Kidney Diseases最新文献

{"title":"The Clinical Efficacy Evaluation of the KHA-200 Hemoperfusion Device in the Treatment of End-Stage Renal Disease Patients Undergoing Blood Purification Therapy.","authors":"Qing Yang, Guiqun Liu, Min Guo, Dunlu Yuan, Jingjing Huang, Zhu Zhou, Qing Li","doi":"10.1159/000545262","DOIUrl":"https://doi.org/10.1159/000545262","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of the study was to assess the impact of employing the KHA-200 hemoperfusion device in conjunction with hemodialysis therapy in the elimination of serum solutes among maintenance hemodialysis (MHD) patients.</p><p><strong>Methods: </strong>A total of ninety-two MHD patients from our hospital's hemodialysis center were judiciously chosen and allocated randomly into two groups: the conventional hemodialysis group, serving as the control group, and the group utilizing the KHA-200 hemoperfusion device in combination with hemodialysis, denoted as the experimental group, in a 1:1 ratio. We compared variations in serum solute indices, including blood urea nitrogen, creatinine, potassium, calcium, phosphorus, high-sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6), β2-microglobulin (β2-MG), parathyroid hormone (PTH), homocysteine (Hcy), albumin, both prior to and post-treatment. Meanwhile, a comparison of the serum solute clearance rates in the two groups was performed.</p><p><strong>Results: </strong>Following treatment, both groups exhibited substantial reductions in blood urea nitrogen, creatinine, uric acid, potassium, phosphorus, PTH, and Hcy (<i>p</i> < 0.001). There were no statistically significant distinctions between the two groups in terms of urea nitrogen, creatinine, uric acid, and potassium clearance (<i>p</i> > 0.05). Conversely, the experimental group demonstrated a significant effect on the elimination of IL-6 and β2-MG (<i>p</i> < 0.001). Furthermore, the experimental group's performance in reducing blood phosphorus, PTH, IL-6, β2-MG, and Hcy was significantly superior to that of the control group (<i>p</i> < 0.05). Moreover, the reduction in systolic blood pressure in the experimental group was better than in the control group.</p><p><strong>Conclusion: </strong>Employing the KHA-200 hemoperfusion device in tandem with hemodialysis excels in removing blood phosphorus and certain medium-sized uremic toxins, including PTH, IL-6, β2-MG, and Hcy, surpassing the performance of conventional hemodialysis.</p>","PeriodicalId":17830,"journal":{"name":"Kidney Diseases","volume":"11 1","pages":"270-282"},"PeriodicalIF":3.2,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032608","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}

{"title":"Sacubitril-Valsartan Lowers Blood Pressure in Patients on Dialysis: A Randomized Controlled Multicenter Study.","authors":"Li Lin, Weijing Bian, Qun Luo, Liang Wang, Na Liu, Min Yang, Jun Cen, Kedan Cai, Jia Hua, Hongwei Gu, Hualin Qi, Zhihong Wang, Jianying Niu, Yu Chen, Yizheng Gu, Chun Hu, Suhua Li, Yan Li, Nan Chen, Xiao Li","doi":"10.1159/000545195","DOIUrl":"https://doi.org/10.1159/000545195","url":null,"abstract":"<p><strong>Introduction: </strong>Individuals with end-stage kidney disease frequently grapple with uncontrolled hypertension, which elevates their risk for cardiovascular complications.</p><p><strong>Methods: </strong>This randomized, controlled, multicenter study, conducted across 10 hospitals, aimed to compare the effectiveness and safety of sacubitril-valsartan versus irbesartan in managing hypertension among dialysis patients. The primary efficacy variable of the present study was the reduction in office blood pressure (BP) after 12 months of treatment. Participants were randomly allocated to receive either sacubitril-valsartan (angiotensin receptor-neprilysin inhibitor [ARNI]) or irbesartan (angiotensin receptor blocker [ARB]) treatment over a 12-month period. We gauged treatment efficacy through office and 24-h ambulatory BP readings, as well as serum concentrations of N-terminal pro-brain natriuretic peptide (NT-proBNP). Safety outcomes were also evaluated.