EMJ Nephrology最新文献

{"title":"Immune Complex-Mediated Membranoproliferative Glomerulonephritis Secondary to Primary Biliary Cholangitis: A Rare Case Report","authors":"Kadir Intas, G. Okyay, A. Sağlam, M. Aylı","doi":"10.33590/emjnephrol/lqjl1550","DOIUrl":"https://doi.org/10.33590/emjnephrol/lqjl1550","url":null,"abstract":"Immune complex-mediated membranoproliferative glomerulonephritis (iMPGN) can develop in association with autoimmune diseases such as primary biliary cholangitis (PBC), a chronic cholestatic liver disease characterised by destruction of the small and medium-sized bile ducts. Although the pathogenesis cannot be clearly defined, iMPGN and PBC overlap through the activation of innate and adaptive immune cells and the production of proinflammatory mediators. In this report, the authors present a case in which iMPGN and PBC were diagnosed simultaneously.","PeriodicalId":348431,"journal":{"name":"EMJ Nephrology","volume":" 20","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141680170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of Potassium Intake on the Renoprotective Response to Sodium Restriction and Hydrochlorothiazide in Patients with Diabetic Nephropathy","authors":"Caspar Lieshout, L. Vogt, A. Kwakernaak, M. Hemmelder, Goos Laverman, Gerjan Navis, Martin Borst","doi":"10.33590/emjnephrol/wxnl1545","DOIUrl":"https://doi.org/10.33590/emjnephrol/wxnl1545","url":null,"abstract":"","PeriodicalId":348431,"journal":{"name":"EMJ Nephrology","volume":" 0","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141677322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ERA 2024 Interview: Peter Stenvinkel","authors":"P. Stenvinkel","doi":"10.33590/emjnephrol/cxaz4342","DOIUrl":"https://doi.org/10.33590/emjnephrol/cxaz4342","url":null,"abstract":"","PeriodicalId":348431,"journal":{"name":"EMJ Nephrology","volume":" 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141678468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kidneys and Blood Pressure: A Key Link","authors":"","doi":"10.33590/emjnephrol/newl9732","DOIUrl":"https://doi.org/10.33590/emjnephrol/newl9732","url":null,"abstract":"","PeriodicalId":348431,"journal":{"name":"EMJ Nephrology","volume":" 15","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141678928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accessibility and Affordability Issues for Renal Replacement Therapy Remain Challenges in Resource-Limited Healthcare Settings: A Case Report and Critique of Literature for Chronic Kidney and End-Stage Renal Disease","authors":"Janvier Nzayikorera","doi":"10.33590/emjnephrol/jukr8145","DOIUrl":"https://doi.org/10.33590/emjnephrol/jukr8145","url":null,"abstract":"Chronic kidney disease (CKD) continues to be a global public health problem. Globally, the prevalence of CKD is approximately 8–16% in the general population. Most patients with CKD advance to kidney failure and require dialysis or kidney transplantation. Screening for CKD, diagnosing CKD, treating CKD and its consequences to stop its progression, and renal replacement therapy (RRT) are all parts of comprehensive CKD care. A 28-year-old male presented with complaints of awareness of his heart beating, abdomen and lower limb swelling, and generalised body weakness for 2 days. His blood pressure was 222/147 mmHg on admission day. Six days post-admission, he displayed violent chest pain and dyspnoea, along with profound generalised body swelling. Laboratory studies revealed creatinine of 22.49 mg/dL (0.6–1.1), urea of 236.5 mg/dL (10.0–50), albumin of 2.15 mg/dL (3.8–5.1), potassium of 7.19 mmol/L (3.5–5.5), and haemoglobin of 6.2 g/dL (8.0–17.0). The diagnoses of uremic pericarditis, pulmonary oedema, hyperkalaemia, hypertensive emergency, and normochromic anaemia secondary to end-stage renal diseases were made. He qualified for the RRT. CKD is a serious, non-communicable disease that is commonly encountered in clinical practice in both developed and developing countries and needs the utmost attention. RRT is crucial for comprehensive CKD management; however, in resource-limited healthcare settings, RRT is non-accessible and non-affordable. The lack of RRT marks the mistreatment of patients with renal diseases by the global healthcare system. The author calls for designing new strategies that aim to ensure equitable accessibility and affordability for RRT globally.","PeriodicalId":348431,"journal":{"name":"EMJ Nephrology","volume":" 30","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141680252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Lack of Consensus on the Management of Chronic Active Antibody-Mediated Rejection Harming Renal Transplant Recipients?","authors":"L. Rostaing","doi":"10.33590/emjnephrol/11000024","DOIUrl":"https://doi.org/10.33590/emjnephrol/11000024","url":null,"abstract":"In 2022, over 92,000 kidney transplants were performed globally. With advancements in transplant science, 1-year graft survival rates have reached 94.3% for deceased donor kidney transplant recipients, and 97.8% for living recipients. However, 5-year graft survival remains at 76.3% and 86.5%. Antibody-mediated rejection (AMR) is one of the most common causes of immune-related allograft rejection. Chronic active AMR (CABMR) typically develops 6–12 months post-transplant; 76% of kidney transplant recipients with CABMR experience graft loss 1.9 years after diagnosis. Despite these alarming figures, consensus guidelines on the management of post-transplant patients have not been updated with advancements in testing and protocol biopsies, and there is currently no consensus in Europe on CABMR management.","PeriodicalId":348431,"journal":{"name":"EMJ Nephrology","volume":"19 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140742615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Tip Placement on Fibrin Sheath Formation in Poorly Functioning Tunnelled Haemodialysis Lines","authors":"Jordan Loon, J. Woodley-Cook","doi":"10.33590/emjnephrol/10307734","DOIUrl":"https://doi.org/10.33590/emjnephrol/10307734","url":null,"abstract":"Background and Objectives: Fibrin sheath formation is a common cause of haemodialysis (HD) line dysfunction requiring frequent interventional line exchanges. This study assessed HD tip and line placement, line length, and demographics in poorly functioning HD lines due to fibrin sheath formation, to determine if there is a correlation between these factors and repeatedly poor function.