International Urology and Nephrology最新文献

{"title":"Associations between frailty status and humoral response to SARS-cov-2 vaccination in kidney transplantation and dialysis.","authors":"Henry H L Wu, Rajkumar Chinnadurai","doi":"10.1007/s11255-024-04220-4","DOIUrl":"10.1007/s11255-024-04220-4","url":null,"abstract":"","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"1037-1038"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142346789","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":"Amniotic bladder therapy: study of micronized amnion/chorion for the treatment of interstitial cystitis/bladder pain syndrome (IC/BPS) at 6 months.","authors":"Kyle O'Hollaren, Jack Considine, Codrut Radoiu, Raghav Madan, Aron Liaw, Nivedita Dhar","doi":"10.1007/s11255-024-04251-x","DOIUrl":"10.1007/s11255-024-04251-x","url":null,"abstract":"<p><strong>Background: </strong>Intravesical application of birth tissue has been reported to inhibit inflammation, alleviate collagen fiber accumulation, and enhance bladder tissue generation. We have previously reported that intra-detrusor micronized amnion monolayer (AM) injections provide short-term clinical improvement in refractory IC/BPS patients. Herein, we evaluate the therapeutic responses and adverse events of micronized amnion/chorion bilayer (AC) in patients with refractory IC/BPS with 6 months follow-up.</p><p><strong>Methods: </strong>Fifteen patients affected by IC/BPS who failed conventional therapy received 100 mg of reconstituted micronized AC was injected intra-detrusor via cystoscopy under general anesthesia, using a 23-gauge needle. Twenty 0.5-mL injections were administered into the lateral and posterior bladder walls, avoiding the dome and trigone. Changes in interstitial cystitis symptom index (ICSI), Interstitial cystitis problem index (ICPI), Bladder pain/ interstitial cystitis symptom score (BPIC-SS) and Overactive Bladder Assessment Tool (OAB), from baseline to 6 months post-injection were evaluated retrospectively. The safety of injections was analyzed.</p><p><strong>Results: </strong>Fifteen total refractory IC/BPS patients with an average age of 41.1 ± 14.5 years were included in the study, receiving intra-detrusor injections of 100 mg of micronized AC. One month after injections, significant improvement in IC/BPS symptom scores was noted in all patients. All patients maintained a sustained clinical response at 6 months post-injection. No product-related adverse events were observed.</p><p><strong>Conclusion: </strong>Our findings indicate that the AC formulation significantly reduces time to symptom relief in patients with refractory interstitial cystitis/bladder pain syndrome (IC/BPS) and maintains a sustained response up to 6 months post-injection. These results suggest a promising clinical benefit of using an amnion/chorion bilayer product for treating IC/BPS. Further research is needed to confirm these findings and assess the long-term durability of this treatment approach. This study represents the first evidence supporting the clinical advantages of an amnion/chorion bilayer product in managing IC/BPS.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"753-758"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142500536","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":"Relationship of serum calcium concentration with chronic kidney disease and mortality in type 2 diabetes mellitus patients: evidence from the NHANES 1999-2018.","authors":"Minzi Qiu, Yanxia Chen, Ben Ke, Xiangdong Fang, Chengyun Xu, Jinghai Hua","doi":"10.1007/s11255-024-04272-6","DOIUrl":"10.1007/s11255-024-04272-6","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to explore the relationship of serum calcium (Ca) concentration with diabetic kidney disease (DKD) and all-cause mortality among type 2 diabetes mellitus (T2DM) patients using National Health and Nutrition Examination Surveys (NHANES).</p><p><strong>Methods: </strong>Data of T2DM patients aged ≥ 40 years were screened from the NHANES database from 1999 to 2018. The outcomes were the risk of DKD diagnosed by urine albumin-to-creatinine ratio (UACR) ≥ 30 mg/g or estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m² and the risk of all-cause mortality ascertained by linkage to National Death Index (NDI) records through 31 December 2019. The weighted univariate and multivariate logistic regression model and cox proportional hazard model were utilized to explore the relationships of serum Ca concentration with DKD and all-cause mortality, respectively, with odds ratios (ORs), hazard ratios (HRs) and 95% confidence interval. The relationships were further explored stratified by age, gender, body mass index (BMI), the duration of T2DM, and the history of cardiovascular disease (CVD), cancer and DKD.