Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia最新文献

{"title":"Renal expression of Bach1 and oxidative stress in chronic kidney disease: evidence from a preclinical model.","authors":"Beatriz Oliveira Da Cruz, Patricia Pereira Almeida, Nathalia Silva-Costa, Michele Lima Brito, D'Angelo Carlo Magliano, Milena Barcza Stockler-Pinto","doi":"10.1590/2175-8239-JBN-2025-0333en","DOIUrl":"10.1590/2175-8239-JBN-2025-0333en","url":null,"abstract":"<p><strong>Introduction: </strong>The transcription factor BTB and CNC homology 1 (Bach1) represses the nuclear factor erythroid 2-related factor 2 (Nrf2), which controls antioxidant gene expression, and its role in chronic kidney disease (CKD) remains unclear.</p><p><strong>Methods: </strong>CKD was induced by 5/6 nephrectomy in rats. Kidney fibrosis and oxidative stress markers were measured. The gene expression of Nrf2, Bach1, and nuclear factor kappa B (NF-κB) was assessed.</p><p><strong>Results: </strong>CKD increased oxidative stress markers in plasma, kidney, and heart, as well as promoted kidney fibrosis. Moreover, CKD reduced cardiac Nrf2 expression. However, Bach1, Nrf2, and NF-κB remained unchanged in the kidney.</p><p><strong>Conclusion: </strong>CKD did not modulate Bach1 mRNA levels in the kidneys of 5/6 nephrectomized rats.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"48 3","pages":"e20250333"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13282137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148258159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methanol intoxication and acute kidney injury: pathophysiological mechanisms and therapeutic approaches.","authors":"Guilherme Nobre Nogueira, Camilla Beatriz Marinho Teles, Marcos Vinicius Sousa Varão, Anderson Carneiro Costa, Gabriel Moreira de Lima Ramos, Elizabeth De Francesco Daher","doi":"10.1590/2175-8239-JBN-2025-0344en","DOIUrl":"10.1590/2175-8239-JBN-2025-0344en","url":null,"abstract":"<p><p>Methanol intoxication is a potentially lethal condition that primarily affects the central nervous system, but it can also induce significant renal damage. Acute kidney injury (AKI) in this context is often underestimated, despite being an important prognostic marker associated with increased mortality and morbidity. This review aims to elucidate the pathophysiological mechanisms linking methanol intoxication to AKI, describe the cellular and metabolic pathways involved, and discuss current therapeutic approaches for renal protection and recovery. A descriptive and analytical review was conducted through searches in the PubMed, Embase, and Cochrane Library databases, including studies published between 2000 and 2025. Eligible articles addressed methanol-related nephrotoxicity, AKI mechanisms, or treatment strategies involving fomepizole, hemodialysis, and renal support. The nephrotoxic effects of methanol are mediated by the accumulation of formic acid, which inhibits mitochondrial cytochrome oxidase, leading to tissue hypoxia, oxidative stress, and cellular apoptosis. The main renal alterations include osmotic nephrosis and acute tubular necrosis, frequently associated with metabolic acidosis, rhabdomyolysis, or hemolysis. Risk factors such as anemia, sepsis, volume depletion, and acute pancreatitis exacerbate renal injury. AKI is linked to higher rates of multiple organ failure and in-hospital mortality. Methanol-induced AKI results from multifactorial mechanisms involving mitochondrial dysfunction, oxidative stress, and hemodynamic instability.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"48 3","pages":"e20250344"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13205139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148015495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex-specific differences in serum phosphate persist in patients with CKD.","authors":"Martina Schatz, Rafael Tavares, Luciene M Dos Reis, Rosilene M Elias, Rosa M A Moyses","doi":"10.1590/2175-8239-JBN-2025-0345en","DOIUrl":"10.1590/2175-8239-JBN-2025-0345en","url":null,"abstract":"<p><strong>Introduction: </strong>Phosphate plays a critical role in numerous metabolic processes, and sex-specific differences have been identified in its concentrations in the general population. However, such differences have not been investigated in the context of CKD, in which additional factors may exert a more pronounced impact on these levels.</p><p><strong>Methods: </strong>This retrospective study was conducted in an outpatient nephrology clinic and included data from 632 patients with CKD stages 1-5.</p><p><strong>Results: </strong>Serum phosphate was negatively associated with age (r = -0.08; p = 0.04) and estimated glomerular filtration rate (eGFR) (r = -0.23; p < 0.001). Women had significantly higher serum phosphate levels than men (3.6 mg/dL vs. 3.3 mg/dL; p = 0.01), an association confirmed in multivariate analysis. No significant sex differences were observed in serum calcium, parathyroid hormone (PTH), 25-hydroxyvitamin D, or the use of vitamin D supplements, calcium salts, or calcitriol.</p><p><strong>Conclusion: </strong>Even in the presence of CKD, women have higher serum phosphate (P) levels than men. This sex difference should be considered in the management of CKD-mineral and bone disorder (CKD-MBD).