Nephrology Dialysis Transplantation最新文献

{"title":"Dietary vitamin E and tocopherol isoform intake and the progression of chronic kidney disease.","authors":"Yanjun Zhang, Ziliang Ye, Yuanyuan Zhang, Sisi Yang, Xiaoqin Gan, Yu Huang, Hao Xiang, Yiting Wu, Yiwei Zhang, Xianhui Qin","doi":"10.1093/ndt/gfaf052","DOIUrl":"10.1093/ndt/gfaf052","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>It is unclear whether dietary vitamin E and tocopherol isoform intake is associated with health outcomes in patients with chronic kidney disease (CKD). We hypothesize that different dietary tocopherol isoforms have different health effects in people with CKD. Therefore, we aimed to investigate the association between dietary vitamin E and tocopherol isoforms and risks of CKD progression and all-cause mortality in patients with CKD.</p><p><strong>Methods: </strong>In this prospective cohort study, 3791 participants with CKD in the Chronic Renal Insufficiency Cohort (CRIC) were included. The main exposures included dietary vitamin E and tocopherol isoforms, which were estimated by the validated Diet History Questionnaire at baseline, Year 2 and Year 4 before the study outcome was diagnosed. The primary outcome was CKD progression, defined as a 50% decline in the estimated glomerular filtration rate from baseline or initiation of kidney replacement therapy. The secondary outcome was all-cause mortality.</p><p><strong>Results: </strong>During a median follow-up of 5.5 years, 1188 (31.3%) CKD progression events occurred. There was an L-shaped relationship between total vitamin E intake and risks of CKD progression and all-cause mortality. Regarding dietary tocopherol isoforms, there was an L-shaped relationship of dietary beta-tocopherol with risks of CKD progression and all-cause mortality, a reversed J-shaped relationship between dietary gamma-tocopherol and the risk of CKD progression and a U-shaped association between dietary delta-tocopherol and the risk of CKD progression. There was no significant association between dietary alpha-tocopherol and risks of CKD progression and all-cause mortality.</p><p><strong>Conclusions: </strong>There was an L-shaped association between total vitamin E and CKD progression in patients with CKD. Different dietary tocopherol isoforms have different relationships with CKD progression in patients with CKD, which included an L-shaped association for beta-tocopherol, a reversed J-shaped association for gamma-tocopherol, a U-shaped association for delta-tocopherol and a non-significant association for alpha-tocopherol.</p>","PeriodicalId":19078,"journal":{"name":"Nephrology Dialysis Transplantation","volume":" ","pages":"1854-1864"},"PeriodicalIF":5.6,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143575873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex-specific cardiac dysfunction in mice with chronic kidney disease.","authors":"Yitong Zhao, Karen Yang, Christy M Nguyen, Hongmei Wu, Han Liu, Leandro M Velez, Jin Kyung Kim, Marcus Seldin, Wei Ling Lau","doi":"10.1093/ndt/gfaf056","DOIUrl":"10.1093/ndt/gfaf056","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular disease (CVD) is the leading cause of death among patients with chronic kidney disease (CKD). Rodent models are widely used to study uremic CVD pathophysiology. We compared cardiac function parameters in male and female animals from two established mouse CKD models and examined associations between gut-derived uremic toxins and echocardiogram findings.</p><p><strong>Methods: </strong>Male and female adult C57Bl/6J mice were randomly assigned to control, adenine-induced CKD and 5/6 nephrectomy CKD groups. Echocardiography was performed on all mice at age 17 weeks (5 weeks after CKD induction). Serum creatinine, cystatin C and gut-derived uremic toxins were analyzed at study termination, and RNA sequencing of left ventricle tissue was performed and analyzed.