Journal of Nephrology最新文献

{"title":"The critical gap in kidney function monitoring for patients with dementia: clinical, ethical, and economic implications.","authors":"Hiroki Ito, Takefumi Mori","doi":"10.1007/s40620-025-02388-1","DOIUrl":"https://doi.org/10.1007/s40620-025-02388-1","url":null,"abstract":"","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957847","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":"Correction: Effective management of lupus nephritis using a novel combination therapy with low-dose steroids: a case report.","authors":"Niloufar Ebrahimi, Duvuru Geetha, Joselyn Reyes-Bahamonde, Craig W Zuppan, Amir Abdipour, Sayna Norouzi","doi":"10.1007/s40620-025-02408-0","DOIUrl":"https://doi.org/10.1007/s40620-025-02408-0","url":null,"abstract":"","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957747","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":"ALECT2 amyloidosis-associated granulomatous interstitial nephritis.","authors":"Julie Pradella, Hamza Sakhi, Jean-Michel Goujon, Anissa Moktefi","doi":"10.1007/s40620-025-02402-6","DOIUrl":"https://doi.org/10.1007/s40620-025-02402-6","url":null,"abstract":"","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957734","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":"Awareness and management of stage 3 chronic kidney disease among primary care practitioners in Italy: a nation-wide observational study.","authors":"Pietro Ferrara, Davide Rozza, Ippazio C Antonazzo, Manuel Zamparini, Elena Zanzottera Ferrari, Pasquale Palladino, Domenico Santoro, Lorenzo G Mantovani, Giampiero Mazzaglia","doi":"10.1007/s40620-025-02384-5","DOIUrl":"https://doi.org/10.1007/s40620-025-02384-5","url":null,"abstract":"<p><strong>Background: </strong>Stage 3 chronic kidney disease (CKD) often remains undiagnosed until more severe symptoms appear. This study assessed awareness and management of CKD among Italian general practitioners (GPs), focusing on early detection and current practices.</p><p><strong>Methods: </strong>A nation-wide, retrospective observational study was conducted using data from The Health Improvement Network (THIN®) database. Each participant was required to have had at least one interaction with a GP for either medical or administrative purposes (considering the index date), and to have a minimum of three years of retrospective data available  from January 2021 to June 2022. The study evaluated the proportion of individuals aged ≥ 40 years who underwent a second serum creatinine test after ≥ 90 days, referrals to nephrologists, and CKD diagnosis confirmation and categorization. Multivariable Poisson regression models analyzed data to identify associations between patient characteristics and outcomes, in both the overall cohort and in the sub-group with available urine albumin-to-creatinine ratio (uACR) measurement.</p><p><strong>Results: </strong>Among 347,548 adults aged ≥ 40 years, 18,002 (5.2%) had an initial estimated glomerular filtration rate (eGFR) indicating possible stage 3 CKD (30-59 mL/min/1.73 m²), and 1495 of these had a concomitant uACR assessment. Data concerning follow-up testing and specialist referrals were inconsistent, and available only for 53.0% and 9.0% of the patients, respectively. Overall, 15.3% met the criteria for KDIGO stage 3 CKD, yet CKD ICD-9-CM diagnostic codes were recorded for only 905 (5.0%) patients. Factors associated with these outcomes were analyzed, including age, comorbidities, treatments, and laboratory values.</p><p><strong>Conclusions: </strong>Substantial gaps in GP awareness and adherence to CKD management guidelines were identified, particularly in follow-up testing, referral practices, and diagnostic coding. Targeted educational interventions and standardized care protocols are needed to enhance CKD detection and management in primary care, improving patient outcomes and healthcare system performance.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957708","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":"Exploring the effect of roxadustat on oxidative stress: a pilot-exploratory study in CKD patients using a molecular biology approach.","authors":"Martina Cacciapuoti, Pulcherie Ghislaine Makoudjou, Giulia Driussi, Ilaria Caputo, Anna Basso, Lorenzo A Calò, Federico Nalesso","doi":"10.1007/s40620-025-02393-4","DOIUrl":"https://doi.org/10.1007/s40620-025-02393-4","url":null,"abstract":"","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957853","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":"Deceased donor kidney transplantation in candidates with pre-transplant hematological malignancies: a literature review and recipient allocation proposal in Singapore.","authors":"Emmett Tsz Yeung Wong, Ian Tatt Liew, Hein Than, Aloysius Yew Leng Ho, Chandramouli Nagarajan, Yeow Tee Goh, Charles Thuan Heng Chuah, Michelle Limei