Journal of Nephrology最新文献

{"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}

{"title":"The impact of a secondary, rare, non-pathogenic PKD1 variant on disease progression in autosomal dominant polycystic kidney disease.","authors":"Elhussein A E Elhassan, Kane E Collins, Sophia Heneghan, Edmund Gilbert, Hana Yang, Sarah R Senum, Rachel S Schauer, Doaa E Elbarougy, Stephen F Madden, Susan L Murray, Omid Sadeghi-Alavijeh, Joshua Carmichael, Daniel Gale, Shohdan M Osman, Claire Kennedy, Matthew D Griffin, Liam Casserly, Brona Moloney, Paul O'Hara, Amali Mallawaarachchi, Francesca Ciurli, Claudio Graziano, Constantin A Wolff, Ria Schönauer, Gaetano LaManna, Axelle Durand, Sophie Limou, Jan Halbritter, Irene Capelli, Emma McCann, Peter C Harris, Gianpiero L Cavalleri, Katherine A Benson, Peter J Conlon","doi":"10.1007/s40620-025-02211-x","DOIUrl":"https://doi.org/10.1007/s40620-025-02211-x","url":null,"abstract":"<p><strong>Background: </strong>Autosomal dominant polycystic kidney disease (ADPKD) is caused primarily by pathogenic variants in the PKD1 and PKD2 genes. Although the type of ADPKD variant can influence disease severity, rare, hypomorphic PKD1 variants have also been reported to modify disease severity or cause biallelic ADPKD. This study examines whether rare, additional, potentially protein-altering, non-pathogenic PKD1 variants contribute to ADPKD phenotypic outcomes.</p><p><strong>Methods: </strong>We investigated the prevalence of rare, additional, potentially protein-altering PKD1 variants in patients with PKD1-associated ADPKD. The association between rare, additional, potentially protein-altering variants and phenotypic outcomes, including progression to kidney failure, age at onset of hypertension and urological events, height-adjusted total kidney volume, and predicting renal outcomes in PKD (PROPKD) score, were examined.</p><p><strong>Results: </strong>Rare, additional, potentially protein-altering variants were detected in 6% of the 932 ADPKD patients in the study. The presence of rare, additional, potentially protein-altering variants was associated with 4 years earlier progression to kidney failure (hazard ratio (HR): 1.66; 95% confidence interval (CI): 1.18-2.34; P = 0.003), with in-trans rare, additional, potentially protein-altering variants (n = 13/894) showing a greater risk of kidney failure (HR: 1.83; 95% CI 1.00-3.33; P = 0.049). We did not detect statistically significant differences between rare, additional, potentially protein-altering variants and other phenotypic outcomes compared to those without rare, additional, potentially protein-altering variants.</p><p><strong>Conclusions: </strong>In patients with PKD1-associated ADPKD, our findings suggest that rare, additional, potentially protein-altering variants in PKD1 may influence disease severity. These findings have potential clinical implications in counselling and treating patients with rare, additional, potentially protein-altering variants, but further investigation of such variants in larger, longitudinal cohorts with detailed, standardised phenotype data is required.</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":"143066235","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":"Phenotypic outcomes of PKD1 compared with non-PKD1 genetically confirmed autosomal dominant polycystic kidney disease.","authors":"Elhussein A E Elhassan, Darragh O'Donoghue, Sophia Heneghan, Omri Teltsh, Sahin Sarihan, Shohdan M Osman, Michelle Clince, David Synnott, Sophie Craig, Amy Hudson, Brendan Doyle, David Lappin, Donal J Sexton, Liam Casserly, John Holian, Colm Magee, Mark Denton, Clodagh Sweeney, Atif Awan, Emma McCann, Gianpiero L Cavalleri, Katherine A Benson, Peter J Conlon","doi":"10.1007/s40620-024-02184-3","DOIUrl":"https://doi.org/10.1007/s40620-024-02184-3","url":null,"abstract":"<p><strong>Background: </strong>Autosomal Dominant Polycystic Kidney Disease (ADPKD) represents the most common monogenic cause of kidney failure. While identifying genetic variants predicts disease progression, characterization of recently described ADPKD-like variants is limited. We explored disease progression and genetic spectrum of genetically-confirmed ADPKD families with PKD1 and non-PKD1 variants.</p><p><strong>Methods: </strong>In this observational study, we evaluated the clinical (ADPKD-related complications, estimated glomerular filtration rate (eGFR) decline, and progression to kidney failure), radiological (height-adjusted total kidney volume (ht-TKV)), and genetic characteristics of ADPKD families referred to the Irish Kidney Gene Project. Logistic regression and Kaplan-Meier analyses examined relationships between genetic variants and disease progression.