International Urology and Nephrology最新文献

{"title":"Methodological considerations on the safety and efficacy of adding voclosporin to standard treatment for lupus nephritis: a commentary.","authors":"Menglu Ni, Wenbo Hu, Linsong Gao, Yuying Mao","doi":"10.1007/s11255-026-05186-1","DOIUrl":"10.1007/s11255-026-05186-1","url":null,"abstract":"","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"5117-5118"},"PeriodicalIF":2.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837844","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":"Early-start vs. conventional-start peritoneal dialysis in AKI from cardiorenal syndrome type 1: a randomized controlled trial (STARRT-PD).","authors":"Watanyu Parapiboon, Suriyan Yupaniad, Pachara Saengngammongkhol, Piti Niyomsirivanich, Tanin Simtharakaew","doi":"10.1007/s11255-026-05185-2","DOIUrl":"10.1007/s11255-026-05185-2","url":null,"abstract":"<p><strong>Purpose: </strong>Peritoneal dialysis (PD) is a feasible option for acute kidney injury (AKI) in hemodynamically unstable patients. However, the optimal timing for initiating PD in cardiorenal syndrome type 1 (CRS1) remains unclear.</p><p><strong>Methods: </strong>In a cardiac care unit of a tertiary hospital in Thailand, CRS1 patients who had AKI stage II between October 2020 and September 2021 were enrolled in a randomized, open-label controlled study. Patients were randomized into two groups: early-start PD strategy (starting PD within 24 h after AKI stage II) and conventional-start PD strategy (starting PD at 72 h if reaching AKI stage III or with an indication). The primary outcome was 30-day mortality. Secondary outcomes included fluid balance, sodium removal during the first 5 days, and PD safety.</p><p><strong>Results: </strong>77 CRS1 patients were enrolled, and 53 eligible participants were included in a modified intention-to-treat analysis (26 in the early-start group and 27 in the conventional-start group). Dialysis was initiated in 26 patients (100%) in the early-start group and 11 patients (40%) in the conventional-start group. The 30-day mortality was 65% (17 patients) in the early-start group and 40% (11 patients) in the conventional-start group (relative risk 1.68; 95% confidence interval 0.92-3.07; p = 0.07). The first 5-day fluid balance and sodium removal were comparable between the two groups. PD-related complications occurred in 6 events (early-start) and 3 events (conventional-start).</p><p><strong>Conclusion: </strong>Among CRS1 patients with AKI, early-start and conventional-start PD showed comparable 30-day mortality risk (Thai Clinical Trial Registry number, TCTR20200928003).</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"4979-4987"},"PeriodicalIF":2.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147874337","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":"Dynamic changes in FGF-21 and their association with inflammation and pulmonary function in ESRD patients undergoing peritoneal dialysis: a prospective cohort study.","authors":"Changda Lin, Lishuang Che, Yun Zhang, Yueting Li, Jinhai Chen","doi":"10.1007/s11255-026-05195-0","DOIUrl":"10.1007/s11255-026-05195-0","url":null,"abstract":"<p><strong>Background: </strong>End-stage renal disease (ESRD) is frequently accompanied by systemic inflammation and pulmonary dysfunction. Fibroblast growth factor-21 (FGF-21), an emerging metabolic and inflammatory biomarker, may be involved in these pathological processes. This study aimed to evaluate dynamic changes in FGF-21 and their association with inflammatory markers-including C-reactive protein (CRP) and interleukin-6 (IL-6)-as well as pulmonary function in ESRD patients receiving peritoneal dialysis (PD).</p><p><strong>Methods: </strong>In this prospective cohort study, 150 ESRD patients initiating PD were enrolled. Serum FGF-21, CRP, and IL-6 levels were measured at baseline and at 1, 3, and 6 months after PD initiation. Pulmonary function parameters, including forced expiratory volume in one second (FEV₁), forced vital capacity (FVC), diffusing capacity for carbon monoxide (DL_CO) and maximal voluntary ventilation (MVV), were assessed at baseline and 6 months. Longitudinal changes in FGF-21, CRP, and IL-6 were analyzed using linear mixed-effects models and correlation analyses were used to examine associations among FGF-21, inflammatory markers, and lung function.