Iranian journal of kidney diseases最新文献

{"title":"Association of Renal CD68+ Cell Infiltration with Oxford Classification in IgA Nephropathy.","authors":"Mitra Mehrazma, Fatemeh Gharehdaghli, Shahrzad Ossareh, Fereshteh Saddadi, Morteza Ziaheidari, Alireza Amanollahi","doi":"10.61882/ijkd.20.4.9412","DOIUrl":"https://doi.org/10.61882/ijkd.20.4.9412","url":null,"abstract":"<p><strong>Introduction: </strong>IgA nephropathy (IgAN) is the most common form of primary glomerulonephritis worldwide. The Oxford classification (MEST-C) a standardized histopathological scoring system evaluating mesangial hypercellularity (M), endocapillary hypercellularity (E), segmental glomerulosclerosis (S), interstitial fibrosis/tubular atrophy (T), and cellular or fibrocellular crescents (C), provides a histopathological framework to predict disease progression. However, the role of immune cell infiltration-particularly CD68+ macrophages-in these pathological features remains underexplored.</p><p><strong>Objective: </strong>To investigate the association between renal CD68+ macrophage infiltration and the Oxford classification parameters in patients with IgA nephropathy.</p><p><strong>Methods: </strong>This study included 146 patients with biopsy-proven IgAN at Hasheminejad Kidney Center between 2013 and 2020. Immunohistochemical staining for CD68 was performed on paraffin-embedded kidney biopsy sections. CD68+ macrophages were quantified separately in the glomerular and interstitial compartments. Finally, the associations between macrophage counts and Oxford classification components (M, E, S, T, C) were analyzed.</p><p><strong>Results: </strong>Glomerular CD68+ cell counts were significantly higher in samples with M1, E1, T1, and C1 lesions (P < .05). Interstitial CD68+ cells were significantly elevated in T1 lesions (mean: 10.6 vs. 4.7 in T0; P < .001). Receiver operating characteristic (ROC) analysis demonstrated high diagnostic accuracy for interstitial CD68+ cells in predicting T1 (AUC = 0.98) and for glomerular CD68⁺ macrophage in predicting E1 (AUC = 0.88).</p><p><strong>Conclusion: </strong>CD68+ macrophage infiltration is closely associated with active and chronic lesions in IgAN, particularly endocapillary hypercellularity and tubular atrophy. Quantification of CD68+ macrophage may serve as a valuable histological marker for assessing disease activity and guiding prognosis in IgAN.</p>","PeriodicalId":14610,"journal":{"name":"Iranian journal of kidney diseases","volume":"20 4","pages":"207-214"},"PeriodicalIF":0.9,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148874180","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":"Kidney Health for All: Caring for People, Protecting the Planet.","authors":"Raymond Vanholder, Dina Abdellatif, Augusto Cesar Soares Dos Santos, Ricardo Correa-Rotter, Natarajan Gopalakrishnan, Bill Wang, Stefanos Roumeliotis, Alessandro Balducci, Ágnes Haris, Manjusha Yadla, Li-Li Hsiao","doi":"10.61882/ijkd.20.4.9623","DOIUrl":"https://doi.org/10.61882/ijkd.20.4.9623","url":null,"abstract":"<p><p>The current kidney care model - focused on late-stage disease and in-center hemodialysis - is unsustainable, because of costs, environmental burden, poor outcomes, and reduced quality of life. The 78th World Health Assembly's recognition of kidney disease as a serious health threat presents a critical opportunity to reshape kidney care. Aligned with this, the 2026 World Kidney Day theme, \"Kidney Health for All: Caring for People, Protecting the Planet\", calls for a systematic change. A sustainable model must prioritize early detection and prevention, reducing the need for kidney replacement therapy. Transplantation and home dialysis benefit people with kidney failure, environment and society. Dialysis itself must become more eco-friendly without compromising care quality, recognizing that planetary perturbations in turn affect kidney health. Conservative care should also be considered, particularly for elderly and frail patients, if the quality-of-life benefits outweigh the perspectives offered by dialysis. Achieving this shift requires coordinated action across all stakeholders; education and engagement of the public, policy makers and health professionals to raise awareness about the threat of kidney disease; and an urgent move toward patient-centered care.