Nephrology (Carlton, Vic.)最新文献

{"title":"Correspondence on \"New Onset of Primary Membranous Nephropathy After COVID-19 mRNA Vaccination in Affected Sjogren's Syndrome\".","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.1111/nep.70074","DOIUrl":"https://doi.org/10.1111/nep.70074","url":null,"abstract":"","PeriodicalId":520716,"journal":{"name":"Nephrology (Carlton, Vic.)","volume":"30 7","pages":"e70074"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532846","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":"Mitigating Lipotoxicity: A Potential Mechanism to Delay Chronic Kidney Disease Progression Using Current Pharmacological Therapies.","authors":"Suthiya Anumas, Reiko Inagi","doi":"10.1111/nep.70098","DOIUrl":"https://doi.org/10.1111/nep.70098","url":null,"abstract":"<p><p>Lipotoxicity, defined as the excessive accumulation of lipids in non-adipose tissues due to dysregulated lipid metabolism, is associated with several metabolic disorders, including insulin resistance, chronic kidney disease (CKD) and obesity. It contributes to renal injury through multiple interrelated mechanisms, including endoplasmic reticulum (ER) stress, mitochondrial dysfunction, impaired autophagy, inflammation and oxidative stress, and ultimately causes damage to various renal cell types. Although current pharmacological therapies have demonstrated renoprotective effects, including renin-angiotensin system inhibitors (RASi), sodium-glucose co-transporter 2 inhibitors (SGLT2i), glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and non-steroidal mineralocorticoid receptor antagonists (NS-MRAs), their precise mechanisms of action are not fully understood. Lipid-lowering agents have also shown potential renal benefits in some studies, although their exact mechanisms are also still unclear. Emerging preclinical evidence indicates that these therapies may attenuate lipotoxicity via enhanced fatty acid oxidation (FAO), reduced cholesterol biosynthesis, decreased de novo lipogenesis, anti-inflammatory and antioxidant effects and improved mitochondrial function. These effects may represent key mechanisms in the attenuation of CKD progression. This review focuses on the proposed mechanisms by which these agents may alleviate lipotoxicity. It examines the cellular responses to lipid dysregulation and finally emphasises the need for further research to clarify these pathways and their clinical relevance.</p>","PeriodicalId":520716,"journal":{"name":"Nephrology (Carlton, Vic.)","volume":"30 7","pages":"e70098"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144645216","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":"Changes in Dialysis Practice Patterns in Australia and New Zealand During the COVID-19 Pandemic Period.","authors":"Daniela Potter, Kevan R Polkinghorne, Annie Conway, Christopher E Davies, Eric Au, Andrew Pilmore, Helmant Kulkarni, Mathew Blake Roberts, Peter Kolovos, Claire Dendle, Solomon Menahem, Sradha Kotwal","doi":"10.1111/nep.70077","DOIUrl":"10.1111/nep.70077","url":null,"abstract":"<p><strong>Aim: </strong>The COVID-19 pandemic caused widespread global disruptions to healthcare systems. There has been no assessment of this on dialysis practice at a binational level.</p><p><strong>Methods: </strong>A multi-centre retrospective observational cohort study using data from the ANZDATA Registry was performed, with adult incident dialysis patients (1 January 2018 to 31 December 2022). Patients commencing dialysis during 2020-2022 were compared to 2018-2019 for the primary outcome of dialysis incidence rate. Secondary outcomes included estimated glomerular filtration rate (eGFR) at dialysis start, initial treatment location (home vs. facility), modality (haemodialysis vs. peritoneal dialysis), haemodialysis access, frequency, and duration. Commencement during lockdown in 2020-2021 was also analysed.</p><p><strong>Results: </strong>11 690 patients commenced dialysis during 2020-2022 and 7366 commenced during 2018-2019, with no differences in incidence rate across the pandemic years (2020: p = 0.163, 2021: p = 0.139, 2022: p = 0.190). Compared to pre-pandemic years, uptake of home-based therapies was higher in 2020 (OR = 1.16, 95% CI 1.06-1.27, p = 0.002) with no difference in 2021 and 2022. Peritoneal dialysis uptake was higher in 2020 (OR = 1.15, 95% CI 1.04-1.26, p = 0.005) and 2021 (OR = 1.11, 95% CI 1.01-1.21, p = 0.037) with no difference in 2022. Haemodialysis patients were less likely to commence with an arteriovenous fistula or graft in 2022, compared to pre-pandemic years (OR = 0.87, 95% CI 0.78-0.96, p = 0.005). Odds of commencing haemodialysis with an arteriovenous fistula or graft were reduced during lockdown (OR = 0.79, 95% CI 0.65-0.95, p = 0.014).