International Urology and Nephrology最新文献

{"title":"Correlation between the course of kidney injury and clinicopathology and prognosis of children with Henoch-Schönlein purpura nephritis.","authors":"Yuying Sun, Xiaoqing Yang, Leying Xi, Zhiyuan Feng, Xianqing Ren","doi":"10.1007/s11255-024-04336-7","DOIUrl":"10.1007/s11255-024-04336-7","url":null,"abstract":"<p><strong>Purpose: </strong>Henoch-Schönlein purpura nephritis (HSPN) has a poor prognosis and variable pathophysiology. The present study aimed to analyze the kidney injury, clinicopathology, and prognosis of HSPN children.</p><p><strong>Methods: </strong>This retrospective study examined 249 children with HSPN. The patients' pathological and clinical data were collected. The patients were divided into the following groups according to the duration of their kidney injury: groups with disease duration of < 2 weeks, 2 weeks to 1 month, 1-2 months, 2-4 months, 4-6 months, and ≥ 6 months. The clinicopathological and prognostic relationships were examined between the groups.</p><p><strong>Results: </strong>We enrolled 249 children with HSPN (average age of 10.12 ± 3.01 years). There were 161 boys (64.66%) and 88 girls (35.34%). Altogether, 191 children (76.71%) developed kidney injury within 2 months. A total of 37 children (14.86%) showed recurrent renal damage after 6 months. Most patient groups exhibited hematuria and proteinuria, with type III pathology being the most common. During 2 weeks and 1 month of kidney injury, the acute pathology index peaked and then decreased; then, it increased again after 4 months as recurrence occurred. The chronic pathology index was the highest in the group with a disease duration of 2-4 months and it increased with increasing disease duration. The prognosis worsens with the disease duration.</p><p><strong>Conclusion: </strong>Children with HSPN showed disease remission after a duration of 4-6 months. The acute and chronic pathology indexes peaked between 2 weeks to 1 month and 2-4 months, respectively. Patients with kidney injury occurring within a month had a much higher remission rate.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"1625-1631"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894373","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":"Deep learning-based prediction of tumor aggressiveness in RCC using multiparametric MRI: a pilot study.","authors":"Guiying Du, Lihua Chen, Baole Wen, Yujun Lu, Fangjie Xia, Qian Liu, Wen Shen","doi":"10.1007/s11255-024-04300-5","DOIUrl":"10.1007/s11255-024-04300-5","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the value of multiparametric magnetic resonance imaging (MRI) as a non-invasive method to predict the aggressiveness of renal cell carcinoma (RCC) by developing a convolutional neural network (CNN) model and fusing it with clinical characteristics.</p><p><strong>Methods: </strong>Multiparametric abdominal MRI was performed on 47 pathologically confirmed RCC patients between 2019 and 2023. Preoperative MRI was performed on all patients to assess their clinical characteristics. The CNN model was developed and validated to assess the predictive value of b value images, combined b value images, apparent diffusion coefficient (ADC), intravoxel incoherent motion (IVIM), diffusion kurtosis imaging (DKI), and their parametric maps for RCC aggressiveness. The least absolute shrinkage and selection operator (LASSO) regression was used to identify clinical features highly correlated with RCC aggressiveness. These clinical features were combined with selected b values to develop a fusion model. All models were evaluated using receiver operating characteristic (ROC) curve analysis.</p><p><strong>Results: </strong>A total of 47 patients (mean age, 56.17 ± 1.70 years; 37 men, 10 women) were evaluated. LASSO regression identified renal sinus/perirenal fat invasion, tumor stage, and tumor size as the most significant clinical features. The combined b values of b = 0,1000 achieved an area under the curve (AUC) of 0.642 (95% CI: 0.623-0.661), and b = 0,100,1000 achieved an AUC of 0.657 (95% CI: 0.647-0.667). The fusion model combining clinical features with b = 0,1000 yielded the highest performance with an AUC of 0.861 (95% CI: 0.667-0.992), demonstrating superior predictive accuracy compared to the other models.</p><p><strong>Conclusion: </strong>Deep learning using a CNN fusion model, integrating multiple b value images and clinical features, could effectively promote the preoperative prediction of tumor aggressiveness in RCC patients.