</p><p><strong>Results: </strong>Over 6 months of PD, FGF-21, CRP, and IL-6 levels significantly decreased (p < 0.01). Mixed-effects linear time models demonstrated a significant decline in FGF-21 (Estimate =  - 0.0457, p < 0.001), which remained significant after adjusting for residual renal function, dialysis adequacy (Kt/V), BMI, and smoking status (p < 0.001). Pulmonary function improved, with FEV₁ increasing by 0.098 L (p < 0.001), FVC by 0.101 L (p < 0.001), and DL_CO by 0.47 mL/min/mmHg (p < 0.001). However, MVV did not show a significant change (p = 0.320). However, correlations between FGF-21 and pulmonary function and inflammatory factors were weak and non-significant (all p > 0.05). Subgroup analyses showed that age and baseline CRP did not significantly affect FEV₁ improvement, but patients with lower baseline FGF-21 showed slightly better recovery.</p><p><strong>Conclusion: </strong>FGF-21 demonstrates consistent associations with inflammatory markers including CRP and IL-6, and inversely relates to pulmonary function in ESRD patients undergoing PD. These findings support the potential role of FGF-21 as an integrative biomarker for systemic inflammation, renal impairment, and respiratory dysfunction in this population.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"5005-5013"},"PeriodicalIF":2.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147948564","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":"Establishment and characterization of a rat model of ureteral scar stricture induced by mechanical injury.","authors":"Aobing Mei, Qiangqiang Cheng, Miaoqing Cai, Chaokai Pu, Lei Liu, Tingtao Hu, Xijun Wu, Xu Sun","doi":"10.1007/s11255-026-05199-w","DOIUrl":"10.1007/s11255-026-05199-w","url":null,"abstract":"<p><p>Ureteral stricture is a common complication in urological practice. However, many existing animal models cause excessive tissue damage or exhibit inconsistent healing; consequently, the pathogenesis of clinical ureteral stricture of mechanical origin is not accurately reproduced. This study aimed to establish a rat model of ureteral scar stricture induced by mechanical injury and to characterize its morphological and molecular features. Adult male Sprague-Dawley rats underwent left ureteral occlusion using a micro-hemostatic clamp for 12 h. Renal morphology and function were evaluated by color Doppler ultrasound at 4, 6, and 8 weeks after surgery. Pathological and molecular changes in the injured ureter and ipsilateral kidney were assessed by histopathology, immunohistochemistry, reverse transcription quantitative PCR (RT-qPCR), and Western blot (WB). Progressive hydronephrosis of the left renal pelvis was observed over time. Marked fibroblast proliferation and collagen deposition were noted in the injured ureteral segment. Expression levels of alpha-smooth muscle actin (α-SMA), collagen type I (Col Ⅰ) and collagen type III (Col Ⅲ), fibronectin (FN), and SMAD3/p-SMAD3 were significantly increased. These findings suggest that mechanical ureteral injury induces a typical fibrotic response and leads to scar stricture formation. This model appears to reliably mimic the development and progression of ureteral stricture and may provide a useful platform for further studies on the mechanisms of ureteral scar formation, as well as for the development of preventive and therapeutic strategies.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"4685-4701"},"PeriodicalIF":2.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13694443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147972455","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":"Critical appraisal of \"Blood pressure effects of SGLT2 inhibitors in kidney transplant recipients: a systematic review and meta-analysis\".","authors":"Abdullah Tahir, Muhammad Usman Faiz, Muhammad Zaib, Muhammad Zaeem Haider, Mohsin Zahur, Kiran Gohar","doi":"10.1007/s11255-026-05214-0","DOIUrl":"10.1007/s11255-026-05214-0","url":null,"abstract":"","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"5123-5124"},"PeriodicalIF":2.