Journal of Nephrology最新文献

Acute kidney injury in pregnancy is associated with increased risks for adverse maternal and neonatal outcomes: an integrated health system study. 妊娠期急性肾损伤与孕产妇和新生儿不良结局风险增加相关：一项综合卫生系统研究

IF 2.6 4区医学

Journal of Nephrology Pub Date : 2026-10-16 DOI: 10.1093/joneph/aajag125

Mehdi Kashani, Darah Dilmaghani, Regan N Theiler, Yan Li, Deondre Jordan, Danette Bruns, Farbod Yousefi, Vesna D Garovic, Kianoush B Kashani

{"title":"Acute kidney injury in pregnancy is associated with increased risks for adverse maternal and neonatal outcomes: an integrated health system study.","authors":"Mehdi Kashani, Darah Dilmaghani, Regan N Theiler, Yan Li, Deondre Jordan, Danette Bruns, Farbod Yousefi, Vesna D Garovic, Kianoush B Kashani","doi":"10.1093/joneph/aajag125","DOIUrl":"https://doi.org/10.1093/joneph/aajag125","url":null,"abstract":"Background: Pregnancy-related acute kidney injury (PrAKI) is an uncommon but serious complication associated with adverse maternal and neonatal outcomes, with limited data in high-resource settings.Methods: We conducted a retrospective cohort study of 29 586 deliveries at Mayo Clinic hospitals between 2017 and 2022. PrAKI was defined using Kidney Disease Improving Global Outcomes (KDIGO) creatinine criteria. Maternal characteristics, nephrotoxin exposure, clinical interventions, and neonatal outcomes were compared between patients with and without PrAKI.Results: PrAKI occurred in 341 patients (1.15%). Compared with controls, PrAKI was associated with higher rates of chronic hypertension (28.7% vs 5.2%), cesarean delivery (68.5% vs 35.1%), intensive care unit (ICU) admission (59.1% vs 6.2%), and nephrotoxin exposure (58.7% vs 31.6%) (all P < .0001). Dialysis was required in 7.1% of patients with PrAKI, with 1.17% remaining dependent at discharge and 0.88% at 30 and 90 days; no control patients required dialysis. Neonates of mothers with PrAKI had higher rates of prematurity and neonatal ICU (NICU) admission (48.7% vs 9.8%; P < .0001). Maternal mortality was rare.Conclusions: PrAKI is a marker of severe maternal illness and is associated with adverse maternal and neonatal outcomes. Although most patients recover kidney function, a subset develop persistent dysfunction. Early identification, cautious use of nephrotoxic medications, and structured postpartum follow-up are essential.","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149194597","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}

引用次数: 0

2-Deoxy-2-[18F]Fluorosorbitol (18F-FDS) as a Potential PET Tracer for Renal Imaging and GFR Measurement: Comparative Assessment with 68Ga-EDTA and 99mTc-DTPA. 2-脱氧-2-[18F]氟山梨醇（18F- fds）作为肾脏成像和GFR测量的潜在PET示踪剂：与68Ga-EDTA和99mTc-DTPA的比较评价

IF 2.6 4区医学

Journal of Nephrology Pub Date : 2026-10-15 DOI: 10.1093/joneph/aajag262

Humeyra Battal-Kaplan, Bilge Volkan-Salancı, Nezire Saygılı, Suleyman Can Ozturk, Suna Erdoğan

{"title":"2-Deoxy-2-[18F]Fluorosorbitol (18F-FDS) as a Potential PET Tracer for Renal Imaging and GFR Measurement: Comparative Assessment with 68Ga-EDTA and 99mTc-DTPA.","authors":"Humeyra Battal-Kaplan, Bilge Volkan-Salancı, Nezire Saygılı, Suleyman Can Ozturk, Suna Erdoğan","doi":"10.1093/joneph/aajag262","DOIUrl":"https://doi.org/10.1093/joneph/aajag262","url":null,"abstract":"Background: Accurate assessment of glomerular filtration rate (GFR) is critical for monitoring renal function. This study aims to evaluate its feasibility as a PET radiopharmaceutical for renal imaging and GFR assessment. Its novelty lies in the direct, head-to-head comparison with 68Ga-EDTA and 99mTc-DTPA to comprehensively assess the potential advantages and translational relevance of 18F-FDS for clinical GFR measurement.Methods: 18F-FDS was synthesized via a reduction reaction, and its radiochemical purity was evaluated using radio-TLC. In vitro stability was assessed for up to 4 hours. Plasma protein and erythrocyte binding rates of 18F-FDS, 68Ga-EDTA, and 99mTc-DTPA were determined to evaluate their pharmacokinetic suitability for renal imaging. Dynamic and static renal imaging was performed in healthy male Wistar rats. Time-activity curves were generated to calculate Tmax, biological half-life (T1/2), normalized residual activity (NORA), and GFR.Results: 18F-FDS was synthesized with a radiochemical purity exceeding 98% and demonstrated high in vitro stability over 4 hours. Plasma protein binding and erythrocyte of 18F-FDS was lower than for all radiopharmaceuticals. Dynamic small-animal imaging revealed rapid renal uptake and efficient urinary excretion for all agents. No statistically significant differences were observed in GFR values or kinetic parameters derived from 18F-FDS and 68Ga-EDTA imaging (p > 0.05).Conclusions: The favorable in vitro characteristics and renal kinetic profiles of 18F-FDS support their potential use as PET radiopharmaceuticals for renal imaging and GFR quantification. In particular, the low plasma protein binding and comparable GFR measurements suggest that 18F-FDS may serve as a promising alternative to established tracers for functional renal assessment.","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149194621","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}