</p><p><strong>Results: </strong>Genomic sequencing was performed on 261 ADPKD families, and 75.8% (198/261 families, comprising 391 individuals) were identified to harbor pathogenic/likely pathogenic variants; 74.2% (147/198) PKD1 families and 23.2% (46/198) non-PKD1 families, which include PKD2 (n = 29 families), IFT140 variants (n = 4), ALG5, DNAJB11 and NEK8 (n = 3 each), ALG8 and ALG9 variants (n = 2 each). The remaining 2.6% (5/198) accounted for non-ADPKD variants. Compared to PKD1, non-PKD1 families were characterized by a milder phenotype; milder eGFR decline (- 1.4 mL/min/1.73m²/year vs. - 3.2; p < 0.001), smaller ht-TKV (449.7 mL/m vs. 1769; p 0.002) and a delayed progression towards kidney failure (73 vs. 52 years; HR: 0.12, p < 0.001 [95% CI: 0.07-0.19]). ADPKD-NEK8 heterozygotes demonstrated earlier progression to kidney failure (average age 8 vs. 49 years for PKD1; Bonferroni-corrected p 0.017).</p><p><strong>Conclusion: </strong>Non-PKD1 variants have heterogeneous phenotypic and genotypic attributes resulting in milder disease, although ADPKD-NEK8 is an important exception with early progression.</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":"143066115","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 role of education level on climate change belief, concern and action: a multinational survey of healthcare professionals in nephrology.","authors":"Shaifali Sandal, Ugochi Onu, Winston Fung, Maria Pippias, Brendan Smyth, Letizia De Chiara, Divya Bajpai, Workagegnehu Hailu Bilchut, Ehab Hafiz, Dearbhla M Kelly, Peace Bagasha, Vivekanand Jha, Isabelle Ethier","doi":"10.1007/s40620-024-02195-0","DOIUrl":"https://doi.org/10.1007/s40620-024-02195-0","url":null,"abstract":"<p><strong>Background: </strong>Climate change poses a significant risk to kidney health, and countries with lower national wealth are more vulnerable. Yet, citizens from lower-income countries demonstrate less concern for climate change than those from higher-income countries. Education is a key covariate. To examine its role in explaining this perception gap, we obtained the perspectives of a highly educated cohort of healthcare professionals.</p><p><strong>Methods: </strong>This was a cross-sectional survey of healthcare professionals involved in kidney care. Responses were compared by the income level of the participant's country (per World Bank).</p><p><strong>Results: </strong>Of the 849 healthcare professionals from 107 countries (63.4% from lower and middle-income countries) that participated, most believed climate change was happening (97.9%), displayed a high level of concern (73.3%), and took personal action to combat climate change (62.0%). While the proportion who believed in climate change did not vary by income level (high:98.1%, upper-middle:97.2%, lower-middle:97.8%, low:100%, p = 0.73), the proportion with a higher level of concern (high:80.7%, upper-middle:74.9%, lower-middle:67.5%, low:53.8%, p < 0.001), and who took climate action (high:76.2%, upper-middle:63.1%, lower-middle:51.2%, low:30.8%, p < 0.001) decreased by national wealth. Barriers to involvement in sustainable kidney care were lack of time (54.4%), knowledge (39.7%), and peer support (30.3%). Only 34.0% were aware of national mitigation plans and barriers related to finances, technologies, tools, methods, research, and evidence were perceived as greater obstacles in lower-income countries.</p><p><strong>Conclusions: </strong>Our results highlight that predictors and correlates of climate change risk perception vary across countries. Education alone is unlikely to increase individual and group engagement in climate change. A better understanding of these factors can inform strategies towards climate action in different settings.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059352","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":"Tackling chronic kidney disease in Nepal: from evidence to action.","authors":"Shiva Raj Mishra, Suresh Mehata, Vishnu Khanal, Nipun Shrestha","doi":"10.1007/s40620-024-02200-6","DOIUrl":"https://doi.org/10.1007/s40620-024-02200-6","url":null,"abstract":"<p><p>Chronic kidney disease (CKD) poses a significant burden in Nepal. We reviewed the epidemiology of CKD in Nepal and proposed strategies to mitigate its burden. A nationwide survey of non-communicable diseases in 2019 reported CKD prevalence of 6.2% (95% Confidence Interval [CI]: 5.7-6.6%). Further, we found that the age-standardized prevalence of chronic kidney disease in Nepal grew by 0.11% (95% uncertainty interval, [UI]: 0.10-0.11%) per annum between 1990 and 2021. Despite the high burden (10,887.7 prevalent CKD per 100,000 population), the country only has 56 nephrologists and 60 hemodialysis centers, the majority of which are located in the country's capital, serving only 15% of the population. CKD requires multi-component interventions that address the diverse causes and pathological expressions of the disease. Integrating interventions across the care continuum, such as health education and literacy, screening, lifestyle modifications, and improved access to renal replacement therapies, can enhance effective coverage and scalability of care. Additionally, it is crucial to explore and address disparities in access to CKD treatment, including gender and socioeconomic disparities.