Nefrologia最新文献

{"title":"The role of strain wave elastography in the evaluation of renal fibrosis in patients with kidney diseases","authors":"Hanaa Ibrahim Okda ,&nbsp;Rabab Alaa Eldin Keshk ,&nbsp;Noha El-Anwar ,&nbsp;Ahmed Mohammed El Behiry ,&nbsp;Sally Maher Gamaleldin","doi":"10.1016/j.nefro.2024.10.007","DOIUrl":"10.1016/j.nefro.2024.10.007","url":null,"abstract":"<div><h3>Background</h3><div>A renal biopsy represents the gold standard in the diagnosis, prognosis and management of patients with chronic kidney disease and glomerulonephritis. Strain wave elastography (SE) is a developing technique to assess tissue elasticity. The aim of this study was to correlate between the strain index value of renal parenchyma and degree of renal fibrosis detected with renal biopsy.</div></div><div><h3>Method</h3><div>For 68 patients who were referred for a kidney biopsy, SE test was performed. The Banff scoring system was utilized to classify the IFTA grading of kidney fibrosis that assigns a severity level of mild, moderate, or severe. Receiver operating characteristic curve (ROC) was utilized to correlate between the severity of renal fibrosis and the grade of renal elasticity determined by SE.</div></div><div><h3>Results</h3><div>In total, 38 males and 30 females, the echogenicity, qualitative and semiquantitative elastography showed significant positive correlation with serum creatinine, percentage of fibrosis, <em>G</em> score and tubular atrophy and significant negative correlation with eGFR. ROC curve of SE for diagnosis of interstitial fibrosis shown that echogenicity has sensitivity 100.0%, specificity 62.5%, positive predictive value (PPV) 75.0%, negative predictive value (NPV) 100.0% with area under curve (AUC) 0.906, while qualitative elastography has sensitivity 77.8%, specificity 75.0%, PPV 77.8%, NPV 75.0%, AUC 0.833, semi quantitative elastography has sensitivity 83.3%, specificity 93.8%, PPV 93.8%, NPV 83.3% with AUC 0.915.</div></div><div><h3>Conclusion</h3><div>SE approach is simple to use, and can differentiate between varying stages of renal fibrosis. However, further research is required before it can be frequently used in clinical practice.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 3","pages":"Pages 259-270"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143528948","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":"Concurrent extramedullary hematopoiesis and AA amyloidosis in the kidney","authors":"Özant Helvaci ,&nbsp;Emine Merve Savaş ,&nbsp;Rahime Duran ,&nbsp;Betül Ögüt","doi":"10.1016/j.nefro.2024.12.001","DOIUrl":"10.1016/j.nefro.2024.12.001","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 3","pages":"Pages 276-277"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143528772","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":"Hemodialysis vascular access in the elderly: Promising results from a tertiary center","authors":"Bruno Fraga Dias ,&nbsp;Fernanda Silva ,&nbsp;Isabel Fonseca ,&nbsp;Paulo Almeida ,&nbsp;José Queirós","doi":"10.1016/j.nefro.2024.10.005","DOIUrl":"10.1016/j.nefro.2024.10.005","url":null,"abstract":"<div><h3>Background</h3><div>Hemodialysis patients, particularly the elderly, present challenges for vascular access (VA) creation due to age-related vascular changes and comorbidities. This study aimed to characterize outcomes related to VA in elderly patients (≥75 years) and compare them with younger patients, focusing on primary failure, maturation failure, and patency rates.</div></div><div><h3>Methods</h3><div>This retrospective study included patients evaluated in VA consultations between January 2019 and December 2021; patients were evaluated through physical examination and Color Doppler Ultrasound to determine the suitability of vessels for VA construction. Demographic data, proposed and created VA types were assessed. The primary outcomes were the evaluation and comparison of primary failure and maturation failure of VA in the elderly (O) and younger (Y) groups. Secondary outcomes included the assessment of primary patency and primary assisted patency at 6, 12, and 24 months in both groups.</div></div><div><h3>Results</h3><div>Among 167 patients, 36 were elderly. There were no significant differences in proposed and created VA types between the Y and O groups and radial-cephalic AVFs were the most commonly constructed VA in both groups.