International Urology and Nephrology最新文献

{"title":"Spectrum and impact of urinary tract infections among adult renal allograft recipients in a tertiary care center of Northeast India.","authors":"Manjuri Sharma, Faheem Nazir Qanoongo, Prodip Kumar Doley, Gayatri Pegu, Miranda Pegu","doi":"10.1007/s11255-025-04571-6","DOIUrl":"10.1007/s11255-025-04571-6","url":null,"abstract":"<p><strong>Background: </strong>Urinary tract infections (UTI) pose a significant threat to renal allograft recipients (RARs), jeopardizing graft function and patient survival. This study aimed to investigate the incidence, microbiological profile, risk factors, and impact of UTI on renal allograft outcomes.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted at a tertiary care center in Assam, India, from July 2022 to January 2024, including 220 RARs aged over 18 years. Detailed clinical, microbiological, and outcome data were collected and analyzed. Multivariate logistic regression was performed to identify independent risk factors.</p><p><strong>Results: </strong>The incidence of UTI was 55/220, (25%), with a higher incidence in females 32/55 (58%). The highest incidence occurred within the first 3 months post-transplant (42.3%), followed by 4-6 months (34.6%), and beyond 6 months (23.1%). Asymptomatic bacteriuria 25/55 (45%) and cystitis (19/55 (35%) were the most common UTI types. Escherichia coli 22/55 (44%) and Klebsiella pneumoniae 18/55 (32%) were the predominant uropathogens, with 7/55 (12%) of isolates being multi-drug resistant (MDR) and 4/55 (7%) pan-drug resistant (PDR). Female gender [odds ratio (OR) 6.73, 95% confidence interval (CI) 4.53-12.65, p < 0.001)], prolonged Foley's catheterization (OR 3.92, 95% CI 2.95-4.88, p = 0.019), and urinary tract abnormalities (OR 2.83, 95% CI 1.61-4.17, p = 0.027) emerged as significant independent risk factors. UTI led to acute graft dysfunction in 54% (30/55) of cases, and 3% (2/55) underwent graft nephrectomy. However, 76% (23/30) of patients with acute graft dysfunction due to UTI achieved complete recovery with management.</p><p><strong>Conclusions: </strong>This study on UTI in renal transplant recipients in India found a 25% incidence rate, highest within the first 3 months post-transplant. Asymptomatic bacteriuria was common, despite UTI-related graft challenges, most acute dysfunctions resolved with management. Female gender, prolonged catheterization, and urinary tract abnormalities were significant risk factors.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"3867-3878"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The nephroprotective effect of metformin with cisplatin in bladder cancer: randomized clinical trial.","authors":"Samah E Mahran, Salem Eid Salem, Nirmeen A Sabry, Samar F Farid","doi":"10.1007/s11255-025-04505-2","DOIUrl":"10.1007/s11255-025-04505-2","url":null,"abstract":"<p><strong>Purpose: </strong>Cisplatin-based combination chemotherapy is the mainstay treatment strategy in various forms of carcinomas and sarcomas. However, its dosage and therapeutic efficacy are significantly limited by its nephrotoxicity. Based on metformin renal benefits in different studies, the study aims to determine safety and the potential nephroprotective effect of metformin when used with cisplatin in patients with bladder cancer.</p><p><strong>Methods: </strong>This was a prospective, randomized, parallel, controlled, open-label study in which 78 chemotherapy naïve bladder cancer patients aged 18-65 years and would receive gemcitabine/cisplatin regimen were selected and randomly assigned to treatment or control group in 1:1 allocation. Both groups were receiving cisplatin standard-of-care regimen, whereas metformin (500 mg, twice daily) was added to the treatment group's regimen only. Patients were prospectively followed up for four cycles of gemcitabine/cisplatin with assessment of renal function tests, serum neutrophil gelatinase-associated lipocalin (NGAL), cystatin-c, and metformin's adverse effects.</p><p><strong>Results: </strong>Serum creatinine, serum NGAL, and cystatin-C significantly increased in the control group only (P < 0.001). Estimated glomerular filtration rate (eGFR) significantly declines in the control group only (P < 0.001). On the contrary, serum NGAL significantly improved in the treatment group (P = 0.02) with stable and normal mean value of serum creatinine, eGFR, and cystatin-C without a concomitant significant increase in adverse events, such as hypoglycemia, gastrointestinal symptoms, or weight loss compared to the control group.