Nefrologia最新文献

{"title":"Fabry disease as a trigger of immune-mediated glomerular disease: Clinical hypotheses and literature review","authors":"Javier Martínez de Victoria Carazo ,&nbsp;Haylen Marin ,&nbsp;Francisco Javier De la Hera Fernández ,&nbsp;Carlos Mañero Rodríguez ,&nbsp;César Ramírez Tortosa ,&nbsp;José Luís Callejas Rubio","doi":"10.1016/j.nefro.2025.01.003","DOIUrl":"10.1016/j.nefro.2025.01.003","url":null,"abstract":"<div><div>Fabry disease (FD) is an X-linked genetic disorder characterized by alpha-galactosidase deficiency, leading to the accumulation of globotriaosylceramide. This accumulation causes multi-organ dysfunction, with renal involvement being particularly significant. Recently, the immunological relationship of this disease has been investigated, including the inactivation of enzyme therapies by antibodies and systemic inflammation. We present the case of a 15-year-old patient with FD and ANCA-associated vasculitis (AAV). A narrative review was conducted by searching PubMed with the terms “Fabry disease” AND “vasculitis” AND “glomerulonephritis,” identifying 9 relevant articles. These cases were compared with the current one, emphasizing pathophysiological aspects. 75% of patients had fever, 50% had peripheral edema, and 25% had otorhinolaryngological involvement. Pauci-immune necrosis was found in 75%. Therapeutically, all cases were treated with plasmapheresis, 75% with cyclophosphamide, and only one case required hemodialysis during follow-up. The association of FD with vasculitis is rare, with only five cases, only one with positive ANCA. The role of the immune system in FD, still not fully understood, seems to contribute significantly to pathogenesis and complications. This case highlights the need for further research on the immunological role in FD and its relationship with vasculitis and other autoimmune diseases.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 5","pages":"Pages 401-409"},"PeriodicalIF":2.0,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143868871","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":"Impact of iron chelation with deferasirox on telomere length and oxidative stress in hemodialysis patients: A randomized study","authors":"Blanca Olivia Murillo Ortiz ,&nbsp;Joel Ramírez Emiliano ,&nbsp;Marcos Javier Romero Vázquez ,&nbsp;Lauro Fabián Amador Medina ,&nbsp;Sandra Martínez Garza ,&nbsp;Edna Montserrat Ramos Rodríguez","doi":"10.1016/j.nefro.2024.06.006","DOIUrl":"10.1016/j.nefro.2024.06.006","url":null,"abstract":"<div><h3>Background</h3><div>Recent studies have demonstrated the effectiveness, safety, and tolerability of deferasirox in patients in peritoneal dialysis, however, its effect has not been studied in patients undergoing hemodialysis.</div></div><div><h3>Objective</h3><div>To investigate the impact of iron chelation on telomere length, oxidative stress, and ferritin levels in patients undergoing hemodialysis.</div></div><div><h3>Methods</h3><div>This is an open-label study, with a control group of patients undergoing hemodialysis, who will receive treatment with deferasirox 15<!--> <!-->mg/kg/day for 6 months for iron chelation. Telomere length was measured using real-time PCR. Serum ferritin levels and oxidation markers were evaluated. To evaluate the pharmacokinetics and safety of deferasirox, plasma concentrations were analyzed by HPLC.</div></div><div><h3>Results</h3><div>Fifty-four patients were included to receive deferasirox, and a control group of 50 patients. Significant differences were observed in serum ferritin levels (<em>p</em> <!-->&lt;<!--> <!-->0.0001), TBARS (thiobarbituric acid reactive substances) (<em>p</em> <!-->&lt;<!--> <!-->0.01). Telomere length had a significant increase after chelation (<em>p</em> <!-->&lt;<!--> <!-->0.001). The serum deferasirox concentration at zero time at 48<!--> <!-->h was maintained within a range of 2.67–23.78<!--> <!-->mmol/L.</div></div><div><h3>Conclusions</h3><div>Our results demonstrate that iron chelation in hemodialysis patients significantly reduces ferritin and TBARS, resulting in an increase in telomere length. Deferasirox proves to be beneficial for patients with iron overload undergoing hemodialysis.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 1","pages":"Pages 68-76"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141394413","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":"Cardiovascular risk assessment: Missing albuminuria contributing to gender inequality","authors":"Patricia de Sequera ,&nbsp;Javier Arias ,&nbsp;Borja Quiroga ,&nbsp;María Benavent ,&nbsp;Fabio Procaccini ,&nbsp;Iago Romero ,&nbsp;Guillermo López ,&nbsp;Javier Diez ,&nbsp;Alberto Ortiz","doi":"10.1016/j.nefro.2024.02.010","DOIUrl":"10.1016/j.nefro.2024.02.010","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Chronic kidney disease (CKD) is associated with high cardiovascular disease (CVD) risk, and requires specific interventions to decreases CVD risk.