International Urology and Nephrology最新文献

{"title":"Microscopic single-tubule technique for spermatocelectomy in cases of spermatocele: a rarely used surgical method and ıts outcomes.","authors":"Mehmet Sefa Altay, Ömer Uslu, Fevzi Bedir, Hüseyin Kocatürk, Ibrahim Karabulut, Banu Bedir, Şaban Oğuz Demirdöğen, Isa Özbey","doi":"10.1007/s11255-025-04464-8","DOIUrl":"https://doi.org/10.1007/s11255-025-04464-8","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to promote the microscopic single-tubule spermatocelectomy technique. The technique significantly reduces the risks of epididymal injury, infertility, and spermatocele recurrence rates.</p><p><strong>Methods: </strong>From January 2015 to June 2024, male patients aged between 18 and 50 years who underwent microscopic single-tubule spermatocelectomy with the intent to preserve fertility were included in this study. Data on patient age, preoperative and postoperative sperm analysis results, and complication rates were recorded. Statistical analyses were performed using the Statistical Package for the Social Sciences (SPSS) v26 for Windows.</p><p><strong>Results: </strong>The mean age of the patients was 40.93 ± 6.20 years. The average size of the spermatoceles was 6.44 ± 2 cm. The mean duration of the operation was 45.44 ± 8.82 min. While there was no statistically significant difference in sperm count and volume averages between preoperative and postoperative measurements, a statistically significant was observed in sperm motility. In terms of complications, 3.7% of the patients (n = 1) developed an infection. No epididymal bleeding or iatrogenic tubule opening was detected under the microscope. None of the patients experienced bleeding, spermatocele recurrence, testicular atrophy, or sperm granuloma. Pathological evaluations revealed no epididymal tissue in any of the cases.</p><p><strong>Conclusion: </strong>Microscopic single-tubule spermatocelectomy reduces the risk of epididymal injury and testicular atrophy, and it is associated with low complication rates. Particularly in male patients desiring fertility preservation, microscopic single-tubule spermatocelectomy offers high success rates and low complication rates and should be considered the preferred surgical technique.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692180","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 and efficacy of WVTT (Rezum) in young men: preliminary data.","authors":"Antonio Minore, Loris Cacciatore, Giovanni Ferrari, Giampaolo Siena, Raffaele Balsamo, Simone Morselli, Roberto Castellucci, Francesco Varvello, Luca Cindolo","doi":"10.1007/s11255-025-04463-9","DOIUrl":"https://doi.org/10.1007/s11255-025-04463-9","url":null,"abstract":"<p><strong>Objectives: </strong>Water vapor thermal therapy (WVTT) is one of the latest developed minimally invasive surgical treatments (MIST) for benign prostatic hyperplasia-related symptoms (LUTS/BPH). We focused on the functional outcomes of patients < 50 years treated with Rezūm for BPH.</p><p><strong>Methods: </strong>We prospectively recorded data on patients treated with Rezūm at 5 institutions from April 2020 to June 2021. Uroflowmetry, prostatic specific antigen (PSA), ultrasonography assessing prostate volume and post voiding residual volume (PVR), the International Prostate Symptom Score (IPSS), International Index of Erectile Function (IIEF-5), and the question yes/no assessing ejaculatory dysfunction were recorded at baseline, and 3, 6 and 12 months later.</p><p><strong>Results: </strong>Ten patients were enrolled. The median operative time was 9 (IQR 8.25-13) min. All patients were dismissed a few hours after surgery with an indwelling urinary catheter that was removed after a median of 7 days (IQR 7-7). Each patient experienced an improvement both in terms of IPSS domain and in terms of maximal flow (Qmax) and PVR with a significative difference from the baseline observed at 3 months, stable until the last follow-up. Everyone maintained or gained antegrade ejaculation. No major post-operative complications were recorded, as just one patients experienced acute urinary retention after catheter removal.</p><p><strong>Conclusions: </strong>WVTT treatment is a feasible and safe minimally invasive option for patients < 50 y old with LUTS/BPH and showed optimal early functional outcomes.