Nephron最新文献

{"title":"Home-Based Dialysis and Person-Centered Care: A Scoping Review.","authors":"Beate Nygaard-Andersen, Astrid Torbjørnsen, Peter Forde Hougaard, Ann-Chatrin Linqvist Leonardsen, Axel Wolf, Jeanette Finderup","doi":"10.1159/000544699","DOIUrl":"10.1159/000544699","url":null,"abstract":"<p><strong>Introduction: </strong>Managing dialysis at home requires the involvement of the patient in decisions, treatment, and their illness and health. Evidence-based person-centered care interventions focus on listening to the patient's narrative, establishing a partnership between patients and healthcare professionals, and documenting care and treatment in a shared health plan. Therefore, a person-centered care intervention is expected to enhance the patient's ability to manage dialysis at home. This study aimed to identify and map evidence for person-centered interventions and home-based dialysis for individuals with kidney failure.</p><p><strong>Methods: </strong>A scoping review was conducted based on the approach of Arksey and O'Malley. A systematic search was carried out in Medline, CINAHL, and Scopus for articles in all languages and without time restrictions. Person-centered care interventions concerning home dialysis were included. Two independent researchers assessed the literature. Data were extracted using NVIVO, and a relational analytical framework was employed to synthesize the data.</p><p><strong>Results: </strong>The search identified 9,443 articles, of which 16 met the inclusion criteria. A total of 13 person-centered care interventions were identified. Eight interventions aimed to involve the patient in the decision regarding the type of dialysis modality, with six interventions identified to involve the patient in treatment, illness, and health. Only one intervention was identified to involve the patient in the decisions that follow once the patient has commenced dialysis treatment. Five interventions showed a correlation between a person-centered care intervention and the number of patients in home dialysis.</p><p><strong>Conclusion: </strong>There is a need for interventions for patients in home dialysis to be adapted to a more person-centered care approach, particularly regarding the involvement of the patient in their treatment, illness, and health, as well as the decisions that follow the initiation of dialysis treatment.</p>","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"1-16"},"PeriodicalIF":2.3,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542594","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":"1-13"},"PeriodicalIF":2.3,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum Levels of B-Cell Activating Factor and A Proliferation-Inducing Ligand in Children with Steroid-Sensitive Nephrotic Syndrome.","authors":"Chen Ling, Zhi Chen, Lin Hua, Hejia Zhang, Dan Wu, Yue Xi, Lei Lei, Shuting Quan, Xiaoxue Li, Xiaorong Liu","doi":"10.1159/000544761","DOIUrl":"10.1159/000544761","url":null,"abstract":"<p><strong>Introduction: </strong>The therapeutic efficacy of B-cell-depleting anti-CD20 treatments is well established for children with steroid-sensitive nephrotic syndrome (SSNS), thus suggesting that B cells may play an important role in the occurrence of this disease. However, the role of B-cell survival factors and cytokines in SSNS has yet to be fully elucidated.</p><p><strong>Methods: </strong>We used commercially available ELISA kits to determine the serum levels of B-cell activating factor (BAFF) and a proliferation-inducing ligand (APRIL) in 84 children with SSNS and 25 healthy controls. Then, we performed correlation analysis between these two serum factors and clinical parameters in children with SSNS.</p><p><strong>Results: </strong>The serum level of BAFF in the relapse group was 1,295.2 ± 584.2 pg/mL, significantly higher than other groups (p < 0.001). The serum level of APRIL in the relapse group was 2,830.5 ± 945.8 pg/mL, significantly higher than the other groups (p < 0.001). The proportion (%) of memory B cells was positively correlated with the levels of BAFF and APRIL in children with SSNS (Pearson's correlation coefficient: r = 0.351, p = 0.001; Pearson's r = 0.234, p = 0.032). The proportion (%) of transitional B cells was negatively correlated with the levels of BAFF (Pearson's r = -0.237, p = 0.030) while the serum levels of IgG were negatively correlated with those of APRIL (Pearson's r = -0.274, p = 0.012).</p><p><strong>Conclusions: </strong>Our data indicate that BAFF appears to play a role in the recurrence of SSNS while APRIL appears to play a role in the pathogenesis of this condition, thus indicating that these molecules represent potential therapeutic targets for SSNS.