Nefrologia最新文献

{"title":"Hacia una hemodiálisis sostenible: de la reflexión a la práctica","authors":"Marta Arias-Guillén , M. Dolores Arenas , Claudia Yuste","doi":"10.1016/j.nefro.2025.501368","DOIUrl":"10.1016/j.nefro.2025.501368","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 10","pages":"Article 501368"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145610388","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":"Experience with new anti-CD20 monoclonal antibodies for immune-mediated glomerulopathies in a tertiary hospital","authors":"Jorge Iván Zamora ,&nbsp;Marina López-Martínez ,&nbsp;Natalia Ramos ,&nbsp;Sheila Bermejo ,&nbsp;Irene Agraz ,&nbsp;Clara García-Carro ,&nbsp;Marc Patricio ,&nbsp;Juan Carlos León ,&nbsp;Néstor Toapanta ,&nbsp;Oriol Bestard ,&nbsp;María José Soler","doi":"10.1016/j.nefro.2025.501372","DOIUrl":"10.1016/j.nefro.2025.501372","url":null,"abstract":"<div><div>In the recent years, new humanized anti-CD20 monoclonal antibodies have been developed to optimize B-cell depletion. Our objective is to describe the experience at our center with the use of new anti-CD20 drugs in glomerular diseases. We included patients from our center treated with second-generation anti-CD20 monoclonal antibodies for glomerular diseases between January 2017 and January 2024. Patients were followed for one year after the initiation of treatment. Six patients were included, 2 (33%) men, with a median age of 59.5 (49–75) years. Diagnoses were 2 (33%) minimal change disease, 1 (16.7%) mixed cryoglobulinemia type-II, 1 (16.7%) membranous nephropathy, 1 (16.7%) fibrillary glomerulonephritis (FGN), and 1 (16.7%) focal segmental glomerulosclerosis. The indications for the new anti-CD20 therapy were 4 (66%) for refractory disease, 1 (16.7%) recurrent flares, and 1 (16.7%) due to an anaphylactic reaction to rituximab. The new anti-CD20 used were obinutuzumab in 4 (66%) and ofatumumab in 2 patients (33%). Before the start of the treatment median creatinine was 1.39<!--> <!-->mg/dL (0.91–2.38) median serum albumin 2.7<!--> <!-->g/dL [2.5–3.9<!--> <!-->g/dL] and urine protein–creatinine ratio (UPCR) 5.75<!--> <!-->g/g [2.38–4.85<!--> <!-->g/g]. A total of 5 (83%) patients achieved partial/complete remission within the first 6 months of follow-up. By month twelve of the follow-up 4 (66.67%) patients remained with partial/complete remission. None of the patients had serious side effects. In conclusion, the use of new anti-CD20 therapies for the treatment of immune-mediated glomerular diseases is a safe and effective alternative for its treatment. Further research and clinical trials should be conducted to confirm these positive results.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 10","pages":"Article 501372"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145610385","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":"TC-peritoneografía: técnica diagnóstica clave en diálisis peritoneal. Nuestra experiencia","authors":"M. Moreiras-Plaza,&nbsp;A. Fijó-Prieto,&nbsp;A. Canto-Calviño,&nbsp;B. Santaclara-Pousada,&nbsp;V. Toledo-Cepeda","doi":"10.1016/j.nefro.2025.501394","DOIUrl":"10.1016/j.nefro.2025.501394","url":null,"abstract":"<div><div>Non-infectious complications are common in Peritoneal Dialysis, and usually require imaging tests for diagnosis and evaluation. Computerized tomography (CT)-peritoneography is a CT modality in which, before imaging, radiological contrast is instilled into the peritoneum mixed with the dialysis solution. CT-peritoneography is a simple, fast and accessible test, with a higher diagnostic yield than other more modern imaging techniques, especially in the case of leaks and hernias. We present our experience and results with CT-peritoneography over 10 years. We conclude that CT-peritoneography is the technique of choice for the diagnosis of many of the non-infectious complications in Peritoneal Dialysis, especially in cases of dialysate leakage or hernias.