Journal of Nephrology最新文献

{"title":"Hyperammonemic encephalopathy requiring hemodialysis in a child with distal renal tubular acidosis.","authors":"Behruz Huseynli, Emine Akkuzu, Bahar Büyükkaragöz, Sevcan A Bakkaloğlu","doi":"10.1007/s40620-025-02218-4","DOIUrl":"https://doi.org/10.1007/s40620-025-02218-4","url":null,"abstract":"<p><p>A 3.5-year-old girl with genetically proven distal renal tubular acidosis presented with lethargy, after numerous episodes of vomiting and poor feeding. Laboratory investigations revealed severe metabolic acidosis, hypokalemia and a serum ammonia level of 515 mmol/L (normal range: 19-50 mmol/L). Despite treatment with sodium bicarbonate, potassium supplementation, sodium benzoate and carglumic acid, her condition required hemodialysis, which resulted in rapid improvement in clinical and metabolic parameters. Hyperammonemia in distal renal tubular acidosis results from impaired ammonium excretion and increased ammoniagenesis due to hypokalemia and chronic metabolic acidosis, particularly during metabolic decompensation. This case had the highest ever reported serum ammonia level in distal renal tubular acidosis with encephalopathic findings, necessitating hemodialysis treatment. Routine monitoring of serum ammonia levels in distal renal tubular acidosis patients during metabolic stress is essential.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365099","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":"Severe kidney dysfunction after assisted reproductive technology: a case series suggesting the need for higher awareness of risks.","authors":"Eman Nagy, Rasha Shemies, Mohamed Taman, Nagy Sayed-Ahmed, Giorgina Barbara Piccoli","doi":"10.1007/s40620-025-02226-4","DOIUrl":"https://doi.org/10.1007/s40620-025-02226-4","url":null,"abstract":"<p><strong>Background: </strong>Assisted reproductive technology (ART) has significantly increased the rate of conception and live births in women with fertility problems. Having a kidney disease negatively affects a woman's reproductive health, making infertility a significant concern, and women with chronic kidney disease (CKD) are increasingly seeking treatment with assisted reproductive technology. The side effects of assisted reproductive technology are not fully known and its impact on kidney function, especially if a woman has undergone repeated treatments, is likewise not known.</p><p><strong>Methods: </strong>This case series gathers all consecutive patients who were followed by the Mansoura University Hospital's Obstetric Nephrology Service or were admitted to its Nephrology and Gynecology Department during pregnancy with a diagnosis of acute or chronic kidney function impairment after conceiving with an assisted reproductive technology method, in the period from 2021 to 2024.</p><p><strong>Results: </strong>Of the approximately 150 pregnancies referred to the Obstetric Nephrology Clinic, 6 were referred for acute or acute-on-chronic kidney function impairment, or nephrotic syndrome after conceiving via assisted reproductive technology. In one patient, CKD was overlooked and later progressed to kidney failure; one had probable CKD, but discontinued follow-up before confirmation; and one had a kidney malformation, diagnosed during pregnancy. All presented with early or very early severe hypertension and proteinuria, before 20 weeks, while preeclampsia and the hypertensive disorders of pregnancy are conventionally defined as developing after 20 weeks of gestation. Three had complete recovery postpartum, one progressed to kidney failure, while two were lost to follow-up.</p><p><strong>Conclusion: </strong>Severe early-pregnancy kidney impairment after assisted reproductive technology is probably more frequent than previously reported. Assessment of kidney function after assisted reproductive technology should be mandatory, to make it possible for timely specialized kidney care to be given.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365213","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":"Sleep disorders in hemodialysis patients.","authors":"Georges Kosmadakis, Aura Necoara, Julien Baudenon, Clémence Deville, Ioana Enache","doi":"10.1007/s40620-025-02229-1","DOIUrl":"https://doi.org/10.1007/s40620-025-02229-1","url":null,"abstract":"","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364534","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":"Diabetic kidney disease and cardiac autonomic neuropathy: insights on exercise rehabilitation.","authors":"Vasiliki Michou, Georgios Tsamos, Dimitra Vasdeki, Evangelia Kouidi, Asterios Deligiannis","doi":"10.1007/s40620-025-02216-6","DOIUrl":"https://doi.org/10.1007/s40620-025-02216-6","url":null,"abstract":"<p><p>Patients with Diabetic Kidney Disease (DKD) suffer from various complications of diabetes mellitus, including autonomic neuropathy. Cardiac autonomic nervous system dysfunction is a common disorder in patients with diabetes mellitus and Chronic Kidney Disease (CKD), and is associated with an increased risk of arrhythmias and cardiovascular morbidity and mortality. Although the effects of exercise training have been thoroughly studied in different patient populations with CKD or diabetes mellitus, few studies have investigated the effects of exercise on cardiac autonomic nervous system activity in patients with DKD. This narrative review aims to summarize the evidence regarding the effects of exercise training on cardiac autonomic nervous system modulation in DKD patients.