Kidney Diseases最新文献

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Artificial Intelligence Models in Diagnosis and Treatment of Kidney Diseases: Current Status and Prospects. 人工智能模型在肾脏疾病诊治中的应用现状与展望
IF 3.2 4区 医学
Kidney Diseases Pub Date : 2025-06-12 eCollection Date: 2025-01-01 DOI: 10.1159/000546397
Cheng Li, Jing Liu, Ping Fu, Jie Zou
{"title":"Artificial Intelligence Models in Diagnosis and Treatment of Kidney Diseases: Current Status and Prospects.","authors":"Cheng Li, Jing Liu, Ping Fu, Jie Zou","doi":"10.1159/000546397","DOIUrl":"https://doi.org/10.1159/000546397","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI) has made significant advances in nephrology, revolutionizing the diagnosis, prognosis, and treatment of kidney diseases.</p><p><strong>Summary: </strong>This review provides an overview of AI applications in nephrology, introducing the basic structures of each model, highlighting both traditional machine-learning approaches and neural networks, and providing model application comparisons along with selection recommendations. It discussed key challenges in deciding appropriate AI models for specific tasks and evaluated their advantages, limitations, and optimal use cases. Current applications of AI in nephrology mainly include diagnosis and disease outcome prediction, medical image analysis, treatment recommendations, and personalized health management, supported by massive electronic health records and multimodal data integration. Traditional machine learning models perform well on datasets of varying sizes and structures, while neural networks excel at handling complex and imaging data. Emerging hardware innovations are expected to improve the performance of neural network models, enabling more accurate diagnosis and automated analysis in clinical practice. In the future, AI will have great potential to advance individualized patient care and enable real-time data processing in nephrology.</p><p><strong>Key messages: </strong>An overview of AI applications in nephrology is provided in this review.</p>","PeriodicalId":17830,"journal":{"name":"Kidney Diseases","volume":"11 1","pages":"491-507"},"PeriodicalIF":3.2,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12266707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Are Your Kidneys OK? Detect Early to Protect Kidney Health. 你的肾脏还好吗?早期发现,保护肾脏健康。
IF 3.2 4区 医学
Kidney Diseases Pub Date : 2025-06-10 eCollection Date: 2025-01-01 DOI: 10.1159/000546671
Joseph A Vassalotti, Anna Francis, Augusto Cesar Soares Dos Santos, Ricardo Correa-Rotter, Dina Abdellatif, Li-Li Hsiao, Stefanos Roumeliotis, Agnes Haris, Latha A Kumaraswami, Siu-Fai Lui, Alessandro Balducci, Vassilios Liakopoulos
{"title":"Are Your Kidneys OK? Detect Early to Protect Kidney Health.","authors":"Joseph A Vassalotti, Anna Francis, Augusto Cesar Soares Dos Santos, Ricardo Correa-Rotter, Dina Abdellatif, Li-Li Hsiao, Stefanos Roumeliotis, Agnes Haris, Latha A Kumaraswami, Siu-Fai Lui, Alessandro Balducci, Vassilios Liakopoulos","doi":"10.1159/000546671","DOIUrl":"10.1159/000546671","url":null,"abstract":"","PeriodicalId":17830,"journal":{"name":"Kidney Diseases","volume":"11 1","pages":"482-490"},"PeriodicalIF":3.2,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12237290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Subtypes of Intracranial Carotid Arteriosclerosis and Vascular Prognosis in Chronic Kidney Disease Patients. 慢性肾病患者颅内颈动脉硬化亚型及血管预后。
IF 3.2 4区 医学
Kidney Diseases Pub Date : 2025-06-10 eCollection Date: 2025-01-01 DOI: 10.1159/000546853
Bo-Ching Lee, Hsin-Hsi Tsai, Jia-Zheng Huang, Ya-Fang Chen, Li-Kai Tsai, Tai-Shuan Lai