</p><p><strong>Results: </strong>Totally, 6595 T2DM patients were included. Of these patients, 2441 (37.01%) had DKD and 1868 (28.32%) deaths occurred over a mean follow-up of 104.50 (± 1.61) months. In fully adjusted model, we observed high serum Ca concentration was associated with high risk of DKD (OR = 1.45, 95% CI 1.18-1.77) and high all-cause mortality risk (HR = 1.33, 95% CI 1.16-1.52). These relationships remained significant after performing subgroup analyses. The Restricted cubic spline curves shown that linear correlations were observed between serum Ca concentration and DKD as well as all-cause mortality (P < 0.05).</p><p><strong>Conclusions: </strong>Elevated serum Ca concentration may predict the high risk of DKD and poor prognosis in T2DM patients, and future large-scale and well-designed prospective cohort study is needed to explore the association of serum Ca concentration and DKD and prognosis in T2DM patients.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"1009-1018"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638946","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":"Predictive performance of machine learning models for kidney complications following coronary interventions: a systematic review and meta-analysis.","authors":"Soroush Najdaghi, Delaram Narimani Davani, Davood Shafie, Azin Alizadehasl","doi":"10.1007/s11255-024-04257-5","DOIUrl":"10.1007/s11255-024-04257-5","url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury (AKI) and contrast-induced nephropathy (CIN) are common complications following percutaneous coronary intervention (PCI) or coronary angiography (CAG), presenting significant clinical challenges. Machine learning (ML) models offer promise for improving patient outcomes through early detection and intervention strategies.</p><p><strong>Methods: </strong>A comprehensive literature search following PRISMA guidelines was conducted in PubMed, Scopus, and Embase from inception to June 11, 2024. Study characteristics, ML models, performance metrics (AUC, accuracy, sensitivity, specificity, precision), and risk-of-bias assessment using the PROBAST tool were extracted. Statistical analysis used a random-effects model to pool AUC values, with heterogeneity assessed via the I² statistic.</p><p><strong>Results: </strong>From 431 initial studies, 14 met the inclusion criteria. Gradient Boosting Machine (GBM) and Support Vector Machine (SVM) models showed the highest pooled AUCs of 0.87 (95% CI: 0.82-0.92) and 0.85 (95% CI: 0.80-0.90), respectively, with low heterogeneity (I² < 30%). Random Forest (RF) had a similar AUC of 0.85 (95% CI: 0.78-0.92) but significant heterogeneity (I² > 90%). Multilayer perceptron (MLP) and XGBoost models had moderate pooled AUCs of 0.79 (95% CI: 0.74-0.84) with high heterogeneity. RF showed strong accuracy (0.83, 95% CI: 0.70-0.96), while SVM had balanced sensitivity (0.69, 95% CI: 0.63-0.75) and specificity (0.73, 95% CI: 0.60-0.86). Age, serum creatinine, left ventricular ejection fraction, and hemoglobin consistently influenced model efficacy.</p><p><strong>Conclusions: </strong>GBM and SVM models, with robust AUCs and low heterogeneity, are effective in predicting AKI and CIN post-PCI/CAG. RF, MLP, and XGBoost, despite competitive AUCs, showed considerable heterogeneity, emphasizing the need for further validation.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"855-874"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545339","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":"Sodium-chloride difference is not strongly correlated with base excess in chronic kidney disease: an anion gap problem.","authors":"Moritz Kerbl-Knapp, Gregor Lindner, Georg-Christian Funk, Christoph Schwarz","doi":"10.1007/s11255-024-04274-4","DOIUrl":"10.1007/s11255-024-04274-4","url":null,"abstract":"<p><strong>Introduction: </strong>The prevalence of metabolic acidosis is high in patients with chronic kidney disease (CKD). For the diagnosis, a blood gas analysis is necessary, but not always available. The aim of the study was to evaluate the base excess (BE) of the sodium-chloride difference (BE_Na-Cl = Na⁺-Cl^--34 mmol/l) as a screening parameter for hyperchloremic metabolic acidosis.