Nephron最新文献

{"title":"GlomCon Hawaii: The First International Hybrid Glomerular Diseases Conference.","authors":"Niloufar Ebrahimi, Zohreh Gholizadeh Ghozloujeh, Ali Poyan Mehr, Harish Seethapathy, Kate Robson, Dia R Waguespack, Rica Mae Pitogo, Sayna Norouzi","doi":"10.1159/000543592","DOIUrl":"10.1159/000543592","url":null,"abstract":"","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"364-370"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008761","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":"10.1159/000546526","url":null,"abstract":"<p><strong>Introduction: </strong>Atypical hemolytic uremic syndrome (aHUS) is a rare, complement-mediated disorder characterized by microangiopathic 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. 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 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":"539-544"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","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":"Change in Urine Albumin-Creatinine Ratio and Occurrence of Hyperkalemia in Patients Initiating Finerenone in the USA: A Cohort Study from the FOUNTAIN Platform.","authors":"Csaba P Kovesdy, Natalie Ebert, David Vizcaya, Michael Walsh, Mikhail N Kosiborod, J Bradley Layton, Ryan Ziemiecki, Catherine B Johannes, Manel Pladevall-Vila, Patrick O Gee, Nichole Jefferson, Annie Chicoye, Maria Lopes, Bishnu Bahadur Thapa, Gary Curhan, Luis Rangel, Mudit Bhartia, Fangfang Liu, Alfredo E Farjat, Nikolaus G Oberprieler","doi":"10.1159/000543923","DOIUrl":"10.1159/000543923","url":null,"abstract":"<p><strong>Introduction: </strong>In 2021, finerenone - a novel, selective nonsteroidal mineralocorticoid receptor antagonist - was approved in the USA to treat adults with chronic kidney disease (CKD) and type 2 diabetes (T2D). This study aimed to describe characteristics and short-term outcomes of patients prescribed finerenone since regulatory approval.</p><p><strong>Methods: </strong>This was a retrospective cohort study using claims and electronic health records data from the OM1 Real-World Data Cloud™. A total of 15,948 US adults with a previous diagnosis of CKD and T2D who initiated 10 mg or 20 mg finerenone between July 2021 and August 2023 were included. Dosing was evaluated at baseline and over up to 12-month follow-up. Change from baseline in urine albumin-to-creatinine ratio (UACR) was evaluated at 4 and 12 months (among 913 and 443 patients, respectively, with available repeat UACR values). Hyperkalemia occurrence was determined at 12 months and over total follow-up.</p><p><strong>Results: </strong>Median follow-up was 7.2 months. Mean age was 70.3 years, and 44.1% were female. At baseline (-365; 0 days), 70% had CKD stage 3; for patients with UACR measurements, 80.8% had moderate/severe albuminuria (≥30 mg/g). Median UACR was 203 mg/g. Co-medication use was ACE inhibitors/ARBs (51%), SGLT2is (38%), and GLP-1 RAs (26%). 86% of patients initiated 10 mg finerenone, and among 2,212 patients still under observation at 12 months, 70% were on 10 mg. For finerenone initiators with available UACR data, UACR was reduced by 33% at 4 months and 38% at 12 months. Hyperkalemia occurred in 1.2% of the cohort by 12 months (incidence 2.0 per 100 person-years).</p><p><strong>Conclusion: </strong>Patients who initiated finerenone had a notable reduction in median UACR at 4 months, sustained at 12 months; hyperkalemia occurrence appeared to be low. These initial findings from US clinical practice should be complemented by results from other real-world cohorts of patients started on finerenone.</p>","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"371-383"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12215156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What Is the Role of Sex Differences in Obesity-Associated Chronic Kidney Disease?","authors":"Justo Sandino-Pérez, Celia González-García, Paúl José Hernández Velasco, Enrique Morales, Justo Sandino","doi":"10.1159/000546354","DOIUrl":"10.1159/000546354","url":null,"abstract":"<p><strong>Background: </strong>Obesity is a well-established risk factor for chronic kidney disease (CKD), and its impact varies between sexes. Women generally have higher rates of obesity, which increases their susceptibility to CKD. However, men tend to experience faster disease progression and a higher likelihood of death related to end-stage kidney disease. These differences may be driven by a combination of hormonal, metabolic, and physiological factors.