Journal of Nephrology最新文献

{"title":"Potential role of a reduced nephron endowment and impaired kidney functional reserve in the pathogenesis of hypertensive disorders of pregnancy.","authors":"Silvia Visentin, Pierpaolo Zorzato, Erich Cosmi, Maria Cristina Mancuso, Letizia Dato, Francesco Cavallin, Gianluigi Ardissino","doi":"10.1007/s40620-025-02330-5","DOIUrl":"https://doi.org/10.1007/s40620-025-02330-5","url":null,"abstract":"","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144698812","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":"Sustainable health care in a renal centre - carbon saving is coupled with cost-efficiency.","authors":"Stephanie Mei Yann Choo, Gareth Murcutt, Ingeborg Steinbach, John Stoves","doi":"10.1007/s40620-025-02354-x","DOIUrl":"https://doi.org/10.1007/s40620-025-02354-x","url":null,"abstract":"<p><strong>Background: </strong>Healthcare contributes significantly to global carbon dioxide equivalent emissions, with kidney care contributing disproportionately to this. Renal medicine was one of the first specialities to actively develop a \"green\" community. This paper is a retrospective review of a series of comprehensive and impactful green initiatives across various aspects of kidney care delivery in a kidney unit from 2007 to 2024.</p><p><strong>Methods: </strong>The interventions include using e-consultations and virtual clinics, online priming of haemodialysis machines, upgrade of water treatment systems, centralised dialysate acid delivery, use of 1:44 acid concentrate, use of dialysate autoflow function, installation of energy-efficient lighting, and incremental and decremental dialysis practices. Financial and environmental saving estimates for the haemodialysis-related interventions were calculated based on a 40-bed haemodialysis unit. A hybrid carbon footprinting approach was utilised to calculate the greenhouse gas and financial savings.</p><p><strong>Results: </strong>The cumulative estimated greenhouse gas and financial savings exceed 1,000 tonnes of carbon dioxide equivalent and £2.8 million, respectively. Among sustainable initiatives in haemodialysis, online priming, use of central acid delivery, dialysate autoflow facility, and incremental and decremental haemodialysis showed the most significant savings.</p><p><strong>Conclusions: </strong>Interventions to facilitate environmental sustainability may require upfront funding and staff investment of time and effort, but the dividend is long-term environmental protection, financial savings, enhanced quality of care, greater staff satisfaction and enhanced service resilience. Sharing these experiences may help other institutions to integrate green initiatives into everyday service planning.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690565","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":"The impact of frailty and malnutrition on hospitalisation and survival in people with kidney failure.","authors":"Dawson Jessica, Smyth Brendan, Ryan Michele, Randall Ann-Maree, Clifford Katharine, Thomsett Max, Li Chen-Lei Kelly, Mark A Brown","doi":"10.1007/s40620-025-02356-9","DOIUrl":"https://doi.org/10.1007/s40620-025-02356-9","url":null,"abstract":"<p><strong>Background: </strong>Malnutrition and frailty are common, with rates increasing as kidney disease progresses and with ageing. Conservative kidney management has emerged as a kidney failure treatment that prioritises quality of life and symptom management, typically offered to the elderly. The aim of this study was to determine the incidence and impact of frailty and malnutrition on hospitalisations, quality of life and mortality in people with kidney failure.</p><p><strong>Methods: </strong>This two-year longitudinal study recruited people choosing conservative kidney management and, as a comparator group, people aged 75 years and over who were commenced on dialysis. Participants underwent assessment of frailty, nutritional status and quality of life every 6 months. Hospitalisation and death data were extracted from medical records.