Journal of Nephrology最新文献

{"title":"Characteristics of Acute kidney injury in Xizang: a retrospective analysis from the largest tertiary hospital in the Xizang Autonomous region, China.","authors":"Lang-Jie Chi-Lie, Ya-Hui Yang, Lei Zhang, Wen Tang, Yong A","doi":"10.1007/s40620-025-02395-2","DOIUrl":"https://doi.org/10.1007/s40620-025-02395-2","url":null,"abstract":"","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145064875","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":"Do psycho-behavioural interventions improve mental and physical health in chronic kidney disease? A systematic review of randomised controlled trials.","authors":"Pooja Schmill, Natasha Seaton, Sharlene Greenwood, Joanna L Hudson, Emily McBride, Sam Norton, Joseph Chilcot","doi":"10.1007/s40620-025-02372-9","DOIUrl":"https://doi.org/10.1007/s40620-025-02372-9","url":null,"abstract":"<p><strong>Background: </strong>Depression and anxiety are common in chronic kidney disease (CKD) and worsen clinical outcomes. Psycho-behavioural interventions offer a promising, non-pharmacological approach. However, most evidence comes from people with kidney failure with distinct treatment needs, limiting relevance to earlier stages of CKD, where timely support may enhance self-management and slow progression. This systematic review evaluates the effectiveness of psycho-behavioural interventions in adults with CKD without dialysis or transplantation.</p><p><strong>Methods: </strong>We searched MEDLINE, EMBASE, PsycINFO, Cochrane Central, and Web of Science (inception-March 2025) for randomised controlled trials (RCTs) testing psycho-behavioural interventions in adults with CKD (not on kidney replacement therapy), with depression and/or anxiety as primary or secondary outcomes. Risk of bias (RoB-2) and certainty of evidence were assessed. Given methodological heterogeneity across studies, vote counting by effect size and narrative synthesis were applied.</p><p><strong>Prospero: </strong>CRD42024515733.</p><p><strong>Results: </strong>Five RCTs (N = 631) met the inclusion criteria, evaluating cognitive behavioural therapy, self-efficacy training, mindfulness-based stress reduction, and physical activity, delivered digitally, by phone, or in person. Moderate-certainty evidence showed consistent improvements (100% positive) in self-efficacy and physical function. Low-certainty evidence indicated 100% positive effects on self-management, while findings for depression were mixed (67% positive), with one study reporting worsening symptoms. Evidence for anxiety, fatigue, quality of life, and kidney function was inconclusive due to high inconsistency and imprecision.</p><p><strong>Conclusion: </strong>Psycho-behavioural interventions may enhance self-efficacy, self-management, and physical function in CKD. However, evidence for mental health and kidney outcomes remains limited. Robust, long-term RCTs with tailored, multi-component approaches are needed to support integration into kidney care.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029676","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 stones and quack doctors.","authors":"Awu Isaac Oben","doi":"10.1007/s40620-025-02419-x","DOIUrl":"https://doi.org/10.1007/s40620-025-02419-x","url":null,"abstract":"","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023514","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":"An observational study on mesangial C4d staining as a prognostic tool in IgA nephropathy.","authors":"Srinidhi Viswanathan, Jayalakshmi Seshadri, Anila Abraham Kurien, Harrini Devi Palani Baskar, Prem Kumar Devaraju, Prathiba Parthasarathy, Praveenkumar Natarajan, Sumathi Govindaraju, Gopikumar Sekar, Sakthirajan Ramanathan, Dineshkumar Thanigachalam, Sheik Sulthan Alavudeen, Shivakumar Dakshinamoorthy, Seenivasan Mookaiah, Gopalakrishnan Natarajan","doi":"10.1007/s40620-025-02410-6","DOIUrl":"https://doi.org/10.1007/s40620-025-02410-6","url":null,"abstract":"<p><strong>Background: </strong>IgA nephropathy is a disease with a highly variable natural history, for which there is an increasing understanding of the role of complement activation in its pathogenesis and progression. We aimed to assess the clinical and prognostic implications of C4d staining in the kidney biopsy of IgA nephropathy patients.</p><p><strong>Methods: </strong>This was a retrospective observational study wherein the medical records of IgA nephropathy patients were reviewed and baseline characteristics, kidney biopsy findings, treatment response and follow-up data were noted. We aimed to estimate the prevalence of C4d staining and assess its correlation with clinical presentation, MEST-C scoring as well as its predictive value on renal outcomes.