Nephron最新文献

{"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":"384-391"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","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":"A Case of IgG4-Related Disease Manifesting as Extensive Abdominal Periarteritis and Membranous Nephropathy, Successfully Controlled with Low-Dose Steroid Therapy without Relapse or Complications.","authors":"Minami Matsumoto, Shinya Yamamoto, Hideki Yokoi, Sho Koyasu, Shigeo Hara, Takahiro Tsuji, Minamiguchi Sachiko, Motoko Yanagita","doi":"10.1159/000542414","DOIUrl":"10.1159/000542414","url":null,"abstract":"<p><strong>Introduction: </strong>IgG4-related disease (IgG4-RD) is an immune-mediated fibroinflammatory disease that can affect nearly every organ system, including blood vessels and the kidney. IgG4-related vascular lesions mainly involve the aorta, and the dominant renal manifestation is tubulointerstitial nephritis (TIN). Here, we report a case of IgG4-RD demonstrating extensive abdominal periarteritis and membranous nephropathy (MN).</p><p><strong>Case presentation: </strong>The patient was a 71-year-old man with peptic ulcer who developed nephrotic syndrome, with a low serum albumin level (1.8 g/dL), massive urinary protein (6.1 g/day), and high serum IgG4 level (435 mg/dL). Computed tomography images revealed soft tissue mass around the medium-sized abdominal arteries. Renal pathological findings showed MN and focal infiltration of numerous IgG4-positive cells in the interstitium. The findings of high serum IgG4 levels, periarteritis, and focal inflammation with rich IgG4-positive plasma cells led to the diagnosis of IgG4-RD. We chose low-dose steroid therapy to prevent the recurrence of the peptic ulcer and aneurysm formation in the affected arteries, which can occur with medium to high doses of prednisolone. We successfully controlled IgG4-related periarteritis and kidney disease without relapse or complications.</p><p><strong>Conclusion: </strong>The varied clinical manifestations of IgG4-RD sometimes make the diagnosis challenging. However, clinicians should diagnose IgG4-RD based on serological, radiological, and pathological evaluations because, without appropriate therapy, IgG4-RD can lead to irreversible organ failure caused by swelling, obstruction, or fibrosis of the organs.</p>","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"213-221"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11991716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576460","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":"Urine miR-340-5p Predicts the Adverse Prognosis of Sepsis-Associated Acute Kidney Injury and Regulates Renal Tubular Epithelial Cell Injury by Targeting KDM4C.","authors":"Mengmeng Pu, Huanhuan Zhao, Silei Xu, Xiaohui Gu, Qiang Feng, Peng Huang","doi":"10.1159/000541348","DOIUrl":"10.1159/000541348","url":null,"abstract":"<p><strong>Introduction: </strong>Sepsis-associated acute kidney injury (SA-AKI) is a common complication of sepsis. miR-340-5p has been identified as an effective biomarker of various human diseases. As the downstream target, the involvement of lysine (K)-specific demethylase 4C (KDM4C) in SA-AKI would help interpret the regulatory mechanism of miR-340-5p. The significance of miR-340-5p in the onset and progression of SA-AKI was evaluated to provide a potential therapeutic target for SA-AKI.</p><p><strong>Methods: </strong>This study enrolled 64 healthy individuals (control) and 159 sepsis patients (92 SA-AKI and 67 non-AKI) and collected urine samples. The urine level of miR-340-5p was analyzed by PCR, and a series of statistical analyses were conducted to assess the clinical significance of miR-340-5p in the occurrence and development of SA-AKI. The injured renal tubular epithelial cells were established with LPS induction. The roles of miR-340-5p in cellular processes were evaluated.</p><p><strong>Results: </strong>Increasing urine miR-340-5p discriminated SA-AKI patients from healthy individuals (AUC = 0.934) and non-AKI sepsis patients (AUC = 0.806) sensitively. Additionally, elevated miR-340-5p could predict the adverse prognosis (HR = 5.128, 95% CI = 1.259-20.892) and malignant development of SA-AKI patients. In vitro, lipopolysaccharide (LPS) also induced an increased level of miR-340-5p and significant cell injury in the renal tubular epithelial cell; silencing miR-340-5p could alleviate the suppressed proliferation, migration, and invasion caused by LPS. In mechanism, miR-340-5p negatively regulated KDM4C, which mediated the function of miR-340-5p.</p><p><strong>Conclusion: </strong>miR-340-5p served as a diagnostic and prognostic biomarker of SA-AKI and regulated renal tubular epithelial cell injury via modulating KDM4C.</p>","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"197-206"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142648456","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 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":"283-287"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","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}

