International Urology and Nephrology最新文献

{"title":"Current applications and research trends of ultrasound examination in acute kidney injury assessment: a bibliometric analysis.","authors":"Jiawei Jiang, Jinqiang Zhou, Jiating Bao, Hongmei Gao","doi":"10.1007/s11255-025-04363-y","DOIUrl":"10.1007/s11255-025-04363-y","url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury (AKI) is a significant clinical condition, and ultrasound examination has emerged as a crucial non-invasive imaging method for assessing kidney status, especially in its diagnosis and management. This study aims to perform a bibliometric analysis to clarify current research trends in ultrasound assessment of AKI.</p><p><strong>Methods: </strong>We conducted a literature search in the Web of Science database using keywords related to ultrasound examinations of acute kidney injury, up to November 15, 2023. The results were analyzed using the bibliometric software package in R. Relevant literature information was analyzed.</p><p><strong>Results: </strong>A total of 1109 articles were included in the study. Research papers published between 2019 and 2024 demonstrated a significant upward trend. The United States, China, and Italy ranked as the top three countries in terms of publication volume. Among the top 10 research institutions with the highest number of publications, 6 are in the United States, with Université de Montréal being the institution with the most publications. Keyword trends focused on: resistive index, risk factors, therapy, glomerular filtration rate, survival, etc. CONCLUSION: This bibliometric study highlights the advancements in ultrasound examination for AKI and underscores the importance of such analyses in determining research trends. Future research should emphasize the integration of various imaging techniques to improve diagnostic accuracy and clinical management of AKI.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"1933-1944"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12049308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983540","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":"Comparative study between silodosin, tamsulosin, silodosin plus tadalafil, and tamsulosin plus tadalafil as a medical expulsive therapy for lower ureteral stones: a prospective randomized trial.","authors":"Mohamed Mahmoud Dogha, Ismail Gamal A Sherif, Yasmin M Madney, Hadeer S Harb, Hoda Rabea","doi":"10.1007/s11255-024-04356-3","DOIUrl":"10.1007/s11255-024-04356-3","url":null,"abstract":"<p><strong>Purpose: </strong>To examine the safety and efficiency of a single-drug therapy with silodosin or tamsulosin versus combined therapy with silodosin plus tadalafil and tamsulosin plus tadalafil as a medical expulsive therapy (MET) for lower ureteral stones.</p><p><strong>Methods: </strong>This research was a prospective randomized clinical trial carried out at Fayoum University Hospital, Egypt, over one year. Patients with lower ureteral stones (5-10 mm) were randomly allocated into one of four treatment groups. Group A received silodosin 8 mg per day; Group B received tamsulosin 0.4 mg per day; Group C received silodosin 8 mg plus tadalafil 5 mg daily, and Group D received tamsulosin 0.4 mg plus tadalafil 5 mg daily. Treatment was prescribed for up to 4 weeks. The study outcomes were the stone expulsion rate, stone expulsion time, the amount of analgesics used, the frequency of pain episodes, hospital visits, and any treatment-related adverse effects.</p><p><strong>Results: </strong>One hundred eighty patients who fulfilled the inclusion criteria completed the study. Group C had a significantly elevated stone expulsion rate (91.1%) compared to Group A (57.8%) and Group B (71.1%) [P = 0.015, P < 0.001, respectively]. Group D had a significantly elevated stone expulsion rate (86.7%) compared to Group B (57.8%) [P = 0.002] and higher than Group A (71.1%). Group C and Group D had significantly less stone expulsion time, analgesic needs, and episodes of renal colic, and fewer hospital visits than Group A and Group B. No significant differences were found in adverse effects like orthostatic hypotension, dizziness, backache, headache, myalgia, and nausea between the patient groups.</p><p><strong>Conclusion: </strong>Combining silodosin with tadalafil and tamsulosin with tadalafil was more efficient as MET for lower ureteric stones than a single treatment with silodosin or tamsulosin.