Nephron最新文献_第3页

Acute Renal Infarction: A 12-Year Retrospective Analysis. 急性肾梗塞：12 年回顾性分析

IF 2.3 4区医学

Nephron Pub Date : 2024-09-09 DOI: 10.1159/000541333

Sheldon Greenberg, Kundan Jana, Kalyana Janga, Meng-Hsun Lee, Mary Lockwood

{"title":"Acute Renal Infarction: A 12-Year Retrospective Analysis.","authors":"Sheldon Greenberg, Kundan Jana, Kalyana Janga, Meng-Hsun Lee, Mary Lockwood","doi":"10.1159/000541333","DOIUrl":"10.1159/000541333","url":null,"abstract":"Introduction: Acute renal infarction (ARI) is a relatively rare and underdiagnosed condition. Presenting symptoms are nonspecific, and imaging is the mainstay for diagnosis. This study attempts to characterize the profile of patients with ARI and identify possible risk factors.Methods: All inpatients admitted with diagnosis of ARI between 2010 and 2022 were included in this single-center retrospective observational study. Patients with chronic renal infarction, iatrogenic causes, and without radiographic evidence of ARI were excluded. Clinical, laboratory, and radiological findings of patients were collected. Patients were grouped into three groups based on probable etiology: cardiovascular, hypercoagulable disorders, and idiopathic, and analyzed.Results: Eighty-five patients were included. Mean age of patients was 61.6 ± 17.54 years. Cardiovascular group had the highest number of patients (49.4%) of which atrial fibrillation was the most common etiology (59.5%). Malignancy was the most common etiology in the hypercoagulable disorder group (69.3%). Patients in the idiopathic group were significantly younger and had higher mean body mass index than the other 2 groups at presentation. Smokers had 9 times higher risk of renal infarction in cardiovascular group and 1.7 times higher risk in hypercoagulable when compared to the idiopathic group. 48.2% of patients developed renal infarction though they were on antiplatelets/anticoagulants.Conclusion: ARI is a rare and often underdiagnosed condition that can have residual renal dysfunction. It is important to consider ARI as a differential especially in young patients with risk factors even if they are on anticoagulation medication.","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"1-7"},"PeriodicalIF":2.3,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142291731","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}

引用次数: 0

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. 终末期肾病患者对预先护理计划的偏好：在印度一家三级医疗中心的肾科医疗服务提供者中开展的横断面调查。

IF 2.3 4区医学

Nephron Pub Date : 2024-09-09 DOI: 10.1159/000541347

Bharathi Naik, Arun Ghoshal, Anuja Damani, Pankaj Singhai, Ravindra Prabhu Attur, Naveen Salins, Ajith M Nayak, Shankar Prasad Nagaraju

{"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":"Introduction: 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.Methods: 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.Results: 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.Conclusion: 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.","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"1-9"},"PeriodicalIF":2.3,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Lipophagy and Mitophagy in Renal Pathophysiology. 肾脏病理生理学中的噬脂性和噬丝性。

IF 2.3 4区医学

Nephron Pub Date : 2024-08-23 DOI: 10.1159/000540688

Nicolas Dupont, Fabiola Terzi

引用次数: 0

Phenotypic Discordance among Siblings with Autosomal Recessive Polycystic Kidney Disease: Case Report and Review of the Literature. 常染色体隐性遗传多囊肾兄弟姐妹间的表型不一致：病例报告和文献综述。

IF 2.3 4区医学

Nephron Pub Date : 2024-08-05 DOI: 10.1159/000540741

Marc Henein, Felicia Russo, Zachary T Sentell, Rémi Goupil, Thomas M Kitzler

引用次数: 0

Severe Leptospirosis with Acute Kidney Injury: A Case Description and Literature Review. 重症钩端螺旋体病并发急性肾损伤--病例描述和文献综述。

IF 2.3 4区医学

Nephron Pub Date : 2024-08-05 DOI: 10.1159/000540300

Clara Daschner, Anna-Sophie Schübler, Matthias Jung, Niklas Ayasse, Gökhan Yücel, Faeq Husain-Syed, Jan Leipe, Bernhard K Krämer, Babak Yazdani

