Journal of Nephrology最新文献

{"title":"Cross-lagged analysis in nephrology.","authors":"Carmine Zoccali, Giovanni Tripepi, Graziella D'Arrigo","doi":"10.1007/s40620-025-02319-0","DOIUrl":"https://doi.org/10.1007/s40620-025-02319-0","url":null,"abstract":"<p><p>Cross-lagged analysis is a statistical method employed to examine directional relationships between variables over time, making it especially valuable for addressing causality challenges in clinical research. This method is essential for comprehending complex bidirectional relationships, such as stress and immunity, dietary habits and metabolic conditions, or medication adherence and health outcomes. By analyzing longitudinal data, cross-lagged analysis establishes temporal precedence, tests reciprocal influences, and controls for confounding variables, thereby enhancing causal inferences. In nephrology, this approach can be beneficial for studying the interaction between acute kidney injury (AKI) and chronic kidney disease (CKD), clarifying whether AKI episodes accelerate CKD progression or if pre-existing CKD increases susceptibility to AKI. It also illuminates the relationship between CKD and cardiovascular diseases, investigating whether CKD exacerbates heart failure or vice versa while considering shared risk factors like hypertension and diabetes. Furthermore, cross-lagged analysis can elucidate the kidney-brain connection by examining whether CKD leads to cognitive decline through mechanisms such as uremic toxin accumulation or if neurological dysfunction worsens kidney outcomes through sympathetic overactivation. Cross-lagged analysis accommodates latent variables and measurement errors, allowing researchers to explore how variables interact over time. This method provides a strong framework for understanding dynamic relationships in nephrology, offering critical insights to guide interventions and advance knowledge of disease progression mechanisms.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144285026","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 uptake of an antigen-based approach to membranous nephropathy: a survey of general nephrologists and glomerular disease experts.","authors":"Eibhlin Goggins, Andrew DeLaat, Bryce Barr, Jonathan Taliercio, Ali Mehdi, Georges Nakhoul, Brendan Bowman, Corey Cavanaugh","doi":"10.1007/s40620-025-02313-6","DOIUrl":"https://doi.org/10.1007/s40620-025-02313-6","url":null,"abstract":"<p><strong>Background: </strong>In recent years, there has been an emergence of new antigens discovered in membranous nephropathy (MN). Whether these antigens have impacted the approach to, and management of, MN patients undertaken by nephrologists is still unclear.</p><p><strong>Methods: </strong>We conducted a cross-sectional international survey pertaining to 13 antigens recently discovered in MN. The survey was distributed by the National Kidney Foundation, direct emails, and social media.</p><p><strong>Result: </strong>PLA2R, THSD7A, NELL1, and EXT1/2 testing were readily available while the most common response for other antigen testing was 'Not Performed' or 'Unknown'. All respondents had tested for or treated PLA2R-positive MN. Of 79 respondents, only 12.7% had treated THSD7A, 15.2% for NELL1 and 6.3% for EXT1/2 positive MN. For PLA2R, THSD7A, and NELL1, a majority chose rituximab (75.4, 87.5, and 80.0%, respectively) as initial treatment, and would treat with immunosuppression before completing 6 months of conservative therapy. A majority of respondents would routinely or occasionally omit a kidney biopsy in the setting of positive serum anti-PLA2R antibodies, however, 27.5% would rarely do so. There was no clear consensus across respondents regarding the use of anti-PLA2R serum levels in determining remission.</p><p><strong>Conclusion: </strong>Although many new MN antigens have been discovered, there is limited availability of tests identifying these less common antigens. While the survey suggests potential for utilization of an antigen-tailored approach based on identified differences in screening and treatment practices, there remains a lag in the full adoption of this new information. Further progress in accessibility of antigen testing and research into antigen associations will enable a more individualized approach to the management of MN.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275065","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":"Correction: Residual kidney function modifies the effect of cinacalcet on serum phosphorus levels among peritoneal dialysis patients.","authors":"Miho Murashima, Naohiko Fujii, Shunsuke Goto, Takeshi Hasegawa, Masanori Abe, Norio Hanafusa, Masafumi Fukagawa, Takayuki Hamano","doi":"10.1007/s40620-025-02333-2","DOIUrl":"https://doi.org/10.1007/s40620-025-02333-2","url":null,"abstract":"","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258286","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: unilateral renal artery stenosis presenting with hyponatremic hypertensive syndrome and posterior reversible encephalopathy syndrome in a child.","authors":"Muhammad