</p><p><strong>Results: </strong>A total of 85 participants were recruited (n = 60 conservative kidney management, n = 25 dialysis). At baseline, 56% were assessed as frail and 33% as malnourished. In the total cohort, frailty was associated with a higher rate of hospitalisations, and longer hospital stays. These associations appeared to be driven by the dialysis group, as no differences in hospitalisation rates or length of stay were observed in the conservative kidney management group based on frailty status. In the conservative kidney management group, frailty was not associated with mortality (HR 1.42, 95% CI 0.71-2.84; p = 0.3), however, being malnourished was associated with reduced 2-year survival (HR 2.10, 95% CI 1.13-3.90; p = 0.024).</p><p><strong>Conclusions: </strong>Frailty and malnutrition are common, resulting in adverse outcomes in elderly conservative kidney management and dialysis populations. Nutrition is a key intervention in both frailty and malnutrition, with clinical trials needed to evaluate safe and effective interventions.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690566","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":"Body water distribution, early malnutrition and sarcopenia in ADPKD: insights from a cross sectional study.","authors":"Maria Teresa Sciarrone Alibrandi, Matteo Brambilla Pisoni, Rodolfo Fernando Rivera, Martina Catania, Marta Vespa, Liliana Italia De Rosa, Romina Bucci, Kristiana Kola, Sara Farinone, Lorena Citterio, Maria Vittoria Vergani, Paolo Manunta, Giuseppe Vezzoli","doi":"10.1007/s40620-025-02327-0","DOIUrl":"https://doi.org/10.1007/s40620-025-02327-0","url":null,"abstract":"<p><strong>Background: </strong>Bioelectrical impedance analysis is a non-invasive method used to assess body composition and nutritional status in patients with chronic kidney disease (CKD). However, its reliability in autosomal dominant polycystic kidney disease (ADPKD) remains uncertain due to altered fluid distribution caused by cystic organ enlargement. This cross-sectional study compared bioelectrical impedance analysis-derived body composition and nutritional parameters between patients with ADPKD and those with non-ADPKD CKD.</p><p><strong>Methods: </strong>A total of 218 CKD patients (71 with ADPKD and 147 with non-ADPKD CKD, stages 1-5D) were enrolled. To control for baseline differences, 1:1 propensity score matching was applied. All participants underwent bioelectrical impedance analysis to assess body water compartments, skeletal muscle mass, fat mass, and phase angle. In the ADPKD group, parameters were further analyzed based on the presence of organomegaly, defined as nephromegaly (total kidney volume > 750 mL or kidney length > 16 cm) or hepatomegaly (liver transverse diameter > 25 cm).</p><p><strong>Results: </strong>After matching, two balanced groups of 71 patients each were compared. ADPKD patients showed significantly higher total and extracellular water than controls, both as absolute values normalized to height squared and as a percentage of body weight. Among ADPKD patients, the 41 with organomegaly had significantly lower phase angle, fat mass, fat-free mass, and skeletal muscle mass than the 30 without organomegaly-despite a paradoxical increase in body mass index (BMI). These changes were independent of kidney function.</p><p><strong>Conclusions: </strong>Bioelectrical impedance analysis detected altered fluid distribution and early signs of malnutrition and sarcopenia in ADPKD, supporting the need for proactive nutritional monitoring, especially in patients with organomegaly.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690564","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":"Long-term prediction of mortality by heart rate turbulence in hemodialysis patients and the impact of diabetes mellitus-a longitudinal observational study.","authors":"Nora Hannane, Christopher C Mayer, Julia Matschkal, Felix Bormann, Axel Krieter, Jürgen R Braun, Claudius Küchle, Lutz Renders, Roman Günthner, Georg Schmidt, Alexander Müller, Siegfried Wassertheurer, Uwe Heemann, Bernhard Haller, Marek Malik, Christoph Schmaderer, Matthias Christoph Braunisch","doi":"10.1007/s40620-025-02357-8","DOIUrl":"https://doi.org/10.1007/s40620-025-02357-8","url":null,"abstract":"<p><strong>Background: </strong>Diabetes-driven impaired autonomic nervous system function might contribute to increased mortality in hemodialysis patients. Our study aimed to validate heart rate turbulence as a long-term predictor of mortality in this vulnerable cohort.