Nefrologia最新文献

{"title":"Renal outcomes of sacubitril/valsartan compared with valsartan under triple whammy exposure in heart failure patients: A retrospective observational study","authors":"Yusuke Nakazawa,&nbsp;Midori Nakamura,&nbsp;Yusuke Kashiwagi,&nbsp;Takashi Kawakubo","doi":"10.1016/j.nefro.2026.501530","DOIUrl":"10.1016/j.nefro.2026.501530","url":null,"abstract":"<div><h3>Background</h3><div>The concurrent use of renin–angiotensin–aldosterone system (RAAS) inhibitors, diuretics, and nonsteroidal anti-inflammatory drugs (NSAIDs), known as the “triple whammy (TW),” increases the risk of acute kidney injury (AKI). Sacubitril/valsartan has demonstrated favorable renal effects in heart failure populations; however, its impact under triple whammy exposure remains unclear.</div></div><div><h3>Methods</h3><div>This single-center retrospective observational study included patients with heart failure receiving valsartan or sacubitril/valsartan in combination with diuretics who were newly prescribed an NSAID between May 2013 and July 2024. Changes in serum creatinine (SCr) within 30 days after NSAID initiation were compared between groups. Multivariable linear regression was performed to identify determinants of relative SCr change. Factors associated with AKI, defined as an increase in SCr ≥0.3<!--> <!-->mg/dL, were evaluated using multivariable logistic regression with Firth's penalized likelihood method to address sparse event counts.</div></div><div><h3>Results</h3><div>A total of 168 patients were included (valsartan, <em>n</em> <!-->=<!--> <!-->71; sacubitril/valsartan, <em>n</em> <!-->=<!--> <!-->97). The sacubitril/valsartan group had a higher diuretic burden at baseline. Despite this, relative increases in SCr were significantly smaller compared with the valsartan group. In multivariable linear regression analysis, higher loop-diuretic-equivalent dose was independently associated with greater SCr elevation, whereas sacubitril/valsartan use was associated with smaller relative SCr increases. In Firth logistic regression analysis, higher loop-diuretic dose was independently associated with AKI, while sacubitril/valsartan use was not significantly associated with AKI.</div></div><div><h3>Conclusions</h3><div>Under triple whammy exposure, sacubitril/valsartan was associated with smaller early increases in SCr compared with valsartan, while diuretic intensity emerged as a consistent determinant of renal deterioration. Although causality cannot be established, these findings highlight the importance of volume management and support further prospective investigation.</div><div>.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"46 7","pages":"Article 501530"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148694352","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 phenotype predicts anti-PLA2R serology in nephrotic range proteinuria","authors":"Asil Demirezen,&nbsp;Nuri Alperen Malkoç,&nbsp;Veysel Baran Tomar,&nbsp;Taha Enes Çetin,&nbsp;Ömer Faruk Akçay,&nbsp;Sena Türkmen,&nbsp;Özlem Gülbahar,&nbsp;Betül Öğüt,&nbsp;İpek Işık Gönül,&nbsp;Galip Güz,&nbsp;Ülver Derici,&nbsp;Yasemin Erten,&nbsp;Kadriye Altok,&nbsp;Özant Helvacı","doi":"10.1016/j.nefro.2026.501529","DOIUrl":"10.1016/j.nefro.2026.501529","url":null,"abstract":"<div><h3>Background</h3><div>The 2021 KDIGO guidelines permit non-invasive diagnosis of membranous nephropathy using anti-PLA2R antibodies in patients with nephrotic syndrome. However, optimal patient selection for anti-PLA2R testing remains undefined, particularly in patients with nephrotic-range proteinuria without nephrotic syndrome.</div></div><div><h3>Methods</h3><div>We conducted a retrospective analysis of 156 consecutive patients with nephrotic-range proteinuria presenting to a tertiary nephrology center between November 2022 and July 2024. Patients were stratified by clinical phenotype: nephrotic syndrome versus nephrotic-range proteinuria without nephrotic syndrome. Primary outcomes were anti-PLA2R positivity rates and anti-PLA2R-positive membranous nephropathy frequency between groups.</div></div><div><h3>Results</h3><div>Anti-PLA2R positivity was significantly higher in nephrotic syndrome patients compared to those with nephrotic-range proteinuria without nephrotic syndrome (26.5% vs 9.6%, <em>p</em> <!-->=<!--> <!