</div><div>Primary and maturation failure rates were similar (Y group: 17.3% and 5.6%; O group: 9.7% and 10.7%, respectively). Primary patency and primary assisted patency rates did not significantly differ between groups at 6, 12, and 24 months.</div></div><div><h3>Conclusion</h3><div>The impact of age on the feasibility of VA should not be exaggerated. Preoperative assessment and a tailored approach enable successful autologous access creation in elderly patients, resulting in outcomes comparable to those of younger patients.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 3","pages":"Pages 228-237"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143528952","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":"Twister® en el manejo aséptico de catéteres permanentes en hemodiálisis","authors":"Miguel Angel. Suárez Santisteban ,&nbsp;María Vanesa García-Bernalt Funes ,&nbsp;Pedro Dorado Hernández ,&nbsp;Antonio Gascón Mariño","doi":"10.1016/j.nefro.2024.11.006","DOIUrl":"10.1016/j.nefro.2024.11.006","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 3","pages":"Pages 273-275"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143528773","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":"Hacia una disminución de la negativa de los pacientes a la realización de fístula arteriovenosa: Nuevas herramientas y nuevos actores en el equipo interdisciplinar del acceso vascular. Presentación del proyecto ERCAV","authors":"Florentina Rosique López ,&nbsp;M. Luz Sánchez-Tocino ,&nbsp;David Hernán Gascueña ,&nbsp;José Luis Santos-Ascarza Bacariza ,&nbsp;Leonor Andúgar Rocamora ,&nbsp;Daniel Gallego Zurro ,&nbsp;Juan Bernardo Cabezuelo Romero ,&nbsp;Mario Prieto Velasco ,&nbsp;Adoración Martínez Losa ,&nbsp;Fernando Hadad-Arrascue ,&nbsp;Laura Martínez Alarcón ,&nbsp;Diana Manzano Sánchez ,&nbsp;Esperanza Melero Rubio ,&nbsp;María López Picasso ,&nbsp;Aitana Hernández ,&nbsp;Sandra Rubio Paez ,&nbsp;Ramón Roca-Tey ,&nbsp;José Ibeas López ,&nbsp;María Dolores Arenas ,&nbsp;Grupo Español Mutildisciplinar del Acceso Vascular (GEMAV),&nbsp;GTAVSEN (Grupo de Trabajo del Acceso Vascular de la S.E.N.),&nbsp;Grupo de Trabajo de ERCA (Grupo de Trabajo de Enfermedad Renal Crónica Avanzada),&nbsp;Federación ALCER (Federación Nacional de Asociaciones para la lucha contra las enfermedades del riñón)","doi":"10.1016/j.nefro.2024.11.004","DOIUrl":"10.1016/j.nefro.2024.11.004","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 3","pages":"Pages 189-193"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143528949","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":"Oxidative stress and inflammation on metabolic abnormalities and renal involvement in prediabetic subjects across Europe","authors":"Sebastián Mas-Fontao ,&nbsp;Esther Civantos ,&nbsp;Nisa Boukichou-Abdelkader ,&nbsp;Manuel Soto-Catalan ,&nbsp;Marta Romeo-Colas ,&nbsp;Arantxa Marco ,&nbsp;Carmen Gomez-Guerrero ,&nbsp;Juan Antonio Moreno ,&nbsp;Jaakko Tuomilehto ,&nbsp;Rafael Gabriel ,&nbsp;Jesús Egido ,&nbsp;on behalf of ePREDICE investigators","doi":"10.1016/j.nefro.2024.10.003","DOIUrl":"10.1016/j.nefro.2024.10.003","url":null,"abstract":"<div><h3>Background</h3><div>Studying the mechanisms involved in the transition from prediabetes to diabetes and its associated complications, such as kidney disease, is a growing challenge. This study focuses on identifying valuable biomarkers for the early detection of kidney damage, evaluating molecules associated with oxidative stress and inflammation in prediabetic individuals across Europe.</div></div><div><h3>Methods</h3><div>In plasma samples from individuals with prediabetes included in the ePREDICE study, we determined molecules related to oxidative stress (advance oxidative protein products-AOPP) and inflammatory biomarkers (C-reactive protein – CRP; Interleukin 6 – IL-6), and correlated them with anthropometric and biochemical data, assessing their potential for the early diagnosis of renal involvement.</div></div><div><h3>Results</h3><div>Among the 967 people with prediabetes, 94 presented some sign of renal impairment such as albuminuria, hyperfiltration or hypofiltration. Significant variations were identified between oxidative stress and inflammatory biomarkers (upper and lower quartiles of AOPP, CRP and IL6), and parameters associated with blood pressure, glucose metabolism, lipid profile, and fatty liver index. In particular, both types of biomarkers were associated with components of the metabolic syndrome. There were significant associations between AOPP and CRP, and the presence of albuminuria, but not with renal function. Overall, CRP was a better biomarker than IL-6 for most of the parameters studied.