Journal of Nephrology最新文献

{"title":"Minimal change glomerular disease associated with solid neoplasms: a systematic review.","authors":"Domenico Cozzo, Francesca Orlando, Mariolina Bruno, Adam Ogna, Valentina Forni Ogna","doi":"10.1007/s40620-024-02084-6","DOIUrl":"10.1007/s40620-024-02084-6","url":null,"abstract":"<p><strong>Background: </strong>Paraneoplastic minimal change disease (MCD) has been associated with hematological malignancies, whereas solid malignancies are commonly associated with membranous glomerulonephritis. In this systematic review of the literature, we describe the clinical features, treatment and outcome of MCD associated with solid neoplasms.</p><p><strong>Methods: </strong>We performed a systematic review of the MEDLINE, COCHRANE, EMBASE and SCOPUS databases, including case reports of adult patients with biopsy-proven MCD and solid malignancy, without language or time restrictions.</p><p><strong>Results: </strong>Sixty-seven papers were included, presenting 86 cases with a mean age of 57.8 ± 14.7 years; 41.0% were women. Nephrotic syndrome was the initial presentation in 96.2% of patients; 67.2% had kidney function impairment, and 21.2% required kidney replacement therapy. The most frequent malignancies were malignant thymoma (34.9%), kidney (14.0%), lung (12.8%), and gastrointestinal tumors (12.8%). In 40.7% of cases, the neoplasm diagnosis preceded MCD by 33.8 ± 46.1 months, while in 31.4%, it followed diagnosis of MCD by 12.4 ± 22.6 months. In 27.9%, the neoplasm and kidney disease were diagnosed simultaneously. Immunosuppressive therapy was started in 79.1% of cases and tumor-specific treatment in 83.7%. Remission of MCD was achieved in 80.2% of patients: 38.2% responded to immunosuppressive treatment alone and 29.6% to oncological treatment alone.</p><p><strong>Conclusions: </strong>The association between MCD and solid neoplasms is well-documented. Immunosuppressive therapy alone induced nephrotic syndrome remission in over one-third of cases; most others responded to tumor-specific treatment. Solid tumor screening should be considered in MCD independently of the steroid response, though more data on solid tumor-associated MCD prevalence are needed for a definitive statement.</p><p><strong>Prospero trial registration number: </strong>CRD42024521854.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":"343-352"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142348488","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":"Opioid use and poisoning in hospitalized patients with chronic kidney disease.","authors":"Nadim Zaidan, Youssef Jalloul, David S Goldfarb, Hiba Azar, Suzanne El-Sayegh","doi":"10.1007/s40620-024-02159-4","DOIUrl":"10.1007/s40620-024-02159-4","url":null,"abstract":"<p><strong>Background: </strong>Identifying factors associated with uncomplicated and complicated opioid use is essential, especially with regard to safety concerns in impaired kidney function. Literature about opioid prescription and their potential complications in patients with different stages of chronic kidney disease (CKD) is scarce. This study describes opioid use and poisoning in hospitalized CKD patients.</p><p><strong>Methods: </strong>The National Inpatient Database (NIS) was queried from 2016 to 2020 to identify which patients with known CKD stages were admitted with diagnoses of uncomplicated and complicated opioid use, and opioid poisoning. Patients with end-stage kidney disease receiving any form of renal replacement therapy were excluded. CKD1 served as a reference, and demographic and socio-economic characteristics were accounted for. Logistic regressions were performed to evaluate the relationship between CKD stages and each condition.</p><p><strong>Results: </strong>The final cohort included 2,917,404 (14,587,017 weighted) CKD patients, of whom 1.763 ± 0.023% and 1.177 ± 0.016% had uncomplicated and complicated opioid use, respectively. Odds of uncomplicated use were lower with more advanced CKD stages. We observed an increase of complicated use with milder forms of CKD. No differences in odds of complicated opioid use were found when CKD4-5 patients were compared to CKD1. After adjustment, opioid use was found to be the main predictor of poisoning in hospitalized CKD patients.</p><p><strong>Conclusion: </strong>Prescribers appear to be more cautious in patients with advanced CKD, with lower odds of being on opioid analgesics in this group. Most CKD patients had higher odds of complicated use, and poisoning was essentially driven by complicated opioid use rather than CKD stage.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":"531-540"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142769795","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":"What should nephrologists know about the metaverse? A commentary.","authors":"Carmine Zoccali, Francesca Mallamaci","doi":"10.1007/s40620-024-02204-2","DOIUrl":"10.1007/s40620-024-02204-2","url":null,"abstract":"","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":"315-317"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142978970","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":"SOLFA study: a multicenter, open-label, prospective, randomized study to investigate the clotting propensity of asymmetric cellulose triacetate membrane compared to synthetic membranes in on line HDF.","authors":"Marta Puerta, María Teresa Jaldo, Patricia Muñoz, Patricia Martínez-Miguel, Francisco Maduell, Carolina Lancho, Antonio Luis García-Herrera, Sunny Eloot, Patricia de Sequera","doi":"10.1007/s40620-024-02197-y","DOIUrl":"10.1007/s40620-024-02197-y","url":null,"abstract":"<p><strong>Background: </strong>Performing hemodialysis without heparin is still challenging. The objective of the present work was to evaluate the impact on thrombogenicity of the hemodialysis circuit using synthetic membranes compared to the asymmetric cellulose triacetate (ATA) membrane.