</p><p><strong>Results: </strong>A total of 131 kidney biopsies were studied in which the prevalence of C4d staining was 63.36%. C4d positivity was significantly associated with hypertension (P = 0.005), greater degree of proteinuria (P = 0.013) and lower estimated glomerular filtration rate (eGFR) (P = 0.04) at presentation. MEST-C score analysis revealed significant association of Segmental sclerosis (S1), Tubular atrophy and Interstitial Fibrosis (T1, T2) and a greater degree of glomerulosclerosis with C4d staining (P value < 0.001). On follow-up, lesser rates of complete remission, higher serum creatinine and lower eGFR were seen in the C4d positive group (P < 0.001). C4d positivity independently predicted progression to kidney failure [HR: 2.42; 95% CI:1.11-5.26 (P = 0.026)] with 5-year kidney survival of 58% (P < 0.001).</p><p><strong>Conclusion: </strong>Mesangial C4d deposition is associated with adverse clinical and pathological characteristics and is an independent risk factor for progression to kidney failure in patients with IgA nephropathy. Thus, C4d staining could be integrated into routine kidney biopsy analysis as a potentially useful biomarker for prognostication and targeted complement-based therapies.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023509","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 characteristics of treatments for sleep disordered breathing in people receiving dialysis: a scoping review.","authors":"Daniel S March, Lizelle Bernhardt, Kelly Barber, Ffion Curtis, Patrick J Mowles, Nina Morris, Ellesha A Smith, Sonny Vargeson, James O Burton","doi":"10.1007/s40620-025-02370-x","DOIUrl":"https://doi.org/10.1007/s40620-025-02370-x","url":null,"abstract":"<p><strong>Background: </strong>Individuals with kidney failure experience elevated cardiovascular risk, potentially worsened by the presence of sleep disordered breathing. Despite this association, prevalence of sleep apnoea, and evidence for effective treatments are poorly understood in people with kidney failure. This review examines sleep apnoea prevalence, types of sleep apnoea, and treatment interventions in people with kidney failure receiving dialysis.</p><p><strong>Methods: </strong>Guidelines for scoping reviews were followed and the following databases were searched for both peer reviewed and grey literature: MEDLINE, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials (CENTRAL), ClinicalTrials.gov, the Web of Sciences Core Collection, OpenGrey, ETHos and ProQuest. All databases were searched from inception to 18th October, 2024. Random-effects proportional meta-analysis was used to estimate prevalence. A narrative synthesis of the interventions from the included studies for sleep apnoea was reported.</p><p><strong>Results: </strong>There were 36 included studies. Pooled data from 19 studies indicated that sleep apnoea prevalence was 59% (95% CI 47%, 70%). Pooled data estimated mild apnoea prevalence at 21% (95% CI 16%, 26%) (11 included studies), with moderate and severe prevalence being 44% (95% CI 30%, 60%) (14 included studies). The majority of sleep apnoea was obstructive (75% (95% CI 53%, 89%)) with the remaining being central (15% (95% CI 8%, 28%)) and mixed (15% (95% CI 3%, 49%)) in nature.</p><p><strong>Conclusion: </strong>The prevalence of sleep apnoea is high in people receiving dialysis. Currently there is insufficient evidence for the effective treatment of sleep apnoea in this population.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029924","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":"Acute kidney injury and in-hospital mortality in COVID-19: a causal analysis using directed acyclic graphs.","authors":"Paola Andrea Gallego Aristizabal, Tania Paola Lujan Chavarría, Joaquín Rodelo-Ceballos, Sara Botero Bolívar, Sara Isabel Vergara Hernández, Isabella Rocha Giraldo, Cristian Fernando Marcillo Calderón, Ana María Londoño Giraldo, Federico Rincon Acosta, María Paula Sanchez Carmona, Paula Andrea Salazar Ospina, Fabián Jaimes","doi":"10.1007/s40620-025-02415-1","DOIUrl":"https://doi.org/10.1007/s40620-025-02415-1","url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury (AKI) is a common complication in patients affected by COVID-19 and has been strongly associated with increased mortality. However, its independent contribution remains debated. This study aimed to evaluate the independent association using a directed acyclic graph-based approach.