Kidney Research and Clinical Practice最新文献

{"title":"Association of metformin with cardiovascular and graft outcomes in kidney transplant recipients with posttransplantation diabetes mellitus.","authors":"Dongyeon Lee, Jiyun Jung, Sichan Kim, Jaeyun Lee, Jangwook Lee, Chung Hee Baek, Hyunwook Kwon, Sung Shin, Younghoon Kim, Sung Joon Shin, Su-Kil Park, Jae Yoon Park, Hyosang Kim","doi":"10.23876/j.krcp.23.085","DOIUrl":"10.23876/j.krcp.23.085","url":null,"abstract":"<p><strong>Background: </strong>Posttransplantation diabetes mellitus (PTDM) is a crucial problem after kidney transplantation. We aimed to determine whether metformin affects cardiovascular and graft outcomes in patients with PTDM.</p><p><strong>Methods: </strong>This retrospective cohort study included 1,663 kidney transplant recipients without preexisting diabetes mellitus. The patients were divided into metformin and non-metformin groups, with matched propensity scores. We also estimated metformin's effect on percutaneous coronary intervention (PCI), major adverse cardiovascular events (MACEs), acute rejection, and graft failure.</p><p><strong>Results: </strong>Of 634 recipients with PTDM, 406 recipients were treated with metformin. The incidence of PCI was 2.4% and 7.1% in the metformin and non-metformin groups, respectively (p = 0.04). The metformin group exhibited a lower risk of PCI in Cox regression analyses (hazard ratio [HR], 0.27; 95% confidence interval [CI], 0.10-0.77; p = 0.014), especially in subgroups with male sex, age over 49 years (median), long-term metformin use (mean of ≥1,729 days), and simultaneous tacrolimus administration. Long-term metformin use was also associated with lower incidence of MACEs (HR, 0.09; 95% CI, 0.01-0.67; p = 0.02). Incidence of graft failure was 9.9% and 17.0% in the metformin and non-metformin groups, respectively (p = 0.046). Both long-term use and higher dose of metformin, as well as tacrolimus administration with metformin, were associated with a lower risk of graft failure (HR, 0.29; 95% CI, 0.11-0.75; p = 0.01; HR, 0.39; 95% CI, 0.18-0.85; p = 0.02; and HR, 0.39; 95% CI, 0.19-0.79; p = 0.009, respectively).</p><p><strong>Conclusion: </strong>Metformin use is associated with a decreased risk of developing coronary artery disease and better graft outcomes in PTDM.</p>","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":"86-98"},"PeriodicalIF":3.8,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12824509/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139425049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence, risk factors, and mortality of acute kidney injury in patients receiving immune checkpoint inhibitors: analysis by acute kidney injury subtype.","authors":"Yu-Been Seo, Ho Jin Lee, Young Eun Choi, Taeyeon Koo, Sewon Oh, Yoon Ji Choi, Soohyeon Lee, Myung Gyu Kim, Kyong Hwa Park, Sang Kyung Jo","doi":"10.23876/j.krcp.25.410","DOIUrl":"https://doi.org/10.23876/j.krcp.25.410","url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury (AKI) is a common complication in patients receiving immune checkpoint inhibitor (ICI) therapy. It can result from conventional causes or immune-mediated mechanisms. This study aimed to determine the incidence, risk factors, and clinical outcomes of all-cause AKI in patients treated with ICIs.</p><p><strong>Methods: </strong>We retrospectively analyzed adults treated with ICIs at Korea University Anam Hospital between 2015 and 2024. AKI occurring within 12 months after treatment initiation was defined according to the KDIGO (Kidney Disease: Improving Global Outcomes) criteria. It was classified as transient azotemia (recovery within 72 hours) or sustained AKI (>72 hours), including acute tubular necrosis (ATN), obstruction, and ICI-associated AKI (ICI-AKI).</p><p><strong>Results: </strong>Among 943 patients, the overall incidence of AKI was 32.1%. ATN was most common, followed by transient azotemia, obstruction, and immune-mediated acute tubulointerstitial nephritis. Pre-existing chronic kidney disease and proton pump inhibitor use were independent risk factors for immune-mediated AKI, whereas low serum albumin, high C-reactive protein, and hepatobiliary cancers were associated with ATN. Transient azotemia and ATN were independently associated with higher mortality. Although ICI-AKI was also significantly associated with increased mortality, the association was modest and should be interpreted cautiously given the limited number of cases (n = 25).</p><p><strong>Conclusion: </strong>ATN and transient azotemia were more frequent than ICI-AKI and were associated with worse prognosis; ICI-AKI also showed a statistically significant but modest association with mortality. Identifying different risk factors for each subtype may help clinicians achieve earlier recognition and optimize management in patients receiving ICI therapy.</p>","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microplastic and nanoplastic risks for hemodialysis patients and the environment.","authors":"Faissal Tarrass, Meryem Benjelloun","doi":"10.23876/j.krcp.25.473","DOIUrl":"https://doi.org/10.23876/j.krcp.25.473","url":null,"abstract":"","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond hematologic remission: what the kidney tells us in amyloid light-chain amyloidosis.","authors":"Ji Eun Jang","doi":"10.23876/j.krcp.26.415","DOIUrl":"https://doi.org/10.23876/j.krcp.26.415","url":null,"abstract":"","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of waist circumference trajectories with incident chronic kidney disease.","authors":"Jun-Hyuk Lee, Hwan-Sik Hwang, Jun-Hwan Park, Yu-Mi Kim, Do-Hoon Kim, Hoon-Ki Park","doi":"10.23876/j.krcp.26.129","DOIUrl":"https://doi.org/10.23876/j.krcp.26.129","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease (CKD) is a major public health burden. Waist circumference (WC) is associated with CKD risk, but the prognostic significance of longitudinal WC change remains uncertain. We examined the association between WC trajectories and incident CKD in Korean adults.