Nefrologia最新文献

{"title":"¿Cuál es el impacto clínico del uso de la ecuación EKFC en la estimación de filtrado glomerular por creatinina en pacientes trasplantados renales?","authors":"Miguel Martínez-Belotto,&nbsp;María José Ortega,&nbsp;Covadonga López del Moral,&nbsp;Rosalía Valero,&nbsp;Juan Carlos Ruiz,&nbsp;María de la Oliva Valentín,&nbsp;Emilio Rodrigo","doi":"10.1016/j.nefro.2025.501430","DOIUrl":"10.1016/j.nefro.2025.501430","url":null,"abstract":"<div><h3>Background and objective</h3><div>Chronic kidney disease (CKD) is a prevalent condition, typically assessed using indirect markers such as estimated glomerular filtration rate (eGFR). The CKDEPI-2009 equation has been the most widely used estimation equation over the past decade. However, due to its limitations, alternative formulas aiming for greater accuracy compared to measured GFR (mGFR) have been developed. In 2020, the European Kidney Function Consortium (EKFC) validated a new, more precise equation covering the full age spectrum, which has been studied in various populations but remains underexplored in kidney transplant recipients. Our objectives were to evaluate the impact of changing estimation equations in this population, to measure comorbidity prediction and to check CKD reclassification.</div></div><div><h3>Materials and methods</h3><div>We conducted a retrospective observational study including all kidney transplant recipients at our center from 2006 to 2022 with graft survival greater than one year. We analyzed differences between CKD-EPI 2009 and EKFC across the entire cohort and within subgroups based on diabetes mellitus, sex, and age. We compared the prediction of CKD-related comorbidities, including anemia, acidosis, hyperkalemia, and hyperphosphatemia. We assessed concordance and reclassification across CKD stages based on KDIGO criteria.</div></div><div><h3>Results</h3><div>In a cohort of 616 kidney transplant recipients, EKFC and CKD-EPI 2009 showed a high correlation with excellent agreement across all subgroups (Intraclass Correlation Coefficient<!--> <!-->=<!--> <!-->0.9945). EKFC provided significantly lower estimates than CKD-EPI 2009 (-0.2<!--> <!-->mL/min/1.73 m²), particularly in CKD stages 1–3a, in women (-0.6<!--> <!-->ml/min/1,73<!--> <!-->m²), and in patients over 60 years (-1.4<!--> <!-->mL/min/1.73 m²). Concordance in KDIGO staging was very good (weighted κ<!--> <!-->=<!--> <!-->0.946). EKFC reclassified 6.5% of patients into a different CKD stage, mainly in earlier stages and more frequently in patients over 60. ROC curve analysis showed no clinically significant differences in predicting CKD-related comorbidities.</div></div><div><h3>Conclusions</h3><div>In kidney transplant recipients, EKFC and CKD-EPI 2009 show high correlation and are largely interchangeable. EKFC yields slightly lower eGFR values, particularly in women, older patients, and those with mild CKD, but the magnitude of these differences is small and of limited clinical relevance. These findings are consistent with the literature in this underrepresented population.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"46 2","pages":"Article 501430"},"PeriodicalIF":2.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146090856","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":"Eficacia de iptacopán en glomerulonefritis membranoproliferativa por inmunocomplejos idiopática refractaria al tratamiento convencional","authors":"Raquel López Hidalgo ,&nbsp;Mercedes Caba Molina ,&nbsp;Francisco Javier Ruiz Escolano ,&nbsp;Elena Delgado Sánchez de Murga ,&nbsp;Ma Teresa Fernández Quirós ,&nbsp;Ma José Espigares Huete","doi":"10.1016/j.nefro.2025.501426","DOIUrl":"10.1016/j.nefro.2025.501426","url":null,"abstract":"<div><div>Membranoproliferative glomerulonephritis due to immune complexes (MPGN-IC) idiopathic is a diagnosis of exclusion, made after ruling out the most common etiological processes associated with this pattern of glomerular injury (infectious, autoimmune diseases, gammopathies, among others). Idiopathic MPGN-IC shares with C3 glomerulopathy the activation of the alternative complement pathway, often evidenced by decreased serum C3 levels.