International Urology and Nephrology最新文献

{"title":"Rituximab, tacrolimus, cyclophosphamide and cyclosporin in primary membranous nephropathy with nephrotic syndrome: comparison of safety profiles, effect on remission rate, 24-h urinary total protein, serum albumin, and serum creatinine levels using network meta-analysis.","authors":"Ni Cai, Shu-Ying Zhu, Jin-Jing Huang, Yan-Xia Chen, Chong Huang, Xiao-Hua Qin","doi":"10.1007/s11255-025-04549-4","DOIUrl":"10.1007/s11255-025-04549-4","url":null,"abstract":"<p><strong>Objective: </strong>To compare the efficacy and safety of four immunosuppressive therapies, either alone or in combination, for primary membranous nephropathy through a network meta-analysis.</p><p><strong>Methods: </strong>A literature search was conducted for randomized controlled trials (RCTs) of Cyclophosphamide (CTX), Cyclosporin (CsA), Tacrolimus (TAC), and Rituximab (RIT) in the treatment of primary membranous nephropathy. Two researchers independently screened articles, extracted data, and evaluated the quality. Outcome indicators included dichotomous variables and continuous variables, which were represented by risk ratios (RR) and mean differences (MD), respectively. Then, various interventions were ranked according to the surface under the cumulative ranking curve (SUCRA).</p><p><strong>Results: </strong>A total of 21 randomized controlled trials (RCTs) were included, encompassing 1396 patients. In terms of the overall response rate (ORR), RIT+TAC was superior to CsA (RR = 0.15, 95% CI: 0.04, 0.54), CTX (RR = 0.09, 95% CI: 0.03, 0.31), and RIT (RR = 7.06, 95% CI: 2.29, 21.80). The SUCRA value of RIT+TAC was the highest, reaching 93.5%. Regarding the total 24-h urinary protein (24UTP), RIT+TAC was better than RIT (MD = 17.05, 95% CI: 6.49, 44.79), RIT+CTX (MD = 6.99, 95% CI: 2.55, 19.17), TAC (MD = 0.12, 95% CI: 0.07, 0.18), CsA (MD = 0.06, 95% CI: 0.00, 0.86), and CTX (MD = 0.05, 95% CI: 0.03, 0.10). The SUCRA value of RIT+TAC was the highest, at 99.4%. For serum albumin, RIT+CTX was superior to CTX (MD = 0.00, 95% CI: 0.00, 0.29), and the SUCRA value of RIT+CTX was the highest, at 76.7%. For serum creatinine (Scr), RIT+TAC was better than TAC (MD = 0.00, 95% CI: 0.00, 0.13), and CsA was better than TAC (MD = 7.86e+07, 95% CI: 3.65e+06, 1.69e+09). The SUCRA value of RIT+TAC was the highest, at 79.9%. In terms of the incidence of adverse reactions, CTX had a higher rate than RIT+CTX (RR = 11.12, 95% CI: 1.34, 92.15). The SUCRA value of RIT+CTX was the lowest, at 5.3%.</p><p><strong>Conclusion: </strong>In terms of improving ORR, reducing 24UTP and lowering Scr, the RIT+TAC regimen may be the most optimal. Conversely, RIT+CTX demonstrated the best efficacy in improving ALB and also exhibited relatively better safety profile.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"3733-3750"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008056","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":"Management and treatment variations in premature ejaculation: a nationwide survey by the Andrology Working Group of the Society of Urological Surgery in Turkey.","authors":"Gökhan Çeker, Onder Cinar, Tahsin Turunç, Yalçın Kızılkan, Hakan Anıl, Ugur Akgün, Emine Cengiz Çavuşoğlu, Çağrı Doğan, Harun Bal, Ümit Gül, Murat Gül","doi":"10.1007/s11255-025-04592-1","DOIUrl":"10.1007/s11255-025-04592-1","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the diagnostic and therapeutic approaches to premature ejaculation (PE), focusing on variations in clinical practices and guideline adherence.</p><p><strong>Methods: </strong>A structured survey was anonymously distributed via Google Forms to 900 clinicians between April 30 and June 10, 2024, of whom 378 completed the questionnaire, yielding a response rate of 42%. Participants included urologists, andrologists, psychiatrists, and sexual psychotherapists. The questionnaire covered diagnostic criteria, laboratory investigations, treatment preferences, management strategies for comorbid conditions, along with attitudes toward behavioral and invasive interventions. Statistical analyses included descriptive statistics, chi-square, and Fisher's exact tests.</p><p><strong>Results: </strong>The study revealed marked variability in the diagnosis and treatment of PE. While the ISSM definition was the most commonly used guideline (40.5%), psychiatrists predominantly relied on DSM-5-TR criteria (88.2%). Laboratory testing, including testosterone and thyroid function evaluations, was employed by 54.2% of participants. Dapoxetine was the most preferred first-line therapy (31.2%), followed by behavioral therapies (20.6%) and local anesthetics (19.6%). For patients unresponsive to initial therapies, couple-based sexual psychotherapy (18.6%) and use of long-acting daily SSRIs (14.8%) were the most preferred second-line treatments. Combination therapies were widely adopted (89.1%), though their components varied significantly. Surgical and invasive treatments, such as hyaluronic acid injections, were rarely utilized (18.3%), with most physicians reserving them for refractory cases. Pelvic floor relaxation exercises were recommended by 72% of participants, while 87.5% endorsed behavioral therapies for PE.