Journal of Nephrology最新文献

{"title":"Efficacy and safety of obinutuzumab on progressive IgA nephropathy: a case series.","authors":"Qingyun Ding, Cheng Xue, Xiang Gao, Xiaojing Tang, Sanli Zhang, Yawei Liu, Bing Dai","doi":"10.1007/s40620-025-02423-1","DOIUrl":"https://doi.org/10.1007/s40620-025-02423-1","url":null,"abstract":"<p><p>IgA nephropathy (IgAN) is the most prevalent glomerulonephritis globally, significantly contributing to kidney failure. B cells are central to its pathogenesis through IgA production. While rituximab is commonly used to deplete B cells, obinutuzumab, a type II anti-CD20 antibody, may provide more effective and sustained depletion. This report regards the efficacy and safety of obinutuzumab in patients with progressive IgAN refractory to other immunosuppressive therapies. We discuss three patients with progressive IgAN aged 21, 35, and 57 years. All patients exhibited significant proteinuria and hematuria, with kidney biopsies confirming IgAN. In addition to supportive care, they all showed favorable responses to initial immunosuppressive therapy but developed kidney function impairment and nephrotic-range proteinuria 2-4 years after discontinuing initial treatments. Following intolerance and/or poor response to a new round of immunosuppressive medications, one patient was switched from rituximab to obinutuzumab (1000 mg), while 2 patients received obinutuzumab (1000 mg, 2 doses). After 12 months of follow-up, all patients achieved sustained B-cell depletion, with a reduction in IgA/C3, proteinuria, and hematuria, and improvement in kidney function. Mild infusion reactions were noted, but no severe adverse events occurred. These findings provide preliminary, hypothesis-generating insights into the efficacy of obinutuzumab in progressive IgAN and highlight the need for further studies on these issues.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145258292","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":"Semaglutide in overweight non-diabetic peritoneal dialysis patients: a real-world single-center experience.","authors":"Giuseppe Paribello, Fortuna Papa, Maria Chiara Ganzerli, Antonio Pisani, Eleonora Riccio","doi":"10.1007/s40620-025-02453-9","DOIUrl":"https://doi.org/10.1007/s40620-025-02453-9","url":null,"abstract":"","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251345","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":"Chylous ascites following bilateral nephrectomy.","authors":"Jean Bertrand, Eric Goffin","doi":"10.1007/s40620-025-02454-8","DOIUrl":"https://doi.org/10.1007/s40620-025-02454-8","url":null,"abstract":"","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145244629","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 failure in the course of focal segmental glomerulonephritis in a patient after alloHSCT - a case study and review of the literature.","authors":"Aleksandra Kaszyńska, Małgorzata Kępska-Dzilińska, Ewa Karakulska-Prystupiuk, Agnieszka Perkowska-Ptasińska, Jolanta Małyszko","doi":"10.1007/s40620-025-02375-6","DOIUrl":"https://doi.org/10.1007/s40620-025-02375-6","url":null,"abstract":"<p><p>Nephrotic syndrome is a rare complication of allogeneic haematopoietic stem cell transplantation (alloHSCT). Its pathogenesis is not fully understood. Membranous nephropathy and minimal change disease are the most common causes of nephrotic syndrome. Nephrotic syndrome occurs more frequently in people with chronic graft-versus-host disease (GvHD). Glucocorticosteroids and cyclosporine are the most common treatments, but their use is associated with the risk of side effects and variable responses. We present a case of a patient after alloHSCT with advanced GvHD who developed nephrotic syndrome resistant to immunosuppressive treatment. Additionally, when her kidney function deteriorated, she required kidney replacement therapy. We would like to emphasise the importance of kidney biopsy as a tool for determining the extent of kidney damage and the possible response to therapy.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238807","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":"Determinants of left ventricular mass in children with autosomal recessive polycystic kidney disease.","authors":"Mathew Lin, Jeremy Rubin, Robert A Palermo, Jarcy Zee, Erum A Hartung","doi":"10.1007/s40620-025-02426-y","DOIUrl":"https://doi.org/10.1007/s40620-025-02426-y","url":null,"abstract":"<p><strong>Background: </strong>Hypertension and left ventricular (LV) hypertrophy (LVH) are common in autosomal recessive polycystic kidney disease (ARPKD). We examined clinical determinants of LV mass in children with ARPKD.</p><p><strong>Methods: </strong>Retrospective study of patients with ARPKD with available echocardiogram data. Casual blood pressure (BP) percentiles, 24-h ambulatory BP monitor (ABPM) parameters, antihypertensive medications, and estimated glomerular filtration rate (eGFR) within 6 months of echocardiogram were collected. Outcomes included LV mass Z-score, LV mass index [LVMI in g/m^2.7 and g/(m^2.16 + 0.09)], and LVH.</p><p><strong>Results: </strong>Thirty patients with ARPKD (median age 7.2 years [IQR 3.4, 12.8]) had echocardiograms, 28 had casual BPs, 11 had ABPMs, and 93% were on antihypertensives. LVH occurred in 23% based on LVMI in g/m^2.7 > 95th percentile, and in 50% based on LVMI > 45 g/(m^2.16 + 0.09). Younger age correlated with higher number of antihypertensives (ρ = - 0.46, P = 0.014) and higher casual systolic and diastolic BP percentiles (r = - 0.74, P < 0.001; r = - 0.81, P < 0.001). After adjusting for age, sex, and eGFR, LV mass was not significantly associated with casual BP or ABPM, except for a negative association between LV mass Z-score and casual diastolic BP percentile (β coefficient - 0.31, P = 0.04). After adjusting for age, sex, and casual BP, both LVMI [in g/m^2.7 and g/(m^2.16 + 0.09)] and LV mass Z-score were significantly negatively associated with eGFR (β -1.08, P = 0.003; β -0.79, P = 0.007; and β -0.07, P = 0.01, respectively).</p><p><strong>Conclusions: </strong>Young children with ARPKD have a higher burden of hypertension. LV mass was unexpectedly not significantly associated with BP but was negatively associated with eGFR.