Nephrology Dialysis Transplantation最新文献

{"title":"Functional outcomes in pediatric patients on renal replacement therapy in a worldwide registry.","authors":"Kristin J Dolan, Katja M Gist, Abby Basalely, Gabriella Bottari, Abhishek Chakraborty, Mihaela Damian, Dana Fuhrman, Denise C Hasson, Catherine Joseph, Dave Kwiatkowski, Susan Martin, Jenn Nhan, Nicolas Ollberding, David T Selewski, Danielle Soranno, Michelle C Starr, Amy Strong, Sameer Thadani, Huaiyu Zang, Ayse Akcan Arikan","doi":"10.1093/ndt/gfaf067","DOIUrl":"https://doi.org/10.1093/ndt/gfaf067","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>Mortality rates of children supported with continuous renal replacement therapy (CRRT) have improved, yet morbidity remains high. We aimed to evaluate the functional outcomes of children receiving CRRT using functional status scale (FSS). We hypothesized that children receiving CRRT will have worse FSS compared to their baseline, acquire new morbidity at hospital discharge and 6-and 12-months post discharge, and lack of renal recovery will contribute to worsening functional status.</p><p><strong>Methods: </strong>This is a retrospective chart review from The Worldwide Exploration of Renal Replacement Outcomes Collaborate in Kidney Disease (WE-ROCK), an international multi-center registry. 28 centers across 5 countries participated in this analysis. Children birth to 25 years, on CRRT for AKI or FO, were included. Patients with underlying kidney disease, on extracorporeal membrane oxygenation, and non-survivors were excluded. FSS was collected at discharge (n = 527), 6 months (n = 387), and 12 months post-discharge (n = 344). The primary outcome was FSS at discharge and 6 months. Secondary outcomes included: new morbidity at discharge and 6 months; FSS at 12 months; and the impact of renal recovery on functional outcomes.</p><p><strong>Results: </strong>527 patients had median FSS of 7[6,9] at hospital discharge. 39%(n = 204) had worse FSS. 18%(95/527) acquired a new morbidity at discharge. Predictors of FSS at discharge were baseline FSS(OR 1.30[95% CI 1.11-1.52]), weight(OR 0.99[95% CI 0.98-0.9997]), comorbidities(OR 1.88[95% CI 1.16-3.04]), mechanical ventilation(OR 1.72(95%CI 1.04-2.85]), and sepsis on ICU admission(OR 1.46[95% CI 1.01-2.21]). 387 patients had median FSS score of 6[6,8] at 6 months. 10%(n = 39/387) acquired new morbidity at 6 months. The significant predictors of FSS at 6 months were FSS at discharge(OR 2.36 [95%CI 1.95-2.84]) and presence of comorbidities(OR 1.77[95%CI 1.03-3.06]).</p><p><strong>Conclusion: </strong>This is the first large, multi-center study evaluating functional outcomes of children on CRRT. Persistent morbidity following discharge emphasizes the importance of comprehensive identification and multidisciplinary follow up to optimize patient outcomes.</p>","PeriodicalId":19078,"journal":{"name":"Nephrology Dialysis Transplantation","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035963","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":"Early identification of CKD in patients with solitary functioning kidney.","authors":"Luigi Cirillo, Tommaso Mazzierli, Alessandra Bettiol, Andrea La Tessa, Marco Moscato, Samantha Innocenti, Elisa Buti, Carmela Errichiello, Marco Materassi, Catia Olianti, Lorenzo Masieri, Francesca Becherucci","doi":"10.1093/ndt/gfaf063","DOIUrl":"https://doi.org/10.1093/ndt/gfaf063","url":null,"abstract":"","PeriodicalId":19078,"journal":{"name":"Nephrology Dialysis Transplantation","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028657","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":"A Meta-analysis of Graft Survival, Patient Survival, and Delayed Graft Function in First-Time and Repeat Kidney Transplants.","authors":"Mehmet Kanbay, Sama Mahmoud Abdel-Rahman, Crischentian Brinza, Lasin Ozbek, Elif Yayci, Ozgur Aktas, Candan Genc, Mustafa Guldan, Ezgi N Alper, Alexandru Burlacu, Andreea Covic, Adrian Covic","doi":"10.1093/ndt/gfaf066","DOIUrl":"https://doi.org/10.1093/ndt/gfaf066","url":null,"abstract":"<p><strong>Background: </strong>Previous evidence showed that while first-time kidney transplants typically yield better outcomes, repeat and subsequent transplants were associated with increased risks of graft failure and adverse patient outcomes, yet conflicting findings exist. The aim of this meta-analysis is to compare graft survival and delayed graft function (DGF) outcomes in first-time kidney transplants (KT), repeat kidney transplants (regrafts), and subsequent KT.