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The Impact of Age and Body Composition on the Agreement between Estimated and Measured GFR in Heart Transplant Recipients. 年龄和身体成分对心脏移植受者估计和测量的 GFR 之间一致性的影响。
IF 2.3 4区 医学
Nephron Pub Date : 2025-01-01 Epub Date: 2024-09-14 DOI: 10.1159/000540530
Mads Hornum, Morten Buus Jørgensen, Lærke Marie Sidenius Nelson, Bo Feldt-Rasmussen, Kasper Rossing, Esteban Porrini, Peter Oturai, Finn Gustafsson
{"title":"The Impact of Age and Body Composition on the Agreement between Estimated and Measured GFR in Heart Transplant Recipients.","authors":"Mads Hornum, Morten Buus Jørgensen, Lærke Marie Sidenius Nelson, Bo Feldt-Rasmussen, Kasper Rossing, Esteban Porrini, Peter Oturai, Finn Gustafsson","doi":"10.1159/000540530","DOIUrl":"10.1159/000540530","url":null,"abstract":"<p><strong>Background: </strong>Estimated GFR (eGFR) has shown poor agreement with measured GFR (mGFR) in several populations. We investigated the impact of age and body composition on the accuracy and precision of eGFR in heart transplant (HTx) recipients.</p><p><strong>Methods: </strong>In a longitudinal, observational, retrospective study design, patients receiving first-time HTx with at least one registered mGFR value within 15 months after HTx and a corresponding plasma creatinine were included. GFR was measured by 51Cr-EDTA and eGFR calculated by creatinine-based CKD-EPI formula.</p><p><strong>Results: </strong>A total of 150 patients with a total of 723 mGFR measurements were included. During the first year after HTx, mean weight increased by 4.2 kg (CI: 3.2 to 5.1) followed by an annual decrease of 0.35 kg/year (Cl: -0.05 to 0.74). mGFR increased by 7.5 mL/min (Cl: 3.2 to 11.8) the first year but was stable hereafter (0.0 mL/min/year; CI: -1.0 to 1.0). The initial weigh gain and increase in mGFR were most pronounced in patients <45 years. Neither eGFR adjusted nor unadjusted for BSA detected the initial increase in mGFR. At 1 year after HTx, limits of agreement on the Bland-Altman plot were -37.2 to 33.1 mL/min with a bias of -2.1 mL/min (Cl: -5.0 to 0.9). In patients <45 years, eGFR significantly overestimated mGFR by 7.1 mL/min (Cl: 1.0 to 13.2) and showed a significant lower precision than patients >45 years. There was no effect of BMI class, weight, BSA, or change in BMI class on the difference between eGFR and mGFR.</p><p><strong>Conclusion: </strong>eGFR is, on average, accurate but imprecise in HTx patients. The agreement is affected by age but not body composition.</p>","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"18-28"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142291736","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
Immediate-Release versus Extended-Release Tacrolimus: Comparing Blood Pressure Control in Kidney Transplant Recipients - A Retrospective Cohort Study. 速释与缓释他克莫司:比较肾移植受者的血压控制 - 一项回顾性队列研究。
IF 2.3 4区 医学
Nephron Pub Date : 2025-01-01 Epub Date: 2024-09-22 DOI: 10.1159/000541334
Chien-Wen Yang, Juan Carlos Q Velez, Debbie L Cohen
{"title":"Immediate-Release versus Extended-Release Tacrolimus: Comparing Blood Pressure Control in Kidney Transplant Recipients - A Retrospective Cohort Study.","authors":"Chien-Wen Yang, Juan Carlos Q Velez, Debbie L Cohen","doi":"10.1159/000541334","DOIUrl":"10.1159/000541334","url":null,"abstract":"<p><strong>Background: </strong>Hypertension (HTN) is a common side effect of tacrolimus (Tac), the first-line antirejection medication for kidney transplant recipients. The impact of immediate-release tacrolimus (Tac IR) dosed twice daily versus extended-release tacrolimus (Tac ER) dosed once daily on long-term blood pressure control in kidney transplant recipients remains understudied. This study aims to compare the use of Tac IR versus Tac ER in kidney transplant recipients and evaluate the effects of the different formulations on systolic blood pressure (SBP), diastolic blood pressure (DBP), and HTN crisis.</p><p><strong>Methods: </strong>This retrospective cohort study at a single institution collected baseline characteristics, time-varying exposure to Tac IR versus Tac ER, SBP, DBP, HTN crisis, and confounders at each posttransplant visit. A marginal structural linear mixed-effects model was employed to analyze the longitudinal blood pressure control in kidney transplant recipients receiving Tac IR and Tac ER.