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"1827-1833"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949090","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":"Efficacy and safety of teriparatide in kidney transplant recipients with osteoporosis and low bone turnover: a real-world experience.","authors":"Daniele Vetrano, Francesco Aguanno, Alessia Passaseo, Simona Barbuto, Francesco Tondolo, Veronica Catalano, Guido Zavatta, Uberto Pagotto, Gaetano La Manna, Giuseppe Cianciolo","doi":"10.1007/s11255-025-04383-8","DOIUrl":"10.1007/s11255-025-04383-8","url":null,"abstract":"<p><strong>Introduction: </strong>Kidney transplantation is the preferred treatment for end-stage kidney disease (ESKD), enhancing survival and quality of life. However, kidney transplant recipients (KTRs) are at high risk for bone disorders, particularly low bone turnover disease, which increases fracture risk. Teriparatide, an anabolic agent, may provide a beneficial treatment option for these patients.</p><p><strong>Materials and methods: </strong>This single-center, retrospective observational study involved 18 KTRs with osteoporosis, low bone turnover, and a history of vertebral or non-vertebral fractures. Patients received teriparatide (20 μg/day) for up to 2 years. Areal bone mineral density (aBMD) at the lumbar spine (LS), total hip (TH), femoral neck (FN), and trabecular bone score (TBS) were measured at baseline, 1 year, and 2 years. In addition, bone turnover markers (BTMs), serum calcium, phosphorus, parathyroid hormone (PTH), and kidney function were monitored.</p><p><strong>Results: </strong>Significant increases in LS aBMD were observed after 1 year (0.941 ± 0.152 vs 1.043 ± 0.165, p = 0.04) and maintained after 2 years compared to baseline (0.941 ± 0.152 vs 1.074 ± 0.154, p = 0.03). TH aBMD significantly increased after 2 years (0.753 ± 0.145 vs 0.864 ± 0.141, p = 0.04), while FN and TBS showed non-significant improvement. Teriparatide was well-tolerated, with mild and transient hypercalcemia and hypophosphatemia.</p><p><strong>Conclusion: </strong>Teriparatide significantly improved BMD at the LS and TH in KTRs with osteoporosis and low bone turnover, showing a favorable safety profile.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"1965-1975"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12049390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052543","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":"Effectiveness and safety of finerenone in membranous nephropathy patients: a retrospective, real‑world study.","authors":"Haowen Lin, Qingqing Gao, Yuhe Yin, Siqi Peng, Xiaoying Dong, Zewen Zhao, Renwei Huang, Yiming Tao, Sichun Wen, Bohou Li, Qiong Wu, Sijia Li, Ting Lin, Hao Dai, Feng Wen, Zhuo Li, Lixia Xu, Jianchao Ma, Zhonglin Feng, Xiaoyan Bai, Shuangxin Liu","doi":"10.1007/s11255-025-04381-w","DOIUrl":"10.1007/s11255-025-04381-w","url":null,"abstract":"<p><strong>Purpose: </strong>We aimed to conduct a retrospective analysis to assess the efficacy and safety of finerenone in patients with membranous nephropathy (MN).</p><p><strong>Methods: </strong>This study conducted a retrospective analysis of patients with MN who were treated with finerenone for follow-up period ranging from 3 to 6 months. The study compared the estimated glomerular filtration rate (eGFR), urine total protein-to-creatinine ratio (PCR), urine albumin-to-creatinine ratio (ACR), serum creatinine concentration (SCr), blood pressure and serum potassium (K+) during the follow-up period.</p><p><strong>Result: </strong>In this study, 20 patients with MN were treated with finerenone for a follow-up period of 3 to 6 months. Prior to treatment, the average eGFR was 65.15 mL/min/1.73 m², the average PCR was 3643.63 mg/g, and the average ACR was 2489.44 mg/g. After 3 months of treatment, 80% of patients experienced a decrease in PCR. The median decrease percentages in PCR and ACR are 24.49% and 28.82%, respectively. After 6 months of treatment, the median decrease percentages in PCR and ACR are 42.03% and 43.66%, respectively while the eGFR remained stable with little variation from baseline. During the treatment period, there were minimal changes in serum potassium levels and serum creatinine levels and no treatment discontinuations or hospitalizations due to hyperkalemia were observed. Blood pressure decreased by about 10 mmHg in 6 patients (30%), while there was no difference before and after the addition of finerenone in the remaining 14 (70%) patients.