</p>","PeriodicalId":14610,"journal":{"name":"Iranian journal of kidney diseases","volume":"20 4","pages":"195-206"},"PeriodicalIF":0.9,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148874157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Girl with End-Stage Kidney Disease Due to Granulomatosis with Polyangiitis Presenting with Gastrointestinal Bleeding \"a rare presentation\".","authors":"Nahid Rahimzadeh, Azizollah Yousefi","doi":"10.61882/ijkd.20.4.9390","DOIUrl":"https://doi.org/10.61882/ijkd.20.4.9390","url":null,"abstract":"<p><p>Granulomatosis with polyangiitis (GPA) is an uncommon vasculitis affecting small- and medium-sized vessels, predominantly in adults (average age approximately 45 years) and infrequently in children. It can involve multiple organ systems.  In patients with end-stage kidney disease (ESKD) due to GPA, disease activity is often tends to wane after the commencement of dialysis. We report a 12-year-old girl with ESKD due to GPA who presented with severe gastrointestinal (GI) bleeding and profound anemia, owing to diffuse microaneurysms in the small bowel (particularly the ileum) and colon-an exceedingly rare manifestation. She responded dramatically to induction therapy comprising methylprednisolone pulse, plasmapheresis, rituximab followed by maintenance therapy with prednisolone and mycophenolate mofetil.  This case highlights that while the recurrence risk of ANCA-associated vasculitis in dialysis patients is low, the possibility remains and may present with atypical extrarenal involvement. Given the elevated risk of infection with immunosuppression in ESKD patients, maintenance immunosuppressive therapy may be discontinued in the absence of extrarenal disease-but this decision necessitates careful consideration.</p>","PeriodicalId":14610,"journal":{"name":"Iranian journal of kidney diseases","volume":"20 4","pages":"248-251"},"PeriodicalIF":0.9,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148874146","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":"Risk Factors for Mortality in Patients with Severe Acute Kidney Injury Treated with CRRT: A Single-Center Retrospective Study.","authors":"De Kang, Yingbing Wang, PingLong Lin, Bosheng Huang, Yuanlve Chen, Qingjiang Zheng, Fengjuan Ye, Yitao Wang","doi":"10.61882/ijkd.20.4.9351","DOIUrl":"https://doi.org/10.61882/ijkd.20.4.9351","url":null,"abstract":"<p><strong>Introduction: </strong>To explore the risk factors of in-hospital death in patients with severe acute kidney injury (AKI) after continuous renal replacement therapy (CRRT) and to build a prediction model.</p><p><strong>Methods: </strong>In total, 378 patients with AKI were treated in the ICU of affiliated hospital of Fujian Medical University, Zhangzhou City, between June 2018 and August 2024. All patients received CRRT. According to prognosis, patients were divided into the survivor and mortality groups. The clinical data from both groups were compared. A nomogram prediction model was developed based on independent risk factors identified through multivariable logistic regression analysis.</p><p><strong>Results: </strong>Overall, 195 patients (51.59%) died in the hospital. Compared with the Acute Physiology and Chronic Health Evaluation II (APACHE II), the mortality group had significantly higher Acute Physiologic Assessment and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA) scores, mechanical ventilation rates, lactic acid levels, SCr at baseline, the last recorded SCr before death or discharge, duration of anuria before CRRT, total duration of RRT, and ICU stay, while initial and final eGFR were significantly lower (all, P < .05). Multivariable logistic regression analysis showed that APACHE Ⅱ score, SOFA score, duration of anuria before CRRT, and total duration of RRT were independent risk factors for hospital death in AKI (P < .05), while initial higher eGFR was a protective factor (P < .05). The consistency index (C-index) of the nomogram model was 0.751 (95%CI: 0.683~0.819), and the AUC of the ROC curve was 0.738 (95%CI: 0.701~0.775), which had good discrimination. The evaluation results of the calibration curve and clinical decision curve suggested that the model was accurate and effective.</p><p><strong>Conclusion: </strong>The APACHE II score, SOFA score, anuria duration before CRRT, and total RRT time were independently associated with in-hospital mortality of AKI patients treated with CRRT. These findings demonstrate the severity markers of AKI; nevertheless, prospective validation will remain necessary.</p>","PeriodicalId":14610,"journal":{"name":"Iranian journal of kidney diseases","volume":"20 4","pages":"215-223"},"PeriodicalIF":0.9,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148874186","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 Melatonin Supplementation on Glycemic and Lipid Profiles in Kidney Transplant Recipients: A Clinical Trial.","authors":"Fatemeh Pourrezagholi, Hossein Amini, Omid Moradi, Behnam Mahdavi, Aylar Nadiri Niri, Niloufar Taherpour, Sahand Ameri, Mohammad Sistanizad, Parinaz Kafi","doi":"10.61882/ijkd.20.4.9579","DOIUrl":"10.61882/ijkd.20.4.9579","url":null,"abstract":"<p><strong>Introduction: </strong>Melatonin plays a crucial role in regulating sleep and has potent antioxidant properties. However, the relationship between melatonin supplementation and metabolic factors related to diabetes and lipid profiles-which are associated with increased mortality in kidney transplant recipients has not yet been fully clarified.