Nephron最新文献

{"title":"The Impact of the Selective Cytopheretic Device on Neutrophil-to-Lymphocyte Ratios and Hematological Parameters in AKI: A Pooled Analysis.","authors":"Sai Prasad N Iyer, Nicholas J Ollberding, Jay L Koyner, Lenar T Yessayan, Kevin K Chung, H David Humes","doi":"10.1159/000546528","DOIUrl":"https://doi.org/10.1159/000546528","url":null,"abstract":"<p><strong>Background: </strong>The Selective Cytopheretic Device (SCD) is an immunomodulatory cell-directed extracorporeal therapy that reprograms activated neutrophils and monocytes towards immune homeostasis in hyperinflammatory conditions such as acute kidney injury (AKI). However clinical mechanisms remain unclear.</p><p><strong>Methods: </strong>We examined the effect of SCD treatment from prior AKI adult clinical studies on systemic inflammation through neutrophil-to-lymphocyte ratios (NLR) and other hematological measures to gain insights into the mechanism of the SCD. Linear-mixed effects regression was used to estimate differences in NLR and other hematological measures between SCD treated patients and controls over the first six days after initiating CKRT.</p><p><strong>Results: </strong>Hematological data were analyzed from 76 adult patients with AKI requiring continuous kidney replacement therapy (CKRT) treated with the SCD, and 32 CKRT only control patients. SCD reduced NLR across all individual studies through Day 6 of treatment, while the control group demonstrated upward trends in NLR past day 3. When analyzed as pooled groups, both cohorts displayed similar baseline NLRs (SCD = 23.6 vs. control = 21.7; p=0.636). SCD treated patients demonstrated a statistically significant reduction in NLR vs. control patients at Day 6 (SCD = 13.3 vs. control = 25.7 at day 6; ptrend = 0.011). This difference was maintained following sensitivity analysis upon exclusion of an ICU study due to a shorter follow-up period (SCD = 13.7 vs. control = 25.6; ptrend = 0.013). NLR reductions in the SCD group were driven by decreases in neutrophils and increases in lymphocytes. No statistically significant differences were observed between groups for monocyte-to-lymphocyte ratio (MLR) levels or platelets over the same treatment duration.</p><p><strong>Conclusions: </strong>In a pooled analysis of multiple AKI adult clinical studies SCD treatment demonstrated reductions in NLR. This analysis provides further clinical mechanistic evidence of leukocyte immunomodulation in targeting the dysregulation of effector immune cells in hyperinflammatory conditions such as AKI and sepsis.</p>","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"1-19"},"PeriodicalIF":2.3,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199575","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":"Telepathology in renal allograft pathology: current trends and future prospects.","authors":"Akihiro Tsuchimoto, Yuta Matsukuma, Kenji Ueki, Kosuke Masutani, Toshiaki Nakano","doi":"10.1159/000546527","DOIUrl":"https://doi.org/10.1159/000546527","url":null,"abstract":"<p><p>Background In contemporary kidney transplantation, the pathology is important for diagnosing various problems with an allograft. Striking a balance is essential to achieve accuracy and speed of a diagnosis. However, because of the distinctive characteristics of renal allograft pathology, there is a lack of pathologists with expertise in this specific domain. Summary A telepathology system using digital pathology can facilitate the delivery of diagnostic outcomes even in settings where pathologists with expertise may not be continuously available. This system is equivalent in diagnostic ability and superior in speed to the method using conventional diagnosis by light microscopy with glass slides. The pathology guidelines of various countries have emphasized the importance of ensuring the quality of digital pathology. Although maintaining the quality of diagnosis is necessary, telepathology in renal allograft pathology is an innovative tool that can shorten the time to diagnosis and address the shortage of pathologists. Unfortunately, the routine use of telepathology is currently limited to only a few institutions in Japan. One of the reasons for this limited use is the heavy burden on facilities requesting biopsies to set up infrastructure, such as slide scanners and servers.