</div><div>Currently, there is no specific treatment for this type of glomerulonephritis; however, various immunosuppressive agents (such as prednisone, mycophenolate, cyclophosphamide, rituximab) have been used depending on the severity of the case.</div><div>We present a clinical case diagnosed with idiopathic MPGN-IC presenting as an aggressive nephritic-nephrotic syndrome with rapidly progressive renal deterioration unresponsive to conventional therapy, requiring hemodialysis. Complete remission was achieved after initiating treatment with iptacopan, an oral inhibitor of factor B of the alternative complement pathway, and we demonstrate the patient's evolution over 12 months of treatment.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"46 2","pages":"Article 501426"},"PeriodicalIF":2.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146090750","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":"Glomerulonefritis fibrilar: características clínico-patológicas y tratamiento en un centro terciario español","authors":"Efraín Tatis ,&nbsp;Natalia Ramos Terrades ,&nbsp;María Alejandra Gabaldón ,&nbsp;Irene Agraz ,&nbsp;Marina López-Martinez ,&nbsp;Sara Núñez-Delgado ,&nbsp;Juan Carlos León ,&nbsp;Néstor Toapanta ,&nbsp;Sheila Bermejo ,&nbsp;Oriol Bestard ,&nbsp;María José Soler","doi":"10.1016/j.nefro.2025.501417","DOIUrl":"10.1016/j.nefro.2025.501417","url":null,"abstract":"<div><h3>Introduction</h3><div>Fibrillary glomerulonephritis (FGN) has a poor prognosis and lacks standardized treatment. In this study, we describe clinicopathological characteristics, clinical course, and management of patients with FGN at our center.</div></div><div><h3>Materials and methods</h3><div>A retrospective cohort study of 13 patients diagnosed with FGN by positive DNAJB9 at kidney biopsy between 2019 and 2024. Demographic data, comorbidities, laboratory values, histopathological findings, and treatments were collected, Complete remission was defined as proteinuria &lt;<!--> <!-->500<!--> <!-->mg/g with normal renal function; partial remission as &gt;50% reduction in proteinuria to &lt;<!--> <!-->2000<!--> <!-->mg/g with stable renal function; and no remission as absence of improvement, progression to end-stage kidney disease (ESKD), or death.</div></div><div><h3>Results</h3><div>The mean age was 61.4 years, 69,2% male, median proteinuria of 2318<!--> <!-->mg/g (38% nephrotic range) and serum creatinine 1.64<!--> <!-->mg/dL, Histopathological findings: 29% global glomerulosclerosis. The most frequent pattern was membranoproliferative (61.6%), followed by mesangial (30.8%) and membranous in 1 patient (7.7%), Hypoalbuminemia (&lt;3<!--> <!-->g/dL) was associated with worse prognosis (HR 6.52, <em>P</em>=.04); proteinuria &gt;3500<!--> <!-->mg/g and creatinine showed non-significant trends. Immunosuppression was given in 84.6% of patients: rituximab (RTX) (61.5%), RTX<!--> <!-->+<!--> <!-->mycophenolate (7.7%), sequential RTX followed by ocrelizumab and obinutuzumab (7.7%), and corticosteroids alone (7.7%). Partial remission was achieved in 30.8%, all within the exclusive RTX group, A total of 38.4% progressed to ESKD or death.</div></div><div><h3>Conclusions</h3><div>In our study, FGN showed poor prognosis and partial response to RTX. FGN with hypoalbuminemia had worse outcomes. Prospective studies and larger cohorts are needed to validate these findings and optimize its management.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"46 2","pages":"Article 501417"},"PeriodicalIF":2.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146090859","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":"Tele-nephrology in practice: Economic impact and primary care perspectives","authors":"Sofia Sousa ,&nbsp;Sofia Santos ,&nbsp;Beatriz Braga ,&nbsp;Ana Cunha ,&nbsp;Idalina Beirão","doi":"10.1016/j.nefro.2025.501432","DOIUrl":"10.1016/j.nefro.2025.501432","url":null,"abstract":"<div><h3>Aims</h3><div>Telemedicine used in nephrology has demonstrated non-inferiority to traditional care and acceptance by healthcare professionals and patients; however, cost effectiveness was less commonly reported. We aim to describe our centre's experience with virtual consultations (VCs) and estimate cost reduction, as well as assess general practitioners’ (GPs) perspectives.