</p><p><strong>Conclusion: </strong>This study revealed substantial variability in PE management, its multifaceted etiology and guideline limitations. The findings underscore the need for standardized, evidence-based protocols to enhance clinical outcomes and optimize patient satisfaction.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"3655-3665"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234104","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 effects of GLUT9 and URAT1 inhibitors on cardiovascular diseases: a drug-targeted Mendelian randomization study.","authors":"Qian Xu, Xinyu Liang, Wei Shi, Huafeng Zhang","doi":"10.1007/s11255-025-04594-z","DOIUrl":"10.1007/s11255-025-04594-z","url":null,"abstract":"<p><strong>Objective: </strong>The strong association between hyperuricemia and cardiovascular diseases prompts this study to investigate the effects of uric acid-lowering drugs, GLUT9 and URAT1 inhibitors (GLUT9i and URAT1i), on cardiovascular diseases using Mendelian randomization (MR) analyses.</p><p><strong>Methods: </strong>In GWAS data, SNPs strongly associated with blood uric acid within 100 kb regions around the GLUT9 and URAT1 genes are identified, serving as proxies for the targeted effects of genes on uric acid. Subsequently, these SNPs were utilized for MR analyses with gout, common cardiovascular diseases (heart failure, myocardial infarction, ischemic stroke, venous thromboembolism), and their risk factors (blood glucose, lipid levels, blood pressure). MR-Egger was employed for pleiotropy testing, and Cochran's Q test was utilized for heterogeneity testing to ensure the robustness of the MR analysis.</p><p><strong>Results: </strong>Both URAT1i and GLUT9i are effective drugs for gout. URAT1i is associated with a reduced risk of heart failure (OR 0.76, 95% CI 0.63, 0.92, P = 0.004), decreased diastolic blood pressure (β = - 0.07, 95% CI - 0.13, 0.00, P = 0.048), reduced high-density lipoprotein levels (β = - 0.05, 95% CI - 0.10, - 0.01, P = 0.016), and increased fasting blood glucose levels (β = 0.07, 95% CI 0.02, 0.13, P = 0.006). Conversely, GLUT9i leads to reductions in fasting blood glucose (β = - 0.03, 95% CI - 0.05, - 0.01, P = 0.013) and diastolic blood pressure (β = - 0.03, 95% CI - 0.05, - 0.01, P = 0.005), and increases in high-density lipoprotein (β = 0.02, 95% CI 0.00, 0.03, P = 0.011).</p><p><strong>Conclusion: </strong>For patients suffering from gout in conjunction with conditions like hyperglycemia, dyslipidemia, and hypertension, GLUT9i may represent a more promising therapeutic approach.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"3909-3915"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234014","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 presence of abnormal palpatory findings in the sacrococcygeal area is correlated with chronic pelvic pain: a cross-sectional study.","authors":"Daniele Origo, Fulvio Dal Farra, Marco Tramontano","doi":"10.1007/s11255-025-04521-2","DOIUrl":"10.1007/s11255-025-04521-2","url":null,"abstract":"<p><strong>Objective: </strong>This study examines the prevalence of abnormal palpatory findings (APFs) in the different pelvic areas among individuals with chronic pelvic pain syndrome (CPP-CPPS) and assesses correlations between APFs and clinical and psychosocial symptoms.</p><p><strong>Methods: </strong>In this cross-sectional study, 326 participants (162 CPP-CPPS patients, 164 controls) underwent a standardized palpatory assessment of the sacroiliac, sacrococcygeal, and pelvic floor regions. The manual procedure was performed by two expert physiotherapists with a certification in osteopathic manipulation, following a consensus training. We assessed symptom severity and psychosocial variables using the NIH Chronic Prostatitis Symptom Index (NIH-CPSI), the Hospital Anxiety and Depression Scale (HADS), and the Fear Avoidance Belief Questionnaire (FABQ). Correlation analyses explored relationships between APFs, the presence of pain, and psychosocial variables.</p><p><strong>Results: </strong>APFs were significantly associated with CPP/CPPS, particularly in the sacrococcygeal (r = 0.609, p < 0.01) and pelvic floor (r = 0.620, p < 0.01) regions, indicating a moderate-to-strong correlation. The multivariate analysis confirmed that sacrococcygeal APFs (OR 3.02, 95% CI 1.96-4.65, p < 0.001) and pelvic floor APFs (OR 2.99, 95% CI 1.87-4.78, p < 0.001) were independently associated with CPP/CPPS, whereas sacroiliac findings showed a weak correlation. The correlations between APFs and psychosocial issues (anxiety, depression, fear-avoidance) were weak (r = 0.25).