</p><p><strong>Results: </strong>Baseline office BP averaged 150/82 mm Hg and median NT-proBNP was 6,336 pg/mL. In the intention-to-treat analysis, office systolic BP reduction was significantly greater in the ARNI than ARB group (-10.4 vs. -4.6 mm Hg, <i>p</i> = 0.003) after adjustment for baseline BP. In hemodialysis (HD) patients, the mean systolic/diastolic BP reduction was also greater in the ARNI than ARB group (-15.9/2.4 vs. -6.6/1.1 mm Hg, <i>p</i> < 0.05). While for peritoneal dialysis (PD) patients, there were no significant between-group differences (<i>p</i> = 0.087). Per-protocol analyses in 215 patients on office BP and 137 patients on 24-h BP produced similar results. During the study period, there was no between-group difference in the overall incidence of fatal and nonfatal events and hyperkalemia.</p><p><strong>Conclusion: </strong>In dialysis patients with hypertension, especially those undergoing HD, ARNI demonstrated superior effectiveness in reducing BP compared to ARB. The safety profiles of both treatments were comparable and acceptable.</p>","PeriodicalId":17830,"journal":{"name":"Kidney Diseases","volume":"11 1","pages":"206-217"},"PeriodicalIF":3.2,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12007916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002706","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}

{"title":"Preservation of Urinary Podocyte Markers in Diabetic Kidney Disease by Sodium-Glucose Cotransporter 2 Inhibitor Therapy.","authors":"Chuanlei Li, Jack Kit-Chung Ng, Gordon Chun-Kau Chan, Winston Wing-Shing Fung, Kai-Ming Chow, Cheuk-Chun Szeto","doi":"10.1159/000545225","DOIUrl":"https://doi.org/10.1159/000545225","url":null,"abstract":"<p><strong>Introduction: </strong>Sodium-glucose cotransporter 2 inhibitor (SGLT2i) is a standard treatment for kidney and cardiovascular protection in diabetic kidney disease (DKD). We investigated the effect of SGLT2i on the urinary podocyte-associated molecule levels in DKD.</p><p><strong>Methods: </strong>We studied 24 DKD patients who were started on SGLT2i treatment and 25 patients who were not treated (control group). Urinary levels of podocyte-associated molecules, their corresponding mRNA levels in urinary sediment, estimated glomerular filtration rate (eGFR), and urine albumin-creatinine ratio (UACR) were measured at baseline and 3 months later.</p><p><strong>Results: </strong>Urinary levels of podocin, podocalyxin, and synaptopodin increased significantly over 3 months in the control group, while the levels remained static in the treatment group. After 3 months of treatment, urinary podocin (2.95 [0.92-5.45] vs. 9.15 [1.88-24.80] ng/μmol-Cr, <i>p</i> < 0.01), podocalyxin (367.3 [299.5-768.6] vs. 920.6 [369.3-2,060.4] ng/μmol-Cr, <i>p</i> < 0.01), and synaptopodin levels (13.17 [9.86-47.02] vs. 35.56 [17.59-134.08] ng/μmol-Cr, <i>p</i> < 0.05) were significantly lower in the treatment than the control group. Urinary sediment mRNA levels of podocin, podocalyxin, synaptopodin, and nephrin did not change in both groups. However, there was no significant correlation between urinary podocyte-associated marker levels and eGFR or UACR at baseline or after treatment.</p><p><strong>Conclusion: </strong>SGLT2i prevents the progressive increase in the urinary excretion of podocyte-specific molecules in DKD patients, suggesting that SGLT2 inhibitors have a protective effect on the podocytes.</p>","PeriodicalId":17830,"journal":{"name":"Kidney Diseases","volume":"11 1","pages":"218-225"},"PeriodicalIF":3.2,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12037159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017223","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}