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"1365-1379"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818161","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":"Etiology of panurethral strictures in a low socioeconomic status population.","authors":"Kunj Jain, Radhika Patel, Aleksandar Popovic, Meher Pandher, Amjad Alwaal","doi":"10.1007/s11255-024-04328-7","DOIUrl":"10.1007/s11255-024-04328-7","url":null,"abstract":"<p><strong>Introduction: </strong>Panurethral strictures represent the most severe form within the anterior urethral stricture spectrum, requiring more technically complex repairs and resulting in poorer outcomes compared to localized anterior urethral strictures (penile or bulbar). This abstract aims to describe the distinct characteristics of patients with panurethral strictures in a low socioeconomic status population.</p><p><strong>Methods: </strong>Patients presenting with localized anterior (penile or bulbar) or panurethral strictures at University Hospital in Newark, NJ, between 2021 and 2023 were retrospectively identified. Data were extracted from electronic medical records and analyzed statistically using IBM SPSS Software.</p><p><strong>Results: </strong>Among the patients, 33 had localized anterior urethral strictures, and 22 had panurethral stricture disease. Hispanic and African American patients accounted for the majority of stricture cases (63.6%), including 59% of the panurethral stricture cohort. The only statistically significant factor contributing to panurethral disease was lichen sclerosis (p < 0.05). Patients with panurethral strictures had a higher incidence of inflammatory and systemic diseases such as STDs, recurrent UTIs, diabetes, and hypertension, while those with localized anterior urethral strictures showed a higher incidence of iatrogenic factors, including prior catheterizations and transurethral surgeries. However, these factors did not reach a statistical significance. Hypospadias repair was observed in 6% of localized anterior urethral stricture cases, compared to 13.6% of panurethral stricture cases.</p><p><strong>Conclusion: </strong>While iatrogenic causes remain the predominant contributors, inflammatory and systemic conditions, particularly lichen sclerosis, significantly influence the development of panurethral strictures. Early surgical intervention and better management of systemic diseases may prevent the progression of localized anterior urethral strictures to panurethral disease, but further studies utilizing larger number of patients may shed light on the significance of these systemic factors.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"1389-1393"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003436/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142836645","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":"Letter to Editor: Effect of heart failure and atrial fibrillation on cardiorespiratory fitness in hemodialysis patients.","authors":"Muhammad Owais, Mansha Mansoor, Abdur Rehman","doi":"10.1007/s11255-024-04311-2","DOIUrl":"10.1007/s11255-024-04311-2","url":null,"abstract":"","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"1659-1660"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794454","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":"Pyeloduodenal fistula: a review of the current literature.","authors":"K Spanggaard, N K Hvid, M Diatchikhine, T H Olesen, L Lund","doi":"10.1007/s11255-024-04327-8","DOIUrl":"10.1007/s11255-024-04327-8","url":null,"abstract":"<p><strong>Purpose: </strong>Pyeloduodenal fistula (PDF) is a communication between the renal pelvis and the duodenum. It is often secondary to other diseases. It is a rare condition and therefore infrequently described in the literature. The aim is to present a review of the current literature on PDF and to give an update of its aetiology, symptoms, investigations and treatments.</p><p><strong>Methods: </strong>Pubmed, Cochrane Library and Embase were used to search for existing literature in English and Scandinavian languages with available abstracts in the period Jan 2000-Dec 2023.</p><p><strong>Results: </strong>No meta-analysis or reviews were found. In total, 24 original articles were found, including 25 cases all in all of both traumatic and spontaneous pyeloduodenal fistulas. Only four cases (15%) represented traumatic pyeloduodenal fistulas, and all of the spontaneous cases involved the right kidney and occurred due to calculi and pyonephrosis in 81% and 76% of the cases, respectively. Fever and flank pain were reported in 67% and 57% of the cases, respectively. Diagnosis was done by a CT urography or antegrade pyelography in 80% of the cases. More than 50% of all cases were managed by nephrectomy. Total parenteral nutrition (TPN) was administered alongside the nephrectomy in 28% of all cases.