCs) were isolated. Donor cells were treated with Mitomycin-C as inactivated stimulators, and recipient PBMCs were labeled with CFSE as responder cells for flow cytometric analysis of the responder cell proliferation. Post-transplant renal function was monitored by serial measurements of serum creatinine levels, which were then correlated with MLR proliferation rates. Additionally, the relationship between pre-transplant MLR proliferation and DSA titers was examined. Correlative analyses were also performed between MLR outcomes and DSA levels, as well as the panel reactive antibody (PRA) outcomes.</p><p><strong>Results: </strong>Significant increases in the percentage of proliferating responder cells were observed at days 3 and 5 relative to baseline (day 0). A positive correlation was identified between day 5 proliferation rates and PRA Class II levels. Pre-transplant cellular proliferation did not significantly correlate with serum DSA titers measured at six months post-transplant. Conversely, a statistically significant positive correlation was detected between day 5 MLR proliferation and serum creatinine levels at six months post-transplantation.</p><p><strong>Conclusion: </strong>The CFSE-MLR assay represents a reliable association with post-transplant immunological status and allograft function. Nevertheless, further evidence-based research with larger cohorts is warranted to validate these findings and strengthen their clinical applicability.</p>","PeriodicalId":14181,"journal":{"name":"International Journal of Nephrology and Renovascular Disease","volume":"19 ","pages":"580439"},"PeriodicalIF":2.3,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13069981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147673396","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":"Malaria-Associated Acute Kidney Injury: A Key Driver of Mortality in Endemic Regions.","authors":"Gerald Olwit, Timothy Bakka Gutanamuka, Hans Chinomso Chris-Uchendu, Aime Ishimwe Mugisha","doi":"10.2147/IJNRD.S600266","DOIUrl":"10.2147/IJNRD.S600266","url":null,"abstract":"<p><strong>Background: </strong>Malaria remains a major global health challenge, particularly in endemic regions where severe disease contributes substantially to morbidity and mortality. Among its systemic complications, malaria-associated acute kidney injury (MAKI) is increasingly recognized as a significant yet underappreciated contributor to poor clinical outcomes. Despite advances in antimalarial therapy, MAKI continues to be associated with high mortality and growing evidence suggests a link to long-term renal sequelae, including chronic kidney disease (CKD). This review synthesizes current evidence on the epidemiology, pathophysiology, clinical presentation, diagnosis, management, and long-term outcomes of MAKI.</p><p><strong>Methods: </strong>A focused PubMed/MEDLINE search (2015-2025) was conducted to identify relevant studies across different age groups and Plasmodium species. Emphasis was placed on epidemiology, mechanisms of kidney injury, clinical features, management strategies, and renal outcomes. Studies were selected based on relevance to the review objectives.</p><p><strong>Results: </strong>MAKI is a serious complication of severe malaria, resulting from a multifactorial process involving intravascular hemolysis, microvascular obstruction, inflammation, endothelial dysfunction, and volume depletion. Plasmodium falciparum remains the most commonly implicated species, although Plasmodium vivax and Plasmodium knowlesi are increasingly recognized causes. Clinically, MAKI is associated with prolonged hospitalization, increased need for renal replacement therapy, and higher mortality. Emerging evidence also indicates that survivors are at risk of incomplete renal recovery and progression to CKD.</p><p><strong>Conclusion: </strong>MAKI is a critical driver of both acute mortality and long-term kidney disease in malaria. Early recognition, prompt management, and post-recovery renal monitoring are essential to improve outcomes. Greater awareness and further research are needed to define preventive strategies and long-term renal implications, particularly in resource-limited endemic regions.