Poon, Wee Joo Chng, Melissa Gaik Ming Ooi, Widanalage Sanjay Prasad De Mel, Allen Eng Juh Yeo, Terence Kee, Anantharaman Vathsala","doi":"10.1007/s40620-025-02381-8","DOIUrl":"https://doi.org/10.1007/s40620-025-02381-8","url":null,"abstract":"<p><p>Deceased donor kidneys are a scarce national resource, and principles of utilitarianism and justice govern allocation. Kidney transplant recipients with a prior history of cancer show an increased risk of malignancy- and non-malignancy-related mortality compared to their counterparts without a previous history of malignancy. The inferior survival of a recipient with pre-transplant malignancy questions the allocation of a scarce resource to a population at anticipated poorer patient and graft survival. However, patient survival has significantly improved with advances in therapeutics for hematological malignancies, which led to an updated consensus expert opinion by the American Society of Transplantation in 2019. Nevertheless, the candidacy of patients with pre-transplant hematological malignancies in countries with a scarcity of deceased donor kidneys and a prolonged wait time may warrant specific considerations. This review details the basis for evaluation and candidacy recommendations for patients with a history of hematological malignancy for waitlist placement for deceased donor kidney transplantation, while optimizing scarce deceased donor organ supply in  Singapore. It considers the available evidence in countries where organ scarcity is a distinct challenge; thus, this consensus report is tailored to these constraints and may not be fully generalizable to other countries or transplant allocation algorithms.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957683","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":"Hemoadsorbtion with Cytosorb in the Treatment of Refractory Cardiogenic Shock in a Septic Pediatric Patient: is it worth it?-Lessons for the clinical nephrologist.","authors":"Andrea Spasiano, Elena Caporossi, Leonardo Gottin, Nicoletta Pertica, Pietro Manuel Ferraro","doi":"10.1007/s40620-025-02394-3","DOIUrl":"https://doi.org/10.1007/s40620-025-02394-3","url":null,"abstract":"","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957835","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":"Frailty compared to sarcopenia as the predictor of mortality for elderly hemodialysis patients.","authors":"Moatasem Ghoneim, Andrew Davenport","doi":"10.1007/s40620-025-02368-5","DOIUrl":"https://doi.org/10.1007/s40620-025-02368-5","url":null,"abstract":"<p><strong>Background: </strong>Hemodialysis (HD) patients are at an increased risk of sarcopenia and related mortality. As the number of elderly patients with chronic kidney disease (CKD) undergoing HD continues to grow, the prevalence of frailty also rises. This study aims to assess whether frailty or sarcopenia constitutes a greater risk to patient survival.</p><p><strong>Methods: </strong>A single-center cohort of HD patients was followed for four years. Clinical frailty scores and body composition, assessed using multifrequency bioelectrical impedance analysis, were utilized to evaluate survival outcomes.</p><p><strong>Results: </strong>Among 173 HD patients, mean age 64.7 ± 15.6 years, 102 (58.9%) male, 31 (17.9%) diabetic, 66 (38.1%) were sarcopenic, and 132 (76.3%) were frail. Kaplan-Meier analysis revealed no significant differences in survival between patients categorized as non-obese and non-sarcopenic, obese and non-sarcopenic, non-obese and sarcopenic, or obese and sarcopenic. However, frail patients showed significantly higher mortality. Multivariable logistic regression analysis identified frailty as an independent predictor of mortality (hazard ratio [HR] 2.1, 95% confidence interval [CI] 1.2-3.6, p = 0.004), while sarcopenia was not statistically significant (HR 1.01, 95% CI 0.83-1.25, p = 0.86).</p><p><strong>Conclusion: </strong>Frailty, rather than sarcopenia, was associated with mortality in HD patients. While multifrequency bioelectrical impedance analysis requires specialized equipment, clinical frailty scores offer a rapid and cost-effective screening tool.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957833","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":"Optimizing urine albumin-to-creatinine ratio testing and referral pathways for chronic kidney disease: a nominal group technique consensus study among Italian experts.","authors":"Irene Capelli, Michele De Benedictis, Andrea Di Lenarda, Vittorio Di Maso, Paolo Fabbrini, Paola Galli, Carlo Garofalo, Antonio Maria Leone, Maria Ida Maiorino, Marita Marengo, Sara Pasqualetti, Francesco Pesce, Alberto Polimeni, Michele Provenzano, Danilo Ribichini","doi":"10.1007/s40620-025-02371-w","DOIUrl":"https://doi.org/10.1007/s40620-025-02371-w","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease (CKD) represents a major global health burden, often diagnosed at advanced stages when treatment is less effective. Albuminuria, assessed by the urine albumin-to-creatinine ratio (uACR), is a key biomarker for CKD detection and risk stratification. Despite guideline recommendations, adherence to uACR testing remains low, limiting early diagnosis and timely referral. The ALLIANCE project aimed to develop a multidisciplinary consensus on optimizing uACR testing and referral pathways for improved CKD management in at-risk populations.