Nephron最新文献

{"title":"Comparative Effectiveness of Lipid-Lowering Therapies in Increasing High-Density Lipoprotein Cholesterol Levels in Patients with Chronic Kidney Disease.","authors":"Mohammad Abdullah Al Zubair Naim, Fridtjof Thomas, Elani Streja, Robert Lowell Davis, Kamyar Kalantar-Zadeh, Keiichi Sumida, Csaba P Kovesdy","doi":"10.1159/000551276","DOIUrl":"10.1159/000551276","url":null,"abstract":"<p><strong>Background: </strong>In patients with chronic kidney disease (CKD), lower and subfunctional high-density lipoprotein cholesterol (HDL-C) is associated with poor cardiovascular outcomes. Notwithstanding such poor outcomes, the primary therapeutic target in patients with CKD is low-density lipoprotein cholesterol (LDL-C), and the comparative effectiveness of commonly used lipid-lowering therapies (LLTs) in changing HDL-C levels in patients with non-dialysis-dependent CKD (NDD-CKD) remains unclear.</p><p><strong>Methods: </strong>In this retrospective cohort study, using a target trial emulation framework, we examined a nationwide cohort of 3,562,882 US Veterans with normal kidney function enrolled between October 2004 and September 2006 and identified 247,270 incident CKD patients eligible for de novo LLT exposure, occurring during longitudinal follow-up until October 2019. We defined de novo LLT initiation using pharmacy dispensation data and followed patients for up to 1 year. We compared the intraindividual slopes of HDL-C levels in de novo fibrates and niacin users with those in statin users, using mixed-effects models adjusted for baseline and time-varying covariates. We also compared the odds of having a clinically meaningful (>10% from baseline) increase in HDL-C following LLT initiation.</p><p><strong>Results: </strong>A total of 38,223 patients with incident CKD initiated de novo LLT (statin [n = 35,284], fibrate [n = 1,805], and niacin [n = 1,134]). The mean (standard deviation) age was 67.3 (10.5) years; 95.0% were men, and 20.6% were Black. Compared to statin users, the multivariable-adjusted annualized intraindividual increase of HDL-C was significantly higher following fibrate {1.15 mg/dL/year (95% confidence interval [CI]: 0.43, 1.87); p = 0.002} and niacin monotherapy (2.51 mg/dL/year [95% CI: 1.62, 3.41]; p < 0.001). Furthermore, niacin (OR: 1.37 [95% CI: 1.07, 1.75]; p = 0.012) was more likely than statins to provide a clinically meaningful elevation in HDL-C. Our findings were consistent in several sensitivity analyses.</p><p><strong>Conclusion: </strong>Among patients with NDD-CKD, de novo prescriptions of fibrates or niacin are associated with a greater increase in HDL-C levels compared to statins. Further studies are warranted to investigate whether such differences have meaningful effects on clinical outcomes.</p>","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"498-512"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147317379","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":"Living Kidney Donation: An Update.","authors":"Ana González Rinne, Anna Manonelles, Carla Burballa, Esther González Monte","doi":"10.1159/000551271","DOIUrl":"10.1159/000551271","url":null,"abstract":"<p><strong>Background: </strong>Living donor kidney transplantation offers superior long-term outcomes compared to deceased donor transplantation. However, ensuring long-term donor safety remains the primary objective of the clinical assessment process. Pre-donation risk evaluation can be challenging, particularly in specific borderline scenarios where evidence is limited.</p><p><strong>Summary: </strong>This review explores several critical aspects of the decision-making process in living kidney donor (LKD) assessment. It addresses how to evaluate potential donors with complex medical or psychosocial profiles, including those with obesity, advanced age, psychiatric histories, or past substance use. The review also emphasizes the importance of using accurate and reliable tools for donor evaluation, such as measured glomerular filtration rate, particularly in cases with borderline kidney function, and discusses the growing role of genetic testing as it becomes more accessible. Furthermore, it considers how socioeconomic, cultural, and religious factors can influence both the willingness to donate and the likelihood of being selected as a donor. Lastly, the review underscores the essential role of long-term follow-up in safeguarding donor health and optimizing outcomes.</p><p><strong>Key messages: </strong>To safely expand the pool of eligible LKDs, it is essential to use precise evaluation tools, ensure and enable long-term follow-up, and promote research to improve risk stratification and guide decision-making. In this review, we update information in the evaluation of LKDs highlighting gaps in current knowledge and practice.