</p>","PeriodicalId":14181,"journal":{"name":"International Journal of Nephrology and Renovascular Disease","volume":"19 ","pages":"600266"},"PeriodicalIF":2.3,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13049373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147622886","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":"Discharge-Based Recovery After Dialysis-Requiring Acute Kidney Injury: A National U.S. Analysis of Sociodemographic and Hospital Factors.","authors":"Brent Tai, Thomson Tai","doi":"10.2147/IJNRD.S593458","DOIUrl":"10.2147/IJNRD.S593458","url":null,"abstract":"<p><strong>Background: </strong>Dialysis-requiring acute kidney injury (AKI-D) represents the most severe form of AKI and is associated with substantial morbidity. As survival after AKI-D improves, recovery following hospitalization has emerged as a critical but understudied phase of care. Whether recovery trajectories differ across sociodemographic groups and hospital contexts remains poorly understood. Dialysis-requiring AKI affects approximately 2-3% of hospitalized adults nationally and carries high post-acute morbidity, underscoring the importance of understanding recovery trajectories beyond survival.</p><p><strong>Methods: </strong>We conducted a retrospective, nationally representative study using the 2022 Healthcare Cost and Utilization Project National Inpatient Sample. Adult hospitalizations complicated by AKI-D among patients without pre-existing end-stage kidney disease who survived to discharge were included. The primary outcome was dialysis dependence or non-recovery at discharge, operationalized using discharge disposition as a pragmatic surrogate for post-acute recovery following receipt of acute dialysis. Survey-weighted logistic regression models adjusted for demographics, illness severity, and hospital characteristics were used to estimate adjusted odds ratios. Marginal standardization was applied to derive adjusted probabilities and absolute risk differences. Effect modification by hospital context was examined.</p><p><strong>Results: </strong>Among survivors of dialysis-requiring AKI, approximately 40% were discharged to non-home settings, indicating a substantial burden of incomplete recovery at hospital discharge. After adjustment, adults aged ≥85 years had more than two-fold higher odds of non-recovery compared with those aged 50-64 years (adjusted OR 2.19), while self-pay patients had substantially lower odds compared with Medicare beneficiaries (adjusted OR 0.45). Patients with Medicaid or no-charge encounters-and several racial and ethnic minority groups-also exhibited lower adjusted probabilities of non-recovery. Hospital characteristics modified these associations, with payer-related differences in non-recovery varying by teaching status, bed size, and geographic region. Certain hospital settings exhibited both higher overall non-recovery burden and larger disparities. Sensitivity analyses using alternative outcome definitions and excluding patients with chronic kidney disease yielded consistent findings.</p><p><strong>Conclusion: </strong>Incomplete recovery at hospital discharge is common among survivors of dialysis-requiring AKI and is shaped by both patient-level vulnerability and hospital context. Institutional environments appear to modify recovery disparities, highlighting hospitals as potential leverage points for improving equitable post-AKI outcomes. Efforts to enhance recovery after AKI-D should extend beyond the acute hospitalization to address post-discharge transitions and system-level factors.</p>","PeriodicalId":14181,"journal":{"name":"International Journal of Nephrology and Renovascular Disease","volume":"19 ","pages":"593458"},"PeriodicalIF":2.3,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13048865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147622880","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":"Current Insights and Future Directions on the Role of GLP-1 Receptor Agonists in Chronic Kidney Disease.","authors":"Kavya Rajan, Arjun Krishen Jutley, Michael W Holliday, Sankar D Navaneethan","doi":"10.2147/IJNRD.S522424","DOIUrl":"10.2147/IJNRD.S522424","url":null,"abstract":"<p><p>Chronic kidney disease (CKD) incidence continues to rise along with obesity and diabetes, driving substantial medical, psychosocial, and economic burdens for patients. Beyond glycemic control and the recommended therapies of ACEI/ARB, SGLT2 inhibitors and non-steroidal