</p><p><strong>Methods: </strong>This randomized, double-blind, placebo-controlled trial was conducted at Labbafinejad Hospital, Tehran, Iran. Adult kidney transplant recipients (≥6 months post-transplant) received either 6 mg/day melatonin or placebo for three months. A modified intention-to-treat analysis included 42 patients per group. The primary outcomes were changes in fasting blood sugar (FBS) and HbA1c levels, while secondary outcomes included blood pressure and lipid profile parameters. Between-group effects were estimated using linear regression adjusted for baseline values and confounders.</p><p><strong>Results: </strong>In the melatonin group, FBS decreased by a median of 6.5 mg/dL (P < .001) and HbA1c by 0.25 units (P < .001), whereas both parameters increased in the placebo group. The adjusted between-group effect favored melatonin for HbA1c (β = -0.30%; 95% CI: -0.59 to -0.01; P < .001) but not for FBS (β = -2.61 mg/dL; 95% CI: -17.93 to 12.71; P = .283). Triglyceride levels decreased by 16 mg/dL in the melatonin group compared with an increase of 13.5 mg/dL in the placebo group (adjusted β = -23.77 mg/dL; 95% CI: -45.50 to -2.04; P = .032). No significant differences were observed in blood pressure and renal function.</p><p><strong>Conclusion: </strong>Melatonin supplementation for three months modestly improved glycemic control and lowered serum triglyceride levels in kidney transplant recipients, with no effects on blood pressure or kidney function. These results support melatonin's potential as an adjunct therapy for metabolic dysregulation in this population, warranting further investigation into its long-term benefits.</p>","PeriodicalId":14610,"journal":{"name":"Iranian journal of kidney diseases","volume":"20 4","pages":"234-247"},"PeriodicalIF":0.9,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148874142","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":"Risk Factors for High-Grade Vesicoureteral Reflux in ChildrenTwo Years or Younger with Febrile Urinary Tract Infections.","authors":"Sajjad Khaleghi Archangan, Mitra Naseri, Nooshin Tafazoli","doi":"10.61882/ijkd.20.4.9514","DOIUrl":"https://doi.org/10.61882/ijkd.20.4.9514","url":null,"abstract":"<p><strong>Introduction: </strong>High-grade vesicoureteral reflux (VUR) in infants with febrile urinary tract infections is linked to a heightened risk of renal scarring. Identifying risk factors for high-grade vesicoureteral reflux could enable more selective use of voiding cystourethrography, thereby reducing unnecessary invasive procedures. This study aimed to determine the independent risk factors of high-grade vesicoureteral reflux in children ≤ two years with febrile urinary tract infections.</p><p><strong>Methods: </strong>According to the defined sample size, a total of 223 children aged two years or younger were referred to the nephrology clinic of Dr.Sheikh children's hospital affiliated to Mashhad University of Medical Sciences from March 2006 to August 2023, meeting the inclusion criteria. Participants who underwent both kidney ultrasound and voiding cystourethrography (VCUG) were included in the analysis. Univariable and multivariable logistic regression tests were utilized to identify independent risk factors of high-grade VUR.</p><p><strong>Results: </strong>Of 223 children included in the study, 180 were girls (80.7%). The median age at the presentation was 8.5 months. High-grade vesicoureteral reflux was identified in 23.8%. The univariable analysis revealed that male sex, abnormal renal ultrasound, hydronephrosis, prenatal hydronephrosis, and infections with non- E.coli as potential risk factors. In the multivariable analysis, male sex (OR = 4.41, P < .001), abnormal renal ultrasound (OR = 3.35, P < .001), hydronephrosis (OR = 5.69, P < .001), and prenatal hydronephrosis (OR = 6.31, P = .004) were confirmed independent risk factors .</p><p><strong>Conclusion: </strong>Male sex, abnormal kidney ultrasound, hydronephrosis, and prenatal hydronephrosis are independent risk factors of high-grade vesicoureteral reflux in children aged ≤2 years with febrile urinary tract infections.