</p><p><strong>Methods: </strong>A modified nominal group technique was used to achieve expert consensus. Seven nephrologists and eight specialists in other disciplines  (cardiologists, endocrinologists, diabetologists, and a clinical biochemist) participated in structured discussions and ranked statements across three domains: (1) at-risk population definition, (2) barriers to uACR testing, and (3) CKD management and referral. Relevance rankings were analyzed using hierarchical clustering.</p><p><strong>Results: </strong>Twenty-seven consensus statements were developed, eight of which were deemed highly relevant. Key recommendations included expanding CKD risk awareness to encompass obesity and family history, enhancing clinician education, and improving coordination between nephrologists and other specialists. Early nephrology referral was emphasized for patients with marked albuminuria, rapid renal decline, or specific risk factors. Integration of digital health tools, including shared electronic health records, was advised to support coordinated care.</p><p><strong>Conclusions: </strong>The ALLIANCE project identified critical gaps in CKD detection and management. Addressing these through clinician education, standardized uACR testing protocols, and multidisciplinary collaboration may improve outcomes and reduce cardiorenal risk. Implementation of these consensus recommendations could facilitate earlier diagnosis and better management of high-risk patients.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144957783","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":"Trust in physicians as a mediator of the relationship between person-centered care and medication adherence in patients undergoing hemodialysis: a cross-sectional study.","authors":"Yusuke Kanakubo, Ryohei Inanaga, Tatsunori Toida, Tetsuro Aita, Mamiko Ukai, Atsuro Kawaji, Takumi Toishi, Masatoshi Matsunami, Yu Munakata, Tomo Suzuki, Tadao Okada, Noriaki Kurita","doi":"10.1007/s40620-025-02387-2","DOIUrl":"10.1007/s40620-025-02387-2","url":null,"abstract":"<p><strong>Background: </strong>Person-centered care and trust in physicians influence medication adherence among dialysis patients. However, the mechanisms linking person-centered care to medication adherence, particularly the mediating effect of trust in physicians, remain unclear. This study investigated the interrelationships between person-centered care, trust in physicians, and medication adherence.</p><p><strong>Methods: </strong>Using a multicenter cross-sectional study of Japanese adults receiving outpatient hemodialysis at six dialysis centers, person-centered care was assessed using the 13-item Japanese Primary Care Assessment Tool-Short Form (JPCAT-SF), which included longitudinality and care coordination. Trust in physicians was measured using the five-item Wake Forest Physician Trust Scale. Medication adherence was measured using the 12-item Adherence Starts Knowledge (ASK-12) scale. General linear models examined person-centered care, physician trust, and medication adherence relationships. Mediation analysis determined how much trust in physicians mediated the person-centered care-medication adherence relationship.</p><p><strong>Results: </strong>A total of 483 patients, with median age and dialysis vintage of 71.9 and 5.7 years, respectively, were included in the analysis. High-quality person-centered care was associated with lower barriers to medication adherence in a dose-response manner across JPCAT-SF quartiles compared to no usual source of care. Trust in physicians partially mediated this relationship in a dose-response pattern, with the proportion of the indirect effect increasing from 16.1% (95% CI 4.5-33.8%) in Q2 to 33.3% (95% CI 17.4-65.5%) in Q4. Similar findings were observed for person-centered care subdomains.</p><p><strong>Conclusions: </strong>High-quality person-centered care was associated with medication adherence, with trust in physicians playing a key mediating role. Strategies to enhance medication adherence in hemodialysis patients should incorporate multidimensional person-centered care approaches, building trust and strengthening continuity and care coordination.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873659","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}