{"title":"E -cigarettes and kidney health: current knowledge and future perspectives.","authors":"Susanne M Lang, Julia Hoffmann, Helmut Schiffl","doi":"10.1007/s11255-024-04278-0","DOIUrl":"https://doi.org/10.1007/s11255-024-04278-0","url":null,"abstract":"<p><strong>Background: </strong>Chronic conventional cigarette smoking has been closely linked to incident chronic kidney disease (CKD) in the general population. It is associated with the acceleration of pre-existing CKD and failure of kidney allograft function. Cessation of conventional cigarette smoking is effective in reducing the increased risk of smoking induced kidney damage.</p><p><strong>Methods: </strong>This narrative review summarizes current knowledge and future study perspectives of the impact of e-cigarettes (e-cigs) use on kidney health.</p><p><strong>Results: </strong>The past decade has seen a dramatic increase in the use of electronic nicotine delivering systems, also called e-cigs. Compared to conventional cigarette smoking, little is known concerning the effects of e-cigs use on kidney health. A few cross-sectional studies suggest an association between vaping and kidney damage (albuminuria, reduction in estimated glomerular filtration rate) in adolescents and young adults. Furthermore, limited animal experiments indicate that e-cigs constituents/aerosols may lead to structural and functional kidney damage. The renal health effects of e-cigs remain largely uncertain and make it difficult to draw definitive conclusions about e-cigs use and kidney health. The relatively new popularity of e-cigs, the wide variability in device design and e-liquid formulations, and the lack of standardized methods to measure daily or life-long e-cigs exposure make it challenging to conduct comprehensive long-term studies.</p><p><strong>Conclusions: </strong>Nephrologists should actively address smoking habits in their patients and urge cessation of conventional cigarette smoking as well as e-cigs use to prevent CKD progression and improve overall health.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620748","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}
Moritz Kerbl-Knapp, Gregor Lindner, Georg-Christian Funk, Christoph Schwarz
{"title":"Sodium-chloride difference is not strongly correlated with base excess in chronic kidney disease: an anion gap problem.","authors":"Moritz Kerbl-Knapp, Gregor Lindner, Georg-Christian Funk, Christoph Schwarz","doi":"10.1007/s11255-024-04274-4","DOIUrl":"https://doi.org/10.1007/s11255-024-04274-4","url":null,"abstract":"<p><strong>Introduction: </strong>The prevalence of metabolic acidosis is high in patients with chronic kidney disease (CKD). For the diagnosis, a blood gas analysis is necessary, but not always available. The aim of the study was to evaluate the base excess (BE) of the sodium-chloride difference (BE<sub>Na-Cl</sub> = Na<sup>+</sup>-Cl<sup>-</sup>-34 mmol/l) as a screening parameter for hyperchloremic metabolic acidosis.</p><p><strong>Methods and statistical analysis: </strong>We retrospectively performed acid-base analyses of 168 non-dialysed patients with CKD according to the physiologic and to the Stewart's approach. We performed linear regression analysis, Bland-Altman plot and receiver operating characteristics (ROC) analysis of BE<sub>Na-Cl</sub> and BE to evaluate the accuracy of BE<sub>Na-Cl</sub> predicting the BE. We further investigated possible confounding factors.</p><p><strong>Results: </strong>The corrected R<sup>2</sup> for the correlation of BE<sub>Na-Cl</sub> and BE was 0.60 (p < 0.001). The Bland-Altman plot showed a good overall agreement. The bias was negligible, but the 95%-limits of agreement showed a wide interval (10.4 mmol/l). For BE ≤ 2 mmol/l, the ROC analysis yielded an AUC of 0.89 and moderate sensitivity (0.75) and specificity (0.86) for the optimal BE<sub>Na-Cl</sub> threshold (≤ 2 mmol/l). Subgroup analysis showed similar results. The main factor for the imprecision of BE<sub>Na-Cl</sub> predicting the BE across all stages of CKD is the variability of the serum anion gap (SAG).</p><p><strong>Conclusions: </strong>The BE<sub>Na-Cl</sub> is not an adequate parameter for screening of hyperchloremic acidosis because of the high variability of the SAG. Only, if the BE<sub>Na-Cl</sub> is ≤ 5 mmol/l, a hyperchloremic acidosis should be suspected. Therefore, a complete blood gas analysis is necessary for the correct diagnosis of acid-base disorders in patients with chronic kidney disease.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620768","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}