</p><p><strong>Conclusion: </strong>There was no change in the incidence rate of dialysis patients during 2020-2022, although there were differences in home dialysis uptake and starting access type.</p>","PeriodicalId":520716,"journal":{"name":"Nephrology (Carlton, Vic.)","volume":"30 7","pages":"e70077"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12277125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144677137","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":"Risk Factors for the Development of BK Polyomavirus and Treatment Outcomes in Kidney Transplant Recipients: An 8-Year Retrospective Cohort Study.","authors":"Alyssa Pradhan, Melanie Wyld, Susan Wan, Rebecca Davis, Kushani Jayasinghe, Kate Wyburn","doi":"10.1111/nep.70058","DOIUrl":"10.1111/nep.70058","url":null,"abstract":"<p><strong>Background: </strong>BKPyV-DNAemia occurs in up to 30% of kidney transplant recipients (KTRs), with graft-threatening BKPyV-nephropathy in up to 10%. Risk factors for BKPyV-DNAemia, BKPyV-nephropathy, and associated graft loss are incompletely described. We sought to determine the prevalence, risk factors for, and long-term impact of BKPyV-DNAemia.</p><p><strong>Methods: </strong>A single-centre retrospective study of adult KTRs between 2010 and 2018. We used logistic regression to determine odds ratios (OR) of BKPyV-DNAemia, and survival analysis to assess the impact of BKPyV-DNAemia on graft and patient survival.</p><p><strong>Results: </strong>Of 522 patients, 100 (19%) developed BKPyV-DNAemia and 43 (8.2%) developed BKPyV-nephropathy, resulting in the loss of two grafts. Factors associated with the development of BKPyV-DNAemia were non-Caucasian ethnicity (OR 1.76, CI 0.98-3.16), pre-transplant diabetes (OR 2.06, CI 1.02-4.14) and HLA mismatch of 3/6 or 4/6 (OR 2.37, CI 1.06-5.56) and HLA mismatch of 5/6 and 6/6 (OR 2.53, CI 1.20-5.63). Additionally, a greater than 25 mg per day prednisolone dose following acute transplant and acute rejection in the first month post-transplant was associated with an increased risk of BKPyV-DNAemia (OR 3.06, CI 1.66-6.06 and OR 2.36, CI 1.16-4.75 respectively). Over a 10-year follow-up, the development of BKPyV-DNAemia and BKPyV-nephropathy was not associated with reduced graft or patient survival.</p><p><strong>Conclusion: </strong>While BKPyV-DNAemia and BKPyV-nephropathy remain prevalent in KTR, there were low rates of associated graft loss and no demonstrable impact on long-term graft or patient survival.</p>","PeriodicalId":520716,"journal":{"name":"Nephrology (Carlton, Vic.)","volume":"30 6","pages":"e70058"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12133353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144218570","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":"Economic Evaluation of Rituximab Versus Corticosteroid-Cyclophosphamide or Cyclosporine in Patients With Membranous Nephropathy in Republic of Korea.","authors":"Heejung Choi, Yoon Cho, Minjeong Lee, Ji-Woo Yun, Hankil Lee, Inwhee Park","doi":"10.1111/nep.70063","DOIUrl":"https://doi.org/10.1111/nep.70063","url":null,"abstract":"<p><strong>Background: </strong>Cyclic corticosteroid-cyclophosphamide or cyclosporine is a well-known membranous nephropathy (MN) treatment but has high risks of adverse drug reactions (ADRs). Rituximab has a non-inferior effect compared to previous treatments, with fewer ADRs. However, the high cost of rituximab is a pharmacoeconomic disincentive.</p><p><strong>Methods: </strong>We conducted a cost-minimisation analysis to evaluate the relative and absolute costs of rituximab versus corticosteroid-cyclophosphamide or cyclosporine in patients with MN over 2 years using a decision-tree model based on ADRs from two pivotal trials (RI-CYCLO and MENTOR). We included costs of medication, time, transportation, and ADRs. Deterministic sensitivity analysis and threshold analysis were performed to assess the uncertainty of the model input parameters and estimate the appropriate price of rituximab.</p><p><strong>Results: </strong>The total expected cost for rituximab was $4132, and $2684 for the comparators, with an expected incremental cost of $1448. Despite a 2.8 times higher medication cost, rituximab reduced ADR costs by 96.3% ($223), time costs by 31.1% ($280), and transportation costs by 46.8% ($180). A 46.9% price reduction of rituximab would make it an economically favourable option for treating MN compared to comparators.</p><p><strong>Conclusions: </strong>If the price of rituximab is reduced, it can be a good alternative to corticosteroid-cyclophosphamide or cyclosporine for MN in the Republic of Korea.