</p><p><strong>Summary: </strong>Sex-based differences play a crucial role in the development and progression of CKD related to obesity. While women are more frequently affected by obesity, men face a greater risk of severe disease outcomes. Approaches to managing obesity - including lifestyle changes, surgical interventions, and medications - may have differing effects and risk profiles in men and women. These disparities highlight the need for a gender-sensitive approach in both research and clinical practice.</p><p><strong>Key messages: </strong>Obesity increases the risk of CKD, with notable differences between sexes in both prevalence and disease outcomes. Biological differences, such as hormonal and metabolic factors, contribute to sex-specific patterns in disease manifestation and treatment response. Weight loss strategies, pharmacological treatment effectiveness, and side effects may vary depending on sex. Incorporating a gender-based perspective into the diagnosis, treatment, and research of obesity-related CKD is essential for improving patient care and achieving equitable health outcomes.</p>","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"530-538"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","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":"Prospective Evaluation of Remote Software Based Surveillance Supplementing Clinical Monitoring for Haemodialysis Vascular Access.","authors":"Alshymaa Rafiek Eltahan, Zulfikar Pondor, Rosemary L Donne, David Lewis, Maharajan Raman, Jan Cowperthwaite, Marinela Liliana Resiga, Paul Hinchliffe, Jazzle Lim, Paula Gleave, Jonathan Allsopp, Dimitrios Poulikakos","doi":"10.1159/000543609","DOIUrl":"10.1159/000543609","url":null,"abstract":"<p><strong>Background: </strong>Efficient arteriovenous vascular access (VA) surveillance is vital for early identification of dysfunctional access, allowing timely intervention to prevent thrombosis. This study compares the efficacy of adding remote software surveillance to standard clinical care across our units.</p><p><strong>Methods: </strong>We conducted a 12-month prospective study on maintenance haemodialysis (HD) patients using Vasc-Alert software technology to assist clinical decision-making in 2 satellite HD units (group 1) and standard care in the remaining 3 HD units (group 2). Patients with Vasc-Alert-derived high Access Risk Score (ARS) (≥7) underwent clinical assessment and were referred for fistulogram based on relevant Kidney Disease Outcome Quality Initiative (KDOQI) criteria. Data on referrals for fistulogram, subsequent VA events, access abandonment, and complication-free days-extended (CFD-extended) were collected. VA survival analysis of post-intervention primary patency rate at 3 and 6 months was conducted.</p><p><strong>Results: </strong>There were 23 (28.1%) pre-emptive correction of stenosis and 6 (7.3%) thrombosis episodes in group 1, compared to 40 (19.5%) and 21 (10.2%) in group 2 (p value 0.155, 0.587), respectively). Among the thrombotic episodes, 83% of cases in group 1 had been detected during surveillance and referred for diagnostic fistulogram ± angioplasty but developed thrombosis while awaiting elective intervention compared to 19% in group 2 (p = 0.004). Median time from fistulogram request to thrombosed VA was 26 days (interquartile range: 21-42 days). Group 1 exhibited better post-intervention primary patency rates and longer CFD compared to group 2 (p value <0.001, 0.002, respectively).</p><p><strong>Conclusion: </strong>Incorporating Vasc-Alert technology into VA clinical surveillance pathway was associated with improved early detection of high-risk VA, higher primary patency rates, and longer CFD-extended compared to standard of care. Improving elective interventional radiology capacity for timely intervention (<3 weeks from referral) is crucial to materialise the benefits of enhanced surveillance in preventing acute thrombosis.