</p><p><strong>Results: </strong>Markers of kidney dysfunction were elevated in both CKD models. The gut-derived uremic toxin indoxyl sulfate was increased in both CKD models, while trimethylamine N-oxide was increased in adenine CKD mice and p-cresyl sulfate in nephrectomy animals. Left ventricular volume was increased in nephrectomy animals. Cardiac output was decreased in male CKD animals from both models compared with controls, and ejection fraction was decreased in male 5/6 nephrectomy mice. Female controls had lower stroke volume and cardiac output than male counterparts, and female CKD animals had preserved cardiac output and ejection fraction when compared with female controls. The gut-derived uremic toxins trimethylamine N-oxide and indoxyl sulfate correlated with decreased cardiac output in male animals. Transcriptomics of cardiac tissue revealed sex-based variations in matrix metalloproteinase and mitochondrial pathways associated with cardiac dysfunction.</p><p><strong>Conclusions: </strong>Our work highlights sex differences in cardiac function and serum chemistries in two established preclinical CKD models. Gut-derived uremic toxins may impact cardiorenal pathophysiology and low cardiac output in male CKD animals.</p>","PeriodicalId":19078,"journal":{"name":"Nephrology Dialysis Transplantation","volume":" ","pages":"1865-1875"},"PeriodicalIF":5.6,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Matrix metalloproteinase (MMP)-10 aggravates podocyte injury in glomerulonephritis.","authors":"Takuya Ishimura, Keisuke Osaki, Sayaka Sugioka, Akira Ishii, Hiroyuki Yamada, Naohiro Toda, Shoko Ohno, Yukiko Kato, Taiji Matsusaka, Takeshi Tokudome, Motoko Yanagita, Hideki Yokoi","doi":"10.1093/ndt/gfaf076","DOIUrl":"10.1093/ndt/gfaf076","url":null,"abstract":"<p><strong>Background: </strong>Podocytes are integral to maintaining glomerular filtration barrier. Our previous research underscored the crucial role of podocyte guanylyl cyclase-A (GC-A) in the pathogenesis of severe albuminuria in both systemic and podocyte-specific GC-A knockout mice subjected to heminephrectomy, high salt, and aldosterone (ALDO) treatment. This study investigates the role of matrix metalloproteinase-10 (MMP-10) on glomerular injury, which was found to be highly expressed in glomeruli of ALDO-treated GC-A knockout mice.</p><p><strong>Methods: </strong>To investigate the role of MMP-10 in glomerulonephritis, we used MMP-10 knockout mice subjected to anti-glomerular basement membrane (GBM) nephritis. Additionally, we created systemic GC-A and MMP-10 double knockout mice, as well as podocyte-specific GC-A and systemic MMP-10 double knockout mice, to analyze glomerular injury. In vitro, changes in inflammatory mRNA are examined in MMP-10-overexpressing or -knockdown mouse podocytes following stimulation of tumor necrosis factor (TNF)-α.</p><p><strong>Results: </strong>We demonstrate that MMP-10 is highly expressed in the kidneys of patients with glomerulonephritis. MMP-10 knockout mice showed less albuminuria and lower expression of pro-inflammatory and pro-fibrotic mRNAs compared to control mice in anti-GBM nephritis. Additionally, systemic or podocyte-specific GC-A and systemic MMP-10 knockout mice exhibited improved albuminuria, preserved nephrin expression, and reduced GBM thickening compared to systemic or podocyte-specific GC-A knockout mice with ALDO treatment. MMP-10 was co-localized with podocytes and endothelial cells. In vitro studies using mouse podocytes revealed that MMP-10 overexpression upregulated inflammatory mRNA changes induced by TNF-α, whereas MMP-10 knockdown mitigated inflammation. Co-culture of mouse podocytes with human endothelial cells showed reduced inflammation following MMP-10 reduction in endothelial cells. Moreover, activated MMP-10 cleaved nephrin in vitro, contributing to podocyte injury.</p><p><strong>Conclusion: </strong>These findings suggest that GC-A ablation leads to upregulation of MMP-10, resulting in nephrin loss, and that systemic deletion of MMP-10 ameliorates GC-A-induced podocyte injury.