</p><p><strong>Conclusion: </strong>Metformin prevented renal damage and deterioration in kidney function in cisplatin-treated patients. Therefore, it is a promising agent in reducing cisplatin-induced nephrotoxicity. The study was registered in ClinicalTrials.gov on December, 16, 2023, Identifier Number NCT06215976.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"3611-3624"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of estimated glomerular filtration rate with proliferative diabetic retinopathy: a systematic review and meta-analysis.","authors":"Prakasini Satapathy, Abhay M Gaidhane, Nasir Vadia, Soumya V Menon, Kattela Chennakesavulu, Rajashree Panigrahi, Sanjit Sah, Ambana Yappalparvi, S Govinda Rao, Khang Wen Goh, Rachana Mehta, Muhammed Shabil, Mahendra Singh, Edward Mawejje, Ganesh Bushi","doi":"10.1007/s11255-025-04547-6","DOIUrl":"10.1007/s11255-025-04547-6","url":null,"abstract":"<p><strong>Background: </strong>Proliferative diabetic retinopathy (PDR) is a serious vision-threatening complication of diabetes. Chronic kidney disease (CKD), measured by estimated glomerular filtration rate (eGFR), shares similar pathophysiological mechanisms with diabetic retinopathy, including inflammation, oxidative stress, and vascular dysfunction. However, the strength of the association between eGFR and PDR remains unclear. This review evaluates the association between reduced eGFR and the risk of PDR in individuals with diabetes.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted in PubMed, Embase, and Web of Science, from inception to October 2024. Observational studies reporting both eGFR values and PDR status were included. Study quality was assessed using the Newcastle-Ottawa Scale. Pooled standardized mean differences (SMD) were calculated using a fixed-effects model when heterogeneity was low (I² ≤ 50%). Subgroup analyses based on eGFR estimation method Modification of Diet in Renal Disease (MDRD) and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), sensitivity analyses, and meta-regression for diabetes duration and HbA1c were conducted. Publication bias was evaluated using funnel plots and Egger's test.</p><p><strong>Results: </strong>A total of 11 studies were included, comprising 602 patients with PDR and 5,475 individuals without diabetic retinopathy. The pooled SMD for eGFR between PDR and non-PDR groups was - 0.43 (95% CI - 0.52 to - 0.34; P < 0.0001), indicating significantly lower eGFR in PDR patients. Heterogeneity was moderate (I² = 42.3%). Subgroup analysis showed an SMD of - 0.58 (95% CI - 1.02 to - 0.14; I² = 0%) using the MDRD formula and - 0.43 (95% CI - 0.58 to - 0.28; I² = 80.4%) with the CKD-EPI formula. Meta-regression revealed a significant negative association between diabetes duration and PDR proportion (P = 0.0155), but no association with HbA1c (P = 0.7798). The prediction interval ranged from - 0.53 to - 0.33. Funnel plot asymmetry suggested potential publication bias (P < 0.05).</p><p><strong>Conclusions: </strong>This systematic review and meta-analysis found a significant association between reduced eGFR and PDR in patients with diabetes, with consistent findings across studies and eGFR estimation methods. Though heterogeneity suggests caution in interpretation. Additional prospective using standardized methodologies are needed to clarify causality and enhance risk prediction.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"3687-3699"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reappraising machine learning models for vascular calcification in CKD: methodological concerns and clinical gaps.","authors":"Muhammad Khubaib Iftikhar","doi":"10.1007/s11255-025-04597-w","DOIUrl":"10.1007/s11255-025-04597-w","url":null,"abstract":"<p><p>Lin et al. (Int Urol Nephrol, 2025) contribute to the literature on abdominal aortic calcification (AAC) in chronic kidney disease (CKD) using interpretable machine learning. However, several limitations hinder its clinical applicability. The cross-sectional design restricts causal inference, while the lack of external validation limits generalizability. Critical confounders such as pharmacologic interventions and lifestyle factors are omitted, risking bias in the model. In addition, treating CKD as a binary variable oversimplifies its complexity. Despite the promising use of SHAP analysis, the study lacks clinical translation for actionable risk stratification and personalized treatment. Future research should address these gaps to enhance the model's clinical utility.