Adel Sayed, Mohamed Ezzat Al Ghwass, Ashraf Sayed Kamel, Remon Magdy Yousef Awad","doi":"10.1007/s40620-025-02320-7","DOIUrl":"https://doi.org/10.1007/s40620-025-02320-7","url":null,"abstract":"","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258287","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":"Prevalence and risk factors of chronic kidney disease of unknown etiology in Northeast Thailand.","authors":"Ubon Cha'on, Adisorn Aranyapal, Sunee Lertsinudom, Deanpen Japrung, Weerakanya Maneeprakorn, Panibud Wongprommek, Thanachai Panaput, Richard J Johnson, Jared M Brown, Carlos A Roncal-Jimenez, Chagriya Kitiyakara, Chalida Aphinives, Amod Sharma, Sirirat Anutrakulchai","doi":"10.1007/s40620-025-02302-9","DOIUrl":"https://doi.org/10.1007/s40620-025-02302-9","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease of unknown etiology (CKDu) has been reported mainly in agricultural communities, in hot and humid climates, but whether this is occurring in Thailand has not been fully documented. The prevalence of CKD is higher in Northeast Thailand compared to other parts of the country and this region is hot, tropical, and agriculturally based. Therefore, we evaluated the prevalence of CKDu determined by various criteria and the associated risk factors of CKDu in this region.</p><p><strong>Methods: </strong>A population-based survey was conducted in rural sub-districts between 2017-2019 in which blood and urine samples were collected for determination of CKD, and ultrasonography was performed to evaluate for renal structural abnormalities. Public and household water were analyzed for contaminants: sixteen samples of water within the study area, encompassing natural untreated surface water sources, shallow groundwater, and locally produced tap water were collected for physical and chemical analyses based on the guidelines for drinking-water quality, as recommended by the World Health Organization (WHO) in 2011. The mandatory criteria were: suspected CKDu one time measurement CKDu1: eGFR < 60 mL/min, CKDu2: eGFR < 60 mL/min and dipstick protein ≤ 1 +, in the absence of evidence of other kidney diseases or diabetes. Further assessment included: Repeat assessment after 12 weeks, confirmed one or more of; - eGFR < 60 ml/min/1.73 m², Albuminuria ≥ 30 mg/g Cr, Hematuria > 3 RBCs/high power field. Ultrasound criteria were confirmed parenchymatous change without other structural abnormalities, assessed by two radiologists.</p><p><strong>Results: </strong>The prevalence of CKD was 26.85% in the study population (n = 2205) including 6.26% of unknown etiology. The percentages of probable or possible CKDu in participants aged ≤ 70 years as assessed by different criteria were 5.48% (this study criterion); 4.27% (Sri Lanka 2018 criterion); 2.53% (India 2017 criterion) and 1.48% (Mesoamerican 2020 criterion). CKDu was significantly associated with age, male sex, increase in serum uric acid and leukocyte count, decrease in hemoglobin, and consumption of groundwater contaminated with potential nephrotoxins (such as cadmium, lead, fluoride, and glyphosate). The analysis of the 16 water samples revealed that 14 (from natural surface water, shallow groundwater and locally produced tap water) contained heavy metals exceeding the standard limits.</p><p><strong>Conclusions: </strong>CKDu is present in rural northeastern Thailand. The observation of a link with groundwater contaminated with cadmium, lead, fluoride and glyphosate should be further investigated.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258288","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":"Assessing the reliability of self-reported home blood pressure measurements in dialysis patients.","authors":"Rodrigo Bezerra, Audes D M Feitosa, Romero Barbosa, Filipe C Aguiar, Rogerio H Passos, Ana F Moura, José A Moura-Neto, Andrei C Sposito, Wilson Nadruz","doi":"10.1007/s40620-025-02324-3","DOIUrl":"https://doi.org/10.1007/s40620-025-02324-3","url":null,"abstract":"","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258285","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":"Global change through regional policy-green nephrology in action.","authors":"Jane Waugh, Andrew J Mallett","doi":"10.1007/s40620-025-02323-4","DOIUrl":"https://doi.org/10.1007/s40620-025-02323-4","url":null,"abstract":"","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225741","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":"Primary hyperoxaluria type 1 diagnosis in adult dialysis patients: prediction model assessment in a group of Italian patients.","authors":"Pietro Manuel Ferraro, Eloisa Arbustini, Diego Bellino, Chiara Caletti, Irene Capelli, Giovanna Capolongo, Maria Rosa Caruso, Paola Cianfrone, Maria Michela D'Alessandro, Marina Di Luca, Giovanni Gambaro, Alessandra Palmisano, Andrea Ranghino, Gaia Santagostino Barbone, Francesca Viazzi, Loretta Zambianchi, Giorgia Mandrile","doi":"10.1007/s40620-025-02243-3","DOIUrl":"https://doi.org/10.1007/s40620-025-02243-3","url":null,"abstract":"<p><strong>Background: </strong>To increase the diagnostic rate of primary hyperoxaluria type 1 (PH1) in the adult dialysis setting, a prediction model based on five readily available clinical parameters was recently developed and validated in an adult hemodialysis population. To further test the prediction model in clinical practice, this case series describes the retrospective application of the diagnostic algorithm in a group of adult dialysis patients with PH1 treated at different Italian nephrology centers.