</p>","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"1-14"},"PeriodicalIF":2.3,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199600","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":"METABOLIC DYSFUNCTION-ASSOCIATED FATTY LIVER DISEASE IN ADVANCED CHRONIC KIDNEY DISEASE: IMPACT ON PATIENT SURVIVAL.","authors":"Cesar Garcia-Cantón, Yaiza Rivero, Elvira Bosch, Fátima Batista, Jesus M Gonzalez-Martin, Selene González, Sonia Guinea, Antonio Tugores, Sara Aladro, Sara Afonso, Saulo Fernandez, Domingo Hernandez, Mauro Boronat","doi":"10.1159/000546525","DOIUrl":"https://doi.org/10.1159/000546525","url":null,"abstract":"<p><strong>Introduction: </strong>Metabolic dysfunction-associated fatty liver disease (MAFLD) is a prevalent liver condition commonly associated with obesity, metabolic syndrome, and type 2 diabetes mellitus. It has also been linked to an increased risk of cardiovascular events and overall mortality. Recent studies have established pathophysiological connections between MAFLD and chronic kidney disease (CKD). This study aimed to determine the prevalence of MAFLD in patients with advanced chronic kidney disease (ACKD), identify associated factors, and evaluate its impact on patient survival.</p><p><strong>Methods: </strong>A retrospective longitudinal cohort study was conducted with incident patients diagnosed with stage 4 or 5 CKD, not on dialysis, who initiated care for ACKD between 2011 and 2015. Clinical and laboratory data were collected, and the presence of MAFLD was estimated using the Fatty Liver Index (FLI). To assess the impact of FLI and other variables on survival, Kaplan-Meier univariate analysis and Cox regression multivariate analysis were performed, with follow-up through February 2024.</p><p><strong>Results: </strong>Among 367 patients, 60.2% had diabetes, and 70.8% had an FLI ≥ 60. Age and diabetes mellitus were significant factors associated with a higher likelihood of FLI ≥ 60. FLI was identified as an independent risk factor for decreased survival in patiets with diabetes, after adjusting for other variables (HR, 1.015; 95% CI 1.004-1.027; p=0.009). However, in non-diabetic patients, FLI was not a significant predictor of lower survival in multivariate Cox regression analysis.</p><p><strong>Conclusions: </strong>MAFLD is highly prevalent in patients with ACKD, particularly among those with diabetes, for whom it may represent an independent risk factor for reduced survival. This association was not observed in non-diabetic ACKD patients. These results suggest the need to design preventive and treatment strategies for MAFLD in this population.</p>","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"1-18"},"PeriodicalIF":2.3,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143229","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":"Perioperative Management of Atypical Hemolytic Uremic Syndrome in a Patient on Maintenance Eculizumab Therapy: A Case Report and Review of the Literature.","authors":"Aydan Mütiş Alan, Mevlüt Tamer Dinçer, Ata Kaykioğlu, Bahar Türk, Eda Nuhoğlu Kantarci, Nurhan Seyahi, Sinan Trabulus, Ahmet Emre Eşkazan","doi":"10.1159/000546526","DOIUrl":"https://doi.org/10.1159/000546526","url":null,"abstract":"<p><strong>Introduction: </strong>Atypical hemolytic uremic syndrome (aHUS) is a rare, complement-mediated disorder characterized by hemolytic anemia, thrombocytopenia, and acute kidney injury. Eculizumab, a monoclonal antibody that inhibits complement component C5, is a cornerstone therapy for aHUS but increases the risk of infections, particularly from encapsulated organisms. Surgical procedures can also raise infection risks or exacerbate thrombotic microangiopathy (TMA). However, data on the perioperative management of patients with aHUS, particularly those receiving eculizumab, remain limited.</p><p><strong>Case presentation: </strong>A 73-year-old male with a history of prostate cancer presented with acute kidney injury, thrombocytopenia, and hemolysis, leading to a diagnosis of atypical hemolytic uremic syndrome (aHUS). He was treated with eculizumab, which improved kidney function and eliminated the need for dialysis. Four months later, he developed abdominal pain and was found to have gallstones. The patient subsequently underwent a laparoscopic cholecystectomy while continuing maintenance eculizumab therapy. The procedure was performed without any complications, and the patient was discharged in stable condition.</p><p><strong>Conclusion: </strong>This case report details the successful perioperative management of a patient with aHUS on maintenance eculizumab undergoing cholecystectomy, highlighting the importance of careful management, including continued complement inhibition and infection prevention strategies. Our report emphasizes the need for individualized perioperative care to minimize risks in aHUS patients requiring surgery.