Nefrologia最新文献

{"title":"Refractory C3 glomerulonephritis unresponsive to bortezomib","authors":"Taha Enes Cetin, Ulver Derici, Galip Güz, Betül Ogüt, Ozant Helvacı","doi":"10.1016/j.nefro.2025.501401","DOIUrl":"10.1016/j.nefro.2025.501401","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"46 1","pages":"Article 501401"},"PeriodicalIF":2.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145963349","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":"Incidencia e impacto clínico-económico del fracaso renal agudo intrahospitalario en Andalucía","authors":"Marina Almenara Tejederas ,&nbsp;Wenceslao Aguilera Morales ,&nbsp;Blanca Angulo Vázquez ,&nbsp;Melissa Cintra Cabrera ,&nbsp;Alfonso Lara Ruiz ,&nbsp;Mercedes Salgueira Lazo","doi":"10.1016/j.nefro.2025.501397","DOIUrl":"10.1016/j.nefro.2025.501397","url":null,"abstract":"<div><h3>Background and Objective</h3><div>Acute kidney injury (AKI) is associated with high morbidity and mortality, an increased risk of developing or worsening chronic kidney disease (CKD), and elevated healthcare costs. There are no registries analyzing the incidence of hospital-acquired AKI. The objectives of this study were to determine the incidence of AKI among hospitalized adult patients in Andalusia, analyse its impact on in-hospital mortality and economic burden, identify clinical units where quality improvement strategies could be implemented, and evaluate the impact of nephrology involvement on clinical outcomes in this population.</div></div><div><h3>Materials and Methods</h3><div>This retrospective study included hospital admissions of patients aged over 18 years across healthcare facilities affiliated with the Andalusian Public Health System between 2017 and 2021. Data were obtained from the Minimum Basic Data Set (CMBD) provided by the Technical Advisory Subdirectorate for Information Management of the Andalusian Health Service (SAS), covering 82 hospitals and 28 specialized units. A sub-analysis was conducted on the 11 clinical units with the highest AKI incidence: Nephrology, Cardiovascular Surgery, Internal Medicine, Infectious Diseases, Cardiology, Gastroenterology, Hematology and Clinical Hemotherapy, Pulmonology, Medical Oncology, Orthopedic Surgery and Traumatology, and Urology.</div></div><div><h3>Results</h3><div>The overall incidence of AKI during the study period was 58.5 per 1,000 hospitalizations (5.8% of total admissions), increasing from 46.7 to 68.3 per 1,000 admissions between 2017 and 2021. Incidence varied significantly among clinical units, ranging from 11.3 to 305 cases per 1,000 hospitalizations. Nephrology (305/1,000), Internal Medicine (172.9/1,000), and Infectious Diseases (108/1,000) had the highest incidence rates. AKI diagnosis was associated with prolonged hospital stay (13.55 days in patients with AKI vs. 7.69 days in those without), increased healthcare costs (€107,377.51 vs. €56,342.69), and higher in-hospital mortality (23.03% vs. 4.03%).</div></div><div><h3>Conclusions</h3><div>The relatively low overall AKI incidence may be underestimated due to study limitations. Nevertheless, the data reveal a progressive increase in hospital-acquired AKI over the study period, with a marked impact on length of stay, healthcare costs, and mortality. Implementing more effective care models focused on prevention, early detection, and treatment of AKI could improve patient safety and reduce associated costs. The proactive integration of Nephrology within the multidisciplinary management of AKI emerges as a key factor in improving both short- and long-term outcomes and promoting the sustainability of the healthcare system by mitigating the economic burden of AKI.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"46 1","pages":"Article 501397"},"PeriodicalIF":2.