</p><p><strong>Methods: </strong>Heart rate turbulence is a non-invasive, 24 h electrocardiography-Holter-based assessment of cardiovascular autonomic responses. Hemodialysis patients of the \"rISk strAtification in end-stage Renal disease\" (ISAR) study, a prospective, multicenter observational study, were followed up for six years. Mortality hazard, and correlations between clinical characteristics and mortality, were assessed using Cox regression models.</p><p><strong>Results: </strong>Heart rate turbulence measurement at baseline was available in 290 hemodialysis patients, 99 (34%) with diabetes mellitus. In a multivariable analysis, abnormal heart rate turbulence was associated with a 2.1-fold (95% CI: 1.4-3.2; p < 0.001) increased risk for all-cause and 3.1-fold (95% CI: 1.5-6.2; p = 0.001) increased risk for cardiovascular mortality. The co-occurrence of abnormal heart rate turbulence and diabetes mellitus represented the strongest risk constellation, increasing all-cause mortality risk to a hazard ratio of 5.8 (95% CI: 3.3-10.4; p < 0.001) and cardiovascular mortality risk to 6.1 (95% CI: 2.5-15.1; p < 0.001). This association with mortality risk remained significant after multivariate adjustment. The interaction term between the two comorbidities indicated an approximately additive effect on mortality risk.</p><p><strong>Conclusions: </strong>Heart rate turbulence significantly contributed to the prediction of long-term mortality risk in hemodialysis patients. Diabetes mellitus is a major driver of cardiovascular autonomic dysfunction, which plays a crucial role in mortality among dialysis patients. Heart rate turbulence measurement identifies high-risk patients in the dialysis setting, enhancing precision in risk prediction and stratification, and allowing an opportunity for personalized monitoring and prevention.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642840","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":"Potentially reversible severe cardiac involvement in thrombotic microangiopathies with malignant hypertension.","authors":"Marco Allinovi, Silvia Menale, Valentina Querin, Leonardo Caroti, Giulia Antognoli, Calogero Lino Cirami, Niccolò Marchionni, Valentina Scheggi","doi":"10.1007/s40620-025-02334-1","DOIUrl":"https://doi.org/10.1007/s40620-025-02334-1","url":null,"abstract":"<p><strong>Background: </strong>Thrombotic microangiopathy (TMA) represents a pathological response to endothelial damage, caused by genetic or acquired factors. It includes conditions like thrombotic thrombocytopenic purpura, atypical hemolytic uremic syndrome (aHUS), and secondary TMAs. Malignant hypertension can both result from and trigger TMA. This study aims to identify risk factors for severe cardiac involvement, defined as a left ventricular ejection fraction ≤ 50%, in patients with concomitant TMA and malignant hypertension, and to investigate the evolution of cardiac anomalies post-TMA remission.</p><p><strong>Methods: </strong>We retrospectively collected data of 33 patients with TMA and malignant hypertension, admitted to our hospital between January 2014 and December 2023. Patients were followed up to monitor kidney function, blood pressure, and hematological parameters, and those with severe cardiac involvement at admission underwent repeated echocardiograms. Genetic testing for complement factors was performed to identify aHUS cases.</p><p><strong>Results: </strong>Severe cardiac involvement was diagnosed in 9 patients, all of whom exhibited left ventricular hypertrophy and varying degrees of diastolic dysfunction and valve regurgitation. Patients with severe cardiac involvement had significantly higher interventricular septal and posterior wall thickness at admission. Over a mean follow up of 42 months, all patients with severe cardiac involvement showed recovery of left ventricular systolic function. Patients with severe cardiac involvement had a higher incidence of respiratory failure [5/9 (56%) vs 2/24 (8%) patients, p = 0.003] and kidney failure [7/9 (78%) vs 8/24 (33%) patients, p = 0.022].