</p><p><strong>Methods: </strong>Prospective, multicenter, randomized, crossover, open-label study. In each of the two phases of the study, six consecutive hemodialysis sessions were performed over two weeks, in which the patients were dialyzed with the dialyzer randomly assigned (synthetic vs asymmetric cellulose triacetate membrane). During the six sessions of both phases, the heparin dose was progressively reduced from the full usual heparin dose in the first session to zero heparin in the sixth session. After each session, visual inspection of the venous chamber and dialyzer was performed, and a coagulation score was assigned. A micro- computed tomography (CT) scanning of some dialyzers was also executed at Ghent University.</p><p><strong>Results: </strong>Comparison of the last completed sessions shows that there were significant differences depending on the dialyzer used: 60% of dialysis sessions with asymmetric cellulose triacetate could be completed without heparin versus 24% with synthetic membranes (p = 0.01). We also found differences in the number of sessions completed: 46% with the asymmetric cellulose triacetate membrane and 7% with the synthetic membrane (p = 0.001). The results obtained with the micro-CT analysis were also better with the asymmetric cellulose triacetate.</p><p><strong>Conclusions: </strong>Our findings strongly suggest that asymmetric cellulose triacetate membranes may be useful in situations in which dialysis should be performed without heparin or with low-dose heparins.</p><p><strong>Trail registry: </strong>NCT06505616.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":"697-705"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006825","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":"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":"745-749"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","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}

{"title":"Prognostic impact of neutrophil-to-lymphocyte ratio and vascular access in patients on chronic hemodialysis.","authors":"Caterina Carollo, Ettore Mancia, Alessandra Sorce, Chiara Altieri, Dario Altieri, Giuliano Brunori, Giuseppe Mulè","doi":"10.1007/s40620-024-02203-3","DOIUrl":"10.1007/s40620-024-02203-3","url":null,"abstract":"<p><strong>Background: </strong>The neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and derived-neutrophil-to-lymphocyte ratio (d-NLR), which can be obtained from complete blood count, have gained attention due to their widespread availability and low cost of testing; they have recently been proposed as prognostic markers in various chronic diseases. The primary objective of our study was to investigate the potential prognostic role of inflammatory markers derived from blood cell counts regarding all-cause mortality in patients with kidney failure undergoing hemodialysis, and the use of such markers in risk stratification based on the type of vascular access used.</p><p><strong>Methods: </strong>This retrospective study included 236 patients from the Nephrology Unit  of Trento. Demographic, anamnestic, clinical, and biochemical data, as well as total mortality, were collected. Neutrophil-to-lymphocyte ratio and the erythropoietin resistance index were calculated.</p><p><strong>Results: </strong>The study cohort was divided into tertiles based on the neutrophil-to-lymphocyte ratio distribution. Patients in the third tertile exhibited significantly lower mean values of weight, serum albumin, serum iron, and transferrin, whereas mean erythropoietin resistance index values, and age were higher compared to those in the first and second tertiles, in which mortalilty was also higher. The area under the ROC curve (AUC) for neutrophil-to-lymphocyte ratio related to total mortality (AUC = 0.64) was wider than that for C-reactive protein (AUC = 0.61). Cox regression analysis suggested that neutrophil-to-lymphocyte ratio was independently associated with mortality, even after adjusting for confounding factors.</p><p><strong>Conclusion: </strong>Our study suggests that neutrophil-to-lymphocyte ratio is a useful tool for the early risk stratification and management of patients with kidney failure.