</p>","PeriodicalId":19078,"journal":{"name":"Nephrology Dialysis Transplantation","volume":" ","pages":"1961-1976"},"PeriodicalIF":5.6,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143982204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How to individualize renoprotective therapy in obese patients with chronic kidney disease: a commentary by the Diabesity Working Group of the ERA.","authors":"Enrique Morales, William P Martin, Sebastjan Bevc, Trond G Jenssen, Marius Miglinas, Matias Trillini","doi":"10.1093/ndt/gfaf069","DOIUrl":"10.1093/ndt/gfaf069","url":null,"abstract":"<p><p>The interrelated pandemics of obesity and type 2 diabetes mellitus (T2DM) are fuelling an increase in the prevalence of chronic kidney disease (CKD), which amplifies the risk of cardiovascular events and may progress to end-stage kidney disease (ESKD). Treatment options for such patients have rapidly expanded over the past decade and continue to evolve. Herein, we primarily focus on glucagon-like peptide-1 receptor agonists (GLP-1RAs) and their role in the management of CKD in the setting of overweight/obesity and T2DM. Recommendations from the recent Kidney Disease: Improving Global Outcomes CKD guidelines are summarized and new evidence arising since publication of these guidelines is highlighted. We review clinical studies supporting the role of GLP-1RAs in patients with diabesity and CKD, including the FLOW trial, as well as exploring potential mechanisms of their nephroprotective effects. Their role in the management of patients with ESKD on maintenance dialysis and after kidney transplantation, while less evidence-based, is also discussed. The potential for other gut hormone-based therapies, including GLP-1/glucose-dependent insulinotropic polypeptide dual agonists (tirzepatide), triple agonists (incorporating glucagon agonism) and amylin analogues to improve cardiovascular and kidney outcomes in patients with CKD, is explored. We highlight the role of novel therapies distinct from the gut-kidney axis, including non-steroidal mineralocorticoid receptor antagonists (nsMRAs). We outline the potential for multitarget therapy incorporating renin-angiotensin-aldosterone system inhibitors, sodium-glucose co-transporter-2 inhibitors, incretin-based treatments and nsMRAs to improve cardiovascular and kidney outcomes in patients with overweight/obesity and T2DM. Current unknowns in the timing and sequence of multitarget therapy in patients with CKD are emphasized. Priority research questions for the future are highlighted throughout the review.</p>","PeriodicalId":19078,"journal":{"name":"Nephrology Dialysis Transplantation","volume":" ","pages":"1977-1988"},"PeriodicalIF":5.6,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SGLT2 inhibitors in CKD: are they really effective in all patients?","authors":"Paola Romagnani","doi":"10.1093/ndt/gfaf051","DOIUrl":"10.1093/ndt/gfaf051","url":null,"abstract":"<p><p>Sodium-glucose cotransporter 2 (SGLT2) inhibitors effectively slow chronic kidney disease (CKD) progression and reduce cardiovascular events. However, their efficacy across all CKD subgroups remains uncertain. Major clinical trials primarily included overweight or obese patients with advanced CKD, where sodium retention, volume expansion and glomerular hyperfiltration are key disease drivers. In contrast, many underrepresented CKD subgroups, such as Alport syndrome or most immune-mediated glomerular disorders, often affect lean individuals whose CKD progression is not linked to these mechanisms. Emerging evidence suggests that the renal benefits of SGLT2 inhibitors may depend on body mass index (BMI), with greater effects observed in patients with higher BMI, while those with BMI <25 may show minimal/no benefit. This raises concerns about their applicability in lean, non-diabetic CKD patients, whose disease progression may involve alternative pathways, such as inflammation, autoimmunity or genetic abnormalities. Animal studies further suggest that SGLT2 inhibitors provide limited renal protection in certain genetic and immune-mediated kidney diseases. Additionally, molecular data indicate that SGLT2 expression is predominantly restricted to the proximal tubule, implying a limited role in CKD driven by non-hyperfiltration mechanisms. While SGLT2 inhibitors have revolutionized CKD treatment in diabetes, obesity and heart failure, their role in lean, non-diabetic patients remains unclear. Dedicated clinical trials are needed to assess their efficacy in underrepresented CKD subgroups, including pediatric patients, and ensure evidence-based, personalized treatment strategies.