Journal of Nephrology最新文献

{"title":"Mycobacterium fortuitum as a Cause of Refractory Culture-Negative Peritonitis in a Peritoneal Dialysis Patient.","authors":"Eva Schreterova, Jaroslav Rosenberger, Tatiana Baltesova, Matus Dohal, Vera Dvorakova","doi":"10.1093/joneph/aajag235","DOIUrl":"https://doi.org/10.1093/joneph/aajag235","url":null,"abstract":"","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897485","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":"Glyoxal acid-free as a safer and reliable alternative to glutaraldehyde for renal ultrastructural pathology.","authors":"Gianandrea Pasquinelli, Francesco Vasuri, Paolo Detillo, Benedetta Bussolati, Sabrina Valente","doi":"10.1093/joneph/aajag238","DOIUrl":"https://doi.org/10.1093/joneph/aajag238","url":null,"abstract":"<p><strong>Background: </strong>Renal ultrastructural diagnosis still relies on glutaraldehyde fixation, but this fixative is toxic and has limited tissue penetration. We evaluated whether acid-free glyoxal can provide adequate preservation for renal transmission electron microscopy and whether diagnostically useful information can be recovered from paraffin-embedded tissue.</p><p><strong>Methods: </strong>Normal human renal cortical tissue from nephrectomy specimens was fixed in acid-free glyoxal for 24, 48, or 72 hours and processed for transmission electron microscopy; tissue fixed in 2.5% buffered glutaraldehyde served as a control. Additional acid-free glyoxal-fixed paraffin-embedded samples were recovered and reprocessed. Preservation of podocyte foot processes, slit diaphragms, endothelial fenestrations, and the glomerular basement membrane were assessed. Conventional histology, automated immunohistochemistry, and exploratory immunofluorescence were also evaluated.</p><p><strong>Results: </strong>Fixation for 24 hours preserved the main ultrastructural components of the glomerular filtration barrier, although the basement membrane appeared less compact than after glutaraldehyde fixation. Preservation improved markedly after 48 and 72 hours, with clear slit diaphragms, endothelial fenestrations, and balanced image contrast. Tissue recovered from paraffin blocks also yielded adequate ultrastructural detail for common diagnostic questions. Conventional histology was preserved, whereas automated immunohistochemical reactivity was reduced for the markers tested.</p><p><strong>Conclusions: </strong>With appropriate fixation times, acid-free glyoxal provides good to excellent preservation of renal glomerular ultrastructure and allows recovery of diagnostically useful transmission electron microscopy findings from paraffin-embedded tissue, supporting its use as a safer and more versatile alternative to glutaraldehyde in renal diagnostic pathology.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897541","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":"Early-onset pseudohypoaldosteronism type 2 due to a dominant KLHL3 mutation presenting with hyperkalaemia in a 2-month-old infant.","authors":"Tugba Tastemel Ozturk, Behiye Sarikaya Ozdemir, Melike Ataseven Kulalı, Husniye Yucel, Evrim Kargın Çakıcı","doi":"10.1093/joneph/aajag237","DOIUrl":"https://doi.org/10.1093/joneph/aajag237","url":null,"abstract":"","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897483","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":"Crescents in native kidney biopsies from patients with IgA nephropathy and the risk of recurrence after kidney transplantation: a retrospective cohort study, systematic literature review and meta-analysis of observational studies.","authors":"Gabriella Guzzo, Muaamar Al-Gobari, Cécile Jaques, Daniel Teta, Manuel Pascual, Francisco Herrera-Gomez","doi":"10.1093/joneph/aajag169","DOIUrl":"https://doi.org/10.1093/joneph/aajag169","url":null,"abstract":"<p><strong>Background: </strong>IgA nephropathy (IgAN) is associated with a high risk of kidney failure. Whenever this occurs, the best treatment option is kidney transplantation. IgAN recurrence in the kidney allograft may increase the risk of allograft loss. The association of glomerular crescents in native IgAN is a negative prognostic factor for the progression to kidney failure. The aim of our study was to clarify whether the presence of crescents in native kidney biopsies represents a risk factor for IgAN recurrence in renal allografts.</p><p><strong>Methods: </strong>The association between glomerular crescents in native kidney biopsies and IgAN recurrence was investigated in IgAN patients who underwent kidney transplantation at Lausanne University Hospital from 2003 to 2019. A systematic literature review was performed in MEDLINE, Embase, Cochrane CENTRAL, Web of Science and PMC from inception to November 2025, excluding reviews. Aggregate data were analyzed in a meta-analysis. The overall Risk Ratio (RR) with their corresponding 95% confidence interval (95% CI) was obtained via the Hartung-Knapp-Sidik-Jonkman adjustment method, after verifying heterogeneity (I2). Reporting bias was visualized in a funnel plot using STATA.