Nephrology (Carlton, Vic.)最新文献

{"title":"60th ANZSN Congress 30 August - 3 September 2025 Perth, Western Australia.","authors":"","doi":"10.1111/nep.70084","DOIUrl":"https://doi.org/10.1111/nep.70084","url":null,"abstract":"","PeriodicalId":520716,"journal":{"name":"Nephrology (Carlton, Vic.)","volume":"30 Suppl 3 ","pages":"7"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145234869","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":"Isolated Antiphospholipid Syndrome Nephropathy (aPL Nephropathy)-A Rare Cause of a Rapid Decline in Kidney Function in a Patient With Systemic Lupus Erhythematosus.","authors":"Kseniia Kurginian, Ekaterina Stolyarevich, Pavel Novikov, Sergey Moiseev, Nikolay Bulanov","doi":"10.1111/nep.70111","DOIUrl":"10.1111/nep.70111","url":null,"abstract":"<p><p>Lupus nephritis (LN) is one of the most common renal manifestations of systemic lupus erythematosus (SLE). However, conditions other than LN can result in a rapid decline in kidney function. We present a clinical case of a young patient with SLE who developed arterial hypertension, arthralgia and morning stiffness in knee and hand joints, an increase in serum creatinine levels from 194 to 532 mol/L, proteinuria of 1.65 g/L and thrombocytopenia of 1000/μL. Kidney biopsy showed isolated antiphospholipid antibody nephropathy (aPL-N) without any signs of proliferative LN or tubulointerstitial nephritis. The patient was treated with low-molecular-weight heparin, followed by warfarin (target INR 2.0-3.0), low-dose glucocorticoids and azathioprine, resulting in SLE remission and partial recovery of kidney function. This study demonstrates that isolated aPL-N can cause a rapid decline in kidney function in patients with SLE. To avoid diagnostic errors, kidney biopsy should be performed in a timely manner in all patients with SLE according to standard indications.</p>","PeriodicalId":520716,"journal":{"name":"Nephrology (Carlton, Vic.)","volume":"30 8","pages":"e70111"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144877929","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":"Regional Citrate vs. Systemic Unfractionated Heparin Anticoagulation for Continuous Renal Replacement Therapy in Paediatric Patients: Systematic Review and Meta-Analysis.","authors":"Yi Wang, Lan Yang, Yaping Liu, Yuan Yang, Yanxingli Han, Jing Yang, Lanqi Zhou, Ming Dong, Jun Yang, Jianhua Zhou, Yu Zhang","doi":"10.1111/nep.70107","DOIUrl":"10.1111/nep.70107","url":null,"abstract":"<p><p>The efficacy and safety of unfractionated heparin (UFH) and regional citrate anticoagulation (RCA) in continuous renal replacement therapy (CRRT) are subjects of controversy across paediatric patients. We conducted a search of the PubMed, Embase and Cochrane Library databases from inception to 2024. The Newcastle-Ottawa Scale was used to assess the quality of the included studies. Sensitivity analysis confirmed the stability of results; publication bias was investigated by Egger test. We conducted a search of the PubMed, Embase and Cochrane Library databases from inception to 2024, and 12 studies were included. Compared with UFH, RCA significantly prolonged circuit survival time (WMD 12.09, 95% CI: [4.48, 19.71], p = 0.002), reduced the risk of filter clotting (RR = 0.60, 95% CI: [0.42-0.85], p = 0.004) and bleeding (RR = 0.42, 95% CI: [0.23-0.79], p = 0.007). Although citrate anticoagulation was more likely to cause metabolic alkalosis (RR = 3.22, 95% CI: [1.34-7.75], p = 0.009) and hypocalcemia (RR = 2.92, 95% CI: [1.93-4.41], p < 0.001), metabolic complications were manageable and mild. Further subgroup analysis of paediatrics showed that, compared with children with an average weight > 10 kg, citrate anticoagulation significantly extended the circuit survival time of children with an average weight ≤ 10 kg (p < 0.001). Sensitivity analysis confirmed that the results were generally robust. RCA could be the first choice for anticoagulation in paediatrics, especially for infants weighing ≤ 10 kg.</p>","PeriodicalId":520716,"journal":{"name":"Nephrology (Carlton, Vic.)","volume":"30 8","pages":"e70107"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144819058","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":"Patient Needs and Priorities for a Goal-Setting Intervention in Kidney Transplant Recipients: A Workshop Report.","authors":"Colm O'Reilly, Dale Coghlan, Anastasia Hughes, Karine Manera, Andrea Matus Gonzalez, Javier Recabarren Silva, Angela Rejuso, Nicole Scholes-Robertson, Armando Teixeira-Pinto, Germaine Wong, Rebecca Wu, Jeff S Coombes, Jacki Liddle, John Kanellis, Martin Howell, Yeoungjee Cho, Kelly Lambert, Rebekah Laidsaar-Powell, Allison Jaure, Chandana Guha","doi":"10.1111/nep.70106","DOIUrl":"https://doi.org/10.1111/nep.70106","url":null,"abstract":"<p><strong>Aim: </strong>Kidney transplant recipients have an increased risk of side effects and complications and must adhere to a complex treatment regimen. Goal-setting interventions have the potential for improving behavioural, health and quality of life outcomes. The aim of the workshop was to identify the priorities of kidney transplant recipients regarding goal-setting domains, and to describe their perspectives on the design and implementation of goal-setting interventions.