Shane A Tinsley, Alex Stephens, Marco Finati, Giuseppe Chiarelli, Giuseppe Ottone Cirulli, Chase Morrison, Caleb Richard, Keinnan Hares, Jonathan Lutchka, Akshay Sood, Nicolò Buffi, Giovanni Lughezzani, Carlo Bettocchi, Andrea Salonia, Alberto Briganti, Francesco Montorsi, Giuseppe Carrieri, Craig Rogers, Firas Abdollah
{"title":"Surgery versus radiation for clinically positive nodal prostate cancer in an other cause mortality risk weighted cohort.","authors":"Shane A Tinsley, Alex Stephens, Marco Finati, Giuseppe Chiarelli, Giuseppe Ottone Cirulli, Chase Morrison, Caleb Richard, Keinnan Hares, Jonathan Lutchka, Akshay Sood, Nicolò Buffi, Giovanni Lughezzani, Carlo Bettocchi, Andrea Salonia, Alberto Briganti, Francesco Montorsi, Giuseppe Carrieri, Craig Rogers, Firas Abdollah","doi":"10.1007/s11255-024-04253-9","DOIUrl":"https://doi.org/10.1007/s11255-024-04253-9","url":null,"abstract":"<p><strong>Purpose: </strong>This study examined cancer control metrics between surgery and radiation for clinically positive nodal prostate cancer in an other-cause mortality weighted cohort, to circumvent limitations in previous studies.</p><p><strong>Methods: </strong>The Surveillance, Epidemiology, and End Results Research Plus database was queried to identify men with clinically positive nodal prostate cancer at diagnosis between 2004 and 2017 who were treated with surgery or radiation. A competing-risks regression model was used to calculate the 10-year other-cause mortality risk using available covariates, including treatment type. Inverse probability of treatment weighting was then used to balance covariates, including other-cause mortality risk. Then, competing-risks cumulative incidence curves and multivariable models, which were weighted on the calculated other-cause mortality risk, were used to examine the impact of treatment type on cancer-specific mortality, after accounting for covariates.</p><p><strong>Results: </strong>4739 patients underwent surgery whereas 1039 underwent radiation. The median follow-up was 4.7 years (2.6-8.2). Other-cause mortality was statistically different between treatment arms in the unweighted cohort (Gray's p = 0.005), but that difference disappeared in the weighted cohort (Gray's p = 0.2). At 10 years, the cancer-specific mortality rate was 27.6% (22.2-33.9) for radiation versus 18.1% (16.2-20.3) for surgery (p < 0.001). On competing-risks multivariable analysis, radiation had 1.86-fold (95% CI 1.69-2.12) higher hazard likelihood from one year to the next compared to surgery (p < 0.001).</p><p><strong>Conclusion: </strong>Clinically positive nodal patients treated with radiation fare worst cancer-specific mortality than those that underwent surgery, using calculated other-cause mortality risk.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620780","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":"Identifying influencing factors and constructing a prediction model for long COVID-19 in hemodialysis patients.","authors":"Ding Chen, Xinlun Li, Chang Xiao, Wangyan Xiao, Linjing Lou, Zhuo Gao","doi":"10.1007/s11255-024-04276-2","DOIUrl":"https://doi.org/10.1007/s11255-024-04276-2","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to identify the potential influencing factors and construct a prediction model for long COVID in hemodialysis patients.</p><p><strong>Methods: </strong>We retrospectively reviewed 115 patients undergoing hemodialysis in a tertiary hospital between December 2022 and January 2023. Both univariate and multivariate logistic regression models were applied to identify potential influencing factors, and the prediction model was constructed using an ROC curve.