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"3919-3920"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic efficacy of suburethral sling in treatment of neurogenic and non-neurogenic stress urinary incontinence in men.","authors":"Tsu-Hsiu Huang, Tien-Lin Chang, Yuan-Hong Jiang, Jia-Fong Jhang, Jen-Hung Wang, Hann-Chorng Kuo","doi":"10.1007/s11255-025-04539-6","DOIUrl":"10.1007/s11255-025-04539-6","url":null,"abstract":"<p><strong>Purpose: </strong>Stress urinary incontinence (SUI) is usually secondary to prostatectomy or neurological lesions in men. The results of male suburethral slings for treating male SUI are presented.</p><p><strong>Methods: </strong>The patients with postprostatectomy incontinence (PPI) (n = 47) and neurogenic SUI (NSUI) (n = 20) underwent the suburethral sling procedure using a polypropylene mesh and cardiovascular patch. In patients with PPI, the retrograde leak point pressure (RLPP) was set at 50-60 cmH₂O, and in patients with NSUI, the RLPP was adjusted to no urine leakage without interfering catheterization. The treatment was considered successful when the patient achieved either complete or social continence at the 3-month follow-up. The revision and infection rates were also assessed.</p><p><strong>Results: </strong>The mean age of the cohort was 63.9 ± 16.5 years; the mean follow-up period was 40.1 ± 48.7 months. The success rate was 56.7% for the entire cohort, 57.4% for the PPI group, and 55% for the NSUI group. The patients with PPI who did not receive radiotherapy had a higher success rate (63%) than those who received prior radiotherapy (33%). Among patients for whom the suburethral sling procedure was successful, those with PPI had a higher BMI, whereas those with NSUI had a higher corrected Qmax and RLPP. No significant difference in baseline abdominal LPP was observed between the two groups.</p><p><strong>Conclusions: </strong>The suburethral sling procedure is safe and effective for male patients with SUI. Although radiotherapy reduced the success rate, intraoperative RLPP measurement enabled effective tension adjustment, particularly in patients with NSUI.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"3533-3541"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oncological outcomes after non-surgical management versus radical cystectomy in non-organ-confined non-urothelial bladder cancer.","authors":"Mattia Longoni, Andrea Marmiroli, Fabian Falkenbach, Quynh Chi Le, Michele Nicolazzini, Calogero Catanzaro, Federico Polverino, Jordan A Goyal, Gennaro Musi, Markus Graefen, Felix K H Chun, Alessandro Volpe, Riccardo Schiavina, Nicola Longo, Fred Saad, Shahrokh F Shariat, Marco Moschini, Giorgio Gandaglia, Francesco Montorsi, Alberto Briganti, Pierre I Karakiewicz","doi":"10.1007/s11255-025-04566-3","DOIUrl":"10.1007/s11255-025-04566-3","url":null,"abstract":"<p><strong>Introduction: </strong>We hypothesized that among non-organ-confined (NOC, T3-4 and/or N1-3) non-urothelial carcinoma of urinary bladder (non-UCUB) patients, bladder-sparing non-surgical management (NSM) provides cancer-specific mortality (CSM) rates comparable to those of radical cystectomy (RC).</p><p><strong>Methods: </strong>Within the SEER database (2004-2021) rates of NSM vs. RC use in NOC non-UCUB patients were tabulated. Nearest-neighbor 1:1 propensity score matching (PSM) for age, sex, stage, race/ethnicity, and histological subtype was applied. Cumulative incidence plots depicted five-year CSM. Univariable and multivariable competing risks regression (CRR) models were fitted. Sensitivity analyses were performed within squamous cell carcinoma (SCC), small cell carcinoma (small-CC) and adenocarcinoma (ADK).</p><p><strong>Results: </strong>Of 775 NOC non-UCUB patients, 290 (37.4%) received NSM vs. 485 (62.6%) RC. After PSM, five-year CSM rate was 70.4% after NSM vs. 60.6% after RC and NSM was associated with 1.6-fold higher CSM relative to RC (multivariable HR [mHR]: 1.61, p < 0.001). In sensitivity analyses within 253 (32.6%) SCC, after re-applying PSM, five-year CSM rate was 85.0% after NSM vs. 53.3% after RC and NSM was associated with 2.8-fold higher CSM relative to RC (mHR: 2.80, p < 0.001). Conversely, within 216 (27.9%) small-CC and 135 (17.4%) ADK patients, CSM after NSM did not differ from CSM after RC (54.3 vs. 62.5%, mHR: 0.85; 69.8 vs. 71.7%, mHR: 1.0; all p > 0.05).</p><p><strong>Conclusion: </strong>In NOC non-UCUB patients, NSM is associated with higher CSM than RC. Subgroup analyses according to histological subtypes suggest that these differences virtually exclusively originated from SCC patients but not from their small-CC and ADK counterparts.