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 10","pages":"Article 501394"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145610411","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":"Association of hemoglobin and red cell distribution width ratio with new cardiovascular events in peritoneal dialysis patients","authors":"Rong Wei ,&nbsp;Wenying Zhang ,&nbsp;Na Tian ,&nbsp;Xiaojiang Zhan ,&nbsp;Fenfen Peng ,&nbsp;Xiaoyang Wang ,&nbsp;Qingdong Xu ,&nbsp;Ning Su ,&nbsp;Juan Wu ,&nbsp;Xingming Tang ,&nbsp;Xiaoran Feng ,&nbsp;Xianfeng Wu ,&nbsp;Qian Zhou ,&nbsp;Zhiyong Xie ,&nbsp;Jianbo Liang ,&nbsp;Yueqiang Wen","doi":"10.1016/j.nefro.2025.501370","DOIUrl":"10.1016/j.nefro.2025.501370","url":null,"abstract":"<div><h3>Objective</h3><div>Peritoneal dialysis (PD) patients, who are more likely to have a poor prognosis for new cardiovascular events (CVE), are the focus of our research. We aim to investigate whether the hemoglobin-to-red cell distribution width (HRR) ratio is associated with a higher risk of new-onset CVE in PD patients. This research could potentially lead to new strategies for predicting and preventing new-onset CVE in PD patients.</div></div><div><h3>Methods</h3><div>One thousand four hundred seventy-four patients from November 1, 2005, to December 31, 2016, were divided into high and low HRR groups using restricted cubic spline (RCS). Various statistical methods were utilized to study the impact of HRR changes on new-onset CVE in PD patients, including Kaplan–Meier cumulative incidence curves, multivariate COX regression, competitive risk analysis, and forest plots to analyze subgroup interactions.</div></div><div><h3>Results</h3><div>During the follow-up period, 104 new-onset CVEs were recorded. Restricted cubic spline showed a non-linear relationship between HRR and new-onset CVE. A multifactorial COX regression analysis model showed reduced HRR as an independent risk factor for new-onset CVE (HR, 1.737; 95% CI 1.119–2.695, <em>P</em> <!-->=<!--> <!-->0.014). Kaplan–Meier analysis showed a significant difference in survival between the two groups of patients (<em>P</em> <!-->=<!--> <!-->0.002). The competing risks model found that after excluding endpoint events, there was still a significant difference in new-onset CVE (<em>P</em> <!-->=<!--> <!-->0.0009) between the different HRR groups. In subgroup analyses, there were no significant differences between groups.</div></div><div><h3>Conclusions</h3><div>Low hemoglobin to red cell distribution width ratio (HRR) is associated with a higher risk of new-onset CVE in PD patients.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 10","pages":"Article 501370"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145610414","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":"Alfabetización en salud renal en la era digital: la experiencia de la plataforma Salud Renal Siempre","authors":"María Dolores Arenas Jiménez,&nbsp;Julia Audije-Gil,&nbsp;Paula Manso,&nbsp;David Hernán,&nbsp;Fabiola Dapena,&nbsp;Ana Balseiro,&nbsp;Cristina Sanz","doi":"10.1016/j.nefro.2025.501409","DOIUrl":"10.1016/j.nefro.2025.501409","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 10","pages":"Article 501409"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145610410","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":"Construction of risk factors and prediction model for arteriovenous graft thrombosis","authors":"Yumei Fang,&nbsp;Xia Cao","doi":"10.1016/j.nefro.2025.501365","DOIUrl":"10.1016/j.nefro.2025.501365","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to identify risk factors for thrombosis in arteriovenous grafts and construct a predictive model to assess thrombosis risk in patients undergoing maintenance hemodialysis (MHD).</div></div><div><h3>Methods</h3><div>A total of 160 MHD patients with arteriovenous graft were included and divided into a thrombosis group (<em>n</em> <!-->=<!--> <!-->39) and a control group (<em>n</em> <!-->=<!--> <!-->121). Univariate and multivariate logistic regression analyses were performed to identify independent risk factors. A nomogram prediction model was developed using R software, and its predictive performance was evaluated through calibration curves and C-index validation.</div></div><div><h3>Results</h3><div>Multivariate analysis identified diabetes, hypotension during dialysis, arteriovenous graft stenosis, compression hemostasis<!--> <!-->&gt;<!--> <!-->30<!--> <!-->min, and calcium-phosphorus product<!--> <!-->&gt;<!--> <!-->55<!--> <!-->mg²/dL² as independent risk factors for arteriovenous graft thrombosis. The nomogram model demonstrated good predictive accuracy, with an initial C-index of 0.753 and a validated C-index of 0.735.</div></div><div><h3>Conclusion</h3><div>The established nomogram effectively predicts arteriovenous graft thrombosis risk, aiding early identification and targeted intervention for high-risk patients.