{"title":"Subtypes of Intracranial Carotid Arteriosclerosis and Vascular Prognosis in Chronic Kidney Disease Patients.","authors":"Bo-Ching Lee, Hsin-Hsi Tsai, Jia-Zheng Huang, Ya-Fang Chen, Li-Kai Tsai, Tai-Shuan Lai","doi":"10.1159/000546853","DOIUrl":"https://doi.org/10.1159/000546853","url":null,"abstract":"<p><strong>Introduction: </strong>Vascular calcification, linked to atherosclerosis, is a significant cardiovascular risk factor in chronic kidney disease (CKD). While different intracranial carotid arteriosclerosis subtypes affect stroke risk in the general population, their prevalence, causes, and impact on CKD patients remain unclear.</p><p><strong>Methods: </strong>This cohort study used data from the National Taiwan University Hospital's pre-end-stage renal disease care database, including 2,622 CKD patients with brain CT scans from 2006 to 2020. Intracranial carotid artery calcifications were categorized as intimal or internal elastic lamina (IEL) subtypes. Multivariable Cox regression assessed the associations between each calcification subtype and incident stroke or vascular mortality.</p><p><strong>Results: </strong>Among 2,622 patients, 2,470 (94.2%) had calcifications classifiable as intimal (<i>n</i> = 719, 27.4%), IEL (<i>n</i> = 1,642, 62.6%), or mixed (<i>n</i> = 109, 4.2%) subtypes. Multivariable analysis revealed that IEL subtype was associated with older age, diabetes, prior vascular diseases, and impaired renal function (<i>p</i> < 0.05). Over a median follow-up of 3.9 years, IEL subtype exhibited a higher risk of any stroke (adjusted hazard ratio [HR] [95% CI]: 2.0 [1.2-3.2], <i>p</i> = 0.007) and vascular death (adjusted HR [95% CI]: 2.0 [1.4-3.0], <i>p</i> < 0.001), compared to those without calcification. Furthermore, the IEL subtype displayed a higher risk of any stroke (adjusted HR [95% CI]: 1.6 [1.1-2.3], <i>p</i> = 0.017) and vascular death (adjusted HR [95% CI]: 1.6 [1.3-2.1], <i>p</i> < 0.001) compared to the intimal subtype.</p><p><strong>Conclusion: </strong>IEL calcification is prevalent in CKD patients and associated with aging, diabetes, and impaired renal function. It poses a higher risk of cerebrovascular events compared to those without calcification or with intimal calcification.</p>","PeriodicalId":17830,"journal":{"name":"Kidney Diseases","volume":"11 1","pages":"508-517"},"PeriodicalIF":3.2,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12266704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Erratum. 勘误表。
IF 3.2 4区 医学
Kidney Diseases Pub Date : 2025-05-26 eCollection Date: 2025-01-01 DOI: 10.1159/000546078
{"title":"Erratum.","authors":"","doi":"10.1159/000546078","DOIUrl":"https://doi.org/10.1159/000546078","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1159/000520586.].</p>","PeriodicalId":17830,"journal":{"name":"Kidney Diseases","volume":"11 1","pages":"319"},"PeriodicalIF":3.2,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144150964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Finerenone in Primary IgA Nephropathy: A Matched Case-Control Study. 芬烯酮治疗原发性IgA肾病:一项匹配病例-对照研究。
IF 3.2 4区 医学
Kidney Diseases Pub Date : 2025-05-23 eCollection Date: 2025-01-01 DOI: 10.1159/000546536
Yan Ouyang, Qingjie Weng, Xinyi Zhu, Zijin Chen, Wen Du, Qing Zhao, Jing Xu, Xiaofan Hu, Zhaohui Wang, Jingyuan Xie
{"title":"Finerenone in Primary IgA Nephropathy: A Matched Case-Control Study.","authors":"Yan Ouyang, Qingjie Weng, Xinyi Zhu, Zijin Chen, Wen Du, Qing Zhao, Jing Xu, Xiaofan Hu, Zhaohui Wang, Jingyuan Xie","doi":"10.1159/000546536","DOIUrl":"10.1159/000546536","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to evaluate whether supplementation of finerenone to renin-angiotensin system inhibitor (RASi) therapy confers additional renoprotective benefit versus RASi therapy only in clinical IgA nephropathy (IgAN).