</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"48 3","pages":"e20250345"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13160562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147874187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between inflammatory markers and mortality in hemodialysis patients.","authors":"Cigdem Cindoglu, Burcu Beyazgül, Derya Abuşka, Ufuk Acar","doi":"10.1590/2175-8239-JBN-2025-0312en","DOIUrl":"10.1590/2175-8239-JBN-2025-0312en","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to evaluate the association between mortality and biomarkers reflecting inflammatory and nutritional status in hemodialysis (HD) patients, including the systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), C-reactive protein-to-albumin ratio (CAR), hemoglobin, albumin, lymphocyte and platelet (HALP) score, and prognostic nutritional index (PNI).</p><p><strong>Methods: </strong>This retrospective cohort study included 135 patients on routine HD. Baseline sociodemographic data, complete blood count, and biochemical parameters were recorded. Patients were followed for one year and classified as survivors or non-survivors. Predictors of mortality were analyzed using logistic regression (Enter method), with multicollinearity assessed by the variance inflation factor (VIF) and tolerance statistics.</p><p><strong>Results: </strong>The mean age of the patients included in the study was 55.2 ± 16.6 years, and 47.4% were male. In univariate analyses, age, albumin, calcium, CRP, white blood cell count, neutrophil count, hematocrit, hemoglobin, SII, NLR, CAR, and PNI were found to be significantly associated with survival (all p < 0.05). In the multivariate logistic regression analysis, only CAR (aOR = 1.374; 95% CI 1.011-1.869), PNI (aOR = 0.861; 95% CI 0.775-0.956), and hemoglobin (aOR = 0.725; 95% CI 0.532-0.988) were identified as independent predictors. The model's accuracy rate was 82%, and the AUC value was calculated as 0.87.</p><p><strong>Conclusion: </strong>Our study demonstrated that easily accessible and low-cost parameters, particularly CAR and PNI, are clinically valuable in predicting survival. The identification of hemoglobin levels as an independent predictor further supports the prognostic significance of hematological parameters. This study may serve as a basis for future research on the prognostic use of these biomarkers, emphasizing the need for large-scale and prospective studies.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"48 3","pages":"e20250312"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13166101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147874198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Will non-invasive methods replace bone biopsy in patients with chronic kidney disease?","authors":"Daniel Souza Gonçalves de Araujo, Claudio Oka Lobo Filho, Francisco Ribeiro Barbosa","doi":"10.1590/2175-8239-JBN-2025-0385en","DOIUrl":"10.1590/2175-8239-JBN-2025-0385en","url":null,"abstract":"","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"48 3","pages":"e20250385"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13034618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147574146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of an automated chromogenic in situ hybridization protocol for detection of cytomegalovirus in formalin-fixed, paraffin-embedded renal graft biopsies.","authors":"Juliana Vitor Rangel, Janice Mery Chicarino de Oliveira Coelho, Lilimar da Silveira Rioja, Luís Cristóvão Porto, Andréa Monte-Alto-Costa","doi":"10.1590/2175-8239-JBN-2024-0255en","DOIUrl":"10.1590/2175-8239-JBN-2024-0255en","url":null,"abstract":"<p><strong>Introduction: </strong>Histopathological diagnosis of human cytomegalovirus (HCMV) infection in formalin-fixed, paraffin-embedded (FFPE) tissues stained with hematoxylin-eosin relies on the identification of characteristic cytopathic changes, including eosinophilic intranuclear and cytoplasmic viral inclusions. Chromogenic in situ hybridization (CISH) enables the localization of specific nucleic acid sequences in histological sections, increasing diagnostic sensitivity. Automated CISH platforms allow standardized and reproducible detection of viral RNA or DNA in FFPE tissues. This study aimed to validate an automated CISH protocol for the detection of HCMV in multiple tissue types, including renal allograft biopsies processed at the Anatomical Pathology Division of UERJ.</p><p><strong>Methods: </strong>Two groups of FFPE samples were analyzed. The first group included ten samples from various tissues, including kidney, palate, esophagus, stomach, and colon; nine positive and one negative for HCMV by immunohistochemistry (IHC). The second group included twenty renal allograft biopsies; nineteen without previous diagnosis and one positive by IHC. For CISH, fluorescein-conjugated oligonucleotide probes targeting HCMV RNA expressed during the early replication phase were used, with hybridization and detection performed on an automated platform.</p><p><strong>Results: </strong>In Group 1, all samples, including the case previously negative by IHC, were positive for HCMV by CISH. In Group 2, six of the twenty renal biopsies were positive, including the sample already identified as positive by IHC.</p><p><strong>Conclusions: </strong>The automated CISH protocol demonstrated high sensitivity and reproducibility for HCMV detection, supporting its validation and use in the diagnosis of renal biopsies and other tissues, as well as its incorporation into the routine workflow of Anatomical Pathology laboratories.