Journal of Nephrology最新文献

{"title":"The therapeutic potential of peritoneal dialysis in congenital heart diseases. A lesson for the clinical nephrologist.","authors":"Antonio Granata, Rosario Maccarrone, Alessio Sturiale, Fabio Dipasqua, Francesco Amico","doi":"10.1093/joneph/aajag110","DOIUrl":"10.1093/joneph/aajag110","url":null,"abstract":"","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":"1322-1325"},"PeriodicalIF":2.6,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148712684","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":"Hidden glyoxylic acid in hair straightening products: a forensic lesson for the nephrologist.","authors":"David De Saint Gilles, Sabrina Khelil, Jennifer Kervadec, Ellie Tang, Emmanuel Letavernier","doi":"10.1093/joneph/aajag071","DOIUrl":"10.1093/joneph/aajag071","url":null,"abstract":"","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":"1314-1317"},"PeriodicalIF":2.6,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148252042","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":"Efficacy and safety of finerenone with or without combination therapy in patients with non-diabetic chronic kidney disease: a real-world observational study.","authors":"Yanli Fang, Yun Shao, Xinyi Lin, Qihui Xu, Yu Shang, Mingli Chen, Siyi Chen, Yinqiu Lv, Jianna Zhang, Huidi Zhang","doi":"10.1093/joneph/aajag094","DOIUrl":"10.1093/joneph/aajag094","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate the efficacy and safety of finerenone, with or without combination therapy of sodium-glucose cotransporter-2 inhibitors (SGLT2i) or renin-angiotensin system inhibitors (RASi), in Chinese patients with non-diabetic chronic kidney disease (non-diabetic CKD) at different follow-up time points.</p><p><strong>Methods: </strong>Patients with non-diabetic CKD who received finerenone treatment from March 2023 to August 2025 were retrospectively enrolled. According to the treatment regimens, patients were divided into four groups: finerenone monotherapy group (without SGLT2i or RASi), finerenone + SGLT2i group, finerenone + RASi group, and finerenone + SGLT2i + RASi group. The main evaluated indicators included urine albumin-to-creatinine ratio (UACR), urine protein-to-creatinine ratio (UPCR), serum creatinine (Scr), estimated glomerular filtration rate (eGFR), and serum potassium (K+) levels.</p><p><strong>Results: </strong>A total of 483 patients were enrolled in this study, including 229 males (47.41%); baseline UACR was 520.1 (interquartile range [IQR], 259.2-993.9) mg/g. After receiving finerenone treatment for 18 months, the UACR decreased by 69.18%. During the study period, the change in eGFR remained stable, with only 2.48% of patients experiencing an eGFR decline >30%. Hyperkalemia occurred in only 6 patients (1.24%), indicating a good safety profile during the medication period.</p><p><strong>Conclusion: </strong>Finerenone can effectively reduce proteinuria in patients with non-diabetic CKD. Dual or triple combination therapy demonstrated more pronounced effects, with an overall favorable safety profile. Nevertheless, careful monitoring of short-term changes in eGFR and serum K+ levels remains essential during finerenone therapy.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":"1206-1213"},"PeriodicalIF":2.6,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148603910","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":"Compact green dialysis: circular economy approach to advancing sustainability in resource-limited health-care settings.","authors":"Eason Chang, Lim Jo Anne","doi":"10.1093/joneph/aajag050","DOIUrl":"10.1093/joneph/aajag050","url":null,"abstract":"<p><strong>Background: </strong>Hemodialysis is highly water-intensive, with conventional reverse osmosis systems discarding approximately 40%-70% of treated water as reject waste. Although high-recovery reverse osmosis upgrades can mitigate these losses, they are often associated with substantial capital investment. Existing green dialysis models also require considerable physical space and, when combined with additional labor costs, are frequently unsustainable, thereby limiting their feasibility across many dialysis units.</p><p><strong>Objective: </strong>To evaluate the design and performance of a compact aquaponic reuse system using existing legacy dialysis reverse osmosis reject water, and to compare it with a previous larger-scale model.</p><p><strong>Methods: </strong>A reuse system was implemented within a 39.6 m² corridor adjacent to a dialysis unit. Reject water from a reverse osmosis system was channeled to aquaculture tanks and subsequently to hydroponic columns. Performance indicators included fish survival, vegetable yield, labor demand, water-reuse efficiency, economic outcomes, and comparison with an earlier 310 m² system.