</p><p><strong>Results: </strong>Of the 115 included patients, 60 experienced long COVID, with a prevalence of 52.2%. The univariate analysis found that a three-dose COVID-19 vaccination was associated with a reduced risk of long COVID (OR: 0.10; 95%CI: 0.01-0.86; P = 0.036). However, severe COVID (OR: 9.49; 95%CI: 1.14-78.90; P = 0.037), undergoing CT examination (OR: 3.01; 95%CI: 1.34-6.78; P = 0.008), and abnormal neutrophil (OR: 5.95; 95%CI: 1.26-28.19; P = 0.025), and platelet (OR: 2.39; 95%CI: 1.11-5.13; P = 0.025) counts were associated with a higher risk of long COVID. After adjusting for potential confounding factors, undergoing CT examination (OR: 2.60; 95%CI: 1.02-6.64; P = 0.046) and having abnormal neutrophil (OR: 8.16; 95%CI: 1.57-42.38; P = 0.013) and monocyte (OR: 17.77; 95%CI: 1.30-242.29; P = 0.031) counts were associated with a higher risk of long COVID. The prediction model constructed based on these factors showed a relatively better predictive value (AUC: 0.738; 95%CI: 0.648-0.828; P < 0.001).</p><p><strong>Conclusions: </strong>The risk of long COVID-19 in hemodialysis patients was significantly related to undergoing CT examination and having abnormal neutrophil and monocyte counts, and the prediction model constructed using these factors showed a moderate predictive value.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620757","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":"Association between blood lead levels and serum creatinine: a cross-sectional study.","authors":"Qi Su, Wangjuejue Zhang, Dingqi Li, Xiucheng Lan, Leilei Guo, Diang Chen","doi":"10.1007/s11255-024-04277-1","DOIUrl":"https://doi.org/10.1007/s11255-024-04277-1","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this cross-sectional study was to investigate the association between blood lead levels and serum creatinine.</p><p><strong>Methods: </strong>In the present study, sample data were derived from the National Health and Nutrition Examination Survey (NHANES) 2015-2018 of participants with complete data of blood lead levels and serum creatinine. Multivariate linear regression models were used to examine the association between blood lead levels and serum creatinine. The nonlinear connection was described using fitted smoothing curves and threshold effect analysis. Furthermore, subgroup analyses and interaction tests were performed.</p><p><strong>Results: </strong>A total of 9026 participants were enrolled in this study, and the mean serum creatinine for all subjects was 0.86 ± 0.34 mg/dL. When blood lead levels were divided into quartiles, it was found that participants' serum creatinine levels gradually increased with increasing blood lead levels (Q1: 0.77 ± 0.19 mg/dL, Q2: 0.84 ± 0.23 mg/ dL, Q3: 0.89 ± 0.34 mg/dL, Q4: 0.94 ± 0.50 mg/dL). Compared to the lowest serum quartile, the highest quartile of blood lead levels had a positive correlation with serum creatinine in the fully adjusted model (β = 0.05 95% CI 0.01-0.08). Smooth curve fittings and threshold effect analysis showed an inverted J-shaped nonlinear relationship between blood lead levels and serum creatinine, with an inflection point of 3.10 (μg/dL). Subgroup analyses and interaction tests revealed that diabetes mellitus impacted the relationship between serum creatinine and blood lead levels.</p><p><strong>Conclusion: </strong>This study suggests a positive correlation between blood lead levels and serum creatinine.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620747","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 the effectiveness and safety of 7.5 Fr ultra-thin flexible ureteroscope combined with a tip-flexible suctioning ureteral access sheath for the treatment of kidney stones.","authors":"Haiyang Hu, Mao Qin, Longwei Yang, Hongyu Hu, Guodong Qin, Ming Qiu, Yu Gao, Jianguo Dou, Tingjia Wu, Pinghua Long, Wei Zhang","doi":"10.1007/s11255-024-04269-1","DOIUrl":"https://doi.org/10.1007/s11255-024-04269-1","url":null,"abstract":"<p><strong>Objective: </strong>To compare the efficacy and safety of using a 7.5 Fr flexible ureteroscope (f-URS) with tip-flexible suctioning ureteral access sheath (TFS-UAS) versus a 9.2 Fr f-URS with traditional ureteral access sheath (T-UAS) in the treatment of kidney stones.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 205 patients with kidney stones measuring 1.0-2.0 cm treated with 7.5 Fr and 9.2 Fr f-URS in the Urology Department of The Affiliated Dazu Hospital of Chongqing Medical University from November 2022 to November 2023. The patients were randomly divided into two groups. Among them, 78 patients were selected to use the 7.5 Fr f-URS, which was designated as the GroupA. The remaining 127 patients were selected to use the 9.2 Fr f-URS, which served as the GroupB. The study compared the operation duration, lithotripsy duration, surgical success rate, immediate postoperative stone-free rate (SFR), 1-month postoperative SFR, and the incidence rate of postoperative complications between the two patient groups.