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

{"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":"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":"Late diagnosis of Gitelman syndrome in an elderly patient: identification of a novel SLC12A3 pathogenic variant.","authors":"Lígia Ribeiro, Micael Pompermayer, Catarina Santos, Joana Coutinho","doi":"10.1590/2175-8239-JBN-2026-0105en","DOIUrl":"10.1590/2175-8239-JBN-2026-0105en","url":null,"abstract":"<p><p>Gitelman syndrome (GS) is an inherited salt-wasting, hypokalemic tubulopathy caused mainly by biallelic loss-of-function variants in the SLC12A3 gene. Despite being classically diagnosed in adolescence, delayed recognition may occur. We present the case of a 74-year-old man with a history of hypokalemia, in whom the diagnostic evaluation revealed hypokalemia, hypomagnesemia, metabolic alkalosis, hypocalciuria, and secondary hyperreninemic hyperaldosteronism, consistent with renal potassium wasting. Given the late presentation, the main challenge was the need to distinguish an inherited tubulopathy from common acquired causes of hypokalemia. Genetic testing was performed, identifying a previously unreported homozygous out-of-frame deletion in exon 25 of the SLC12A3 gene, predicted to result in loss of protein function and therefore to be pathogenic. Treatment with supplementation plus spironolactone achieved sustained biochemical improvement and clinical stability during long-term follow-up. This case highlights that GS should be considered in patients with chronic unexplained hypokalemia regardless of age, and that genetic testing is essential for definitive diagnosis.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"48 3","pages":"e20260105"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13577598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148976778","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":"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}

{"title":"An image of multiple bullous lesions in a patient on hemodialysis.","authors":"Ana Claudia Siqueira Marques, Rafael Fantelli Stelini, Rodrigo Bueno Oliveira","doi":"10.1590/2175-8239-JBN-2026-0077en","DOIUrl":"10.1590/2175-8239-JBN-2026-0077en","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":"e20260077"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13317795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148351923","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":"Pregnancy and kidney transplantation: optimized clinical and obstetric management to reduce maternal and perinatal complications.","authors":"Annie Caroline Magalhães Santos, Rogério Caixeta Moraes de Freitas, Soubhi Kahhale, Rossana Pulcineli Vieira Francisco, Marco Aurélio Knippel Galletta","doi":"10.1590/2175-8239-JBN-2025-0208en","DOIUrl":"10.1590/2175-8239-JBN-2025-0208en","url":null,"abstract":"<p><strong>Objective: </strong>Review the literature to provide guidance on the appropriate clinical and obstetric management of pregnant women with kidney transplants to reduce maternal and perinatal complications.</p><p><strong>Methods: </strong>The PubMed and SciELO databases, which evaluated pregnancy and kidney transplantation, were searched, focusing on clinical and obstetric management. Other variables of interest were preconception counseling, fertility, the safety of immunosuppressants, maternal complications, perinatal complications, graft worsening during pregnancy, and postpartum guidance.</p><p><strong>Results: </strong>A total of 354 articles were identified, of which 76 were included in the analysis. Studies suggest that attempts to conceive should begin at least one year after kidney transplantation in the absence of graft rejection, with stable renal function (creatinine < 1.5 mg/dL and minimal proteinuria < 500 mg/24 h), with adjustment of the class and dose of immunosuppressants (preferably corticosteroids, azathioprine, cyclosporine, tacrolimus, and hydroxychloroquine). Preeclampsia prophylaxis with acetylsalicylic acid (81-50 mg/night) and calcium (1-1.5 g/day) should be universal in this group. Monitoring of renal function, fetal growth, and fetal vitality must be frequent.</p><p><strong>Conclusion: </strong>Pregnancy in kidney transplant recipients is challenging due to maternal and perinatal risks. However, the present review demonstrates that clinical and obstetric management by an experienced multidisciplinary team contributes to better maternal and perinatal outcomes in pregnancies among kidney transplant recipients.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"48 3","pages":"e20250208"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13076013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147673647","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":"Allopurinol in chronic kidney disease: navigating between pathophysiology, experimental evidence, and real-world challenges.","authors":"Ana Beatriz Vargas-Santos, Rosa Weiss Telles, Geraldo da Rocha Castelar-Pinheiro","doi":"10.1590/2175-8239-JBN-2026-E011en","DOIUrl":"https://doi.org/10.1590/2175-8239-JBN-2026-E011en","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":"e2026E011"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13475758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148758328","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}