{"title":"Severe Leptospirosis with Acute Kidney Injury: A Case Description and Literature Review.","authors":"Clara Daschner, Anna-Sophie Schübler, Matthias Jung, Niklas Ayasse, Gökhan Yücel, Faeq Husain-Syed, Jan Leipe, Bernhard K Krämer, Babak Yazdani","doi":"10.1159/000540300","DOIUrl":"10.1159/000540300","url":null,"abstract":"Introduction: Leptospirosis is a globally transmitted zoonotic disease caused by Leptospira spp., a highly mobile, obligate aerobic, spiral-shaped bacteria. Described first by Adolf Weil in 1886, leptospirosis in Germany is rare, leading to a delayed diagnosis due to diverse symptoms. Most cases are mild, but severe forms, like Weil's disease, cause life-threatening complications such as fever, jaundice, hemoptysis, and acute kidney injury (AKI). The aim of this work was to provide a literature review of leptospirosis with renal manifestation based on a case report.Case presentation: We report the case of an 81-year-old male patient with initially unclear oliguric AKI, bilateral pulmonary infiltrates, and jaundice. After excluding common AKI causes, the expanded patient history suggested possible rat contact in his chicken coop. Finally, we serologically identified an infection with Leptospira spp. by positive IgM, proving that the illness was compatible with classical Weil's disease. The patient underwent temporary hemodialysis and antibiotic treatment with intravenous penicillin G for 2 weeks. Under therapy, the AKI, hyperbilirubinemia, and clinical condition of the patient improved. The patient was discharged after 2 weeks. In the following controls, slightly impaired kidney function was observed, indicating a progress of his chronic kidney disease (CKD).Conclusion: Although leptospirosis is rare, there are some cases with a fulminant course. Impairment of renal function often correlates with severity of the disease requiring antibiotic treatment. In some cases, AKI progresses to CKD demonstrating the need to raise awareness for leptospirosis.","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"1-8"},"PeriodicalIF":2.3,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141893865","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}

引用次数: 0

Systems Biology and Novel Biomarkers for the Early Detection of Diabetic Kidney Disease. 用于早期检测糖尿病肾病的系统生物学和新型生物标记物。

IF 2.3 4区医学

Nephron Pub Date : 2024-07-29 DOI: 10.1159/000540307

Priscila Villalvazo, Carlos Villavicencio, Marina Gonzalez de Rivera, Beatriz Fernandez-Fernandez, Alberto Ortiz

{"title":"Systems Biology and Novel Biomarkers for the Early Detection of Diabetic Kidney Disease.","authors":"Priscila Villalvazo, Carlos Villavicencio, Marina Gonzalez de Rivera, Beatriz Fernandez-Fernandez, Alberto Ortiz","doi":"10.1159/000540307","DOIUrl":"10.1159/000540307","url":null,"abstract":"Diabetic kidney disease is the most common driver of chronic kidney disease (CKD)-associated mortality and kidney replacement therapy. Despite recent therapeutic advances (sodium glucose co-transporter 2 [SGLT2] inhibitors, finerenone), the residual kidney and mortality risk remains high for patients already diagnosed of having CKD (i.e., estimated glomerular filtration rate <60 mL/min/1.73 m2 or urinary albumin:creatinine ratio >30 mg/g). The challenge for the near future is to identify patients at higher risk of developing CKD to initiate therapy before CKD develops (primary prevention of CKD) and to identify patients with CKD and high risk of progression or death, in order to intensify therapy. We now discuss recent advances in biomarkers that may contribute to the identification of such high-risk individuals for clinical trials of novel primary prevention or treatment approaches for CKD. The most advanced biomarker from a clinical development point of view is the urinary peptidomics classifier CKD273, that integrates prognostic information from 273 urinary peptides and identifies high-risk individuals before CKD develops.","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"1-7"},"PeriodicalIF":2.3,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141792891","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}

引用次数: 0

Predicting outcomes after transplantation of deceased donor kidneys of marginal quality within the Eurotransplant service area. 预测欧洲移植服务区内质量不佳的已故捐献者肾脏移植后的效果。

IF 2.3 4区医学

Nephron Pub Date : 2024-07-24 DOI: 10.1159/000540304

Florian G Scurt, Carl L Fischer-Fröhlich, Angela Ernst, Peter R Mertens, Jan U Becker, Christos Chatzikyrkou