mineralocorticoid receptor antagonists, glucagon-like peptide-1 receptor agonists (GLP-1RAs) have emerged as a cornerstone therapy to benefit mortality, heart and kidney outcomes. The following review will discuss recent advances to our understanding of the kidney benefits of GLP1 agonism in high-risk populations, including patients with type 2 diabetes mellitus, obesity, those with established cardiovascular disease. Renal signals from cardiovascular outcomes trials disclosed less albuminuria and slower estimated glomerular filtration rate (eGFR) decline with GLP1RA therapy, often additive to sodium-glucose cotransporter-2 inhibition. Dedicated kidney studies now show semaglutide slows CKD progression and lowers mortality in diabetics with CKD, underscoring the relevance of new guidelines that recommend GLP1RA therapy for specific populations. Future priorities should include trials of GLP-1RA in non-diabetic patients with CKD, as well as further evaluation of dual or triple agonists (GLP-1/GIP/glucagon) and clarification of oral GLP1RA efficacy. Overall, GLP-1-based therapies represent a transformative strategy to improve weight, cardiovascular health, and kidney outcomes in diabetic CKD patients.</p>","PeriodicalId":14181,"journal":{"name":"International Journal of Nephrology and Renovascular Disease","volume":"19 ","pages":"522424"},"PeriodicalIF":2.3,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13023396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147573978","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 Impact of Pharmaceutical Care on Infection Control Measures Among Hemodialysis Patients. A Randomized Interventional Study.","authors":"Raghad Saad Hussien, Kawa Ahmad Obeid","doi":"10.2147/IJNRD.S585790","DOIUrl":"10.2147/IJNRD.S585790","url":null,"abstract":"<p><strong>Purpose: </strong>This study seeks to highlight the impact of clinical pharmacists in protecting hemodialysis patients from catheter-related infections. By ensuring appropriate antimicrobial use, guiding patients on prevention practices, and collaborating with the healthcare team. This study also examines how pharmacists improve safety, treatment adherence, and quality of life.</p><p><strong>Patients and methods: </strong>This randomized interventional study was conducted between November 2024-April 2025. Patients were divided into intervention and non-intervention groups. The care bundle comprised culture-guided antibiotic locks (except gentamicin-heparin), in-hospital exit-site dressing with 3M Tegaderm by trained staff, and safety medication checks (e.g, blood-pressure monitoring before the use of erythropoiesis-stimulating agents) were used. The primary endpoint was the incidence of catheter-related bloodstream infections (CRBSIs); secondary endpoints were length of stay, admissions, ICU admissions, catheter replacements, and death. Monthly averages of vitals, drug therapy problems (DTPs), and laboratory parameters were obtained for both groups.</p><p><strong>Results: </strong>A total of ninety patients included in this study. The patients were randomly assigned to either the intervention or non-intervention group and a total 81 out of 90 patients successfully completed the study. After four visits and six months of implementing infection control measures within the context of pharmaceutical care, the infection rate showed a significant reduction in the intervention group (from 0.64±0.48 to 0.20±0.4, p =0.0001) compared with the non-intervention group (0.66±0.48 to 0.71±0.45, p =0.9731). The mean differences increased over time, reaching 0.26 (95% CI of diff.= 0.09 to 0.43) at visit 1, 0.41 (95% CI of diff.= 0.24 to 0.58) at visit 3, and 0.51 (95% CI of diff.= 0.34 to 0.68) at visit 4.</p><p><strong>Conclusion: </strong>Clinical pharmacist intervention via implementing infection control within the context of a pharmaceutical-care process can improve infection rates among hemodialysis patients.