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":"717-723"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441091","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 cyst infection management among European nephrologists: a survey.","authors":"Charles Ronsin, Nora Schwotzer, Johann Morelle, Miquel Blasco, Fadi Fakhouri, Simon Ville","doi":"10.1007/s40620-025-02239-z","DOIUrl":"10.1007/s40620-025-02239-z","url":null,"abstract":"","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":"809-811"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143677159","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":"Depression and anxiety in people with kidney disease: understanding symptom variability, patient experience and preferences for mental health support.","authors":"Joseph Chilcot, Christina J Pearce, Natalie Hall, Zara Rehman, Sam Norton, Sophie Griffiths, Joanna L Hudson, Lucy Mackintosh, Amanda Busby, David Wellsted, Julia Jones, Shivani Sharma, Paula Ormandy, Nick Palmer, Pooja Schmill, Maria Da Silva-Gane, Neal Morgan, Dimitrios Poulikakos, Kristin Veighey, Stuart Robertson, Rob Elias, Ken Farrington","doi":"10.1007/s40620-024-02194-1","DOIUrl":"10.1007/s40620-024-02194-1","url":null,"abstract":"<p><strong>Background: </strong>Depression and anxiety are commonly experienced by people with chronic kidney disease (CKD). This study aimed to evaluate person- and service-level factors associated with depression and anxiety symptoms. We sought to also understand utilisation of mental health treatments and preferences for future psychological support.</p><p><strong>Methods: </strong>An online survey recruited participants from six UK kidney services with varying levels of psychosocial provision. The survey was also advertised on social media. Participants completed screening questionnaires for depression and anxiety, alongside questions about mental health history, self-efficacy, treatment and support. The study included adults (18 years or older) living with CKD (stages 3b and above) or those receiving any form of Kidney Replacement Therapy (KRT), including individuals with a functioning kidney transplant. Eligible participants had to complete study measures and be proficient in reading and writing in either English or Welsh, as the survey was administered in these languages. This survey was developed with our Patient and Public Involvement group and was administered from January 2023 until 31st January, 2024 using Qualtrics and RedCap.</p><p><strong>Results: </strong>Four hundred fifty-eight people completed the survey. Moderate-severe symptoms of depression and anxiety were 37.7% and 26.5%, respectively. Over 50% reported a history of diagnosed depression. In addition to depression, sleep problems and fatigue were identified as future support needs, with over a third indicating a preference for in-centre provision. In case-mix adjusted analysis, there was no variability in depression and anxiety symptoms across centres. Centre location and size were unrelated to symptoms. Age, female gender, current mental health treatments, self-efficacy and perceptions regarding opportunity for support, were associated with symptoms of depression and anxiety. In sub-analysis, there was a negative association between psychosocial staffing levels and depression symptoms.</p><p><strong>Conclusion: </strong>Patient-related factors and behavioural characteristics were related to variation of these symptoms. There was little evidence of symptom variability across centres, although in a small sub-analysis, psychosocial provision showed a weak negative correlation with depression symptoms. Our findings highlight preferences of future needs which could be helpful for designing future research and service provision.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":"675-686"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971289","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":"Aortic valve thrombosis in nephrotic syndrome: a case report.","authors":"Shogo Taira, Morikuni Nishihira, Kageyuki Oba, Kohei Narayama, Akihiko Yamauchi","doi":"10.1007/s40620-024-02026-2","DOIUrl":"10.1007/s40620-024-02026-2","url":null,"abstract":"<p><p>We report a rare case of aortic valve thrombosis in a 55-year-old man. He had reduced urine output and generalized edema four days before admission. He felt sick and had chest pain on the day of admission. Severe hypoalbuminemia and massive proteinuria were present, and a diagnosis of nephrotic syndrome was made. An electrocardiogram showed findings suspicious for acute myocardial infarction, and emergency catheterization was performed. However, no coronary artery stenosis or occlusion was found at that time. A subsequent contrast-enhanced CT scan and transesophageal echocardiography revealed a thrombus in the aortic valve. The thrombus nearly occluded the left coronary artery. Emergency surgery was performed to remove the thrombus. His postoperative course was stable, but nephrotic syndrome persisted. A renal biopsy diagnosed minimal change disease. Treatment with 50 mg/day of prednisolone induced remission, and he was discharged on day 43. There were no aortic valve abnormalities. Nephrotic syndrome was considered the main contributor to thrombus formation. Aortic valve thrombosis associated with nephrotic syndrome is a very rare but potentially fatal condition that requires attention.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":"725-731"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141792658","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":"Impact of iron and erythropoiesis-stimulating agent dose on mortality of hemodialysis patients with cancer.","authors":"Arthur Michon-Colin, Yannis Lombardi, Guillaume Seret, Frédéric Lavainne, Angelo Testa, Hamza Ayari, Guy Rostoker, Pablo Antonio Urena Torres, Maxime Touzot","doi":"10.1007/s40620-024-02162-9","DOIUrl":"10.1007/s40620-024-02162-9","url":null,"abstract":"","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":"795-797"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142828675","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}