</p><p><strong>Methods and statistical analysis: </strong>We retrospectively performed acid-base analyses of 168 non-dialysed patients with CKD according to the physiologic and to the Stewart's approach. We performed linear regression analysis, Bland-Altman plot and receiver operating characteristics (ROC) analysis of BE_Na-Cl and BE to evaluate the accuracy of BE_Na-Cl predicting the BE. We further investigated possible confounding factors.</p><p><strong>Results: </strong>The corrected R² for the correlation of BE_Na-Cl and BE was 0.60 (p < 0.001). The Bland-Altman plot showed a good overall agreement. The bias was negligible, but the 95%-limits of agreement showed a wide interval (10.4 mmol/l). For BE ≤ 2 mmol/l, the ROC analysis yielded an AUC of 0.89 and moderate sensitivity (0.75) and specificity (0.86) for the optimal BE_Na-Cl threshold (≤ 2 mmol/l). Subgroup analysis showed similar results. The main factor for the imprecision of BE_Na-Cl predicting the BE across all stages of CKD is the variability of the serum anion gap (SAG).</p><p><strong>Conclusions: </strong>The BE_Na-Cl is not an adequate parameter for screening of hyperchloremic acidosis because of the high variability of the SAG. Only, if the BE_Na-Cl is ≤ 5 mmol/l, a hyperchloremic acidosis should be suspected. Therefore, a complete blood gas analysis is necessary for the correct diagnosis of acid-base disorders in patients with chronic kidney disease.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"981-988"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620768","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":"Increased risk of genitourinary cancer in kidney transplant recipients: a large-scale national cohort study and its clinical implications.","authors":"Hyunho Kim, Kyung-Hee Chae, Arum Choi, Mi-Hyeong Kim, Ji Hyung Hong, Bum Soon Choi, Sukil Kim, Tae Hyun Ban","doi":"10.1007/s11255-024-04244-w","DOIUrl":"10.1007/s11255-024-04244-w","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the risk of genitourinary (GU) cancer in kidney transplant recipients (KTRs) compared to that in the general population, focusing on potential risk factors and clinical implications.</p><p><strong>Methods: </strong>Using a national cohort of approximately 360,000 individuals, including 31,542 KTRs, we conducted a retrospective analysis of the data from 2007 to 2018. Propensity score matching was used to compare KTRs with a healthy population, adjusting for age, sex, diabetes, hypertension, and hypercholesterolemia.</p><p><strong>Results: </strong>We identified a significantly increased risk of GU cancers, particularly bladder and kidney cancers, in KTRs. Multivariate analysis revealed a higher risk of GU cancer associated with kidney transplantation [hazard ratio (HR) 2.133, 95% confidence interval (CI) 1.641-2.772] and hypercholesterolemia (HR 1.725, 95% CI 1.227-2.425), with older age and male sex also being significant risk factors. Conversely, no significant increase in prostate cancer risk was observed in KTRs compared to the general population.</p><p><strong>Conclusion: </strong>This national cohort-based study indicated an increased risk of GU cancer in KTRs, underscoring the need for targeted cancer surveillance and pre- and post-transplant counseling. These findings provide valuable insights for the development of cancer surveillance programs for KTRs and highlight the necessity for further research in this field.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"715-722"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11821677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142500539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of the effectiveness and safety of 7.5 Fr ultra-thin flexible ureteroscope combined with a tip-flexible suctioning ureteral access sheath for the treatment of kidney stones.","authors":"Haiyang Hu, Mao Qin, Longwei Yang, Hongyu Hu, Guodong Qin, Ming Qiu, Yu Gao, Jianguo Dou, Tingjia Wu, Pinghua Long, Wei Zhang","doi":"10.1007/s11255-024-04269-1","DOIUrl":"10.1007/s11255-024-04269-1","url":null,"abstract":"<p><strong>Objective: </strong>To compare the efficacy and safety of using a 7.5 Fr flexible ureteroscope (f-URS) with tip-flexible suctioning ureteral access sheath (TFS-UAS) versus a 9.2 Fr f-URS with traditional ureteral access sheath (T-UAS) in the treatment of kidney stones.