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148015559","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":"A critical appraisal of the causal association between sleep disorders and nephrolithiasis using Mendelian randomization.","authors":"Abubakar Shahid, Eisha Adnan, Maham Afzal, Abhishek Prasad, Mohamed Ibraheem, Hussain Ramzan","doi":"10.1007/s11255-026-05228-8","DOIUrl":"10.1007/s11255-026-05228-8","url":null,"abstract":"","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"4909-4910"},"PeriodicalIF":2.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148251553","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":"Comparative functional, perioperative and oncological outcomes of robot-assisted and open radical prostatectomy: a systematic review and meta-analysis.","authors":"Caio Vinicius Suartz, Mateus Silva Santos Costa, Caio Felipe Araujo Matalani, Marcelo Ribeiro da Rocha, José Pedro Cassemiro Micheleto, Pedro Luis Furlam, Henrique Laurent Lepine, Roberto Iglesias Lopes, Thalita Bento Talizin, José Bessa Júnior, Walid Shahrour, Walid Shabana, Axel S Merseburger, Leonardo Oliveira Reis, Maurício Dener Cordeiro, William Carlos Nahas, Paul Toren, Leopoldo Alves Ribeiro-Filho, Guillaume Ploussard, Vincent Fradet, Frédéric Pouliot","doi":"10.1007/s11255-026-05182-5","DOIUrl":"10.1007/s11255-026-05182-5","url":null,"abstract":"<p><strong>Introduction: </strong>Robot-assisted radical prostatectomy (RARP) has increasingly replaced open radical prostatectomy (ORP) based on evidence suggesting improved perioperative outcomes and faster recovery. However, few randomized trials directly compare both techniques. This review compares perioperative, functional, and oncological outcomes of RARP versus ORP, integrating newly available high-impact studies.</p><p><strong>Methods: </strong>A thorough search of major databases was conducted from the inception of each database up to November 2025, adhering to PRISMA guidelines. Two reviewers independently screened studies in a three-step process-titles, abstracts, and full texts. Only randomized controlled trials (RCTs) and prospective studies comparing RARP and ORP were included. All variables were entered into a spreadsheet for analysis and cross-checked. The primary endpoints assessed were perioperative complications, functional recovery (urinary continence and erectile function), and oncological outcomes.</p><p><strong>Results: </strong>A total of 27 studies comprising 38,530 patients were included. Compared with ORP, RARP was associated with significantly reduced intraoperative blood loss (mean difference [MD] :  - 576.78; p < 0.01), lower transfusion rates (Odds Ratio [OR] 0.27; p < 0.0001), and shorter hospital stay (MD:   - 1.44 days; p < 0.0001). RARP also demonstrated fewer postoperative complications (OR 0.59; p = 0.002). Regarding functional outcomes, RARP yielded superior urinary continence recovery at 3 months and improved erectile function recovery (OR 1.43). Additionally, RARP showed a lower biochemical recurrence rate at 24 months (OR 1.34), with no significant difference observed in short-term follow-up (< 12 months).</p><p><strong>Conclusion: </strong>RARP offers advantages over ORP, particularly in reducing perioperative morbidity and enhancing functional recovery while maintaining comparable or superior oncological outcomes. However, further randomized controlled trials with extended follow-up are necessary to confirm these findings.</p><p><strong>Key messages: </strong>1. RARP was associated with significantly reduced blood loss, lower transfusion requirements, and shorter hospitalization. 2. Functional outcomes favored RARP, including superior recovery of urinary continence and higher rates of nerve-sparing preservation. 3. Overall, the evidence supports RARP as a safe, effective, and clinically advantageous approach for localized prostate cancer.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"4575-4593"},"PeriodicalIF":2.