International Urology and Nephrology最新文献

{"title":"Letter to the editor: telemedicine-supported assisted home hemodialysis in elderly and multimorbid patients: a real-world cohort study in a public healthcare system.","authors":"Aisha Imran, Tooba, Muhammad Hassan Saeed","doi":"10.1007/s11255-026-05206-0","DOIUrl":"10.1007/s11255-026-05206-0","url":null,"abstract":"","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"5121-5122"},"PeriodicalIF":2.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148015501","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":"Beyond the stone: nephrolithiasis as a metabolic sentinel in upper tract urothelial carcinoma and papillary renal cell carcinoma: toward a risk-stratified management framework.","authors":"Sicheng Wan, Shunyu Gao, Ke Huang, Yunjin Bai","doi":"10.1007/s11255-026-05160-x","DOIUrl":"10.1007/s11255-026-05160-x","url":null,"abstract":"<p><strong>Context: </strong>Nephrolithiasis is increasingly recognized as a recurrent disorder that often coexists with broader metabolic vulnerability. Observational studies have also raised the possibility that stone disease may identify patients with a higher subsequent risk of upper tract urothelial carcinoma (UTUC) and, less consistently, renal cell carcinoma (RCC), particularly papillary RCC (pRCC).</p><p><strong>Objective: </strong>To critically review the epidemiologic and mechanistic literature linking nephrolithiasis to UTUC and RCC, distinguish association from causation, and outline a clinically practical risk-stratified framework.</p><p><strong>Evidence acquisition: </strong>This narrative review was informed by targeted searches of population-based cohort studies, meta-analyses, guideline documents, and mechanistic studies relevant to nephrolithiasis, UTUC, RCC, obstruction, infection, inflammation, and metabolic dysregulation. Greater weight was given to subtype-specific epidemiologic studies and directly relevant upper-tract biology, whereas indirect mechanistic data were interpreted as emerging or hypothesis-generating.</p><p><strong>Evidence synthesis: </strong>The available literature supports three main conclusions. First, epidemiologic studies suggest an association between nephrolithiasis and increased risk of UTUC, with more limited and lower-specificity evidence for RCC, especially pRCC. Second, shared metabolic abnormalities-including obesity, diabetes, hypertension, dyslipidemia, smoking, and hyperuricemia-may contribute both to lithogenesis and to a pro-inflammatory milieu relevant to carcinogenesis. Third, mechanistic data support biologic plausibility through chronic obstruction, recurrent epithelial injury, crystal toxicity, inflammasome activation, and infection-related inflammation. However, surveillance bias, reverse causation, and heterogeneous endpoint definitions limit causal inference. Current evidence, therefore, supports nephrolithiasis as a clinically relevant marker of metabolic vulnerability and a possible biological contributor in selected contexts, rather than an established causal driver.</p><p><strong>Conclusions: </strong>Current evidence does not support universal proactive intervention or routine oncologic surveillance for all stone formers. A more defensible clinical approach is risk stratification. Patients with recurrent, early-onset, infection-related, obstructive, or metabolically complicated stone disease may warrant intensified metabolic assessment, a lower threshold for selective stone-directed intervention in defined scenarios, and individualized follow-up. Dedicated cancer surveillance should remain selective and investigational pending prospective validation.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"4557-4567"},"PeriodicalIF":2.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148015509","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":"From association to intervention: rethinking post-nephrectomy care in the COVID-19 era.","authors":"Xiaohui Han, Keda Lu","doi":"10.1007/s11255-026-05128-x","DOIUrl":"10.1007/s11255-026-05128-x","url":null,"abstract":"","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"5109-5110"},"PeriodicalIF":2.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147645131","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 \"Effect of large language model on diagnostic accuracy and clinical completeness among nephrology fellows managing transplant infection\".","authors":"Damisha Jabeen","doi":"10.1007/s11255-026-05146-9","DOIUrl":"10.1007/s11255-026-05146-9","url":null,"abstract":"","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"5111-5112"},"PeriodicalIF":2.