International Urology and Nephrology最新文献

{"title":"Reassessing finerenone's role in IgA nephropathy: methodological and clinical considerations.","authors":"Muhammad Naveed, Uzair Ahmed, Syyeda Nargis","doi":"10.1007/s11255-025-04596-x","DOIUrl":"https://doi.org/10.1007/s11255-025-04596-x","url":null,"abstract":"<p><p>This letter addresses the study \"Effectiveness and Safety of Finerenone in the Treatment of IgA Nephropathy Patients\" by Qingqing Gao, which investigates finerenone as adjunct therapy in IgA nephropathy. While the study offers promising insights, key methodological limitations-including lack of randomization, blinding, and small sample size-raise concerns regarding selection bias and external validity. Additionally, the omission of important clinical parameters such as blood pressure and inflammatory markers limits the scope of safety monitoring. The letter emphasizes the need for larger, multicenter, randomized controlled trials with improved monitoring strategies, including MEST-C scoring, to enhance diagnostic accuracy and outcome interpretation. Despite the study's strengths in reporting UACR reduction and stable eGFR, a more rigorous research design is essential to fully evaluate finerenone's long-term efficacy and safety in this patient population.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225470","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 Yajima et al. (2025): \"Association between initial intravenous fluid volume and the composite outcome of hemodialysis dependence or in-hospital mortality in inpatients with rhabdomyolysis\".","authors":"Anfal Khan, Mohammad Idrees, Ameer Afzal Khan, Rahman Syed","doi":"10.1007/s11255-025-04589-w","DOIUrl":"10.1007/s11255-025-04589-w","url":null,"abstract":"","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215802","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":"Application of teriparatide in CKD-related osteoporosis: efficacy and safety considerations.","authors":"Lin Luo","doi":"10.1007/s11255-025-04599-8","DOIUrl":"https://doi.org/10.1007/s11255-025-04599-8","url":null,"abstract":"<p><p>The efficacy and safety of teriparatide in treating osteoporosis associated with chronic kidney disease (CKD) exhibit variability. Vetrano et al. demonstrated that teriparatide can improve bone density in renal transplant recipients with low bone turnover, with a favorable safety profile. In contrast, Hara et al. found that alendronate was more effective in preventing fractures in patients with CKD stages 3b/4. This discrepancy may be linked to CKD staging and the degree of bone metabolic disturbances. Responses in bone turnover markers are also inconsistent. In advanced CKD patients, the increase in bone resorption markers is limited. The risk of hypercalcemia (22.2%) is associated with the patient's calcium-phosphate metabolism status and parathyroid function. Future research should incorporate bone biopsy and multicenter studies to clarify the efficacy differences across CKD stages and bone turnover types, optimizing individualized application strategies.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215801","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":"Creatinine as a predictor of proliferative diabetic retinopathy among patients with type 2 diabetes mellitus: a systematic review and meta-analysis.","authors":"Ganesh Bushi, Abhay M Gaidhane, Nasir Vadia, Soumya V Menon, Kattela Chennakesavulu, Rajashree Panigrahi, Muhammed Shabil, Anju Rani, Sanjit Sah, Ambanna Yappalparvi, Khang Wen Goh, Diptismita Jena","doi":"10.1007/s11255-025-04590-3","DOIUrl":"https://doi.org/10.1007/s11255-025-04590-3","url":null,"abstract":"<p><strong>Background: </strong>Proliferative diabetic retinopathy (PDR) is a sight-threatening complication of type 2 diabetes mellitus (T2DM), with limited tools available for early prediction. Serum creatinine, a marker of kidney function, may reflect shared microvascular pathology between diabetic nephropathy and retinopathy. However, its role in predicting PDR remains unclear. This review assessed the association between serum creatinine levels and the presence of PDR among patients with T2DM.</p><p><strong>Methods: </strong>This systematic review and meta-analysis followed PRISMA guidelines and was registered in PROSPERO (CRD42024595835). A comprehensive search was conducted in PubMed, Embase, and Web of Science up to October 3, 2024. Observational studies reporting serum creatinine levels in patients with PDR versus non-proliferative diabetic retinopathy (NPDR) or no diabetic retinopathy (non-DR) were included. Standardized mean differences (SMDs) were pooled using a random-effects model. Heterogeneity was assessed with the I² statistic, and sensitivity analyses, meta-regression, and publication bias assessments were performed.</p><p><strong>Results: </strong>Eighteen studies involving 25,034 individuals were included. Serum creatinine levels were significantly higher in patients with PDR compared with non-DR (SMD, 0.97; 95% CI, 0.61-1.33; I² = 95.7%) and NPDR (SMD, 0.46; 95% CI, 0.15-0.77; I² = 82.7%). Sensitivity analyses confirmed the robustness of these findings. Meta-regression revealed no significant influence of HbA1c or diabetes duration on effect sizes. The association persisted despite high heterogeneity and potential publication bias.