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255773","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":"Nurses' knowledge and perspectives on pregnancy among dialysis patients.","authors":"Ghada Ankawi","doi":"10.1007/s40620-025-02232-6","DOIUrl":"https://doi.org/10.1007/s40620-025-02232-6","url":null,"abstract":"<p><strong>Background: </strong>Pregnancy on dialysis is a rare and complex event, necessitating careful planning. Nurses play a vital role in the dialysis team, providing essential education and support to patients. This study aimed to explore nurses' knowledge and perspectives regarding pregnancy in dialysis patients.</p><p><strong>Methods: </strong>An electronic survey was distributed to six dialysis centers in Saudi Arabia, spanning four regions. A total of 127 nurses participated, of whom 88.2% were hemodialysis (HD) nurses and 11.8% were peritoneal dialysis nurses. Survey responses were summarized using descriptive statistics, presented as percentages.</p><p><strong>Results: </strong>Regarding the impact of kidney failure on reproductive health, only 53.5% of respondents recognized it as a cause of menstrual irregularities. However, 82.7% acknowledged that it reduces fertility, and 89% responded \"yes\" to the possibility of pregnancy while on dialysis, with 61.4% agreeing that female patients of reproductive age with kidney failure require contraception. Despite known limitations, 63% identified a pregnancy test as the preferred method for pregnancy confirmation. In terms of dialysis modality, 63% believed HD to be associated with a higher likelihood of pregnancy. Additionally, 79.5% selected renal transplantation as a measure to increase the likelihood of pregnancy. Regarding pregnancy risks, 89% agreed it poses both fetal and maternal risks. Finally, only 18.1% reported consistently discussing pregnancy-related topics with reproductive-age patients.</p><p><strong>Conclusions: </strong>Nurses are essential to patient education in the dialysis setting. This study identifies potential knowledge gaps and proposes a framework of learning objectives on reproductive health to be integrated into nursing training.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255776","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":"Lessons for the clinical nephrologist: a rare presentation of extrapulmonary tuberculosis in a hemodialysis patient.","authors":"Athish Kannan Karur, Prasanna Kumar, Shobhana Nayak-Rao","doi":"10.1007/s40620-024-02183-4","DOIUrl":"https://doi.org/10.1007/s40620-024-02183-4","url":null,"abstract":"","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189367","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":"Exploring the spectrum of postpartum acute kidney injury: is micro-veinous renal thrombosis a potential cause? A lesson for the clinical nephrologist.","authors":"David Rozenblat, Cédric Rafat, David Buob, Alexandre Hertig, David De Saint Gilles","doi":"10.1007/s40620-025-02228-2","DOIUrl":"https://doi.org/10.1007/s40620-025-02228-2","url":null,"abstract":"","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189364","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":"Retraction Note: Elevation of miR-21, through targeting MKK3, may be involved in ischemia pretreatment protection from ischemia-reperfusion induced kidney injury.","authors":"Zhihui Li, Xu Deng, Zhijuan Kang, Ying Wang, Tuanhong Xia, Niu Ding, Yan Yin","doi":"10.1007/s40620-025-02230-8","DOIUrl":"https://doi.org/10.1007/s40620-025-02230-8","url":null,"abstract":"","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143079833","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":"Sustained Low-Efficiency Dialysis (SLED) with Regional Citrate Anticoagulation (RCA) and new dialysis equipment: a prospective study with serum citrate measurements and electrolyte monitoring.","authors":"Francesca Di Mario, Giuseppe Regolisti, Filippo Fani, Brenda Menegazzo, Cristina Zambrano, Paolo Greco, Caterina Maccari, Tommaso Di Motta, Giuseppe Vizzini, Chiara Italiano, Enrico Fiaccadori","doi":"10.1007/s40620-024-02201-5","DOIUrl":"https://doi.org/10.1007/s40620-024-02201-5","url":null,"abstract":"<p><strong>Background: </strong>Sustained-Low Efficiency Dialysis (SLED) is an increasingly used Kidney Replacement Therapy (KRT) modality in critically ill patients. This study was aimed at evaluating the safety and efficacy of simplified Regional Citrate Anticoagulation (RCA) for SLED using new hemodialysis equipment.