{"title":"Predicting outcomes after transplantation of deceased donor kidneys of marginal quality within the Eurotransplant service area.","authors":"Florian G Scurt, Carl L Fischer-Fröhlich, Angela Ernst, Peter R Mertens, Jan U Becker, Christos Chatzikyrkou","doi":"10.1159/000540304","DOIUrl":"https://doi.org/10.1159/000540304","url":null,"abstract":"Introduction: Kidneys of marginal quality are increasingly being used to overcome the shortage of donor organs. However, accurate prediction of outcome is needed to optimise the use of these kidneys. We aimed to test the performance of a recently proposed score consisting of delayed graft function (DGF), renal function recovery (RFR), and glomerular filtration rate (GFR) <30 ml/min per 1.73 m2 90 days after transplantation for risk assessment of patient and graft survival.Material and methods: A total of 221 adult brain death donors with marginal kidneys, transplanted into 223 recipients within Eurotransplant were included in the analysis. Multivariable Cox proportional hazards models were constructed to assess death-censored and all-cause censored graft failure and recipient mortality at one and three years.Results: Recipients with DGF had a higher risk of death-censored graft loss (HR, 95%CIs: 3.058 (1.195 - 7.825)). Recipients with a GFR <30ml/min/1.73m² at 90 days after transplantation had a higher risk of death censored and all-cause graft failure (HR, 95%CIs: 2.122 (1.129-3.990 and 2.122 (1.129 - 3.990)). None of the three components of the proposed score was associated with a higher risk of mortality.Conclusion: DGF and eGFR <30 ml/min/1.73m² but not RFR at 90 days predicted graft failure after transplantation of marginal kidneys. However, no combination of these factors was able to predict short-term patient and graft survival.","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141759975","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}

引用次数: 0

Impact of Renin-Angiotensin System Blockade on Mortality and Allograft Loss among Renal Transplant Recipients: A Systematic Review and Meta-Analysis. 肾素-血管紧张素系统阻断对肾移植受者死亡率和异体移植损失的影响：系统回顾与元分析》。

IF 2.3 4区医学

Nephron Pub Date : 2024-07-22 DOI: 10.1159/000540305

Chin-Wei Kung, Yi-Chih Lin, Chi-Shin Tseng, Yu-Hsiang Chou

{"title":"Impact of Renin-Angiotensin System Blockade on Mortality and Allograft Loss among Renal Transplant Recipients: A Systematic Review and Meta-Analysis.","authors":"Chin-Wei Kung, Yi-Chih Lin, Chi-Shin Tseng, Yu-Hsiang Chou","doi":"10.1159/000540305","DOIUrl":"10.1159/000540305","url":null,"abstract":"Introduction: The blockade of the renin-angiotensin system (RAS) has a beneficial effect on reducing the levels of proteinuria and blood pressure in patients with chronic kidney disease (CKD) and reduces the risk of developing end-stage kidney disease in CKD patients. Nonetheless, a debate persists regarding the impact of RAS inhibitors on outcomes such as mortality and graft survival in renal transplant patients. To assess the effect of RAS inhibitors on graft recipients in the past decade, we conducted a systematic review and meta-analysis.Methods: We searched Embase, PubMed, and the Cochrane Central Register of Clinical Trials from January 1, 2012, to August 1, 2022. We included 14 articles, comprising 5 randomized controlled trials (RCTs) and 9 cohort studies, including 45,377 patients. These studies compared patient or graft survival between an RAS inhibitor treatment arm and a control arm.Results: The meta-analysis revealed that RAS blockade was significantly associated with lower mortality in cohort studies (risk ratio [RR] = 0.66, 95% confidence interval [CI]: 0.55-0.79), reduced allograft loss in cohort studies (RR = 0.62, 95% CI: 0.54-0.71), and significant changes in systolic blood pressure in RCTs. Subgroup analysis of the groups of interest (interventions involving RAS blockade, follow-up period of ≥5 years) showed consistently reduced mortality (RR = 0.67, 95% CI: 0.56-0.81) and reduced allograft loss (RR = 0.61, 95% CI: 0.54-0.70).Conclusions: Our results demonstrated that the application of RAS blockade among renal transplant recipients was associated with lower mortality and allograft loss in cohort studies but not in RCTs. More powered clinical trials are needed to evaluate the effects of RAS blockade in renal transplant recipients.","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"1-11"},"PeriodicalIF":2.3,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141620421","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}

引用次数: 0

Burden of Chronic Kidney Disease of Undetermined Aetiology (CKDu) in a Tertiary Care Public Hospital in North India. 印度北部一家三级公立医院病因未明的慢性肾病（CKDu）的负担。

IF 2.3 4区医学

Nephron Pub Date : 2024-07-22 DOI: 10.1159/000539317

Indradip Maity, Hemchand Sati, Geetika Singh, Dipankar Bhowmik, Sanjay Kumar Agarwal, Soumita Bagchi