</p><p><strong>Results: </strong>In terms of demographic characteristics, the size of calculi, surgical success rate, and 1-month postoperative SFR, there was no statistically significant difference between GroupA and GroupB. However, GroupA demonstrated superior performance compared to GroupB in operation duration (48 (40.55) min vs 74 (56.94) min), lithotripsy duration (35 (27.43) min vs 59 (42.78) min), and immediate postoperative SFR (53.52% (38/71) vs 29.41% (35/119)), with statistically significant differences observed (P < 0.05). In terms of complication occurrence, GroupA reported 10 cases of minor (Grade 1) complications, whereas GroupB had 32 cases of minor (Grade 1) complications and 7 cases of severe complications (including 2 cases of Grade 3 and 5 cases of Grade 4). The difference between the two groups was statistically significant (P < 0.05). The GroupA reported significantly fewer cases of postoperative fever (4) and analgesic treatment (3) compared to GroupB, which had 18 fever cases and 19 analgesic cases (P < 0.05).The GroupA did not experience any cases of septicemia or steinstrasse. Conversely, the GroupB had 5 cases of septicemia and 3 cases of steinstrasse, including 2 patients who underwent reoperation. Both groups also reported cases of ureteral mucosal rupture (5 in GroupA, 10 in GroupB), but these differences were not statistically significant (P > 0.05).</p><p><strong>Conclusion: </strong>Compared with 9.2 Fr f-URS combined with T-UAS, the use of 7.5 Fr f-URS with TFS-UAS in the treatment of kidney stones has higher lithotripsy efficiency and lower complication rate. This combination is safe and effective in the treatment of kidney stones.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620745","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}
Bo Zhao, Zhenwang Zhang, Xiying Guo, Xiufen Liu, Min Lei, Shuang Guo, Qing Yao, Feixue Zhang, Tie Peng, Aimei Liu, Botao Jiang, Dan Zhu
{"title":"Mesenchymal stem cell-derived exosomes in renal ischemia-reperfusion injury: a new therapeutic strategy.","authors":"Bo Zhao, Zhenwang Zhang, Xiying Guo, Xiufen Liu, Min Lei, Shuang Guo, Qing Yao, Feixue Zhang, Tie Peng, Aimei Liu, Botao Jiang, Dan Zhu","doi":"10.1007/s11255-024-04258-4","DOIUrl":"https://doi.org/10.1007/s11255-024-04258-4","url":null,"abstract":"<p><p>Renal ischemia-reperfusion injury (RIRI) is a serious kidney condition that causes significant damage due to lack of blood flow. This injury leads to oxidative stress and inflammation, which can cause acute tubular necrosis and kidney failure. Stem cell-derived exosomes, small vesicles released by stem cells, have shown promise in treating RIRI. Mesenchymal stem cells (MSCs) have been used to mitigate RIRI, and their exosomes have been found to play a crucial role in repairing damaged tissues. This review explores the key roles of exosomes from different sources of MSCs in RIRI, the potential of MSC-derived exosomes in treating this disease, and future research directions.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620759","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 neoadjuvant chemohormonal therapy for high-risk prostate cancer treated with robot-assisted laparoscopic radical prostatectomy: a propensity score-matched analysis (the MSUG94 group).","authors":"Yuki Yokoyama, Makoto Kawase, Shin Ebara, Tomoyuki Tatenuma, Takeshi Sasaki, Yoshinori Ikehata, Akinori Nakayama, Masahiro Toide, Tatsuaki Yoneda, Kazushige Sakaguchi, Jun Teishima, Kazuhide Makiyama, Takahiro Inoue, Hiroshi Kitamura, Kazutaka Saito, Fumitaka Koga, Shinji Urakami, Takuya Koie","doi":"10.1007/s11255-024-04268-2","DOIUrl":"https://doi.org/10.1007/s11255-024-04268-2","url":null,"abstract":"<p><strong>Purpose: </strong>The optimal neoadjuvant regimen before radical prostatectomy (RP) in patients with high-risk (HR) prostate cancer (PCa) remains to be determined. This retrospective multicenter cohort study assessed the effectiveness and safety of neoadjuvant chemohormonal therapy (NCHT) in patients with HR-PCa undergoing robot-assisted laparoscopic radical prostatectomy (RALP).