</p><p><strong>Methods: </strong>Primary IgAN patients administered RASi therapy at Ruijin Hospital from January 2023 to December 2023 were retrospectively enrolled, with an estimated glomerular filtration rate (eGFR) ≥25 mL/min/1.73 m<sup>2</sup>. IgAN patients treated with steroids or immunosuppressants were excluded. The analyzed patients were divided into the finerenone and RASi groups based on finerenone use status. Patients were selected via 1:1 propensity score matching (PSM) based on age, sex, 24-hour urine protein, eGFR, and sodium-dependent glucose transporter-2 inhibitor (SGLT2i) use status. The primary endpoint was the change in urinary protein at 9 months compared to baseline. Secondary endpoints included eGFR decline and safety outcomes, with additional data collection at 12 months.</p><p><strong>Results: </strong>After PSM, 62 patients were included, with 31 in each group. The finerenone group showed a greater reduction in urinary protein (-29.03% vs. 41.47%, <i>p</i> < 0.001) and a slower least squares mean eGFR slope (1.87 vs. -4.13 mL/min/1.73 m<sup>2</sup>, <i>p</i> = 0.03) at 9 months compared with the RASi group. Subgroup analysis suggested a trend toward greater improvement with SGLT2i addition, but the interaction was not statistically significant (<i>p</i> = 0.31), likely due to the limited sample size. Extended follow-up at 12 months confirmed these findings, demonstrating a sustained reduction in proteinuria (<i>p</i> = 0.001). Hyperkalemia rates remained similar in both groups at 4, 9, and 12 months.</p><p><strong>Conclusions: </strong>The combination of finerenone with RASi is associated with a greater reduction in urinary protein and potentially better stabilization of eGFR compared with RASi alone in IgAN patients. However, these findings require further validation in prospective studies.</p>","PeriodicalId":17830,"journal":{"name":"Kidney Diseases","volume":"11 1","pages":"440-449"},"PeriodicalIF":3.2,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12215197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144553920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Efficacy and Safety of Finerenone in Asian Patients with Type 2 Diabetes and Chronic Kidney Disease: A FIDELITY Analysis. 菲尼酮治疗亚洲2型糖尿病和慢性肾病患者的疗效和安全性:一项FIDELITY分析
IF 3.2 4区 医学
Kidney Diseases Pub Date : 2025-05-22 eCollection Date: 2025-01-01 DOI: 10.1159/000545415
Takashi Wada, Stefan D Anker, Zhihong Liu, Byung Wan Lee, Chien-Te Lee, Peter Rossing, Luis M Ruilope, Christiane Ahlers, Meike Brinker, Amaninder Mann, Satoshi Yamashita, Bertram Pitt
{"title":"Efficacy and Safety of Finerenone in Asian Patients with Type 2 Diabetes and Chronic Kidney Disease: A FIDELITY Analysis.","authors":"Takashi Wada, Stefan D Anker, Zhihong Liu, Byung Wan Lee, Chien-Te Lee, Peter Rossing, Luis M Ruilope, Christiane Ahlers, Meike Brinker, Amaninder Mann, Satoshi Yamashita, Bertram Pitt","doi":"10.1159/000545415","DOIUrl":"10.1159/000545415","url":null,"abstract":"<p><strong>Introduction: </strong>In FIDELITY, a prespecified pooled analysis of the phase III FIDELIO-DKD and FIGARO-DKD trials, finerenone reduced the risk of cardiovascular (CV) and kidney events versus placebo in patients with type 2 diabetes and chronic kidney disease, on optimized renin-angiotensin system blockade. This FIDELITY post hoc subanalysis explores the efficacy and safety of finerenone in Asian patients.</p><p><strong>Methods: </strong>For this subanalysis, efficacy outcomes included a CV composite (time to CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure) and kidney composite (kidney failure, sustained ≥57% estimated glomerular filtration rate [eGFR] decrease from baseline over ≥4 weeks or renal death) outcome. A change in urine albumin-to-creatinine ratio (UACR) from baseline to month 4 and eGFR slopes was also assessed. All outcomes were assessed by baseline eGFR (<60 and ≥60 mL/min/1.73 m<sup>2</sup>) and UACR (<300 and ≥300 mg/g) subgroups. Safety outcomes were reported as treatment-emergent adverse events, including laboratory evaluations for hyperkalemia.