</div></div><div><h3>Conclusion</h3><div>These results highlight the important associations of oxidative stress and inflammation with metabolic abnormalities linked to the prediabetic state and its complications such as fatty liver and renal involvement. Although these results need to be confirmed, our study suggests that AOPP and CRP could be simple biomarkers of interest in predicting the risk of loss of renal function in people with prediabetes.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 3","pages":"Pages 238-248"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143528953","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":"Escombroidosis y bacteriemia por Raoultella ornithinolytica en paciente trasplantado renal: a propósito de un caso","authors":"Sofía López San Román ,&nbsp;Eva López Melero ,&nbsp;Ángela Rey Cárdenas ,&nbsp;Nerea Prieto Domínguez ,&nbsp;Enrique Gruss Vergara","doi":"10.1016/j.nefro.2024.11.005","DOIUrl":"10.1016/j.nefro.2024.11.005","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 3","pages":"Pages 271-272"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143528771","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":"Enfermedad renal diabética y polimorfismos de los genes ELMO1 y AGTR1: revisión sistemática","authors":"Yuliana Martínez-Nava ,&nbsp;María Camila Ogaz-Escarpita ,&nbsp;Sandra Alicia Reza-López ,&nbsp;Irene Leal-Berumen","doi":"10.1016/j.nefro.2024.10.001","DOIUrl":"10.1016/j.nefro.2024.10.001","url":null,"abstract":"<div><h3>Background</h3><div>Diabetic kidney disease (DKD) is one of the main complications of diabetes, the main cause of chronic kidney disease (CKD) and end-stage renal disease (ESRD) worldwide. The etiopathogenesis of DKD is complex and multifactorial; recently, genetic susceptibility has gained relevance since certain ethnicities, such as Native Americans and Mexican Americans, have a higher risk of developing this disease. Numerous studies have described that single nucleotide polymorphisms (SNPs), including those for ELMO1 and AGTR1 genes, could be associated with DKD.</div></div><div><h3>Objective</h3><div>To carry out a systematic review of the scientific literature on the association of SNPs of the ELMO1 and AGTR1 gene with DKD in adult patients with type 2 diabetes mellitus (T2D).</div></div><div><h3>Methods</h3><div>Systematic review in PubMed, Google Scholar, Worldwide Science, and Science Direct databases. The selection of publications was carried out following the guidelines proposed by PRISMA (Preferred Reporting Items for Systematic Reviews and Meta Analyses). Original articles that reported results in the adult population with T2D were included. Information about the allelic and genotypic frequencies of the SNPs and their association with DKD was obtained.</div></div><div><h3>Results</h3><div>The polymorphisms most frequently associated with a DKD higher risk were rs741301, rs1345365, and rs10951509 for the ELMO1 gene, whereas the rs5186 and rs388915 for the AGTR1 gene.</div></div><div><h3>Conclusion</h3><div>The risk of developing DKD depends on several factors, including the genetic susceptibility conferred by the ELMO1 and AGTR1 gene polymorphisms, without ignoring the patient's lifestyle and environmental factors. The studies about these polymorphisms’ association with DKD will allow a better understanding of non-modifiable risk factors for developing this disease and recognize the differences between different studied ethnicities, which would allow faster detection of patients with T2D susceptible to developing DKD, become early markers of kidney damage, as well as implementing preventive strategies on the most susceptible ethnicities.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 3","pages":"Pages 194-213"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143528950","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":"Clinicopathological characteristics and outcomes of patients with unexplained renal impairment: A single center study","authors":"Radwa A. Ellisy ,&nbsp;Effat A. Tony ,&nbsp;Wesam Ismail ,&nbsp;Rabab Radi ,&nbsp;Mohamed Ismail Seddik ,&nbsp;Essam M. Abdel Aziz","doi":"10.1016/j.nefro.2024.10.006","DOIUrl":"10.1016/j.nefro.2024.10.006","url":null,"abstract":"<div><h3>Background</h3><div>Chronic kidney disease (CKD) is a growing health problem. About 20% of CKD patients have undetermined causes. Data describing histopathological patterns of unexplained impaired kidney functions in Egypt are lacking. We aimed to identify the clinicopathological characteristics and short-term outcomes of adult cases with unexplained impaired kidney functions.