</p><p><strong>Conclusion: </strong>Elevated serum creatinine levels are significantly associated with the presence of PDR in patients with T2DM. Although creatinine may serve as a potential biomarker for identifying individuals at risk of PDR progression, further prospective, standardized studies are needed to validate its clinical utility.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215803","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":"Evaluation of cystography/voiding cystourethrography prior to renal transplantation: a systematic review and meta-analysis.","authors":"Kyousuke A Kamiya, Jose Benito A Abraham, Ernesto L Gerial","doi":"10.1007/s11255-025-04583-2","DOIUrl":"https://doi.org/10.1007/s11255-025-04583-2","url":null,"abstract":"<p><strong>Purpose: </strong>This meta-analysis investigates the necessity of pre-operative cystography or voiding cystourethrography (VCUG) in end-stage renal disease (ESRD) patients awaiting kidney transplantation, particularly those without prior urologic abnormalities. While detailed bladder evaluations are common in transplant assessments, the utility of invasive imaging procedures like cystography or VCUG has been questioned. These tests often reveal minimal abnormalities in oligoanuric patients with otherwise healthy bladders, whose bladder capacity typically improves post-transplant. Moreover, the diagnostic yield of such tests is low in the absence of prior urologic history.</p><p><strong>Methods: </strong>Following PRISMA guidelines, a systematic literature review was conducted across five databases to identify comparative studies up to June 2024. Studies included compared VCUG findings in ESRD patients without previous urologic disease to those with known urologic issues, such as recurrent urinary tract infections, hydronephrosis, vesicoureteral reflux, bladder dysfunction, or prior urologic surgery.</p><p><strong>Results: </strong>Data from five studies revealed that only 4.8% (43 out of 902) of patients without a urologic history showed abnormal VCUG findings. In contrast, 45.4% (127 out of 280) of patients with known urologic abnormalities had abnormal results. Statistical analysis showed a significantly lower risk of abnormal findings in patients without prior urologic disease (Risk Ratio = 0.07; 95% CI 0.02-0.29; p = 0.0003).</p><p><strong>Conclusion: </strong>The results suggest that routine pre-transplant VCUG may be unnecessary for ESRD patients without a history of urologic issues. Eliminating such procedures in this low-risk group could reduce healthcare costs, avoid unnecessary invasive testing, and streamline the transplant evaluation process without compromising patient safety.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199120","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":"Assessing causality between kidney stones and osteoporosis: strengths, gaps, and future needs.","authors":"Maryam Irshad, Shahzeen Irshad, Sehrish Irshad","doi":"10.1007/s11255-025-04587-y","DOIUrl":"https://doi.org/10.1007/s11255-025-04587-y","url":null,"abstract":"","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199118","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":"Advances in organ protection: ischemic preconditioning and erythropoietin as protective strategies.","authors":"Jingying Wang, Wanlu Tao, Zhentao Guo, Jinxin Liu","doi":"10.1007/s11255-025-04586-z","DOIUrl":"https://doi.org/10.1007/s11255-025-04586-z","url":null,"abstract":"<p><strong>Background: </strong>Ischemic preconditioning (IPC) and erythropoietin (EPO) are known for their protective effects against organ damage caused by ischemia, ischemia-reperfusion (I/R), and certain drugs. This review aims to summarize the literature on IPC and EPO, focusing on their mechanisms and exploring their relationship in organ protection.</p><p><strong>Methods: </strong>A comprehensive search of PubMed databases was conducted using keywords, such as IPC, EPO, ischemia-reperfusion, and organ protection. Articles were screened for relevance to IPC or EPO-mediated organ protection, excluding studies on hypoxic preconditioning and pharmacological preconditioning.</p><p><strong>Results: </strong>IPC and EPO have demonstrated protective effects across various organs, including kidneys, liver, heart, small intestine, retina, stomach, pancreas, and nervous system. They exert their effects through anti-apoptotic, anti-oxidative stress, and anti-inflammatory mechanisms involving distinct signaling pathways. Evidence suggests a potential interaction between IPC and EPO, with IPC potentially elevating serum EPO levels and EPO enhancing the protective effects of IPC, particularly in the heart via the JAK-STAT pathway.</p><p><strong>Conclusions: </strong>IPC and EPO hold promise as therapeutic strategies for mitigating organ damage in ischemic conditions. Further research is needed to elucidate their interaction in organ protection given the current limitations in evidence. Nonetheless, their individual mechanisms and clinical applications underscore their potential utility in clinical settings.