International Urology and Nephrology最新文献

{"title":"Efficacy of Bushen Qudu Formula in the treatment of uremic pruritus in patients undergoing hemodialysis.","authors":"Peng-Sheng Zhang, Chun-Ting Chen, Wei-Nan Zheng, Yi-Fang Yang, Yong-Zhi Li","doi":"10.1007/s11255-025-04661-5","DOIUrl":"https://doi.org/10.1007/s11255-025-04661-5","url":null,"abstract":"<p><strong>Objective: </strong>Currently, there is no optimal treatment for uremic pruritus, and traditional Chinese medicine (TCM) presents distinct theoretical perspectives and potential advantages. Bushen Qudu Formula has been reported to improve both pruritus and constipation in patients on hemodialysis who have uremia. The aim of this study is to evaluate the therapeutic efficacy of Bushen Qudu Formula on pruritus and constipation in patients undergoing hemodialysis who have uremia, as well as its impact on serum urea nitrogen, C-reactive protein, calcium, phosphorus, and potassium levels.</p><p><strong>Methods: </strong>A survey was conducted on 207 patients on maintenance hemodialysis to assess pruritus and constipation. A total of 139 patients with pruritus were randomly assigned to either the treatment group or the control group. Patients in the treatment group received Bushen Qudu Formula orally, while those in the control group were administered cetirizine orally. Pruritus and constipation scores, as well as changes in serum urea nitrogen, C-reactive protein, calcium, phosphorus, and potassium levels were compared between the two groups of patients.</p><p><strong>Results: </strong>The incidence and improvement of pruritus in patients undergoing hemodialysis were positively correlated with the incidence and improvement of constipation. Post-treatment, both groups showed significant improvement in pruritus, with patients in the treatment group showing better results than those in the control group. In the treatment group, there was a significant decrease in the levels of serum urea nitrogen, C-reactive protein, and potassium (P < 0.05), whereas no significant changes were observed in the control group. The differences in serum calcium and phosphorus levels pre- and post-treatment in both groups were not significant (P > 0.05).</p><p><strong>Conclusion: </strong>In this study, it was found that Bushen Qudu Formula was effective in alleviating pruritus and constipation in patients undergoing hemodialysis as well as reducing the levels of serum urea nitrogen, C-reactive protein, and potassium, with no significant effect on serum calcium and phosphorus levels.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707481","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":"Unaddressed confounders in the association between proteinuria and thyroid function in CKD.","authors":"Nimrah Bhatti, Devia Lalwani, Maheen Masood, Noor Un Nisa Irshad, Abdul Karim Soomro, Hem Raj","doi":"10.1007/s11255-025-04687-9","DOIUrl":"https://doi.org/10.1007/s11255-025-04687-9","url":null,"abstract":"","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144698498","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":"Visceral fat measured with CT helps predict recurrence-free survival in patients with localized clear cell renal cell carcinoma.","authors":"Zhan Feng, Yaoyao Wu, Zhengyu Hu, Piao Yang, Zhi Li","doi":"10.1007/s11255-025-04681-1","DOIUrl":"https://doi.org/10.1007/s11255-025-04681-1","url":null,"abstract":"<p><strong>Background: </strong>To investigate the prognostic significance of visceral fat to predict recurrence-free survival in patients with localized clear cell renal cell carcinoma (ccRCC).</p><p><strong>Methods: </strong>This study included patients with localized ccRCC who had undergone curative surgery. Visceral, subcutaneous fat and the relative visceral fat area (rVFA) were quantified utilizing preoperative CT images. The association between rVFA and recurrence-free survival (RFS) was explored using restricted cubic splines, Cox proportional hazards regression, and Kaplan-Meier survival analysis. The predictive capability of rVFA was evaluated using the Boruta algorithm, a predictive model was developed using the random survival forest (RSF) with results visualized via Shapley additive explanations (SHAP).