</p><p><strong>Methods: </strong>We convened an online workshop co-designed with consumers and researchers with three breakout groups involving 18 adult kidney transplant recipients in Australia. Participants identified and voted for goal-setting domains (e.g., diet and nutrition), in order of priority, discussed reasons for their priorities, and provided suggestions for the design and implementation of a goal-setting program. Votes were then scored to reflect the level of priority assigned to each domain. Transcripts from the workshop were analysed thematically.</p><p><strong>Results: </strong>Of the seven goal-setting domains voted as important to patients, the top five domains were: treatment management (53 points), diet and nutrition (22 points), physical fitness (15 points), social participation (6 points) and mental health (5 points). Four themes that captured the discussions were: adapting to complex self-management responsibilities, strengthening motivation, ensuring safety and contributing to long-term benefits.</p><p><strong>Conclusion: </strong>In a co-design process, kidney transplant recipients prioritised the goal-setting domains that addressed treatment, lifestyle and psychosocial wellbeing, and suggested that a goal-setting intervention should involve coaching and monitoring.</p>","PeriodicalId":520716,"journal":{"name":"Nephrology (Carlton, Vic.)","volume":"30 8","pages":"e70106"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144805585","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":"Ageing Is Not a Disease: Reconsidering Chronic Kidney Disease Diagnosis in the Elderly.","authors":"Diego Moriconi","doi":"10.1111/nep.70101","DOIUrl":"https://doi.org/10.1111/nep.70101","url":null,"abstract":"","PeriodicalId":520716,"journal":{"name":"Nephrology (Carlton, Vic.)","volume":"30 8","pages":"e70101"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144746987","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":"60th ANZSN Congress 30 August - 3 September 2025 Perth, Western Australia.","authors":"","doi":"10.1111/nep.70081","DOIUrl":"https://doi.org/10.1111/nep.70081","url":null,"abstract":"","PeriodicalId":520716,"journal":{"name":"Nephrology (Carlton, Vic.)","volume":"30 Suppl 3 ","pages":"4"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145234823","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":"Clinical Value of Metagenomic Next-Generation Sequencing in Early Diagnosis of Peritoneal Dialysis-Associated Peritonitis: A Randomised Controlled Observational Trial.","authors":"Aiting Li, Zhijin Chen, Qianyun Deng, Caiyan Zheng, Haofei Hu, Zhiming Ye","doi":"10.1111/nep.70094","DOIUrl":"10.1111/nep.70094","url":null,"abstract":"<p><strong>Aim: </strong>While metagenomic next-generation sequencing (mNGS) is a high-throughput diagnostic tool capable of rapidly and accurately identifying pathogenic microorganisms, predicting their antibiotic resistance/susceptibility profiles, its clinical utility in peritoneal dialysis-associated peritonitis (PDAP) remains unvalidated. This study aims to evaluate its ability to enable early pathogen detection and predict antibiotic susceptibility, thereby informing optimised treatment strategies.</p><p><strong>Method: </strong>A prospective randomised controlled trial was conducted in patients diagnosed with PDAP. Participants were divided into two groups: (1) the culture & mNGS group (n = 78), where both conventional dialysis effluent culture and mNGS were performed, and clinicians had access to mNGS results; and (2) the only culture group (n = 76), where clinicians relied solely on culture results. All patients were examined for mNGS, but only patients in the culture & mNGS group had mNGS results that were known to their clinicians. Empirical intraperitoneal antimicrobial therapy was initiated for all patients, with subsequent regimen adjustments based on clinical judgement, culture reports, and/or mNGS findings. The study duration spanned from the initiation of anti-infective therapy to 3 months post-treatment. Outcomes included the comparative performance of culture versus mNGS, mNGS-based antimicrobial resistance prediction accuracy, and the clinical impact on treatment decisions.</p><p><strong>Results: </strong>The culture & mNGS group demonstrated a significantly higher pathogen detection rate than the only culture group (p = 0.001). mNGS identified pathogens faster than conventional culture (p < 0.001) and detected polymicrobial infections at a higher rate (p = 0.018). mNGS achieved 88.94% accuracy in predicting antimicrobial resistance. No significant difference was observed between the culture & mNGS group and the only culture group in time to normalisation of dialysis effluent leukocyte counts (p = 0.31).</p><p><strong>Conclusion: </strong>Integrating mNGS into diagnostic workflows enhances pathogen detection efficiency, accelerates results, and improves the precision of antimicrobial therapy. These advantages suggest that mNGS-guided strategies may optimise clinical management of PDAP.