</p><p><strong>Conclusion: </strong>A pyeloduodenal fistula often involves the right kidney and often occurs as a result of chronic renal inflammatory disease. The fistulas are most efficiently diagnosed with a CT scanning with contrast or retrograde pyelography. The most frequently used management of pyeloduodenal fistula is nephrectomy after closure of the duodenum with somatostatin and TPN.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"1357-1363"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142836648","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":"Evaluating the use of tunneled hemodialysis catheters in the treatment of acute kidney disease patients requiring hemodialysis: a case-control study.","authors":"Mazin M T Shigidi","doi":"10.1007/s11255-024-04292-2","DOIUrl":"10.1007/s11255-024-04292-2","url":null,"abstract":"<p><strong>Purpose: </strong>Tunneled hemodialysis catheters (TDCs) are increasingly used in the emergency management of severe acute kidney disease (AKD). This study aimed to evaluate the effectiveness of TDCs in AKD patients requiring hemodialysis.</p><p><strong>Methods: </strong>A case-control study was conducted in Khartoum, Sudan between February and September 2020. Adult patients admitted to the Baraha Medical City Intensive Care Unit with AKD due to non-infectious causes, and requiring hemodialysis were enrolled. Patients were randomly assigned to undergo hemodialysis using either tunneled or non-tunneled hemodialysis catheters (NTDCs). The performance and complications associated with TDCs were assessed during the hospital stay, after discharge, and until catheter removal. Data were analyzed using SPSS.</p><p><strong>Results: </strong>A total of 122 patients with a mean age of 60.4 ± 5.7 years were included. AKD was primarily due to acute tubular necrosis (67.2%) and interstitial nephritis (16.4%). Indications for hemodialysis were mostly acute pulmonary edema (64.8%) and symptomatic uremia (27.9%). TDCs were used in 54 (44.3%) patients, while NTDCs were used in 68 (55.7%). The right internal jugular vein was the most common insertion site (95.9%). TDCs were associated with significantly higher blood flow (P < 0.0001) and lower rates of exit site infections (P = 0.034), catheter-related bacteremia (P = 0.011), and catheter malfunction (P = 0.001). They showed a significantly longer functional duration compared to NTDCs (P < 0.0001).</p><p><strong>Conclusion: </strong>TDCs appear to be a safer and more effective option for AKD patients requiring urgent and prolonged hemodialysis, with fewer complications and longer catheter function.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"1609-1614"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686824","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":"Obesity measurement methods estimated mortality risk in patients undergoing hemodialysis: a systematic review and meta-analysis.","authors":"Henni Kusuma, Huan-Fang Lee, Miaofen Yen, Susan Jane Fetzer, Le Trinh Lam","doi":"10.1007/s11255-024-04312-1","DOIUrl":"10.1007/s11255-024-04312-1","url":null,"abstract":"<p><strong>Purpose: </strong>The impact of obesity on mortality risk in patients undergoing hemodialysis (HD) remains uncertain due to conflicting findings across obesity measurement methods. This study aimed to assess the obesity measurements influence mortality risk in HD populations.</p><p><strong>Methods: </strong>Systematic review and meta-analysis were conducted following PRISMA guidelines, registered on PROSPERO (CRD42023429943). Relevant observational studies analyzing mortality risk using obesity measurements in adult HD patients up to March 27, 2023 were included from multiple databases, including EMBASE, MEDLINE (OVID), and CINAHL (EBSCO). Pooled analyses with a random-effects model were performed using RevMan 5.4.</p><p><strong>Results: </strong>Twenty-three studies involving 381,580 subjects were reviewed. A meta-analysis of 15 studies in event-based analysis showed contrasting results between anthropometry and body composition analysis in predicting all-cause mortality. Obese patients indicated by body mass index (BMI) had a lower mortality risk than non-obese patients (RR = 0.73, 95% CI: 0.70-0.76, p < 0.001). In contrast, abdominal obesity measured by waist circumference (WC) or waist-to-hip ratio (WHR) increased mortality risk (RR = 1.35, 95% CI: 1.01-1.80, p = 0.04). Studies using bioelectrical impedance analysis (BIA) demonstrated an increased mortality risk for obese patients (RR = 1.22, 95% CI: 1.05-1.41, p = 0.009).</p><p><strong>Conclusions: </strong>Obese patients undergoing HD exhibit different mortality risks depending on the methods of obesity measurement. The observed 'obesity paradox' in patients on HD, where lower mortality is seen with obesity measured by BMI, may reflect BMI's limitations in differentiating fat mass. More studies with other anthropometry and body composition analysis are needed to clarify this phenomenon.