</p><p><strong>Results: </strong>The Lausanne cohort included 63 patients with IgAN who underwent kidney transplantation. We found no association between glomerular crescents in native kidney biopsies and IgA recurrence in the renal allograft. Five additional cohorts were included in our meta-analysis, ultimately merging data from 311 patients, of whom 23% with recurrent IgAN. Crescent prevalence ranged from 12 to 62%, confirming the absence of association with an increased risk of IgAN recurrence [RR 1.53 (95% CI: 0.40-5.90), P = .41].</p><p><strong>Conclusions: </strong>Glomerular crescents, especially when present in more than 25% of viable glomeruli, remain an unfavorable prognostic factor for the progression of IgAN to kidney failure; however, they may not represent a risk factor for disease recurrence in renal allografts.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891990","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":"Chronic kidney disease progression with proton pump inhibitors versus H2 receptor antagonists in NSAID users.","authors":"Susin Park, Pusoon Chun","doi":"10.1093/joneph/aajag176","DOIUrl":"https://doi.org/10.1093/joneph/aajag176","url":null,"abstract":"<p><strong>Background: </strong>Clinical evidence comparing the renal impact of proton pump inhibitors (PPIs) and Histamine-2 receptor antagonists (H2RAs) in patients with chronic kidney disease (CKD) receiving traditional non-steroidal anti-inflammatory drugs (tNSAIDs) is lacking. We evaluated CKD progression risk associated with PPIs versus H2RAs within a tNSAID-treated cohort to inform clinical prescribing.</p><p><strong>Methods: </strong>This retrospective cohort study used South Korean nationwide claims data (2018-2023). Stabilized inverse probability of treatment weighting (SIPTW) balanced the cohorts. Restricted cubic spline Cox regression addressed non-linear associations between CKD progression and cumulative exposure to tNSAIDs and acid suppressants (PPIs or H2RAs). Sensitivity analyses addressing unspecified CKD stages confirmed the robustness of the primary findings.</p><p><strong>Results: </strong>Among 141 093 tNSAID initiators with CKD prescribed PPIs (n = 5315) or H2RAs (n = 7112), PPIs were associated with higher CKD progression risk than H2RAs (adjusted hazard ratio [aHR] 1.38, 95% CI 1.10-1.74). Baseline comorbidities-hypertension (aHR 2.03, 95% CI 1.37-2.99]), diabetes (1.69 [1.29-2.21]), and a history of kidney disease (1.43 [1.13-1.81])-and prior diuretic use (2.00 [1.56-2.58]) were associated with increased risk of CKD progression. In contrast, dapagliflozin or empagliflozin use was protective (0.49 [0.27-0.89]). The risk of CKD progression for PPIs relative to H2RAs was most pronounced in females, those with CKD stage 3, patients aged ≥71 years, and those with 1-15 days of treatment (all P < .05).</p><p><strong>Conclusion: </strong>Our findings suggest that H2RAs may be associated with a lower risk of CKD progression than PPIs in tNSAID users with CKD, potentially offering a safer alternative when PPI therapy is not indispensable.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881048","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":"Blood pressure in haemodialysis: measurement, volume control and drug selection.","authors":"Yoshitaka Furuto, Daiki Yoshino, Akio Namikawa, Dai Sato, Yuko Shibuya","doi":"10.1093/joneph/aajag181","DOIUrl":"https://doi.org/10.1093/joneph/aajag181","url":null,"abstract":"<p><p>Hypertension in haemodialysis is common, prognostically important, and difficult to manage because blood pressure measurement is often imprecise, extracellular volume is dynamic, and low blood pressure may reflect heart failure, frailty, impaired forward flow, autonomic dysfunction, or excessive ultrafiltration rather than therapeutic success. Contemporary evidence supports ambulatory blood pressure monitoring as the reference standard and home blood pressure monitoring as the most practical longitudinal method, while accepted targets remain unsettled. Treatment should begin with standardised assessment of interdialytic blood pressure burden and sodium-volume control through dietary sodium restriction, dialysate sodium consideration, dry-weight reassessment, ultrafiltration management, and adequate treatment time. This sequence helps distinguish true treatment resistance from pseudoresistance caused by dialysis-unit measurement artefacts, volume excess, short treatment time, sodium burden, medication nonadherence, poorly timed dosing, or dialytic drug removal. Once persistent hypertension is