</p>","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"469-481"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147348611","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":"Proliferative Glomerulonephritis with Monoclonal Immunoglobulin Deposits with Severe Acute Kidney Injury Successfully Managed by Clone-Directed Therapy: A Case Report.","authors":"Shohei Maekawa, Shinya Yamamoto, Tatsuaki Kosaka, Hisashi Kamido, Yasuyuki Arai, Yayoi Ogawa, Naoka Murakami, Yuki Teramoto, Motoko Yanagita","doi":"10.1159/000552029","DOIUrl":"10.1159/000552029","url":null,"abstract":"<p><p><p>Introduction: Proliferative glomerulonephritis with monoclonal immunoglobulin deposits (PGNMID) is a form of monoclonal gammopathy of renal significance, characterized by kidney injury caused by monoclonal immunoglobulin deposition in the glomeruli. While detectable clones are only found in 20-30% of PGNMID, plasma cell- or B-cell-targeting therapies are suggested to be effective. Recent case reports suggested immune dysregulation, such as viral infections or vaccinations, could potentially trigger the onset or relapse of PGNMID. Here, we report a case of PGNMID without detectable clones, which relapsed after viral enteritis, presenting with severe acute kidney injury (AKI) and nephrotic syndrome. Case Presentation: A 60-year-old man, originally diagnosed with IgG3 lambda type PGNMID with nephrotic syndrome (urine protein/creatinine ratio (UPCR) of 5.3 g/gCr), was treated with non-clone-directed therapeutic regimens, including glucocorticoids. The patient initially achieved a partial response with a UPCR of 1-3 g/gCr and negative microhematuria. Approximately 2 years later, the patient presented with severe AKI (Cr 11.0 mg/dL) requiring dialysis, and nephrotic syndrome (UPCR 5.5 g/gCr, and serum albumin 2.4 g/dL) after having had viral enteritis. Second kidney biopsy confirmed a similar pattern of injury consistent with PGNMID with IgG3 lambda deposition, severe endocapillary inflammation, mesangial expansion, and remarkable narrowing of the glomerular capillary lumina. As it was refractory to glucocorticoid pulse therapy, clone-directed therapies with daratumumab and bortezomib were initiated. This intervention resulted in the cessation of dialysis and an improvement in urinary parameters. Conclusion: Clinicians should recognize that severe AKI may develop during the course of PGNMID, potentially triggered by infections. Furthermore, this case highlights the efficacy of clone-directed therapy with daratumumab and bortezomib in treating recurrent PGNMID without detectable clones. </p>.</p>","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"599-607"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13286475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147717349","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":"Kidney Health for All: Caring for People, Protecting the Planet.","authors":"Raymond Vanholder, Dina Abdellatif, Augusto Cesar Soares Dos Santos, Ricardo Correa-Rotter, Natarajan Gopalakrishnan, Bill Wang, Stefanos Roumeliotis, Alessandro Balducci, Ágnes Haris, Manjusha Yadla, Li-Li Hsiao","doi":"10.1159/000552619","DOIUrl":"10.1159/000552619","url":null,"abstract":"","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"695-706"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147988269","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":"Differential Diagnosis of Thrombotic Microangiopathy: Overlapping Features of Thrombotic Thrombocytopenic Purpura and Complement-Mediated Thrombotic Microangiopathy in a Dengue-Infected Patient.","authors":"Gabriel Sartori Pacini, Renato George Eick, Renata Asnis Schuchmann, Mário Sergio Fernandes, Lucas Gobetti da Luz, Illan George Balestrin, Karla Lais Pêgas, Milton Kalil, Maurício Lutzky","doi":"10.1159/000547796","DOIUrl":"10.1159/000547796","url":null,"abstract":"<p><strong>Background: </strong>Thrombotic microangiopathy (TMA) encompasses a group of rare, life-threatening disorders characterized by microangiopathic hemolytic anemia, thrombocytopenia, and organ damage, most commonly affecting the kidneys. Complement-mediated TMA (CM-TMA), a subtype of TMA, is often associated with dysregulation of the complement system due to genetic mutations. Dengue virus has been recognized as a potential trigger of secondary TMA and may precipitate CM-TMA in genetically predisposed individuals.</p><p><strong>Case presentation: </strong>We report the case of a 47-year-old woman with a history of thrombotic thrombocytopenic purpura (TTP) who presented with fever, gastrointestinal symptoms, anemia, thrombocytopenia, and acute kidney injury. Dengue infection was confirmed by a positive NS1 antigen. Laboratory and peripheral smear findings indicated TMA. Therapeutic plasma exchange was started due to previous history of TTP, with partial clinical response. ADAMTS13 activity was preserved at 60.7%. Kidney biopsy demonstrated features of TMA. Genetic testing identified a heterozygous pathogenic variant in the CD46 gene, supporting the diagnosis of CM-TMA. Notably, the patient showed sustained clinical improvement without the use of eculizumab.</p><p><strong>Conclusion: </strong>This case illustrates the diagnostic challenges of TMA in patients with overlapping clinical features and potential infectious triggers. In dengue-endemic regions, the virus should be recognized as a possible precipitating factor for TMA, particularly in individuals harboring complement gene mutations. A multidisciplinary approach - integrating clinical, laboratory, histopathological, and genetic data - is essential for accurate diagnosis and personalized management of TMA syndromes.