Kidney International Reports最新文献

{"title":"Systematic Review and Network Meta-Analysis of Initial Treatments for Lupus Nephritis","authors":"Ariel Izcovich ,&nbsp;Fernando Tortosa ,&nbsp;Agustín Bengolea ,&nbsp;Moira Magdalena Pissinis ,&nbsp;Martín Ragusa ,&nbsp;Mariano Fielli ,&nbsp;Camila Agnoletti ,&nbsp;Rosana Quintana ,&nbsp;Ana Malvar ,&nbsp;Marina Scolnik ,&nbsp;Eloisa Bonfá ,&nbsp;Eduardo F. Borba ,&nbsp;Odirlei Andre Monticielo ,&nbsp;Edgard Torres dos Reis-Neto ,&nbsp;Loreto Massardo ,&nbsp;José A. Gómez-Puerta ,&nbsp;Carlos Enrique Toro-Gutiérrez ,&nbsp;Jorge A. Esquivel-Valerio ,&nbsp;Hilda Fragoso Loyo ,&nbsp;Juan Manuel Mejia-Vilet ,&nbsp;Guillermo Pons-Estel","doi":"10.1016/j.ekir.2025.06.047","DOIUrl":"10.1016/j.ekir.2025.06.047","url":null,"abstract":"<div><h3>Introduction</h3><div>This study aimed to evaluate the comparative efficacy and safety of various initial treatments for active lupus nephritis (LN) through a systematic review and network meta-analysis (NMA).</div></div><div><h3>Methods</h3><div>We conducted a comprehensive literature search across multiple databases from inception to February 2025 to identify randomized controlled trials (RCTs) comparing initial treatments for LN. We performed a frequentist random-effects NMA using the restricted maximum likelihood method to estimate heterogeneity. We used the GRADE approach to assess the certainty of evidence.</div></div><div><h3>Results</h3><div>We included 40 RCTs encompassing 5450 patients and 16 interventions (12 drugs administered alone or in combination). Mycophenolic acid analogs (MPAAs) were selected as the common comparator. The network meta-analysis revealed that voclosporin (VCS) combined with MPAA (risk difference [RD]: 281.38 more/1000, 95% confidence interval [CI]: 146.26 more to 456.42 more; high certainty), belimumab (BEL) combined with MPAA (RD: 145.02 more/1000, 95% CI: 72.73 more to 230.92 more; high certainty), and obinutuzumab (OBI) combined with MPAA (RD: 134.23 more/1000, 95% CI: 30.37 more to 269.68 more; moderate certainty) increased complete renal response (CRR) compared with MPAA alone. Tacrolimus (TAC) combined with MPAA (RD: 113.69 more/1000, 95% CI: 25.23 more to 217.7 more; low certainty) also showed potential benefits but with low certainty evidence.</div></div><div><h3>Conclusion</h3><div>Combination therapies, particularly VCS, BEL, or OBI with MPAA, provide enhanced outcomes for LN initial treatment. Given the complexity of LN, clinicians should weigh these findings alongside considerations such as drug availability, cost, and individual patient preferences to guide treatment decisions.</div></div>","PeriodicalId":17761,"journal":{"name":"Kidney International Reports","volume":"10 9","pages":"Pages 2977-2990"},"PeriodicalIF":5.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144933869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meta-Analysis of Randomized Controlled Trials on Gamma-Aminobutyric Acid Analogues and Opioid-Based Therapies for CKD-Associated Pruritus","authors":"Wannasit Wathanavasin ,&nbsp;Theerachai Thammathiwat ,&nbsp;Paweena Susantitaphong","doi":"10.1016/j.ekir.2025.06.037","DOIUrl":"10.1016/j.ekir.2025.06.037","url":null,"abstract":"<div><h3>Introduction</h3><div>Chronic kidney disease (CKD)-associated pruritus (CKD-aP) is one of the most distressing symptoms of patients with CKD, adversely affecting their quality of life and survival. This study aimed to investigate the efficacy and safety of gamma-aminobutyric acid (GABA) analogues and opioid-based therapies in patients with CKD-aP.</div></div><div><h3>Methods</h3><div>The eligible studies were searched from PubMed, Embase, and Scopus up to January 22, 2025. Only randomized controlled trials (RCTs) that reported the treatment effect on pruritus severity scores were included, focusing on both unidimensional scales and multidimensional scales. The results were synthesized using a random-effect model and provided weighted mean difference (WMD) and relative risk (RR) with a 95% confidence interval (CI).