&lt;/div&gt;&lt;div&gt;The guidelines indicate that systematic global CVD risk assessment is recommended in individuals with any major vascular risk factor. The European Society Cardiology (ESC) guidelines, he European Renal Association (ERA) Council and the Spanish Society of Nephrology (S.E.N.) in collaboration with 15 Scientific Societies recommend assessing albuminuria in all these populations.&lt;/div&gt;&lt;div&gt;We have evaluated current clinical practice regarding the assessment of CVD risk factors (blood pressure, albuminuria, serum cholesterol, glycemia and creatinine) in different adult health user populations, analyzing the results separately for men and women, given recent evidence on gender differences in the recognition, monitoring, and management of CKD.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Observational, retrospective, non-interventional single center study performed in a hospital using Electronic Health Record (EHR) data.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Among 707,493 healthcare users, 612,619 were adults, and of these 332,943 (54.3%) females; 73,632 (12.0%) had DM and 121,445 (19.8%) hypertension. Mean (SD) age was 68.91&lt;!--&gt; &lt;!--&gt;±&lt;!--&gt; &lt;!--&gt;21.4 years; 261,694 (36.9%) were older than 50 years.&lt;/div&gt;&lt;div&gt;Only 8522 (1.39%) had undergone albuminuria testing as compared with 264,684 (43.21%) tested for serum creatinine, 140,492 (22.93%) for serum cholesterol, 263,381 (42.99%) for serum glucose, and 226,448 (36.96%) for blood pressure. Albuminuria was the only cardiovascular risk factor assessed more frequently in men than in women.&lt;/div&gt;&lt;div&gt;Albuminuria, as other CVD risk factors, was more frequently assessed in patients with DM (6.71% of patients) or hypertension (4.81%), but albuminuria assessment remained suboptimal compared with 58–87% for other cardiovascular risk factors. For adults with diabetes or hypertension, albuminuria was assessed more frequently in men than in women.&lt;/div&gt;&lt;div&gt;Albuminuria assessment in those older than 50 years was also suboptimal at 2.24%, as compared with 31–47% for other CVD risk factors.&lt;/div&gt;&lt;div&gt;Albuminuria and EGFR are needed to screen for CKD, meaning that a urine test for albumin and creatinine and a serum test for creatinine are needed. To these, we may add assessment of blood pressure, serum cholesterol (for familial hypercholesterolemia) and serum glucose for Diabetes. Albuminuria was the only cardiovascular risk factor that was assessed more frequently in men (up to nearly 60% more frequently), indicating that screening for CKD and CVD risk in women is suboptimal. This result is surprisingly consistent across time and in all age groups. This is the first time that gender disparities in the assessment of albuminuria have been revealed.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Albuminuria is assessed infrequently, even in patients wit","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 1","pages":"Pages 87-93"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143102993","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":"Diferencias en la elección de la modalidad de diálisis entre inmigrantes y españoles en Barcelona","authors":"María Dolores Arenas-Jiménez ,&nbsp;José Luis Fernández-Martin ,&nbsp;Isabel Galcerán Herrera ,&nbsp;Marisol Fernández-Chamarro ,&nbsp;Guillermo Pedreira-Robles ,&nbsp;Silvia Collado Nieto ,&nbsp;Julia Farrera Núñez ,&nbsp;Eva Rodríguez García ,&nbsp;Alicia Moreno Rodríguez ,&nbsp;Laura Morro Fernández ,&nbsp;Marta Crespo Barrio ,&nbsp;Julio Pascual Santos","doi":"10.1016/j.nefro.2024.01.003","DOIUrl":"10.1016/j.nefro.2024.01.003","url":null,"abstract":"<div><div>Few studies have analyzed the freedom to choose their renal replacement treatment (RRT) modality in Spain. In a total of 673 patients with ACKD (stage 4 and 5) seen at the outpatient ACKD clinic of Hospital del Mar, Barcelona, Catalonia (Spain) from 2009 to 2020, we retrospectively compared immigrant and Spanish patients in order to analyze the impact of migration on RRT decision-making and its subsequent evolution in advanced CKD (ACKD) consultation and identifies the social and economic needs of this population. One hundred thirteen (16.8%) patients were immigrants and 560 were Spanish (83.2%). Migrants more frequently chose HD at a center (79.5%) than PD (12.5%) compared to Spaniards (HD 55.5% and 25% PD) despite being younger and more independent in basic and instrumental activities of daily living. Immigrant patients started RRT with lower eGFR (8.1 vs. 9.1<!--> <!-->mL/min/1.73<!--> <!-->m³) and after a shorter follow-up time in the ACKD consultation than the Spaniards (22 vs. 32 months). The language barrier was associated with a greater choice of center-based HD and active employment status favored the choice of PD. Spanish patients had a significantly higher relative risk of mortality compared with immigrant patients (HR<!