</p>","PeriodicalId":14181,"journal":{"name":"International Journal of Nephrology and Renovascular Disease","volume":"19 ","pages":"585790"},"PeriodicalIF":2.3,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12999364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147498989","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":"Effects of Chronic Intermittent Hypoxia and Subsequent Normoxic Recovery on Renal Senescence and the PI3K/Akt/P21 Pathway in Rats.","authors":"HaiBo Li, MingZhi Chen, Fang Han, HaoNan Zhang, MeiNa Jin, Wei Bai, ChuXuan Jia, Ying Han, Cuiying Wei","doi":"10.2147/IJNRD.S575874","DOIUrl":"10.2147/IJNRD.S575874","url":null,"abstract":"<p><strong>Background: </strong>CIH, the hallmark of OSA, is a recognized driver of multi-organ injury. While its contribution to renal dysfunction is acknowledged, the specific roles of key senescence-regulating pathways-particularly the PI3K/Akt/p21 axis and the anti-aging protein Klotho-in CIH-induced renal senescence remain largely unexplored.</p><p><strong>Purpose: </strong>This study aimed to investigate the effects of CIH and subsequent normoxic reoxygenation on renal senescence in rats, and to elucidate the dynamic involvement of the PI3K/Akt/p21 pathway and the anti-aging protein Klotho in this process.</p><p><strong>Methods: </strong>Forty 5-week-old male Sprague-Dawley rats were randomly assigned to NC and CIH groups. The CIH group was exposed to IH (range 6.5-7.5%, 30 cycles/h, 8 h/day) for 8 weeks, followed by a 4-week normoxic recovery period. Renal function (SCr, BUN,CysC), histopathology (cortex-to-medulla ratio, tubular epithelial density), and the expression of senescence-related molecules (p21, Klotho, PI3K/AKT pathway components) were assessed at weeks 0, 8, and 12. Statistical significance was determined by two-way ANOVA with Tukey's post hoc test.</p><p><strong>Results: </strong>Following 8 weeks of CIH exposure, rats exhibited significant renal dysfunction, with SCr increased by 21.3%, BUN by 24.0%, and CysC by 27.9% compared to controls (all P<0.05), alongside histopathological alterations including cortical atrophy, medullary expansion, and reduced tubular epithelial density (P<0.05).These changes were associated with upregulation of p21 and downregulation of PI3K/AKT signaling and Klotho (P<0.05). After 4 weeks of normoxic recovery, renal function and PI3K/Akt/p21 signaling were largely restored (P>0.05 vs NC). However, cortical-medullary structural imbalance and suppressed Klotho expression persisted (P<0.05). Statistical significance was determined by two-way ANOVA with Tukey's post hoc test).</p><p><strong>Conclusion: </strong>CIH induces a partially reversible renal senescence phenotype in rats, which is associated with dynamic modulation of the PI3K/Akt/p21 axis. The persistent suppression of Klotho may underlie irreversible structural injury, providing novel mechanistic insights into OSA-associated kidney disease.</p>","PeriodicalId":14181,"journal":{"name":"International Journal of Nephrology and Renovascular Disease","volume":"19 ","pages":"575874"},"PeriodicalIF":2.3,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12991308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147473749","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":"Prevalence and Factors Associated with Albuminuria Screening Among High-Risk Adults in Saudi Arabia: A Retrospective Cross-Sectional Study.","authors":"Mohamed A Albekery, Mohammed Alnuhait, Ibrahim S Alhomoud, Khalid Alhussain, Munirah K Alkulaib, Gharam M Alanazi, Zainab F Alshaikh, Fatimah S Alibrahim, Kawthar Y Alburayman, Ghadeer H Alhajji, Bassem A Almalki, Ibrahim F Aldossary, Lulwah Al Turki, Abdulaziz Almulhim","doi":"10.2147/IJNRD.S580140","DOIUrl":"10.2147/IJNRD.S580140","url":null,"abstract":"<p><strong>Background: </strong>Albuminuria is a key marker for the early detection of chronic kidney disease (CKD) in patients with diabetes mellitus and hypertension. Despite guideline recommendations for albuminuria testing in these high-risk populations, adherence remains suboptimal.</p><p><strong>Methods: </strong>A retrospective study was conducted at a tertiary center in Al-Ahsa, Saudi Arabia. Data were collected from the records of 516 adults with diabetes mellitus, hypertension, or both. Patients with CKD were excluded. The primary outcome was the rate of albumin-to-creatinine ratio (ACR) testing.