</p><p><strong>Trial registration: </strong>ChiClinicalTrials.gov identifier: CTR2300070995 (28/04/2023).</p>","PeriodicalId":520716,"journal":{"name":"Nephrology (Carlton, Vic.)","volume":"30 8","pages":"e70094"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12319393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144777656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"60th ANZSN Congress 30 August - 3 September 2025 Perth, Western Australia.","authors":"","doi":"10.1111/nep.70083","DOIUrl":"https://doi.org/10.1111/nep.70083","url":null,"abstract":"","PeriodicalId":520716,"journal":{"name":"Nephrology (Carlton, Vic.)","volume":"30 Suppl 3 ","pages":"5"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145234882","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":"Incidence of Malignancy in Post-Donation Living Kidney Donors: A Single-Center, Retrospective Cohort Study in Japan.","authors":"Kana Shirai, Masatomo Ogata, Marie Murata-Hasegawa, Takamasa Miyauchi, Yuko Sakurai, Hideo Sasaki, Kazunobu Shinoda, Yugo Shibagaki, Masahiko Yazawa","doi":"10.1111/nep.70108","DOIUrl":"10.1111/nep.70108","url":null,"abstract":"<p><strong>Aim: </strong>Long-term health outcomes in living kidney donors (LKDs) are generally favourable. However, recent studies suggest a slightly increased malignancy risk when compared to the general healthy population. Malignancies are influenced by environmental and racial factors; nonetheless, descriptive epidemiological studies on malignancy incidence in LKDs in Asia are lacking. In this study, we aimed to investigate the incidence and characteristics of post-donation malignancies in LKDs.</p><p><strong>Methods: </strong>This retrospective observational study included 196 LKDs who underwent nephrectomies between 2008 and 2023. LKDs were categorised into new-onset malignancy and non-malignancy cohorts. Postoperative malignancy surveillance combined population-based cancer screenings, employer-sponsored health examinations, self-paid health checkups, and active surveillance. Baseline characteristics, cancer types, outcomes, and the correlation between cancer incidence and postoperative albuminuria were analysed.</p><p><strong>Results: </strong>Eighteen LKDs (9.2%) developed malignancies over a mean follow-up of 6.7 ± 4.1 years, with an incidence rate of 13.6 per 1000 person-years. The most common cancers were gastric, colorectal, and prostate. Malignancy was more frequent in older donors, males, and those with postoperative hypertension. Most cases were detected at an early stage, allowing curative treatment. The most common diagnostic category of cancer identified was performed as part of our institution's active surveillance. No notable correlation was observed between albuminuria and cancer incidence.</p><p><strong>Conclusion: </strong>While some LKDs developed post-donation malignancies, appropriate and balanced cancer surveillance is essential in managing LKDs, in whom the principle of \"do no harm\" must be upheld. Establishing a structured system, including public screening programmes and LKD-specific surveillance, would help ensure donor safety and long-term health.</p>","PeriodicalId":520716,"journal":{"name":"Nephrology (Carlton, Vic.)","volume":"30 8","pages":"e70108"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144850354","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":"A Novel PHEX Mutation in X-Linked Hypophosphataemic Rickets With Reduced Expression of NaPi-IIa and NaPi-IIc in the Proximal Tubules: A Case Report.","authors":"Masahiro Muto, Tomohito Gohda, Miyuki Takagi, Takashi Kobayashi, Masao Kihara, Harumi Saeki, Takayasu Mori, Eisei Sohara, Shinichi Uchida, Yuichiro Yamashiro, Yusuke Suzuki","doi":"10.1111/nep.70104","DOIUrl":"https://doi.org/10.1111/nep.70104","url":null,"abstract":"<p><p>X-linked hypophosphataemia (XLH, MIM#307800) is an inherited form of rickets resulting from mutations in the phosphate-regulating neutral endopeptidase (PHEX) gene on the X chromosome. These mutations lead to elevated circulating fibroblast growth factor 23 (FGF23), which disrupts phosphate homeostasis and contributes to XLH pathogenesis. We present a sporadic case of a 41-year-old woman diagnosed with rickets in childhood who later developed persistent proteinuria. Kidney biopsy revealed segmental sclerosis with a perihilar lesion in one of 19 glomeruli, along with dilated proximal tubules, reduced expression of the sodium-dependent phosphate transporters (NaPi-IIa and NaPi-IIc) and lysosomal particle accumulation in proximal tubule epithelial cells. Next-generation sequencing identified a novel heterozygous missense mutation in PHEX (c.2179T>A; p.Phe727Ile), which, to our knowledge, has not been previously reported. Detailed kidney biopsy findings in XLH are rare. This case report provides novel insights into XLH pathophysiology, highlighting kidney-specific pathological changes and reinforcing the importance of genetic testing for precise diagnosis and management.</p>","PeriodicalId":520716,"journal":{"name":"Nephrology (Carlton, Vic.)","volume":"30 8","pages":"e70104"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144791803","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}