</p><p><strong>Results: </strong>Fish survival was 90% with 180 kg/year yield, while hydroponics produced 90 kg/year. Compared with the earlier model, the compact system used a 7.8-fold smaller footprint yet achieved 2.5-fold higher water-reuse efficiency, 2.3-4.7-fold higher fish biomass, and 7.3-14.7-fold higher crop yield per square meter. Labor requirements were approximately 3-fold lower and operating costs 2.5-fold lower, while net annual surplus was 8.2-fold higher with a 2-fold faster payback period.</p><p><strong>Conclusions: </strong>This compact platform demonstrated that dialysis reverse osmosis reject water can be safely and productively reused within a confined footprint while delivering higher efficiency than a larger-scale model.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":"1144-1150"},"PeriodicalIF":2.6,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497668","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":"Combination therapy with mineralocorticoid receptor antagonists and SGLT2 inhibitors in chronic kidney disease: an updated meta-analysis.","authors":"Hisashi Kamido, Masashi Hasebe, Chen-Yang Su, Naoki Sawa, Satoshi Yoshiji","doi":"10.1093/joneph/aajag136","DOIUrl":"10.1093/joneph/aajag136","url":null,"abstract":"","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":"1299-1301"},"PeriodicalIF":2.6,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794338","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":"Medical student reliance on artificial intelligence in nephrology education.","authors":"Amrit Kirpalani, Peter Zhan Tao Wang","doi":"10.1093/joneph/aajag033","DOIUrl":"10.1093/joneph/aajag033","url":null,"abstract":"<p><strong>Background: </strong>Large language models such as ChatGPT are increasingly used in medical education and may influence student learning and decision-making. Despite strong performance on factual recall, limitations in clinical reasoning raise concerns about how learners engage with artificial intelligence (AI)-generated recommendations, particularly in challenging domains such as renal physiology, where foundational understanding underpins clinical application.</p><p><strong>Methods: </strong>Fifty-seven first-year medical students completed 24 multiple-choice questions during a pediatric nephrology and urology case-based learning session. Each clinical question was paired with a corresponding foundational science question and presented in random order. Students answered individually, reviewed a ChatGPT-generated answer (deliberately correct or incorrect), and then re-answered the question. Change-to-match behavior was recorded. Response-level analyses used generalized estimating equation logistic regression to account for repeated measures within students, with sensitivity analyses adjusting for item difficulty.</p><p><strong>Results: </strong>A total of 1357 paired responses were analyzed. Students changed their answers to match ChatGPT in 22.3% of cases. Change-to-match behavior was more frequent for foundational than clinical questions (24.1% vs. 20.4%). After adjusting for clustering and item difficulty, foundational question type remained associated with greater likelihood of change-to-match behavior (odds ratio [OR] 1.57, 95% confidence interval [CI] 1.08-2.29). Incorrect-to-correct answer changes exceeded correct-to-incorrect changes, resulting in a modest net improvement in accuracy.</p><p><strong>Conclusions: </strong>Medical students selectively relied on AI-generated recommendations, particularly when uncertain and when engaging with foundational content. These findings suggest that reliance on AI is context-dependent and highlight the importance of domain-sensitive AI literacy in nephrology education.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":"1158-1164"},"PeriodicalIF":2.6,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148455450","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 autosomal road.","authors":"Tarek Zieneldien","doi":"10.1093/joneph/aajag178","DOIUrl":"10.1093/joneph/aajag178","url":null,"abstract":"","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":"1330"},"PeriodicalIF":2.6,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148818670","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 changes in cardiorenal risk scores after SGLT2 inhibitor initiation in patients with CKD with and without type 2 diabetes.","authors":"Irene Capelli, Daniele Vetrano, Danilo Ribichini, Michele Provenzano, Sasha Albertini, Sabrina Berti, Ilirjana Sanfilippo, Valentina Vicennati, Uberto Pagotto, Gaetano La Manna, Giuseppe Cianciolo","doi":"10.1093/joneph/aajag105","DOIUrl":"10.1093/joneph/aajag105","url":null,"abstract":"<p><strong>Background: </strong>Sodium-glucose cotransporter-2 inhibitors (SGLT2i) have become the standard of care in managing chronic kidney disease (CKD) and heart failure (HF), both in patients with and without type 2 diabetes mellitus (T2DM). Nonetheless, identifying those at persistent high cardiovascular (CV) and renal risk remains critical.