{"title":"Development and Validation of a Clinical Prediction Model for Stages of Acute Kidney Injury in Critically Ill Patients.","authors":"Nam Nguyen-Hoang, Wenbo Zhang, Jacqueline Koeze, Harold Snieder, Eric Keus, Gerton Lunter","doi":"10.1159/000545150","DOIUrl":"https://doi.org/10.1159/000545150","url":null,"abstract":"<p><strong>Introduction: </strong>Among critically ill patients, acute kidney injury (AKI) has a high incidence and leads to poor prognosis. As AKI is often only detected well after onset, early risk stratification is crucial. This study aimed to develop and internally validate the first clinical prediction model for different stages of AKI in critically ill adults.</p><p><strong>Methods: </strong>We utilized data from the Simple Intensive Care Studies II (SICS-II), a prospective cohort study at the University Medical Center Groningen, the Netherlands. The prognostic outcome was the highest KDIGO-based stage of AKI within the first 7 days of ICU stay. Candidate predictors included fifty-nine readily available variables in critical care. Least absolute shrinkage and selection operator and proportional odds logistic regression were used for variable selection and model estimation, respectively. Receiver operating characteristic (ROC) curve, calibration plot, and decision curve analysis were applied to evaluate model performance and clinical usefulness.</p><p><strong>Results: </strong>Of the SICS-II cohort, 976 patients were eligible for our analyses (median [interquartile range] age 64 [52-72] years, 38% female). Within 7 days after ICU admission, 29%, 23%, and 14% of patients progressed to their highest severity of AKI at stages 1, 2, and 3, respectively. We derived a 15-variable model for predicting this maximum ordinal outcome with an area under the ROC curve of 0.76 (95% CI, 0.74-0.78) in bootstrap validation. The model showed good calibration and improved net benefit in decision curve analysis over a range of clinically plausible thresholds.</p><p><strong>Conclusion: </strong>Using readily available predictors in the ICU setting, we could develop a prediction model for different stages of AKI with good performance and promising clinical usefulness. Our findings serve as an initial step towards applying a valid and timely prediction model for AKI severity, possibly helping to limit morbidity and improve patient outcomes.</p>","PeriodicalId":17830,"journal":{"name":"Kidney Diseases","volume":"11 1","pages":"226-239"},"PeriodicalIF":3.2,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015675","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}

{"title":"Clinical Manifestations and Prognosis of Chronic Kidney Disease after Hematopoietic Stem Cell Transplantation.","authors":"Yu Zhang, Guisheng Ren, Wencui Chen, Jinzhou Guo, Xiaomei Wu, Weiwei Xu, Xianghua Huang","doi":"10.1159/000545198","DOIUrl":"https://doi.org/10.1159/000545198","url":null,"abstract":"<p><strong>Introduction: </strong>Kidney disease is a common complication of hematopoietic stem cell transplantation (HSCT). However, there is limited research on the clinical pathology and prognosis of patients who develop chronic kidney disease (CKD) after HSCT.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 50 patients diagnosed with CKD through kidney biopsy between September 2008 and May 2024. The patients were categorized based on their pathological presentations into groups with thrombotic microangiopathy (TMA) or membranous nephropathy (MN).</p><p><strong>Results: </strong>The renal pathological results revealed that TMA was the most prevalent pathological type, accounting for 40% of cases, followed by MN at 32%, and mesangial proliferative glomerulonephritis at 16%, among others. Clinically, patients with TMA predominantly presented with renal insufficiency, whereas those with MN mainly exhibited nephrotic syndrome. Patients with MN showed favorable responses to treatment, achieving complete and partial response rates of 14.3% and 71.4%, respectively. Among the 50-patient cohort, 45 remained alive, corresponding to a 5-year overall survival rate of 87.8%. The 5-year renal survival rate was observed to be 78.8%, with 3 patients (6.98%) requiring kidney replacement therapy.</p><p><strong>Conclusion: </strong>TMA and MN are the two most common pathological findings in patients with CKD following HSCT. Both conditions exhibit favorable responses to combined steroids and immunosuppressant therapy. Notably, patients with MN demonstrate a higher overall response rate and superior treatment outcomes compared to those with TMA.</p>","PeriodicalId":17830,"journal":{"name":"Kidney Diseases","volume":"11 1","pages":"195-205"},"PeriodicalIF":3.2,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12005694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017221","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}