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728894","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 implementation of intermittent catheterisation in neurogenic lower urinary tract dysfunction: a clinical practice guideline in Germany - update 3.0.","authors":"Ines Kurze, Veronika Geng, Peter Wenig, Maike König, Ralf Böthig","doi":"10.1007/s11255-026-05236-8","DOIUrl":"10.1007/s11255-026-05236-8","url":null,"abstract":"<p><strong>Background: </strong>Although intermittent catheterisation (IC) has been established as the standard method of bladder emptying in cases of neurogenic bladder dysfunction since the 1960s, there are still many uncertainties in everyday nursing practice regarding the specific implementation of IC. It, therefore, seemed necessary to standardise the IC procedure and develop specific recommendations for performing IC based on an interprofessional, interdisciplinary consensus process.</p><p><strong>Methods: </strong>In 2014, an interprofessional, interdisciplinary working group developed initial Clinical Practice Guidelines (CPG) in accordance with the rules of the Association of the Scientific Medical Societies in Germany (AWMF) based on the evidence level of a structured consensus process. The methods used to develop the CPG and the professional associations involved are described in detail. These CPG have been consistently refined and have been available as update 3.0 since 2026.</p><p><strong>Results: </strong>The CPG describes in detail the topics of indications for IC, definitions, detailed descriptions of the various catheter characteristics, specific implementation of IC including disinfection of hands and meatus urethrae, management of complications such as urinary tract infections (UTIs) or autonomic dysreflexia, and options for UTI prophylaxis, and provides specific recommendations for action.</p><p><strong>Conclusions: </strong>This CPG, based on consensus-based evidence, has proven itself in clinical and everyday use for over 10 years. Due to the regular further development of the CPG, the guideline will also be able to meet future challenges such as changing demographic conditions of our patients with an increase in older patients with complex medical situations and increased use of permanent urinary catheter drainage or increased cost pressure in the healthcare system, even in developed countries. Consensus-based CPGs are an important component of evidence-based medicine, especially in situations where there are few randomised-controlled trials and none are expected in the future. Such CPGs can also address aspects that are likely to become even more important in the future, such as sustainability and environmental issues.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"4625-4637"},"PeriodicalIF":2.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13694555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148351930","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":"Association between time in range and incident early diabetic kidney disease in patients with type 2 diabetes: a retrospective cohort study.","authors":"Ling Chen, Lingyan Zhang, Niuniu Zhou","doi":"10.1007/s11255-026-05210-4","DOIUrl":"10.1007/s11255-026-05210-4","url":null,"abstract":"<p><strong>Background: </strong>Diabetic kidney disease (DKD) is a leading cause of end-stage renal disease in type 2 diabetes mellitus (T2DM). Time in range (TIR), a continuous glucose monitoring-derived metric, has emerged as an important glycemic control indicator, but evidence linking TIR to incident early DKD in T2DM remains limited.</p><p><strong>Methods: </strong>This retrospective cohort study included 498 Chinese T2DM patients with preserved kidney function at baseline who underwent continuous glucose monitoring between January 2020 and December 2022, with follow-up until December 2024. TIR and other glycemic metrics were assessed at baseline. The primary outcome was incident early DKD. Cox proportional hazards models evaluated associations between TIR and early DKD risk, with comprehensive adjustment for demographics, clinical characteristics, and medications. Subgroup and sensitivity analyses were performed.