</div></div><div><h3>Results</h3><div>A total of 27 RCTs involving 2836 patients with CKD-aP were analyzed. Treatment with GABA analogues was associated with significantly greater reductions in 10-cm visual analog scale (VAS) and 5-D itch scores with nonsignificant increased incidence of adverse events (AEs) or adverse drug reactions (ADRs). In addition, opioid receptor–targeting treatments significantly decreased worst itch numeric rating scale (WI-NRS), 5-D itch, Skindex-10, and 100-mm VAS, but showed significantly higher rates of AEs or ADRs, particularly related to gastrointestinal issues, as well as neurological disorders such as sleep disturbances.</div></div><div><h3>Conclusion</h3><div>Our results suggest that GABA analogues and opioid-based therapies, particularly difelikefalin, have significant potential in alleviating itch intensity and improving the quality of life of patients with CKD-aP. However, opioid-based therapies, especially those involving μ-receptor antagonists such as naltrexone and nalbuphine, are associated with a higher incidence of AEs or ADRs. Given the substantial heterogeneity observed in most of the results, interpretation should be approached with caution.</div></div>","PeriodicalId":17761,"journal":{"name":"Kidney International Reports","volume":"10 9","pages":"Pages 2991-3005"},"PeriodicalIF":5.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144933870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dysregulated Anaerobic Glycolysis in Podocytes is Relevant to the Progression of Focal Segmental Glomerulosclerosis","authors":"Masahiro Sugimura ,&nbsp;Kayaho Maeda ,&nbsp;Katsuaki Shibata ,&nbsp;Hiroshi Seko ,&nbsp;Yohei Kozaki ,&nbsp;Akiyoshi Hirayama ,&nbsp;Tomoyoshi Soga ,&nbsp;Takaya Ozeki ,&nbsp;Yuka Sato ,&nbsp;Noritoshi Kato ,&nbsp;Tomoki Kosugi ,&nbsp;Kenji Kadomatsu ,&nbsp;Shoichi Maruyama","doi":"10.1016/j.ekir.2025.06.022","DOIUrl":"10.1016/j.ekir.2025.06.022","url":null,"abstract":"<div><h3>Introduction</h3><div>Minimal change disease (MCD) and focal segmental glomerulosclerosis (FSGS) are podocytopathies with varying clinical courses and therapeutic responses. FSGS often leads to end-stage renal disease. Consequently, their heterogeneity requires case stratification and pathophysiological elucidation. The involvement of energy metabolism in FSGS pathogenesis and stratification has not been clarified. Therefore, this study aimed to verify whether evaluating energy kinetics can be a new approach to MCD or FSGS stratification and explore the role of energy metabolism in MCD or FSGS.</div></div><div><h3>Methods</h3><div>Cultured human podocytes were treated with sera from patients with biopsy-confirmed MCD or FSGS. Serum-treated podocytes were analyzed for apoptosis using flow cytometry, metabolomics via mass spectrometry, and real-time adenosine triphosphate (ATP) production rates using an extracellular flux analyzer. Adriamycin-induced nephropathy was induced in podocyte-specific lactate dehydrogenase (LDH) A (LDHA)-deficient and control mice.</div></div><div><h3>Results</h3><div>The sera from patients with FSGS significantly induced apoptosis in human podocytes compared with those from individuals with MCD. Apoptosis severity was associated with segmental obliteration and corticosteroid resistance. Metabolomic analysis revealed differences in anaerobic glycolysis and tricarboxylic acid cycle (TCA)-related metabolites in podocytes exposed to the sera of patients with MCD and FSGS. In the podocytes treated with sera from patients with FSGS, glycolytic ATP production significantly decreased in cases with high apoptosis rates. The sera from patients with FSGS suppressed LDHA activity, suppressed α-actinin 4 (ACTN4) expression, and promoted actin remodeling of podocytes. Segmental sclerosis was more prominent in podocyte-specific LDHA-deficient mice with adriamycin-induced nephropathy than in control mice.</div></div><div><h3>Conclusion</h3><div>FSGS progression was associated with decreased anaerobic glycolysis in podocytes.