{"title":"Precision Treatment of IgA Nephropathy Based on a New Framework: Angiorenal Protection, Immunity Inhibition, B-Cell/Plasma-Cell Modulation, and Complement Inhibition.","authors":"Cheng Xue, Shengqiang Yu, Wei Gou, Yelei Xu, Li Yang, Bing Dai","doi":"10.1159/000544998","DOIUrl":"10.1159/000544998","url":null,"abstract":"","PeriodicalId":17830,"journal":{"name":"Kidney Diseases","volume":"11 1","pages":"154-159"},"PeriodicalIF":3.2,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11968098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780371","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}

{"title":"Prognostic Value of Blood Pressure Rhythmicity for Estimated Glomerular Filtration Rate in Male Hypertensive Patients Aged 55 and Older.","authors":"Lulu Wang, Han Tian, Xinxin Xu, Xinyan Gu, Liu Li, Hui Zheng, Jie Xu, Chunsun Dai, Lei Jiang","doi":"10.1159/000544992","DOIUrl":"10.1159/000544992","url":null,"abstract":"<p><strong>Introduction: </strong>Blood pressure (BP) exhibits a circadian rhythm characterized by higher levels during wakefulness and lower levels during sleep; however, the functional and structural impact of the rhythms of BP remains uncertain.</p><p><strong>Methods: </strong>Two hundred hypertensive males aged 55 and older without overt cardiovascular or cerebrovascular diseases were enrolled in this longitudinal study. Of these, 188 were included in the analyses (12 lacked valid BP records for part of the 24-h period). Rhythmic profiling of BP was performed using ARSER, and rhythmicity was considered significant at <i>p</i> < 0.05. Estimated glomerular filtration rate (eGFR) was calculated using the Chronic Kidney Disease Epidemiology (CKD-EPI) formula. The primary outcome was the change in eGFR.</p><p><strong>Results: </strong>The average age was 64.9 ± 7.2 years. For systolic BP (SBP), 38 of the subjects exhibited a 12-h rhythm and 43 subjects a 24-h rhythm; for diastolic BP (DBP), 38 exhibited a 12-h rhythm, and 36 exhibited a 24-h rhythm. During the 3-year follow-up period, 16 of the subjects died, and 36 were lost to follow-up. The mean eGFR at baseline and follow-up were, respectively, 86.6 ± 14.0 and 81.0 ± 17.1 mL min^-1 1.73 m^-2 (<i>p</i> = 0.001). The urinary albumin:creatinine ratio did not vary significantly among the groups (<i>p</i> = 0.059). Subjects with 12-h rhythmic SBP exhibited a smaller reduction in eGFR than those with arrhythmic SBP (<i>p</i> = 0.014). However, the changes in eGFR were similar among the groups displaying 12-h or 24-h rhythmic DBP or arrhythmic DBP. We defined a decline in eGFR as a reduction of >1/2 SD between baseline and follow-up. Adjusting for confounding factors (including age, smoking, alcohol consumption, diabetes mellitus, BMI, albumin levels, administration time of antihypertensive drugs, and duration of hypertension), the risk of a decline in eGFR was 70% lower in subjects with 12-h rhythmic SBP than in those with arrhythmic SBP (heart rate = 0.307 [0.108-0.874], <i>p</i> = 0.027).</p><p><strong>Conclusion: </strong>SBP with a 12-h period is a protective predictor of the decline in eGFR in hypertensive males. It is, therefore, necessary to focus on the rhythmic profiling of BP.</p>","PeriodicalId":17830,"journal":{"name":"Kidney Diseases","volume":"11 1","pages":"186-193"},"PeriodicalIF":3.2,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11975331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803658","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}