-->0.007). Membranous nephropathy diagnosis was more frequent in the nephrotic syndrome group (43.3% vs 23.2%, <em>p</em> <!-->=<!--> <!-->0.008). Among patients with confirmed anti-PLA2R-positive membranous nephropathy, anti-PLA2R antibody levels were significantly higher in nephrotic syndrome patients (<em>p</em> <!-->=<!--> <!-->0.008).</div></div><div><h3>Conclusions</h3><div>Clinical phenotype strongly predicts anti-PLA2R diagnostic yield in nephrotic-range proteinuria. These findings support KDIGO guidelines emphasizing nephrotic syndrome presence for non-invasive anti-PLA2R-positive membranous nephropathy diagnosis and suggest prioritizing anti-PLA2R testing in nephrotic syndrome patients for optimal resource utilization in limited settings.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"46 7","pages":"Article 501529"},"PeriodicalIF":2.1,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148694290","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 crónica oculta en atención primaria: la importancia de la confirmación diagnóstica para evitar sobrediagnósticos","authors":"Manuel M. Ortega Marlasca ,&nbsp;Carmen Sánchez García ,&nbsp;Joao Dourado Mendonça ,&nbsp;Palomares Pulido Rosado ,&nbsp;José Pedro Novalbos-Ruiz","doi":"10.1016/j.nefro.2025.501453","DOIUrl":"10.1016/j.nefro.2025.501453","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"46 5","pages":"Article 501453"},"PeriodicalIF":2.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147801988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of the carbon footprint of pharmacological treatments in advanced chronic kidney disease and peritoneal dialysis: Oral vs. subcutaneous administration","authors":"Susana Lomas-Calatayud ,&nbsp;Francesc Moncho ,&nbsp;Elena Gimenez-Civera ,&nbsp;Maria Jesús Puchades ,&nbsp;Lorena Gandía ,&nbsp;Claudia Forquet ,&nbsp;Marco Montomoli ,&nbsp;Raquel Pardillo ,&nbsp;Manuel Alos ,&nbsp;Nayara Panizo ,&nbsp;Jose Luis Górriz","doi":"10.1016/j.nefro.2026.501504","DOIUrl":"10.1016/j.nefro.2026.501504","url":null,"abstract":"<div><h3>Background</h3><div>Carbon footprint quantification currently stands as the most accepted model for assessing the ecological impact of human activities.</div><div>Selecting the most environmentally friendly treatment for pathologies arising from advanced chronic kidney disease can reduce the carbon footprint.</div></div><div><h3>Methods</h3><div>We aimed to analyze the carbon footprint from using subcutaneous administration treatments versus oral medication in patients with the same medical condition: advanced chronic kidney disease (ACKD) (CKD stage 4 or 5 not in dialysis) or peritoneal dialysis (PD).</div><div>This is an observational, cross-sectional study with 41 patients, 19 receiving oral medication (cinacalcet), and 22 subcutaneously administered erythropoiesis-stimulating agent (darbepoetin alfa). Both treatments were dispensed at the Hospital Clínico Universitario de Valencia internal pharmacy.</div><div>The carbon footprint was calculated using analytical techniques from hybrid life cycle models of the studied medications. For this analysis, three groups were considered: patient and supplies transportation, energy, and waste disposal.</div></div><div><h3>Results</h3><div>A total of 41 patients were included, with a median age of 72 years (IQR: 63–80). No significant between-group differences were detected in analytical parameters. The overall carbon footprint derived from the subcutaneous treatment process with erythropoiesis-stimulating agents (ESA) was 95,512.93<!--> <!-->kg of CO₂/year, compared to 12,199.85<!--> <!-->kg of CO₂/year resulting from cinacalcet treatment (<em>p</em> <!-->&lt;<!--> <!-->0.001). Group-wise analysis did not detect significant differences in travel-related consumption. However, in waste generation and transportation, ESA use showed a significantly higher carbon footprint than oral medication use (<em>p</em> <!-->&lt;<!--> <!-->0.001), partly attributable to the refrigeration energy consumption of darbepoetin (inexistent for cinacalcet).</div></div><div><h3>Conclusions</h3><div>The use of drugs not requiring subcutaneous administration with syringes could significantly reduce healthcare-related carbon footprint.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"46 5","pages":"Article 501504"},"PeriodicalIF":2.