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691655","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":"Role and application prospective of non-steroidal MRA in the treatment of diabetic kidney disease.","authors":"Yu Sun, Mingzhu Wang","doi":"10.1007/s11255-025-04456-8","DOIUrl":"https://doi.org/10.1007/s11255-025-04456-8","url":null,"abstract":"<p><p>Chronic kidney disease (CKD) has diverse etiologies and complex pathogenesis, and is prone to recurrent episodes and prolonged illness. In recent years, the prevalence of CKD has been increasing year by year, and the global prevalence in the general population has reached 14.3%. Diabetic kidney disease (DKD) is a common complication of diabetes mellitus (DM), and about 20-40% of DM patients have combined DKD, which is also the main cause of CKD and end-stage renal disease (ESRD). DM catalyzes CKD in approximately 30-50% of global cases, affecting around 285 million individuals. It primarily triggers diabetic nephropathy (DN), the leading cause of end-stage renal disease worldwide. Research indicates that activation of the mineralocorticoid receptor (MR) plays a role in the onset and progression of DKD. Counteracting MR overactivation offers antioxidative, anti-inflammatory, and anti-fibrotic benefits, thereby ameliorating target organ damage. MR antagonists (MRAs) such as spironolactone and eplerenone have been validated for renal protection. However, their clinical application is hindered by adverse effects including hyperkalemia, gynecomastia in males, erectile dysfunction, and menstrual irregularities in females. Finerenone, a novel non-steroidal MRA, exhibits a unique mechanism of action, binding to MR and inhibiting the recruitment of transcription co-factors involved in gene expression, effectively slowing the progression of diabetic nephropathy (DN). In addition, finerenone demonstrates improved safety and efficacy in treating heart failure and chronic kidney disease. It also plays a significant role in the management of atrial fibrillation and myocardial infarction. This article reviews recent studies on finerenone, summarizing its mechanism of action in treating DN, evidence from clinical trials, adverse reactions, combined use with other inhibitors, and future prospective, aiming to provide insights for the prevention and treatment of DN.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692183","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":"Liquid-based kidney injury molecule-1 as a diagnostic and prognostic indicator in renal cell carcinoma: A systematic review and meta-analysis.","authors":"Sike He, Dingbang Liu, Junru Chen, Xingming Zhang, Jiayu Liang, Jinge Zhao, Xu Hu, Zhenhua Liu, Hao Zeng, Guangxi Sun","doi":"10.1007/s11255-025-04447-9","DOIUrl":"https://doi.org/10.1007/s11255-025-04447-9","url":null,"abstract":"<p><strong>Purpose: </strong>Noninvasive biomarkers for renal cell carcinoma (RCC) are vital but scarce. Kidney injury molecule-1 (KIM-1) is a transmembranous glycoprotein that is sensitive and specific to kidney injury. KIM-1 is overexpressed in RCC, and its ectodomain can be detected in blood and urine. Here, we explored whether KIM-1 is a diagnostic or prognostic indicator in RCC.</p><p><strong>Methods: </strong>A comprehensive online literature search was performed in PubMed, Web of Science, Embase, Cochrane Library, ClinicalTrails, and Database of major urological or oncological congress. We screened the literature and extracted the data according to the selection criteria. The quality of eligible studies was measured via the Quality Assessment of Diagnostic Accuracy Studies-2 tool and the Newcastle-Ottawa scale. The certainty of the evidence (CoE) was assessed by the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) score. The sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), area under the curve of the summary receiver operating characteristic curve (AUROC), and survival outcomes were subsequently estimated in Stata and MetaDisc. Subgroup analysis, meta-regression, and sensitivity analysis were performed to reveal the source of heterogeneity.</p><p><strong>Results: </strong>A total of eight studies were included for further analysis. The pooled sensitivity of KIM-1 for RCC diagnosis was 0.78 (95% CI: 0.69-0.85, I² = 84.61%, p < 0.01), and the pooled specificity was 0.79 (95% CI: 0.65-0.89, I² = 90.72%, p < 0.01). The AUROC was 0.85 (95% CI: 0.82-0.88). A moderate CoE was indicated by GRADE score. A higher KIM-1 level was associated with worse disease-free survival (HR = 1.76, 95% CI: 1.48-2.09, I² = 0.00%, p < 0.001). Study continent, number of study center, and sample type are the potential contributors of heterogeneity.</p><p><strong>Conclusion: </strong>Liquid-based KIM-1 is a promising noninvasive biomarker for early RCC detection, surveillance, and prognosis prediction. More validations in large cohorts are needed to confirm these findings.