</p><p><strong>Results: </strong>The final analysis included 654 patients, with mean ages of 52.0 years for Tac IR and 50.3 years for Tac ER. Males constituted 56.7% in Tac IR and 55.0% in Tac ER. Notably, the black population had 2.44 times higher odds of receiving Tac ER after adjusting for the rest of the baseline characteristics. No difference was found between longitudinal SBP (p = 0.386, 95% CI: -1.00, 2.57) or DBP (p = 0.797, 95% CI: -1.38, 1.06).</p><p><strong>Conclusion: </strong>Our study indicates that posttransplant patients taking Tac ER exhibit no difference in chronic SBP and DBP controls compared to Tac IR.</p>","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"57-65"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11850199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142291733","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}
引用次数: 0
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 : 2025-01-01 Epub 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":"<p><strong>Introduction: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"11-17"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","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
Sex Differences in Kidney Health and Disease. 肾脏健康和疾病的性别差异。
IF 2.3 4区 医学
Nephron Pub Date : 2025-01-01 Epub Date: 2024-10-15 DOI: 10.1159/000541352
Brian J Harvey, Diego Alvarez de la Rosa
{"title":"Sex Differences in Kidney Health and Disease.","authors":"Brian J Harvey, Diego Alvarez de la Rosa","doi":"10.1159/000541352","DOIUrl":"10.1159/000541352","url":null,"abstract":"<p><strong>Background: </strong>Sex differences exist in kidney physiology and disease which are underpinned by the biological actions of the sex hormones estrogen, progesterone and testosterone. In this review, we present an up-to-date discussion of the hormonal and molecular signalling pathways implicated in sex differences in kidney health and disease.</p><p><strong>Summary: </strong>Estrogen and progesterone have protective effects on renal blood flow, glomerular filtration rate and nephron ion and water reabsorptive processes, whereas testosterone tends to compromise these functions. The biological effects of estrogen appear to be the most important in reinforcing kidney function and protecting against kidney diseases in females. The actions of estrogen are myriad but all tend to bolster kidney physiology to maintain a steady-state and adaptable extracellular fluid volume (ECFV) and blood pressure. Estrogen safeguards ECFV homeostasis by stimulating renal epithelial sodium channel (ENaC) and water channel (AQP2) expression and transport function. Renal maintenance of ECFV within narrow physiological limits is a first-line of defense against hypertension and lowers the risk of cardiovascular disease in women. The estrogenic and XX chromosome basis for a female advantage are evident in a wide range of kidney diseases including acute kidney injury, chronic kidney disease, end-stage kidney disease, diabetic kidney disease, and polycystic kidney disease. The molecular mechanisms involve estrogen regulation of nephron ion and water transport, genetic immunogenic responses, activation of the protective arm of the renin angiotensin-aldosterone system and XX chromosome reinforcement of immune responses. Kidney disease can also predispose patients to cancer and women are protected in renal cancer with lower incidence, morbidity, and mortality than age-matched men with the disease.</p><p><strong>Key messages: </strong>This review underscores the importance of incorporating sex-specific considerations into clinical practice and basic research to bridge the gap in understanding and addressing biological sex disparities in kidney disease and renal cancer.</p>","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"77-103"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142470479","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
NF-κB/miR-455-5p/SOCS3 Axis Aggravates Sepsis-Induced Acute Kidney Injury through Promoting Renal Inflammation. NF-κB/miR-455-5p/SOCS3轴通过促进肾脏炎症加重脓毒症诱发的急性肾损伤。
IF 2.3 4区 医学
Nephron Pub Date : 2025-01-01 Epub Date: 2024-10-08 DOI: 10.1159/000541727
Mingjuan Yan, Ni Zhang, Li Quan, Wei Bin, Jing Xi, Caoshuai Dou, Zhiwen Liu, Yongfeng Gui, Liang-Hong Yin