</div></div><div><h3>Methods</h3><div>Retrospective study of the patients referred for VC between January 2020 and December 2022 at Unidade Local de Saúde de Santo António (ULSSA). We analyzed patients’ demographics, including distance to hospital and autonomy, and estimated economic savings related to nephrologist's time, patient transport and lost workdays. To assess GPs’ perspective, we administered a brief, closed-question survey to GPs to assess awareness, use, and satisfaction with VCs.</div></div><div><h3>Results</h3><div>A total of 456 patients were included, of which 260 (57%) were female and median age was 80 years old (IQR 72–87). Distance from the hospital varied between one and 540<!--> <!-->km, with a median distance of 16<!--> <!-->km (IQR 6–19). Estimated total savings were €16,697.89, equivalent to €36.62 per patient per consult. The nephrologist time cost was estimated at €966.11 for virtual consultations compared with €3622.92 for initial face-to-face consultations, resulting in a time-related cost reduction of €2656.81. Forty-seven GPs of a total of 236 GPs (20%) completed the survey; from the responders, 28% had used VCs and 77% reported satisfaction with the response. Prescription guidance was the most identified strength of VC. Lack of awareness was the main barrier to use.</div></div><div><h3>Conclusions</h3><div>In this single-center experience, VCs reduced costs and travel burden while being acceptable to GPs. However, many GPs were unaware of this pathway, underscoring the need for promotion and integration in primary-care workflows. Future multicentre studies should evaluate clinical outcomes including avoidable face-to-face visits, hospitalizations, time to advice) and include patient and nephrologist perspective.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"46 2","pages":"Article 501432"},"PeriodicalIF":2.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146090854","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":"Unlocking the circular economy potential of spent dialysate in hemodialysis","authors":"Faissal Tarrass,&nbsp;Meryem Benjelloun","doi":"10.1016/j.nefro.2025.501431","DOIUrl":"10.1016/j.nefro.2025.501431","url":null,"abstract":"<div><div>Spent dialysate, a byproduct of hemodialysis, is traditionally discarded but holds significant potential for resource recovery within a circular economy framework. This literature review synthesizes research on the composition, ecotoxicological risks, treatment technologies, and resource recovery opportunities of spent dialysate. Characterized by high salinity, nitrogenous compounds, and contaminants like antibiotic resistance genes (ARGs), per- and polyfluoroalkyl substances (PFAS), and microplastics, spent dialysate poses moderate environmental risks, including eutrophication and antimicrobial resistance dissemination. Advanced treatment methods, such as reverse osmosis (RO) and nanofiltration (NF), effectively remove contaminants, while struvite crystallization and energy recovery via heat exchangers and microbial fuel cells (MFCs) enable the valorization of water, nutrients, and energy. These approaches reduce carbon emissions by 30–50% and offer economic benefits through cost savings and revenue generation. However, regulatory gaps, high infrastructure costs, and limited research on microplastics highlight the need for further investigation to fully realize the circular potential of spent dialysate. This review synthesizes these challenges, identifies key implementation barriers, and outlines critical research priorities to translate this promising concept into sustainable practice.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"46 2","pages":"Article 501431"},"PeriodicalIF":2.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146090857","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":"Micro/nanoplastics and kidney—Letter to the Editor","authors":"Leonard Whye Kit Lim","doi":"10.1016/j.nefro.2025.501407","DOIUrl":"10.1016/j.nefro.2025.501407","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"46 2","pages":"Article 501407"},"PeriodicalIF":2.