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13694353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148149868","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":"B7-1 and PD-L1 crosstalk in podocyte injury: from molecular mechanisms to novel therapeutic strategies for nephrotic syndrome.","authors":"Xiaodong Zhang, Canhui Wu","doi":"10.1007/s11255-026-05237-7","DOIUrl":"10.1007/s11255-026-05237-7","url":null,"abstract":"<p><p>Nephrotic syndrome (NS) is a clinical condition characterized by substantial proteinuria, and its global incidence is increasing. Current treatment strategies mainly rely on glucocorticoids and immunosuppressants. Nevertheless, a proportion of patients may develop steroid resistance or suffer from disease relapse. Podocyte injury plays a central role in the pathogenesis of proteinuria in NS. Recent studies have increasingly highlighted the significance of the immune checkpoint molecules B7-1 and PD-L1 in podocytes, particularly their cis-interaction on the podocyte surface. This review systematically elaborates on the molecular basis, mechanisms of action, and the mechanisms underlying cis-interaction, as well as recent advances in targeted therapies involving B7-1 and PD-L1. It offers new perspectives for precision immunotherapy in NS, thereby promoting the translation of mechanistic insights into clinical applications. However, significant controversies remain regarding authentic B7-1 expression in podocytes, the strength of evidence for the PD-L1/B7-1 cis‑interaction in kidney disease, and the translational gaps between animal models and human NS. This review critically discusses these unresolved issues and outlines priority directions for future research.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"4883-4891"},"PeriodicalIF":2.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148217559","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":"Two-step enucleation combined with needle electrode: a modified TURBT technique to enhance detrusor muscle detection.","authors":"Fan Gao, Xin Chen, Wenfeng Gao, Qiang Cheng, Bin Jiang, Yin Lu, Nanxin Zou, Qing Ai, Hongzhao Li, Jie Zhu","doi":"10.1007/s11255-026-05211-3","DOIUrl":"10.1007/s11255-026-05211-3","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the safety and efficacy of a modified two-step needle-electrode enucleation technique for improving detrusor muscle (DM) detection in transurethral resection of bladder tumor (TURBT).</p><p><strong>Methods: </strong>This retrospective study included 103 patients undergoing bipolar TURBT between 2019 and 2023, assigned to Two-step enucleation (n = 37), En bloc enucleation (n = 32), or Conventional TURBT (cTURBT) (n = 34). Inverse probability of treatment weighting (IPTW) was applied to mitigate selection bias. Weighted comparisons used survey-design-adjusted methods, including Rao-Scott chi-square tests and weighted regression models. Outcomes included DM detection, operation time, complications, recovery metrics, and short-term recurrence.</p><p><strong>Results: </strong>After IPTW, the Two-Step group demonstrated a higher DM detection rate than the cTURBT group (95.8% vs. 69.4%; adjusted p = 0.03), with an odds ratio of 12.40 (95%CI 1.17-131.92; p = 0.04). No significant difference was observed between the Two-Step and En bloc groups. The Two-Step procedure required a longer operation time than En bloc enucleation (27.7% increase; 95% CI 3.1-58.2%; p = 0.03) and was associated with a longer hospital stay than cTURBT (16.6% increase; 95% CI 2.9-32.2%; p = 0.02). No other statistically significant differences were found among the three groups.</p><p><strong>Conclusion: </strong>Two-step enucleation with a needle electrode improves DM detection compared with cTURBT. The procedure time is slightly longer than that of En bloc enucleation. Larger prospective studies are warranted to validate these findings, the perioperative safety, and the long-term oncological outcomes.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"4739-4750"},"PeriodicalIF":2.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148053966","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":"Comment on \"Intradialytic protein supplementation: fish vs whey protein in hemodialysis patients\".","authors":"Shahzaib Burfat, Priyanka Ochani, Ayushman Ochani","doi":"10.1007/s11255-026-05166-5","DOIUrl":"10.1007/s11255-026-05166-5","url":null,"abstract":"","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"5113-5114"},"PeriodicalIF":2.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771300","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}