</p><p><strong>Results: </strong>Among 516 patients (mean age 63.7 ± 7.6 years), the overall prevalence of ACR testing was 59.1%. Testing was highest in the diabetes-only subgroup (69.5%), followed by the diabetes with hypertension subgroup (66.3%), and lowest in the hypertension-only subgroup (19.3%) (p<0.001). Testing was more likely in patients with high HbA1c, more outpatient visits, and among individuals using angiotensin receptor blockers (ARBs) and sodium-glucose cotransporter-2 (SGLT-2) inhibitors. After adjustment, hypertension-only patients were less likely to be tested (adjusted odds ratio [AOR] = 0.14; 95% CI: 0.07-0.31), whereas the use of ARBs (AOR = 3.17; 95% CI: 1.69-5.93) and SGLT2 inhibitors (AOR = 3.00; 95% CI: 1.31-6.90) was independently associated with increased testing. Of those tested, 40% had albuminuria (A2 or A3).</p><p><strong>Conclusion: </strong>Albuminuria testing is substantially underutilized among high-risk patients in Saudi Arabia. Individuals with hypertension only are the least likely to undergo screening. This suggests a gap between clinical practice and guideline recommendations. These findings highlight the need for strategies to improve early CKD detection, particularly in primary care.</p>","PeriodicalId":14181,"journal":{"name":"International Journal of Nephrology and Renovascular Disease","volume":"19 ","pages":"580140"},"PeriodicalIF":2.3,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12974127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147432755","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":"Patient Education in Chronic Kidney Disease: A Position Statement of the Polish Society of Nephrology.","authors":"Monika Lichodziejewska-Niemierko, Magdalena Mosakowska, Marcin Adamczak, Beata Naumnik","doi":"10.2147/IJNRD.S582946","DOIUrl":"10.2147/IJNRD.S582946","url":null,"abstract":"<p><p>Chronic kidney disease (CKD) is an increasing public health challenge, affecting about 11% of adults worldwide. Kidney diseases are now the third fastest-growing cause of death globally, and the number of patients reaching end-stage kidney disease continues to rise, resulting in growing demand for renal replacement therapy. A variety of clinical and individual factors influence the management of the disease. However, meaningful patient participation in this process is only possible when patients possess adequate knowledge of their disease and treatment options. Patient education is therefore a fundamental component of CKD management. It promotes behaviors that improve disease control and slow disease progression, while empowering patients to actively engage in shared decision-making and enhancing quality of life. Although both Polish and international guidelines highlight the need for structured education and its integration into comprehensive care models, practical recommendations on how such programs should be organized remain scarce. This article presents an expert opinion based on clinical experience and current literature. The recommendations outline key principles for designing and implementing high-quality educational initiatives that can be applied across nephrology centers and tailored to different stages of CKD. They also provide a framework for establishing a nationwide nephrology education system built on best practices and evidence-based standards.</p>","PeriodicalId":14181,"journal":{"name":"International Journal of Nephrology and Renovascular Disease","volume":"19 ","pages":"582946"},"PeriodicalIF":2.3,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12927763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147283554","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":"Safety and Efficacy of Therapeutic Plasma Exchange in Pediatric Non-Neurological Diseases.","authors":"Monika Miklaszewska, Magdalena Błasiak, Przemysław Korohoda, Ewelina Jarosz-Wójcik, Katarzyna Zachwieja, Karina Madej-Świątkowska, Dorota Drożdż","doi":"10.2147/IJNRD.S572328","DOIUrl":"10.2147/IJNRD.S572328","url":null,"abstract":"<p><strong>Introduction: </strong>Therapeutic plasma exchange (TPE) is a recognized treatment in pediatric immune-mediated and toxicological disorders, though evidence remains limited. This study assesses the safety and efficacy of TPE in children with non-neurological diseases treated at a tertiary hospital over 27 years. We focused on non-neurological indications to avoid excessive data heterogeneity.</p><p><strong>Methods: </strong>This retrospective analysis included 97 children (51 nephrological, 46 non-nephrological), who underwent 380 TPE procedures between 1997 and 2023. Indications were categorized according to ASFA 2023 guidelines. Effectiveness was evaluated semi-quantitatively based on clinical and laboratory parameters up to 3 months post-treatment. Safety was assessed by incidence of adverse events (AEs), allergic AEs, and mortality.