</p><p><strong>Methods: </strong>This retrospective cohort study included 5,429 adults aged 40-69 years from the Korean Genome and Epidemiology Study Ansan-Ansung cohort who were free of CKD at baseline and during the 6-year exposure period. WC trajectories were classified as stable, increasing, or decreasing using Gaussian finite mixture modeling. Incident CKD during the subsequent 12-year event accrual period was defined as new-onset reduced estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 or urine dipstick albumin ≥1+ on two consecutive measurements. Multivariable Cox models estimated hazard ratios (HRs) and 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Over a median follow-up of 11.8 years, 576 participants (10.6%) developed CKD. Compared with the stable WC trajectory, the increasing WC trajectory was associated with a higher risk of incident CKD (adjusted HR, 1.41; 95% CI, 1.17-1.71), whereas the decreasing trajectory was not (adjusted HR, 0.83; 95% CI, 0.56-1.23). Secondary analyses showed higher risks of incident reduced eGFR and new-onset dipstick albuminuria in the increasing WC group, and time-varying Cox analysis supported the primary finding. Restricted cubic spline analysis demonstrated a significant linear dose-response relationship.</p><p><strong>Conclusion: </strong>Serial WC increase may serve as a simple, clinically accessible marker of cumulative metabolic burden and future CKD risk.</p>","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combined empagliflozin and liraglutide therapy protects against tacrolimus-induced pancreatic and renal injury associated with oxidative stress reduction.","authors":"Do Hyun Na, Xianying Fang, Hanbi Lee, Sang Hun Eum, Eun Jeong Ko, Hye Eun Yoon, Yoo Jin Shin, Sun Woo Lim, Byung Ha Chung","doi":"10.23876/j.krcp.26.147","DOIUrl":"https://doi.org/10.23876/j.krcp.26.147","url":null,"abstract":"<p><strong>Background: </strong>Sodium-glucose cotransporter-2 inhibitors (SGLT2is) and glucagon-like peptide-1 receptor agonists (GLP-1RAs) are widely used in type 2 diabetes mellitus for glycemic control and organ protection. This study investigated whether the combined use of empagliflozin (EMPA) and liraglutide (LIRA) could protect against pancreatic and renal damage caused by tacrolimus (TAC).</p><p><strong>Methods: </strong>Male Sprague-Dawley rats received TAC for 4 weeks, either alone, or in combination with EMPA, LIRA, or both. Metabolic, histologic, and molecular parameters were assessed in vivo and in vitro. TAC caused hyperglycemia, reduced creatinine clearance, pancreatic β-cell loss, renal tubulointerstitial fibrosis, and increased oxidative stress and apoptosis.</p><p><strong>Results: </strong>Either EMPA or LIRA alone partially attenuated these changes, whereas their combination provided enhanced protection- improving kidney function, preserving islet integrity, and reducing fibrosis and cell death. In the kidney and pancreas, dual therapy restored antiapoptotic and antioxidant signaling while suppressing profibrotic pathways, thereby mitigating oxidative stress and injury. Cell-based experiments further confirmed that EMPA plus LIRA enhanced cell viability and reduced reactive oxygen species generation in TAC-injured HK-2 and INS-1 cells.</p><p><strong>Conclusion: </strong>These findings indicate that combined SGLT2i and GLP-1RA therapy confers additive metabolic protection associated with attenuation of oxidative stress in tacrolimus-induced pancreatic and renal damage in this preclinical model, warranting further investigation of its potential as an adjunct strategy for posttransplant diabetes mellitus and nephrotoxicity.</p>","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Membranoproliferative glomerulonephritis in a new therapeutic era: current landscape and unresolved questions.","authors":"Yu Ho Lee","doi":"10.23876/j.krcp.26.417","DOIUrl":"https://doi.org/10.23876/j.krcp.26.417","url":null,"abstract":"","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uremic toxins and hemodialysis vascular access: a modifiable risk or just one piece of the puzzle?","authors":"Hoon Suk Park","doi":"10.23876/j.krcp.26.404","DOIUrl":"https://doi.org/10.23876/j.krcp.26.404","url":null,"abstract":"","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early referral to nephrology: a cornerstone of multidisciplinary diabetes care for proactive kidney health management.","authors":"Jung-Hwa Ryu","doi":"10.23876/j.krcp.26.405","DOIUrl":"https://doi.org/10.23876/j.krcp.26.405","url":null,"abstract":"","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149172264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reappraising spherical adsorptive carbon in advanced chronic kidney disease: who might benefit and when?","authors":"Jung-Hwa Ryu","doi":"10.23876/j.krcp.26.402","DOIUrl":"https://doi.org/10.23876/j.krcp.26.402","url":null,"abstract":"","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149165971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}