引用次数: 0

Association of eGFR Discrepancy With Subsequent Frailty in Middle-Aged and Older Adults. 中老年人eGFR差异与随后的虚弱的关系

IF 2.6 4区医学

Journal of Nephrology Pub Date : 2026-10-14 DOI: 10.1093/joneph/aajag261

Jingru Bi, Yilin Pan, Wenkai Guo, Pengcheng Ji, Yuansheng Xie

{"title":"Association of eGFR Discrepancy With Subsequent Frailty in Middle-Aged and Older Adults.","authors":"Jingru Bi, Yilin Pan, Wenkai Guo, Pengcheng Ji, Yuansheng Xie","doi":"10.1093/joneph/aajag261","DOIUrl":"https://doi.org/10.1093/joneph/aajag261","url":null,"abstract":"Background: Creatinine- and cystatin C-based estimated glomerular filtration rate estimates are influenced by different non-GFR determinants. Their difference (eGFRcys-eGFRcr) may therefore provide information beyond either marker alone. We examined its longitudinal association with frailty and exploratory indirect associations through grip strength.Methods: We analyzed 15,309 observations from 11,174 China Health and Retirement Longitudinal Study participants aged 45 years or older across 2011-2013 and 2015-2018. Standardized eGFR discrepancy was the exposure; follow-up outcomes were the 32-item Frailty Index and frailty (Frailty Index ≥0.25). Linear mixed models and generalized estimating equations accounted for repeated observations. Model 3 was primary; eGFRcys adjustment was a conditional sensitivity analysis.Results: Median age was 60.0 years, and 53.4% of participants were female. A 1-SD higher discrepancy was associated with a lower follow-up Frailty Index (β, -0.503; 95% CI, -0.678 to -0.328; P < 0.001) and lower odds of frailty (OR, 0.851; 95% CI, 0.804-0.900; P < 0.001). Associations persisted after eGFRcys adjustment. Exploratory three-wave analyses showed indirect associations through grip strength, not causal mediation.Conclusions: Higher eGFR discrepancy was longitudinally associated with lower subsequent frailty burden. Further studies are needed to clarify its clinical interpretation and underlying determinants.","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182545","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}

引用次数: 0

Prognostic utility of Oxford MEST-C classification for allograft failure in transplant IgA nephropathy: A systematic review and meta-analysis. 牛津MEST-C分级对移植IgA肾病同种异体移植失败的预后价值：系统回顾和荟萃分析。