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147801995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eculizumab en el tratamiento de 2 casos de enfermedad anti-MBG","authors":"Candela Moliz ,&nbsp;Myriam León ,&nbsp;Beatriz Avilés ,&nbsp;Eugenia Sola ,&nbsp;Verónica López","doi":"10.1016/j.nefro.2026.501485","DOIUrl":"10.1016/j.nefro.2026.501485","url":null,"abstract":"<div><div>Anti-glomerular basement membrane (anti-GBM) disease is a rare but potentially life-threatening autoimmune disorder characterized by rapidly progressive glomerulonephritis and/or alveolar hemorrhage. It is caused by autoantibodies directed against the α3 chain of type IV collagen expressed in the basement membranes of the kidney and lung.</div><div>Standard treatment usually includes plasma exchange, cyclophosphamide, and corticosteroids. Despite all therapeutic efforts, renal prognosis remains very poor in many cases.</div><div>Recent studies have suggested a pathogenic role of complement activation in the renal damage associated with this disease. Eculizumab is a terminal complement inhibitor that binds to the C5 protein, thereby blocking the generation of the proinflammatory components C5a and C5b-9. This provides immediate inhibition of the proinflammatory and cytotoxic sequelae of the complement system.</div><div>Here, we report the successful use of eculizumab in two patients with anti-GBM disease.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"46 5","pages":"Article 501485"},"PeriodicalIF":2.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147801989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The potential of forward osmosis in reducing water consumption in hemodialysis","authors":"Faissal Tarrass,&nbsp;Meryem Benjelloun","doi":"10.1016/j.nefro.2026.501492","DOIUrl":"10.1016/j.nefro.2026.501492","url":null,"abstract":"<div><div>Hemodialysis is a life-sustaining treatment for patients with end-stage renal disease, but it is notoriously resource-intensive, requiring vast quantities of high-purity water. This significant water footprint presents economic and environmental challenges, particularly in water-scarce regions. Forward osmosis (FO), an emerging membrane technology, offers a promising alternative to conventional reverse osmosis (RO) for dialysate preparation and regeneration by leveraging osmotic energy rather than hydraulic pressure. This literature review synthesizes current research on the application of FO in hemodialysis, focusing on its potential to reduce water usage, its operational principles, and the technical challenges hindering its widespread adoption. The analysis covers FO's roles in direct dialysate preparation from tap water and spent dialysate regeneration, its energy efficiency advantages, and critical hurdles such as membrane performance and draw solution recovery. The review concludes that while FO holds considerable promise for creating more sustainable and portable dialysis systems, targeted research into membrane optimization, biocompatible draw solutions, and hybrid systems is essential for its clinical translation.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"46 5","pages":"Article 501492"},"PeriodicalIF":2.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147801987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pain, quality of life, work ability and psychosocial well-being in living kidney donors: A scoping review","authors":"Giada De Colle ,&nbsp;Beatrice Mazzoleni ,&nbsp;Giovanni Cangelosi ,&nbsp;Marco Sguanci ,&nbsp;Sara Morales Palomares ,&nbsp;Franca Barbic ,&nbsp;Camilla Crippa ,&nbsp;Francesco Reggiani ,&nbsp;Marta Calatroni ,&nbsp;Daniela Cattani ,&nbsp;Diego Lopane ,&nbsp;Giuliano Anastasi ,&nbsp;Stefano Mancin","doi":"10.1016/j.nefro.2026.501487","DOIUrl":"10.1016/j.nefro.2026.501487","url":null,"abstract":"<div><h3>Background</h3><div>Chronic kidney disease (CKD) is a progressive condition characterized by structural and functional impairments in the kidneys, affecting around 10–15% of the global population. Kidney transplantation from living donors is regarded as the most effective treatment for CKD. Little is known about the consequences in kidney donors in term of quality of life, work ability and overall health status, including pain syndromes developing. This may drive intervention to support donors and promoting their engagement.