</p><p><strong>Conclusions: </strong>Severe cardiac involvement in TMA associated with malignant hypertension is common but largely reversible. Early identification and tailored treatment can lead to improved outcomes. This study highlights the importance of comprehensive cardiac assessment in managing TMA patients with malignant hypertension.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144637309","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":"Atypical hemolytic uremic syndrome is not always complement mediated: lesson for the clinical nephrologist.","authors":"Andrea Spasiano, Francesca Menni, Martina Ambrogio, Alessandro Naticchia, Nicola Panocchia, Pietro Manuel Ferraro, Gianluigi Ardissino","doi":"10.1007/s40620-025-02359-6","DOIUrl":"https://doi.org/10.1007/s40620-025-02359-6","url":null,"abstract":"","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626593","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":"Alcohol consumption and incidence of decline in glomerular filtration rate and of proteinuria: the Osaka Kenko Innovation (TOKI) study.","authors":"Yuko Nakamura, Naoko Otsuki, Qinyan Li, Maki Shinzawa, Isao Matsui, Miyae Yamakawa, Asuka Oyama, Hiroshi Toki, Ryohei Yamamoto","doi":"10.1007/s40620-025-02339-w","DOIUrl":"https://doi.org/10.1007/s40620-025-02339-w","url":null,"abstract":"<p><strong>Background: </strong>Although excessive alcohol consumption is a critical factor for non-communicable diseases, its clinical relevance to chronic kidney disease is controversial.</p><p><strong>Methods: </strong>This retrospective cohort study, including 80,765 men and 88,507 women aged 40-74 years who underwent annual health checkups in Japan between April 2012 and March 2017, assessed a dose-dependent association between alcohol consumption (rare, occasional, and daily drinkers with ≤ 19, 20-39, 40-59, and ≥ 60 g/day) and incidence of ≥ 30% decline in estimated glomerular filtration rate (eGFR), eGFR < 60 ml/min/1.73 m² and presence of proteinuria (dipstick urinary protein ≥ 1 +), using Cox proportional hazards models adjusted for clinically relevant factors.</p><p><strong>Results: </strong>The incidence of ≥ 30% eGFR decline was observed in 1231 (1.5%) men and 1291 (1.5%) women during the median observation period of 2.8 and 2.9 years, respectively. In men, daily drinkers consuming ≥ 40 g/day of ethanol were at significantly high risk for ≥ 30% eGFR decline (adjusted hazard ratio [95% confidence interval] of rare, occasional, and daily drinkers with ≤ 19, 20-39, 40-59, and ≥ 60 g/day: 1.00 [reference], 1.05 [0.87, 1.27], 0.99 [0.80, 1.21], 1.05 [0.88, 1.26], 1.23 [1.01, 1.51], 1.61 [1.22, 2.11], respectively). Similar dose-dependent associations with incidence of eGFR < 60 ml/min/1.73 m² and proteinuria were observed in men. Contrary to men, alcohol consumption was not associated with eGFR decline and proteinuria in women.</p><p><strong>Conclusion: </strong>Men with alcohol consumption ≥ 40 g/day were at a high risk of eGFR decline and development of proteinuria.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144618633","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 SGLT2i on bone health in patients with lupus nephritis: randomized double blinded placebo-controlled clinical trial.","authors":"Mohamed Hosney Badawi, Eman Nagy, Ehab Wahba Wafa, Amr El-Husseini, Nourelsabah Mohamed, Mohamed Abo El-Ghar, Wael Ibrahim Mortada, Kareem Ahmed Nabieh, Mohamed Abd El-Kader Sobh","doi":"10.1007/s40620-025-02351-0","DOIUrl":"https://doi.org/10.1007/s40620-025-02351-0","url":null,"abstract":"<p><strong>Background: </strong>Patients with systemic lupus erythematosus (SLE) commonly experience osteoporosis and are at increased risk of bone fractures. Sodium-glucose co-transporter 2 inhibitors (SGLT2i) have shown promising cardiovascular and renal benefits in patients with kidney disease; however emerging evidence suggests that they may negatively impact bone health. This study aims to investigate the impact of SGLT2i on bone metabolism in patients with lupus nephritis (LN).