</p>","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"1-10"},"PeriodicalIF":2.3,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144143220","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 between Salivary pH and estimated glomerular filtration rate status in a community-dwelling population: A Cross-sectional Study.","authors":"Yukihide Aoyama, Chiyoko Uchiyama, Yasushi Koike, Koichiro Hayashi, Itoyo Tokuda, Hiroyuki Sato, Akihiro Hirakawa, Yukio Yamamoto, Wataru Kobayashi, Kazushige Ihara, Koichi Murashita, Shigeyuki Nakaji","doi":"10.1159/000546401","DOIUrl":"https://doi.org/10.1159/000546401","url":null,"abstract":"<p><strong>Introduction: </strong>Globally, chronic kidney disease (CKD) is a common condition, associated with several complications and high mortality. Early detection and monitoring of CKD is important for prolonging healthy life expectancy. Salivary pH is reported to increase in patients with chronic renal failure; however, the association between salivary pH and the estimated glomerular filtration rate (eGFR) status, which is usually considered to assess kidney function at clinical settings, has not been adequately studied. Therefore, this study aimed to examine the association between salivary pH and eGFR through multivariate analysis.</p><p><strong>Methods: </strong>We conducted a cross-sectional study using the data from a community-based cohort study conducted between 2017 and 2019 in Japan. We aimed to develop a prediction model to determine the eGFR status using salivary pH, instead of blood urea nitrogen (BUN), in combination with self-reported information (age, sex, body mass index, disease history, medication, and lifestyle) in 1,056 subjects (433 men and 623 women) who participated in the study in 2017. We first identified the logistic model including several explanatory variables in addition to BUN (BUN model) and also developed the logistic model that replaced BUN with salivary pH (pH model). We examined the predictive accuracy of the two developed models using the validation data of 298 subjects (116 men and 182 women) who participated in the study in 2019.</p><p><strong>Results: </strong>BUN and salivary pH were significantly associated with the eGFR status (odds ratio (ORs): 1.24, 95% confidence interval (CI): 1.17-1.32, P < 0.001 for BUN; ORs: 0.96, 95% CI: 0.94-0.98, P < 0.001 for salivary pH, respectively). The developed pH model included age, kidney disease history, diabetes history, habitual medication for hypertension, habitual alcohol consumption status, and habitual exercise status in addition to salivary pH. The pH model showed accuracy comparable to that of BUN model in determining the eGFR status (area under the curve for the pH and BUN models was 0.796 and 0.799, respectively; P = 0.933).</p><p><strong>Conclusion: </strong>This study clarified the association between salivary pH and the eGFR status.</p>","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"1-21"},"PeriodicalIF":2.3,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111357","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":"Chronic allograft injury by recurrent crystalline nephropathy of Adenine Phosphoribosyl transferase Deficiency, even after early initiation of XOR inhibitor.","authors":"Noriko Uesugi, Yoshifumi Miura, Yuuki Nakafusa, Naoko Ikeda, Kousuke Masutani","doi":"10.1159/000546495","DOIUrl":"https://doi.org/10.1159/000546495","url":null,"abstract":"<p><strong>Introduction: </strong>Adenine phosphoribosyl　transferase (APRT) deficiency is a rare genetic disorder of purine metabolism that results in excessive renal excretion of poorly soluble 2,8-dihydroxyadenine (DHA), leading to urolithiasis, crystalline nephropathy, and renal failure. Recurrence after renal transplantation usually occurs in the early post-transplantation period and is sometimes the initial indication for the disease. Allograft survival is poor without adequate treatment with xanthine oxidase (XOR) inhibitors to reduce DHA levels.</p><p><strong>Case presentation: </strong>A 49-year-old Japanese man with a history of recurrent renal stones presented with mild renal dysfunction three months after renal transplantation. Allograft biopsy revealed numerous brown crystals within the tubules and active interstitial inflammation. Febuxostat, a high-dose XOR inhibitor, was immediately prescribed. APRT deficiency was confirmed through urine metabolome analysis. The patient's renal function improved, and the febuxostat dose was subsequently reduced. One-year allograft biopsy demonstrated markedly reduced inflammation and crystals; however, an expanded scarred area with focal active inflammation and a few small crystals were observed.