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199117","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 significance of a new early diagnostic model for bladder cancer based on genome-wide microarray profiling of serum exosomal lncRNAs.","authors":"Liming Zhao, Guang Tian, Xiaohua Wang, Luning Li, Yongli Gao, Yisheng Gao, Jinfeng Wang","doi":"10.1007/s11255-024-04360-7","DOIUrl":"10.1007/s11255-024-04360-7","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of our report was to recognize bladder cancer (BC)-specific serum exosome-derived long non-coding RNAs (lncRNAs) profile for early diagnosis of BC.</p><p><strong>Methods: </strong>Potential BC-specific exosomal lncRNA indicators were discerned by genome-wide microarray profiling analysis of serum exosomes from 10 healthy participants and 10 early stage BC patients (Ta and T1), followed by multi-stage validation through quantitative real-time PCR (qRT-PCR) in BC cells, culture solution as well as 200 serum specimens and 50 tissue specimens from non-muscle-invasive bladder cancer (NMIBC) patients. The diagnostic panel was established using logistic regression and evaluated by receiver-operating characteristic (ROC) curve.</p><p><strong>Results: </strong>In the training stage, a diagnostic panel was constructed based on three up-regulated exosomal lncRNAs (G023016, RP11-553N19.1, and LINC0087) in NMIBC patients compared with healthy controls, yielding an area under ROC curve (AUC) of 0.827. We verified tumor-derived origin of these three lncRNAs which existed steadily in serum because of being enclosed in exosomes. The three-lncRNA panel was demonstrated to perform well in terms of NMIBC diagnosis, revealing AUC values of 0.809 and 0.812, respectively, in the following expanded validation stage and double-blind stage which was demonstrated to be significantly superior to that of urine cytology in double-blind stage (AUC = 0.630) (P < 0.0001). Moreover, serum exosome-derived G023016 significantly associated with tumor grade and TNM stage (P = 0.006 and P < 0.001, respectively), and LINC0087 significantly associated with TNM stage (P = 0.023).</p><p><strong>Conclusion: </strong>The three-exosomal lncRNA signature could function as qualified blood-based non-invasive indicator for early diagnosis of BC.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"1771-1783"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949088","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":"Effect of three-drug single-pill antihypertensive combinations in patients with uncontrolled hypertension.","authors":"Xuan Zhao, Shamikha Cheema, Muhammad Shaheer Bin Faheem, Muhammad Ahmad Abbasi, Farhan Ahmed","doi":"10.1007/s11255-024-04323-y","DOIUrl":"10.1007/s11255-024-04323-y","url":null,"abstract":"","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"1983-1984"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142836633","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":"Partial versus radical cystectomy in localized colorectal cancer: a systematic review and meta-analysis.","authors":"Bernardo Fontel Pompeu, Lucas Soares de Souza Pinto Guedes, Carlos Magno Costa Coaracy Sobrinho, Julia Hoici Brunini, Leonardo Borges, Sergio Mazzola Poli de Figueiredo, Samuel Aguiar Junior, Fernanda Bellotti Formiga","doi":"10.1007/s11255-025-04367-8","DOIUrl":"10.1007/s11255-025-04367-8","url":null,"abstract":"<p><strong>Purpose: </strong>Locally advanced colorectal tumors frequently invade adjacent organs, particularly the urinary bladder in the sigmoid colon and upper rectum, complicating multivisceral resections. This study compared postoperative outcomes of partial cystectomy (PC) and total cystectomy (TC) in patients with locally advanced colorectal cancer.</p><p><strong>Methods: </strong>A systematic review was conducted in PubMed, Scopus, Central Register of Clinical Trials, and Web of Science for studies published up to November 2024. Odds ratios (ORs) and mean differences (MDs) with 95% confidence intervals (CIs) were pooled using a random-effects model. Heterogeneity was assessed with I² statistics. Statistical analyses were performed in R Software 4.4.1.</p><p><strong>Results: </strong>Nine retrospective studies including 894 patients were analyzed. Among them, 433 (48.43%) underwent PC, and 461 (51.57%) underwent TC. Compared to TC, PC was associated with significantly lower rates of surgical site infection (OR 0.33; 95% CI 0.13-0.80; p = 0.015), shorter operative time (MD - 169.7 min; 95% CI - 214.1 to - 125.3; p < 0.01), reduced blood loss (MD - 1005.9 ml; 95% CI - 1362.1 to - 649.8; p < 0.01), and shorter hospital stay (MD - 6.6 days; 95% CI - 9.4 to - 3.9; p < 0.01). No significant differences were observed between groups in local or distant recurrence, urinary and intestinal leaks, pelvic abscess, ileus, urinary tract infection, or 90-day mortality.</p><p><strong>Conclusion: </strong>Partial cystectomy demonstrated superior postoperative outcomes, including fewer surgical site infections, reduced operative time, less blood loss, and shorter hospitalization. Oncological outcomes and other postoperative complications were comparable between PC and TC, supporting PC as a safe and effective option in selected patients.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"1661-1672"},"PeriodicalIF":1.8,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142965042","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}