IF 2.6 4区医学

Journal of Nephrology Pub Date : 2026-10-14 DOI: 10.1093/joneph/aajag258

Ashutosh Rath, Jitendra Singh Nigam, Immanuel Pradeep, Pallavi Prasad

{"title":"Prognostic utility of Oxford MEST-C classification for allograft failure in transplant IgA nephropathy: A systematic review and meta-analysis.","authors":"Ashutosh Rath, Jitendra Singh Nigam, Immanuel Pradeep, Pallavi Prasad","doi":"10.1093/joneph/aajag258","DOIUrl":"https://doi.org/10.1093/joneph/aajag258","url":null,"abstract":"Background: The prognostic value of Oxford MEST-C classification for predicting allograft loss in transplant IgAN remains inconsistent across studies due to transplant-specific challenges. This meta-analysis evaluates the prognostic value of each component of MEST-C as a predictor of allograft failure.Methods: A systematic search was performed in PubMed, Embase, Scopus, and the Cochrane Central through March 16, 2026, to identify studies reporting hazard ratios (HRs) for MEST-C scores and graft loss. Univariable and multivariable HRs were pooled using a random-effects model. Potential sources of heterogeneity were identified through sensitivity, subgroup, and meta-regression analyses.Results: The study included nine cohorts comprising 1,185 kidney transplant recipients. Pooled analyses showed that S, T, and C lesions were consistently associated with allograft loss, whereas the prognostic value of M and E lesions and the total MEST-C score was less consistent. Subgroup and meta-regression analyses identified geographic region, donor source, and cohort size as significant effect modifiers; however, given the limited number of studies, these associations remain exploratory and hypothesis-generating.Conclusion: This meta-analysis of retrospective cohort studies found that S, T, and C lesions were associated with allograft loss after adjustment in heterogeneous, study-specific models, whereas independent associations for M and E were inconsistent. The total MEST-C score showed univariable predictive value; however, limited multivariable pooling failed to confirm an independent association with graft loss. Its clinical utility requires robust prospective validation before routine reporting can be recommended.","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182542","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}

引用次数: 0

Dialysis and renal transplantation in Gaza: a crisis of access in a war zone. 加沙的透析和肾移植：战区的准入危机。

IF 2.6 4区医学

Journal of Nephrology Pub Date : 2026-10-10 DOI: 10.1093/joneph/aajag161

Hani Al Wahidi, Baraa Habash, Yousef Khelfa, Reem A Mustafa

{"title":"Dialysis and renal transplantation in Gaza: a crisis of access in a war zone.","authors":"Hani Al Wahidi, Baraa Habash, Yousef Khelfa, Reem A Mustafa","doi":"10.1093/joneph/aajag161","DOIUrl":"10.1093/joneph/aajag161","url":null,"abstract":"Since October 7th, 2023, the healthcare system in Gaza has suffered severe damage. Patients with chronic kidney diseases, particularly those needing dialysis, are among the most affected. This study aimed to summarize the impact of the war on patients with kidney failure. Data were collected by either visiting the dialysis centers or contacting them through phone calls and text messages. We found that the total number of patients had decreased from 1022 patients in late 2022 to 750 patients in late 2024. This decrease occurred despite new patients initiating dialysis between October 2023 and December 2024. The number of dialysis machines also decreased from 178 in 2022 to 109 in 2024, despite 35 new dialysis machines being supplied through the World Health Organization (WHO). Consumables, water, electricity, and other necessary resources became increasingly difficult to access. Al Rantisi hospital, the only hospital providing dialysis to 38 pediatric patients before October 2023, is no longer functioning and the surviving eight children are receiving dialysis using adult machines in other centers. This study underscores the pressing need for humanitarian action in Gaza and the need for global policies to protect vulnerable patients, including those with kidney failure.","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":"1326-1329"},"PeriodicalIF":2.6,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148808738","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}

引用次数: 0

Nephrology in space: from fluid conservation to cosmic kidney disease. 空间肾脏病学：从液体守恒到宇宙肾病。

IF 2.6 4区医学

Journal of Nephrology Pub Date : 2026-10-10 DOI: 10.1093/joneph/aajag163

Marco Pizzarelli, Francesco Pizzarelli

引用次数: 0

Impact of HIF-prolyl hydroxylase inhibitors on VEGF expression and vascular adverse events in chronic kidney disease: a meta-analysis of 34 randomized controlled trials. hif -脯氨酸羟化酶抑制剂对慢性肾脏疾病中VEGF表达和血管不良事件的影响：34项随机对照试验的荟萃分析

IF 2.6 4区医学

Journal of Nephrology Pub Date : 2026-10-10 DOI: 10.1093/joneph/aajag065

Seyed Mahdi Montazer, Amirali Asadi, Amirali Taghipour, Arshia Rajabi, Arshak Shabanian, Mehdi Daraei, Ali Bahmani, Mohammad Javad Bay, Mehdi Karimi