</p><p><strong>Methods: </strong>The 8-hour SLED sessions were performed with a Surdial X Nipro^® hemodialysis machine and a cellulose triacetate filter. A concentrated citrate solution (ACD-A) was infused in predilution with a target circuit citrate concentration of 2.5-3 mmol/L. Blood recalcification in the extracorporeal circuit mainly occurred through the backfiltration phenomenon by dialysis fluid (Ca²⁺ 1.5 mmol/L). Serum citrate levels were directly measured during KRT by enzymatic methods and an extensive daily laboratory workup was performed. Changes in laboratory variables at the end of the SLED sessions were analyzed with mixed-effects linear models for repeated measures.</p><p><strong>Results: </strong>Eighty-one SLED treatments were performed in 27 patients (APACHE II score 21 ± 6). The prescribed duration was attained for the majority of the treatments (72/81, 88%). No major bleeding episodes or side effects of citrate accumulation occurred. While calcium infusion was needed in 19/81 SLED sessions (23%), phosphate and magnesium supplementation was necessary following about 25% of all SLED sessions.</p><p><strong>Conclusions: </strong>Our simplified regional citrate anticoagulation protocol for SLED with a new \"conventional\" dialysis machine resulted safe and effective, also for critically ill patients, ensuring a good match between the prescribed and delivered dialysis dose. Close electrolyte monitoring and early supplementation allowed to tailor the dialysis prescription to the patient's actual needs, while avoiding KRT-related complications.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074875","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":"Clinical presentation, outcomes and risk of relapses of lupus podocytopathy in a multicentre Italian cohort.","authors":"Grazia Dea Bonelli, Savino Sciascia, Marta Calatroni, Vincenzo L'imperio, Roberta Fenoglio, Lorenza Maria Argolini, Camillo Carrara, Nicola Lepori, Francesco Reggiani, Alessandra Bortoluzzi, Fausta Catapano, Mariele Gatto, Chiara Tani, Elisa Longhitano, Maurizio Garozzo, Barbara Trezzi, Emanuele Conte, Domenico Santoro, Maria Gerosa, Marta Mosca, Dario Roccatello, Renato Alberto Sinico, Gabriella Moroni","doi":"10.1007/s40620-024-02178-1","DOIUrl":"https://doi.org/10.1007/s40620-024-02178-1","url":null,"abstract":"<p><strong>Background: </strong>In an Italian cohort of lupus podocytopathy patients, we aimed to characterize the presenting features, therapy, and outcomes, and explore differences between relapsing and non-relapsing patients.</p><p><strong>Methods: </strong>We identified 29 patients with lupus podocytopathy from 1994 to 2023 in 11 Italian Nephrology/Rheumatology Units, and divided them into two groups: relapsing and non-relapsing. Given the limited sample size, a p-value ≤ 0.2 was considered as significant.</p><p><strong>Results: </strong>The median age of the patients was 43 (25-52) years, 89.7% were females, 89.6% presented with nephrotic syndrome, 34.4% with acute kidney dysfunction, and 44% with arterial hypertension. After corticosteroids and/or immunosuppressive therapy, complete (25 patients) or partial remission (4 patients) occurred within a median of 4 (1-9) months. Nine patients (31%) relapsed. After a further course of therapy, remission was achieved within 5 (2-11) months. Relapsing patients had higher serum creatinine (0.94 [0.73-2.65] vs 0.8 [0.6-1.1] mg/dl; p = 0.12), lower estimated glomerular filtration rate (76 [32.5-107.5] vs 93 [59.3-109.7] ml/min/1.73m²; p = 0.23) and higher proteinuria (7.7 [5.9-11.7] vs 6.5 g/day [3.2-10.1]; p = 0.14) at lupus podocytopathy diagnosis than non-relapsing subjects. Activity indexes at biopsy were higher [(1 (0-2) vs 0 (0-1); p = 0.08] and cutaneous systemic lupus erythematosus manifestations were more prevalent (44.4% vs 10.5%; p = 0.06) in relapsing patients. After an observation of 49 (18-23) months, 86.2% of patients were in complete remission while 13.8% remained in partial remission. One patient developed mild chronic kidney function impairment.</p><p><strong>Conclusions: </strong>Lupus podocytopathy typically presents with nephrotic syndrome and kidney dysfunction, it responds favourably to treatment, and generally results in a favourable renal outcome. We observed that more active renal and extrarenal lupus manifestations at the onset of lupus podocytopathy were indicative of higher susceptiblity to disease recurrence.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066187","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}