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 205 patients with kidney stones measuring 1.0-2.0 cm treated with 7.5 Fr and 9.2 Fr f-URS in the Urology Department of The Affiliated Dazu Hospital of Chongqing Medical University from November 2022 to November 2023. The patients were randomly divided into two groups. Among them, 78 patients were selected to use the 7.5 Fr f-URS, which was designated as the GroupA. The remaining 127 patients were selected to use the 9.2 Fr f-URS, which served as the GroupB. The study compared the operation duration, lithotripsy duration, surgical success rate, immediate postoperative stone-free rate (SFR), 1-month postoperative SFR, and the incidence rate of postoperative complications between the two patient groups.</p><p><strong>Results: </strong>In terms of demographic characteristics, the size of calculi, surgical success rate, and 1-month postoperative SFR, there was no statistically significant difference between GroupA and GroupB. However, GroupA demonstrated superior performance compared to GroupB in operation duration (48 (40.55) min vs 74 (56.94) min), lithotripsy duration (35 (27.43) min vs 59 (42.78) min), and immediate postoperative SFR (53.52% (38/71) vs 29.41% (35/119)), with statistically significant differences observed (P < 0.05). In terms of complication occurrence, GroupA reported 10 cases of minor (Grade 1) complications, whereas GroupB had 32 cases of minor (Grade 1) complications and 7 cases of severe complications (including 2 cases of Grade 3 and 5 cases of Grade 4). The difference between the two groups was statistically significant (P < 0.05). The GroupA reported significantly fewer cases of postoperative fever (4) and analgesic treatment (3) compared to GroupB, which had 18 fever cases and 19 analgesic cases (P < 0.05).The GroupA did not experience any cases of septicemia or steinstrasse. Conversely, the GroupB had 5 cases of septicemia and 3 cases of steinstrasse, including 2 patients who underwent reoperation. Both groups also reported cases of ureteral mucosal rupture (5 in GroupA, 10 in GroupB), but these differences were not statistically significant (P > 0.05).</p><p><strong>Conclusion: </strong>Compared with 9.2 Fr f-URS combined with T-UAS, the use of 7.5 Fr f-URS with TFS-UAS in the treatment of kidney stones has higher lithotripsy efficiency and lower complication rate. This combination is safe and effective in the treatment of kidney stones.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"817-823"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11821792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Renal injury in NSAIDs: a real-world analysis based on the FAERS database.","authors":"Haojie Xu, Jiaming Cao, Hongyi Zhang, Fenglong Fei, Dongming Tang, Donghua Liu, Dongbin Luo","doi":"10.1007/s11255-024-04263-7","DOIUrl":"10.1007/s11255-024-04263-7","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to evaluate the reporting risk of renal injury associated with non-steroidal anti-inflammatory drugs (NSAIDs), with a particular focus on the reporting risk levels and onset times of different NSAIDs.</p><p><strong>Methods: </strong>A pharmacovigilance study was conducted using data from the FAERS database from January 2004 to December 2023. Reports of renal injury were identified, and signal detection was performed using reporting odds ratio (ROR) and Bayesian confidence propagation neural network (BCPNN) methods. The study compared the incidence, mortality rates, and onset times of renal injury across five NSAIDs.</p><p><strong>Results: </strong>Among the 7436 cases of NSAID-associated renal injury analyzed, elderly patients are at an increased risk of renal injury associated with NSAID usage. Ibuprofen had the highest number of reports (3475 cases, 46.7%), while celecoxib had the lowest (542 cases, 7.3%). Ibuprofen showed the highest signal with renal injury (ROR 3.3, IC025 1.7), whereas celecoxib exhibited the lowest (ROR 1.4, IC025 0.4). Aspirin had the highest mortality rate associated with renal injury (18.7%), while ibuprofen had the lowest (3.8%). The median onset time for renal injury was 6 days, with 79.3% of adverse events occurring within the first 30 days of use.