{"title":"Impact of HIF-prolyl hydroxylase inhibitors on VEGF expression and vascular adverse events in chronic kidney disease: a meta-analysis of 34 randomized controlled trials.","authors":"Seyed Mahdi Montazer, Amirali Asadi, Amirali Taghipour, Arshia Rajabi, Arshak Shabanian, Mehdi Daraei, Ali Bahmani, Mohammad Javad Bay, Mehdi Karimi","doi":"10.1093/joneph/aajag065","DOIUrl":"10.1093/joneph/aajag065","url":null,"abstract":"Background Hypoxia-inducible factor prolyl hydroxylase inhibitors (HIF-PHIs) are novel oral agents used to treat renal anemia in chronic kidney disease (CKD). While their erythropoietic effects are well-documented, the potential consequences of HIF-mediated vascular endothelial growth factor (VEGF) activation remain uncertain. This meta-analysis aimed to evaluate the effect of HIF-PHI therapy on VEGF levels and the risk of VEGF-related adverse outcomes in CKD patients. Methods We systematically analyzed 34 randomized controlled trials (RCTs) including 26 trials reporting VEGF levels and additional data on cancer, diabetic retinopathy, peripheral edema, and thrombosis. Subgroup analyses were performed based on drug type, treatment duration, dialysis status, trial phase, and comparator type. Results HIF-PHI treatment was associated with a modest but significant increase in VEGF levels (SMD = 0.23; 95% CI: 0.07-0.39) and a reproducible increase in peripheral edema risk (log RR = 0.22; 95% CI: 0.09-0.35). No significant associations were found for cancer, diabetic retinopathy, or thrombosis. Dialysis status moderated VEGF response, with greater elevation observed in dialysis-dependent patients. Conclusion HIF-PHIs modestly increase VEGF expression, with peripheral edema as the most consistent adverse signal. However, no evidence of oncologic or retinal harm was found in the short term. Long-term surveillance is recommended.","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":"1129-1143"},"PeriodicalIF":2.6,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148562396","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}

引用次数: 0

Frailty in kidney transplant candidates is associated with reduced likelihood of transplantation. 肾移植候选人的虚弱与移植可能性降低有关。

IF 2.6 4区医学

Journal of Nephrology Pub Date : 2026-10-10 DOI: 10.1093/joneph/aajag095

Alice Sabatino, Sara Alibrandi, Tea Dovšak, Marianna Adinolfi, Giuseppe Regolisti, Enrico Fiaccadori, Umberto Maggiore, Ilaria Gandolfini

{"title":"Frailty in kidney transplant candidates is associated with reduced likelihood of transplantation.","authors":"Alice Sabatino, Sara Alibrandi, Tea Dovšak, Marianna Adinolfi, Giuseppe Regolisti, Enrico Fiaccadori, Umberto Maggiore, Ilaria Gandolfini","doi":"10.1093/joneph/aajag095","DOIUrl":"10.1093/joneph/aajag095","url":null,"abstract":"Background: Kidney transplantation is the optimal treatment for kidney failure; however, it represents a major physiological stress. Frailty is a clinical syndrome also characterized by decreased physiological reserve and a reduced ability to cope with stressor events. The aim of this study was to assess the association between frailty status and the likelihood of undergoing kidney transplantation.Methods: This retrospective observational study included all kidney transplant candidates waitlisted at the Kidney Transplant Center of the Parma University Hospital, Italy, between July 2018 and February 2020. Frailty status was assessed using the Fried Frailty Phenotype. Frailty was defined as a Fried frailty phenotype score ≥3, while a score of 1 or 2 indicated a pre-frail condition. The Aalen-Johansen estimator was used to estimate the cumulative probability of transplantation and death/withdrawal according to frailty status (frail vs non-frail). Adjusted analyses were performed using Fine-Gray multivariable regression models.Results: Of the 171 patients enrolled, 39% were non-frail, 51% were pre-frail, and 10% were frail. Patients were followed for a median of 17 months; during this period, 42% underwent transplantation, whereas 6% died or were permanently removed from the waiting list. In adjusted analyses, frail and pre-frail patients combined had a 42% lower likelihood of undergoing transplantation compared with non-frail patients (SubHR 0.58, 95% CI 0.39-0.86; P = .006).Conclusions: Frailty among patients with advanced CKD on the kidney transplant waiting list was associated with a lower probability of undergoing transplantation.","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":"1214-1221"},"PeriodicalIF":2.6,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148603835","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}

引用次数: 0

Hidden glyoxylic acid in hair straightening products: a forensic lesson for the nephrologist. 头发拉直产品中隐藏的乙醛酸：给肾病学家的法医课。

IF 2.6 4区医学

Journal of Nephrology Pub Date : 2026-10-10 DOI: 10.1093/joneph/aajag071

David De Saint Gilles, Sabrina Khelil, Jennifer Kervadec, Ellie Tang, Emmanuel Letavernier

引用次数: 0

The therapeutic potential of peritoneal dialysis in congenital heart diseases. A lesson for the clinical nephrologist. 腹膜透析治疗先天性心脏病的潜力。给临床肾科医生上的一课。

IF 2.6 4区医学

Journal of Nephrology Pub Date : 2026-10-10 DOI: 10.1093/joneph/aajag110

Antonio Granata, Rosario Maccarrone, Alessio Sturiale, Fabio Dipasqua, Francesco Amico

引用次数: 0