</p><p><strong>Results: </strong>In the Asian subpopulation, 1,412/2,858 (49.4%) received finerenone. Finerenone-treated Asian patients had a lower risk of the composite CV outcome (hazard ratio [HR] = 0.90; 95% confidence interval [CI], 0.70-1.15) and nominally significant reductions in the risk of ≥57% and ≥40% eGFR composite kidney outcomes (HR = 0.64; 95% CI, 0.50-0.82 and HR = 0.67; 95% CI, 0.56-0.80, respectively) versus those receiving placebo, irrespective of baseline eGFR and UACR. Data on change of eGFR from baseline over the course of the trials indicated that chronic kidney disease progression in Asian patients was slower with finerenone versus placebo. Overall, safety outcomes were balanced between both populations. Serum potassium values with finerenone were similar between the Asian and non-Asian subpopulations (>5.5 mmol/L: 15.6% versus 17.1%; >6.0 mmol/L: 4.6% versus 2.9%, respectively), while hyperkalemia leading to permanent treatment discontinuation with finerenone was low in both populations (Asian: 1.5%; non-Asian: 1.8%).</p><p><strong>Conclusion: </strong>Finerenone reduced the risk of CV and kidney events and demonstrated a well-tolerated safety profile in the FIDELITY Asian subpopulation.</p>","PeriodicalId":17830,"journal":{"name":"Kidney Diseases","volume":"11 1","pages":"402-415"},"PeriodicalIF":3.2,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12185061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Predicting Adverse Outcomes in Kidney Transplant Recipients Using an Interpretable Model Based on Shear-Wave Elastography. 利用基于剪切波弹性成像的可解释模型预测肾移植受者的不良预后。
IF 3.2 4区 医学
Kidney Diseases Pub Date : 2025-05-16 eCollection Date: 2025-01-01 DOI: 10.1159/000546396
Jieying Wang, Jiayi Yan, Tianyi Zhang, Hong Cai, Wenqi Yang, Liang Ying, Shan Mou, Xinghua Shao
{"title":"Predicting Adverse Outcomes in Kidney Transplant Recipients Using an Interpretable Model Based on Shear-Wave Elastography.","authors":"Jieying Wang, Jiayi Yan, Tianyi Zhang, Hong Cai, Wenqi Yang, Liang Ying, Shan Mou, Xinghua Shao","doi":"10.1159/000546396","DOIUrl":"10.1159/000546396","url":null,"abstract":"<p><strong>Introduction: </strong>Shear-wave elastography (SWE) is a promising noninvasive technique for measuring renal fibrosis after transplantation. This study aimed to develop an interpretable model to predict allograft deterioration in kidney transplant recipients and evaluate the predictive ability of SWE features.</p><p><strong>Methods: </strong>In this prospective cohort study, we performed SWE examinations on kidney transplant recipients at Renji Hospital between October 2020 and August 2023. The primary outcome was a composite of a 40% decline in estimated glomerular filtration rate or end-stage kidney disease. A total of 396 patients with stable renal allograft function were included. Five machine learning methods were used to construct predictive models.</p><p><strong>Results: </strong>Among all participants, 69 (17.4%) individuals reached the outcome. The XGBoost model with the addition of SWE features achieved the highest predictive performance with 20 repeats of nested tenfold cross-validation AUC of 0.870 (95% CI: 0.862-0.878) in the training dataset and 0.868 (95% CI: 0.801-0.935) in the validation dataset. Patients with higher medullary or cortical tissue stiffness had worse prognoses. A high level (>10 kPa) of medullary SWE was an independent risk predictor (adjusted OR, 2.68; 95% CI, 1.12-6.41).</p><p><strong>Conclusion: </strong>The joint use of SWE parameters and laboratory data significantly improved the risk prediction performance for a faster decline in allograft function. This interpretable XGBoost model may provide a readily available system to guide patient monitoring using noninvasive methods.</p>","PeriodicalId":17830,"journal":{"name":"Kidney Diseases","volume":"11 1","pages":"469-481"},"PeriodicalIF":3.2,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12215202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144553921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical and Experimental Insights into the Role of NETosis in IgA Nephropathy Pathogenesis. NETosis在IgA肾病发病机制中的作用的临床和实验研究。