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"48 3","pages":"e20240255"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13123571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fall risk assessment scale for hemodialysis patients (ERQUE_HD): development and validation.","authors":"Veronica Alacarini Farina, Simone Travi Canabarro, Gabriela de Souza, Lucas Teixeira Negrello, Ana Elizabeth Prado Lima Figueiredo","doi":"10.1590/2175-8239-JBN-2025-0283en","DOIUrl":"10.1590/2175-8239-JBN-2025-0283en","url":null,"abstract":"<p><strong>Introduction: </strong>Hemodialysis patients present multiple comorbidities and complications during therapy, factors that increase the risk of falls. Adequate risk assessment is essential for implementing effective preventive measures.</p><p><strong>Objective: </strong>To develop and validate a scale for assessing fall risk in hemodialysis patients.</p><p><strong>Method: </strong>A methodological study with quantitative and qualitative approaches, conducted in five stages: integrative review, focus groups, instrument development, content validation, and scale validation.</p><p><strong>Results: </strong>The integrative review included 17 articles and supported the initial item development. Nine focus groups with patients and healthcare professionals enabled the identification of additional risk factors, resulting in the construction of the ERQUE_HD (Fall Risk Assessment Scale for Hemodialysis Patients), composed of 17 items distributed across four domains: health history, dialysis-related factors, functional capacity, and nutrition. Content validation reached a content validity index (CVI) of 0.95, considered highly satisfactory. The scale was then applied to 66 patients and analyzed using logistic regression with generalized estimating equations (GEE), including variables such as post-dialysis fatigue, interdialytic weight gain, and intradialytic hypotension. Patients classified as high-risk were 8.7 times more likely to experience falls compared to the moderate-risk group. The ERQUE-HD demonstrated good accuracy (AUC = 0.817). Post-dialysis fatigue and interdialytic weight gain >4% were identified as significant fall predictors.</p><p><strong>Conclusion: </strong>The ERQUE-HD proved to be effective in assessing and predicting fall risk among hemodialysis patients.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"48 3","pages":"e20250283"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13248899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148205029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Errata: EPI-DRC Brasil: triagem da doença renal crônica com teste rápido de creatinina durante o Dia Mundial do Rim.","authors":"","doi":"10.1590/2175-8239-JBN-2025-0298erpt","DOIUrl":"10.1590/2175-8239-JBN-2025-0298erpt","url":null,"abstract":"<p><p>[This corrects the article doi: 10.1590/2175-8239-JBN-2025-0298pt].</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"48 3","pages":"e20250298er"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399489/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148584339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to the letter: autonomy and refusal of dialysis: ethical and legal reflections on the Brazilian Society of Nephrology Position Statement.","authors":"Dirceu Reis da Silva, Fernanda Salomão Gorayeb Polacchini, Ana Flávia Moura, Cibele Isaac Saad Rodrigues, Maurício Younes-Ibrahim, Eduardo Rocha, Marina Aline Occhiena Oliveira Neiva, Pedro Túlio Rocha, Patrícia Ferreira Abreu, José A Moura-Neto","doi":"10.1590/21758239-JBN-2025-0326rpen","DOIUrl":"10.1590/21758239-JBN-2025-0326rpen","url":null,"abstract":"","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"48 3","pages":"e20250326rp"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13427307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148630530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unraveling the complex web of acute kidney injury: pathways, biomarkers, and future directions.","authors":"Chengxi Zha, Yaya Qi, De Yang, Guoduo Li, Zhijie He, Deping Xu, Jiansheng Li","doi":"10.1590/2175-8239-JBN-2025-0369en","DOIUrl":"10.1590/2175-8239-JBN-2025-0369en","url":null,"abstract":"<p><p>Acute kidney injury (AKI), a widespread severe acute condition caused by several factors and characterized by a rapid decline in renal function over a short time, is associated with high incidence and mortality rates worldwide. Investigating AKI signaling pathways is crucial for elucidating its pathogenesis, optimizing diagnostic and therapeutic approaches, and developing novel therapeutic agents. This article comprehensively examines AKI pathophysiological mechanisms, apoptosis-related signaling pathways, and inflammatory response pathways. It analyzes clinical signaling pathways associated with epidemiology, diagnostic technologies, and therapeutic strategies, explores advancements in novel biomarker applications, drug development, and gene editing technologies, and discusses current hot topics and controversies. The study further outlines future research trends, personalized treatment prospects, and potential challenges and opportunities, aiming to provide comprehensive insights into AKI signaling pathway research and lay the foundation for further exploration in related fields.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"48 3","pages":"e20250369"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13267843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148251541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}