</div></div><div><h3>Aims</h3><div>This scoping review evaluates the quality of life (QoL), pain syndromes occurrence, mental health and work ability of adult living kidney donors.</div></div><div><h3>Methods</h3><div>A scoping review was performed using the PubMed/Medline, Embase, CINAHL, and Cochrane Library databases between April and September 2023. The review followed the Arksey and O’Malley framework, incorporated guidance from the Joanna Briggs Institute (JBI), and reported to PRISMA-ScR guidelines. The protocol for this review was registered on the Open Science Framework. Risk of bias and study quality were assessed using JBI checklists.</div></div><div><h3>Results</h3><div>Starting from the analysis of 5069 records, 10 studies were included in the present study. The results show scanty data about the issues. The occurrence of medium and high intensity pain after surgery is reported; mental health seems to be moderately compromised and related to symptoms of anxiety and depression. Of interest, QoL seems to be overall improved after the kidney donation, suggesting a phase of adaptation following the surgery. No data are available on the work ability changes after donation.</div></div><div><h3>Conclusion</h3><div>This review emphasizes the presence of positive effects of kidney donation in living donors and, on the other hand the need of improving pain management and mental health support in the first time after surgery. The information about the consequences of kidney donation on work ability is completely lacking. This could be relevant to be known for new potential donors. It also advocates for continued interdisciplinary research for developing evidence-based care strategies to promote donors’ multifaceted well-being.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"46 5","pages":"Article 501487"},"PeriodicalIF":2.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147801990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Síndrome de Fanconi secundario a sarcoidosis: una asociación poco frecuente","authors":"Carlos Gómez-Carpintero ,&nbsp;Miriam Akasbi ,&nbsp;Juan A. Martín Navarro ,&nbsp;Esther Valle Álvarez ,&nbsp;Miryam Polo Cánovas ,&nbsp;Andrea Álvarez Chavez","doi":"10.1016/j.nefro.2025.501448","DOIUrl":"10.1016/j.nefro.2025.501448","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"46 5","pages":"Article 501448"},"PeriodicalIF":2.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147801991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Applicability and clinical significance of the SarQoL (Sarcopenia Quality of Life) tool in peritoneal dialysis patients: A preliminary report","authors":"Michela Musolino ,&nbsp;Federico Ruosi ,&nbsp;Stefanos Roumeliotis ,&nbsp;Christodoula Kourtidou ,&nbsp;Ioannis Alekos ,&nbsp;Michele Andreucci ,&nbsp;Mariateresa Zicarelli ,&nbsp;Giuseppe Coppolino ,&nbsp;Vassilios Liakopoulos ,&nbsp;Evangelia Dounousi ,&nbsp;Davide Bolignano","doi":"10.1016/j.nefro.2026.501513","DOIUrl":"10.1016/j.nefro.2026.501513","url":null,"abstract":"<div><h3>Introduction/Objectives</h3><div>Sarcopenia, characterized by the progressive loss of muscle mass and strength, is highly prevalent in patients on peritoneal dialysis (PD), significantly affecting their quality of life (QoL). The SarQoL questionnaire, a newly validated tool for assessing the impact of sarcopenia on QoL, has never been evaluated in PD patients. This study aimed to explore its applicability and relevance in this population.</div></div><div><h3>Methods</h3><div>Thirty-two adult PD patients were recruited. Sarcopenia risk was assessed using the SARC-F questionnaire, anthropometric measures (e.g., skinfold thickness, body composition), and functional tests (handgrip strength, 30<!--> <!-->s chair-stand test). Correlations with the SarQoL score were thus explored.</div></div><div><h3>Results</h3><div>The mean SarQoL score was 70.95<!--> <!-->±<!--> <!-->15.96, indicating a low to mildly impaired QoL related to sarcopenia. Patients on automated PD (APD) scored significantly higher than those on continuous ambulatory PD (CAPD; <em>p</em> <!-->&lt;<!--> <!-->0.0001). Strong inverse relationships were observed between SarQoL and SARC-F scores (<em>r</em> <!-->=<!--> <!-->−0.77, <em>p</em> <!-->&lt;<!--> <!-->0.0001) and age (<em>r</em> <!-->=<!--> <!-->−0.50, <em>p</em> <!-->=<!--> <!-->0.003). Additionally, the SarQoL score was correlated with diastolic blood pressure (<em>r</em> <!-->=<!--> <!