Nefrologia最新文献

{"title":"Etelcalcetide: What we know eight years since its approval","authors":"Pedro Freitas ,&nbsp;Luciano Pereira","doi":"10.1016/j.nefro.2024.09.004","DOIUrl":"10.1016/j.nefro.2024.09.004","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>The impact of etelcalcetide on patients with chronic kidney disease (CKD) and secondary hyperparathyroidism (SHPT) has been studied since its introduction in 2016/2017. However, only a handful of studies reported clinically relevant outcomes. This narrative review aims to summarize the published data about etelcalcetide, focusing on biochemical, cardiovascular (CV) and bone endpoints, as well as adverse effects and all-cause mortality.</div></div><div><h3>Materials and methods</h3><div>A literature review of the use of etelcalcetide in hemodialysis patients with SHPT was conducted. Several sources were used, such as PubMed, Google Scholar and Cochrane Library.</div></div><div><h3>Results</h3><div>Regarding bone and mineral metabolism, etelcalcetide is effective in reducing serum levels of parathormone (PTH), calcium, phosphate and fibroblast growth factor 23 (FGF23). Preliminary data have highlighted its role in reducing bone turnover and improving mineralization and preservation of bone structure, indicating a possible positive impact on renal osteodystrophy. From a CV perspective, etelcalcetide is associated with a significant reduction in left ventricular hypertrophy. In addition, etelcalcetide reduces FGF23 and increases sclerostin serum levels. This data suggests a possible CV beneficial effect.</div></div><div><h3>Conclusions</h3><div>Etelcalcetide is effective in controlling SHPT. Promising data is available for some bone and surrogate cardiovascular endpoints, suggesting a possible beneficial effect. There is a lack of studies specifically designed to evaluate its role in reducing fractures, CV and all-cause mortality.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 2","pages":"Pages 116-134"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143173298","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":"La litiasis renal en los reyes de la casa de Austria. ¿El primer caso conocido de pielonefritis xantogranulomatosa?","authors":"Víctor M. García Nieto ,&nbsp;Justo Hernández González ,&nbsp;Matilde Clara Gil Villena","doi":"10.1016/j.nefro.2024.10.002","DOIUrl":"10.1016/j.nefro.2024.10.002","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 2","pages":"Pages 187-188"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143173306","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":"Evaluación del rol del equipo de coordinación de nefrología en la consulta externa específica de acceso vascular. ¿Qué podemos aportar de nuevo?","authors":"Néstor Fontseré ,&nbsp;Gaspar Mestres ,&nbsp;Xavi Yugueros ,&nbsp;Daniel Gil ,&nbsp;Carla Blanco ,&nbsp;Valentín Lozano ,&nbsp;Lidia María Rodas ,&nbsp;Arantxa Gelabert ,&nbsp;Paula Escarcena ,&nbsp;Rosa Ramos ,&nbsp;Francisco Maduell","doi":"10.1016/j.nefro.2024.08.002","DOIUrl":"10.1016/j.nefro.2024.08.002","url":null,"abstract":"<div><h3>Background and objectives</h3><div>The key points of a monographic vascular access (VA) consultation are an adequate preoperative assessment, as well as a correct management and optimization of waiting lists. Our main objective of present study was to evaluate the degree of exploratory-dependent concordance in outpatient clinics regarding implanted VA, between nephrology and vascular surgery.</div></div><div><h3>Materials and methods</h3><div>We analyzed VA created or surgically repaired between 2021 and 2022. We compared the differences in the preoperative variables between the groups in which the assessments between the two teams were coincident and non-coincident, and the primary (PP) and secondary (PS) patencies during the follow-up period (Kapplan-Meier curves and Log-rank test, and Cox regression analysis). Significant <em>P</em>≤.05.</div></div><div><h3>Results</h3><div>A total of 605 VA creations or repairs were analyzed: 74 ligations (12.2%), 207 distal arterio-venous fistulaes (AVF) (34.3%), 237 proximal AVF (39.2%), 35 repairs (5.7%), 41 grafts (6.7%) and 11 others (1.9%). After an average waiting list time of 16.5<!