--> <!-->=<!--> <!-->3.27 [95% CI: 1.17–9.17], <em>p</em> <!-->=<!--> <!-->0.024). However, after adjustment by age, this increased relative risk of mortality disappeared (HR 1.99 [0.69–5.76], <em>p</em> <!-->=<!--> <!-->0.206). Almost 60% individuals were not linked to social services. In conclusion, most immigrants in Barcelona choose center-HD versus DP despite being younger and more independent in basic and instrumental activities of daily living and being in a better condition than Spanish patients. Considering the socioeconomic and cultural needs of the immigrant population we serve is necessary to effectively reduce health inequities.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 1","pages":"Pages 59-67"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139632623","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":"Reflexiones sobre el «Documento de consenso sobre tabaquismo y riesgo vascular» de las Sociedades Autonómicas de Hipertensión Arterial y Riesgo Vascular","authors":"Javier Nieto Iglesias ,&nbsp;Alfonso Pobes Martínez de Salinas ,&nbsp;Nicolás Roberto Robles Pérez-Monteoliva ,&nbsp;en representación del Grupo de Prevención de Riesgo Renal y Vascular de la Sociedad Española de Nefrología","doi":"10.1016/j.nefro.2024.09.001","DOIUrl":"10.1016/j.nefro.2024.09.001","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 1","pages":"Pages 1-4"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143098623","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":"Amiloidosis asociada a β2-microglobulina: un vínculo olvidado que debe recordarse","authors":"Javier Arias-Alcala,&nbsp;Celia Novas Moreno,&nbsp;Carlos Novillo Sarmiento,&nbsp;Isabel Lopez-Lopez,&nbsp;Sagrario Soriano,&nbsp;Alejandro Martin-Malo,&nbsp;Cristian Rodelo-Haad","doi":"10.1016/j.nefro.2024.07.002","DOIUrl":"10.1016/j.nefro.2024.07.002","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 1","pages":"Pages 97-99"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141840419","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 characteristics and outcomes of incident haemodialysis-treated adult patients in Kenya: Brief paper about basic research","authors":"Samuel K. Kabinga ,&nbsp;Seth O. McLigeyo ,&nbsp;Anson K. Mwango ,&nbsp;Davies O. Otieno ,&nbsp;Evans A. Onyango ,&nbsp;Priscah D. Chemutai ,&nbsp;Duncan G. Irungu ,&nbsp;John N. Ndungu","doi":"10.1016/j.nefro.2024.09.002","DOIUrl":"10.1016/j.nefro.2024.09.002","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 1","pages":"Pages 94-97"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143102994","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":"Hiperoxaluria secundaria: causas y consecuencias de la enfermedad renal crónica","authors":"Loreto Mariscal de Gante ,&nbsp;Laura Salanova ,&nbsp;Mariel Valdivia Mazeyra ,&nbsp;Rosario Serrano Pardo ,&nbsp;Borja Quiroga","doi":"10.1016/j.nefro.2024.06.003","DOIUrl":"10.1016/j.nefro.2024.06.003","url":null,"abstract":"<div><div>Secondary hyperoxaluria is a metabolic disorder characterized by an increase in urinary oxalate excretion. The etiology may be due to an increase in the intake of oxalate or its precursors, a decrease in elimination at the digestive level, or an increase in renal excretion. Recently, the role of the SLC26A6 transporter in the etiopathogenesis of this disease has been discovered. It is present at both the intestinal and renal levels. Its mechanism of action is altered in situations of systemic inflammation and metabolic syndrome, which could explain the growing increase in cases of secondary hyperoxaluria in recent decades. Treatment includes hygienic dietary measures, as well as drugs aimed at reducing its absorption at the intestinal level by increasing fecal excretion. Different immunomodulatory drugs, microbiome modifiers and SGLT2 inhibitors could constitute new therapeutic targets. At present, we do not have specific treatments for secondary hyperoxaluria, so early diagnosis and measures aimed at preventing the progression of kidney failure are currently the main therapeutic tools.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 1","pages":"Pages 5-14"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141411932","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":"Unexpected identification of peak systolic velocity in the radial artery as a risk factor for functional primary patency of radiocephalic fistulas","authors":"Rui Cong,&nbsp;Songxiu Li,&nbsp;Shasha Shi","doi":"10.1016/j.nefro.2024.07.001","DOIUrl":"10.1016/j.nefro.2024.07.001","url":null,"abstract":"<div><h3>Objective</h3><div>As radiocephalic fistula is not necessarily appropriate for all patients with advanced kidney disease, our aim was to investigate the sensitive indicators that affect the functional primary patency of radiocephalic fistulas.