</p><p><strong>Conclusions: </strong>Sacrococcygeal and pelvic floor APFs appear to be important clinical markers of CPP/CPPS. Their presence may help identify patients who could benefit from targeted manual therapy as part of multimodal management. Further research should evaluate the prognostic value of these findings.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"3521-3531"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12504122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964759","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":"Response to Comment on: \"Comparison between the effect of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers and their combination on mortality in maintenance dialysis patients: a systematic review and meta-analysis\".","authors":"Omar Elkoumi, Ahmed Elkoumi, Mariam Khaled Elbairy","doi":"10.1007/s11255-025-04824-4","DOIUrl":"https://doi.org/10.1007/s11255-025-04824-4","url":null,"abstract":"","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280180","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":"Optimizing the use of HGI in cardiovascular risk stratification for CKD populations.","authors":"Aqsa Memon, Shubham Makkar, Ajay Malviya, F N U Karishma, Ali Yasir, Ali Karim","doi":"10.1007/s11255-025-04839-x","DOIUrl":"https://doi.org/10.1007/s11255-025-04839-x","url":null,"abstract":"","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280166","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 association of roxadustat with copper elevation and hypothyroidism in patients on hemodialysis.","authors":"Suliman Khan, Muhammad Shahmeer Khan, Nihayat Ullah, Muhammad Tausif, Rahman Ullah","doi":"10.1007/s11255-025-04826-2","DOIUrl":"https://doi.org/10.1007/s11255-025-04826-2","url":null,"abstract":"","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280209","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":"Clinical insights on \"Finerenone in type 1 diabetes and chronic kidney disease: short-term efficacy and safety insights\".","authors":"Hafiza Aimal Nizami, Karan Kumar, Noor Un Nisa Irshad","doi":"10.1007/s11255-025-04843-1","DOIUrl":"https://doi.org/10.1007/s11255-025-04843-1","url":null,"abstract":"","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280142","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":"Response to letter to Editor: \"Unaddressed limitations in the reclassification of CKD in the elderly: a brief critique\" by Hassan MB, Raza R, Rani E, Saleem MH, Dar BA, Karim A.","authors":"Fabrizio Cristiano","doi":"10.1007/s11255-025-04827-1","DOIUrl":"https://doi.org/10.1007/s11255-025-04827-1","url":null,"abstract":"","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280173","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":"Nomograms with arterial spin labeling for diagnosing early-stage chronic kidney disease.","authors":"Yongkang Ma, Ran Guo, Jiazhen Wu, Huihui Xu, Chengxiu Zhang, Lingwei Zhou, Xinlei Ye, Qian Wang, Bernd Kuehn, Caixia Fu, Mengxiao Liu, Qingqing Wen, Tingting Mao, Guang Yang, Shuohui Yang","doi":"10.1007/s11255-025-04821-7","DOIUrl":"https://doi.org/10.1007/s11255-025-04821-7","url":null,"abstract":"<p><strong>Purpose: </strong>Chronic kidney disease (CKD) is a global health issue, and early detection and intervention improve prognosis. We sought to construct diagnostic models and nomograms for early staging of CKD using renal blood flow (RBF) from magnetic resonance imaging (MRI) arterial spin labeling, combined with clinical and laboratory data.</p><p><strong>Methods: </strong>A total of 205 participants (training cohort: 124, internal test cohort: 32, and external test cohort: 49), including 48 healthy volunteers (HVs) and 157 CKD stage (S) 1-2 patients undergoing RBF MRI examination, were enrolled. Cortical and medullary RBF were measured, and clinical and laboratory data were recorded. Diagnostic models and nomograms were constructed for differentiating early-stage CKD (S1-2 and S1) patients from HVs using clinical, laboratory characteristics, and RBF values. Area under the curve (AUC), decision curve analysis (DCA), and calibration curve were employed to evaluate the performance, clinical utility, and predictive accuracy of the models.</p><p><strong>Results: </strong>AUCs for differentiating CKD S1-2 and S1 patients from HVs were 0.841 [95% confidence interval (CI) 0.704-0.978] and 0.900 (95% CI 0.739-1.000) in the internal test cohort, and 0.933 (95% CI 0.853-1.000) and 0.895 (95% CI 0.762-1.000) in the external test cohort. The calibration curve and DCA confirmed that nomograms of the combined models demonstrated good concordance between observed and predicted probabilities and better clinical benefit.</p><p><strong>Conclusion: </strong>The combined model and nomogram built using MRI RBF, clinical, and laboratory data could distinguish patients in the early stages of CKD from healthy subjects.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280135","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}