</p>","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"1-8"},"PeriodicalIF":2.3,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516086","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":"THE INFLAMMATORY PATHOGENETIC PATHWAYS OF FABRY NEPHROPATHY AND AGALOPATHY; GLA VARIANTS INDUCTION OF ENDOPLASMIC RETICULUM STRESS.","authors":"Sandro Feriozzi, Paula Rozenfeld","doi":"10.1159/000544760","DOIUrl":"https://doi.org/10.1159/000544760","url":null,"abstract":"<p><p>Fabry disease (FD) is a monogenic disease with highly variable clinical features. This variability suggests that additional pathogenetic pathways may exist besides the intra-lysosomal deposition of globotriaosylceramide (Gb3) and its deacylated form globotriaosylsphingosine (LysoGb3) caused by an enzyme deficiency. Research studies proved that the deposition of Gb3 and LysoGb3 can stimulate inflammatory processes. Mononuclear immune competent cells exposed to Gb3 deposition express adhesion molecules and release proinflammatory and fibrotic cytokines such as interleukin β, tumour necrosis factor-alpha (TNFα), and transforming growth factor beta (TGFβ). These processes determine the activation of inflammation processes associated with chronic inflammation and tissue fibrosis. The pathogenetic mechanisms stimulated by Gb3 and LysoGb3 deposition could become independent from the initial stimulus, causing an irreversible effect, in which Fabry disease-specific therapy can play a limited role. A new disease mechanism, \"Agalopathy\", would coexist with the enzyme deficiency. Missense variants in the coding sequence of the GLA gene would generate the misfolding of the altered protein alpha-galactosidase A. Emergence of misfolded proteins may generate stress of the endoplasmic reticulum (ER), leading to induction of the unfolded protein response (UPR). The UPR causes the release of proinflammatory cytokines and contributes to inflammatory status. This mechanism could be activated independently of glycolipid deposition, and its relationship with inflammatory pathways deserves more research. Strikingly, a zebrafish GLA knockout model that naturally lacks the enzyme that synthesizes Gb3 shows many alterations in lysosomal functions. These pieces of evidence suggest the involvement of alternative pathways independent of Gb3 in FD pathogenesis. This review aims to describe these processes' role in the pathogenesis of renal damage in FD or Agalopathy nephropathies.</p>","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"1-9"},"PeriodicalIF":2.3,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468638","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":"Subclinical Inflammation and Renal Allograft Dysfunction: Myth or Reality?","authors":"Carlos Couceiro, Maria Visent, Josep M Cruzado","doi":"10.1159/000544762","DOIUrl":"10.1159/000544762","url":null,"abstract":"<p><strong>Background: </strong>Since the implementation of the Banff classification, the diagnosis and treatment of transplant rejection have been standardised. However, the rigid categorisation of transplant pathology has limited our perspective on allograft inflammation, particularly disregarding those inflammatory infiltrates who do not reach the category of rejection.</p><p><strong>Summary: </strong>The term subclinical inflammation was introduced to designate the inflammation found in protocol biopsies, without significant renal function deterioration. Following the introduction of modern immunosuppression with tacrolimus and mycophenolate, subclinical rejection rate decreased, and less attention was paid to this entity. However, in the last decades, several studies have evaluated the impact of lower levels of inflammation and demonstrated its negative consequences on long-term outcomes. Although, in some patients, this subclinical inflammation is not permanent and can spontaneously disappear. The uncomplete definition of subclinical inflammation, which only considers renal function stability, and the evaluation of the biopsy as a definitive diagnosis, and not as a picture of an evolving process, are the main reasons why managing this inflammation represents a challenge, especially when there is no pathogenic mechanism identified.</p><p><strong>Key messages: </strong>In this review, we revise the \"natural\" history of inflammation in the kidney allograft and its possible origins based on cellular composition and transcriptomic expression changes in kidney biopsies. In addition, we propose an updated definition and an approach to manage it.