</p><p><strong>Conclusion: </strong>The study indicates that ibuprofen presents the highest signal of renal injury, while celecoxib shows the lowest signal. The likelihood of NSAID-associated renal injury is heightened in elderly patients, and all five studied NSAIDs are linked to an increased likelihood of acute renal injury. NSAID-related renal damage tends to occur early in the treatment process, potentially leading to serious consequences. Due to the inherent limitations of pharmacovigilance studies, certain findings require additional validation like cohort studies. Nonetheless, the potential for an increased risk of renal injury must be taken into account in patient care.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"957-963"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564209","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 between the use of loop diuretics and prognosis in critically ill patients with acute kidney injury: a retrospective propensity score-matched cohort study.","authors":"Hua Xiao, Kai Liu, Hong-Hao Meng, Yun-Peng Peng, Guo-Bao Hong, Xin-Zhou Zhang","doi":"10.1007/s11255-024-04271-7","DOIUrl":"10.1007/s11255-024-04271-7","url":null,"abstract":"<p><strong>Background: </strong>The role of loop diuretics in patients with acute kidney injury (AKI) is controversial. This study examined the association between the use of loop diuretics and prognosis in critically ill patients with AKI.</p><p><strong>Methods: </strong>This study used data from the medical information mart for the intensive care IV database. Adult critically ill patients with AKI were included in the analysis. Patients were partitioned into two groups based on their use of loop diuretics in the ICU, and potentially confounding variables between the two groups were balanced using propensity score matching (PSM). We used time-dependent Cox proportional hazards regression, logistic regression, and Hodges-Lehman estimator to assess the impact of loop diuretics on all-cause mortality, renal replacement therapy (RRT) use, and the length of hospital stay, respectively.</p><p><strong>Results: </strong>This study included a cohort of 19,671 patients. After PSM, both groups consisted of 6200 patients. The use of loop diuretics was associated with a lower risk of in-hospital mortality (HR, 0.672; 95% CI 0.597-0.757; P < 0.001), lower in-ICU mortality (HR, 0.375; 95% CI 0.315-0.446; P < 0.001), and lower odds of in-hospital RRT (OR, 0.472; 95% CI 0.400-0.555; P < 0.001). A sensitivity analysis using the original cohort (HR, 0.624; 95% CI 0.561-0.693; P < 0.001) and weighted cohort (HR, 0.654; 95% CI 0.582-0.736; P < 0.001) also demonstrated lower in-hospital all-cause mortality.</p><p><strong>Conclusions: </strong>The use of loop diuretics is associated with a substantial reduction in mortality among critically ill patients with AKI.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"999-1008"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638942","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":"Mineralocorticoid receptor blockage in kidney transplantation: too much of a good thing or not?","authors":"Baris Afsar, Rengin Elsurer Afsar, Yasar Caliskan, Krista L Lentine","doi":"10.1007/s11255-024-04256-6","DOIUrl":"10.1007/s11255-024-04256-6","url":null,"abstract":"<p><p>Although, kidney transplantation (KT) is the best treatment option for patients with end-stage kidney disease, long-term complications including chronic kidney allograft disease (CKAD) and major adverse cardiovascular events (MACE) are common. To decrease these complications new therapeutic options are necessary. Mineralocorticoid receptor antagonists (MRAs) are one of the promising drugs in this context. In the general population, MRAs had favorable effects on blood pressure regulation, MACE, proteinuria and progression of chronic kidney disease. In the context of KT, there are limited studies showing beneficial effects such as reducing proteinuria and oxidative stress. In this review, we performed a narrative review to assess the use and impact of MRAs in kidney transplant recipients. We found that in KTRs, MRAs are safe and they have favorable or neutral impact on blood pressure, glomerular filtration rate, urinary protein/albumin excretion, and oxidative stress. No data was found regarding major cardiovascular adverse events.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"839-854"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545338","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}