Journal of Nephrology最新文献

{"title":"Validation and modification of renal risk score for prediction of long-term kidney survival in patients with MPO-ANCA-associated glomerulonephritis.","authors":"Meng Yang, Xia Liu, Yinghua Chen, Xin Chen, Feng Xu, Zhengzhao Liu, Haitao Zhang, Caihong Zeng, Weixin Hu","doi":"10.1007/s40620-024-02134-z","DOIUrl":"https://doi.org/10.1007/s40620-024-02134-z","url":null,"abstract":"<p><strong>Background: </strong>Anti-neutrophil cytoplasmic antibody (ANCA) Renal Risk Score has not been widely validated in Chinese patients with myeloperoxidase -ANCA-associated glomerulonephritis and its predictive ability needs to be improved.</p><p><strong>Methods: </strong>Three hundred and forty patients with biopsy-proven myeloperoxidase-ANCA-associated glomerulonephritis were included in this study. They were divided into an oliguric group (urine volume < 400 ml/24 h) and a non-oliguric group (urine volume ≥ 400 ml/24 h). The ANCA Renal Risk Score and Berden classes were used to predict the risk of end-stage kidney disease (ESKD), and Cox regression analysis was performed to evaluate the impact of oliguria on ESKD risk.</p><p><strong>Results: </strong>The predictive performance of ANCA Renal Risk Score was significantly higher than that of Berden classes (AUC: 0.79 vs. 0.709, P = 0.003). Thirty-six (10.6%) patients presented with oliguria. Patients in the oliguric group had significantly lower levels of baseline estimated glomerular filtration rate (eGFR) [6.51(4.55-7.72) vs. 21.22(11.49-36.63) ml/min/1.73 m², P < 0.001], hemoglobin (78.33 ± 16.75 vs. 92.47 ± 18.95 g/L, P < 0.001), serum albumin (32.01 ± 5.92 vs. 36.22 ± 4.84 g/L, P < 0.001), and a lower percentage of normal glomeruli [6.86(0-17.39)% vs. 18.18(9.09-35)%, P < 0.001]. Consistently, the oliguric group had a higher percentage of patients that progressed to ESKD (83.3% vs. 36.2%, P < 0.001). Multivariate Cox regression analysis showed that oliguria was an independent risk factor for ESKD [HR = 2.38(1.39-4.06), P = 0.002]. Oliguria scores (3 points for presence and 0 for absence) were incorporated into the ANCA Renal Risk Score, resulting in ANCA Renal Risk Score-U. The patients were then categorized into four risk groups: low-(0-2 points), moderate-(3-7 points), high-(8-11 points) and very high-(12-14 points). The incidences of ESKD in these groups were 11.1%, 30%, 72.2% and 95.8%, respectively. The predictive efficacy of ANCA Renal Risk Score-U in predicting ESKD risk was significantly higher than that of the ANCA Renal Risk Score (AUC: 0.812 vs. 0.79, P = 0.025).</p><p><strong>Conclusions: </strong>This study has validated the ANCA Renal Risk Score for predicting kidney outcomes among Chinese patients with myeloperoxidase-ANCA-associated glomerulonephritis. Furthermore, the ANCA Renal Risk Score-U model with oliguria as a variable can further improve the prediction of ESKD risk in patients with myeloperoxidase-ANCA-associated glomerulonephritis.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142687073","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":"Commentary on \"The ABCs of post-preeclampsia out-patient nephrology care: the Le Mans strategy\": perspective of patients' association (Grossesse Santé contre la pré-éclampsie).","authors":"Celine Camilleri","doi":"10.1007/s40620-024-02139-8","DOIUrl":"https://doi.org/10.1007/s40620-024-02139-8","url":null,"abstract":"","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142687065","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 feasibility study for understanding the demand and acceptability of a systematic symptom monitoring process in end-stage kidney disease.","authors":"Laetitia Ricci, Cécile Couchoud, Andreia Carvalho, Marie Buzzi, Francis Guillemin, Carole Ayav","doi":"10.1007/s40620-024-02153-w","DOIUrl":"https://doi.org/10.1007/s40620-024-02153-w","url":null,"abstract":"","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142687063","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":"Post-transplant IgA nephropathy: a rapidly evolving field of kidney transplant medicine.","authors":"Mehmet Kanbay, Lasin Ozbek, Mustafa Guldan, Sidar Copur, Jonathan Barratt","doi":"10.1007/s40620-024-02149-6","DOIUrl":"https://doi.org/10.1007/s40620-024-02149-6","url":null,"abstract":"<p><p>IgA nephropathy is the commonest pattern of primary glomerular disease in the world, with high rates of progression to kidney failure. As