</p>","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"1-6"},"PeriodicalIF":2.3,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441530","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":"Membranoproliferative Glomerulonephritis with Striated Ultrastructural Deposits with Significantly Elevated Fibrinogen and Fibronectin on Mass Spectrometry Analysis: A Case Report and Literature Review.","authors":"Manna Ishida, Shinya Yamamoto, Yohei Iwashige, Shuma Miyazawa, Hirosuke Nakata, Koichi Seta, Kensei Yahata, Sachiko Minamiguchi, Yoko Endo, Akiko Mii, Akira Shimizu, Motoko Yanagita","doi":"10.1159/000544709","DOIUrl":"10.1159/000544709","url":null,"abstract":"<p><p>Glomerular diseases with organized deposits can be classified into various etiologies. A diagnostic algorithm based on clinical and pathological findings has been proposed. However, some cases cannot be diagnosed using existing algorithms. Here, we report the case of a 77-year-old man diagnosed with membranoproliferative glomerulonephritis (MPGN) with striated ultrastructural deposits, micro-filament-like substructures with straight bands arranged in parallel in the subendothelial space by two sequential renal biopsies. His examinations and clinical findings were incompatible with known glomerular diseases with organized deposits. Dialysis was initiated 10 months after the second biopsy procedure. Furthermore, we report the first mass spectrometry analysis of laser micro-dissected glomeruli with striated ultrastructural deposits, which revealed significant levels of fibrinogen and fibronectin. Immunostaining was positive for fibrinogen, fibrin, and fibronectin in the subendothelial space. These findings suggest that the deposits were composed of a fibrin-fibronectin complex and that accumulation of these fibrin-fibronectin complexes possibly induced endothelial injury, leading to MPGN. We also reviewed the literature on the clinical and pathological characteristics of the four cases with striated ultrastructural deposits. Our investigation showed that all patients had the MPGN pattern and striated ultrastructural deposits in the subendothelial space, and all underwent hemodialysis within 3 years of renal biopsy. Clinicians should be aware of the findings of glomerulonephritis with striated ultrastructural deposits since this disease may be a new entity and has a poor prognosis.</p>","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"1-11"},"PeriodicalIF":2.3,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414626","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":"CHA2DS2-VASc score as a predictor of cardiovascular and all-cause mortality in a prospective cohort of hemodialysis patients of predominantly African ancestry: The PROHEMO.","authors":"Gabriel Brayan Gutiérrez-Peredo, Andrea Jimena Gutiérrez-Peredo, Iris Montaño-Castellón, Marinho Marques da Silva Neto, Fernanda Albuquerque da Silva, Marcia Tereza Silva Martins, Cacia Mendes Matos, Jean Michell Correia Monteiro, Pedro Guimarães Silva, Gildete Barreto Lopes, Marcelo Barreto Lopes, Luis Claudio Correia, Roberto Pecoits-Filho, Keith C Norris, Antonio Alberto Lopes","doi":"10.1159/000543720","DOIUrl":"https://doi.org/10.1159/000543720","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease (CKD) elevates the risk of cardiovascular and overall mortality among maintenance hemodialysis (MHD) patients. Although initially designed to predict stroke in cases of atrial fibrillation, the CHA2DS2-VASc score demonstrates predictive utility, spanning several cardiovascular conditions. This study seeks to evaluate if the CHA2DS2-VASc score is effective in predicting cardiovascular and all-cause mortality for MHD patients.</p><p><strong>Methods: </strong>The data are part of the \"Prospective Study of the Prognosis of Patients on Chronic Hemodialysis\" (PROHEMO) developed in Salvador, BA, Brazil. We grouped patients according to CHA2DS2-VASc score ≤2 (group 1) and >2 (group 2). Cox regression was used to estimate the hazard ratio of death (HR): unadjusted; and adjusted for hemoglobin, creatinine, albumin, phosphorus, PTH, liver disease, neoplasia/cancer, months of hemodialysis. Additionally, the distribution of each variable in the CHA2DS2-VASc score and its association with mortality were evaluated. Based on the observed associations and the distribution of age (with only 1.3% of patients aged >75 years) and hypertension (only 4.6% normotensive, leading to an imprecise association estimate), a modified CHA2DS2-VASc score was created.</p><p><strong>Results: </strong>A total of 237 patients on hemodialysis (51.57 ± 12.46, 57% male) were included. Mean age was 51.6 ± 12.5 years. A total of 55 deaths, 21 from cardiovascular causes. Compared with CHA2DS2-VASc score <2, the unadjusted hazard of death (Model 1) for score ≥2 was twofold for all-cause mortality (HR=2.05; 95% CI: 1.20, 3.49) and more than three times higher for cardiovascular deaths (HR=3.53; 95% CI: 1.46, 8.54). These HRs did not change substantially with adjustment for covariates. In the most comprehensively adjusted Cox model, the HR for all-cause mortality was 2.43 (95% CI: 1.38, 4.23) and for cardiovascular mortality was 3.52 (95% CI: 1.40, 8.84). These results were similar to those observe for the modified version of CHA2DS2-VASc score.