</p>","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"324-332"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"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":"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 in 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 the 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":"519-529"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","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":"Myths, Realities, and Pathways Forward: A Patient's Thoughts on Person-Centred Care.","authors":"Bill Wang","doi":"10.1159/000541730","DOIUrl":"10.1159/000541730","url":null,"abstract":"","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"178-184"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142470478","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":"Preferences for Advance Care Planning in Patients with End-Stage Kidney Disease: A Cross-Sectional Survey among Nephrology Healthcare Providers in a Tertiary Care Center in India.","authors":"Bharathi Naik, Arun Ghoshal, Anuja Damani, Pankaj Singhai, Ravindra Prabhu Attur, Naveen Salins, Ajith M Nayak, Shankar Prasad Nagaraju","doi":"10.1159/000541347","DOIUrl":"10.1159/000541347","url":null,"abstract":"<p><strong>Introduction: </strong>Advance care planning (ACP) is essential in managing patients with end-stage kidney disease (ESKD), yet its integration into clinical practice remains limited, particularly in low- and middle-income countries. This study explores the preferences, attitudes and perceived barriers of nephrology healthcare providers toward ACP for patients with ESKD in a tertiary care center in India.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted among nephrology healthcare providers at a tertiary care center in India. The survey, developed from literature reviews and pretested, covered demographics, ACP knowledge and attitudes, current practices, and perceived barriers and facilitators. Data collection occurred from September 2022 to March 2023. Quantitative data were analyzed descriptively, and qualitative data through thematic analysis.</p><p><strong>Results: </strong>A total of 50 healthcare providers participated. While 36% acknowledged the importance of ACP, only 8% routinely engaged in ACP discussions. Major barriers included inadequate training (22%), lack of awareness about the importance of discussing ACP among stakeholders (20%), cultural barriers (18%), lack of time (14%), and the absence of institutional protocols for discussion on ACP (14%). Additional barriers included instances where families withhold health information from patients due to fear of losing hope (16%) and patient/family discomfort in discussing ACP (12%). Providers expressed a need for structured ACP protocols and educational programs.</p><p><strong>Conclusion: </strong>Despite recognizing its importance, ACP is underutilized in the care of patients with ESKD in India. Addressing the identified barriers through targeted interventions may enhance ACP practices and improve patient outcomes.</p>","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"48-56"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11731831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142291735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diosgenin Improves Lipid Metabolism in Diabetic Nephropathy via Regulation of miR-148b-3p/DNMT1/FOXO1 Axis.","authors":"Min Luo, Zongren Hu, Jichang Yang, Jinhan Yang, Wen Sheng, Chengxiong Lin, Dian Li, Qinghu He","doi":"10.1159/000541690","DOIUrl":"10.1159/000541690","url":null,"abstract":"<p><strong>Background: </strong>The progression of diabetic nephropathy (DN) is closely associated with lipid accumulation. Diosgenin (Dio) plays a beneficial role in the lipid metabolism associated with multiple diseases. Thus, the mechanism underlying Dio's function in DN associated with aberrant lipid accumulation warrants further investigation.</p><p><strong>Methods: </strong>To model DN in vitro, HK-2 cells were treated with high glucose (HG) and palmitic acid. Cell viability was evaluated using MTT assay. The triglyceride (TG) content in HK-2 cells was measured using a commercial assay kit. The formation of lipid droplets in HK-2 cells was observed using Oil Red O staining. The expression levels of mRNA and protein were detected using RT-qPCR and Western blot, respectively. The DNA methylation of FOXO1 was assessed using MSP. The interaction between DNMT1 and the FOXO1 promoter was confirmed by ChIP assay.