--> <!-->±<!--> <!-->11.6 days, excluding ligations, adequate 1-month maturation was observed in 87.6% of cases. A total of 158 endovascular procedures and 17 surgical repairs were performed during postoperative follow-up. Primary (PP) and secondary (PS) patencies at 6, 12 and 24 months were PP: 76.2%, 64.9%, 57.5% and PS: 86.4%, 81.2%, 74.7%, respectively. Of the total number of procedures, nephrology obtained an adequate degree of agreement in 93.6% of the cases (kappa index: 0.886). The preoperative factors associated with greater discrepancies in assessments were age (<em>P</em>=.022) and arterial diameter (<em>P</em> =.032). The subgroup of non-matched assessments between nephrology and vascular surgery (39 cases) presented a similar PP (at 2 years: 59.2% vs 41.3%, <em>P</em> =.099) but worse PS (at 2 years: 76.6% vs 55.4%, <em>P</em> =.005).</div></div><div><h3>Conclusions</h3><div>No significant observer-dependent differences (nephrologist vs. vascular surgeon) were observed in decision-making regarding the surgical procedure to be performed (93.6% agreement), and discordant cases presented worse secondary patency. After specific training, the nephrology coordination team can make a proper optimisation of social and health resources by reserving referrals to vascular surgery for those cases of greater complexity.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 2","pages":"Pages 159-166"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143173302","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":"Cistitis hemorrágica por adenovirus en receptora de trasplante renopancreático tratada con cidofovir intravesical","authors":"Víctor Joaquín Escudero-Saiz ,&nbsp;Judit Cacho ,&nbsp;Aileen Herceda ,&nbsp;Ángela González-Rojas ,&nbsp;Nuria Esforzado ,&nbsp;Pedro Ventura-Aguiar ,&nbsp;Marta Bodro ,&nbsp;Fritz Diekmann","doi":"10.1016/j.nefro.2024.09.003","DOIUrl":"10.1016/j.nefro.2024.09.003","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 2","pages":"Pages 182-184"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143173304","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":"Nefritis lúpica: 10 cuestiones para pensar","authors":"Enrique Morales ,&nbsp;Maria Galindo","doi":"10.1016/j.nefro.2024.07.005","DOIUrl":"10.1016/j.nefro.2024.07.005","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 2","pages":"Pages 101-105"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143173286","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":"Anosmia, dysgeusia and malnutrition in chronic kidney disease: A systematic review","authors":"Gaetano Ferrara ,&nbsp;Sara Morales Palomares ,&nbsp;Giuliano Anastasi ,&nbsp;Mauro Parozzi ,&nbsp;Lea Godino ,&nbsp;Domenica Gazineo ,&nbsp;Marco Sguanci ,&nbsp;Stefano Mancin","doi":"10.1016/j.nefro.2024.09.005","DOIUrl":"10.1016/j.nefro.2024.09.005","url":null,"abstract":"<div><div>Chronic kidney disease (CKD) is a prevalent health condition associated with numerous complications, including olfactory and taste dysfunction, and malnutrition. This systematic review focused on dysgeusia, smell disorders and malnutrition in CKD patients. The search included scientific databases such as PubMed, Cochrane Library, CINAHL, Scopus, and Web of Science, as well as sources of grey literature. Quality assessment and risk of bias were evaluated using JBI guidelines, while the certainty of evidence was assessed with the Oxford Centre methods. Seven studies were included: two focusing on anosmia and five on dysgeusia. Anosmia was associated with poorer nutritional status, and interventions such as intranasal theophylline showed promise in enhancing olfactory function. Dysgeusia studies highlighted the potential role of zinc deficiency in malnutrition among dialysis patients, with zinc supplementation showing mixed results to improve taste dysfunction. Taste alterations were correlated with upper gastrointestinal symptoms and malnutrition in CKD patients. The analysis of the interconnection between anosmia, dysgeusia, and malnutrition emerges as a crucial starting point for improving nutritional outcomes in chronic kidney disease (CKD) patients, emphasizing the need for accurate assessment and targeted therapeutic interventions to ensure better nutritional health and improved quality of life for these patients.