</div></div>","PeriodicalId":17761,"journal":{"name":"Kidney International Reports","volume":"10 9","pages":"Pages 3239-3254"},"PeriodicalIF":5.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144933953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New Insights Into Renal Involvement During Immune-Mediated Thrombotic Thrombocytopenic Purpura","authors":"Marie Robert ,&nbsp;Valentin Maisons ,&nbsp;Marion Rabant ,&nbsp;Aude Servais ,&nbsp;Charles Antunes ,&nbsp;Nicolas Fage ,&nbsp;Florent von Tokarski ,&nbsp;Sophie Chauvet ,&nbsp;Manon Dekeyser ,&nbsp;Alain Wynckel ,&nbsp;Anna Duval ,&nbsp;Nadine Baroukh ,&nbsp;Agnès Veyradier ,&nbsp;Bérangère S. Joly ,&nbsp;Paul Coppo ,&nbsp;Jean-Michel Halimi","doi":"10.1016/j.ekir.2025.06.039","DOIUrl":"10.1016/j.ekir.2025.06.039","url":null,"abstract":"","PeriodicalId":17761,"journal":{"name":"Kidney International Reports","volume":"10 9","pages":"Pages 3271-3275"},"PeriodicalIF":5.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144933955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to the Letter to the Editor Entitled “Desmopressin After Kidney Biopsy: Are the Risks Worth it?”","authors":"Narayan Prasad ,&nbsp;Jeyakumar Meyyappan","doi":"10.1016/j.ekir.2025.07.010","DOIUrl":"10.1016/j.ekir.2025.07.010","url":null,"abstract":"","PeriodicalId":17761,"journal":{"name":"Kidney International Reports","volume":"10 9","pages":"Pages 3292-3293"},"PeriodicalIF":5.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144933961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seeing the Bigger Picture: Incorporating Cytomegalovirus-Specific Cell-Mediated Immunity Into Risk Prediction for Cytomegalovirus","authors":"Cesar G. Berto ,&nbsp;Elisabet Van Loon","doi":"10.1016/j.ekir.2025.07.027","DOIUrl":"10.1016/j.ekir.2025.07.027","url":null,"abstract":"","PeriodicalId":17761,"journal":{"name":"Kidney International Reports","volume":"10 9","pages":"Pages 2914-2916"},"PeriodicalIF":5.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144933991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of End-Stage Kidney Disease and Topiramate Use","authors":"Jean-Michel Halimi ,&nbsp;Valentin Maisons ,&nbsp;Jean-Baptiste de Fréminville ,&nbsp;Sébastien Roger ,&nbsp;Arnaud Bisson ,&nbsp;Stéphanie Chadet ,&nbsp;Laurent Fauchier","doi":"10.1016/j.ekir.2025.06.003","DOIUrl":"10.1016/j.ekir.2025.06.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Topiramate is widely used for migraine prevention but has pleiotropic effects on renal sodium reabsorption and inflammation. Whether these effects could be associated with lower risk of end-stage kidney disease (ESKD) and cardiovascular outcomes is unknown.</div></div><div><h3>Methods</h3><div>Among 1,745,580 patients with a diagnosis of migraine, the risk of ESKD, cardiovascular outcomes, and death was assessed after propensity matching in patients treated with topiramate versus untreated patients.</div></div><div><h3>Results</h3><div>Overall, 317,936 patients treated with topiramate were properly matched with 317,936 controls by age (43 years old), sex (women: 86%), clinical and biological parameters, comorbid conditions, and baseline medications. After a median follow-up of 3.5 years, patients receiving topiramate had a significant lower risk of ESKD (hazard ratio [HR]: 0.850; 95% confidence interval [CI]: 0.776–0.930; <em>P</em> &lt; 0.0001). Among the subgroup of patients with available data, patients treated with topiramate had a smaller estimated glomerular filtration rate (eGFR) decline over time than the other patients. Albuminuria remained stable during follow-up in the topiramate group but increased in the other patients. They also had a lower risk of death (HR: 0.827 [0.799–0.856]), cardiac arrest or ventricular tachycardia/fibrillation (HR: 0.944 [0.898–0.992]), but a higher risk of ischemic stroke or thromboembolism (HR: 1.366 [1.318–1.416]) than other patients. Similar results were observed when men and women were analyzed separately. No association was found between topiramate use and risks of myocardial infarction, atrial fibrillation, or heart failure.