IgA nephropathy commonly causes kidney failure at a young age, kidney transplantation is commonly used to treat kidney failure. However, high rates of recurrent disease in the allograft remain a common management challenge. The prevalence of post-transplant recurrence approaches 15% at ten years post-transplant and is associated with poor allograft function and high rates of allograft loss. Post-transplant IgA nephropathy has also been described de novo in some case series. Treatment of recurrent IgA nephropathy has been challenging but with the rapid growth of new treatments for IgA nephropathy it is likely that many of these treatments will, over time, transition to the treatment of recurrent disease. In this narrative review, our aim is to evaluate post-transplant IgA nephropathy in terms of epidemiology, risk factors, underlying pathophysiology, diagnosis and management strategies.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676039","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":"Internet use and health literacy among pediatric chronic kidney disease patients and their caregivers.","authors":"Eleanor Bold, Kelsey L Richardson, Amira Al-Uzri, Sarah F Craven, Kira Clark, Kimberly Grzesek, Seiji Koike, Kurt A Freeman","doi":"10.1007/s40620-024-02136-x","DOIUrl":"10.1007/s40620-024-02136-x","url":null,"abstract":"<p><strong>Background: </strong>Management of pediatric chronic kidney disease (CKD) is complex for affected youth and their families. Treatment requires a high level of family engagement to successfully manage medical appointments, inpatient hospital stays, and daily medication regimens. Health literacy has been identified as a possible contributor to health inequities and unsuccessful chronic disease management. This study sought to explore the perceived health literacy, health-related internet use, and provider trust of children with CKD and their caregivers compared to those without chronic health conditions to inform clinical care.</p><p><strong>Methods: </strong>Caregivers and children completed self-report surveys during routine specialty nephrology and general pediatrics clinic visits. In total, 85 caregivers and 46 youth participated. Statistical analyses included exploration of distributional properties, population differences, and group differences based on self-reported perceived health literacy.</p><p><strong>Results: </strong>Caregiver demographics did not significantly vary across samples. Patient demographics varied significantly across samples with regard to ethnicity. Internet use to find health information was low across samples, and caregivers of children without chronic health conditions endorsed significantly higher perceived health literacy compared to caregivers of children with CKD.</p><p><strong>Conclusions: </strong>Implications for practice include consideration of health literacy when treating children with CKD and patient preparedness for transition to adult care.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142668299","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":"Focal segmental glomerulosclerosis in a native African patient with systemic lupus erythematosus.","authors":"Viviane Queyrel-Moranne, Laurent Daniel, Olivier Moranne","doi":"10.1007/s40620-024-02106-3","DOIUrl":"https://doi.org/10.1007/s40620-024-02106-3","url":null,"abstract":"","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622401","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":"Kidney mRNA-protein expression correlation: what can we learn from the Human Protein Atlas?","authors":"Dianne Acoba, Anna Reznichenko","doi":"10.1007/s40620-024-02126-z","DOIUrl":"https://doi.org/10.1007/s40620-024-02126-z","url":null,"abstract":"<p><strong>Background: </strong>The Human Protein Atlas, with more than 10 million immunohistochemical images showing tissue- and cell-specific protein expression levels and subcellular localization information, is widely used in kidney research. The Human Protein Atlas contains comprehensive data on multi-tissue transcript and protein abundance, allowing for comparisons across tissues. However, while visual and intuitive to interpret, immunohistochemistry is limited by its semi-quantitative nature. This can lead to mismatches in protein expression measurements across different platforms.</p><p><strong>Methods: </strong>We performed a comparison of the Human Protein Atlas' kidney-specific RNA sequencing and immunohistochemistry data to determine whether the mRNA and protein abundance levels are concordant.