</p>","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"1-23"},"PeriodicalIF":2.3,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399561","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":"Acute Tubular Necrosis Attributed to High-Dose Everolimus with High-Potency Bisphosphonates for Advanced Breast Cancer: A Case Report.","authors":"Itamar Loewenstein, Nimrod Orr Urtreger, Doron Schwartz, Asia Zubkov, Merav Ingbir","doi":"10.1159/000543924","DOIUrl":"10.1159/000543924","url":null,"abstract":"<p><strong>Introduction: </strong>Everolimus (EVR)-induced kidney injury is rarely reported. Conversely, acute tubular necrosis (ATN) is a recognized complication of high-dose bisphosphonate therapy.</p><p><strong>Case presentation: </strong>SM, a 69-year-old female patient with advanced breast cancer, developed severe kidney injury necessitating renal replacement therapy (RRT) shortly after initiating EVR treatment, while concurrently receiving chronic high-potency bisphosphonate therapy. Kidney biopsy confirmed ATN. Upon discontinuation of both EVR and bisphosphonates, her renal function gradually improved over several months, leading to the cessation of RRT. At a 2-year follow-up, her kidney function has returned to baseline.</p><p><strong>Conclusion: </strong>In this case report, we outline the patient's clinical course and provide a pathophysiological rationale for the synergistic effect of EVR and bisphosphonates in promoting ATN. With the increasing use of EVR in various oncologic indications, we emphasize the reversible nature of this kidney injury and stress the importance of timely recognition and intervention.</p>","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"1-6"},"PeriodicalIF":2.3,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123113","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":"1-13"},"PeriodicalIF":2.3,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding the Support Needs of People with Autosomal Dominant Polycystic Kidney Disease: A Qualitative Phenomenological Descriptive Study.","authors":"Katrine Schmidt Rasmussen, Dinah Sherzad Khatir, Henrik Birn, Selina Emilie Poulsen, Jeanette Finderup","doi":"10.1159/000543269","DOIUrl":"https://doi.org/10.1159/000543269","url":null,"abstract":"<p><strong>Introduction: </strong>Autosomal dominant polycystic kidney disease (ADPKD) is a prevalent hereditary kidney disease and the fourth most common cause of kidney failure. Patients may be aware of their condition from an early age or discover it unexpectedly, with varying levels of familial knowledge about the disease. This chronic condition presents significant challenges for healthcare professionals. The study aimed to investigate how people with ADPKD experience their participation in a dedicated ADPKD clinic and to investigate their support needs in managing their disease in everyday life.</p><p><strong>Methods: </strong>A qualitative phenomenological descriptive study was conducted, involving semi-structured telephone interviews with patients who attended a newly established dedicated ADPKD clinic between March and April 2023. The data were analyzed using Malterud's principles of systematic text condensation.</p><p><strong>Results: </strong>In total, 18 out of 22 patients agreed to participate in the interviews. Six themes emerged from the interviews. Participants expressed feelings of uncertainty about their future and highlighted the necessity for personalized care tailored to their individual circumstances. They reported challenges in coping with emotions associated with the disease and sought assistance in making difficult decisions. Maintaining control over their health and illness was a significant theme, alongside a desire for increased knowledge about their condition.</p><p><strong>Conclusion: </strong>Our study supports existing knowledge in this area. In this study, the participants experienced satisfaction with the dedicated ADPKD clinic, feeling well informed, listened to, and more at ease after the check-up. Investing in a dedicated ADPKD clinic could help alleviate the uncertainty that many people with ADPKD experience.</p>","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"1-8"},"PeriodicalIF":2.3,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059700","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}