</p><p><strong>Results: </strong>Dio treatment reduced TG levels and lipid droplet formation in HK-2 cells co-treated with HG and palmitic acid. Simultaneously, the levels of miR-148b-3p and FOXO1 were increased by Dio, while Dio decreased the expression levels of DNMT1 and SREBP-2. Meanwhile, miR-148b-3p can bind to DNMT1, which in turn inhibits the expression of FOXO1 by mediating the DNA methylation of FOXO1. In addition, FOXO1 negatively regulates the expression of SREBP-2 by interacting with the SREBP-2 promoter. MiR-148b-3p inhibition or silencing of FOXO1 abolished the inhibitory effect of Dio on TG production and lipid droplet formation. This effect was further exacerbated by the downregulation of DNMT1. FOXO1 overexpression may counteract the promotive effects of miR-148b-3p inhibitor on lipid accumulation.</p><p><strong>Conclusions: </strong>Dio treatment reduced TG production and lipid droplet formation in HK-2 cells during the progression of DN by modulating the miR-148b-3p/DNMT1/FOXO1/SREBP-2 axis. This finding provides new evidence supporting the therapeutic potential of Dio for DN.</p>","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"226-239"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142739985","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":"Implementing the Nurse-Led Optimization of Volume and Blood Pressure - Enabling at Multi-Levels Using Technology Program for Chronic Kidney Disease: A Prospective Cohort Study.","authors":"Zhihua Huang, Li Choo Ng, Irene Mok, Chieh Suai Tan, Cynthia Ciwei Lim","doi":"10.1159/000543948","DOIUrl":"10.1159/000543948","url":null,"abstract":"<p><strong>Background: </strong>Fluid overload is a common manifestation of chronic kidney disease (CKD) and is associated with increased hospitalizations and death. However, severe symptomatic fluid overload is potentially preventable with early recognition of mild fluid overload and timely institution of appropriate pharmacotherapy and fluid restriction. We implemented and evaluated the outcomes of a nurse-led clinic that incorporated objective fluid volume assessment using body impedance analysis (BIA) into structured patient education and action plan coaching to patients with CKD and fluid overload.</p><p><strong>Methods: </strong>This was a single-center prospective pre-post-implementation study of adults who participated in the program between August 2022 and April 2024. Patients were eligible if they had CKD not requiring dialysis and had fluid overload and/or systolic blood pressure (BP) >160 mm Hg or diastolic BP >100 mm Hg. The clinical effectiveness outcomes were symptoms and signs of fluid overload and improvement in BP. The patient-reported effectiveness outcomes were chronic disease self-management assessed using the Partner in Health (PIH) questionnaire and health-related quality of life assessed by the EuroQOL-5 Dimension (EQ5D5L) survey. The clinical safety outcomes were (1) hypotension with systolic BP <90 mm Hg and (2) worsening kidney function.</p><p><strong>Results: </strong>Among 107 patients referred to the nurse-led program, 96 attended the first visit. Median age was 68.5 (IQR 60.2, 77.3) years, and eGFR was 21.6 (14.0, 39.7) mL/min/1.73 m2. Almost all participants (93.8%) had symptoms of fluid overload within the past 1 month before the first review. BIA was performed for 52 (54.2%) patients, and the median overhydration was 2.4 (1.3, 3.6) L. The second and third visits were attended by 38 (39.6%) and 28 (29.2%) patients, respectively. For these 28 patients at program completion, symptoms and signs of fluid overload were less frequent and systolic BP (137 [121, 143] vs. 151 [132, 166] mm Hg, p = 0.03) and self-management (PIH score 96 [89, 104] vs. 72 [57, 88], p = 0.001) had improved compared to their baseline visit. EQ5D5L scores were significantly different. None experienced hypotension (systolic BP <90 mm Hg), and kidney function did not change significantly during follow-up.</p><p><strong>Conclusion: </strong>A nurse-led program that incorporated objective fluid volume assessment, structured patient education, and action plan coaching for patients with CKD and fluid overload improved the BP and self-management of those who completed the program.</p>","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"422-434"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12215151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}