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146090751","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":"ANCA positive pauci-immune glomerulonephritis as presenting feature of mantle cell lymphoma: A case report and review of literature","authors":"Gizem Kumru ,&nbsp;Merve Yüksel ,&nbsp;Yasemin Geriş ,&nbsp;Emine Selin Yıldırım ,&nbsp;Saba Kiremitci ,&nbsp;Işınsu Kuzu ,&nbsp;Önder Arslan","doi":"10.1016/j.nefro.2025.501363","DOIUrl":"10.1016/j.nefro.2025.501363","url":null,"abstract":"<div><div>Kidney involvement in mantle cell lymphoma is rare. We report a case of mantle cell lymphoma diagnosed after rapidly progressive glomerulonephritis with biopsy-proven paraneoplastic anti-neutrophil cytoplasmic antibody positive pauci-immune cresentic glomerulonephritis. Lymphoma treatment resulted in improved kidney function. This report demonstrates that pauci-immune cresentic glomerulonephritis can cause kidney impairment as the initial manifestation of mantle cell lymphoma. Physicians should be aware of the atypical presentations of the disease.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"46 1","pages":"Article 501363"},"PeriodicalIF":2.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145963283","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":"Urinary VEGF-A165b mRNA expression in Fabry disease: Pilot study","authors":"Sebastián Jaurretche ,&nbsp;Germán Perez ,&nbsp;Norberto Antongiovanni ,&nbsp;María Victoria del Rosal ,&nbsp;María Luana Brajkovic ,&nbsp;Fernando Perretta ,&nbsp;Graciela Venera","doi":"10.1016/j.nefro.2025.501416","DOIUrl":"10.1016/j.nefro.2025.501416","url":null,"abstract":"<div><h3>Background</h3><div>Vascular endothelial growth factor (VEGF) is associated with renal pathogenesis of Fabry disease (FD). Proteomic studies have demonstrated that circulating levels of VEGF are higher in young FD patients compared with controls and an overexpression of tissue VEGF in animal models of Fabry nephropathy has been reported. In kidneys, VEGF-A is predominantly produced by podocytes, and its action on endothelial dysfunction is known. An alternative VEGF-A isoform, VEGF-A165b, confers benefit in microvascular disease states, and it was studied in diabetic nephropathy having demonstrated a protective function, acting on the restoration of the podocyte glycol-calyx.</div></div><div><h3>Methods</h3><div>Cross-sectional design. Urinary mRNA was obtained by RT-qPCR.</div></div><div><h3>Results</h3><div>48 subjects were included; 24 FD patients (17F/7M – 23.7<!--> <!-->±<!--> <!-->17.5 ys) and 24 healthy volunteers (17F/7M – 23.0<!--> <!-->±<!--> <!-->17.0 ys). 12 adults and 12 pediatrics in both populations Median uACR (<em>p</em> <!-->=<!--> <!-->0.999) and eGFR (<em>p</em> <!-->=<!--> <!-->0.999) were similar between both groups. FD genotypes included were R301Q, R363H, R227Q, del3&amp;4exon, L106R, E398X, L415P and C238Y; 15 FD patients were treatment naïve and 9 receiving ERT (agalsidase-β); median time of ERT was 15.6<!--> <!-->±<!--> <!-->28.3 months. Comparative expression of urinary VEGF-165b-mRNA was higher among FD patients versus controls although without statistical significance (<em>p</em> <!-->=<!--> <!-->0.369). No significant correlations were found between urinary VEGF-165b-mRNA and variables “Age” (<em>p</em> <!-->=<!--> <!-->0.845), “Gender” (<em>p</em> <!-->=<!--> <!-->0.369), “αGal-A” (<em>p</em> <!-->=<!--> <!-->0.631), “Genotype” (<em>p</em> <!-->=<!--> <!-->0.142), “Phenotype” (<em>p</em> <!-->=<!--> <!-->0.898), “uACR” (<em>p</em> <!-->=<!--> <!-->0.744), “eGFR” (<em>p</em> <!-->=<!--> <!-->0.059) and “ERT or Naïve” (<em>p</em> <!-->=<!--> <!-->0.507). A significant correlation between urinary VEGF-165b-mRNA and “time of ERT treatment” was found (<em>p</em> <!-->=<!--> <!-->0.05).