</p>","PeriodicalId":19078,"journal":{"name":"Nephrology Dialysis Transplantation","volume":" ","pages":"1838-1842"},"PeriodicalIF":5.6,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143575912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Controlled access to lumasiran in primary hyperoxaluria type 1: evaluation of a new access route for orphan drugs in the Netherlands.","authors":"Lisa J Deesker, Casper F M Franssen, Eiske Dorresteijn, Nicole C A J van de Kar, S Azam Nurmohamed, David Severs, Sander F Garrelfs, Anke A M G Pisters-van Roy, Carla E M Hollak, Jaap W Groothoff","doi":"10.1093/ndt/gfaf060","DOIUrl":"10.1093/ndt/gfaf060","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>In search for controlled access to expensive innovative orphan drugs, a national access route called 'Orphan Drug Access Protocol' (ODAP) was developed and piloted with lumasiran, a new drug for patients with primary hyperoxaluria type 1 (PH1). Here, we present a 2-year evaluation of this pilot study.</p><p><strong>Methods: </strong>Specialists from the Dutch PH1 Expert Centre and the national ODAP steering group developed a protocol for controlled and conditional treatment of children and adults with PH1 with lumasiran. Indication for treatment is based on specific clinical characteristics. Cessation or continuation of therapy is evaluated every 6 months for 5 years by a national indication committee consisting of PH1 specialists, based on biochemical and clinical response. Drug wastage is minimized by centralizing and pooling patients for administration.</p><p><strong>Results: </strong>Between September 2022 and September 2024, 21 PH1 patients were reviewed and 76% were deemed eligible for lumasiran treatment. Ten patients were already receiving lumasiran through clinical trials or early access programs at time of assessment. The follow-up time with lumasiran was 0.1-6.6 years, including trial years. All patients with >1 year lumasiran treatment responded significantly biochemically and clinically. Details on outcomes are presented. Denials for lumasiran therapy were nearly all based on full pyridoxine responsiveness. All denied patients, except one, had good clinical outcomes. This patient received lumasiran after initial denial based on clinical and biochemical course. Patient selection and minimizing wastage saved approximately €3 227 065 per year based on the official list price.</p><p><strong>Conclusions: </strong>This national ODAP protocol enabled access to lumasiran therapy for severely ill patients, prevented unnecessary treatment in others, and provided new insights into the real-world effectiveness of lumasiran in PH1 patients through systematic monitoring. It may serve as a template for future access routes to new expensive therapeutics in orphan diseases.</p>","PeriodicalId":19078,"journal":{"name":"Nephrology Dialysis Transplantation","volume":" ","pages":"1887-1896"},"PeriodicalIF":5.6,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardio-kidney outcomes for combined versus monotherapy with finerenone or SGLT2 inhibitors in patients with CKD.","authors":"Min-Hsiang Chuang, Hsien-Yi Wang, Wei-Chih Kan, Chih-Chiang Chien, Ming-Yan Jiang, Yun-Ting Huang, Vin-Cent Wu, Jui-Yi Chen","doi":"10.1093/ndt/gfaf064","DOIUrl":"10.1093/ndt/gfaf064","url":null,"abstract":"<p><strong>Background: </strong>Sodium-glucose cotransporter 2 inhibitors (SGLT2i) and finerenone each improve kidney and cardiovascular outcomes in patients with chronic kidney disease (CKD). This study compares the association between combined therapy versus monotherapy with SGLT2i or finerenone and the kidney, cardiovascular and mortality outcomes in CKD patients.</p><p><strong>Methods: </strong>This retrospective cohort study included adults ≥18 years with CKD between 9 July 2021, and 30 November 2023 from multiple centers in the USA, utilizing the TriNetX database. Exposures included treatment with finerenone, SGLT2i or a combination of both. The primary outcome was major adverse kidney events (MAKE). Secondary outcomes included all-cause mortality, major adverse cardiac events (MACE) and end-stage renal disease (ESRD).