{"title":"NF-κB/miR-455-5p/SOCS3 Axis Aggravates Sepsis-Induced Acute Kidney Injury through Promoting Renal Inflammation.","authors":"Mingjuan Yan, Ni Zhang, Li Quan, Wei Bin, Jing Xi, Caoshuai Dou, Zhiwen Liu, Yongfeng Gui, Liang-Hong Yin","doi":"10.1159/000541727","DOIUrl":"10.1159/000541727","url":null,"abstract":"<p><strong>Introduction: </strong>Sepsis is the leading contributor to acute kidney injury (AKI), responsible for 45-70% of AKI occurrences. Despite this, septic AKI is a highly multifactorial and complex condition, and our grasp of its pathogenesis is still not fully developed. Consequently, there remains a significant gap in effective diagnostic and therapeutic strategies for septic AKI.</p><p><strong>Methods: </strong>In the in vitro experiments, BUMPT cells were exposed to lipopolysaccharides (LPS). In vivo experiments involved inducing sepsis in mice through administration of LPS injections. Additionally, in certain experiments, either a miR-455-5p mimic or an anti-miR-455-5p LAN was administered to the mice via injections into the tail vein. The mice were then sacrificed 24 h following LPS administration for subsequent analysis.</p><p><strong>Results: </strong>We observed a significant elevation in miR-455-5p levels within renal tubular cells following LPS-induced septic AKI. Our investigation revealed that NF-κB plays a crucial role in the upregulation of miR-455-5p. Inhibition of NF-κB using TPCA-1 prevented the rise in miR-455-5p levels in BUMPT cells (mouse proximal tubular cells from Boston University) cultured in vitro. Chromatin immunoprecipitation assays confirmed that NF-κB directly interacts with the promoter region of the miR-455-5p gene in response to LPS treatment. Functionally, introducing miR-455-5p mimics intensified cell apoptosis, kidney damage, and the production of inflammatory cytokines, while silencing miR-455-5p had protective effects in septic mice. Notably, administering anti-miR-455-5p enhanced SOCS3 expression, whereas miR-455-5p mimics reduced SOCS3 levels following LPS exposure. Furthermore, our luciferase reporter assays demonstrated that SOCS3 is a direct target of miR-455-5p.</p><p><strong>Conclusion: </strong>This study indicates an NF-κB/miR-455-5p/SOCS3 axis which can exacerbate kidney damage by enhancing renal inflammation. This process highlights potential therapeutic targets for managing septic AKI.</p>","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"104-115"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391975","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 : 2025-01-01 Epub 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":"<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}
引用次数: 0
A Case of Complete Remission of Glucocorticoid-Dependent Nephrotic Syndrome after Targeted-Release Formulation of Budesonide Treatment in a Patient with Mild Mesangial Proliferative IgA Nephropathy. 轻度系膜增生性IgA肾病患者经trf -布地奈德治疗后糖皮质激素依赖性肾病综合征完全缓解1例。
IF 2.3 4区 医学
Nephron Pub Date : 2024-12-23 DOI: 10.1159/000543271
Efstathios Mitsopoulos, Panagiotis Pateinakis, Christodoulos Keskinis, Dorothea Papadopoulou
{"title":"A Case of Complete Remission of Glucocorticoid-Dependent Nephrotic Syndrome after Targeted-Release Formulation of Budesonide Treatment in a Patient with Mild Mesangial Proliferative IgA Nephropathy.","authors":"Efstathios Mitsopoulos, Panagiotis Pateinakis, Christodoulos Keskinis, Dorothea Papadopoulou","doi":"10.1159/000543271","DOIUrl":"10.1159/000543271","url":null,"abstract":"<p><p>The combination of nephrotic syndrome with mild histopathological lesions of IgA nephropathy is considered by some as a special form of IgA nephropathy with superimposed minimal change disease (MCD) while by others as a coincidental deposition of IgA in patients with MCD (MCD-IgAN). We present the first case of complete remission of nephrotic syndrome in a 55-year-old man with MCD-IgAN after the administration of a targeted-release formulation of budesonide (TRF-budesonide). The patient's treatment with TRF-budesonide, even though methylprednisolone, mycophenolate mofetil, and cyclophosphamide had been previously tried, is of particular importance because it not only suggests that TRF-budesonide appears to be a promising treatment for MCD-IgAN but may also provide a new therapeutic option for patients with podocytopathies.</p>","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"1-5"},"PeriodicalIF":2.3,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882288","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