</p><p><strong>Results: </strong>Our study shows that there is a discordance between mRNA and protein expression in the kidney based on the Human Protein Atlas data. Using an external validation mass spectrometry dataset, we show that more than 500 proteins undetected by immunohistochemistry are robustly measured by mass spectrometry. The Human Protein Atlas transcriptome data, on the other hand, exhibit similar transcript detection levels as other kidney RNA-seq datasets.</p><p><strong>Conclusions: </strong>Discordance in mRNA-protein expression could be due to both biological and technical reasons, such as transcriptional dynamics, translation rates, protein half-lives, and measurement errors. This is further complicated by the heterogeneity of the kidney tissue itself, which can increase the discordance if the cell populations or tissue compartment samples do not match. As such, shedding light on the mRNA-protein relationship of the kidney-specific Human Protein Atlas data can provide context to our scientific inferences on renal gene and protein quantification.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622404","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":"Carotid intima media thickness and glomerular filtration rate: a baseline analysis of the PolyIran-L trial.","authors":"Alireza Dehghan, Ali Ardekani, Mohammadreza Akabri, Yasaman Sadeghi, Amir Reza Radmard, Shahin Merat, Masoud Khoshnia, Maryam Sharafkhah, Abolfazl Shiravi Khuzani, Hossein Poustchi, Reza Malekzadeh, Hossein Molavi Vardanjani","doi":"10.1007/s40620-024-02122-3","DOIUrl":"https://doi.org/10.1007/s40620-024-02122-3","url":null,"abstract":"<p><strong>Background: </strong>The relationship between kidney and vascular health is acknowledged, but detailed information is still missing. This study examines the relationship of estimated glomerular filtration rate (eGFR) and carotid intima media thickness, providing insights into the association between atherosclerosis and kidney function.</p><p><strong>Methods: </strong>Participants older than 50 years of age who were part of the PolyIran-L study, a trial nested in the Golestan Cohort Study, were included. The maximal intima media thickness of both common carotid arteries was evaluated using B-mode ultrasonography. Four different cut-off values for abnormal carotid intima media thickness were considered. Correlation of carotid intima media thickness and eGFR was assessed with linear correlation and multivariable binary logistic regression models after adjusting for several confounders.</p><p><strong>Results: </strong>In total, 1562 participants (750 females, 48%) were included in this population-based study. Assuming the eGFR < 45 [mL/min/1.73 m²] group as reference in the crude analysis, those with eGFR ≥ 45 and < 60 [mL/min/1.73 m²] showed an association of being less likely to have carotid intima media thickness above the 0.8 cutoff. However, the fully adjusted analysis showed no significant statistical association between carotid intima media thickness and eGFR.</p><p><strong>Conclusion: </strong>This study did not support the independent association of eGFR and different carotid intima media thickness cutoffs. This pattern may be different in patients with severely decreased eGFR, a subset of cases in which it should be further investigated.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142622398","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":"Cost effectiveness of difelikefalin for the treatment of patients with chronic kidney disease-associated pruritus undergoing hemodialysis in Italy.","authors":"Lucio Manenti, Andrea Marcellusi, Eugenio Di Brino, Andrea Aiello, Asia Barugolo, Patrizia Berto, Marco Soro","doi":"10.1007/s40620-024-02144-x","DOIUrl":"https://doi.org/10.1007/s40620-024-02144-x","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease (CKD)-associated pruritus is a condition that strongly impacts CKD patients and is associated with increased morbidity/mortality, and worse health-related quality of life (HRQoL). Difelikefalin is currently the only drug approved in Europe specifically for treating moderate to severe CKD-associated pruritus in patients undergoing hemodialysis. The KALM-1 and KALM-2 trials showed better efficacy of difelikefalin vs placebo and best supportive care. The aim of this study was to investigate the cost-effectiveness of difelikefalin according to the Italian National Health Service (NHS) perspective.