</p><p><strong>Methods: </strong>Between January and May 2023, adult patients (≥ 18 years) undergoing chronic hemodialysis with a genetic diagnosis of PH1, followed at 14 Italian nephrology centers, were selected for the retrospective application of the prediction model.</p><p><strong>Results: </strong>The presence of at least one red flag of the diagnostic algorithm was reported in most patients (14 out of 15; 93%), two red flags were present in four patients (27%), and three red flags in two patients (13%). A history of active nephrolithiasis was the most common clinical feature (87% of patients), followed by early dialysis initiation, nephrocalcinosis and a family history of CKD (20-27%).</p><p><strong>Conclusions: </strong>Our study provides further evidence on the real-world application of a simple algorithm, implemented by easily accessible clinical parameters, to be used as a screening tool for diagnosing PH1 in adult patients undergoing dialysis. The successful implementation of this prediction model has the potential to facilitate timely diagnosis, improve patient outcomes, and inform targeted therapeutic interventions in this patient setting.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144216144","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":"Lesson for the clinical nephrologist: IgA vasculitis as a paraneoplastic syndrome in a patient with sigmoid adenocarcinoma.","authors":"Jaslyn J L Gan, Chii Yang Kuah, Candice Roufosse, Neill Duncan","doi":"10.1007/s40620-025-02322-5","DOIUrl":"https://doi.org/10.1007/s40620-025-02322-5","url":null,"abstract":"","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144216143","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":"Urine-derived renal tubular epithelial cells resemble functional characteristics of professional antigen-presenting cells and can directly induce BKV-specific T cell responses.","authors":"Toralf Roch, Krystallenia Paniskaki, Patrizia Wehler, Constantin J Thieme, Hanieh Moradian, Arturo Blazquez-Navarro, Moritz Anft, Petra Reinke, Timm H Westhoff, Ulrik Stervbo, Nina Babel","doi":"10.1007/s40620-025-02298-2","DOIUrl":"https://doi.org/10.1007/s40620-025-02298-2","url":null,"abstract":"<p><strong>Background: </strong>Reactivation of the BK virus (BKV) is a critical adverse event after kidney transplantation and can lead to graft loss. BKV-reactive T cell-mediated viral control can be facilitated by reducing immunosuppression. However, the exact mechanism underlying the T cell-mediated BKV clearance in the kidney transplant is not clear.</p><p><strong>Methods: </strong>Here, we used urine-derived renal tubular epithelial cells as a model system to investigate the immunomodulatory capacity of urine-derived renal tubular epithelial cells and their potential to induce T cell responses against BKV. Urine-derived renal tubular epithelial cells were generated by culturing urine-derived cell pellets. To assess the inflammatory potential of urine-derived renal tubular epithelial cells, the cells were treated with Poly I:C or TNFα/IFNγ. To investigate urine-derived renal tubular epithelial cell-induced T cell responses, autologous T cells, isolated from blood were co-cultured with urine-derived renal tubular epithelial cells, in the presence of BKV protein-derived peptides and PolyI:C or TNFα/IFNγ. BKV-reactive T cells, cytokine/chemokine secretion and expression of co-stimulatory molecules were evaluated using multiplex assays and multi-parameter flow cytometry.</p><p><strong>Results: </strong>Urine-derived renal tubular epithelial cells phenotypically resemble renal tubular epithelial cells, as they express CD13, EPCAM, cytokeratin and the myo-inositol oxygenase. After stimulation with PolyI:C, urine-derived renal tubular epithelial cells showed increased levels of CD40 and HLA-ABC, whereas TNFα/IFNγ only induced HLA-DR/ABC expression. Poly I:C and TNFα/IFNγ stimulation of urine-derived renal tubular epithelial cells induced a district pattern of inflammatory cytokines and chemokines that facilitate the migration of certain immune cell subsets. Interestingly, urine-derived renal tubular epithelial cells can present BKV peptides, thereby inducing a functional BKV-reactive CD4 and CD8 T cell response.</p><p><strong>Conclusions: </strong>Urine-derived renal tubular epithelial cells express immunomodulatory molecules, and induce BKV-directed T cell reactivity, indicating that renal epithelial cells may serve as non-conventional antigen-presenting cells in the kidney and thereby help BKV clearance.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144216145","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}