Nephrology Dialysis Transplantation最新文献

{"title":"Long-term outcomes of IgA nephropathy in China.","authors":"Xue Shen, Pei Chen, Muqing Liu, Lijun Liu, Sufang Shi, Xujie Zhou, Jicheng Lv, Hong Zhang","doi":"10.1093/ndt/gfae252","DOIUrl":"10.1093/ndt/gfae252","url":null,"abstract":"<p><strong>Background: </strong>The long-term prognosis of immunoglobulin A nephropathy (IgAN) and the optimal target for proteinuria treatment remain controversial. This study, utilizing a large prospective cohort from China, aims to assess the long-term outcomes of IgAN and to explore the definition of proteinuria remission.</p><p><strong>Methods: </strong>We enrolled 2141 patients with biopsy-proven IgAN, all with at least 12 months of follow-up, from a prospective IgAN cohort at Peking University First Hospital. We utilized Kaplan-Meier analysis, Cox regression and an estimated glomerular filtration rate (eGFR) slope calculated via a linear mixed model to investigate kidney outcomes.</p><p><strong>Results: </strong>The median (Q1, Q3) baseline proteinuria was 1.26 (0.65, 2.40) g/day, and the eGFR was 80 (52, 103) mL/min/1.73 m2. After a mean follow-up of 5.8 (±4.4) years, 509 (24%) patients progressed to end-stage kidney disease (ESKD). The median kidney survival time was 12.4 years, the annual event rate of ESKD was 41.1 per 1000 person-years and the 15-year kidney survival rate was 40%. Time-averaged proteinuria level was strongly associated with kidney failure (adjusted hazard ratio 1.76, 95% confidence interval 1.65 to 1.88). Restriction cubic spline analysis indicated that the risk of ESKD increases rapidly when time-average proteinuria exceeded 0.5 g/day. There was no significant difference in long-term kidney survival between patients with proteinuria <0.3 g/day and those with 0.3-0.5 g/day, with both groups demonstrating a better prognosis.</p><p><strong>Conclusion: </strong>The long-term outcomes for patients with IgAN under current treatment strategies remain poor, with most progressing to ESKD within 15 years. Patients with time-averaged proteinuria ≥0.5 g/day experience worse kidney outcomes, challenging the previous view that proteinuria <1.0 g/day was associated with a low risk of kidney failure.</p>","PeriodicalId":19078,"journal":{"name":"Nephrology Dialysis Transplantation","volume":" ","pages":"1137-1146"},"PeriodicalIF":4.8,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142668486","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":"Oral dysbiosis initiates periodontal disease in experimental kidney disease.","authors":"David Randall, Asil Alsam, Julius Kieswich, Susan Joseph, Joseph Aduse-Opoku, Jonathan Swann, Alan Boyde, Graham Davis, David Mills, Kieran McCafferty, Michael Curtis, Muhammed M Yaqoob","doi":"10.1093/ndt/gfae266","DOIUrl":"10.1093/ndt/gfae266","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>It is presently unclear why there is a high prevalence of periodontal disease in individuals living with chronic kidney disease. Whilst some have argued that periodontal disease causes chronic kidney disease, we hypothesized that alterations in saliva and the oral microenvironment in organisms with kidney disease may initiate periodontal disease by causing dysbiosis of the oral microbiota.</p><p><strong>Methods: </strong>Experimental kidney disease was created using adenine feeding and subtotal nephrectomy in rats, and by adenine feeding in mice. Loss of periodontal bone height was assessed using a dissecting microscope supported by micro-CT, light, confocal and electron microscopy, and immunohistochemistry. Salivary biochemistry was assessed using NMR spectroscopy. The oral microbiome was evaluated using culture-based and molecular methods, and the transmissibility of dysbiosis was assessed using co-caging and microbial transfer experiments into previously germ-free recipient mice.</p><p><strong>Results: </strong>We demonstrate that experimental kidney disease causes a reproducible reduction of alveolar bone height, without gingival inflammation or overt hyperparathyroidism but with evidence of failure of bone formation at the periodontal crest. We show that kidney disease alters the biochemical composition of saliva and induces progressive dysbiosis of the oral microbiota, with microbial samples from animals with kidney disease displaying reduced overall bacterial growth, increased alpha diversity, reduced abundance of key components of the healthy oral microbiota such as Streptococcus and Rothia, and an increase in minor taxa including those from gram-negative phyla Proteobacteria and Bacteroidetes. Co-housing diseased rats with healthy ones ameliorates the periodontal disease phenotype, whilst transfer of oral microbiota from mice with kidney disease causes periodontal disease in germ-free animals with normal kidney function.