</p>","PeriodicalId":520716,"journal":{"name":"Nephrology (Carlton, Vic.)","volume":"30 6","pages":"e70063"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259917","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":"Renal-Limited Thrombotic Microangiopathy Induced by Fruquintinib and Tislelizumab: A Case Report.","authors":"Qiang Liu, Qian Wang, Hu Tan, Weina Zhang, Beining Wang, Tiantian Jin, Li Zhang, Yan Gao","doi":"10.1111/nep.70067","DOIUrl":"https://doi.org/10.1111/nep.70067","url":null,"abstract":"<p><p>Thrombotic microangiopathy (TMA) is a rare but potentially severe condition induced by cancer treatments, including angiogenesis inhibitors and immune checkpoint inhibitors. This case report presents the first documented instance of renal-limited TMA potentially triggered by fruquintinib and tislelizumab in a patient with metastatic rectal cancer. A 60-year-old woman with stage IIIB rectal cancer developed nephrotic syndrome following treatment with fruquintinib and tislelizumab. She had no prior history of kidney disease but presented with lower limb oedema and proteinuria. Renal biopsy-confirmed TMA with focal segmental glomerulosclerosis. Following discontinuation of the drugs and management of hypertension, her renal function improved and proteinuria resolved. This case underscores the importance of monitoring renal function in patients with cancer receiving fruquintinib and immune checkpoint inhibitors, as TMA may develop even after short-term exposure. Early detection through renal biopsy and prompt withdrawal of the causative agents may prevent irreversible renal damage. Further research is required to better understand the pathophysiology of TMA in this context and to inform management strategies.</p>","PeriodicalId":520716,"journal":{"name":"Nephrology (Carlton, Vic.)","volume":"30 6","pages":"e70067"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144319198","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 First Observation and Diagnosis of Nail-Patella Syndrome Using LV-SEM: GBM Abnormalities Mimicking Alport Syndrome.","authors":"Hiroki Ito, Katsuya Ishiyama, Takuo Hirose, Shigemitsu Sato, Risa Ishikawa, Akari Endo, Ikuko Oba-Yabana, Tomoyoshi Kimura, Wako Yumura, Takefumi Mori","doi":"10.1111/nep.70062","DOIUrl":"https://doi.org/10.1111/nep.70062","url":null,"abstract":"<p><p>We report the case of a 32-year-old man with a family history of nail patella syndrome (NPS) who presented with severe kidney dysfunction, hematuria, and proteinuria. A renal biopsy was performed to rule out other kidney diseases and obtain information on the possibility of future renal transplantation, as the renal morphology was relatively preserved and abnormal urinary findings indicative of nephritis. The scarcity of viable glomeruli for conventional transmission electron microscopy (TEM) prompted us to use low-vacuum scanning electron microscopy (LV-SEM) on light microscopy samples. LV-SEM analysis revealed characteristic glomerular basement membrane (GBM) alterations, including a coarse meshwork structure and a ragged pattern, similar to the GBM changes observed in Alport syndrome. These findings, combined with genetic testing results, confirmed the diagnosis of NPS-associated nephropathy. This case represents the first reported use of LV-SEM for observing and diagnosing NPS-associated nephropathy, demonstrating its potential as a valuable diagnostic tool wherein sample availability or quality limits the conventional TEM.</p>","PeriodicalId":520716,"journal":{"name":"Nephrology (Carlton, Vic.)","volume":"30 6","pages":"e70062"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259918","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":"International Congress of Chinese Nephrologists (ICCN) 2024, 13-15 December 2024, Hong Kong.","authors":"","doi":"10.1111/nep.70043","DOIUrl":"https://doi.org/10.1111/nep.70043","url":null,"abstract":"","PeriodicalId":520716,"journal":{"name":"Nephrology (Carlton, Vic.)","volume":"30 Suppl 1 ","pages":"3-391"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593794","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":"Addressing Inequities in Early-Onset Diabetic Kidney Failure in Australia: A Response to Ellis et al.","authors":"Gokhan Koker","doi":"10.1111/nep.70064","DOIUrl":"https://doi.org/10.1111/nep.70064","url":null,"abstract":"","PeriodicalId":520716,"journal":{"name":"Nephrology (Carlton, Vic.)","volume":"30 6","pages":"e70064"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259916","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 IgG Subclass Puzzle in Syphilis-Associated Membranous Nephropathy.","authors":"Hiroki Ikai","doi":"10.1111/nep.70059","DOIUrl":"https://doi.org/10.1111/nep.70059","url":null,"abstract":"","PeriodicalId":520716,"journal":{"name":"Nephrology (Carlton, Vic.)","volume":"30 6","pages":"e70059"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144201338","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}