{"title":"Sodium Retention in Liver Disease: Is ENaC Activation Independent of the Renin-Angiotensin-Aldosterone System a Therapeutic Target?","authors":"Daniel Batlle, Mohammed Z Rehman, Thomas Brannon, Robert Rosa","doi":"10.1159/000542883","DOIUrl":"10.1159/000542883","url":null,"abstract":"","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"222-225"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770684","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":"Chronic Kidney Disease in Diabetes: Is Fish Oil the Answer?","authors":"Luigi Gnudi","doi":"10.1159/000543588","DOIUrl":"10.1159/000543588","url":null,"abstract":"","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"358-363"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12136524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143008760","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":"Care Needs of Adults on Peritoneal Dialysis and Their Informal Caregiver: A Qualitative Study.","authors":"Marta Aramini, Corina Elena Luca, Monica Bianchi, Antonio Bellasi, Giovanna Pezzoli, Pietro Cippà, Loris Bonetti, Antonio Bellasi","doi":"10.1159/000546175","DOIUrl":"10.1159/000546175","url":null,"abstract":"<p><p><p>Introduction: Peritoneal dialysis (PD) provides a sense of control, independence, freedom, and self-efficacy. However, it can also impact a patient's physical, psychological, and social well-being, affecting both patients and family members. This study aimed to investigate the experiences and needs of adults on PD and their informal caregivers to understand how a person-centred approach can improve the response to their needs.</p><p><strong>Methods: </strong>This is a generic descriptive qualitative research study. Data were collected through semi-structured interviews, transcribed, and analysed using Braun and Clarke's thematic analysis and NVivo® software. The data of patients and caregivers were triangulated to better understand their needs.</p><p><strong>Results: </strong>Twelve patients and four informal caregivers were interviewed. We identified five macro-themes: \"living with kidney disease and PD and its needs,\" \"preparation before initiating PD and its needs,\" \"learning about PD and its needs,\" \"impact of dialysis on the need of the patients and caregivers,\" and \"experiences with the care team.\" The pre-dialysis period is crucial, with specific needs for information, education, shared decision-making, and support during the various psychological, physical, and organisational changes in treatment and the disease trajectory. Caregivers' roles are essential and should always be included in the care path.</p><p><strong>Conclusion: </strong>This study emphasises the importance of continuity in care for patients with their care team and how delicate and important the pre-dialysis phase is for informed and shared decision-making regarding kidney replacement treatment. This understanding can help ensure a more person-centred care approach. </p>.</p>","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"558-568"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12169801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034231","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":"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}

{"title":"Advances in Molecular Imaging of Kidney Diseases.","authors":"Barbara Mara Klinkhammer, Ilknur Ay, Peter Caravan, Anna Caroli, Peter Boor","doi":"10.1159/000542412","DOIUrl":"10.1159/000542412","url":null,"abstract":"<p><strong>Background: </strong>Diagnosing and monitoring kidney diseases traditionally rely on blood and urine analyses and invasive procedures such as kidney biopsies, the latter offering limited possibilities for longitudinal monitoring and a comprehensive understanding of disease dynamics. Current noninvasive methods lack specificity in capturing intrarenal molecular processes, hindering patient stratification and patient monitoring in clinical practice and clinical trials.