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673762","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":"Development and validation of a predictive model for postoperative metastasis of upper tract urothelial carcinoma after radical nephroureterectomy and analysis of risk factors for different metastatic sites: a multicenter study.","authors":"ZiMing Kang, Cheng Wang, WanRong Xu, Biao Zhang, JiangHou Wan, HengPing Li, PanFeng Shang","doi":"10.1007/s11255-025-04455-9","DOIUrl":"https://doi.org/10.1007/s11255-025-04455-9","url":null,"abstract":"<p><strong>Purpose: </strong>To develop a prediction model for assessing the risk of postoperative metastasis in upper tract urothelial carcinoma (UTUC) patients after radical nephroureterectomy (RNU) and to analyze independent risk factors for metastasis at different sites.</p><p><strong>Methods: </strong>We retrospectively analyzed data from 555 UTUC patients who underwent RNU at 3 medical centers between January 2012 and August 2023. Patients were randomly divided into a training cohort (n = 388) and a validation cohort (n = 167) at a 7:3 ratio. Univariate and multivariate Cox regression analyses were performed in the training cohort to identify postoperative metastasis risk factors. A nomogram was developed based on these factors and validated. In addition, independent risk factors for metastasis at different sites were analyzed.</p><p><strong>Results: </strong>Among the 555 patients, 122 (22.0%) developed postoperative metastasis. Middle and lower ureteral tumors, T stage ≥ T3, high-grade tumors, lymphovascular invasion (LVI), and a prognostic nutritional index (PNI) < 48.75 were associated with poorer metastasis-free survival (MFS). The nomogram achieved C-indexes of 0.816 and 0.812 in the training and validation cohorts. Age < 65 years was a risk factor for lymph node metastasis, tumor size and necrosis predicted liver metastasis, and a higher preoperative platelet-to-lymphocyte ratio (PLR) was associated with bone metastasis. Median overall survival (OS) for lymph node, lung, liver, multiple sites, bone, and brain metastasis were 14, 10, 6, 5.5, 5, and 4.5 months, respectively.</p><p><strong>Conclusion: </strong>The prediction model developed effectively assesses postoperative metastasis risk in UTUC patients' aids in guiding individualized treatment. The risk factors for different metastasis sites are generally similar, with slight variations, which may offer new directions for future research on site-specific therapeutic strategies.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673752","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 digital dialogue on premature ejaculation: evaluating the efficacy of artificial intelligence-driven responses.","authors":"Hakan Anıl, Mehmet Vehbi Kayra","doi":"10.1007/s11255-025-04461-x","DOIUrl":"https://doi.org/10.1007/s11255-025-04461-x","url":null,"abstract":"<p><strong>Purpose: </strong>This study investigated the quality and comprehensibility of responses generated by three prominent artificial intelligence-powered chatbots (ChatGPT, Gemini, and Llama) when queried about premature ejaculation (PME).</p><p><strong>Methods: </strong>A set of 25 frequently asked questions (FAQs) were identified on the basis of Google Trends and Semrush platforms. Each chatbot was prompted with these questions and their responses were analyzed via a comprehensive set of metrics. Readability was assessed via the Flesch Reading Ease (FRES) and Flesch-Kincaid Grade Level (FKGL) scores. Quality and reliability were evaluated via the modified DISCERN (mDISCERN) and Ensuring Quality Information for Patients (EQIP) scores, which assess the clarity, comprehensiveness, and trustworthiness of health information.</p><p><strong>Results: </strong>Readability scores, as assessed by FRES and FKGL, did not significantly differ across the three chatbots. In terms of quality, the mean EQIP scores were significantly different between the models, with Llama (72.2 ± 1.1) achieving the highest scores, followed by Gemini (67.6 ± 4.5) and ChatGPT (63.1 ± 4.9) (P < 0.001). The median (interquartile range) mDISCERN scores were 2 (1) for ChatGPT, 3 (0) for Gemini, and 3 (1) for Llama (P < 0.001), indicating a significant difference in the quality of information provided by the different models.</p><p><strong>Conclusion: </strong>The three chatbots demonstrated statistically similar results in terms of readability. Llama achieved the highest EQIP score among them. Additionally, both Llama and Gemini outperformed ChatGPT in terms of mDISCERN scores.