</p><p><strong>Methods: </strong>Relevant studies were identified through comprehensive searches in PubMed, Web of Science, Cochrane Library, MEDLINE (Ovid) and Scopus until 8 October 2024. Primary outcomes include graft survival, and DGF compared to repeat, and subsequent kidney transplants.</p><p><strong>Results: </strong>The meta-analysis included a total of 16 studies. Analysis on long-term graft survival revealed that patients who underwent a first KT had significantly better graft survival compared to those who received a second transplant (86.7% vs. 77.6%; OR 1.40, 95% CI 1.14-1.71, p = 0.001). At 5 years post-transplant, first KT recipients continued to demonstrate superior graft survival (OR 1.41, 95% CI 1.13-1.77, p = 0.003), although this difference diminished by 10 years, with no significant disparity observed (OR 1.26, 95% CI 0.88-1.81, p = 0.20). Graft survival at 5 years was also significantly higher in second KT recipients compared to those undergoing a third transplant (OR 2.66, 95% CI 1.86-3.80, p < 0.00001). Patient survival outcomes were largely comparable between first and second KT groups, with no statistically significant differences in overall survival (OR 1.25, 95% CI 0.87-1.81, p = 0.23). At specific time points, the 5-year survival rate showed a borderline non-significant trend favoring first KT recipients (OR 1.63, 95% CI 0.97-2.73, p = 0.06), while the 10-year survival rate showed no difference (OR 0.94, 95% CI 0.67-1.32, p = 0.71). Survival rates between second and subsequent retransplants (e.g., third or fourth KT) showed no significant variation, including at 5 years (p = 0.37 and p = 0.90, respectively). DGF rates did not differ significantly between first and second KT recipients (p = 0.11).</p><p><strong>Conclusion: </strong>These findings underscore the superior graft survival associated with first and second kidney transplants compared to subsequent retransplants, particularly in the early post-transplant period, while highlighting the lack of significant differences in overall patient survival across groups; however, variability in outcomes due to study heterogeneity and patient-specific factors warrants cautious interpretation and tailored clinical approaches.</p>","PeriodicalId":19078,"journal":{"name":"Nephrology Dialysis Transplantation","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006866","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":"Glucocorticoids-induced remission followed by rituximab as maintenance therapy for podocytopathy with minimal change lesions in adults.","authors":"Ling Wang, Chen Yan, Shihui Hou, Xinghong Liu, Fei Xiao, Huanzi Dai","doi":"10.1093/ndt/gfaf050","DOIUrl":"https://doi.org/10.1093/ndt/gfaf050","url":null,"abstract":"","PeriodicalId":19078,"journal":{"name":"Nephrology Dialysis Transplantation","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029382","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":"IdeZ protease does not prevent convertase stabilization by C3 nephritic factors in C3 glomerulopathy.","authors":"Kes H Stevens, Laura M Baas, Nicole C A J van de Kar, Lambertus P W J van den Heuvel, Marloes A H M Michels","doi":"10.1093/ndt/gfaf065","DOIUrl":"https://doi.org/10.1093/ndt/gfaf065","url":null,"abstract":"","PeriodicalId":19078,"journal":{"name":"Nephrology Dialysis Transplantation","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972482","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":"Maintaining kidney health in aging societies: a JSN and ERA call to action.","authors":"Alberto Ortiz, Anneke Kramer, Ivan Rychlík, Masaomi Nangaku, Motoko Yanagita, Kitty J Jager, Fergus J Caskey, Vianda S Stel, Naoki Kashihara, Takahiro Kuragano, Yusuke Suzuki, Yoshiaki Takemoto, Hideki Yokoi, Giuseppe Palladino, Danilo Fliser, Roser Torra, Christoph Wanner","doi":"10.1093/ndt/gfaf068","DOIUrl":"https://doi.org/10.1093/ndt/gfaf068","url":null,"abstract":"<p><p>Chronic kidney disease (CKD) is the fastest growing cause of death, expected to become the fifth global cause of death and the third in some countries with long life expectancy, such as Japan and Spain by 2050. This reflects societal aging, as advancing kidney age is the main risk factor for CKD. The forecasted 140% increase in death rate from CKD by 2050 is reduced to 33% when adjusted for age. The increasing mortality burden is paralleled by higher personal, healthcare, socioeconomic, and environmental burdens and need for kidney replacement therapy to treat kidney failure. To some extent, the higher CKD burden represents the price of success in prolonging longevity by decreasing other causes of death. Now is the time to act to minimize the negative impact of CKD on aging