</p><p><strong>Conclusion: </strong>XOR inhibitors effectively reduce the crystals of recurrent APRT deficiency; however, they cannot prevent chronic injury. Diagnosing recurrent crystalline nephropathy and initiating XOR inhibitors as early as possible is essential for improving allograft survival.</p>","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"1-10"},"PeriodicalIF":2.3,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111358","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":"WHAT IS THE ROLE OF SEX DIFFERENCES IN OBESITY-ASSOCIATED CKD?","authors":"Justo Sandino Pérez, Celia González-García, Paúl José Hernández Velasco, Enrique Morales","doi":"10.1159/000546354","DOIUrl":"https://doi.org/10.1159/000546354","url":null,"abstract":"<p><p>Obesity represents a significant risk factor for chronic kidney disease (CKD), with gender-specific differences in impact. This underscores the importance of considering gender-based differences in diagnosing and treating this condition. Women are more prone to obesity than men, which places them at a greater risk of developing CKD. Nevertheless, men are more likely to experience rapid disease progression and higher mortality rates associated with end-stage kidney disease (ESKD). Hormonal, metabolic and compositional factors may explain these differences. Obesity management demands the implementation of tailored approaches that take into account these gender-specific differences. The effectiveness and risks associated with weight loss strategies, including diet, exercise, and bariatric surgery, may vary between men and women. Furthermore, the efficacy and adverse effects of medications for ESKD and comorbidities, such as hypertension and diabetes, may differ between the sexes. Consequently, it is imperative to integrate a gender perspective into the research, diagnosis, and treatment of obesity-related CKD to improve clinical outcomes and ensure more equitable and effective care.</p>","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"1-18"},"PeriodicalIF":2.3,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045098","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":"Care needs of adults on peritoneal dialysis and their informal caregiver: a qualitative study.","authors":"Marta Aramini, Corina Elena Luca, Monica Bianchi, Antonio Bellasi, Giovanna Pezzoli, Pietro Cippà, Loris Bonetti","doi":"10.1159/000546175","DOIUrl":"https://doi.org/10.1159/000546175","url":null,"abstract":"<p><p>Introduction Peritoneal dialysis (PD) provides a sense of control, independence, freedom, and self-efficacy. However, it can also impact a patient's physical, psychological, and social well-being, affecting both patients and family members. This study aims to investigate the experiences and needs of adults on PD and their informal caregivers to understand how a person-centred approach can improve the response to their needs. Methods This is a generic descriptive qualitative research study. Data were collected through semi-structured interviews, transcribed, and analysed using Braun and Clarke's thematic analysis and NVivo® software. The data of patients and caregivers was triangulated to better understand their needs. Results Twelve patients and four informal caregivers were interviewed. We identified five macro themes: 'Living with kidney disease and peritoneal dialysis and its needs', 'Preparation before initiating PD and its needs', 'Learning about PD and its needs', 'Impact of dialysis on the need of the patients and caregivers' and 'Experiences with the care team.' The pre-dialysis period is crucial, with specific needs for information, education, shared decision-making, and support during the various psychological, physical, and organisational changes in treatment and the disease trajectory. Caregivers' roles are essential and should always be included in the care path. Conclusion This study emphasizes the importance of continuity in care for patients with their care team and how delicate and important the pre-dialysis phase is for informed and shared decision-making regarding kidney replacement treatment. This understanding can help ensure a more person-centred care approach.</p>","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"1-17"},"PeriodicalIF":2.3,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034231","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":"Pathogenesis Mechanism of Ferroptosis and Pharmacotherapy in Kidney Diseases: A Review.","authors":"Lan Li, Heping Zhang, Jincheng Tang","doi":"10.1159/000545387","DOIUrl":"10.1159/000545387","url":null,"abstract":"<p><strong>Background: </strong>Ferroptosis is a novel form of iron-dependent programmed cell death, characterized by lipid peroxidation and the accumulation of reactive oxygen species. Dysregulation of iron metabolism, lipid metabolism, or the antioxidant system can trigger this process. Emerging evidence suggests that ferroptosis is implicated in the pathogenesis and progression of various kidney diseases.