Journal of Nephrology最新文献

{"title":"Total kidney volume as a predictor of measured glomerular filtration rate in patients with solid tumors: a prospective cross-sectional analysis.","authors":"Regis Otaviano Franca Bezerra, Fernando Louzada Strufaldi, Patricia Perola Dantas, Filipe Andrade, Renato A Caires, Elerson Carlos Costalonga, George Barbério Coura Filho, Luiz A Gil, Marcelo Tatit Sapienza, Giovanni Guido Cerri, Emmanuel A Burdmann, Veronica Torres Costa E Silva","doi":"10.1007/s40620-025-02231-7","DOIUrl":"https://doi.org/10.1007/s40620-025-02231-7","url":null,"abstract":"<p><strong>Background: </strong>Although previous data demonstrate that total kidney volume (TKV) correlates with measured glomerular filtration rate (mGFR), evidence is however scarce in the oncology setting. The aim of this is study is to evaluate whether adding TKV to the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) estimating equations improves the prediction of measured glomerular filtration rate (mGFR) in patients with cancer.</p><p><strong>Methods: </strong>We evaluated patients with solid tumors between April 2015 and September 2017 who had undergone contrast computed tomography and GFR measurement through the plasma clearance of ⁵¹Cr-EDTA. Estimated GFR (eGFR) was determined through CKD-EPI equations based on serum creatinine (eGFRcr) and combined with serum cystatin C (eGFRcr-cys). We used the 2009 eGFRcr and 2012 eGFRcr-cys equations and the race-free 2021 eGFRcr, and eGFRcr-cys. TKV was measured using a semi-automatic segmentation program, excluding non-functional tissues. Linear regression models were built, with TKV and eGFR equations as predictors and mGFR as the outcome.</p><p><strong>Results: </strong>We included 189 patients (median age 58.0 [48.0-65.0] years, 49.2% male). Median mGFR and TKV were 82.7 (66.3-94.5) mL/min and 303.1 (257.7-351.8) cm³, respectively. TKV improved the coefficient of determination (R²) when added to 2009 eGFRcr and 2012 eGFRcr-cys equations from 0.62 to 0.73 and 0.73 to 0.80, respectively. For the 2021 eGFRcr and eGFRcr-cys equations, R² improved from 0.65 to 0.75 and 0.75 to 0.82, respectively.</p><p><strong>Conclusion: </strong>These results suggest that TKV measurement improves the prediction of mGFR in association with the CKD-EPI equations in patients with solid tumors.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025258","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":"Ketogenic diets in chronic kidney disease patients: a review for skeptics by skeptics.","authors":"Claudia D'Alessandro, Domenico Giannese, Giorgina Barbara Piccoli, Vincenzo Panichi, Adamasco Cupisti","doi":"10.1007/s40620-025-02285-7","DOIUrl":"https://doi.org/10.1007/s40620-025-02285-7","url":null,"abstract":"<p><p>Over the last few decades, there has been growing interest in the use of ketogenic diets, mainly as a weight loss strategy. Obesity and diabetes are major risk factors for kidney disease, and obese patients with chronic kidney disease (CKD) are potential candidates for weight reducing diets, among them ketogenic diets. Of further relevance to nephrology, a limited number of recent studies suggests a favorable effect of ketogenic diets in patients affected by autosomal dominant polycystic kidney disease (ADPKD). However, concerns remain about safety in patients with CKD, particularly in the long term and in those with poor residual kidney function. The confusion surrounding the definition of ketogenic diets adds to these concerns. The aim of this review is to summarize information on the main types of ketogenic diets used in daily practice and to discuss the options for their implementation in CKD patients, limiting ultra-processed or industrial preparations.Although further studies are needed to identify the profile of CKD patients who may benefit from the implementation of ketogenic diets to treat obesity or slow the progression of ADPKD, and to assess short- and long-term safety and adherence, the available data appear promising. This critical review is intended to stimulate further research.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143986732","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":"Beyond the gift: exploring mental health and quality of life after kidney donation in a resource limited country.","authors":"Muhammad Junaid Tahir, Zoha Aftab, Zahid Nabi","doi":"10.1007/s40620-025-02217-5","DOIUrl":"https://doi.org/10.1007/s40620-025-02217-5","url":null,"abstract":"<p><strong>Background: </strong>Kidney transplant is a life changing treatment. It improves the quality of life and ideally restores the kidney function of recipients. However, it also poses challenges, especially for the donors. Pakistan is a resource-limited country and donors have to face some specific social and cultural challenges. Knowledge about the donor's mental health and quality of life after donation is limited. This study aims to explore the mental health and quality of life after kidney donation.</p><p><strong>Methods: </strong>The study was retrospective and cross-sectional, carried out between August and December 2023. One hundred donors from a single center were selected through convenience sampling. Two questionnaires, namely the Beck Depression Inventory and Satisfaction with life scale were employed during an interview with donors. Data were analyzed using SPSS- 27.