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145963321","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":"Ethical dilemmas of living donor kidney transplantation: A systematic review","authors":"María Isabel Rebollo Mateos ,&nbsp;José López Castro","doi":"10.1016/j.nefro.2025.501398","DOIUrl":"10.1016/j.nefro.2025.501398","url":null,"abstract":"<div><h3>Introduction</h3><div>Living donor kidney transplantation is a crucial treatment for chronic kidney disease, yet it raises significant ethical issues. This systematic review addresses these issues by analysing scientific literature from the past ten years. The objectives include identifying and thoroughly analysing the most common ethical dilemmas, describing them, examining the perspectives of various involved groups, and analysing clinical strategies to address them.</div></div><div><h3>Material and methods</h3><div>Databases such as PubMed, Scopus, and Mendeley were used, following PRISMA guidelines, and 49 relevant studies were included.</div></div><div><h3>Results</h3><div>The identified dilemmas encompass equity in access to transplantation, distributive justice, informed consent, transplant tourism, coercion, and ethical issues related to desensitization.</div></div><div><h3>Discussion</h3><div>The review highlights the need for multidisciplinary approaches and unified protocols to tackle these ethical challenges. It underscores the importance of adhering to fundamental ethical principles, aligning with international bioethical statements.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"46 1","pages":"Article 501398"},"PeriodicalIF":2.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145963322","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":"Expresión linfocitaria y niveles de IL-2 en el síndrome nefrótico corticorresistente por glomeruloesclerosis focal y segmentaria: implicaciones en la respuesta a los inhibidores de calcineurina","authors":"Maria Planella-Cornudella ,&nbsp;Neus Roca-Saladrigues ,&nbsp;Victor Lopez-Baez ,&nbsp;Elias Jatem-Escalante ,&nbsp;Eduard Sole-Mir ,&nbsp;Xavier Gomez-Arbones ,&nbsp;Alvaro Madrid-Aris ,&nbsp;Alfons Segarra-Medrano","doi":"10.1016/j.nefro.2025.501402","DOIUrl":"10.1016/j.nefro.2025.501402","url":null,"abstract":"<div><h3>Background and objective</h3><div>Calcineurin inhibitors (CNI) are the first-line treatment for steroid-resistant nephrotic syndrome (SRNS) due to focal segmental glomerulosclerosis (FSGS), though response rates vary. This study analyzed lymphocyte activation through IL-2 receptor expression on T lymphocytes and serum IL-2Rα (soluble CD25) levels in these patients to evaluate their relationship with response to CNI therapy.</div></div><div><h3>Materials and methods</h3><div>A multicenter case-control study was conducted with 39 patients with steroid-resistant FSGS, diagnosed via renal biopsy, and 23 healthy controls. Clinical, biochemical, and immunological variables were assessed. Soluble CD25 levels were measured using ELISA, and lymphocyte activation was analyzed by flow cytometry. Treatment criteria and response evaluation followed KDIGO guidelines. Diagnostic performance was assessed using ROC curves for soluble CD25.</div></div><div><h3>Results</h3><div>The 48.7% of patients responded to CNI treatment. Soluble CD25 levels and IL-2 expression on CD3 T lymphocytes were significantly associated with CNI response (<em>P</em>&lt;.01): responders had higher CD25 levels (477<!--> <!-->±<!--> <!-->84.47 pg/ml) compared to non-responders (290.28<!--> <!-->±<!--> <!-->85.98 pg/ml). Responders showed a significant reduction in soluble CD25 (−35.8%) and CD3-IL2⁺ cells after remission, alongside increases in CD8 DR⁺ cells and regulatory T cells. ROC analysis identified a soluble CD25 cutoff of 324 pg/ml, with 94% sensitivity and 75% specificity for predicting response to CNI.</div></div><div><h3>Conclusions</h3><div>Elevated soluble CD25 levels and T cell activation were associated with better CNI response. Soluble CD25 could be a predictive biomarker to identify patients with higher likelihood of response, optimizing therapeutic decisions and avoiding unnecessary treatments in steroid-resistant FSGS.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"46 1","pages":"Article 501402"},"PeriodicalIF":2.