</p><p><strong>Results: </strong>Four hundred and forty six patients were included. The follow-up median duration was 48.5 months, during which 57 patients experienced metastasis or death. Restricted cubic spline model revealed a nonlinear association between rVFA and tumor progression, exhibiting a U-shaped curve trend with an inflection point at 0.40. Beyond this threshold, rVFA was significantly correlated with an increased risk of progression. The RSF model yielded an area under the curve (AUC) of 0.89 for predicting 1-year RFS, 0.73 for 3-year RFS, and 0.75 for 5-year RFS. Both Boruta and SHAP analyses identified rVFA as a significant predictive feature.</p><p><strong>Conclusions: </strong>A U-shaped association between rVFA and risk of tumor recurrence was observed among patients with ccRCC. A high rVFA is significantly correlated with an increased risk of adverse events, thus indicating that rVFA is a potential indicator for predicting the prognosis of ccRCC.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690194","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":"Global burden and health inequalities of sex chromosomal DSDs (1990-2021): a GBD 2021 analysis.","authors":"Xingyang Su, Feng Chen, Zeyu Shi, Yifang Tao, Xiujuan Han, Li Xue","doi":"10.1007/s11255-025-04677-x","DOIUrl":"https://doi.org/10.1007/s11255-025-04677-x","url":null,"abstract":"<p><strong>Purpose: </strong>Globally, epidemiological data on sex chromosomal disorders of sex development (DSDs) remain scarce, prompting this study to examine their global disease burden and health inequalities, with a focus on Klinefelter syndrome (KS) and Turner syndrome (TS).</p><p><strong>Methods: </strong>We collected data on the incidence and prevalence of KS and TS from the GBD 2021 and analyzed by location, age, and socio-demographic index (SDI), using estimated annual percentage changes, Spearman's correlation analysis, health inequality analysis, and Bayesian age-period-cohort prediction models. The slope index of inequality and concentration index were employed to assess absolute and relative health inequalities across countries with varying SDI levels.</p><p><strong>Results: </strong>In 2021, there were 68,357 incident cases of KS with an incidence rate of 102.12, and the prevalent cases reached 1,121,754, with an age-standardized prevalence rate (ASPR) of 29.68. For TS, there were 23,929 incident cases, with an incidence rate of 38.32, and 531,784 prevalent cases, with an ASPR of 14.47. The ASPR of KS showed an upward trend, while that of TS exhibited a downward trend. The prevalence of DSDs declined with age, most notably in the 0-9 age groups, with the slowest decline observed in high SDI regions. The highest incidence rate was in Sub-Saharan Africa, while the most significant growth was concentrated in Europe. Correlation analysis revealed a negative association or \"U-shaped\" relationship between the incidence rate of sex chromosomal DSDs and SDI. Inequality analysis indicated that low SDI countries bear a disproportionate burden, with SDI-related inequalities worsening over time, particularly in incidence rates. The burden of KS is forecast to grow modestly by 2036, contrasting with TS's expected gradual decline.</p><p><strong>Conclusions: </strong>Globally, KS has shown increasing impact among sex chromosomal DSDs, contrasting with TS. Persistent disparities across SDI regions highlight urgent needs for enhanced screening and long-term care in low SDI areas to reduce inequalities.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690191","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":"Unraveling the causal link between inflammatory cytokines and hypertensive renal disease: a Mendelian randomization analysis.","authors":"Xuanli Gong, Xi Xu, Mengjiao He, Xin Zhao, Wei Zou","doi":"10.1007/s11255-025-04674-0","DOIUrl":"https://doi.org/10.1007/s11255-025-04674-0","url":null,"abstract":"<p><strong>Purpose: </strong>Hypertensive renal disease is a primary contributor to morbidity and death, with inflammation serving a crucial role in its development. Elevated levels of inflammatory cytokines are frequently observed in hypertensive renal disease patients; however, their causal relationship with the disease remains unclear.</p><p><strong>Methods: </strong>A two-sample Mendelian randomization (MR) analysis was conducted using genetic variants associated with inflammatory cytokine levels obtained from genome-wide association studies (GWAS) of 14,824 healthy participants. Summary statistics for hypertensive renal disease were derived from the FinnGen R10 dataset. The inverse variance weighted (IVW) method was the primary approach for assessing causal effects, complemented by multiple sensitivity analyses to ensure robustness of the findings.