</p><p><strong>Conclusion: </strong>The retrospective analysis indicates that finerenone treatment led to significant reductions in PCR and ACR in patients with membranous nephropathy over a 3 to 6-month period, with minimal impact on eGFR, SCr, and K+ levels, highlighting its capacity as a therapeutic option for MN patient group.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"1945-1953"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005261","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":"Duplex ultrasound compared with digital subtraction angiography in diagnosing significant stenosis of vascular access.","authors":"Ali Jawas, Mohammad Murtuza, Fikri M Abu-Zidan","doi":"10.1007/s11255-025-04588-x","DOIUrl":"https://doi.org/10.1007/s11255-025-04588-x","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluated the diagnostic accuracy of duplex ultrasound (DUS) using peak systolic velocity (PSV), PSV ratio (PSVR), and volume flow in detecting vascular access stenosis, compared to digital subtraction angiography.</p><p><strong>Methods: </strong>A cohort of 121 patients with arteriovenous (AV) fistulas or grafts were evaluated between January 2013 and September 2013 for clinical indicators of dysfunction, including reduced thrill, weak bruit, decreased dialysis flow, high venous pressure or excessive post-dialysis bleeding using our own collective diagnostic criteria based on previously published parameters. Critical stenosis was defined as PSV >400 cm/s, PSVR >3.5, and volume flow <400 mL/min. Angiography was performed for all hemodynamically significant stenoses diagnosed by DUS.</p><p><strong>Results: </strong>Among 121 patients (mean age, 56.6 ± 17.3 years; 64% men), DUS findings included normal studies (24%), mild stenosis (9.9%), moderate stenosis (15.7%), severe stenosis (40.5%), and total occlusions (9.9%). Stenosis locations were at the anastomotic site (86.3%), the junctional (11.3%), and the venous outflow (2.5%). Critical stenosis was identified in 49 (40.5%) patients. Of 46 patients who underwent angiography, critical stenosis was confirmed in 44. DUS demonstrated a positive predictive value (PPV) of 95.6% for detecting significant stenosis, supporting its reliability in vascular access assessment. Study limitations include its small sample size, retrospective design, and limited generalizability. Furthermore, analysis was limited to positive sonographic findings precluding sensitivity/specificity assessment.</p><p><strong>Conclusion: </strong>DUS is accurate in diagnosing severe vascular access stenosis, with a PPV exceeding 95%. Its non-invasive nature and high predictive value support its use as a first-line imaging modality for vascular access evaluation.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199119","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":"Improving search strategies in bibliometric studies on machine learning in renal medicine.","authors":"Hao-Han Rao, Feng Guo, Jie Tian","doi":"10.1007/s11255-024-04335-8","DOIUrl":"10.1007/s11255-024-04335-8","url":null,"abstract":"<p><p>This paper evaluated the bibliometric study by Li et al. (Int Urol Nephrol, 2024) on machine learning in renal medicine. Although the study claims to summarize the forefront trends and hotspots in this field, several key issues require further clarification to effectively guide future research. Firstly, while the authors used the \"*\" wildcard to broaden the search scope, they screened articles only by document type and language, without specific filtering based on titles, abstracts, or full texts. This approach may have led to the inclusion of irrelevant studies, potentially compromising analytical accuracy. Secondly, the authors conducted the search using the Topic (TS) field, which may include articles not closely related to the intended topic. We recommend using Title (TI), Abstract (AB), and Author Keywords (AK) as filtering criteria in future studies to improve search precision. Finally, in the keyword co-occurrence analysis, the authors did not merge synonyms, leading to distortions in keyword frequency rankings; for example, \"machine learning\" and \"machine learning (ML)\" were treated as separate terms. We believe that synonym merging would enhance the accuracy of keyword analysis. Overall, the search strategy by Li et al. demonstrates issues such as imprecise scope and lack of synonym integration. To ensure the comprehensiveness and accuracy of future research, we suggest refining the search strategy, employing precise screening steps, and integrating synonyms to improve the quality of bibliometric studies.