-->0.50, <em>p</em> <!-->=<!--> <!-->0.003), serum albumin (<em>r</em> <!-->=<!--> <!-->0.47, <em>p</em> <!-->=<!--> <!-->0.006), diuresis (<em>r</em> <!-->=<!--> <!-->0.46, <em>p</em> <!-->=<!--> <!-->0.007), number of stands at the chair test (<em>r</em> <!-->=<!--> <!-->0.46, <em>p</em> <!-->=<!--> <!-->0.02), and body fat percentage (<em>r</em> <!-->=<!--> <!-->−0.34, <em>p</em> <!-->=<!--> <!-->0.05).</div></div><div><h3>Conclusion</h3><div>The SarQoL questionnaire may be useful for evaluating sarcopenia's impact on well-being in PD patients. Future studies are needed to confirm these findings in wider cohorts and to explore longitudinal changes in SarQoL scores in response to interventions.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"46 5","pages":"Article 501513"},"PeriodicalIF":2.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147801850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Registro Español de Diálisis y Trasplante (REDYT): informe del año 2023 y análisis evolutivo","authors":"Borja Quiroga ,&nbsp;Beatriz Mahíllo ,&nbsp;Auxiliadora Mazuecos ,&nbsp;Alberto Ortiz ,&nbsp;Maribel Troya Saborido ,&nbsp;Domingo Hernández Marrero ,&nbsp;Sara Trujillo Alemán ,&nbsp;Carmen Santiuste ,&nbsp;Olga Lucía Rodríguez Arévalo ,&nbsp;María Marques Vidas ,&nbsp;María Fernanda Slon-Roblero ,&nbsp;Marta Artamendi Larrañaga ,&nbsp;Iñigo Moina Eguren ,&nbsp;María de la Oliva Valentín Muñoz ,&nbsp;Inmaculada Moreno Alia ,&nbsp;M. Encarnación Bouzas Caamaño ,&nbsp;M. Antonia Blanco Galán ,&nbsp;Javier Deira Lorenzo ,&nbsp;Sara Hernández Ramírez ,&nbsp;Federico Eduardo Arribas Monzon ,&nbsp;Emilio Sánchez Álvarez","doi":"10.1016/j.nefro.2026.501510","DOIUrl":"10.1016/j.nefro.2026.501510","url":null,"abstract":"<div><h3>Introduction</h3><div>Chronic kidney disease (CKD) will be the second leading cause of death worldwide by 2100. The Spanish Dialysis and Transplantation Registry (REDYT) records the incidence, prevalence and mortality of all patients requiring renal replacement therapy (RRT) in Spain. This article focuses on the 2023 report.</div></div><div><h3>Methods</h3><div>Data are provided by Spanish autonomous regions and cities and the <em>Organización Nacional de Trasplantes.</em> Incidence and prevalence rates of RRT have been calculated (considering the Spanish population according to annual data from the Instituto Nacional de Estadística), as well as mortality of patients on RRT in our country during the period 2014-2023.</div></div><div><h3>Results</h3><div>The incidence rate of RRT has increased by 15% over the last decade, reaching 153.7 persons per million people (pmp) in 2023, with 76.6% corresponding to haemodialysis (HD), 16.9% to peritoneal dialysis (PD), and 6.5% to kidney transplantation. Diabetes is the leading cause of CKD requiring RRT (25.2%). The incidence rate of RRT was more than twice as high in men as in women, with large differences among autonomous communities.</div><div>The prevalence rate of RRT in 2023 was 1,404.8 pmp, showing a progressive increase over the last decade, mainly due to a rise in the kidney-transplanted population (55.8%). There was an over 2-fold difference between communities in the transplant/dialysis prevalence ratio (1.93 to 0.77, state average 1.26).</div><div>In 2023, Spain performed 3,690 kidney transplants (76.8 pmp), maintaining the country's position as a global leader. Donation came mainly from brain death donors (47.9%), followed by donation after circulatory death donors (40.3%) and living donors (11.8%). There was a 10-fold difference between communities in the living donor/deceased donor ratio (0.21 to 0.02, state average 0.13).</div><div>The overall annual mortality of patients on RRT returned to pre-pandemic levels at 7.4% (13.3% in HD, 8.5% in PD and 2.6% in transplantation.</div></div><div><h3>Conclusions</h3><div>The incidence and prevalence of patients on RRT continues to increase in Spain, albeit with significant variation between autonomous communities. Annual mortality returned to pre-pandemic levels after 3 years. Nevertheless, public health measures are required to slow CKD progression and promote equity in Spain.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"46 5","pages":"Article 501510"},"PeriodicalIF":2.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147801855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}