</p><p><strong>Summary: </strong>This review explores the pathophysiological mechanisms of ferroptosis, focusing on its role in cellular damage and disease progression in kidney diseases. The roles of iron homeostasis, lipid peroxidation, and antioxidant defenses in ferroptosis are discussed. Studies have demonstrated that inhibiting ferroptosis can protect against kidney injury, highlighting its potential as a therapeutic target. Additionally, current findings on ferroptosis-targeted therapies, including preclinical studies and potential clinical applications, are summarized.</p><p><strong>Key messages: </strong>Ferroptosis plays a critical role in the development and progression of kidney diseases. Understanding the mechanisms governing ferroptosis and its relationship with kidney pathology provides a foundation for novel diagnostic and therapeutic strategies. Further research is needed to identify specific molecular mechanisms and advance clinical trials to translate ferroptosis-targeted therapies into practice, paving the way for innovative therapeutic interventions in kidney diseases.</p>","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"1-13"},"PeriodicalIF":2.3,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012488","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":"Advances on novel biomarkers of alloimmunity in kidney transplantation.","authors":"Claudia Carrera, Delphine Kervella, Elena Crespo, Florianne Hafkamp, Oriol Bestard","doi":"10.1159/000545425","DOIUrl":"https://doi.org/10.1159/000545425","url":null,"abstract":"<p><p>Over the past decade, important advancements in the understanding of transplant physiopathology and refinement of immunosuppressive strategies have been achieved. Yet, this has not been translated into significant improvement on graft and patient survival rates, which is due, at least in part, to the lack of implementation of biomarkers for alloimmune-risk stratification at the patient individual level. In order to individualize non-invasive diagnosis of rejection and treatment decision-making, sensitive and specific biomarkers have been developed for its implementation at different transplant timepoints and clinical contexts, which are at distinct development phases: at pretransplant to refine the baseline donor/recipient immunological risk, for early and non-invasively detection of subclinical rejection post-transplantation; and long-term evaluation for immunosuppression management to either optimize or minimize immunosuppressive burden. Biomarkers may be stratified in those aiming at tracking alloimmune responses, whereas others are devoted to early and non-invasively diagnose the advent of allograft rejection. More advanced biomarkers aiming at monitoring alloimmune responses include donor/recipient HLA molecular matching, donor-specific antibodies (DSA), donor-reactive memory T cells and donor (HLA)-specific B cells as well as some circulating cellular immune, whereas other biomarkers non-invasively assessing allograft injury are circulating donor-derived cell free DNA (dd-cfDNA) and some specific gene expression (GEP) signatures and urinary chemokines. Most importantly, these biomarkers may be fully complementary, while some of them may describe the alloimmune status of a given transplant patient and thus guide treatment decision-making, others could be used for alerting of early allograft damage and injury before any clinical sign is detected. While some of these biomarkers have significantly advanced on their validation process and showed robust data demonstrating their capacity to diagnose, prognosticate or even predict distinct transplant outcomes, others are still on their preliminary validation stages. Thus, interventional clinical trials are highly warranted to demonstrate their value and clinical context of use. This review aims to examine the most promising and advanced biomarkers and immune assays in the field, categorizing them by their diagnostic, prognostic and predictive capabilities. The current validation status of these biomarkers and their roles in clinical trials, aiming to enhance patient outcomes through precision medicine, is also thoroughly discussed.</p>","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"1-25"},"PeriodicalIF":2.3,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981824","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}