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"1585-1600"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806926","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 cornerstones of randomized clinical trials.","authors":"Mercedes Gori, Domenico Abelardo, Annalisa Pitino, Eleni Stamellou, Adamantia Bratsiakou, Carmela Marino, Giovanni Tripepi, Stefanos Roumeliotis, Graziella D'Arrigo","doi":"10.1007/s11255-024-04307-y","DOIUrl":"10.1007/s11255-024-04307-y","url":null,"abstract":"<p><p>Randomized clinical trials (RCTs) are pivotal in medical research, offering critical evidence on the efficacy and safety of treatments. This paper explores the distinct purposes and designs of superiority, non-inferiority, equivalence, and pragmatic trials, each addressing unique research questions. Superiority trials aim to demonstrate a new treatment's effectiveness over existing standards, while non-inferiority and equivalence trials focus on ensuring new treatments are not significantly worse or are similar to existing ones, respectively. Pragmatic trials assess interventions in real-world settings. A fundamental ethical principle in RCTs is clinical equipoise, ensuring unbiased treatment allocation. The CONSORT statement provides guidelines for transparent reporting of RCTs, enhancing the reliability of findings. Key methodological considerations include sample size calculation, randomization, blinding, and the choice between intention-to-treat and per-protocol analyses. Stratified analysis and forest plots further aid in understanding treatment effects across diverse populations. By adhering to these principles, RCTs remain a cornerstone of evidence-based medical practice, advancing patient care and outcomes.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"1555-1561"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768778","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":"Effects of combining zibotentan and dapagliflozins on chronic kidney disease: an innovative frontier.","authors":"Muhammad Abdul Rehman Gulzar, Iqra Gulzar","doi":"10.1007/s11255-024-04310-3","DOIUrl":"10.1007/s11255-024-04310-3","url":null,"abstract":"","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"1657-1658"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768769","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":"Analysis of research trends and hotspots in the primary treatment of end-stage renal disease.","authors":"LuYao Shi, Jian Wang, Tao Wei, Zhang Liang, Le Zhang, ChangYan Li, Tao Liu, WenXing Fan, MinZhang","doi":"10.1007/s11255-024-04290-4","DOIUrl":"10.1007/s11255-024-04290-4","url":null,"abstract":"<p><strong>Background: </strong>There is a lack of bibliometric analysis in research regarding primary therapy for end-stage renal disease (ESRD). This study aims to analyze the literature on ESRD therapy published over the past decade to understand current conditions and study trends for future research.</p><p><strong>Methods: </strong>Data were collected from the Web of Science Core Collection (WOSCC) database. Tools like CiteSpace 6.2.R4, 6.1.R6, VOSviewer 1.6.18, and Bibliometrix R4.1.1 were used to reveal research trends and hotspots. In addition, KEGG/GO analysis examined the probable functionalities of genes implicated in ESRD therapy to guide future research.</p><p><strong>Results: </strong>The bibliometric analysis presented in this paper indicates that the number of publications has remained relatively stable since 2013. The level of international collaboration is notably high, with the United States serving as the dominant research hub in this field. The University of California system is the most prolific institution, and Transplantation Proceedings is the most frequently published journal in this area. Kalantar-Zadeh, Kamyar is recognized as the most published and cited author. Keywords such as \"secondary hyperparathyroidism,\" \"uremic toxins,\" \"cyclosporine,\" \"mycophenolate mofetil,\" and \"biomarkers\" have seen a surge in interest recently, reflecting emerging research trends. Furthermore, inflammation and stem cell research have been identified as promising new therapeutic avenues for ESRD.</p><p><strong>Conclusion: </strong>This study identifies major areas, frontiers, and trends in research on primary treatments for ESRD, providing significant implications for future research.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"1513-1531"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716200","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}