confirmed despite sodium-volume and dry-weight-oriented care, pharmacotherapy becomes necessary. Beta-blockers have the strongest outcome-linked support in haemodialysis, whereas calcium channel blockers (CCBs) are practical complementary agents, and conventional renin-angiotensin system (RAS) blockade is best reserved for selected indications. Mineralocorticoid receptor antagonists (MRAs) should be considered cautiously because recent large dialysis trials and updated meta-analytic evidence have not confirmed clear cardiovascular benefit. Sacubitril/valsartan is biologically plausible when hypertension coexists with heart failure with reduced ejection fraction, left ventricular dysfunction, recurrent congestion, or high natriuretic peptide burden. However, it should be framed as a promising but not yet established selective option rather than routine escalation therapy.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148880988","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":"Nurse-led dynamic urine monitoring reduces acute kidney injury in patients with severe hymenoptera stings: a historically controlled retrospective study.","authors":"Xuyuan Xu, Jiongbin Zheng, Zhengmei Xue, Gang Dong","doi":"10.1093/joneph/aajag179","DOIUrl":"https://doi.org/10.1093/joneph/aajag179","url":null,"abstract":"<p><strong>Background: </strong>To investigate the association of a nurse-led dynamic urine monitoring protocol with acute kidney injury (AKI) risk and clinical outcomes in patients with severe hymenoptera stings.</p><p><strong>Methods: </strong>A historically controlled retrospective design was adopted, with nurse-led dynamic urine monitoring protocol implementation date (January 1, 2022) as the cutoff. Patients were divided into historical control (2019-2021) and dynamic monitoring (2022-2024) groups. The protocol included objective urine color grading, high-frequency dynamic recording, and a standardized situation-background-assessment-recommendation escalation protocol. After propensity score matching was used to balance baseline covariates, AKI incidence and intervention timeliness were compared. Multivariate logistic regression was used to assess the independent association of nurse-led dynamic urine monitoring protocol with AKI risk.</p><p><strong>Results: </strong>Post-propensity score matching, 260 patients were included. Compared with the historical control group, the dynamic monitoring group had lower overall AKI incidence (33.8% vs. 52.3%, P = .003) and fewer patients progressing to severe AKI (Kidney Disease Improving Global Outcomes [KDIGO] stages 2-3; 27.7% vs. 42.3%, P = .013). Regarding response timeliness, the dynamic monitoring group showed shorter times to initiate urine alkalinization and achieve target fluid resuscitation volume, as well as a shorter length of stay in the emergency intensive care unit ([ICU]; all P < .001). Nurse-led dynamic urine monitoring protocol was independently associated with a lower AKI risk (odds ratio [OR] = 0.409, 95% confidence interval [CI]: 0.232-0.720, P = .002).</p><p><strong>Conclusion: </strong>Nurse-led dynamic urine monitoring protocol implementation is independently associated with reduced AKI incidence and shorter emergency ICU length of stay in patients with severe hymenoptera stings. By enabling early recognition and standardized response, nurse-led dynamic urine monitoring protocol is a potentially effective strategy for refined nursing care in this high-risk population.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881060","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":"Acute kidney injury after aminoglycoside exposure in two cystic fibrosis patients receiving triple CFTR modulator therapy.","authors":"Deslais Martin, Novel-Catin Etienne, Nove-Josserand Raphaële, Fouque Denis, Durieu Isabelle","doi":"10.1093/joneph/aajag182","DOIUrl":"https://doi.org/10.1093/joneph/aajag182","url":null,"abstract":"<p><p>The discovery of Cystic Fibrosis Transmembrane conductance Regulator (CFTR) modulators has revolutionized the management and clinical outcomes of cystic fibrosis. However, the pleiotropic effects of these new treatments outside the lungs are still largely unknown. Here we report two unusual cases of acute kidney injury in patient with cystic fibrosis (pwCF) following a first exposure to aminoglycoside while under triple correction therapy. We hypothesize that CFTR modulator therapy restored the reabsorption of aminoglycoside in the proximal tubule of the kidneys, a process that is primarily deficient in patients with cystic fibrosis, thus exacerbating the toxicity of these molecules.