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145963323","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":"Desafíos del embarazo en receptoras de trasplante de páncreas y riñón. Experiencia en nuestro centro","authors":"Ester Cholbi ,&nbsp;Elena Moreno Maestre ,&nbsp;Jordi Espí Reig ,&nbsp;Ana Paz Ventura Galiano ,&nbsp;Pablo González-Calero Borrás ,&nbsp;Diego Rodríguez Ortega ,&nbsp;María Ramos Cebrián ,&nbsp;Juan Francisco Merino Torres ,&nbsp;Beatriz Marcos Puig ,&nbsp;Eva María Montalvá Orón ,&nbsp;Isabel Beneyto Castelló","doi":"10.1016/j.nefro.2025.501400","DOIUrl":"10.1016/j.nefro.2025.501400","url":null,"abstract":"<div><h3>Background and objective</h3><div>Chronic kidney disease affects up to 6% of women of childbearing age, leading to fertility issues and low pregnancy rates. In patients with diabetes mellitus and chronic kidney disease, simultaneous pancreas-kidney transplantation restores renal function and endogenous insulin production, thereby increasing the likelihood of a successful pregnancy. However, pregnancy after transplantation remains high-risk. Several factors may influence maternal and fetal outcomes, including preconception counseling, appropriate maternal medical management, and the careful selection of immunosuppressive therapy to avoid fetal toxicity. Although obstetric, perinatal, and nephrology care have improved since the first reported pregnancy in a simultaneous pancreas-kidney transplantation recipient in 1986, further research is still needed to fully understand its impact on maternal, fetal, and graft outcomes, particularly in the context of combined organ transplantation. The objective of this study is to describe the clinical course of pregnant simultaneous pancreas-kidney transplantation recipients and to evaluate both the impact of transplantation on pregnancy and the prognostic factors that may influence outcomes.</div></div><div><h3>Materials and methods</h3><div>We conducted a descriptive analysis of a case series involving six pregnancies in simultaneous pancreas-kidney transplantation recipients managed at our center. Renal and pancreatic graft function, as well as maternal and fetal outcomes during gestation, were summarized quantitatively and graphically. Detailed, anonymized clinical data were collected for each patient throughout the follow-up period.</div></div><div><h3>Results</h3><div>All pregnancies occurred more than one year after transplantation, allowing for adjustment of immunosuppressive regimens to minimize teratogenic risk. Renal and pancreatic graft function remained stable throughout the follow-up. Three patients experienced uncomplicated pregnancies. The remaining three required hospitalization due to complications: one case of hyperemesis gravidarum, one of preeclampsia, and one of threatened preterm labor secondary to polyhydramnios. Except for one, all deliveries were performed via cesarean section for obstetric indications, resulting in live, healthy neonates. Four births were preterm, with low-birth-weight infants.</div></div><div><h3>Conclusions</h3><div>In our experience, pregnancies in simultaneous pancreas-kidney transplantation recipients were associated with favorable maternal and fetal outcomes. Careful planning and close multidisciplinary monitoring by nephrology, endocrinology, and obstetrics are essential to optimize results during pregnancy.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"46 1","pages":"Article 501400"},"PeriodicalIF":2.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145963284","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":"Hemodiálisis nocturna domiciliaria con bajo flujo de líquido de diálisis: reporte de los dos primeros casos en España","authors":"Pablo Molina ,&nbsp;Elena Galván ,&nbsp;Laura Porcar ,&nbsp;Amparo Alba ,&nbsp;Amanda Hernandis ,&nbsp;Pilar Pascual ,&nbsp;Mercedes González-Moya ,&nbsp;Belén Vizcaíno ,&nbsp;Sandra Beltrán ,&nbsp;María Rodrigo ,&nbsp;Asunción Sancho","doi":"10.1016/j.nefro.2025.501405","DOIUrl":"10.1016/j.nefro.2025.501405","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"46 1","pages":"Article 501405"},"PeriodicalIF":2.