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669838","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 relationship between physical inactivity and sexual dysfunction among patients receiving hemodialysis.","authors":"Adriana Cruz-Bañares, Héctor Armando Rubio-Zapata, Damaris Estrella-Castillo, Juan Pablo Flores-Tapia, Guadalupe Arlene Gutiérrez-Mac","doi":"10.1007/s11255-025-04460-y","DOIUrl":"https://doi.org/10.1007/s11255-025-04460-y","url":null,"abstract":"<p><strong>Background: </strong>Chronic Kidney Disease (CKD), in its final stage, requires renal replacement therapy, such as hemodialysis (HD) to maintain vital functions; nevertheless, it imposes lifestyle changes. For example, physical activity (PA) levels are lower than the World Health Organization recommendations, consequently affecting physical performance. On the other hand, up to 80% of patients receiving HD have reported sexual dysfunction. Therefore, this study aimed to associate physical inactivity with sexual dysfunction in patients receiving HD.</p><p><strong>Methods: </strong>an analytical cross-sectional study was conducted on 116 ambulatory HD patients. Self-reported questionnaires for sexual dysfunction, IIEF and IFSF, and physical performance tests, such as the IPAQ-SF for physical activity levels, the six-minute walk test, the handgrip strength test, and the sit-to-stand test, were used to assess patients. A multivariate regression model was performed to identify predictors of sexual dysfunction.</p><p><strong>Results: </strong>86.4% of women and 84.2% of the men reported sexual dysfunction. An association between physical inactivity and sexual dysfunction was found (OR = 5.6, 95% CI 1.77-17.71, p = 0.003). Logistic regression revealed that PA (OR = 0.997, p = 0.004), diabetes (OR = 7.558, p = 0.028), handgrip strength (OR = 1.819, p =  < 0.001), and sit-to-stand repetitions (OR = 0.779, p = 0.004) were predictors of sexual dysfunction.</p><p><strong>Conclusion: </strong>Our study found that physical inactivity increases the risk of sexual dysfunction in CKD patients receiving HD, where the presence of diabetes is the main risk factor, and physical performance has a protective effect. Therapeutic exercise programs should be implemented as part of an integral approach in HD units, to improve patients' physical and sexual function.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669840","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 intragraft CD38+ B cell on chronic active antibody mediated rejection in kidney transplantation.","authors":"Yu Hui, Linkun Hu, Liangliang Wang, Xuedong Wei, Yuhua Huang, Jianquan Hou","doi":"10.1007/s11255-025-04451-z","DOIUrl":"https://doi.org/10.1007/s11255-025-04451-z","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to determine the relation between CD38+ B-cell infiltration and outcome of transplant recipients diagnosed with chronic active antibody mediated rejection (caABMR).</p><p><strong>Methods: </strong>A total of 67 patients transplanted from April 2003 and July 2021 with biopsy-proved caABMR were included. The density of CD3+ , CD20+ and CD38+ cells were quantified by immunohistochemical staining and baseline information, estimated glomerular filtration rate (eGFR) and 24 h urine quantitative protein at diagnose were collected. Receiver operating characteristic (ROC) curves were used to calculate the cut-off values in the prediction of graft loss and prognosis factors were further analyzed by Cox proportional-hazards analysis. Kaplan-Meier death-censored graft survivals of subgroups divided by CD38+ B-cell infiltration or urine quantitative protein were compared.</p><p><strong>Results: </strong>The median density of CD3+ , CD20+ and CD38+ cells was 278, 167 and 89 (per mm²). CD38+ B cell infiltration in biopsies was associated with graft survival and the cut-off value was ≥ 93/mm² with 92.90% sensitivity, 66.00% specificity, the cut-off values of 24-h urine quantitative protein and eGFR were ≥ 1.85 g and ≤ 29.50 ml/min*1.73m² correspondingly, with 85.70%, 85.60% sensitivity, 64.20%, 74.90% specificity. Cox proportional-hazards analysis showed that the increase of CD38+ B cell infiltration and urine protein were independent risk factors and eGFR was a protective factor for caABMR with the hazard ratios of 1.96 (95%CI 1.03-3.72, P = 0.040), 1.24 (95%CI 1.01-1.52, P = 0.042) and 0.94 (95%CI 0.89-0.99, P = 0.025) correspondingly. Kaplan-Meier survival analysis demonstrated that patients with CD38+ B-cell infiltration ≥ 93/mm² or 24-h urine protein ≥ 1.85 g had significantly reduced graft survival (P < 0.01).