Metabolic Syndrome, Nonalcoholic Fatty Liver Disease, and Graft Inflammation: An Unaddressed Pathogenic Link after Kidney Transplantation. 代谢综合征、非酒精性脂肪性肝病和移植物炎症:肾移植后未解决的致病联系
IF 2.3 4区 医学
Nephron Pub Date : 2024-12-23 DOI: 10.1159/000543276
Arminda Fariña-Hernández, Ana González-Rinne, Alberto Hernández-Bustabad, Rita María Guerra-Rodríguez, Ana Paola Saiz-Udaeta, Juana Alonso-Titos, Domingo Marrero, Antonio Rivero-González, Cristo Adonay Santana-Quintana, Pedro Ruíz-Esteban, Domingo Hernández
{"title":"Metabolic Syndrome, Nonalcoholic Fatty Liver Disease, and Graft Inflammation: An Unaddressed Pathogenic Link after Kidney Transplantation.","authors":"Arminda Fariña-Hernández, Ana González-Rinne, Alberto Hernández-Bustabad, Rita María Guerra-Rodríguez, Ana Paola Saiz-Udaeta, Juana Alonso-Titos, Domingo Marrero, Antonio Rivero-González, Cristo Adonay Santana-Quintana, Pedro Ruíz-Esteban, Domingo Hernández","doi":"10.1159/000543276","DOIUrl":"10.1159/000543276","url":null,"abstract":"<p><p>Kidney transplantation (KT) is the treatment of choice for chronic kidney disease patients, but there is a continued loss of grafts in the long-term (50% at 10 years) due to either patient death or chronic allograft dysfunction. Metabolic syndrome (MS) is very prevalent after KT (30-40%) and its components contribute to the appearance of nonalcoholic fatty liver disease/metabolic dysfunction-associated fatty liver disease (NAFLD/MAFLD) and nonalcoholic steatohepatitis (NASH), which represent the hepatic component of MS. Furthermore, about 20-40% of KT recipients present early graft inflammation, including subclinical inflammation. Thus, the relationship between NAFLD-MAFLD/NASH and graft inflammation may be bidirectional, though no definite link between NAFLD-NASH and graft inflammation is currently known. Additionally, MS-related risk factors are associated with modern immunosuppressants and a negative synergistic effect on graft and patient survival seems plausible. Indeed, proinflammatory cytokines and adipokines released by adipose tissue can generate a low-grade inflammatory state and endothelial dysfunction, both involved in the appearance of CVD, and these disorders are associated with worsening liver lesions and subclinical and clinical atheromatosis. In this review, we discuss the recent clinical evidence regarding the prevalence and risk factors of MS and NAFLD/MAFLD following KT. Additionally, we propose the potential linking mechanism between NAFLD/MAFLD-NASH and post-KT graft inflammation, as well as alternative therapies for NAFLD after KT. Prevention of long-term life-threatening complications in this particular population rests upon better understanding and management of these severe clinical complications.</p>","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"1-11"},"PeriodicalIF":2.3,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882290","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
Association between Metabolic Disorders and Impaired Kidney Function Thereafter in the Japanese General Population. 在日本普通人群中,代谢紊乱与肾功能受损之间的关系。
IF 2.3 4区 医学
Nephron Pub Date : 2024-12-20 DOI: 10.1159/000543267
Fumihiko Kin, Hiroyuki Takase, Naomi Kawakatsu, Kazusa Hayashi, Takeru Isogaki, Yasuaki Dohi
{"title":"Association between Metabolic Disorders and Impaired Kidney Function Thereafter in the Japanese General Population.","authors":"Fumihiko Kin, Hiroyuki Takase, Naomi Kawakatsu, Kazusa Hayashi, Takeru Isogaki, Yasuaki Dohi","doi":"10.1159/000543267","DOIUrl":"10.1159/000543267","url":null,"abstract":"<p><strong>Introduction: </strong>Metabolic syndrome (MetS) and chronic kidney disease are both important risk factors for cardiovascular disease and are closely related to each other. We retrospectively investigated whether MetS or its components increase the risk of development of impaired kidney function in the Japanese general population.</p><p><strong>Methods: </strong>This is a retrospective cohort study which enrolled 14,917 participants who visited our hospital for physical checkups from 2008 to 2018 and had normal estimated glomerular filtration rate (eGFR ≥60 mL/min/1.73 m2) during the baseline examination. Participants were followed up for the median of 1,847 days until 2019 with the development of impaired kidney function (eGFR <60 mL/min/1.73 m2) as the endpoint. The definition of MetS was based on Japanese diagnostic criteria (2005).