{"title":"Uric Acid and Atherosclerosis in Patients with Chronic Kidney Disease: Recent Progress, Mechanisms, and Prospect.","authors":"Yuchu Liu, Zeyu Li, Yuanwen Xu, Haiping Mao, Naya Huang","doi":"10.1159/000543781","DOIUrl":"10.1159/000543781","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease (CKD) is a prevalent global health concern, significantly linked to increased cardiovascular morbidity and mortality. Among various risk factors, uric acid (UA) has emerged as a potentially modifiable contributor to cardiovascular complications in CKD patients.</p><p><strong>Summary: </strong>Elevated serum uric acid levels frequently occur in individuals with CKD and are associated with the development of atherosclerosis (AS). Uric acid has been demonstrated to exacerbate inflammatory processes, promote oxidative stress, and cause endothelial dysfunction, which are critical factors that drive the formation of atherosclerotic plaques. Furthermore, high uric acid levels can worsen renal function, establishing a detrimental cycle that amplifies cardiovascular risk.</p><p><strong>Key messages: </strong>This review investigates the complex interconnection between UA and AS in patients with CKD, highlighting the underlying mechanisms and therapeutic considerations. A more profound comprehension of this relationship is essential for enhancing cardiovascular health and outcomes in this vulnerable population.</p>","PeriodicalId":17830,"journal":{"name":"Kidney Diseases","volume":"11 1","pages":"112-127"},"PeriodicalIF":3.2,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11928073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692688","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}

{"title":"Genetically Predicted Causal Relationship between Gut Microbiota and Various Kidney Diseases.","authors":"Zi-Jin Chen, Rui Wang, Meng-Ying Yao, Jing-Hong Zhao, Bo Liang","doi":"10.1159/000544915","DOIUrl":"10.1159/000544915","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Although recent research suggests that alterations in gut microbiota play a critical role in the pathophysiology of kidney diseases, the causal relationship between specific intestinal flora and the risk of kidney diseases remains unclear. Here, we investigated the causal relationship between gut microbiota and different kidney diseases through mendelian randomization analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Gut microbiota and three types of kidney diseases, including diabetic nephropathy, IgA nephropathy, and membranous nephropathy, were identified from large-scale genome-wide association studies summary data. Inverse variance weighted method was employed to estimate causal relationships. Cochran's &lt;i&gt;Q&lt;/i&gt; test was utilized to uncover any heterogeneity. The mendelian randomization-Egger intercept test was employed to detect horizontal pleiotropy, and the leave-one-out method was used for testing the stability. In addition, the reverse, multivariable, and two-step mendelian randomization analysis was conducted to assess the causation possibilities. Furthermore, the associations between three types of kidney diseases and immune infiltration were determined.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;We identified 1,531 single-nucleotide polymorphisms. There were 6 positive and 9 negative causal effects between gut microbiota and three types of kidney diseases. Specifically, &lt;i&gt;Dialister&lt;/i&gt; was a protective factor for diabetic nephropathy while &lt;i&gt;Lachnospiraceae UCG-008&lt;/i&gt; was a risk factor. &lt;i&gt;Clostridium innocuum&lt;/i&gt; was a protective factor for IgA nephropathy, while &lt;i&gt;Christensenellaceae R.7&lt;/i&gt;, &lt;i&gt;Clostridium sensu stricto&lt;/i&gt;1, &lt;i&gt;Lachnospiraceae UCG-004&lt;/i&gt;, &lt;i&gt;Lachnospiraceae UCG-010&lt;/i&gt;, &lt;i&gt;Oscillospira&lt;/i&gt;, &lt;i&gt;Ruminococcaceae UCG-010&lt;/i&gt;, and &lt;i&gt;Terrisporobacter&lt;/i&gt; were risk factors for IgA nephropathy. &lt;i&gt;Butyricicoccus&lt;/i&gt;, &lt;i&gt;Catenibacterium&lt;/i&gt;, &lt;i&gt;Flavonifractor&lt;/i&gt;, and &lt;i&gt;Lachnospira&lt;/i&gt; were associated with