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 10","pages":"Article 501365"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145610413","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":"Posicionamiento sobre el manejo de la infección oculta por el virus B de la hepatitis (OBI) y anti-HBc+ en las unidades de hemodiálisis","authors":"Guillermina Barril Cuadrado ,&nbsp;Ana Avellón Calvo ,&nbsp;Elena Jiménez Vibora ,&nbsp;Luisa García Buey ,&nbsp;Rosa María Ruiz-Calero Cendrero ,&nbsp;Antonio Cirugeda García ,&nbsp;José Ibeas López ,&nbsp;Cristina García Fernández ,&nbsp;Federico García García ,&nbsp;Roberto Alcázar Arroyo","doi":"10.1016/j.nefro.2025.501355","DOIUrl":"10.1016/j.nefro.2025.501355","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 10","pages":"Article 501355"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145610386","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":"Factores que influyen en la depuración de toxinas urémicas unidas a proteínas en hemodiafiltración","authors":"Víctor Joaquín Escudero-Saiz ,&nbsp;Elena Cuadrado-Payán ,&nbsp;María Rodríguez-García ,&nbsp;Gregori Casals ,&nbsp;Lida María Rodas ,&nbsp;Néstor Fontseré ,&nbsp;José Jesús Broseta ,&nbsp;Francisco Maduell","doi":"10.1016/j.nefro.2025.501391","DOIUrl":"10.1016/j.nefro.2025.501391","url":null,"abstract":"<div><h3>Introduction</h3><div>Protein-bound uremic toxins (PBUTs) have a high affinity for albumin and they are associated with increased cardiovascular morbidity and mortality in hemodialysis patients. Among them, p-cresyl sulfate (pCS) and indoxyl sulfate (IS) stand out due to their high toxicity. Post-dilution hemodiafiltration (HDF) is one of the dialysis techniques that has shown the greatest benefits in terms of patient survival.</div></div><div><h3>Materials and methods</h3><div>This observational, single-center, cross-sectional study evaluated PBUT clearance in 137 patients undergoing post-dilution HDF, analyzing the factors that influence their removal. Reduction ratios (RRs) of IS and pCS were measured, as well as their correlation with dialysis parameters and clinical variables.</div></div><div><h3>Results</h3><div>The mean RR for IS was 53.4%<!--> <!-->±<!--> <!-->9.3%, and for pCS, 48.2%<!--> <!-->±<!--> <!-->11.3%. A significant correlation was observed between the RR of both toxins (<em>r</em> <!-->=<!--> <!-->0.606; <em>P</em> <!-->&lt;<!--> <!-->0.01), suggesting similar elimination mechanisms. In addition, total convective volume showed a positive correlation with the RR of pCS (<em>r</em> <!-->=<!--> <!-->0.19; <em>P</em> <!-->=<!--> <!-->0.027) and a weak correlation with the RR of IS (<em>r</em> <!-->=<!--> <!-->0.155; <em>P</em> <!-->=<!--> <!-->0.07). A significant difference in clearance was found according to sex, with higher RRs in women (<em>P</em> <!-->&lt;<!--> <!-->0.001 for IS and <em>P</em> <!-->=<!--> <!-->0.008 for pCS).</div></div><div><h3>Conclusions</h3><div>The clearance of PBUTs is primarily diffusive. Enhancing all variables related to this physical principle will improve the elimination of these toxins. Post-dilution HDF with high convective volume slightly increases this clearance. However, the results remain insufficient given the high toxicity of these molecules. New strategies, such as the use of adsorptive membranes and competitive molecules, are needed to optimize their removal and reduce the negative cardiovascular impact in hemodialysis patients.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 10","pages":"Article 501391"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145610415","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 para seguir bailando","authors":"Alba Santos García ,&nbsp;Sandra Lizeth Castro Molano ,&nbsp;Jose Andrés Meana","doi":"10.1016/j.nefro.2025.501366","DOIUrl":"10.1016/j.nefro.2025.501366","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 10","pages":"Article 501366"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145610387","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":"Towards a better prevention in cardio-kidney metabolic syndrome: Role of aldosterone and albuminuria","authors":"Luis M. Ruilope ,&nbsp;Bertram Pitt ,&nbsp;Alejandro de la Sierra ,&nbsp;Gema Ruiz-Hurtado","doi":"10.1016/j.nefro.2025.501399","DOIUrl":"10.1016/j.nefro.2025.501399","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 9","pages":"Article 501399"},"PeriodicalIF":2.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145384312","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}