</p><p><strong>Results: </strong>A total of 853 patients were included in the combined group [mean (±standard deviation) age, 66.7 ± 11.4 years; 34.9% female], 942 in the finerenone group (mean age, 68.2 ± 11.4 years; 45.8% female) and 45 948 in the SGLT2i group (mean age, 70.2 ± 11.8 years; 41.4% female). After matching, the combined group had less MAKE compared with finerenone monotherapy [adjusted hazard ratio (aHR) 0.20; 95% confidence interval (CI) 0.09-0.45] or SGLT2i monotherapy (aHR 0.44; 95% CI 0.22-0.89). The hazards of all-cause mortality and ESRD were also lower in the combined group compared with either finerenone or SGLT2i alone, while hazard of MACE was similar between the combined and monotherapy groups. The combined group had higher risk of hyperkalemia compared with SGLT2i monotherapy (aHR = 1.36; 95% CI 1.08-1.71).</p><p><strong>Conclusion: </strong>Combined therapy with finerenone and SGLT2i is associated with less MAKE and all-cause mortality in CKD patients compared with monotherapy. However, the risk of hyperkalemia with finerenone warrants caution.</p>","PeriodicalId":19078,"journal":{"name":"Nephrology Dialysis Transplantation","volume":" ","pages":"1897-1905"},"PeriodicalIF":5.6,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autologous hematopoietic stem cell transplantation for non-AL amyloidosis monoclonal gammopathy of renal significance.","authors":"Mengnan Liu, Liang Zhao, Jinzhou Guo, Wencui Chen, Xiaomei Wu, Weiwei Xu, Xianghua Huang","doi":"10.1093/ndt/gfaf036","DOIUrl":"10.1093/ndt/gfaf036","url":null,"abstract":"<p><strong>Background: </strong>The treatment strategy for non-immunoglobulin light chain (AL) amyloidosis monoclonal gammopathy of renal significance (MGRS) remains unstandardized. Autologous hematopoietic stem cell transplantation (ASCT) has shown favorable results in a limited number of studies.</p><p><strong>Methods: </strong>This single-center, retrospective case-control study included non-AL amyloidosis MGRS patients diagnosed between February 2012 and July 2024; these patients were divided into the ASCT group and non-ASCT group. Baseline characteristics, ASCT characteristics and complications, treatment responses, survival outcomes, and risk factors for progression-free survival (PFS) were analyzed.</p><p><strong>Results: </strong>A total of 53 patients with non-AL amyloidosis MGRS were enrolled in this study, comprising 23 patients who received ASCT and 30 patients who did not receive ASCT. The baseline characteristics were comparable between the ASCT and non-ASCT groups, with exceptions of serum albumin and C3 levels. The median overall survival (OS) and renal survival were not reached in either group. The median PFS was significantly longer in the ASCT group compared to the non-ASCT group (58.4 vs 16.4 months, P = .004). The overall response rate (ORR) and deep response rates of the ASCT group were higher than those of the non-ASCT group, both in hematological and renal responses. In the ASCT group, 18 patients (78.3%) achieved a hematological very good partial response (VGPR) or better, and 21 patients (91.3%) achieved a renal partial response or better after transplantation. Moreover, the ASCT group exhibited higher long-term cumulative incidences of OS and renal survival. The toxicity of ASCT was manageable, and no transplantation-related deaths occurred. There was no statistically significant difference in the median PFS between monoclonal immunoglobulin deposition disease and light chain proximal tubulopathy (P = .539). High serum albumin level at diagnosis, and hematological response ≥VGPR after ASCT were protective factors of PFS.</p><p><strong>Conclusions: </strong>This study confirmed that ASCT was an effective and safe treatment for patients with non-AL amyloidosis MGRS, thereby offering long-term hematological remission and survival benefits.</p>","PeriodicalId":19078,"journal":{"name":"Nephrology Dialysis Transplantation","volume":" ","pages":"1698-1706"},"PeriodicalIF":5.6,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real world data on dual BLyS/APRIL inhibition with telitacicept for lupus nephritis.","authors":"Jingjing Jin, Meng Tan, Ying Tan, Minghui Zhao","doi":"10.1093/ndt/gfaf049","DOIUrl":"10.1093/ndt/gfaf049","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate the efficacy and safety of telitacicept for the treatment of lupus nephritis (LN) in real-world clinical practice.