</div></div><div><h3>Conclusion</h3><div>Overexpression of urinary VEGF-165b-mRNA (with known renal cyto-protective effects) is a probable response to injury in FD nephropathy. The only variable correlated with the highest urinary expression of VEGF-165b-mRNA was the time of ERT treatment. Probably in patients with longer treatment time there is a decrease in FD damage. A limitation of the present work is the low sample size and cross-sectional design.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"46 1","pages":"Article 501416"},"PeriodicalIF":2.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145963285","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":"Documento de consenso para el diagnóstico y tratamiento de la insuficiencia renal aguda","authors":"Natàlia Ramos Terrades ,&nbsp;Patrocinio Rodríguez Benítez ,&nbsp;Jose Manuel Urbizu Gallardo ,&nbsp;María de Valdenebro ,&nbsp;Mercedes Salgueira ,&nbsp;Alicia Molina Andujar ,&nbsp;Judith Martins ,&nbsp;Alejandra Ramos-Galí ,&nbsp;Juan Antonio Moreno ,&nbsp;Cristina de la Cuerda ,&nbsp;Maria Jesus Lloret ,&nbsp;David Menéndez ,&nbsp;Isabel Acosta-Ochoa ,&nbsp;Gregorio Romero-González ,&nbsp;Esteban Poch ,&nbsp;en representación del Grupo FRA de la SEN","doi":"10.1016/j.nefro.2025.501360","DOIUrl":"10.1016/j.nefro.2025.501360","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"46 1","pages":"Article 501360"},"PeriodicalIF":2.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145963286","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":"Medidas de resultados percibidos por el paciente (PROM) en la consulta de acceso a trasplante renal y su relación con la fragilidad","authors":"Dolores Redondo-Pachón ,&nbsp;Anna Bach-Pascual ,&nbsp;Clara Amat-Fernandez ,&nbsp;Betty Chamoun-Huacon ,&nbsp;Olatz Garin ,&nbsp;Yolanda Pardo ,&nbsp;Erica Briones-Vozmediano ,&nbsp;Esther Rubinat-Arnaldo ,&nbsp;Marta Crespo-Barrio ,&nbsp;Guillermo Pedreira-Robles ,&nbsp;María José Pérez-Sáez","doi":"10.1016/j.nefro.2025.501393","DOIUrl":"10.1016/j.nefro.2025.501393","url":null,"abstract":"<div><h3>Background and objective</h3><div>Patient-reported outcomes (PROMs) are key tools for advancing patient-centered clinical practice, with proven benefits for health outcomes. Their application has been extended to different chronic diseases, but there are few studies involving patients with chronic kidney disease (CKD), a population that is aging and frail. The aim of this study was to assess the relationship between frailty and self-reported health-related quality of life in patients with advanced CKD who are eligible for kidney transplantation (KT).</div></div><div><h3>Material and methods</h3><div>KT candidates who were evaluated in the outpatient clinic were included in the study. The PROMIS-29® and PROMIS-Global Health® questionnaires were administered, and T-scores were calculated for each domain. Frailty was assessed using the Fried scale, categorizing participants as frail/pre-frail if FRIED<!--> <!-->&gt;0. Sociodemographic and clinical variables were also collected.</div></div><div><h3>Results</h3><div>139 KT candidates were included in the study: 32% were women, the mean age was 63.5 years, 43.9% were on dialysis, and 64.5% were frail. 71.2% responded to the administered PROMIS. Overall, KT candidates reported their mental health as good (48<!--> <!-->±<!--> <!-->7.4) and their physical health as fair (42.8<!--> <!-->±<!--> <!-->7.3). T-scores for anxiety, fatigue, social functioning, sleep disturbance, pain, and depression were within the normal range compared to the general population. When comparing frail with robust patients, only the physical domain of PROMIS-Global Health® and physical function of PROMIS-29® were worse in the frail group. No differences were found in the other domains.</div></div><div><h3>Conclusions</h3><div>Frail kidney transplant candidates report worse physical function when assessed using PROMs tools. The systematic implementation of PROMs might help to implement strategies to optimize access to the waiting list, improve postKT outcomes, and enhance overall patient care.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"46 1","pages":"Article 501393"},"PeriodicalIF":2.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145963289","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}