societies through primary prevention and early diagnosis and treatment of CKD. Action aimed at maintaining kidney health and delaying kidney aging will contribute to healthy aging as the kidneys have gerosuppressor functions. CKD has the highest negative impact on body aging among chronic non-communicable diseases. This should be part of a move towards novel holistic approaches to healthy longevity represented by concepts such as cardiovascular-kidney-metabolic health, geromedicine, gerosuppressors, and organ rejuvenation. We discuss a conceptual framework for the present and future of kidney aging and kidney health in the elderly, emphasizing opportunities for intervention that underlie the Japanese Society of Nephrology (JSN) and European Renal Association (ERA) call to action on Achieving Kidney Health in Aging/Aged Societies.</p>","PeriodicalId":19078,"journal":{"name":"Nephrology Dialysis Transplantation","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032297","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 inhibition for patients with ADPKD - closing the evidence gap.","authors":"Roman-Ulrich Müller, Dominique Guerrot, Michel Chonchol, Roland Schmitt, Kiyotaka Uchiyama, Ron T Gansevoort, Emilie Cornec-Le Gall","doi":"10.1093/ndt/gfaf061","DOIUrl":"https://doi.org/10.1093/ndt/gfaf061","url":null,"abstract":"<p><p>Inhibitors of the sodium-glucose cotransporter 2 (SGLT2i) were originally developed to treat diabetes mellitus but have shown important renoprotective benefits independently from blood glucose levels. SGLT2i have thus become an important addition to the therapeutic armamentarium to treat patients with chronic kidney disease. However, specific patient populations were excluded from the pivotal trials, for instance patients with very low eGFR, patients on dialysis, kidney transplant recipients and patients with autosomal dominant polycystic kidney disease (ADPKD), the most common genetic kidney disorder. Considering the lack of potent treatment modalities in ADPKD, the use of SGLT2i in this patient population would be of major interest. However, the combination of inconclusive results from preclinical models with the lack of clinical efficacy data and potential disease-specific safety concerns currently exclude patients with ADPKD from this promising therapeutic opportunity. This results in an urgent need for adequately powered clinical trials examining SGLT2i in ADPKD. This review summarizes the current knowledge on SGLT2i in this specific patient population and outlines running and upcoming clinical trial programs in different geographic regions aiming to make SGLT2i accessible to patients with ADPKD.</p>","PeriodicalId":19078,"journal":{"name":"Nephrology Dialysis Transplantation","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811917","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":"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":"https://doi.org/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 July 9, 2021, and November 30, 2023 from multiple centers in the United States, 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>853 patients were included in the combined group [mean (±SD) 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 to finerenone monotherapy [adjusted hazard ratio (aHR)=0.20; 95% 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 to 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 to 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 to monotherapy. However, the risk of hyperkalemia with finerenone warrants caution.</p>","PeriodicalId":19078,"journal":{"name":"Nephrology Dialysis Transplantation","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hydroxychloroquine for all patients with lupus nephritis?: no.","authors":"Fernando Caravaca-Fontán, Federico Yandian, Fernando C Fervenza","doi":"10.1093/ndt/gfae254","DOIUrl":"10.1093/ndt/gfae254","url":null,"abstract":"","PeriodicalId":19078,"journal":{"name":"Nephrology Dialysis Transplantation","volume":" ","pages":"607-609"},"PeriodicalIF":4.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142605436","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":"Hydroxychloroquine for all patients with lupus nephritis: yes.","authors":"Maria Pappa, Dimitrios T Boumpas, Antonis Fanouriakis","doi":"10.1093/ndt/gfae280","DOIUrl":"10.1093/ndt/gfae280","url":null,"abstract":"","PeriodicalId":19078,"journal":{"name":"Nephrology Dialysis Transplantation","volume":" ","pages":"610-613"},"PeriodicalIF":4.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142739734","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}