IF 3.2 4区 医学
Kidney Diseases Pub Date : 2025-05-09 eCollection Date: 2025-01-01 DOI: 10.1159/000546343
Gangan Wang, Yixin Dong, Xiangyu Qiao, Chunyu Jia, Jiahui Wang, Gang Chen, Ke Zheng, Chengyu Jiang, Xuemei Li
{"title":"Clinical and Experimental Insights into the Role of NETosis in IgA Nephropathy Pathogenesis.","authors":"Gangan Wang, Yixin Dong, Xiangyu Qiao, Chunyu Jia, Jiahui Wang, Gang Chen, Ke Zheng, Chengyu Jiang, Xuemei Li","doi":"10.1159/000546343","DOIUrl":"10.1159/000546343","url":null,"abstract":"<p><strong>Introduction: </strong>Neutrophil extracellular traps (NETs) contribute to inflammation and are implicated in autoimmune diseases; however, their role in IgA nephropathy (IgAN) remains unclear. This study aimed to investigate the involvement of NETosis in IgAN and its impact on renal injury and mesangial cell function, utilizing patient samples, mouse models, and in vitro assays.</p><p><strong>Methods: </strong>RNA sequencing was performed on peripheral blood mononuclear cells (PBMCs) from IgAN patients to identify differentially expressed genes (DEGs) and NETosis-related pathways. An IgAN mouse model was established using bovine serum albumin, carbon tetrachloride, and lipopolysaccharide. Mice were treated with the peptidyl arginine deiminase-4 inhibitor GSK484 to evaluate the effects of NETosis inhibition. In vitro assays assessed the impact of NETosis on mesangial cells.</p><p><strong>Results: </strong>RNA sequencing identified 905 DEGs in IgAN patients, with significant enrichment in neutrophil and NETosis pathways. Serum levels of NETosis markers - citrullinated histone H3 (CitH3), myeloperoxidase (MPO), and neutrophil elastase - were elevated in IgAN patients, with CitH3 levels correlating with Gd-IgA1. Inhibiting NETosis with GSK484 reduced CitH3 levels in IgAN mice and improved clinical outcomes, including decreased proteinuria and increased serum albumin. Histological analysis revealed reduced mesangial proliferation. In vitro, NETosis enhanced tumor necrosis factor-α (TNF-α) release from mesangial cells, an effect that was mitigated by GSK484. RNA-seq analysis of kidneys from GSK484-treated IgAN mice also revealed significant alterations in the PPAR signaling pathway. Additionally, TNF-α treatment of mesangial cells resulted in reduced PPARα expression, suggesting that NETosis may modulate this pathway through the release of TNF-α by mesangial cells.</p><p><strong>Conclusion: </strong>Our findings demonstrate that NETosis is upregulated in IgAN and plays a key role in its pathogenesis by promoting inflammatory cytokine release. Inhibition of NETosis improves both clinical and pathological outcomes, highlighting its potential as a therapeutic approach for managing IgAN.</p>","PeriodicalId":17830,"journal":{"name":"Kidney Diseases","volume":"11 1","pages":"450-468"},"PeriodicalIF":3.2,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12215204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144553874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Relationship between Renal Interstitial Vasculopathy and Clinical and Prognosis of Patients with Lupus Nephritis. 狼疮性肾炎患者肾间质血管病变与临床及预后的关系。
IF 3.2 4区 医学
Kidney Diseases Pub Date : 2025-05-02 eCollection Date: 2025-01-01 DOI: 10.1159/000545989