</p><p><strong>Results: </strong>During a median 24-month follow-up, 62 (12.4%) patients developed early DKD. After full adjustment, TIR ≥ 70% was associated with lower early DKD risk versus TIR < 70% (HR = 0.54, 95%CI 0.30-0.96, p = 0.048). A significant dose-response relationship was observed across TIR quartiles (P for trend = 0.008), with each 10% TIR increase associated with a 16% risk reduction (HR = 0.84, 95%CI 0.73-0.98, p = 0.022). The protective association was more pronounced in patients not using sodium-glucose cotransporter 2 inhibitors (P for interaction = 0.036). Results remained consistent across sensitivity analyses.</p><p><strong>Conclusions: </strong>Higher TIR is significantly associated with reduced risk of incident early DKD in T2DM patients with preserved kidney function, exhibiting a clear dose-response pattern. TIR may serve as a valuable complementary metric for assessing renal complication risk.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"5061-5069"},"PeriodicalIF":2.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13694355/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148042308","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":"Three-dimensional virtual models accurately predict preserved parenchymal volume after robot-assisted partial nephrectomy: a prospective study.","authors":"Vital Hevia, Esther García-Rojo, Nahuel Paesano, José Miguel Pérez-Ruiz, Facundo Barrientos-Moll, David Sáenz-Calzada, Gemma Duque-Ruiz, Carlota González-Gallego, Ricardo Brime-Menéndez, Fernando Lista-Mateos, Juan Justo-Quintas, Javier Romero-Otero","doi":"10.1007/s11255-026-05221-1","DOIUrl":"10.1007/s11255-026-05221-1","url":null,"abstract":"<p><strong>Introduction: </strong>Accurate prediction of postoperative renal function remains a challenge in robot-assisted partial nephrectomy (RAPN). Preserved parenchymal volume (PPV) has emerged as a key determinant of long-term renal function. Three-dimensional virtual models (3DVM) enable patient-specific anatomical reconstruction and volumetric quantification, potentially allowing preoperative estimation of PPV. However, their accuracy in predicting postoperative PPV and functional outcomes has not been prospectively validated. This study aimed to assess the accuracy of 3DVM in predicting PPV after RAPN and to explore their relationship with postoperative renal function and anatomical complexity.</p><p><strong>Materials and methods: </strong>A prospective single-centre study included patients undergoing RAPN with preoperative 3DVM-based planning (2022-2024). Estimated preoperative PPV was compared with real postoperative PPV obtained from follow-up 3DVM. Agreement was evaluated using paired statistics and Spearman's correlation. Functional outcomes (serum creatinine, eGFR) were correlated with PPV and WIT, whilst tumour complexity was assessed by PADUA and RENAL scores.</p><p><strong>Results: </strong>Twenty-nine patients were included (mean age 59.7 years; 72% male). Median estimated PPV was 156.7 ml and real postoperative PPV was 148.6 ml, with a mean absolute difference of 7.3 ml (~ 6%). Estimated and real PPV were strongly correlated (ρ = 0.97; p < 0.0001). PADUA score correlated negatively with postoperative eGFR (ρ ≈ -0.4; p < 0.05), whilst RENAL score and WIT did not. Median parenchymal loss was 6%, with low morbidity (17% Clavien I-II).</p><p><strong>Conclusions: </strong>3DVM accurately predict postoperative PPV after RAPN, showing excellent concordance with real volumetric measurements. Integration of 3D volumetry into surgical planning may provide a quantitative tool to support nephron-sparing strategies and functional preservation.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"4829-4839"},"PeriodicalIF":2.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148295014","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 \"Predictive value of the C-reactive protein-albumin-lymphocyte (CALLY) index for all-cause mortality in peritoneal dialysis patients\".","authors":"Wendi Huang, Yuebo Shi, Yuanyi Yang","doi":"10.1007/s11255-026-05171-8","DOIUrl":"10.1007/s11255-026-05171-8","url":null,"abstract":"","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"5119-5120"},"PeriodicalIF":2.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147863994","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":"Safety evaluation of finerenone and identification of factors contributing to nephrotoxicity: re-analysis using FDA adverse event reporting system data.","authors":"Chunhui Du, Zhenyu Zhao","doi":"10.1007/s11255-026-05163-8","DOIUrl":"10.1007/s11255-026-05163-8","url":null,"abstract":"<p><strong>Background: </strong>To evaluate finerenone-associated adverse events (AEs) and to investigate the association between finerenone use and renal injury via data mining of the Food and Drug Administration Adverse Event Reporting System (FAERS).