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"1987-1988"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877305","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":"Unraveling diabetic kidney disease: insights from single-cell RNA sequencing.","authors":"Xiao-Lin Yuan, Bei-Bei Lu, Li Zeng, Ling Zhong","doi":"10.1007/s11255-025-04362-z","DOIUrl":"10.1007/s11255-025-04362-z","url":null,"abstract":"<p><p>The incidence of diabetic kidney disease (DKD) is rising annually. Diabetes leads to structural damage and dysfunction in the kidneys, clinically manifesting as progressive proteinuria and declining renal function, ultimately resulting in end-stage renal disease (ESRD). Recent findings have identified a subset of DKD known as normoalbuminuric diabetic kidney disease (NADKD), characterized by normal urine albumin levels but reduced renal function. These complex clinical presentations and underlying pathophysiology challenge traditional diagnostic and treatment approaches. Single-cell RNA sequencing (scRNA-seq), a novel experimental technique, is employed to analyze gene expression in renal tissue, blood, and urine from DKD patients, enhancing our understanding of tissue function, cellular interactions, and disease progression. This approach facilitates early screening and personalized management of DKD.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"1885-1893"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970838","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":"Predicting intermediate-risk prostate cancer using machine learning.","authors":"Miroslav Stojadinovic, Milorad Stojadinovic, Slobodan Jankovic","doi":"10.1007/s11255-024-04342-9","DOIUrl":"10.1007/s11255-024-04342-9","url":null,"abstract":"<p><strong>Purposes: </strong>Intermediate-risk prostate cancer (IR PCa) is the most common risk group for localized prostate cancer. This study aimed to develop a machine learning (ML) model that utilizes biopsy predictors to estimate the probability of IR PCa and assess its performance compared to the traditional clinical model.</p><p><strong>Methods: </strong>Between January 2017 and December 2022, patients with prostate-specific antigen (PSA) values of ≤ 20 ng/mL underwent transrectal ultrasonography-guided prostate biopsies. Patient's age, PSA, digital rectal exam, prostate volume, PSA density (PSAD), and previous negative biopsy, number of positive cores, Gleason score, and biopsy outcome were recorded. Patients are categorized into no cancer, very low, low-, and intermediate-risk categories. The relationship between the model and IR PCa was investigated using binary generalized linear model (GLM) and assessed its discriminatory ability by calculating the area under the receiver operating characteristic curve (AUC).</p><p><strong>Results: </strong>Among 729 patients, PCa was detected in 234 individuals (32.1%), with 120 (16.5%) diagnosed with IR PCa. The AUC for the novel model compared to the clinical model was 0.806 (95% CI: 0.722-0.889) versus 0.669 (95% CI: 0.543-0.790), with a p-value of 0.018. In DCA, the GLM outperformed the clinical model by over 7%, potentially allowing for an additional 44.3% reduction in unnecessary biopsies. The PSAD emerged as the most significant predictor.</p><p><strong>Conclusion: </strong>We developed a GLM utilizing pre-biopsy features to predict IR PCa. The model demonstrated good discrimination and clinical applicability, which could assist urologists in determining the necessity of a prostate biopsy.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"1737-1746"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921201","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":"Evaluation of risk factors associated with epicardial fat tissue thickness in patients with stage 4 and stage 5 chronic kidney disease.","authors":"Hasan İnce, Zülfükar Yılmaz, Aziz Karabulut, Emre Aydın, Yaşar Yıldırım, Ali Veysel Kara, Ali Kemal Kadiroğlu, Fatma Yılmaz Aydın","doi":"10.1007/s11255-025-04386-5","DOIUrl":"10.1007/s11255-025-04386-5","url":null,"abstract":"<p><strong>Purpose: </strong>Chronic kidney disease (CKD) is a global public health issue, often associated with high mortality and morbidity, especially due to cardiovascular diseases. Epicardial adipose tissue (EAT), the visceral fat surrounding the heart, has been recognized as a significant factor in cardiovascular risk. This study aims to assess the relationship between EAT and body composition in patients with stage 4 and 5 CKD using bioelectrical impedance analysis (BIA).