</p><p><strong>Results: </strong>In the bidirectional MR analysis, the IVW analysis identified two inflammatory cytokines as risk factors for hypertensive renal disease: interferon-gamma levels (OR 1.500, 95% CI 1.130-1.992) and oncostatin-M levels (OR 1.414, 95% CI 1.086-1.841). Additionally, the study identified three cytokines as protective factors against hypertensive renal disease: CD40L receptor levels (OR 0.817, 95% CI 0.679-0.983), interleukin-10 receptor subunit beta levels (OR 0.829, 95% CI 0.703-0.976), and interleukin-20 receptor subunit alpha levels (OR 0.725, 95% CI 0.549-0.957). These results highlight the complex role of inflammatory cytokines in the progression of hypertensive renal disease. No evidence of horizontal pleiotropy, heterogeneity, or reverse causality was found in the above results.</p><p><strong>Conclusion: </strong>This Mendelian randomization analysis identified inflammatory cytokines associated with hypertensive renal disease, providing a foundation for future mechanistic research and potential therapeutic targets.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690193","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":"Impact of early surgical intervention on 1-year outcomes in patients hospitalized for macroscopic hematuria: a retrospective cohort study.","authors":"Cristina Calzas Montalvo, Javier Martín Arranz, Jose L Bernal Sobrino, Silvia Juste Álvarez, Víctor Quirós González, Noelia García Barrio, María P Caro González, Natalia R Miranda Utrera, Javier Gil Moradillo, Alfredo Rodríguez Antolín, Ángel Tejido Sánchez","doi":"10.1007/s11255-025-04684-y","DOIUrl":"https://doi.org/10.1007/s11255-025-04684-y","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the impact of early surgical intervention on outcomes in patients admitted non-electively for macroscopic hematuria, a clinical scenario with limited prior research.</p><p><strong>Methods: </strong>We conducted a single-center, retrospective observational study including 261 consecutive patients admitted non-electively with a primary diagnosis of macroscopic hematuria to the Urology Department at Hospital Universitario 12 de Octubre, Spain, between January 2016 and June 2021. Patients were stratified into three groups: no surgical intervention, surgical intervention within 5 days, and surgical intervention after 5 days. Baseline characteristics, 365-day readmissions, and mortality were analyzed using binary logistic regression, zero-inflated Poisson, and Cox proportional hazards models.</p><p><strong>Results: </strong>The median age was 82 years and the median Charlson Comorbidity Index was 6. Crude 365-day readmission and mortality rates were 50.6% and 30.7%, respectively. Patients who underwent surgical intervention had lower 365-day mortality (hazard ratio [HR] 0.56, 95% confidence interval [CI] 0.32-0.97, p = 0.038) and readmission rates (odds ratio [OR] 0.28, 95% CI 0.15-0.54, p < 0.001). Significant risk factors for 365-day mortality included red blood cell transfusion (HR 2.12, 95% CI 1.29-3.49, p = 0.003), higher Charlson Comorbidity Index (HR 9.16, 95% CI 2.22-37.54, p = 0.002), and greater disease complexity (HR 2.35, 95% CI 1.63-3.39, p < 0.001). The single-center, retrospective design limits the generalizability of these findings.</p><p><strong>Conclusions: </strong>In this cohort of elderly patients with substantial comorbidity, early surgical intervention, when clinically indicated, was associated with significantly reduced 365-day mortality and readmission rates.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144698497","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":"Critical appraisal of metformin's nephroprotective role in cisplatin therapy: need for rigorous validation.","authors":"Hussain Ramzan, Haseeb Naveed, Imran Saeed, Azeem Rab Nawaz","doi":"10.1007/s11255-025-04680-2","DOIUrl":"https://doi.org/10.1007/s11255-025-04680-2","url":null,"abstract":"","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690190","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 prognostic role of hemoglobin, albumin, lymphocyte, and platelets score in peritoneal dialysis.","authors":"Xiaoyu Guo, Panai Song, Yijin Qian, Ning Zhuo, Xiaohui Fu, Yinghong Liu","doi":"10.1007/s11255-025-04679-9","DOIUrl":"https://doi.org/10.1007/s11255-025-04679-9","url":null,"abstract":"<p><strong>Background: </strong>The Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) index serves as a novel composite biomarker reflecting both systemic inflammation and nutritional status in clinical practice.