</p><p><strong>Results: </strong>Overall, 70 females and 30 males participated. Only 9 donors (9%), reported significant disturbance in their mental health, amongst which 2 were males and 7 were females. Of note, two recipients of their donation passed away, while another experienced graft failure. Insomnia and tiredness were significant contributors to the donors' inability to work, with a reported percentage of 25%. In addition, dissatisfaction with life was reported by 8 donors only. There was no significant association between depression and satisfaction with life and age, marital and education status and time since transplant. Only status of the graft in the recipient was associated with an impact on the donor's mental health. Thirteen donors exhibited depression post-nephrectomy, with 4% experiencing mild disturbance and 9% showing major mood disturbances including borderline clinical depression and moderate depression. Notably, none of the donors had test scores indicating extreme depression.</p><p><strong>Conclusion: </strong>Kidney donation has no severe impact in terms of mental health and quality of life in donors. Apart from the status of the graft, none of the demographic characteristics had a significant impact on the mental health of donors.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029464","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":"Preliminary results of a questionnaire aimed at evaluating the carbon footprint of hemodialysis facilities.","authors":"Adolfo Marco Perrotta, Giorgina Barbara Piccoli, Marco Di Giandomenico, Silverio Rotondi, Sandro Mazzaferro","doi":"10.1007/s40620-025-02301-w","DOIUrl":"https://doi.org/10.1007/s40620-025-02301-w","url":null,"abstract":"","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016529","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":"Reduced intensity incremental hemodialysis start does not decrease life expectancy and saves money: results of the RIDDLE study.","authors":"Andrea Campo, Franco Goia, Roberto Cottino, Carmen Gandolfo, Giusto Viglino","doi":"10.1007/s40620-025-02271-z","DOIUrl":"https://doi.org/10.1007/s40620-025-02271-z","url":null,"abstract":"<p><strong>Background: </strong>Since 2001, twice-weekly hemodialysis has been the standard method for starting hemodialysis at the Alba Hospital (Piedmont, Italy).</p><p><strong>Methods: </strong>Incident patients who started in-center hemodialysis from January 2001 to December 2016, had sufficient residual kidney function (urine output > 500 ml/day), and survived on hemodialysis > 1 year were selected and followed until death or censoring on December 31, 2019. The endpoints for the whole cohort are survival, duration of twice-weekly hemodialysis, preservation of residual kidney function, and cost savings. Analysis was performed on subgroups with long-term (L: >  = 365 days) or short-term (S: < 365 days) twice-weekly hemodialysis duration, matched for age, sex, year of hemodialysis start, type of vascular access and diabetes.</p><p><strong>Results: </strong>The study included 146 patients with a total follow-up of 251,328 patient-days, of which 80,635 on twice-weekly hemodialysis. The median survival was 1793 days, median twice-weekly hemodialysis duration was 417 days, and median residual kidney function duration was 820 days. In the matched comparison, the long-term duration twice-weekly hemodialysis group had lower admissions (18.2 vs 27.7/1000 patient-days) and unscheduled hemodialysis session rates (0.26 vs 0.75/1000 patient-days) and greater median residual kidney function duration (1353 vs 445 days), but similar median survival (1809 vs 1744 days). During twice-weekly hemodialysis, 12,291 hemodialysis sessions were spared, resulting in a cost saving of 1,986,226 Euros, based on current local reimbursement fees.</p><p><strong>Conclusions: </strong>Twice-weekly hemodialysis, under strict clinical surveillance appears to be a safe, feasible, and cost-saving method for initiating hemodialysis in patients with residual kidney function.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012244","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":"Impaired kidney function does not confer an additional risk for osteopenia/osteoporosis in older individuals.","authors":"Fernando T M Freire, Venceslau A Coelho, Alexandre L Busse, Nigar Sekercioglu, Rosa M A Moyses, Rosilene M Elias","doi":"10.1007/s40620-025-02294-6","DOIUrl":"https://doi.org/10.1007/s40620-025-02294-6","url":null,"abstract":"","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030299","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":"Fatal seafood-borne carbapenem-resistant Vibrio cholerae peritonitis in a PD patient: lessons for the clinical nephrologist.","authors":"Kornrawee Sawasdichai, Piyaporn Towannang, Tanittha Chatsuwan, Dhammika Leshan Wannigama, Talerngsak Kanjanabuch","doi":"10.1007/s40620-025-02277-7","DOIUrl":"https://doi.org/10.1007/s40620-025-02277-7","url":null,"abstract":"","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025257","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":"Learning from the implementation