\u0000\u0000Patients and Methods: Patient medical records were retrospectively reviewed to include those who have had poorly functioning HD lines with fluoroscopic evidence of a fibrin sheath from 2011–2019. Analysis of variance and t-tests were performed to determine the significance of various factors on the time until a line exchange was required.\u0000\u0000Results: Patients with an HD tip placed in the inferior vena cava underwent an exchange the soonest (130.23 days), while tips in the superior vena cava went the longest without required intervention (968.80 days; p=0.007). Lines in the left internal jugular vein had the most days without intervention, and lines in the femoral vein had the least (1,132.80 versus 142.50 days, respectively; p=0.007). Furthermore, 19 cm lines went 816.75 days without intervention, and 42 cm lines went 114.73 days without intervention (p=0.049). Intervention-free days decreased if the patient had undergone previous interventions (p<0.001). Patients with diabetes required intervention before those without diabetes (694.09 versus 917.08 days, respectively; p=0.033).\u0000\u0000Conclusion: Factors such as HD tip and line placement, line length, previous interventions, and diabetic status demonstrated a correlation with how frequently tunnelled HD lines required intervention due to fibrin sheath formation.","PeriodicalId":348431,"journal":{"name":"EMJ Nephrology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130809707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Filling the Gap by Targeting the Gut: First Disease-Modifying Treatment Approved for IgA Nephropathy","authors":"Jennifer Taylor","doi":"10.33590/emjnephrol/10302464","DOIUrl":"https://doi.org/10.33590/emjnephrol/10302464","url":null,"abstract":"This symposium took place during the 60th European Renal Association (ERA) Congress, held in Milan, Italy, and virtually. Bengt Fellström, Uppsala University, Sweden, described the relationship between IgA nephropathy (IgAN) and gastrointestinal mucosal reactivity. Fellström then outlined the history of Nefecon (Calliditas Therapeutics, Stockholm, Sweden, and STADA Arzneimittel, Bad Vilbel, Germany), which was developed based on the assumption that the gut plays a major role in the pathophysiology of the disease, and that there was a high unmet need for a well-tolerated and effective therapy. Nefecon was specifically designed to target the origins of IgAN. A Phase IIb clinical trial showed, for the first time, that 9 months of treatment with Nefecon was well-tolerated and effective in patients at risk of disease progression. Jonathan Barratt, University of Leicester, UK, and John Walls Renal Unit, Leicester General Hospital, UK, presented biomarker data supporting the efficacy data in clinical trials, and presented topline data from Part B of the Phase III NefIgArd trial. Specifically, the results demonstrated an average 5.05 mL/min/1.73 m2 estimated glomerular filtration rate (eGFR) treatment benefit in favour of Nefecon versus placebo over 2 years. This confirmed that the eGFR benefit of 9 months of active treatment with Nefecon was maintained during the observational follow-up. The eGFR benefit with Nefecon versus placebo was consistent regardless of baseline urine protein-creatinine ratio (UPCR). At 2 years, the 30% reduction in UPCR in the Nefecon versus placebo arm was similar to the percentage reduction at the end of the 9-month treatment period, plus 15 months follow-up off treatment. Patients treated with Nefecon experienced decreasing levels of proteinuria while on active treatment and for 3 months afterwards, suggesting a continued biologic effect. Barratt presented UK registry data showing that, despite being treated with the current standard of care for IgAN, three-quarters of adults and half of paediatric patients developed kidney failure or died within 20 years of disease onset. Barratt suggested a paradigm shift in the treatment approach for all patients with IgAN, who have a risk of developing kidney failure in their lifetime.","PeriodicalId":348431,"journal":{"name":"EMJ Nephrology","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115146466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Review of the 60th European Renal Association (ERA) Congress","authors":"Jaki Smith","doi":"10.33590/emjnephrol/10304934","DOIUrl":"https://doi.org/10.33590/emjnephrol/10304934","url":null,"abstract":"","PeriodicalId":348431,"journal":{"name":"EMJ Nephrology","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123123765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deceased Donor Transplantation: Patient Selection, Ethics, and New Approaches","authors":"Darcy Richards","doi":"10.33590/emjnephrol/10305728","DOIUrl":"https://doi.org/10.33590/emjnephrol/10305728","url":null,"abstract":"RENAL transplantation was a hot topic at the 60th European Renal Association (ERA) Congress 2023, which took place both virtually and in-person in Milan, Italy, between 15th–18th June. One such session saw experts in transplant medicine, surgery, and transplant ethics deliver presentations on deceased donor kidney transplantation. Co-chaired by Marta Crespo, Hospital del Mar, Barcelona, Spain, and Christophe Mariat, University Hospital Saint-Étienne, Saint-Priest-en-Jarez, France, this symposium delivered invaluable insights into donor selection, transplant ethics, and approaches to improve graft viability and implementation.","PeriodicalId":348431,"journal":{"name":"EMJ Nephrology","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127878524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}