</p><p><strong>Conclusions: </strong>We advocate that periodontal disease should be regarded as a complication of kidney disease, initiated by oral dysbiosis through mechanisms independent of overt inflammation or hyperparathyroidism.</p>","PeriodicalId":19078,"journal":{"name":"Nephrology Dialysis Transplantation","volume":" ","pages":"1187-1202"},"PeriodicalIF":4.8,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682460","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":"Unveiling the risks: protecting privacy in single-cell genomics data.","authors":"Rafael Kramann, Christoph Kuppe, Valerie Luyckx, Wim van Biesen, Stefanie Steiger","doi":"10.1093/ndt/gfaf010","DOIUrl":"10.1093/ndt/gfaf010","url":null,"abstract":"","PeriodicalId":19078,"journal":{"name":"Nephrology Dialysis Transplantation","volume":" ","pages":"1077-1080"},"PeriodicalIF":4.8,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971680","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":"Monocyte/macrophage pyroptosis and C5b-9-induced cyst enlargement in Pkd1-/- mice.","authors":"Yang Yang, Deyang Kong, Meihan Chen, Jiayi Lv, Jie Zhou, Cheng Xue, Shuwei Song, Minghui Song, Lu Ma, Zhiguo Mao, Changlin Mei","doi":"10.1093/ndt/gfae262","DOIUrl":"10.1093/ndt/gfae262","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>The levels of C5b-9, terminal products of complement activation, were significantly elevated in autosomal dominant polycystic kidney disease (ADPKD). However, the precise mechanisms by which C5b-9 facilitates cyst growth remain incompletely elucidated.</p><p><strong>Methods: </strong>Three groups of chronic-onset Pkd1-/- mice were established: one group received intravenous injections of 0.5 mg/kg C5b-9, another was administered 1.0 mg/kg monoclonal anti-C9 antibodies, and a control group received 1 mg/kg IgG isotype control. All treatments were administered biweekly for two months (postnatal day 180-240). Renal macrophages from distinct subsets were sorted using fluorescence-activated cell sorting. To deplete macrophages, liposome clodronate was injected intraperitoneally. Sublethal irradiation followed by bone marrow reconstruction was performed in Pkd1-/- mice to evaluate the role of bone marrow-derived macrophages (BMDMs) in ADPKD progression.</p><p><strong>Results: </strong>(i) In vitro, sublytic C5b-9 did not affect the viability of renal tubular epithelial cells, but significantly induced M1-like polarization and pyroptosis of BMDMs. (ii) In vivo, C5b-9 notably triggered pyroptosis of Ly6C+ monocytes and a reduction in circulating monocyte numbers as cysts enlarged. (iii) Residual Ly6C+ monocytes infiltrated renal tissues and differentiated into Ly6C+ macrophages, which exhibited a greater susceptibility to pyroptosis compared to Ly6C- macrophages. (iv) Although limited evidence has recently suggested that Ly6C- monocytes may also be affected by C5b-9, upregulation of CCR2 in Ly6C- macrophages was observed in C5b-9-treated Pkd1-/- mice, implying that Ly6C- monocytes could represent a significant source of M2 macrophages.</p><p><strong>Conclusions: </strong>C5b-9 infusion promoted renal tubular epithelial cell proliferation by inducing pyroptosis of Ly6C+ monocytes/macrophages, contributing to progressive cyst enlargement in chronic-onset PKD mice.</p>","PeriodicalId":19078,"journal":{"name":"Nephrology Dialysis Transplantation","volume":" ","pages":"1161-1174"},"PeriodicalIF":4.8,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142624549","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":"Modelling heterogeneity in the progression of chronic kidney disease.","authors":"Elena Butz, Ulla T Schultheiss, Peggy Sekula","doi":"10.1093/ndt/gfae288","DOIUrl":"10.1093/ndt/gfae288","url":null,"abstract":"<p><p>Cohort studies with comprehensive follow-up periods that track patients with chronic kidney disease (CKD) and gather extensive health data are important for understanding the diverse progression patterns of CKD. This review explores the potential of emerging analytical techniques that can be applied in addition to conventional analysis approaches to enhance CKD research by offering more detailed insights into disease progression. To maximize the insights available from CKD cohort data with extended follow-up, we examined two advanced approaches: analysis of disease trajectories and analysis of recurrent events. The analysis of trajectories examines the timing and relationships between events, uncovering progression patterns and identifying key events that could signal future outcomes. In contrast, the application of recurrent event analysis facilitates the examination of repeated occurrences of significant events, thereby providing a more nuanced understanding of the evolution of risk over time. Using data from the German Chronic Kidney Disease study, this review illustrates how these approaches can enhance conventional analyses. The application of these supplementary methodologies to CKD research has the potential to facilitate a transition towards a more personalized approach to patient care. The insights gained may inform the development of tailored treatment strategies and contribute to enhanced overall patient outcomes.