</div></div><div><h3>Conclusion</h3><div>In men and women with migraine, topiramate was significantly associated with lower risks of ESKD and death, but higher risks of ischemic stroke or thromboembolism.</div></div>","PeriodicalId":17761,"journal":{"name":"Kidney International Reports","volume":"10 8","pages":"Pages 2642-2650"},"PeriodicalIF":5.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144757079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IgA Nephropathy in the Elderly","authors":"Dana V. Rizk ,&nbsp;Emily Dryer ,&nbsp;Ashutosh Tamhane ,&nbsp;Jan Novak ,&nbsp;Bruce A. Julian ,&nbsp;Robert J. Wyatt","doi":"10.1016/j.ekir.2025.05.012","DOIUrl":"10.1016/j.ekir.2025.05.012","url":null,"abstract":"<div><h3>Introduction</h3><div>Knowledge about IgA nephropathy (IgAN) presentation and prognosis for elderly patients is limited. We assessed clinical and histologic findings among patients aged ≥ 60 years at diagnosis and examined factors associated with the risk of kidney failure and death.</div></div><div><h3>Methods</h3><div>We identified those patients at our center between 1996 and 2020. Age, sex, race, chronic kidney disease (CKD) stage, and histologic MEST-C classification at biopsy were collected. Outcomes of kidney failure and death were ascertained by using United States Renal Data System (USRDS) and National Death Index (NDI), respectively. Associations of baseline predictors with kidney failure were examined by using cause-specific Cox hazards regression with all-cause mortality as competing risk. For all-cause mortality, standard Cox proportional hazards regression analysis was used. Cumulative survival probabilities were examined using Kaplan-Meier survival curves.</div></div><div><h3>Results</h3><div>Among 127 patients, median estimated glomerular filtration rate (eGFR) was 25 ml/min per 1.73 m², 81% had proteinuria ≥ 1000 mg/g creatinine, 35% and 17% had CKD stages 4 and 5, respectively. Forty-five patients progressed to kidney failure and 86 died. Overall, Kaplan-Meier estimate of median time to kidney failure was 11.3 years and to death was 7.5 years. Males were more likely to progress to kidney failure than females. Kidney failure strongly associated with CKD stages 3, 4, and 5 versus stages 1 or 2; findings remained unchanged after adjusting for histology. Mortality was associated with increasing age and advanced CKD.</div></div><div><h3>Conclusion</h3><div>IgAN diagnosed at elderly age is associated with severe clinical phenotype and portends a poor prognosis because of high risk of kidney failure and death.</div></div>","PeriodicalId":17761,"journal":{"name":"Kidney International Reports","volume":"10 8","pages":"Pages 2651-2658"},"PeriodicalIF":5.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144757080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to the Letter to the Editor Entitled “Optimizing Furosemide Use in Advanced CKD: Balancing Risks and Benefits”","authors":"M. Costes-Albrespic ,&nbsp;N. Alencar de Pinho ,&nbsp;Z.A. Massy ,&nbsp;S. Liabeuf","doi":"10.1016/j.ekir.2025.05.048","DOIUrl":"10.1016/j.ekir.2025.05.048","url":null,"abstract":"","PeriodicalId":17761,"journal":{"name":"Kidney International Reports","volume":"10 8","pages":"Pages 2877-2878"},"PeriodicalIF":5.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144757000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fedratinib-Induced Kidney Injury Confirmed by Biopsy","authors":"Sophie Le Grand ,&nbsp;Pierre Guy ,&nbsp;Suzanne Tavitian ,&nbsp;Magali Colombat ,&nbsp;Arnaud Del Bello ,&nbsp;Julie Belliere","doi":"10.1016/j.ekir.2025.06.029","DOIUrl":"10.1016/j.ekir.2025.06.029","url":null,"abstract":"","PeriodicalId":17761,"journal":{"name":"Kidney International Reports","volume":"10 8","pages":"Pages 2875-2876"},"PeriodicalIF":5.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144757175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}