</p><p><strong>Results: </strong>Throughout the study, 2,150 participants (25.9 per 1,000 person-year) developed impaired kidney function after their baseline checkup. The incidence of impaired kidney function was more frequent in participants with MetS (39.3 per 1,000 person-year) than without (24.2 per 1,000 person-year, p < 0.001). Moreover, each MetS component was positively associated with the incidence of impaired kidney function, where the incidence of impaired kidney function increased with the number of MetS components at baseline (0, 1, 2, and ≥3 component(s); 17.3, 26.9, 32.9, and 39.7 per 1,000 person-year, respectively). Multivariate Cox hazard analysis revealed that MetS was an independent risk factor for impaired kidney function after adjusting for known risk factors (hazard ratio, 1.29; 95% confidence interval, 1.15-1.45).</p><p><strong>Conclusions: </strong>Testing for MetS and its components can help evaluate the risk of developing impaired kidney function in the general population.</p>","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"1-7"},"PeriodicalIF":2.3,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877450","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
A Multimethod International Mapping Exercise of Arts Interventions in Renal Units: The PAINT Project. 肾脏单元艺术干预的多方法国际制图练习:PAINT项目。
IF 2.3 4区 医学
Nephron Pub Date : 2024-12-09 DOI: 10.1159/000542878
Trisha Forbes, Anna Wilson, Clare McKeaveney, Claire Carswell, Christopher Bailey, Jenny Baxley Lee, Mayleen Laico, Claire Meaney, Helen Noble
{"title":"A Multimethod International Mapping Exercise of Arts Interventions in Renal Units: The PAINT Project.","authors":"Trisha Forbes, Anna Wilson, Clare McKeaveney, Claire Carswell, Christopher Bailey, Jenny Baxley Lee, Mayleen Laico, Claire Meaney, Helen Noble","doi":"10.1159/000542878","DOIUrl":"10.1159/000542878","url":null,"abstract":"<p><strong>Introduction: </strong>Due to the chronic nature of kidney disease, the challenges of symptom burden, and reduced mortality and comorbidity, individuals living with the condition experience substantial anxiety and depression. Incorporating the arts into clinical practice is encouraged to promote and support mental health and well-being. The aim of the PAINT project was to undertake an international mapping exercise to identify the current provision of arts programmes in kidney centres for people living with kidney disease.</p><p><strong>Methods: </strong>A multimethod approach was employed, involving a cross-sectional online survey and semi-structured qualitative interviews, which employed qualitative description research design. Healthcare staff working in kidney centres or organisations providing arts activities to individuals living with kidney disease were recruited into the study.</p><p><strong>Results: </strong>One hundred and nineteen participants from 29 countries responded to the survey, with 39 of the respondents reporting arts activities in their renal unit. There was a wide range of respondents in terms of role, and the types of arts activities included visual arts activities, music, literature/creative writing, film, movement/dance, and craft. Individuals with chronic kidney disease who had taken part in arts activities were mostly adults (64%), and most were undergoing haemodialysis (82%). Sixteen respondents participated in the semi-structured interviews and encouraged the adoption of arts activities for people living with kidney disease. Three themes were identified: enhanced well-being and positive outcomes for individuals living with kidney disease; staff engagement and enthusiasm; and barriers to participation.</p><p><strong>Conclusions: </strong>This overview of arts activities being offered globally to people living with kidney disease and experiences of renal healthcare staff who provide activities in their units are encouraging in terms of arts in healthcare. These practitioners have observed the benefits of this person-centred arts approach in action, predominantly in terms of the positive impact on the well-being of individuals with kidney disease and improved relationships with staff in dialysis units. Further attention and funding should be focused on arts activities within renal centres.</p>","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"1-14"},"PeriodicalIF":2.3,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142801718","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}
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