</p><p><strong>Methods: </strong>A cohort model represented by four health states (No, Mild, Moderate, and Severe pruritus) was adapted to the Italian setting. The model used data from the KALM-1 and -2 trials for efficacy, integrated with other publications for HRQoL estimations. To assess the cost of disease management, a recent Italian publication on CKD-associated pruritus was used and a price of €27 per difelikefalin vial was assumed. The base case analysis over a 15-year time horizon, and an additional 10-year scenario analysis, were established. Additionally, both deterministic univariate analysis and probabilistic multivariate sensitivity analyses were developed. Discount rates of 3% were applied. An acceptability threshold of 40,000 €/quality-adjusted life-year (QALY) was considered.</p><p><strong>Results: </strong>The results show that difelikefalin plus best supportive care is cost-effective vs best supportive care alone, with an incremental cost-effectiveness ratio, in the base case, of €35,823/QALY. Both the scenario and sensitivity analyses confirmed the strength of the results.</p><p><strong>Conclusions: </strong>Difelikefalin was found to be a cost-effective treatment for the Italian NHS. These results support its reimbursement and its inclusion in routine clinical practice.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604784","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":"Improving the sustainability and quality of kidney health care through life cycle assessments, quality improvement, education and technical innovations: the KitNewCare approach.","authors":"Brett Duane, Ingeborg Steinbach, Rachel Stancliffe, Stefi Barna, David Cameron, Ilaria de Barbieri, Edita Noruisiene, Frances Mortimer, Karin Gerritsen, Raymond Vanholder, Gabriele Donati, Gaetano Alfano, Jolanta Malyszko, Giulia Ligabue, Bridget Johnston, Mary Louise Wratten, Marialuisa Caiazzo, Elisabeth Schmid, Alberto Ortiz","doi":"10.1007/s40620-024-02114-3","DOIUrl":"https://doi.org/10.1007/s40620-024-02114-3","url":null,"abstract":"<p><p>The European Union (EU)-funded KitNewCare consortium aims to create and manage a comprehensive EU-wide programme focusing on sustainability in Kidney Care. Around 850 million people have chronic kidney disease (CKD) worldwide and by 2030, 6 million will need kidney replacement therapy, mainly haemodialysis. As the world population gets older, projections for the end of the century worsen. From a sustainability perspective, healthcare systems contribute around 5-11% of total carbon emissions. Kidney care is one of the most resource-intensive specialties. In addition to energy, haemodialysis and peritoneal dialysis require transportation of patients and personnel to and from facilities, use large volumes of water and generate significant plastic waste. Overall, current dialysis is not sustainable in the medium term. Primary prevention, early diagnosis and treatment of CKD and transplantation will decrease the need for dialysis, but this will take time and will not prevent the need for dialysis in millions of persons. There is a need to improve knowledge around the environmental and financial cost of kidney care and social and health outcomes of each patient pathway including using holistic tools such as life cycle assessment. This knowledge will allow workflow optimisations, organisational transformations and technological innovations across Europe, learning from different clinical sites. KitNewCare will build a European-wide knowledge base for sustainability in kidney care, develop and introduce a novel 4-factor database for comprehensive impact analysis, implement optimised processes and organisational transformations in four European clinical sites. It will also pilot innovations from small- and medium-sized high-tech enterprises with a focus on kidney care, and establish a network for continuous monitoring, benchmarking, and implementation of sustainable solutions across healthcare sectors. This paper presents the rationale behind selecting kidney disease as a focal point, summarises the current state of knowledge, and outlines the foundational statement underlying KitNewCare's operational framework.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604789","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}