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059354","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":"Psoas muscle gauge and adverse clinical outcomes in patients on hemodialysis.","authors":"Takahiro Yajima, Maiko Arao","doi":"10.1007/s40620-024-02191-4","DOIUrl":"https://doi.org/10.1007/s40620-024-02191-4","url":null,"abstract":"<p><strong>Background: </strong>The relationship between the psoas muscle gauge (PMG), a combined sarcopenia indicator obtained from psoas muscle index (PMI) and psoas muscle density (PMD), and adverse clinical outcomes in patients on hemodialysis remains unclear. We examined whether psoas muscle gauge could predict all-cause mortality and new cardiovascular events more accurately than psoas muscle index in these patients.</p><p><strong>Methods: </strong>We retrospectively included 217 hemodialysis patients who underwent abdominal computed tomography. We calculated the psoas muscle gauge (arbitrary unit [AU]) at the fourth lumbar vertebra level as follows: PMI (cm²/m²) × PMD (Hounsfield units). We categorized the patients into higher and lower psoas muscle gauge groups based on sex-specific cutoffs obtained from the young Asian population. The outcomes were death and new cardiovascular events.</p><p><strong>Results: </strong>The psoas muscle gauge cutoffs were set at 231.1 and 328.8 AU in women and men, respectively. Eighty-five deaths and 95 new cardiovascular events occurred during the follow-up period of 4.4 (2.4-7.3) years. The 5-year survival rates were 59.2% and 94.9% in the lower and higher psoas muscle gauge groups, respectively (p < 0.0001). Moreover, after adjusting for sex and age, history of cardiovascular disease, C-reactive protein, modified creatinine index, and geriatric nutritional risk index, lower psoas muscle gauge was independently associated with increased all-cause death and new cardiovascular events (adjusted hazard ratio (aHR) 7.65; 95% confidence interval (CI) 2.37-24.66 and aHR 2.98; 95% CI 1.54-5.75, respectively). The concordance index (C-index) for predicting all-cause mortality and new cardiovascular events significantly improved when either psoas muscle index or psoas muscle gauge were added to the baseline risk model. Additionally, the C-index of the psoas muscle gauge-added model was significantly higher than that of the psoas muscle index-added model (0.815 vs. 0.784, p = 0.026) only when predicting all-cause mortality.</p><p><strong>Conclusions: </strong>Psoas muscle gauge accurately predicted the risk of all-cause mortality and new cardiovascular events in patients undergoing hemodialysis. For predicting all-cause mortality, psoas muscle gauge may be recommended compared to psoas muscle index.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052827","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":"A period prevalence study of palliative care need and provision in adult patients attending hospital-based dialysis units.","authors":"Alannah L Cooper, Natalie Panizza, Rebecca Bartlett, Dipna Martin-Robins, Janie A Brown","doi":"10.1007/s40620-024-02193-2","DOIUrl":"https://doi.org/10.1007/s40620-024-02193-2","url":null,"abstract":"<p><strong>Background: </strong>Advanced chronic kidney disease is a life-limiting disease that is known to benefit from palliative care. Unmet palliative care need in patients with kidney failure is commonly reported but the level of need among patients receiving haemodialysis is unknown.</p><p><strong>Methods: </strong>A period prevalence study of adult patients attending two hospital-based dialysis units was conducted. Patient medical records were reviewed using the Gold Standards Framework Proactive Indication Guidance to assess for potential palliative care need.</p><p><strong>Results: </strong>A total of 128 patient medical records were reviewed, 45% (n = 58) of patients could have potentially benefitted from palliative care. Of the patients with indicators for palliative care, 72% (n = 42) had no evidence of receiving or awaiting any form of palliative care. High levels of palliative care need were found in patients who identified as Aboriginal or Torres Strait Islander and non-Indigenous patients.</p><p><strong>Conclusions: </strong>This study found high levels of palliative care need among adult patients attending hospital-based dialysis units. The majority of patients with indicators were not receiving any form of palliative care.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047123","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":"Reno-protective effects of xanthine oxidase inhibitors in patients with type 2 diabetes and chronic kidney disease: a systematic review and meta-analysis.","authors":"Chiwon Choi, Myeong Gyu Kim, Jae Hyun Kim","doi":"10.1007/s40620-024-02199-w","DOIUrl":"https://doi.org/10.1007/s40620-024-02199-w","url":null,"abstract":"<p><strong>Background: </strong>The effect of lowering uric acid levels on renal function in patients with diabetic kidney disease remains unclear. Previous randomized controlled trials (RCTs) have reported conflicting results regarding the effects of xanthine oxidase inhibitors on renal function. This study aimed to examine the renoprotective effects of xanthine oxidase inhibitors (febuxostat and topiroxostat) in patients with diabetic kidney disease.