</p><p><strong>Methods: </strong>Retrospective, multicenter cohort study in Medellín, Colombia, from June 2020 to April 2022. AKI was defined according to KDIGO criteria. A directed acyclic graph was constructed to map the hypothesized causal relationship between AKI and mortality, integrating evidence from a comprehensive literature review and expert´s consensus. A Poisson regression model with robust variance was applied to estimate adjusted incidence rate ratios (IRRs) for mortality.</p><p><strong>Results: </strong>A total of 1722 patients were included, of whom 30.7% developed AKI. Mortality was higher among patients with AKI (58.1% vs. 19.6%). A directed acyclic graph was used to identify a minimal sufficient adjustment set for confounding control. After adjustment, the IRRs for in-hospital mortality were 1.25 (95% CI: 1.09-1.43) for stage 1, 1.62 (95% CI: 1.35-1.93) for stage 2, and 1.64 (95% CI: 1.46-1.85) for stage 3.</p><p><strong>Conclusions: </strong>AKI is independently and significantly associated with an increased risk of mortality in COVID-19 patients. This study makes a novel contribution by applying directed acyclic graphs to enhance causal inference. Directed acyclic graphs provide a rigorous framework for identifying true confounders and avoiding inappropriate adjustment for mediators, thereby reducing bias and improving the validity of causal estimates. In clinical settings where randomized controlled trials are not feasible, the use of directed acyclic graphs represents a robust alternative for exploring causal relationships.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023460","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":"Regression equation for kidney function based on the ultrasonographic volumetry of the renal cortex.","authors":"Shotaro Hoi, Tomoaki Takata, Yudai Fujino, Kana Kageyama, Sosuke Taniguchi, Yukina Yoshida, Yukari Mae, Takuji Iyama, Takaaki Sugihara, Hajime Isomoto","doi":"10.1007/s40620-025-02417-z","DOIUrl":"https://doi.org/10.1007/s40620-025-02417-z","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease (CKD) is a public health concern; kidney size correlates with kidney function, except in diabetic kidney disease (DKD), where the kidney enlarges, limiting morphological measurement applications in CKD management. However, cortical size changes in DKD along with CKD progression remain understudied. We investigated kidney morphology alterations in patients with and without diabetes and established a regression equation for kidney function incorporating morphological alterations.</p><p><strong>Methods: </strong>We included 312 patients who underwent kidney morphological measurements at Tottori University Hospital between 2018 and 2024. After excluding 34 subjects, 278 patients were divided into derivation and validation groups. Ultrasonography was used to assess kidney morphology including parenchymal, cortical, and medullary thicknesses, length, and kidney and cortical volumes. The non-diabetic and diabetic groups were compared at each CKD stage. Multivariate linear regression generated renal function equations.</p><p><strong>Results: </strong>In the derivation group (247 patients), height-adjusted cortical volume was strongly associated with kidney function in patients without diabetes (r = 0.513, p < 0.001) and with diabetes (r = 0.701, p < 0.001). Cortical volume was significantly larger in patients with than in those without diabetes at each CKD stage, except stages 4 and 5. In the validation group (31 patients), the predicted estimated glomerular filtration rate (eGFR) strongly correlated with the actual eGFR (r = 0.803, p < 0.001).</p><p><strong>Conclusions: </strong>A strong correlation between cortical size and kidney function was observed. Cortical size alterations depended on the cause of CKD. A regression equation incorporating kidney size can help assess the eGFR. These findings could help formulate strategies for improving CKD management.