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148880925","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":"Associations between physical activity levels and self-perceived quality of life and well-being in hemodialysis patients and their informal caregivers: a multicenter cross-sectional study.","authors":"Ourania Κougioumtzidou, Vasiliki Michou, Eleni Intzevidou, Vasileios Lamprou, Angeliki Kanaki, Aikaterini Papagianni, Asterios Deligiannis, Evangelia Kouidi","doi":"10.1093/joneph/aajag180","DOIUrl":"https://doi.org/10.1093/joneph/aajag180","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to investigate the associations between the physical activity of hemodialysis (HD) patients and their informal caregivers and measures of their well-being and quality of life (QoL).</p><p><strong>Methods: </strong>This multi-center cross-sectional study included one hundred and four HD patient- informal caregiver pairs [HD patients: 76 males (73.1%) vs. Caregivers: 32 males (30.8%)], who completed a form collecting demographic and clinical information, followed by five self-reported questionnaires: 1) The International Physical Activity Questionnaire (IPAQ) short form, 2) the Center for Epidemiological Studies Depression Scale (CES-D), 3) the Generalized Anxiety Disorder Scale (GAD-7), 4) the Fatigue Assessment Scale (FAS) and 5) the 36-Item Short Form Survey Instrument-2nd version (SF-36v2). Additionally, caregivers were also asked to complete the Zarit Burden Interview (ZBI).</p><p><strong>Results: </strong>HD patients had a mean IPAQ score of 856.4 MET-min/week (moderate activity). Their mean questionnaire scores were: CES-D 14.5 ± 9.0, GAD-7 5.1 ± 5.4, FAS 24.0 ± 8.0, physical component summary 41.0 ± 10.7, and mental component summary 47.7 ± 9.7. Notably, 38.5% of patients exhibited depressive symptomatology and 55.8% reported fatigue. Informal caregivers had a mean IPAQ score of 1564 MET-min/week (moderate activity) and the following mean scores: CES-D 13.7 ± 8.2, GAD-7 4.7 ± 4.7, FAS 20.4 ± 6.8, ZBI 22.2 ± 15.6, physical component summary 52.3 ± 9.7, and mental component summary 48.7 ± 8.3. Among informal caregivers, 36.5% showed depressive symptoms and 38.0% reported fatigue.</p><p><strong>Conclusions: </strong>The study demonstrated the significance of integrating physical activity and exercise into the daily routines of HD patients and their informal caregivers. More active individuals reported experiencing less fatigue, greater vitality, and improved overall physical health.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881055","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":"Olfactory dysfunction in hemodialysis patients: baseline differences and longitudinal changes compared with healthy controls.","authors":"Saliha Yıldırım, Gülay Turgay, Ayşe Zeynep Bal, Emre Tutal, Siren Sezer","doi":"10.1093/joneph/aajag186","DOIUrl":"https://doi.org/10.1093/joneph/aajag186","url":null,"abstract":"<p><strong>Background: </strong>Olfactory dysfunction is increasingly recognized in patients with chronic kidney disease, particularly among those receiving maintenance hemodialysis (HD). Despite its potential clinical relevance for nutrition and quality of life, longitudinal data on olfactory function in HD patients remain limited.</p><p><strong>Methods: </strong>This prospective observational study included 100 patients undergoing maintenance HD and 52 healthy controls. Olfactory function was assessed using the identification component of the Sniffin' Sticks Test and expressed as the percentage of correctly identified odors. Sixty HD patients underwent repeat olfactory testing after approximately one year. Multivariable regression models were used to evaluate clinical and biochemical factors associated with baseline olfactory function and its longitudinal change.</p><p><strong>Results: </strong>Baseline olfactory identification scores were significantly lower in HD patients compared with controls (60.6% vs 76.1%, P < .001). Overall, 91% of HD patients exhibited olfactory dysfunction, including 74% with hyposmia and 17% with anosmia. Higher global cognitive function scores (β = .42, P = .001) and higher serum albumin levels (β = .29, P = .015) were independently associated with better baseline olfactory performance. Baseline olfactory performance independently predicted longitudinal change (β = .012, P = .006), whereas dialysis adequacy (Kt/V) was not associated with olfactory outcomes.</p><p><strong>Conclusions: </strong>Olfactory dysfunction is highly prevalent in patients undergoing maintenance hemodialysis and is closely linked to cognitive and serum albumin levels. Longitudinal olfactory trajectories vary across individuals and did not appear to be strongly associated with dialysis adequacy in this cohort, suggesting that olfactory impairment may reflect overall disease burden rather than dialysis dose.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148880998","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}