</p><p><strong>Methods: </strong>We conducted a retrospective, 1:1 propensity-matched cohort study involving 132 CKD patients (66 with T2D and 66 without). Participants were followed for 12 months after SGLT2i initiation. Cardiovascular and renal risk were assessed using three validated tools-PREVENT, SCORE2 with CKD Add-on (SCORE2-CKD), and Kidney Failure Risk Equation (KFRE)-calculated at baseline and at 12-month follow-up. Changes in risk scores were analyzed, and logistic regression was used to identify predictors of improvement.</p><p><strong>Results: </strong>After 12 months, PREVENT scores declined significantly in the diabetic subgroup (Δ -2.95, P = .001), whereas non-diabetic patients showed no significant change (Δ -0.80, P = .396). SCORE2-CKD also decreased in diabetics (Δ -3.85, 95% CI -4.35 to -3.35, P = .023) but unexpectedly increased in non-diabetic patients (Δ + 3.25, P = .044). Importantly, individuals at higher baseline risk exhibited the most pronounced declines in both PREVENT and SCORE2-CKD. KFRE-derived renal risk decreased significantly in both groups. Across the entire cohort, variation in estimated glomerular filtration rate (eGFR) and proteinuria were independent predictors of CV risk-score improvement.</p><p><strong>Conclusions: </strong>In this real-world CKD cohort, SGLT2 inhibitor initiation was associated with favorable changes in renal risk scores and with changes in cardiovascular risk estimates, particularly among patients with diabetes and at higher baseline risk. These findings should be interpreted as exploratory changes in predicted risk rather than as evidence of reduction in observed cardiovascular events.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":"1246-1256"},"PeriodicalIF":2.6,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148722362","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":"Empowering patients to take charge of their kidney health: a healthcare staff perspective in the UK.","authors":"Naeema A Patel, Alice C Smith, Matthew P M Graham-Brown, Laura Willcocks, Courtney J Lightfoot","doi":"10.1093/joneph/aajag112","DOIUrl":"10.1093/joneph/aajag112","url":null,"abstract":"<p><strong>Background: </strong>Self-management is an essential component in the effective management of people living with chronic kidney disease (CKD). While self-management is part of practice guidelines, there is limited understanding of healthcare professionals' views on self-management and how patient self-management is supported and integrated in everyday clinical practice. This qualitative study explored healthcare professionals' perspectives on self-management in CKD, including current clinical practices and the requirements for providing effective self-management support.</p><p><strong>Methods: </strong>Semi-structured interviews were conducted with a range of healthcare professionals working in the National Health Service (NHS) in the UK. Topics explored perspectives and experiences of self-management support, lifestyle and education in practice. Interviews were audio recorded, transcribed and analysed using thematic analysis to analyse the data and report themes.</p><p><strong>Results: </strong>Forty-two healthcare professionals were interviewed, and four overarching themes were identified. The themes reflected healthcare professionals' perceptions on CKD self-management, which were: (1) \"the problem with the healthcare landscape in CKD self-management\", (2) need for a personalised approach to CKD management, (3) how to improve self--management support resources, and (4) considerations to improve health equity.</p><p><strong>Conclusions: </strong>The healthcare professionals perceived that the healthcare structure within the NHS does not adequately support self-management, with a notable lack of accessible self-management resources, suggesting a need for evidence-based self-management interventions in CKD that are tailored responsively to individual needs. While these findings arise from the UK context, the issues identified are likely to be relevant and applicable to healthcare systems in other countries.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":"1266-1277"},"PeriodicalIF":2.6,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148764755","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":"Page kidney: imaging clues from a spectrum of etiologies; Lessons for the clinical nephrologist.","authors":"Kavitha B Chittaragi, Shweta Raviraj Poojary, Nayan H B, Harshavardhan Guptha M N","doi":"10.1093/joneph/aajag092","DOIUrl":"10.1093/joneph/aajag092","url":null,"abstract":"","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":"1318-1321"},"PeriodicalIF":2.6,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148684721","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}