</p><p><strong>Methods: </strong>Adult patients with LN receiving additional telitacicept at 80/160 mg once per week were recruited, while patients receiving only standard therapy were included as the control group using a 1:1 propensity score-matching approach. The primary outcomes were the proportions of patients achieving complete renal response (CRR) and primary efficacy renal response (PERR).</p><p><strong>Results: </strong>Forty-four patients in both the control and telitacicept groups were enrolled, with median follow-up periods of 10.78 ± 3.37 and 10.5 ± 3.78 months, respectively. Compared with the control group, a significant improvement was observed in the proportion of patients achieving CRR (11.36% vs 29.55%, P = .034) and PERR (45.45% vs 68.18%, P = .031) in the telitacicept group at the last visit. Median proteinuria was reduced by 0.97 g/day (63.82%) from baseline in the telitacicept group, compared with a reduction of 0.31 g/day (25.31%) in the control group. Additionally, the telitacicept group showed notable treatment responses in the median SLE Disease Activity Index-2000 score, Physician's Global Assessment score and glucocorticoid dose reduction. Subgroup analysis revealed that telitacicept exhibited a more prominent therapeutic effect in patients with type V LN and those with proteinuria exceeding 3 g/day. Telitacicept was well tolerated, and the incidence of adverse events was similar between the two groups.</p><p><strong>Conclusions: </strong>LN patients receiving additional telitacicept treatment demonstrated better disease remission, particularly in those with type V LN and proteinuria ≥3 g/day, with a favorable safety profile in real-world clinical practice.</p>","PeriodicalId":19078,"journal":{"name":"Nephrology Dialysis Transplantation","volume":" ","pages":"1775-1785"},"PeriodicalIF":5.6,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ABCDE to identify and prevent chronic kidney disease: a call to action.","authors":"Charles J Ferro, Christoph Wanner, Valerie Luyckx, Kate Stevens, Sofia Cerqueira, Rasha Darwish, Beatriz Fernandez Fernandez, David Fiel, Rumen Filev, Manfred Grieger, Antonia Lopez, Merike Luman, Jolanta Malyszko, Milena Krasimirova Nikolova-Vlahova, Fiita Romero, Chrysanthi Skalioti, Carla Alexandra Ribeiro Dos Santos Araújo, Ieva Ziedina, Daniel Gallego, Alberto Ortiz, Roser Torra, Raymond Vanholder","doi":"10.1093/ndt/gfaf057","DOIUrl":"10.1093/ndt/gfaf057","url":null,"abstract":"<p><p>Kidney disease is a global health priority affecting >850 million people worldwide. This number is projected to increase over the coming decades given the increasing prevalence of diabetes, hypertension and obesity and the aging population. Chronic kidney disease (CKD) can reduce both life expectancy and quality of life and is intricately linked with cardiac and metabolic health-the cardiovascular-kidney-metabolic multimorbidity syndrome. With early recognition of risk, CKD can be prevented and with timely case finding, early diagnosis and early intervention, its progression can be halted or slowed. The European Renal Association has established the Strong Kidneys Task Force, with the main purpose of creating awareness about the importance of kidney health for individual and population health. In collaboration with the European Kidney Health Alliance and the European Kidney Patients Federation, the ABCDE campaign will empower communities and individuals to remind their healthcare providers to assess their risk of kidney disease. ABCDE asks five simple questions about health status that only the healthcare system can provide: A) Do I have Albumin in my urine? B) What is my Blood pressure? C) What is my Cholesterol? D) Do I have Diabetes? E) What is my current kidney function (Estimated glomerular filtration rate)? This advocacy text aims to inform individuals, communities and front line healthcare workers that capturing the risk of kidney, cardiac and metabolic health is simple, makes sense, is logical and will save lives. Although making meaningful change will take time and involve major personal and societal changes, the first step really is as easy as ABCDE!</p>","PeriodicalId":19078,"journal":{"name":"Nephrology Dialysis Transplantation","volume":" ","pages":"1786-1798"},"PeriodicalIF":5.6,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12451690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143663746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}