an increased risk of membranous nephropathy, while &lt;i&gt;Ruminococcaceae UCG-011&lt;/i&gt; was associated with a decreased risk of membranous nephropathy. Sensitivity analysis indicated the results were robust. No significant pleiotropy or heterogeneity was identified. Notably, the reverse mendelian randomization analysis did not reveal any causal relationship. After adjusting for environmental confounders, including CO, PM 2.5, PM 10, and exposure to tobacco smoke at home, these causal relationships still exist. Additionally, immune infiltration analysis indicated unique immune cell distribution in each type of kidney disease, which are largely consistent with later two-step approach, emphasizing the significance of immunological processes in the diseases.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This study uncovered the causal relationship between gut microbiota and three types of kidney diseases. This discovery provides fresh perspectives on how microbes contribute to kidney diseases, paving the way for more i","PeriodicalId":17830,"journal":{"name":"Kidney Diseases","volume":"11 1","pages":"170-185"},"PeriodicalIF":3.2,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11970880/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795764","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}

{"title":"A Novel Approach to Repositioning Peritoneal Dialysis Catheters.","authors":"Xiuling Chen, Nan Wang, Yurong Zou, Jin Chen, Hui Gao, Guisen Li, Junru Wang","doi":"10.1159/000543824","DOIUrl":"10.1159/000543824","url":null,"abstract":"<p><strong>Introduction: </strong>Peritoneal dialysis (PD) is a crucial kidney replacement therapy for patients with end-stage kidney disease. Despite its advantages over hemodialysis (HD), long-term success can be hindered by catheter dysfunction, which often necessitates revision. Currently, surgical treatment methods for PD catheter malfunction include fluoroscopy-guided procedures and laparoscopic or open surgery to salvage or replace the catheter. Here, we introduce the first novel, minimally invasive surgery for repositioning PD catheters.</p><p><strong>Methods: </strong>From November 2021 to May 2024, 8 patients with PD catheter dysfunction underwent this innovative procedure at the Department of Nephrology, Sichuan Provincial People's Hospital. Surgical Procedure: On the side of the original abdominal incision, blunt separation was used to find the PD catheter tunnel segment. The anterior rectus abdominal muscle sheath was incised, followed by separation of the deep polyester sleeve. The original catheter was exposed in the abdominal port or purse-string suture, and the intra-abdominal segment of the dialysis catheter was pulled out. Blunt cleaning around the periphery was performed to ensure that the PD catheter was smooth, and a rigid guidewire was placed through the intra-abdominal segment of the proximal end of the catheter of the first lateral hole. The intra-abdominal segment of the PD catheter was placed into the pelvis via the original catheter in the abdominal port. Clinical data were retrospectively collected, and patients were followed up for safety and efficacy assessment.</p><p><strong>Results: </strong>In a study involving 8 patients, no significant complications were observed, with an immediate imaging success rate of 100% and a clinical PD catheter reset success rate of 75%. The catheter remained patent until the end of the study, with a mean follow-up time of 17.25 ± 9.25 months.</p><p><strong>Conclusion: </strong>This new method for resetting dysfunctional PD catheters demonstrates technical feasibility, simplicity, cost-effectiveness, and safety. It has the potential to emerge as an alternative, particularly suitable for resource-limited settings.</p>","PeriodicalId":17830,"journal":{"name":"Kidney Diseases","volume":"11 1","pages":"104-111"},"PeriodicalIF":3.2,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11925479/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143670252","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}