</p><p><strong>Results: </strong>The most common indication was thrombotic microangiopathy (TMA, 23.7%), followed by toxicological and hematological disorders. TPE was effective (complete or partial improvement) in 67% of patients; full recovery occurred in 25.8%. In the nephrology group, eGFR increased 3.8-fold by 3 months post-TPE. However, immunosuppressive therapy was used 7.7 times more often in this group. The non-nephrological group had a higher mortality (26.1% vs 9.8%), mostly due to multiple organ failure. Intensive Care Unit admission and ASFA III indications significantly decreased survival odds. Fresh-frozen plasma (FFP) - based TPE was associated with significantly more AEs and interventions compared to TPE without FFP. Over time, FFP use declined, with 100% of TPEs in 2023 performed without FFP.</p><p><strong>Conclusion: </strong>TPE is a safe and effective therapy in selected pediatric non-neurological conditions when performed in specialized centers.</p>","PeriodicalId":14181,"journal":{"name":"International Journal of Nephrology and Renovascular Disease","volume":"19 ","pages":"572328"},"PeriodicalIF":2.3,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13007957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147511892","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":"Adult Diagnosis of Solitary Kidney and Renal Dysplasia in a Male Born Prematurely as a Twin: A Case Report.","authors":"Aime Ishimwe Mugisha","doi":"10.2147/IJNRD.S581747","DOIUrl":"10.2147/IJNRD.S581747","url":null,"abstract":"<p><strong>Background: </strong>Congenital anomalies of the kidney and urinary tract (CAKUT) are a common cause of chronic renal disease and usually manifest either antenatally or in the early years of life. Solitary Kidney with Renal Dysplasia presents early in life due to regular antenatal sonographic scans. The rarity of diagnosis being deferred until adulthood has important implications when there is prematurity and other associated congenital anomalies, such as Congenital Heart Disease.</p><p><strong>Case presentation: </strong>We present a 23-year-old male experiencing sequential generalized edematous changes, decreased urine output, early feelings of fullness during meals, and vomiting following the intake of a meal for the last month. The patient was born prematurely at approximately seven months of gestation, and he was a twin, with the loss of the co-twin soon after birth. There was neither a previous chronic disease nor hospitalization. Physical evaluation showed the patient to be hypertensive with generalized edematous changes of the face and both lower limbs, along with systolic murmurs at the lower edge of the left sternal region. Laboratory findings indicated the presence of severe renal impairment with high serum creatinine and potassium, massive proteinuria, and severe anemia. Renal ultrasound revealed a small, echogenic right kidney compatible with chronic renal disease and an absent left kidney, confirming the suspicion of a solitary right dysplastic kidney. The cardiac study showed dilated cardiac chambers with an atrial septal defect, mild pericardial effusion, and the patient was placed on antihypertensive drugs and diuretics and started on hemodialysis.</p><p><strong>Conclusion: </strong>This is a rare adult presentation of solitary kidney and renal dysplasia in a prematurely born male twin, further compounded by atrial septal defect and end-stage renal disease. This report underscores the significant implications of these complications as a direct sequel to prematurity regarding the associated severe consequences for the subsequent renal and cardiovascular systems of these patients. Antenatal ultrasound scans play a crucial role in the early detection and management of such abnormalities.</p>","PeriodicalId":14181,"journal":{"name":"International Journal of Nephrology and Renovascular Disease","volume":"19 ","pages":"581747"},"PeriodicalIF":2.3,"publicationDate":"2026-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13012138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147511949","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}