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"3639-3646"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deciphering the urinary microRNAs landscape in nephrotic syndrome: implications as prognostic marker-a non-invasive study.","authors":"Pricilla Charmine, Vettriselvi Venkatesan, Sangeetha Geminiganesan, Sudha Ekambaram, B R Nammalwar, R P Parameswari, C D Mohana Priya","doi":"10.1007/s11255-025-04546-7","DOIUrl":"10.1007/s11255-025-04546-7","url":null,"abstract":"<p><p>Nephrotic syndrome is a complex renal condition characterized by abnormal protein permeability into the urine space, leading to edema and renal failure. Recent research suggests that deregulation of microRNAs contributes to the pathogenesis of this disease. MicroRNAs are small, non-coding RNA molecules that regulate gene expression by binding to complementary messenger RNA sequences. In this study, we employed bioinformatics techniques to analyze microRNA expression in urine samples from nephrotic syndrome patients and healthy control participants. Our results revealed a significant disruption of microRNA expression profiles in patients with nephrotic syndrome, indicating that these microRNAs may play a crucial role in the disease. This study highlights the potential of urinary microRNAs as biomarkers for nephrotic syndrome and warrants further investigation into their functional significance in the disease pathogenesis.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"3713-3723"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Finasteride and Doxazosin: A Comparison of Lipid-Modulating Effects in Benign Prostatic Hyperplasia.","authors":"Lauren Calaza, Ryan Wi, Mikhail Torosoff","doi":"10.1007/s11255-025-04523-0","DOIUrl":"10.1007/s11255-025-04523-0","url":null,"abstract":"","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"3667-3668"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of druggable genetic targets for prostate cancer risk based on mendelian randomization and single-cell RNA sequencing.","authors":"Liantai Song, Xinyang He, Yibing Duan, Yifan Chi, Reng Li, Cancan Li, Yutian Liu, Mengxin Yang, Jiameng Wei, Yujia Zhao, Qian Xu","doi":"10.1007/s11255-025-04525-y","DOIUrl":"10.1007/s11255-025-04525-y","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to identify genetic targets linked to prostate cancer risk using advanced genetic analysis techniques.</p><p><strong>Objective: </strong>The goal was to conduct a comprehensive analysis using Mendelian Randomization (MR), colocalization, and single-cell RNA sequencing to identify druggable genes as potential therapeutic targets or diagnostic markers.</p><p><strong>Methods: </strong>The study involved selecting 2608 druggable genes by intersecting expression Quantitative Trait Loci (eQTLs) with druggable genome databases. MR analysis using prostate cancer GWAS data identified genes with causal associations to prostate cancer risk. Colocalization analysis confirmed shared genetic variants influencing both the exposure and outcome. Single-cell RNA sequencing assessed gene expression in prostate tumor cell types, while a phenome-wide association study (PheWAS) evaluated potential side effects.</p><p><strong>Results: </strong>MR analysis identified 58 genes associated with prostate cancer risk, with 12 validated by colocalization analysis. Five genes (BAK1, ATP1B2, PEMT, TPM3, ZDHHC7) demonstrated strong colocalization, indicating potential as drug targets. Single-cell RNA sequencing revealed their enrichment in prostate tumor T cells and macrophages. PheWAS suggested minimal side effects for most, except BAK1, which was linked to increased platelet counts.</p><p><strong>Conclusion: </strong>This study identified several genetic targets associated with prostate cancer risk, highlighting the potential for targeted therapy. By integrating Mendelian randomization analysis, colocalization analysis, and single-cell RNA sequencing, the accuracy of target validation was improved, which may provide new directions for targeted therapy in prostate cancer.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"3583-3594"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correspondence: vancomycin-associated AKI in cirrhosis: a modifiable risk factor absent from current prediction models.","authors":"Maryna Rodrigues Gonçalves, Guilherme Triches, Tammy Shiroma, Eric Akio Hiraga, Allan Bevilaqua Queiros Neto, Carolina Yamada, Tamires Maier, Rosa Marcusso, João Paulo Telles","doi":"10.1007/s11255-025-04632-w","DOIUrl":"10.1007/s11255-025-04632-w","url":null,"abstract":"","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"3923-3924"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144527951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}