</p><p><strong>Summary: </strong>Molecular imaging enables noninvasive and quantitative assessment of physiological and pathological molecular processes. By using specific molecular probes and imaging technologies, e.g., magnetic resonance imaging, positron emission tomography, single-photon emission computed tomography, or ultrasound, molecular imaging allows the detection and longitudinal monitoring of disease activity with spatial and temporal resolution of different kidney diseases and disease-specific pathways. Several approaches have already shown promising results in kidneys and exploratory clinical studies, and validation is needed before implementation in clinical practice.</p><p><strong>Key messages: </strong>Molecular imaging offers a noninvasive assessment of intrarenal molecular processes, overcoming the limitations of current diagnostic methods. It has the potential to serve as companion diagnostics, not only in clinical trials, aiding in patient stratification and treatment response assessment. By guiding therapeutic interventions, molecular imaging might contribute to the development of targeted therapies for kidney diseases.</p>","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"149-159"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576465","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":"Characteristics of Successful Percutaneous Transluminal Renal Angioplasty Cases with Severely Impaired Kidney Function Caused by Bilateral Atherosclerotic Stenosis: A Case Series.","authors":"Hisashi Sugimoto, Shinya Yamamoto, Motoko Yanagita","doi":"10.1159/000542416","DOIUrl":"10.1159/000542416","url":null,"abstract":"<p><strong>Introduction: </strong>Previous randomized controlled trials have not demonstrated the benefits of renal artery stenting with respect to kidney function. However, these trials did not focus on patients with severely impaired kidney function caused by severe bilateral stenosis. Therefore, the efficacy of stenting in such patients remains unclear.</p><p><strong>Case presentation: </strong>We report 4 cases of successful percutaneous transluminal renal angioplasty (PTRA) with severely impaired kidney function with rapid decline caused by bilateral atherosclerotic stenosis. The catheterization before irreversible parenchymal damages was useful in improving kidney function dramatically in these cases of severe bilateral renal artery stenosis. Furthermore, we examined the clinical characteristics of the 4 cases to identify the potential predictors of PTRA effectiveness. Notably, bilateral renal artery >90% stenosis, elevated plasma renin activity, estimated glomerular filtration rate <15 mL/min/1.73 m2 with an accelerated decline within 6 months before PTRA (>50 mL/min/1.73 m2/6 months), and resistance index (RI) <0.7 were identified as common findings.</p><p><strong>Conclusion: </strong>PTRA should be considered a treatment strategy for patients with these features to preserve kidney function and avoid dialysis therapy.</p><p><strong>Introduction: </strong>Previous randomized controlled trials have not demonstrated the benefits of renal artery stenting with respect to kidney function. However, these trials did not focus on patients with severely impaired kidney function caused by severe bilateral stenosis. Therefore, the efficacy of stenting in such patients remains unclear.</p><p><strong>Case presentation: </strong>We report 4 cases of successful percutaneous transluminal renal angioplasty (PTRA) with severely impaired kidney function with rapid decline caused by bilateral atherosclerotic stenosis. The catheterization before irreversible parenchymal damages was useful in improving kidney function dramatically in these cases of severe bilateral renal artery stenosis. Furthermore, we examined the clinical characteristics of the 4 cases to identify the potential predictors of PTRA effectiveness. Notably, bilateral renal artery >90% stenosis, elevated plasma renin activity, estimated glomerular filtration rate <15 mL/min/1.73 m2 with an accelerated decline within 6 months before PTRA (>50 mL/min/1.73 m2/6 months), and resistance index (RI) <0.7 were identified as common findings.</p><p><strong>Conclusion: </strong>PTRA should be considered a treatment strategy for patients with these features to preserve kidney function and avoid dialysis therapy.</p>","PeriodicalId":18998,"journal":{"name":"Nephron","volume":" ","pages":"160-165"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576472","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}