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238785","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":"Hemodynamic effects of hemodialysis: the interaction between the heart and the arteries.","authors":"Aidana Mustafa, Aigerim Yermekbay, Aizhan Zhankorazova, Bauyrzhan Toktarbay, Zaukiya Khamitova, Dinara Jumadilova, Alessandro Salustri","doi":"10.1007/s40620-025-02434-y","DOIUrl":"https://doi.org/10.1007/s40620-025-02434-y","url":null,"abstract":"<p><p>Many studies report that cardiac function is affected by hemodialysis due to alterations in left ventricular morphology and function, particularly left ventricular hypertrophy. Left ventricular hypertrophy is primarily driven by pressure and volume overload, aggravated by factors such as arteriovenous fistulas, anemia, and fluid retention. In addition to left ventricular mass, hemodialysis can impair both left ventricular systolic and diastolic functions, leading to transient reductions in left ventricular ejection fraction, and global longitudinal strain, which are strongly linked to increased mortality. Moreover, chronic dialysis leads to changes in arterial structure and function, including increased intima-media thickness and reduced arterial distensibility, which result in increased afterload. Fluctuating blood pressure during dialysis further affects cardiac function, emphasizing the need for comprehensive assessment of both ventricular and arterial functions, a relationship defined as ventriculo-arterial coupling. In patients with kidney failure, ventriculo-arterial coupling serves as a valuable load-independent prognostic marker, enhancing risk prediction and stratification. Non-invasive tools like echocardiography and speckle-tracking techniques are currently available for evaluating these parameters, enabling early detection and intervention to mitigate cardiovascular risks in patients with kidney failure undergoing hemodialysis. These insights highlight the complex interplay between fluid management, left ventricular function, and arterial stiffness, emphasizing the importance of improved strategies to optimize cardiovascular outcomes in this high-risk population.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238791","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":"Beyond the first pregnancy: learning from the history of a kidney transplant recipient who experienced five pregnancies.","authors":"Ayşe Serra Artan, Ahmet Burak Dirim, Şafak Mirioğlu, Özge Hürdoğan, Müge Doksan, Halil Yazıcı, Aydın Türkmen","doi":"10.1007/s40620-025-02443-x","DOIUrl":"https://doi.org/10.1007/s40620-025-02443-x","url":null,"abstract":"","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145232961","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":"Prediction of kidney function in deceased donor kidney transplant recipients.","authors":"Xiaohong Yu, Jaehoon Paul Jeong, Joonseok Oh","doi":"10.1007/s40620-025-02440-0","DOIUrl":"https://doi.org/10.1007/s40620-025-02440-0","url":null,"abstract":"","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145232979","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":"Longitudinal associations between iron status and patient-reported outcomes in incident dialysis patients: a DOMESTICO substudy.","authors":"Osman Mahic, Thomas S van Lieshout, Alferso C Abrahams, Esmee Driehuis, Ellen K Hoogeveen, Michele F Eisenga, Robin W M Vernooij, Brigit C van Jaarsveld","doi":"10.1007/s40620-025-02363-w","DOIUrl":"https://doi.org/10.1007/s40620-025-02363-w","url":null,"abstract":"<p><strong>Background: </strong>More liberal use of iron therapy is favored in dialysis patients based on lower erythropoietin need and clinical outcomes. However, it remains unclear whether higher iron stores are associated with better patient-reported outcomes. We assessed the longitudinal associations of ferritin and transferrin saturation (TSAT) levels with patient-reported outcomes in incident dialysis patients.</p><p><strong>Methods: </strong>This prospective cohort study included incident dialysis patients who had completed at least one patient-reported outcome questionnaire and had undergone a laboratory assessment (e.g., ferritin, transferrin saturation, hemoglobin) within the first year of dialysis. The primary outcome was health-related quality of life (HRQoL), measured using the 12-Item Short Form (SF-12) survey. Secondary outcomes were the presence of anemia-related symptoms, measured using the Dialysis Symptom Index. We used sequential conditional mean models to adjust for baseline and time-varying confounding.</p><p><strong>Results: </strong>We included 1069 incident dialysis patients, of whom 76% initiated hemodialysis. The mean (SD) age was 64.0 (14.2) years and 34% were female. Over a 1-year follow-up, patients with ferritin levels < 200, > 500 - 700, and > 700 ng/mL did not have a significantly different HRQoL compared to those with levels between 200 - 500 ng/mL, chosen as reference. Similarly, patients with TSAT levels < 20 or ≥ 40% did not have a significantly different HRQoL compared to those with levels between 20 - 39%. No significant differences were found in the odds of experiencing fatigue, shortness of breath, muscle cramps or restless legs between the ferritin and TSAT groups.</p><p><strong>Conclusion: </strong>Differences in iron status parameters were not associated with differences in patient-reported outcomes during the first year of dialysis. Our findings therefore suggest that decisions on iron therapy should be guided by target hemoglobin levels and clinical outcomes in dialysis patients.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206782","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":"Ocular clues to a renal diagnosis: classic imaging in renal coloboma syndrome.","authors":"Aahan Shah, Karthikeyan Mahalingam, Santhakumar Senthilvelan, Sabarinath Shanmugam","doi":"10.1007/s40620-025-02441-z","DOIUrl":"https://doi.org/10.1007/s40620-025-02441-z","url":null,"abstract":"","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199568","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}