</p><p><strong>Methods: </strong>To minimize statistical bias, the data extraction period was set from database inception (2004) to provide a stable background for disproportionality analysis. Four disproportionality algorithms (ROR, PRR, BCPNN, and MGPS) and stricter case-screening methods were employed to improve analytical precision. Additionally, a clinical priority evaluation was conducted to rank clinical risks and surveillance levels for these AEs. Supplementary analysis was performed to assess the relationship between finerenone and renal injury, as well as associated risk factors.</p><p><strong>Results: </strong>A total of 1316 finerenone-related reports were identified. 30 AEs were detected as significantly positive signals, with most being related to renal function (15 PTs, 50%), blood pressure (5 PTs, 16.67%), and blood potassium (4 PTs, 13.33%). Among them, blood glucose increased, blood creatine increased, and flank pain were new potential AEs. Acute kidney injury, hyperkalemia, renal impairment, glomerular filtration rate decreased, blood creatinineincreased, blood potassium increased, and hyponatremia exhibited moderate clinical priority levels and warrant further study. Signals reflecting renal injury were detected in patients regardless of baseline nephropathy. Male sex, taking more than 3 drugs, and using amlodipine may be risk factors for finerenone-related nephrotoxicity.</p><p><strong>Conclusions: </strong>These results highlight new finerenone-related AEs, provide ranked guidance for pharmacovigilance through clinical priority evaluation, and clarify factors that influence renal injury, providing guidance for individualized treatment and improved drug safety.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"4935-4947"},"PeriodicalIF":2.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815114","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 study of perirenal and epicardial fat thickness, oxidative stress, inflammation, and metabolic risk in pre-dialysis diabetic and non-diabetic CKD patients.","authors":"Namesh Kamat, Surya Prakash Thotanolla, Jeeja Jaya Janardhanan, A Y Lakshmi, Aparna R Bitla, V Vanajakshamma, Ram Rapur, Sivakumar Vishnubhotla","doi":"10.1007/s11255-026-05193-2","DOIUrl":"10.1007/s11255-026-05193-2","url":null,"abstract":"<p><strong>Aim and objectives: </strong>This study aimed to evaluate perirenal and epicardial fat thickness and examine their associations with oxidative stress, inflammation, and metabolic markers in pre-dialysis CKD patients (diabetic and non-diabetic) compared with healthy controls.</p><p><strong>Material and methods: </strong>This cross-sectional study included 90 participants (30 diabetic CKD, 30 non-diabetic CKD, and 30 controls). Perirenal fat thickness was assessed by ultrasonography and epicardial fat thickness by echocardiography. Biochemical parameters including renal function, lipid profile, hs-CRP, malondialdehyde (MDA), and ferric reducing antioxidant power (FRAP) were measured. Statistical analysis was performed using parametric or non-parametric tests based on data distribution, with multivariate regression adjusting for age, sex, and BMI.</p><p><strong>Results: </strong>DKD patients had significantly higher perirenal (32.1 ± 5.0 mm) and epicardial (8.72 ± 1.89 mm) fat thickness compared to non-DKD patients and controls. DKD patients also exhibited increased oxidative stress (MDA 4.65 ± 3.39 µmol/L) and decreased antioxidant capacity (FRAP 0.25 ± 0.16 mmol/L). The inflammatory marker hs-CRP was significantly elevated in DKD patients [8.53 (12.64) mg/L]. No significant differences were observed in lipid profiles or atherogenic indices between groups; however, visceral adiposity showed significant positive correlations with atherogenic indices.</p><p><strong>Conclusion: </strong>Pre-dialysis CKD patients, particularly those with diabetes, exhibit increased visceral adiposity along with higher oxidative stress and inflammation. Although atherogenic indices were not significantly different between groups, their association with visceral fat suggests a potential role of regional adiposity as a marker of metabolic risk; however, longitudinal studies are required to establish the prognostic significance.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"5023-5033"},"PeriodicalIF":2.2,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147963663","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}