</p>","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"41-46"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144775858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Monocyte-Lymphocyte Ratio with Cardiovascular Events and All-Cause Mortality in Patients Undergoing Hemodialysis: A Prospective Cohort Study.","authors":"Yamini Mallisetty, Ahmed Kabeil, Cameron Jackson Bergeron, Zhongji Han, Chi-Yang Chiu, Csaba P Kovesdy, Keiichi Sumida","doi":"10.1159/000549074","DOIUrl":"10.1159/000549074","url":null,"abstract":"<p><strong>Introduction: </strong>Elevated monocyte to lymphocyte ratio (MLR) represents a pro-inflammatory immune microenvironment and has been associated with poor clinical outcomes such as cardiovascular disease. However, little is known about its association with outcomes among patients on hemodialysis.</p><p><strong>Methods: </strong>In a nationwide prospective cohort of 952 patients receiving maintenance hemodialysis from 2011-2013, we examined the association of baseline MLR with subsequent risk of cardiovascular events (cardiovascular-related hospitalization and cardiovascular death) and all-cause mortality, using multivariable Cox proportional-hazards models with adjustment for potential confounders. We also examined the mediation effect of inflammatory markers on the association between MLR and cardiovascular events and all-cause mortality, respectively.</p><p><strong>Results: </strong>Overall, patients were 60.1 ± 13.4 years old; 53.3% were male; 39.7% were African American; and 56.9% were diabetic. The median dialysis vintage was 3.1 years. During a median follow-up of 2.1 years, 184 and 207 cases experienced cardiovascular events and all-cause death, respectively. A higher MLR was incrementally associated with higher risk of cardiovascular events and all-cause mortality. The multivariable-adjusted hazard ratios (95% confidence interval) of cardiovascular events and all-cause mortality for 0.1-unit increase in MLR were 1.22 (1.09-1.37) and 1.18 (1.07-1.30), respectively. There was a modest but significant mediation effect of plasma interleukin-6 (IL-6) on the association between MLR and cardiovascular events (28.2%) and all-cause mortality (24.1%).</p><p><strong>Conclusion: </strong>A higher MLR was independently associated with higher risk of cardiovascular events and all-cause mortality in patients on hemodialysis. Our findings suggest the potential of MLR as a simple, cost-effective prognostic biomarker and support IL-6-targeted therapeutic interventions to improve clinical outcomes in patients with ESKD.</p>","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"76-86"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318518","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":"Outcomes and Decision Stability in Older Adults following Structured Counseling on Dialysis versus Conservative Management for Kidney Failure: A Prospective Study.","authors":"Juan Santacruz, Gloria Del Peso, Helena García-Llana, Marta Ossorio, Ana Castillo, María Auxiliadora Bajo, Rafael Sánchez-Villanueva, Alberto Alonso-Babarro","doi":"10.1159/000548248","DOIUrl":"10.1159/000548248","url":null,"abstract":"<p><strong>Background: </strong>The management of kidney failure in older adults has increasingly adopted patient-centered approaches, with conservative kidney management (CKM) recognized as a valid alternative to dialysis in selected cases. Structured counseling is commonly used to support informed decision-making and align treatment with patient goals. However, evidence on its structured application and impact on treatment decisions in this population remains limited. This study evaluates the clinical characteristics, treatment choices, decision stability, and outcomes of older adults with kidney failure who, after a structured counseling session (\"Welcome Meeting\") at La Paz University Hospital, chose either CKM or dialysis.</p><p><strong>Methods: </strong>This prospective, observational, single-center cohort study (April 2015 to December 2019) included participants aged >75 years with CKD-EPI <12 mL/min (<15 mL/min for those with diabetes), Charlson Comorbidity Index >5, and functional impairment (Barthel Index <95 or Palliative Performance Scale <60). All participants received a structured counseling session to support treatment decision-making. Participants then chose either dialysis or CKM. Predictors included treatment choice, clinical outcomes, symptom burden, and healthcare utilization. Decision stability was defined as sustained adherence to the initial treatment choice over the course of follow-up. Analyses were adjusted for potential confounders including age, sex, comorbidity, and functional status. Data were analyzed using SPSS version 27.</p><p><strong>Results: </strong>A total of 103 participants were included (mean age: 84.9 ± 5.5 years); 72% chose CKM and 28% opted for dialysis. CKM participants were older, more often female (p = 0.009), and had greater functional and cognitive impairment (p < 0.001). They also reported more weakness or lack of energy (p = 0.03), constipation (p = 0.03), and poor mobility (p < 0.001) at baseline. At the standardized follow-up assessment, depressive symptoms measured with the IPOS-Renal scale showed a significant reduction in the dialysis group (p = 0.043), while vomiting (p = 0.021) and sore or dry mouth (p = 0.049) increased significantly in the CKM group. Healthcare utilization was higher among dialysis participants. Of the 69 deaths, 65 occurred in the CKM group. Decision stability revealed only 5% of CKM participants switching later to dialysis, with no treatment transitions observed in the dialysis group.