</p><p><strong>Methods: </strong>This observational cohort study enrolled 892 peritoneal dialysis patients categorized by HALP quartiles (Q1-Q4). Through comprehensive survival analyses including Kaplan-Meier curves and multivariable Cox regression, we systematically evaluated the prognostic value of HALP for mortality outcomes. Predictive performance was rigorously assessed using time-dependent receiver operating characteristic analysis and net reclassification improvement metrics.</p><p><strong>Results: </strong>The analysis revealed clinically significant findings where patients in the highest HALP quartile demonstrated markedly better survival outcomes compared to the lowest quartile, with hazard ratios of 0.43 (95% CI 0.21-0.86) for all-cause mortality and 0.23 (95% CI 0.08-0.69) for cardiovascular mortality. Importantly, incorporating HALP into prediction models yielded meaningful clinical improvements, elevating the 5-year mortality prediction accuracy from an AUC and achieving a statistically significant net reclassification improvement of 15%.</p><p><strong>Conclusions: </strong>These findings establish HALP as a practical and robust prognostic indicator in peritoneal dialysis patients that not only independently predicts mortality risk but also provides substantial incremental value beyond conventional risk factors, offering potential clinical utility for risk stratification and patient management decisions.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690192","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 missing links in mitochondrial MR studies for CKD: tissue specificity and clinical relevance; a letter to the editor.","authors":"Sakan Binte Imran, Ekata Agnes Omoijuanfo, Noor Un Nisa Irshad, Kainat Husain, Aleeza Khowaja, Abdul Karim Soomro","doi":"10.1007/s11255-025-04668-y","DOIUrl":"https://doi.org/10.1007/s11255-025-04668-y","url":null,"abstract":"","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144674765","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":"Survivin and Ki-67 immunohistochemical expression in penile squamous cell carcinoma: clinicopathological features and overall survival.","authors":"Mateus W De Bacco, Iago Z Pires, Josenel M B Marçal, Mário B Wagner, André P Fay, Márcio A Averbeck, Gustavo F Carvalhal","doi":"10.1007/s11255-025-04672-2","DOIUrl":"https://doi.org/10.1007/s11255-025-04672-2","url":null,"abstract":"<p><strong>Background: </strong>The present study evaluated Survivin and Ki-67 immunohistochemical expression in squamous cell carcinoma of the penis and its association with clinicopathological features and outcomes.</p><p><strong>Patients and methods: </strong>A retrospective cohort study, from 1998 to 2016, was conducted at a tertiary hospital in Brazil, utilizing a convenience sample. The study collected clinical characteristics, pathological features, and outcomes. Immunohistochemical expressions of Survivin and Ki-67 were performed on formalin-fixed paraffin-embedded specimens from patients with PSCC. Survivin positivity (Survivin +) was defined as any staining in more than 5% of tumor cells, while Ki-67 positivity was defined as any staining in more than 10%. The Mann-Whitney U test and Fisher's exact test were used to perform the associations. Kaplan-Meier curves with log-rank were used to estimate survival.</p><p><strong>Results: </strong>Forty patients undergoing partial or total penectomy were selected, with five subsequently excluded. Among the remaining 35 patients, 15 (42.8%) were Ki-67 positive, and 9 (25.7%) were Survivin + . Ki-67 expression did not demonstrate association with higher tumor grade (73.3% for grades II and III vs. 55% for grade II in the Ki-67 < 10% group; p = 0.06), larger lesions (p = 0.05), or survival outcomes (HR 1.66; 95% CI 0.56-4.98; p = 0.36). Survivin + was more common in grade II and III than grade I (77.8% vs. 22.1; p = 0.027), and Survivin + patients were correlated with worse overall survival (HR 3.73; 95%CI 1.25-11.12; p = 0.01).</p><p><strong>Conclusion: </strong>Ki-67 expression does not seem to have an impact on clinicopathological features and overall survival. The expression of survivin seems to be promising in detecting penile squamous cell carcinoma patients with a worse prognosis.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144674764","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}