</p><p><strong>Conclusion: </strong>A threshold of CD38+ B cell infiltration ≥ 93/mm² was associated with poor graft survival and CD38 might be a potential therapeutic target of caABMR.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669839","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":"Relationship between anogenital distance and testicular position in male infants with cryptorchidism with and without hypospadias.","authors":"Salah Nagla, Shaymaa Elrifaey, Hend Abdelnabi, Ayman Hagras, Ahmed Arafa, Mohamed Hamza, Waleed Dawood","doi":"10.1007/s11255-025-04429-x","DOIUrl":"https://doi.org/10.1007/s11255-025-04429-x","url":null,"abstract":"<p><strong>Purpose: </strong>Anogenital distance (AGD) may indicate hypoverilization and subsequently serve as a predictor future reproduction. In both undescended testis with and without hypospadias, our goal was to study the relationship between testicular position and AGD.</p><p><strong>Methods: </strong>From March 2021 to January 2023, this study was conducted on male infants with and without hypospadias and age-matched controls. Based on the infants' ages, we divided them into four. Group I: under six months, Group II: 7-12 months, Group III: between a year and eighteen months, and Group IV: 19 months up to two years of age. From the verge of the anus to the penile base, the AGD was measured. Clinical examination resulted in the classification of testicular location as high scrotal, inguinal, and non-palpable.</p><p><strong>Results: </strong>Patients with cryptorchidism had AGD means that were substantially lower than those of controls in Groups I, II, III, and IV, respectively (31 ± 2, 33 ± 3), (35.9 ± 4, 37.9 ± 5), (39.9 ± 1.2, 41 ± 1.5), and (40 ± 1.9, 44 ± 1.7). The group of patients with cryptorchidism and hypospadias differed significantly from the controls and those without hypospadias. AGD in patients with upper scrotal locations was substantially shorter. Penile length and AGD of the examined groups exhibited a positive and significant connection.</p><p><strong>Conclusions: </strong>Shorter AGD is linked to a higher prevalence of hypospadias and cryptorchidism in male babies in comparison to normal children. The position of the undescended testis is higher in relation to a shorter AGD.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143648532","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":"Monitoring kidney microanatomy during ischemia-reperfusion using ANFIS optimized CNN.","authors":"Niranjana Devi Balakrishnan, Suresh Kumar Perumal","doi":"10.1007/s11255-025-04449-7","DOIUrl":"https://doi.org/10.1007/s11255-025-04449-7","url":null,"abstract":"<p><p>Kidney disease is a dangerous disease that affects human health and causes various defects. Renal microbiological changes can be monitored using optical coherence tomography (OCT) images to identify the nature of the disease based on behavior during ischemia-reperfusion. Image analysis becomes the more sophisticated part of extracting information from feature dependencies from objects to identify the disease. Most methodologies use feature correlation dependencies in non-relation feature analysis-based disease identification with low precision and recall level. So, classification accuracy needs to be higher performance. To resolve this problem, we proposed the adaptive neuro-fuzzy inference system-based Resnet50 optimal convolutional neural network (ANFIS-CNN) method implemented using deep learning (DL) to monitor kidney disease. Initially, we analyze using OCT images collected from a standard repository. Furthermore, bidirectional filters can be used for preprocessing to reduce image noise. Gaussian filtering can be applied to identify the dependence of kidney structure. Afterward, the color density saturation can be analyzed through edge-based segmentation using the histogram equalization method, and the optimally extracted objects can be identified through edge-based segmentation. These spectral value-based relative feature detection thresholds are combined with texture point-based recursive spectral multiscale feature selection (RSMFS) to produce different entity contrasts. Then, spectral values are optimized with ANFIS-Resnet50 optimal CNN to classify the accuracy by selecting images. Moreover, the proposed method results in high classification accuracy up to 96.1 %, recall rate 95.18 % and precision up to 96.09 % well attained, enhancing their overall performance. The system develops high-performance image recognition for kidney disease monitoring.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657148","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}