</div></div><div><h3>Methods</h3><div>We conducted a prospective study in Assiut University Hospital from August 2018 to May 2022. It included patients with unexplained elevated serum creatinine (serum creatinine<!--> <!-->&gt;<!--> <!-->115<!--> <!-->μmol/L) who underwent renal biopsies. Descriptive statistics were used to summarize data on patient demographics, histopathological patterns, and outcomes after three months. Clinical trial registration number: <span><span>NCT03586531</span><svg><path></path></svg></span>.</div></div><div><h3>Results</h3><div>Overall, 210 native renal biopsies were included in the analysis. Glomerular diseases were the most common pathological finding (<em>n</em> <!-->=<!--> <!-->88, 44.9%), amyloidosis and FSGS were the most prevalent glomerular pathology (15.2%, 14.3%, respectively). Chronic kidney disease of unknown etiology (CKDu) was diagnosed in 8.1% of the cases; histology suggestive of genetic origin was found in 2.5%, and LECT amyloidosis was found in 3.8% of the cases. Poor outcomes were observed in 43.6% of the patients i.e., renal replacement therapy or death. Treatment strategies were changed based on the biopsy findings in 86 patients (40%).</div></div><div><h3>Conclusion</h3><div>Amyloidosis and FSGS were the most common causes of unexplained renal impairment. CKDu is not uncommon in Egypt, and more preventive measures are needed. This study supports the irreplaceable role of renal biopsy in disease diagnosis, treatment decisions, and predicting prognosis even in advanced stages.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 3","pages":"Pages 249-258"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143528853","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":"Evidence for the use of a nonsteroidal mineralocorticoid receptor antagonist for the treatment of chronic kidney disease","authors":"Mariana Morais David Pliças ,&nbsp;Bernardo Marques da Silva ,&nbsp;Edgar Avito Fernandes de Almeida","doi":"10.1016/j.nefro.2024.10.004","DOIUrl":"10.1016/j.nefro.2024.10.004","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Chronic kidney disease morbimortality drives the development of new drugs. This work summarizes the evidence on the use of non-steroidal mineralocorticoid receptor antagonists on chronic kidney disease.</div></div><div><h3>Materials and methods</h3><div>A search was performed on PubMed and ClinicalTrials.gov using relevant keywords for clinical trials and observational studies, finished or ongoing, from 2019 to 2023.</div></div><div><h3>Results</h3><div>Finerenone is currently approved for diabetic kidney disease with albuminuria, with results from two phase three trials, presenting satisfactory results on renal and cardiovascular outcomes and an appropriate safety profile, namely regarding potassium balance. Regarding nondiabetic kidney disease, combining sodium glucose transport protein-2 inhibitors and finerenone points toward reliable results, although these came from non-placebo-controlled trials. An ongoing phase three trial is assessing finerenone efficacy and safety on nondiabetic chronic kidney disease. Esaxerenone is approved for diabetic nephropathies and hypertension in Japan, based on two phase three clinical trials. These trials’ external validity is compromised, as they were only developed in Japan. Ocedurenone presents results from a phase two trial on managing refractory hypertension on chronic kidney disease. Apararenone is being investigated for diabetic kidney disease, with results from a phase two study, limited for only including Japanese patients.</div></div><div><h3>Conclusions</h3><div>With this review we provide a global perspective on the available clinical results for these drugs to improve its evidence-based use.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 3","pages":"Pages 214-227"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143528951","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}