</p><p><strong>Methods: </strong>The study included 80 patients with stage 4 and 5 CKD who were not on dialysis. Body composition was measured using BIA, and EAT was assessed using transthoracic echocardiography(ECHO). Exclusion criteria included heart failure, morbid obesity, pregnancy, and pacemaker use, among others. Various demographic, clinical, and biochemical parameters were also recorded.</p><p><strong>Results: </strong>Patients with stage 5 CKD (6.7 ± 0.12) had significantly higher EAT compared to stage 4 CKD (5.9 ± 0.09) patients. EAT showed a positive correlation with age, BMI, blood pressure, C-reactive protein (CRP), and triglyceride levels, and a negative correlation with albumin and HDL levels. Multivariate analysis revealed that increased systolic blood pressure(SBP)(p:0.019),fat tissue mass (FTM)(p < 0.001), low HDL(p: 0.027), and low albumin(p < 0.001) were independent predictors of EAT.</p><p><strong>Conclusion: </strong>EAT is higher in advanced CKD patients and is associated with several cardiovascular risk factors. Measuring EAT in CKD patients using non-invasive methods like ECHO could be valuable in predicting cardiovascular risks. Addressing the factors that contribute to increased EAT may improve clinical outcomes for CKD patients.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"1977-1982"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074680","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":"Causal association of circulating immune cells with nephrotic syndrome: evidence from a two-sample Mendelian randomization study.","authors":"Sheng Li, Xing Zhou, Chengmeng Liu, Yijie Wang, Qianhui Zhou, Ting Sun","doi":"10.1007/s11255-024-04350-9","DOIUrl":"10.1007/s11255-024-04350-9","url":null,"abstract":"<p><strong>Objective: </strong>Nephrotic syndrome, a debilitating manifestation of kidney disease, often arises from diverse glomerular disorders and is accompanied by notable comorbidities. Despite indications of an immunological etiology, the precise role of immune cells in its pathogenesis remains unclear. This study aimed to elucidate the causal relationships between circulating immune cell phenotypes and nephrotic syndrome using a rigorous bidirectional Mendelian randomization approach.</p><p><strong>Methods: </strong>We conducted a bidirectional Mendelian randomization analysis leveraging public genome-wide association studies (GWAS) datasets to investigate the causal links between 731 immune cell features and nephrotic syndrome. Our primary analysis employed inverse variance weighting (IVW), complemented by MR-Egger regression, simple model, weighted median method, and weighted model techniques to ensure robustness. Sensitivity analyses were performed to address potential biases arising from heterogeneity, horizontal pleiotropy, and single-nucleotide polymorphism (SNP) instability in nephrotic syndrome.</p><p><strong>Results: </strong>Among traits examined, 13 immune cell phenotypes were identified to have significant causal impacts on nephrotic syndrome (adjusted P >  < 0.05). Among these phenotypes, CD25 on unswitched memory B cell, CD25 on memory B cell, CD25 on CD24 + CD27 + B cell, CD25 on IgD-CD38-B cell, CD33dim HLA DR-Absolute Count, and CD127 on granulocyte emerged as causal risk factors, while seven circulating immune cell phenotypes, predominantly monocyte subsets, exhibited protective effects. Furthermore, the reverse Mendelian randomization analysis demonstrated significant effects of nephrotic syndrome on 27 immune phenotypes (P < 0.05).</p><p><strong>Conclusion: </strong>The genetic predictions indicate that multiple circulating immune cell phenotypes, particularly CD25 on specific B-cell subsets, serve as independent risk factors for the onset and progression of nephrotic syndrome. Conversely, monocytes expressing specific phenotypes may exert protective effects against the development of nephrotic syndrome. These findings offer a novel therapeutic approach for the prevention and treatment of nephrotic syndrome.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"1907-1917"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909723","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}