</p><p><strong>Methods: </strong>Relevant RCTs were searched using PubMed, Embase, and Cochrane Central databases. Ultimately, five RCTs were included in the meta-analysis. The assessed renal endpoints included changes in the estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio. The meta-analysis was conducted using Review Manager version 5.4. Standardized mean differences (SMDs) and 95% confidence intervals (CIs) were calculated for changes in renal endpoints between the groups after the study period. A subgroup analysis was conducted based on the type of intervention, results of the risk of bias assessment, and baseline renal function.</p><p><strong>Results: </strong>Although the use of febuxostat or topiroxostat did not induce a significant change in eGFR compared with the placebo, it showed a tendency to delay renal function decline (SMD = 0.32, 95% CI = [- 0.00; 0.64]). There was no significant difference in albuminuria between the two groups (SMD = 0.26, 95% CI = [- 0.10; 0.62]).</p><p><strong>Conclusions: </strong>This study suggests the potential of febuxostat or topiroxostat to delay renal function decline in patients with diabetes and underlying renal impairment, that needs to be confirmed in further studies.</p><p><strong>Trial registration: </strong>INPLASY registration number 202450024.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047042","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":"Effectiveness of rehabilitation in hospitalized hemodialysis patients as compared with rehabilitation in hospitalized patients not on hemodialysis: a retrospective cohort study.","authors":"Ren Takahashi, Hiroki Yabe, Hideaki Ishikawa, Takashi Hibino, Akio Suzumura, Tetsuya Yamada","doi":"10.1007/s40620-024-02192-3","DOIUrl":"https://doi.org/10.1007/s40620-024-02192-3","url":null,"abstract":"<p><strong>Background: </strong>The effectiveness of rehabilitation aimed at improving the activities of daily living and physical functions may differ between hospitalized patients undergoing hemodialysis (HD) and not undergoing HD (non-HD). The aim of the present study was to compare the outcomes of rehabilitation between hospitalized HD and non-HD patients.</p><p><strong>Methods: </strong>This was a retrospective cohort study of inpatients who underwent rehabilitation. We measured the rehabilitation time (min/day), length of hospital stay (days), and the Barthel index (BI). In addition, at the time of admission and discharge, grip strength, isometric knee extension strength, 10 m walking speed, timed up and go test, and short physical performance battery were examined. The outcomes were then compared between the HD and non-HD groups.</p><p><strong>Results: </strong>This study was made up of 902 patients (non-HD group: 765, HD group: 137). Our analysis revealed a lower rehabilitation time [43.3 (0.6) vs. 38.8 (1.2) min/day] and longer hospital stay [48.5 (0.5) vs. 58.1 (2.3) days] in the HD group as compared with the non-HD group (p < 0.05). In addition, the 10 m walking speed [0.75 (0.02) vs. 0.66 (0.03) m/s], timed up and go test [20.8 (0.7) vs. 24.3 (1.0) sec], and short physical performance battery [6.3 (0.6) vs. 4.7 (0.6) points] at discharge were also significantly lower in the HD group as compared with the non-HD group (p < 0.05).</p><p><strong>Conclusion: </strong>Rehabilitation efforts for HD patients need to be improved by securing more time for inpatient rehabilitation and promoting mobility function improvement for these patients.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023648","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":"Co-occurrence of exercise-induced acute kidney injury and rhabdomyolysis in a holding cell at a police station: a case report.","authors":"Ryuta Uwatoko, Hideo Mori, Kayo Ueda, Rei Iio","doi":"10.1007/s40620-024-02186-1","DOIUrl":"https://doi.org/10.1007/s40620-024-02186-1","url":null,"abstract":"<p><p>We present a rare case of a patient with co-occurring exercise-induced acute kidney injury (AKI) and rhabdomyolysis. A 67-year-old man was referred to our department with AKI. Five days before referral, the patient had sudden-onset loin pain while banging and kicking on a door in a holding cell at a police station. Diffusion-weighted magnetic resonance imaging showed wedge-shaped areas of signal hyperintensity in both kidneys. Serum and urinary myoglobin levels were mildly elevated. Kidney biopsy showed cellular injury of the tubular epithelial cells and myoglobin casts in the tubules. The patient was diagnosed with exercise-induced AKI and mild rhabdomyolysis and was treated conservatively. His kidney function improved gradually with no need for hemodialysis. This case report exhibits a unique presentation of the co-occurrence of exercise-induced AKI and rhabdomyolysis after intense anaerobic and aerobic exercise. To the best of our knowledge, this is the first report to pathologically demonstrate co-occurring exercise-induced AKI and rhabdomyolysis.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023640","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}