phase of the new French capitation payment model for chronic kidney disease care: a qualitative study.","authors":"Maxime Raffray, Arnaud Campéon, Damien Bricard, Estelle Augé, Denis Raynaud, Cécile Couchoud, Luc Frimat, Sahar Bayat","doi":"10.1007/s40620-025-02284-8","DOIUrl":"https://doi.org/10.1007/s40620-025-02284-8","url":null,"abstract":"<p><strong>Background: </strong>France introduced a new payment model for care providers of patients with Chronic Kidney Disease (CKD) Grades 4 and 5: the CKD-Capitation Payment model. The model aims to financially incentivise multidisciplinary care for patients. We performed a qualitative study among participating providers to identify obstacles and facilitators of the model implementation as well as the initial benefits and potential policy improvements.</p><p><strong>Methods: </strong>From March to July 2023, we collected data through semi-structured interviews with medical and managerial staff of facilities participating in the new model in France. We purposely selected a sample of facilities based on ownership status and CKD-Capitation Payment model activity data, including the number of patients reported. We performed a thematic analysis of the interview transcripts.</p><p><strong>Results: </strong>We interviewed 22 staff from 14 facilities. Interviews revealed that adapting the information systems to the model requirements was a major obstacle to implementation, undermining efficient medical time allocation and data quality. Securing facility management support and organising the care amid workforce shortages were additional obstacles. Despite these challenges, staff reported positively on the model, noting the increased time spent by nurses with patients and the assertion of dietitians' role. Interviewees reported the need for greater flexibility in visit requirements to better align with patient needs.</p><p><strong>Conclusions: </strong>This study demonstrates how the new capitation payment model introduced in France can enable multidisciplinary and coordinated care for patients with CKD. However, supporting facilities in adopting interoperable information systems and increasing the flexibility of the model appear essential for long-term adoption.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018102","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 preventable problem in pregnancy.","authors":"Kareem Elbosaty, Alaa Sabry, Giorgina B Piccoli, Rasha Shemies","doi":"10.1007/s40620-025-02274-w","DOIUrl":"https://doi.org/10.1007/s40620-025-02274-w","url":null,"abstract":"","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021461","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":"Outpatient clinic for older patients with chronic kidney disease: a model of a multidisciplinary care model.","authors":"Mariana Leister Rocha Innecchi, Carla Maria Avesani, Venceslau A Coelho, Julia Castanheira Lauar, Tiago Emanuel Mendes Costa, Luiza Karla Ramos Pereira de Araújo, Rosa M A Moysés, Rosilene M Elias","doi":"10.1007/s40620-025-02293-7","DOIUrl":"https://doi.org/10.1007/s40620-025-02293-7","url":null,"abstract":"<p><strong>Background: </strong>The number of older patients with chronic kidney disease (CKD) is increasing worldwide. Managing clinical conditions in this population is challenging due to multimorbidity, including frailty, malnutrition, sarcopenia, and functional status impairment. This clinical scenario, in association with the decrease in kidney function, requires specific care.</p><p><strong>Methods: </strong>We propose a new care model for older patients with moderate/advanced CKD involving a multidisciplinary and interdisciplinary team. This team includes nephrologists, geriatric physicians, nurses, and dietitians. To achieve the best results, patients' clinical, laboratory and geriatric conditions are routinely assessed to support better shared decision-making.</p><p><strong>Results: </strong>Since this model was created (July 2017), 607 patients > 60 years old, most of whom had CKD stages 3b to 5, have been seen at least once. Of these, 439 (72.3%) patients have been followed for a median of 19.6 (9.3, 37.1) months, with an average follow-up interval of 4.4 months. At their first visit, most patients were overweight, 68.7% were independent with regard to activities of daily living, and 21.4% had severely impaired functional capacity. Cognitive impairment was found in 40.5% of patients. In 70.1% of the patients, the median decrease in estimated glomerular filtration rate (eGFR) was 1.4 ml/year over time. The change in eGFR did not correlate with age (r = 0.011, p = 0.839). Among patients with CKD stage 4 or 5, 15% decided to not start dialysis based on a shared-decision making process.</p><p><strong>Conclusion: </strong>The proposed multidisciplinary care model for older patients with CKD guides the multiprofessional identification of various conditions that might otherwise go unnoticed, while emphasizing the importance of each healthcare professional. This approach might increase the likelihood of adopting a more holistic view of patients, ultimately leading to better shared decision-making.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987756","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}