</p>","PeriodicalId":14610,"journal":{"name":"Iranian journal of kidney diseases","volume":"20 4","pages":"224-233"},"PeriodicalIF":0.9,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148874189","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 Dapagliflozin on Kidney Function Decline in Chronic Kidney Disease Patients: A Systematic Review.","authors":"Sepideh Shadravan, Rozhan Khezri, Mojgan Zarei Venovel, Mina Mahami-Oskouei, Nakysa Hooman","doi":"10.61882/ijkd.20.4.9534","DOIUrl":"10.61882/ijkd.20.4.9534","url":null,"abstract":"<p><strong>Introduction: </strong>This systematic review aimed to evaluate the impact of dapagliflozin therapy on the progression of chronic kidney disease (CKD) in individuals with CKD.</p><p><strong>Methods: </strong>A comprehensive search for randomized controlled trials (RCTs) concerning dapagliflozin was conducted across multiple databases, including PubMed, Scopus, Web of Science, Cochrane Library, ClinicalTrials.gov, and Google Scholar, from their inception until January 10, 2025. Of 2,806 identified studies, 15 trials met the inclusion criteria. Upon careful assessment to avoid overlapping populations, 11 publications derived from the Dapagliflozin and Prevention of Adverse outcomes in Chronic Kidney Disease (DAPA-CKD) parent trial were excluded, leaving four unique independent trials for narrative synthesis. Due to substantial heterogeneity (I² > 90%) and the limited number of studies, meta-analysis was not performed and findings are presented narratively.</p><p><strong>Results: </strong>A total of 15 articles were identified, 11 were secondary analyses of the DAPA-CKD trial (NCT03036150) reporting on the same 4,304 participants. Following exclusion of overlapping publications, four unique trials remained. The findings for eGFR decline were highly variable across studies, ranging from a mean difference of -6.60 mL/min/1.73m² (Cherney et al., 2020) to +0.93 mL/min/1.73m² (Heerspink et al., 2020). Substantial heterogeneity (I² = 93.7%) precluded meaningful meta-analysis. For composite renal outcomes, only one unique trial reported this outcome, preventing quantitative synthesis.</p><p><strong>Conclusion: </strong>While the effect of Dapagliflozin on eGFR decline was inconclusive due to substantial heterogeneity, the available evidence from the DAPA-CKD trial suggests a reduction in the risk of adverse clinical renal outcomes. However, the limited number of independent trials and considerable heterogeneity underscore the need for more standardized RCTs. Overall, dapagliflozin appears to confer renal protective benefits and is considered safe for patients with CKD.</p>","PeriodicalId":14610,"journal":{"name":"Iranian journal of kidney diseases","volume":"20 4","pages":"181-194"},"PeriodicalIF":0.9,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148874152","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":"Hospitalization Causes in Kidney Transplant Recipients: A Cross-Sectional Study from Isfahan, Iran.","authors":"Mojgan Mortazavi, Shahrzad Shahidi, Atefeh Vaezi, Mohammadreza Maracy, Mohammad Amin Hajiani, Ali Malekinejad, Golsa Ghasemi","doi":"10.61882/ijkd.3.03.9421","DOIUrl":"10.61882/ijkd.3.03.9421","url":null,"abstract":"<p><strong>Introduction: </strong>Kidney transplantation significantly improves survival and quality of life in End-Stage Kidney Disease (ESKD). However, kidney transplant recipients (KTRs) are prone to complications leading to hospitalization. Data on hospitalization etiologies among Iranian KTRs remain limited.</p><p><strong>Methods: </strong>This cross-sectional study included all KTRs hospitalized in the two centers with kidney transplant department in Isfahan between March 2023 and March 2024. Demographic, clinical, and laboratory data were collected from medical records. Etiologies of admission were classified, and descriptive and analytical statistics were calculated using SPSS, version 22.</p><p><strong>Results: </strong>A total of 408 patients (60.7% male, mean age 45.6 ± 15.2 years) were included. The most frequent comorbidities were diabetes mellitus (DM) (27.2%) and hypertension (HTN) (22.2%). Most patients (42.5%) had undergone transplantation for more than 10 years. The leading causes of admission were constitutional symptoms including fever, myalgia, and fatigue in 165 (40.4%), azotemia in 55 (13.5%), dysuria in 23 (5.6%) and limb edema in 21 (5.1%) patients. The main final diagnosis in hospitalized KTRs were infections (42.5%) and acute kidney injury (AKI)/AKI superimposed on chronic kidney disease (CKD) (15.6%). Laboratory findings revealed a mean serum creatinine of 2.58 ± 2.16 mg/dL, with 50% above 1.7 mg/dL. Anemia (Hb < 10 g/dL) was present in 43.7% of cases. Urinalysis showed hematuria in 50.3% and pyuria in 64.2% of patients. Graft failure requiring dialysis occurred in 9 (2.2%) patients. Eighteen (4.4%) patients died during hospitalization period.