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145015649","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":"Generalizing \"volume sparing\" in CRRT risks harm: the critical role of adsorptive membranes.","authors":"Minmin Wang, Wenxiong Li","doi":"10.1007/s40620-025-02391-6","DOIUrl":"https://doi.org/10.1007/s40620-025-02391-6","url":null,"abstract":"","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023504","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 role of renal denervation for the treatment of hypertension in patients with chronic kidney disease: a position paper of the Italian Society of Nephrology.","authors":"Sandro Feriozzi, Yuri Battaglia, Calogero Lino Cirami, Concetta Gangemi, Gaetano La Manna, Loreto Gesualdo, Maria Lorenza Muiesan, Antonello Pani, Federico Pieruzzi, Flavio Ribichini, Stefano Taddei, Stefano Bianchi","doi":"10.1007/s40620-025-02406-2","DOIUrl":"https://doi.org/10.1007/s40620-025-02406-2","url":null,"abstract":"<p><p>Hypertension is a clinical condition associated with an increase in cardiovascular morbidity and mortality. In chronic kidney disease (CKD), hypertension is also a driver of faster disease progression. Correct and appropriate treatment with antihypertensive medication reduces the risk of cardiovascular events and slows kidney disease progression. However, not all hypertensive patients achieve the desired blood pressure goals despite multiple antihypertensive therapies, and these are defined as patients with uncontrolled or resistant hypertension. Renal denervation has been successfully proposed to mitigate the hyperactivity of the sympathetic nervous system in patients with uncontrolled/resistant hypertension. The guidelines of the European Society of Cardiology and the European Society of Hypertension include renal denervation as a therapeutic option for treating hypertension in patients with uncontrolled or resistant hypertension. However, in patients with CKD, diffusion of the procedure has been limited by concerns over possible adverse effects on kidney function. Over the last few years, the improvement of the device-based procedure and the growing experience accumulated in several Nephrology centers have increased the use of renal denervation in patients with CKD. In patients with uncontrolled/resistant hypertension with a significant reduction of glomerular filtration rate (< 40 ml/min/1.73 m²), on dialysis, or living with a kidney transplant, the procedure significantly reduces blood pressure values over time without negative effects on kidney function. Taking into account the effectiveness of renal denervation in patients with uncontrolled or resistant hypertension and CKD, and the lack of defined indications concerning renal denervation in CKD, the Italian Society of Nephrology has decided to publish a position paper reviewing the available evidence in the medical literature.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145015654","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":"24-h urine test application in patients with kidney stone disease: a population-based study in a primary care setting.","authors":"Pietro Manuel Ferraro, Andrea Spasiano, Giovanni Gambaro, Domenico Prezioso, Francesco Lapi, Gaetano Piccinocchi","doi":"10.1007/s40620-025-02389-0","DOIUrl":"https://doi.org/10.1007/s40620-025-02389-0","url":null,"abstract":"<p><strong>Background: </strong>Kidney stone formation is driven by an imbalance between lithogenic substances and crystallization inhibitors. Current guidelines recommend a 24-h urine collection in patients with kidney stone disease to assess the risk of stone formation and monitor therapy compliance. However, real-world data on adherence to these guidelines remain limited and outdated.</p><p><strong>Methods: </strong>We used the Health Search Database to examine laboratory test data of patients with kidney stone disease between 2013 and 2022 in Italy. Adults with at least one episode of kidney or ureteral stones during this period were included. We used the prescription of urinary calcium, oxalate, and citrate levels as a proxy for full metabolic testing.</p><p><strong>Results: </strong>A total of 21,907 adult patients were identified (44.6% women). Only 4.8% (n = 1059) underwent 24-h urine testing, and just 0.6% had all three target measurements. Testing rates were slightly higher in recurrent stone formers (6.1%). The likelihood of receiving a test increased nearly sixfold after a nephrology visit (OR 6.09, 95% CI 5.27-7.05, p < 0.001), compared to a lower increase after urology visits (OR 1.95, 95% CI 1.71-2.23, p < 0.001). Nonetheless, fewer than 10% of kidney stone disease patients consulted a nephrologist, and only half of those with coexisting chronic kidney disease (CKD) had such a referral.</p><p><strong>Conclusion: </strong>Awareness of 24-h urine testing and nephrology referral in stone formers remains low, despite their role in guiding personalized treatment. Promoting their use could enhance patient care by identifying urinary abnormalities and reducing the risk of recurrence and complications.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006252","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}