</p><p><strong>Methods: </strong>We reviewed the datasets of 1023 subjects who underwent RALP at nine Japanese facilities between September 2012 and October 2023. The enrolled patients were divided into two groups using propensity score matching: a RALP-alone group and those who underwent NCHT followed by RALP (NCHT group). The NCHT regimen consisted of a luteinizing hormone-releasing hormone antagonist and tegafur-uracil for at least 3 months before RALP. The primary endpoint was biochemical recurrence (BCR) after RALP. The secondary endpoint was the surgical specimen pathology findings.</p><p><strong>Results: </strong>Propensity score matching identified 139 individuals for each group. Median follow-up was 18.2 months. During follow-up, BCR was observed in 41 patients (29.5%) in the RALP-alone group and 22 patients (15.8%) in the NCHT group (p = 0.010). Pathological results showed significantly more organ-confined PCa and significantly fewer positive surgical margins or lymphovascular invasion in the NCHT group than in the RALP-alone group. The 2-yr biochemical recurrence-free survival (BRFS) was 72.7% and 74.7% in the RALP-alone and NCHT groups, respectively (p = 0.086). Two patients (1.4%) experienced grade 3 liver disorder as an NCHT-related adverse event.</p><p><strong>Conclusion: </strong>The results suggest that NCHT can safely treat HR-PCa and may reduce the incidence of BCR when combined with RALP.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620754","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}
Umair Maaz, Fatima Hussain, Muskan Asghar, Saman Adnan
{"title":"Harnessing ARNI in advanced CKD - a new frontier for cardiac and renal protection.","authors":"Umair Maaz, Fatima Hussain, Muskan Asghar, Saman Adnan","doi":"10.1007/s11255-024-04279-z","DOIUrl":"https://doi.org/10.1007/s11255-024-04279-z","url":null,"abstract":"","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604285","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":"Artificial intelligence algorithms enhance urine cytology reporting confidence in postoperative follow-up for upper urinary tract urothelial carcinoma.","authors":"Cheng-Che Chen, Tsung-Han Yen, Jian-Ri Li, Chih-Jung Chen, Chi-Shun Yang, Jing-Yi Lai, Shu-Jiuan Lin, Cheng-Hung Yeh, Shih-Wen Hsu, Ming-Yu Lin, Tien-Jen Liu, Chuan Shu Chen","doi":"10.1007/s11255-024-04270-8","DOIUrl":"https://doi.org/10.1007/s11255-024-04270-8","url":null,"abstract":"<p><strong>Purpose: </strong>In Taiwan, the incidence of urothelial carcinoma of the upper urinary tract (UTUC) is high and intravesical recurrence is approximately 22%-47%. Thus, postoperative cystoscopy and urine cytology follow-up, which require experienced cytologists, are needed. The AIxURO system aligns with The Paris System (TPS) guidelines for reporting urinary cytology. This study assessed the benefit of early detection of intravesical recurrence after nephroureterectomy using the AIxURO system.</p><p><strong>Methods: </strong>Urine cytology slides (n = 296) from 113 patients with UTUC were retrieved and patient data, pre-operative and postoperative cytology, pathology, and follow-up series for the intravesical recurrence group were collected. Cytology slides were digitized and independently assessed by the AIxURO system, and the results were compared to cytology reports.</p><p><strong>Results: </strong>From January 2022 to August 2023, 113 patients with UTUC underwent nephroureterectomy. Eighty-eight patients (88/113, 77.8%) received 1 or 2 cytology examinations pre-operatively, 44 slides (44/204, 21.5%) were positive and 34 patients (34/113, 30.1%) were diagnosed with UTUC. Postoperative intravesical recurrence was detected in 27 patients (27/113, 23%) at an average of 190.62 days. Thirty-four slides (34/56, 60.7%) were negative for UTUC. Eight patients (8/27, 29.6%) met the criteria for early diagnosis of intravesical recurrence. The AIxURO system identified two more patients (10/27, 37.0%) with early intravesical recurrence.</p><p><strong>Conclusion: </strong>The AIxURO system enhanced postoperative urine cytology reporting confidence and could identify some underdiagnosed slides to enhance the early detection of UTUC with intravesical recurrence. AIxURO may be used for post-nephroureterectomy follow-up and reduce the necessity for cystoscopy.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604267","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}