Xiuhua Ma, Xudong Liu, Xuan Wang, Min Yu, Xiaoling Zhou
{"title":"The Relationship between Renal Interstitial Vasculopathy and Clinical and Prognosis of Patients with Lupus Nephritis.","authors":"Xiuhua Ma, Xudong Liu, Xuan Wang, Min Yu, Xiaoling Zhou","doi":"10.1159/000545989","DOIUrl":"10.1159/000545989","url":null,"abstract":"<p><strong>Introduction: </strong>Renal vascular lesions (RVLs) are a common histopathological feature in lupus nephritis (LN). Despite their frequent occurrence, the clinical significance and prognostic impact of RVLs remain poorly understood. The main objectives of our study were to investigate the clinicopathological characteristics associated with RVLs in LN and to assess their prognostic implications in patients with LN.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of baseline clinical and pathological data, as well as outcomes, for patients diagnosed with biopsy-confirmed lupus nephritis between September 1, 2008, and October 31, 2021. Patients were initially stratified into two groups based on the presence or absence of vascular disease at baseline. Subsequently, they were further categorized into four groups according to the severity of vascular disease. Comparisons were made across these groups with respect to clinical and laboratory parameters, pathological features, and prognostic outcomes. The composite endpoint was defined as death, end-stage renal disease (ESRD), or a ≥30% increase in serum creatinine. Survival analysis was performed using the Kaplan-Meier method to compare the renal survival and overall survival between groups with different severities of RVLs. The log-rank test was employed for univariate survival analysis, and multivariate analysis of survival outcomes was performed using the Cox regression model.</p><p><strong>Results: </strong>In a group of 225 patients, RVLs were found in 101 kidney biopsies, with 72 of these being mild. Among 156 patients with proliferative lupus nephritis, 77 had RVLs. Patients with RVLs were older and exhibited higher levels of serum creatinine, blood urea, uric acid, C-reactive protein, and significantly higher chronicity index and SLEDAI scores. They also had more severe tubulointerstitial lesions, worse clinical manifestations, and lower complete remission rates. Their estimated glomerular filtration rate was lower (<i>p</i> < 0.05). Compared to the NRVLs group, patients in the RVLs group had a lower renal survival rate and overall survival rate, and a significant difference was observed between the groups (<i>p</i> < 0.05). Importantly, the severity of vascular lesions was associated with a lower renal survival rate and overall survival rate, especially in proliferative lupus nephritis.</p><p><strong>Conclusion: </strong>RVLs are a common pathological feature in lupus nephritis and are particularly prevalent among patients with proliferative lupus nephritis. The presence and severity of RVLs are associated with more severe clinicopathological manifestations and a lower complete remission rate in lupus nephritis patients. Furthermore, they are predictive of poorer long-term outcomes, with a particularly pronounced impact on those with proliferative lupus nephritis.</p>","PeriodicalId":17830,"journal":{"name":"Kidney Diseases","volume":"11 1","pages":"377-389"},"PeriodicalIF":3.2,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12162118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144285061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Interferon-Stimulated Genes: Novel Targets in Renal Pathogenesis. 干扰素刺激基因:肾脏发病的新靶点。
IF 3.2 4区 医学
Kidney Diseases Pub Date : 2025-05-02 eCollection Date: 2025-01-01 DOI: 10.1159/000546141
Meng Jia, Shuangxu Han, Liang Li, Yi Fu, Di Zhou
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