</p><p><strong>Methods: </strong>This is a randomized, double-blinded placebo-controlled clinical trial, including 84 adult patients with biopsy-proven LN and estimated glomerular filtration rate (eGFR) > 30 ml/min/1.73m². Patients were randomized 1:1 and stratified according to age and gender to Dapagliflozin (10 mg daily) or placebo groups. Serum creatinine, eGFR, urinary protein-creatinine, calcium-creatinine, and phosphorus-creatinine ratios were measured at baseline and after 12 months. Bone health was assessed at the same time points using bone formation markers (bone-specific alkaline phosphatase, procollagen type 1 N-terminal propeptide) and bone resorption markers (tartrate-resistant acid phosphatase 5b and Sclerostin). Moreover, quantitative computed tomography was used to assess volumetric bone mineral density.</p><p><strong>Results: </strong>Participants had a mean age of 38 ± 7 years, with no significant baseline differences between groups. By the end of the study, there were no significant differences in kidney function or bone turnover biomarkers between the dapagliflozin and placebo groups after adjusting for baseline values. Only the lumber spine 3 (L3) T score of the quantitative computed tomography parameters was significantly better in the dapagliflozin group compared to the placebo group (P = 0.017). In a linear mixed model analysis, dapagliflozin was associated with a significant unadjusted decline in lumbar spine bone mineral density over one year, but this effect was attenuated and became non-significant after adjusting for age, steroid dose, and gender.</p><p><strong>Conclusions: </strong>Dapagliflozin did not significantly affect bone and mineral metabolism in patients with lupus nephritis over a 12-month period. These findings suggest that dapagliflozin is unlikely to have adverse effects on bone health in patients with lupus nephritis, though further research is warranted to confirm these results over longer periods in a larger cohort.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144618636","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":"Supporting people with chronic kidney disease to self-manage their condition: understanding the lived experiences, needs and requirements, and barriers and facilitators.","authors":"Courtney J Lightfoot, Thomas J Wilkinson, Matthew P M Graham-Brown, Alice C Smith","doi":"10.1007/s40620-025-02349-8","DOIUrl":"https://doi.org/10.1007/s40620-025-02349-8","url":null,"abstract":"<p><strong>Background: </strong>Self-management has been identified as an essential component in the effective management of patients with chronic kidney disease (CKD). To effectively develop interventions that support patients with CKD to self-manage, it is crucial to understand their experiences and the factors that may influence their ability to self-manage. This study explored awareness, attitudes and participation with self-management in people living with non-dialysis CKD to understand factors influencing self-management behaviours.</p><p><strong>Methods: </strong>Semi-structured interviews were conducted with 22 individuals living with non-dialysis CKD. Topics explored included perspectives and experiences of self-management, health and lifestyle behaviours, healthcare professional support, and self-management support, including future interventional approaches. Data were audio recorded and transcribed verbatim. Thematic analysis was used to analyse the data and to identify and report themes.</p><p><strong>Results: </strong>Six themes were identified encompassing perspectives, barriers and facilitators of self-management: \"perceptions and experiences of (self-)managing CKD\", \"perceived needs and requirements for self-management education and support\", \"knowledge and capability-related factors\", \"skills and opportunity-related factors\", \"confidence and motivational-related factors\" and \"social support\".</p><p><strong>Conclusion: </strong>Participants perceived that their CKD was not a significant problem, given the lack of concern from their doctor. Despite reporting a lack of awareness and understanding of CKD and its management, participants expressed interest in learning more and implementing appropriate self-management strategies. It was perceived that information and support were provided when it was almost too late, and not when it could potentially have the greatest impact. Perceived barriers and facilitators must be considered when developing interventions to support self-management for people with CKD.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144618637","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}