</div></div><div><h3>Methods</h3><div>This prospective observational study included consecutive patients referred to the Second Hospital of Dalian Medical University for initial creation of radiocephalic fistula from July 2017 to December 2019. Preoperative ultrasound parameters, demographic characteristics, serum indicators and comorbidities were recorded. The functionality of radiocephalic fistulas would be assessed every 6 months until March 2023, following their unassisted maturation, unless AVF dysfunction, kidney transplantation, mortality or loss to follow-up occurred. Kaplan–Meier analysis was employed to illustrate differences in functional primary patency of radiocephalic fistulas, while log-rank tests were utilized to compare survival curves. Univariate and multivariable Cox proportional hazard models were performed, yielding hazard ratios and 95% confidence intervals. The significance level was set at 5% for a two-sided test.</div></div><div><h3>Results</h3><div>The studies included a total of 182 patients who successfully underwent radiocephalic fistulas with primary unassisted maturation. The mean age of the study population was 58 years, with 66 percent being male. All AVFs were placed on the forearm, with 84% located on the left side.</div><div>The primary patency rates of eleven parameters exhibited significant differences between groups stratified by cut-off values at different time points. Notably, the group with a peak systolic velocity of the radial artery near the elbow ≤59<!--> <!-->cm/s demonstrated a higher primary patency rate compared to the &gt;59<!--> <!-->cm/s group at 2 years (78.4% vs 57.5%, <em>P</em> <!-->=<!--> <!-->0.026).</div><div>In the univariate Cox proportional hazard models, the <em>P</em> values for gender, the diameter of radial artery near the elbow, the peak systolic velocity of radial artery near the elbow, the diameter of brachial artery near the elbow were less than 0.1. The multivariable Cox proportional hazard model revealed that only the peak systolic velocity of radial artery near the elbow exhibited a significant impact on the functional primary patency of radiocephalic fistula (HR<!--> <!-->=<!--> <!-->1.017, 95%CI 1.002–1.031, <em>P</em> <!-->=<!--> <!-->0.021).</div></div><div><h3>Conclusions</h3><div>The peak systolic velocity of the radial artery near the elbow is a significant risk factor for functional primary patency of radiocephalic fistula. Preoperative evaluation of the peak systolic velocity could allow to identify patients with a lower likelihood of long-term radiocephalic fistula patency, facilitating improved selection of candidates for radiocephalic fistula creation.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 1","pages":"Pages 77-86"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141847351","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":"Recomendaciones para el diagnóstico y tratamiento de las vasculitis asociadas a anticuerpos anticitoplasma de neutrófilo","authors":"Enrique Morales ,&nbsp;Iñigo Rúa-Figueroa ,&nbsp;José Luis Callejas Rubio ,&nbsp;Ana Ávila Bernabéu ,&nbsp;Ricardo Blanco Alonso ,&nbsp;Maria C. Cid Xutgla ,&nbsp;Gema Fernández Juárez ,&nbsp;Natalia Mena-Vázquez ,&nbsp;Juan José Ríos Blanco ,&nbsp;Joaquín Manrique Escola ,&nbsp;F. Javier Narváez García ,&nbsp;Bernardo Sopeña ,&nbsp;Luis F. Quintana Porras ,&nbsp;Susana Romero-Yuste ,&nbsp;Roser Solans Laqué","doi":"10.1016/j.nefro.2024.07.004","DOIUrl":"10.1016/j.nefro.2024.07.004","url":null,"abstract":"<div><div>Anti-neutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis is characterised by small vessel necrotising inflammatory vasculitis. Prior to immunosupressant therapy availability it usually led to a fatal outcome. Current treatment has changed ANCA-associated vasculitis into a condition with a significant response rate, although with a not negligible relapse occurrence and cumulative organ lesions, mostly due to drug-related toxicities. The use of glucocorticoids, cyclophosphamide and other immunosupressants (such as azathioprine, mychophenolate and methotrexate) was optimised in a series of clinical trials that established the treatment of reference. In recent years, a better knowledge of B lymphocyte function and the role of complement inhibition has transformed the course of this disease while minimising treatment-related adverse effects.</div><div>This multidisciplinary document of recommendations is based on the consensus of three scientific societies (Internal Medicine, Nephrology and Rheumatology) and on the best available evidence on diagnosis, treatment and follow-up of patients with ANCA-associated vasculitis, including some special situations. The aim of this document is to provide updated information and well-grounded clinical recommendations to practising physicians as to how to improve the diagnosis and treatment outcome of our patients.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 1","pages":"Pages 15-58"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143098627","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}