{"title":"Burden of Chronic Kidney Disease of Undetermined Aetiology (CKDu) in a Tertiary Care Public Hospital in North India.","authors":"Indradip Maity, Hemchand Sati, Geetika Singh, Dipankar Bhowmik, Sanjay Kumar Agarwal, Soumita Bagchi","doi":"10.1159/000539317","DOIUrl":"10.1159/000539317","url":null,"abstract":"Introduction: Chronic kidney disease of undetermined aetiology (CKDu) is an important public health problem. Indian data are mostly based on studies from rural regions in south and east India. We examined the burden and profile of CKDu in patients attending a tertiary care hospital in north India.Methods: We assessed records of consecutive new CKD patients registered in a nephrology clinic from January 2015 to June 2022. Patients were classified as having CKDu based on predefined inclusion and exclusion criteria. Clinical and laboratory parameters at presentation and kidney biopsy when done were noted.Results: Records of 32,369 patients with CKD were screened, and 29,663 were included (2,706 excluded due to inadequate data). A total of 370 (1.2%) patients were categorized as CKDu. Mean age was 41 ± 14.7 years, 58.1% being male. Of them, 158 (42.7%) patients were in CKD stage 3, 89 (24.1%) in stage 4, 84 (22.7%) in stage 5, and 39 (10.5%) were dialysis dependent at presentation; 232 (62.7%) patients had proteinuria <0.5 gm/day and 138 (37.3%) between 0.5 and 1 gm/day. Renal histology was available for 65 CKDu patients: 62 had chronic tubulointerstitial nephritis (CTIN) and 3 had non-specific changes.Conclusion: When defined using strict criteria with intensive diagnostic workup, burden of CKDu is low in our hospital-based cohort of CKD patients. CTIN is the predominant histopathological finding in kidney biopsy.","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"1-8"},"PeriodicalIF":2.3,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141534862","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}

引用次数: 0

Unsupervised Clustering of Membranoproliferative Glomerulonephritis and C3 Glomerulopathy Patients Discovers Distinct Patient Groups unlike the Current Classification. 对膜增生性肾小球肾炎和 C3 肾小球病患者进行无监督聚类，发现了与现有分类不同的患者群体。

IF 2.3 4区医学

Nephron Pub Date : 2024-07-04 DOI: 10.1159/000539893

Marja Kovala, Minna Seppälä, Mikolaj Wojnicki, Eero Honkanen, Seppo Meri, Kati Kaartinen, Anne Räisänen-Sokolowski

{"title":"Unsupervised Clustering of Membranoproliferative Glomerulonephritis and C3 Glomerulopathy Patients Discovers Distinct Patient Groups unlike the Current Classification.","authors":"Marja Kovala, Minna Seppälä, Mikolaj Wojnicki, Eero Honkanen, Seppo Meri, Kati Kaartinen, Anne Räisänen-Sokolowski","doi":"10.1159/000539893","DOIUrl":"10.1159/000539893","url":null,"abstract":"Introduction: Membranoproliferative glomerulonephritis is currently divided into immunoglobulin-mediated glomerulonephritis (IC-MPGN) and C3 glomerulopathy (C3G); however, the patients often overlap with histology, complement, clinical and prognostic factors. Our aim was to investigate if an unsupervised clustering method finds different patient groups in 44 IC-MPGN/C3G patients using only histological and clinical data available in everyday clinical work.Methods: Primary IC-MPGN/C3G adult patients were included whose diagnostic (baseline) native biopsy was obtained in 2006-2017. The biopsies were reassessed and the clinical data at baseline and during follow-up were obtained from the medical records. There were 39 baseline histological and clinical variables included in the unsupervised clustering. Follow-up information was combined with the clustering results.Results: The clustering resulted in two clusters (n = 24 and n = 20 patients for clusters 1-2, respectively), where cluster 1 had a significantly higher baseline plasma creatinine (mean 213 vs. 104, respectively, p value <0.001) and a lower baseline eGFR than cluster 2 (mean 37 vs. 70, respectively, p value <0.001). Regarding histology, chronic changes such as lobulated glomeruli, mesangial matrix expansion, and glomeruli double contours were more prevalent in cluster 1 (p value <0.001). Biopsy morphology was more often crescentic and membranoproliferative in cluster 1 (p value <0.001). Although the differences were insignificant, cluster 1 patients were in dialysis in the last follow-up or had a progressive disease more often than cluster 2 patients (21% vs. 5%, 38% vs. 10%).Conclusions: Our results indicate that these patients share greater similarity than the current classification IC-MPGN versus C3G indicates.","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"1-10"},"PeriodicalIF":2.3,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141534863","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}

引用次数: 0