</p>","PeriodicalId":19078,"journal":{"name":"Nephrology Dialysis Transplantation","volume":" ","pages":"1107-1114"},"PeriodicalIF":4.8,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864894","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 hyperkalemia affects the heart: clinical implications.","authors":"Thomas Robert, Laurent Mesnard","doi":"10.1093/ndt/gfae287","DOIUrl":"10.1093/ndt/gfae287","url":null,"abstract":"","PeriodicalId":19078,"journal":{"name":"Nephrology Dialysis Transplantation","volume":" ","pages":"1063-1065"},"PeriodicalIF":4.8,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142838145","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":"Correction to: Hyponatraemia-treatment standard 2024.","authors":"","doi":"10.1093/ndt/gfae213","DOIUrl":"10.1093/ndt/gfae213","url":null,"abstract":"","PeriodicalId":19078,"journal":{"name":"Nephrology Dialysis Transplantation","volume":" ","pages":"1259"},"PeriodicalIF":4.8,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142470741","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":"Recovery from acute kidney injury treated with dialysis in patients with multiple myeloma treated with proteasome inhibitors.","authors":"Swetha R Kanduri, Ambuga Badari, Farhan Ullah, Chien-Wen Yang, Juan Carlos Q Velez","doi":"10.1093/ndt/gfaf028","DOIUrl":"10.1093/ndt/gfaf028","url":null,"abstract":"","PeriodicalId":19078,"journal":{"name":"Nephrology Dialysis Transplantation","volume":" ","pages":"1251-1253"},"PeriodicalIF":4.8,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370789","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":"Smoking cessation and atherosclerotic cardiovascular events and mortality in chronic kidney disease.","authors":"Young Su Joo, Hae-Ryoung Yun, Hyung Woo Kim, Hee Byung Koh, Chan-Young Jung, Tae-Ik Chang, Jung Tak Park, Sue Kyung Park, Young Youl Hyun, Yeong Hoon Kim, Suah Sung, Tae-Hyun Yoo, Kook-Hwan Oh, Shin-Wook Kang, Seung Hyeok Han","doi":"10.1093/ndt/gfae268","DOIUrl":"10.1093/ndt/gfae268","url":null,"abstract":"<p><strong>Background: </strong>Smoking cessation is recommended to reduce excess atherosclerotic cardiovascular disease (ASCVD) and mortality in patients with chronic kidney disease (CKD). However, this recommendation is largely based on observational studies on the general population Therefore, we aimed to evaluate the association of smoking dose and smoking cessation duration with ASCVD and mortality in patients with CKD.</p><p><strong>Methods: </strong>We compiled a comprehensive pooled dataset comprising 66 245 participants with CKD from the KNOW-CKD and the UK Biobank cohort. Additionally, we included 307 353 participants without CKD from the UK Biobank cohort. Participants were categorized according to smoking dose and duration of smoking cessation base on a questionnaire. The primary outcome was a composite of ASCVD events or all-cause mortality.</p><p><strong>Results: </strong>Over a median follow-up period of 13.2 years, 14 671 (22.1%) participants reached the primary outcome. In the pooled CKD cohort, compared to never smokers, and former and current smokers exhibited a 1.30- and 2.14-fold higher risk of the primary outcome, respectively. Among former smokers, the hazard ratios (HRs) (95% confidence intervals [CIs]) for smoking loads <20 and ≥20 pack-years were 1.05 (1.00-1.10) and 2.14 (2.05-2.25), respectively. The increased risk of the primary outcome was attenuated by longer smoking cessation. The HRs (95% CIs) for smoking cessation of <10 years, 10-20 years, and ≥20 years were 1.75 (1.65-1.86), 1.43 (1.34-1.52), and 1.11 (1.06-1.16), respectively, compared with never smokers. This association was also observed in individuals without CKD, but the risk was comparable between former smokers with smoking cessation ≥20 years and non-smokers, suggesting that a longer cessation is required in patients with CKD to offset the smoking-related adverse effects.</p><p><strong>Conclusions: </strong>Among former smokers with CKD, the risk of ASCVD or mortality was substantially attenuated with less smoking load and a longer duration of smoking cessation.</p>","PeriodicalId":19078,"journal":{"name":"Nephrology Dialysis Transplantation","volume":" ","pages":"1203-1212"},"PeriodicalIF":4.8,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142638084","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":"Correction.","authors":"","doi":"10.1093/ndt/gfae219","DOIUrl":"10.1093/ndt/gfae219","url":null,"abstract":"","PeriodicalId":19078,"journal":{"name":"Nephrology Dialysis Transplantation","volume":" ","pages":"1261"},"PeriodicalIF":4.8,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142504679","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}