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145963351","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":"Peritoneal dialysis-related infections due to nontuberculous Mycobacteria in children and adolescents: A critical review of reported cases","authors":"John Dotis ,&nbsp;Antonia Kondou ,&nbsp;Vasiliki Karava ,&nbsp;Athina Papadopoulou ,&nbsp;Nikoleta Printza","doi":"10.1016/j.nefro.2025.501406","DOIUrl":"10.1016/j.nefro.2025.501406","url":null,"abstract":"<div><div>Peritoneal dialysis (PD)-related infections due to nontuberculous <em>Mycobacteria</em> (NTM) are rare in children and adolescents but appear to be increasingly recognized. To better understand the clinical profile, characteristics, management and outcomes of these infections, we conducted a systematic review of pediatric cases reported in the literature. We identified 25 episodes in 23 patients under the age of 18, drawn from 19 studies. The mean age was 7.35 years with a slight male predominance. The most common underlying condition leading to end stage renal disease and initiation of PD, was congenital anomalies of the kidney and urinary tract, particularly hypoplastic or dysplastic kidneys. Clinical manifestations were non-specific, often including fever, abdominal pain and cloudy effluent. Among the reported cases 52% presented with peritonitis, 36% with exit site infection and 12% had both. <em>Mycobacterium abscessus</em> and <em>Mycobacterium</em> <em>fortuitum</em> emerged as the most prevalent species, each accounting for a comparable proportion of the recovered isolates. Notably, <em>Mycobacterium chelonae</em> was the most frequent isolated specie among infants. Diagnosis was frequently delayed and treatment required prolonged antibiotic regimens. Catheter removal was performed in almost all cases, while most patients were temporarily switched to hemodialysis. Mortality rate was low approaching 4%. These findings underscore the need for heightened clinical suspicion, early diagnosis and aggressive management to improve outcomes in pediatric patients with PD-related infections due to NTM.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"46 1","pages":"Article 501406"},"PeriodicalIF":2.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145963287","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":"Future directions of nsMRAs in CKD treatment: Focus on etiologic stratification and drug synergies","authors":"Songhe Chen ,&nbsp;Pingbo Bao","doi":"10.1016/j.nefro.2025.501388","DOIUrl":"10.1016/j.nefro.2025.501388","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"46 1","pages":"Article 501388"},"PeriodicalIF":2.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145963246","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":"El KFRE como criterio de remisión a las consultas de enfermedad renal crónica avanzada","authors":"Eduardo Gallego-Valcarce,&nbsp;Angela Rey-Cárdenas,&nbsp;Eva López-Melero,&nbsp;Ana María Tato-Ribera,&nbsp;Deborah Roldan,&nbsp;Sofía López San Román,&nbsp;Ángel Méndez Abreu,&nbsp;Clara Cases-Corona,&nbsp;Enrique Gruss","doi":"10.1016/j.nefro.2025.501412","DOIUrl":"10.1016/j.nefro.2025.501412","url":null,"abstract":"<div><h3>Background and objective</h3><div>The KDIGO guidelines recommend as a criterion for referral to ACKD consultations a risk &gt;<!--> <!-->10% of requiring renal replacement therapy (RRT) before 2<!--> <!-->years. This risk should be assessed with externally validated prediction models. The prediction model KFRE and the Grams model meet these requirements. In an ACKD unit with a remission criterion of eGFR &lt;<!--> <!-->30<!--> <!-->mL/min, we proposed a retrospective cohort study to evaluate whether the application of a KFRE &gt;<!--> <!-->10% as a remission criterion allows differentiation of patients according to their clinical and analytical characteristics and their evolution.</div></div><div><h3>Patients and methods</h3><div>We studied 573 patients followed in the ACKD clinic for at least 4<!--> <!-->years. In the first consultation we classified them into two groups according to their 2-year KFRE: &lt;<!--> <!-->10% or ≥<!--> <!-->10%. We compared their clinical and analytical characteristics and whether the prognoses made by Grams’ model at baseline matched the observed evolution. Both groups were analysed according to two age ranges: older and younger than 75<!