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 2","pages":"Pages 106-115"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143173297","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":"Life-threatening haemorrhage from a right superior phrenic artery pseudoaneurysm in a peritoneal dialysis patient","authors":"Julian Delicata ,&nbsp;Elena Farrugia ,&nbsp;Reuben Formosa ,&nbsp;Kelvin Cortis ,&nbsp;Emanuel Farrugia","doi":"10.1016/j.nefro.2024.09.008","DOIUrl":"10.1016/j.nefro.2024.09.008","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 2","pages":"Pages 185-186"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143173305","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":"Long-term outcomes after AKI in hospitalized patients with COVID-19","authors":"Bernardo Marques da Silva ,&nbsp;Joana Gameiro ,&nbsp;Joana Lei Teixeira ,&nbsp;Cláudia Costa ,&nbsp;Carolina Branco ,&nbsp;João Oliveira ,&nbsp;João Bernardo ,&nbsp;Filipe Marques ,&nbsp;José Agapito Fonseca ,&nbsp;José António Lopes","doi":"10.1016/j.nefro.2024.08.003","DOIUrl":"10.1016/j.nefro.2024.08.003","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Acute kidney injury (AKI) is frequent in hospitalized patients and contributes to adverse short- and long-term outcomes. We aimed to evaluate the association of AKI and long-term adverse renal events and mortality in a cohort of patients hospitalized with COVID-19.</div></div><div><h3>Material and methods</h3><div>Single-center and retrospective study of hospitalized patients admitted to a Dedicated Unit for COVID-19 at Centro Hospitalar Universitário Lisboa Norte, Portugal, between March 2020 and October 2020. AKI was defined and classified according to the Kidney Disease: Improving Global Outcomes (KDIGO) classification, using SCr criteria. The analyzed outcomes were development of major adverse kidney events (MAKE), major adverse renal cardiovascular events (MARCE), and mortality over a two-year follow-up period.</div></div><div><h3>Results</h3><div>From the included 409 patients, AKI occurred in 60.4% (<em>n</em> <!-->=<!--> <!-->247). Within two years after discharge, 31.8% (<em>n</em> <!-->=<!--> <!-->130) of patients had an eGFR<!--> <!-->&lt;<!--> <!-->60<!--> <!-->mL/min/1.73<!--> <!-->m² and/or a 25% decrease on eGFR and 1.7% (<em>n</em> <!-->=<!--> <!-->7) of patients required RRT, 6.1% (<em>n</em> <!-->=<!--> <!-->25) of patients had CV events and 27.9% (<em>n</em> <!-->=<!--> <!-->114) of patients died. The incidence of MAKE was 60.9% (<em>n</em> <!-->=<!--> <!-->249), and MARCE was 62.6% (<em>n</em> <!-->=<!--> <!-->256). On a multivariate analysis, older age (adjusted HR 1.02 (95% CI: 1.01–1.04), <em>p</em> <!-->=<!--> <!-->0.008), cardiovascular disease (adjusted HR 2.22 (95% CI: 1.24–3.95), <em>p</em> <!-->=<!--> <!-->0.007), chronic kidney disease (adjusted HR 5.15 (95% CI: 2.22–11.93), <em>p</em> <!-->&lt;<!--> <!-->0.001), and AKI (adjusted HR 1.76 (95% CI: 1.12–2.78), <em>p</em> <!-->=<!--> <!-->0.015) were independent predictors of MAKE. Older age (adjusted HR 1.06 (95% CI: 1.04–1.08), <em>p</em> <!-->&lt;<!--> <!-->0.001) and neoplasia (adjusted HR 4.88 (95% CI: 2.37–10.04), <em>p</em> <!-->&lt;<!--> <!-->0.001) were independent predictors of mortality.</div></div><div><h3>Conclusions</h3><div>In this cohort of hospitalized patients with COVID-19, AKI was independently associated with the risk of long-term need for dialysis and/or renal function decline and/or mortality after hospital discharge.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 2","pages":"Pages 150-158"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143173301","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":"Estudio genético en adultos con glomeruloesclerosis focal y segmentaria","authors":"Melissa Pilco-Terán ,&nbsp;Amir Shabaka ,&nbsp;Mónica Furlano ,&nbsp;Ana Tato Ribera ,&nbsp;Isabel Galán Carrillo ,&nbsp;Eduardo Gutiérrez ,&nbsp;Roser Torra ,&nbsp;Gema Fernández-Juárez ,&nbsp;en representación del Grupo de Trabajo de Enfermedades Renales Hereditarias (GTERH) y Grupo de Trabajo de Enfermedades Glomerulares de la Sociedad Española de Nefrología (GLOSEN)","doi":"10.1016/j.nefro.2024.09.006","DOIUrl":"10.1016/j.nefro.2024.09.006","url":null,"abstract":"<div><div>Focal segmental glomerulosclerosis (FSGS) is a histological pattern of injury that derives from various pathological processes that affect podocytes, resulting in loss of selectivity of the glomerular filtration membrane, proteinuria and the development of renal failure that progresses to end-stage kidney disease in a significant number of patients. The classification proposed by the 2021 KDIGO guidelines divides FSGS into four categories: primary, secondary, genetic, and FSGS of undetermined cause, thus facilitating its diagnosis and management. Genetic causes of FSGS present significant clinical variability, complicating their identification. Genetic testing is crucial to identify FSGS of genetic cause. The prevalence of genetic FSGS is significant in children and considerable in adults, highlighting the importance of early diagnosis to avoid unnecessary treatments and facilitate genetic counselling. Massive sequencing techniques have revolutionized genetic diagnosis, allowing the identification of more than 60 genes responsible for podocyte damage. This document proposes clinical recommendations for carrying out genetic studies in adults with FSGS, highlighting the need for a correct classification for adequate therapeutic planning and improvement of results in clinical trials.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 2","pages":"Pages 135-149"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143173299","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":"Unveiling the antiurolithiatic potentiality of two benzene sulfonamide derivatives against ethylene glycol-induced renal calculi","authors":"Ahmed M. Elgendy ,&nbsp;Mohamed S. Nafie ,&nbsp;Zohour I. Nabil ,&nbsp;Nahla S. El-Shenawy ,&nbsp;Heba N. Gad El-Hak","doi":"10.1016/j.nefro.2024.09.007","DOIUrl":"10.1016/j.nefro.2024.09.007","url":null,"abstract":"<div><h3>Objective</h3><div>Oxidative stress and inflammation play crucial roles in the onset of kidney injury and crystal formation caused by hyperoxaluria. Indapamide is a potent medication for treating renal calculi, but it has severe side effects such as hypokalemia, hypercalcemia, and hyperuricemia. Therefore, it is advisable to explore alternative treatments that do not have these side effects. The study aimed to reveal the antiurolithiatic potential of two benzene sulfonamide derivatives (SBCl and SBF; A and B, respectively) against ethylene glycol-induced kidney stones.</div></div><div><h3>Methods</h3><div>The rats were divided into two main groups: the first group consisted of 20 rats with induced kidney stones, and the second group included 15 control rats. This division enabled a comparative analysis between rats with kidney stones and those without, offering insights into the effects of kidney stone induction on various physiological parameters and biochemical markers. The effectiveness of benzene sulfonamide derivatives (compounds A and B) was assessed in rats with induced kidney stones. The treatment was given orally by gavage for 21 days, administered every 48<!--> <!-->h after inducing kidney stones with 0.12<!--> <!-->ml of 5% ethylene glycol (EG).</div></div><div><h3>Results</h3><div>The influence of compounds A and B on electrolytes, biochemical, antioxidant, and inflammatory reactions in induced kidneys underscores their potential therapeutic advantages in alleviating the advancement of kidney stone disease and related complications.</div></div><div><h3>Conclusion</h3><div>Both compounds were found to possess equal effectiveness in inhibiting the complications of stone formation. However, SBCl-EG showed superior antioxidant and inflammatory parameters effects compared to SBF-EG. Our study's findings underscore the potential benefits of derivatives in treating nephrolithiasis and related oxidative disorders, highlighting their superior effects on antioxidant and inflammatory responses compared to standard treatments.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 2","pages":"Pages 167-181"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143173303","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}