</p><p><strong>Conclusion: </strong>After a structured counseling session, elderly kidney failure participants who chose CKM were older, female, and presented greater cognitive and functional impairment. This approach supported informed choices and was associated with a high adherence to the initial treatment decision. Further studies are needed to expand this line of research.</p>","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"300-311"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145605103","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 Relationship of Dietary Inflammatory Index with Anemia in Diabetic Kidney Disease: A Cross-Sectional Study of the NHANES.","authors":"Liyin Guo, Tian Wang","doi":"10.1159/000547798","DOIUrl":"10.1159/000547798","url":null,"abstract":"<p><strong>Introduction: </strong>This study examined the relationship between the dietary inflammatory index (DII) and anemia in patients with diabetic kidney disease (DKD).</p><p><strong>Methods: </strong>All the data were obtained from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2018. The final analysis included 1918 DKD patients, with 500 experiencing anemia. Weighted multivariate logistic regression models were used to assess the association between DII and anemia, with results expressed as odds ratios.</p><p><strong>Results: </strong>Elevated DII scores correlated with an increased incidence of anemia (OR = 1.13, 95% CI: 1.02-1.25). When analyzed as categorical variables, DII scores of 1.57-2.64 (OR = 1.77, 95% CI: 1.13-2.77) and >2.64 (OR = 1.78, 95% CI: 1.12-2.85) were linked to higher anemia risk. Subgroup analyses revealed consistent associations in individuals aged 65 and older (OR = 1.92, 95% CI: 1.16-3.17), those with serum iron levels <73 μg/dL (OR = 2.01, 95% CI: 1.11-3.62), and males (OR = 2.23, 95% CI: 1.21-4.11). Higher DII scores correlated with greater odds of moderate-severe anemia (OR = 1.22, 95% CI: 1.07-1.38).</p><p><strong>Conclusion: </strong>The results indicate that elevated DII scores are associated with an increased occurrence of anemia in DKD patients, emphasizing the importance of lowering pro-inflammatory food consumption as a potential strategy to prevent anemia in this group.</p>","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"52-62"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144962187","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":"9th Update on Fabry Disease.","authors":"David Warnock, Fabian Braun","doi":"10.1159/000552874","DOIUrl":"10.1159/000552874","url":null,"abstract":"","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"1-100"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148163824","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":"A Service Evaluation of Anti-Xa Measurements in Patients with Kidney Impairment in a Tertiary Centre.","authors":"Gerard Gurumurthy, Robyn Haysom, Mikias Lemma, Nadir Aziz, John Hartemink, Yasmin Begum, Jecko Thachil, Kathrine Parker","doi":"10.1159/000551515","DOIUrl":"10.1159/000551515","url":null,"abstract":"<p><p><p>Background: Pre-emptive dose reduction of low-molecular-weight heparins (LMWHs) is often utilised in those with chronic kidney disease (CKD) to prevent bioaccumulation. We report on the association of a pre-emptive dose reduction on anti-Xa range and its correlation with clinical outcomes.</p><p><strong>Methods: </strong>We undertook a retrospective service evaluation of patients with CKD (eGFR < 30 mL/min/1.73 m2) receiving therapeutic dose dalteparin. The primary exposure was dalteparin anti-Xa trough and peak. Primary outcomes were ISTH-defined clinically relevant bleeding, thrombosis, and all-cause mortality within 90 days of LMWH initiation. A multivariate Cox proportional hazards model was employed to assess the relationship between anti-Xa levels and the incidence of bleeding and mortality.</p><p><strong>Results: </strong>A total of 103 patients were identified over a 2-year period. Seventy-eight (75.7%) had anti-Xa monitoring done. Trough anti-Xa distribution was within-target in 58 (75.6%). Patients on dialysis had a higher incidence of bleeding (19 vs. 12, p < 0.05). Patients with bleeding had significantly higher median anti-Xa trough (0.26 vs. 0.13 U/mL, p < 0.01). The median time to bioaccumulation was 19 days. In multivariate Cox models, only anti-Xa trough remained an independent association with bleeding (HR: 1.47 per 0.1 U/mL, 95% CI: 1.05-2.15; p < 0.05). No associations with mortality were identified.</p><p><strong>Conclusion: </strong>In this report, trough anti-Xa measurement of dalteparin is independently associated with bleeding in patients with CKD. Further prospective, larger studies are warranted to validate these results before it can be universally recommended in clinical practice. </p>.</p>","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"525-532"},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13200832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147434434","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}