</p><p><strong>Conclusion: </strong>Infections and acute kidney injury (AKI) were the predominant causes of hospitalization among Isfahan KTR population.</p>","PeriodicalId":14610,"journal":{"name":"Iranian journal of kidney diseases","volume":"20 3","pages":"131-137"},"PeriodicalIF":0.9,"publicationDate":"2026-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156485","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":"Patient Preferences and Information Gaps Underlying the Predominance of Hemodialysis in Türkiye: A Cross-Sectional Survey of 1908 Patients.","authors":"Fatma Betul Guzel, Melis Simsir, Necmi Eren, Sinan Kazan, Serdal Gok, Cansu Ulgen, Ertugrul Erken, Orcun Altunoren, Ozkan Gungor","doi":"10.61882/ijkd.3.03.8950","DOIUrl":"10.61882/ijkd.3.03.8950","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic kidney disease (CKD) is an important public health problem that is increasingly prevalent in Türkiye and the world. Patients with CKD should be informed about renal replacement therapy (RRT) before progression to end-stage kidney disease, and the most appropriate therapy should be selected for each patient. Although three different renal replacement therapy modalities exists, hemodialysis appears to be the most commonly chosen. In this study, we aimed to investigate why hemodialysis is often selected as the first-line therapy by patients.  Methods. In this cross-sectional, survey study; patients aged 18-80, who had been receiving treatment for more than three months and had initiated hemodialysis as their first RRT between 2010 and 2020 in Kahramanmaras, Kocaeli, and Istanbul were included. Patients completed a self-administered multiple-choice questionnarire.</p><p><strong>Results: </strong>A total of 1908 patients were included in the study. Before initiating hemodialysis, 61.1% of patients were under nephrology follow-up, whereas 38.3% had no prior follow-up. Alternative therapies to hemodialysis (peritoneal dialysis and kidney transplantation) were explained to 720 patients (37.7%), but not to 1,159 patients (60.7%). A total of 635 patients (33.3%) were asked about their treatment preferences, while 66% were not. After hemodialysis initiation, 937 patients (49.1%) were listed for cadaveric kidney transplantation, wheras 49.5% were not.</p><p><strong>Conclusion: </strong>Our study is a large, cross-sectional investigation of 1908 patients who selected hemodialysis as their initial RRT. The reasons patients choose hemodialysis over other modalities have long been debated, and substantial knowledge gaps among patients have been identified. We believe that nephrologist follow-up and patient information are important in choosing renal replacement therapy.</p>","PeriodicalId":14610,"journal":{"name":"Iranian journal of kidney diseases","volume":"20 3","pages":"157-162"},"PeriodicalIF":0.9,"publicationDate":"2026-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156502","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":"Tip Lesion Variant of Focal Segmental Glomerulosclerosis in Familial Relapsing Polychondritis.","authors":"Ghalia Khellaf, Rym Hadj Sahraoui, Souad Chelghoum, Lamis Debchi, Nassima Djennane, Ali Benziane","doi":"10.61882/ijkd.3.03.8871","DOIUrl":"10.61882/ijkd.3.03.8871","url":null,"abstract":"<p><p>Relapsing polychondritis (RP) is a rare autoimmune disorder with minimal reported renal involvement. We describe the first case of tip lesion variant of focal segmental glomerulosclerosis (FSGS) in a 60-year-old male with familial RP. The patient initially presented with nephrotic syndrome concomitant with RP, which was diagnosed 17 years ago; renal biopsy revealed minimal change disease at that time. Over the subsequent 17 years, he experienced four RP flares without nephrotic syndrome recurrence until his recent presentation with severe nephrotic syndrome. Repeated renal biopsy confirmed tip lesion variant of FSGS, demonstrating excellent response to corticosteroid therapy with prednisolone 1 mg/kg/day; proteinuria declined from 7g/24h to 0.98g/24h and serum albumin increased from 0.9g/dL to 2.2g/dL within three months. This case underscores the importance of considering FSGS in RP-associated nephrotic syndrome and suggests potential shared immune/genetic mechanisms. To our knowledge, this represents both the first report of tip lesion FSGS in RP and the first documented familial RP case with FSGS development.</p>","PeriodicalId":14610,"journal":{"name":"Iranian journal of kidney diseases","volume":"20 3","pages":"168-174"},"PeriodicalIF":0.9,"publicationDate":"2026-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156658","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}