--> <!-->years.</div></div><div><h3>Results</h3><div>Patients with KFRE ≥<!--> <!-->10% (53.4%), with respect to those with KFRE &lt;<!--> <!-->10%, were significantly younger and their annual eGFR loss was greater. They had different evolution: at 2<!--> <!-->years, 38.9% vs 3% (<em>P</em> <!-->&lt;<!--> <!-->.05) started RRT and 45.8% vs 79.8% (<em>P</em> <!-->&lt;<!--> <!-->.05) remained in the clinic; at 4<!--> <!-->years, 60.7% vs 15.6% (<em>P</em> <!-->&lt;<!--> <!-->.05) started RRT and 16.7% vs 52.3% (<em>P</em> <!-->&lt;<!--> <!-->.05) remained in the clinic. In the group with KFRE&lt;<!--> <!-->10% those ≥<!--> <!-->75<!--> <!-->years vs &lt;<!--> <!-->75<!--> <!-->years initiated RRT and died previously in a significantly different proportion at 2<!--> <!-->years: 1.2 vs 6.1% and 23.7 vs 6.1% respectively (<em>P</em> <!-->&lt;<!--> <!-->.05). In the group with KFRE ≥<!--> <!-->10% those ≥<!--> <!-->75<!--> <!-->years and those &lt;<!--> <!-->75<!--> <!-->years initiated RRT and previously died in a significantly different proportion at 2<!--> <!-->years: 25.9 vs 46.4% and 32.1 vs 5.7%, respectively (<em>P</em> <!-->&lt;<!--> <!-->.05). Prediction models predicted all these differences quite accurately.</div></div><div><h3>Conclusions</h3><div>A KFRE ≥<!--> <!-->10% at 2<!--> <!-->years would be an appropriate criterion for referral to ACKD consultations, since it would select a group of patients who are really going to require RRT in the medium term, regardless of their age, and would avoid the referral of patients at low risk of requiring RRT, mainly elderly patients.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"46 1","pages":"Article 501412"},"PeriodicalIF":2.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145963325","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":"Healthcare resource utilization and costs of chronic kidney disease in Spain across KDIGO categories: Insights from real-world evidence","authors":"Rafael Santamaria ,&nbsp;Carlos Escobar ,&nbsp;Unai Aranda ,&nbsp;Beatriz Palacios ,&nbsp;Margarita Capel ,&nbsp;Ignacio Hernández ,&nbsp;Ana Cebrián ,&nbsp;Roberto Alcázar ,&nbsp;Manuel Gorostidi","doi":"10.1016/j.nefro.2025.501414","DOIUrl":"10.1016/j.nefro.2025.501414","url":null,"abstract":"<div><h3>Aim</h3><div>To determine the healthcare resource utilization and costs in patients with chronic kidney disease (CKD) across the KDIGO stages in real-world clinical practice in Spain.</div></div><div><h3>Methods</h3><div>Observational, retrospective study using the BIG-PAC database. Adults with ≥1 measurement of estimated glomerular filtration rate (eGFR) and albuminuria closest to 1st January 2018 were included. Annual healthcare resource utilization and healthcare costs per patient were analyzed within a two-year follow-up period.</div></div><div><h3>Results</h3><div>70,385 subjects were included, of whom 30.0% had CKD. The proportion of patients with ≥1 hospitalization ranged from 12.0% to 52.9% in categories G3a to G5 A1, from 6.0% to 47.4% in categories G1 to G5 A2 and from 13.5% to 69.8% in categories G1 to G5 A3. First year mean (SD) total cost ranged from 2486.65 (1724.25) to 16,085.75 (11,731.67), 1567.67 (1293.56) to 14,647.70 (11,031.45) and 2799.43 (1800.53) to 20,584.74 (11,563.63) Euros, respectively. Overall, the main driver for total cost was hospitalizations. All these numbers increased as eGFR declined or albuminuria increased and, in general, there was a slight decrease during the second year in all categories.</div></div><div><h3>Conclusions</h3><div>In real-world, CKD may be associated with high healthcare resource utilization and costs that increase as renal function worsens or albuminuria levels increase. Reducing economic burden through primordial and primary prevention policies, and comprehensive management with kidney protective drugs should be a priority.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"46 1","pages":"Article 501414"},"PeriodicalIF":2.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145963326","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}