Minerva Urology and Nephrology最新文献

{"title":"RAASi, MRA and FGF-23 in CKD progression: the usual suspects?","authors":"Giuseppe Cianciolo, Michele Provenzano, Lilio Hu, Simona Barbuto, Maria J Soler, Paola Ciceri, Mario Cozzolino, Gaetano LA Manna","doi":"10.23736/S2724-6051.25.06082-3","DOIUrl":"10.23736/S2724-6051.25.06082-3","url":null,"abstract":"<p><p>Chronic kidney disease (CKD) affects almost 10% of the global population and is a significant health issue. The presence of CKD increases the risk of fatal and non-fatal cardiovascular events, overall mortality, and progression of renal damage leading to kidney failure. Inhibiting the renin-angiotensin-aldosterone system (RAAS) through angiotensin-converting enzyme inhibitor or angiotensin II receptor blockers reduces proteinuria and slows eGFR decline in CKD patients. Several factors can reduce the effect of inhibition RAAS, such as individual variations, drug intolerance, and adverse effects like hyperkalemia. Moreover, the aldosterone breakthrough phenomenon, where aldosterone levels rebound during RAAS therapy, limits treatment efficacy in reducing proteinuria and slowing the progression of CKD and is associated with poor cardiovascular and renal outcomes. Similarly, FGF23 attenuates RAAS blockade effectiveness through, in fact, enhancing the expression of angiotensin-converting enzyme 2 and reducing degradation of angiotensin I to angiotensin 1-9 and angiotensin II to angiotensin 1-7 inducing a reduced efficacy in controlling RAAS-mediated effects and an increase of cardiovascular risk and CKD progression. New therapeutic strategies to reduce the progression of CKD, such as SGLT-2 inhibitors, GLP-1 receptor agonists, and mineralocorticoid receptor antagonists (MRAs), are recommended in CKD patients to reduce the risk of progression and cardiovascular events. Furthermore, these therapies may reduce FGF-23 levels and regulate aldosterone breakthrough. This review aims to clarify the mechanisms underlying CKD progression, with a focus on aldosterone breakthrough, FGF-23, and activins, in order to identify new therapeutic approaches for better management of CKD and its complications.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":"191-202"},"PeriodicalIF":4.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001942","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":"Comment on: \"From nocturnal awakenings to nocturnal voiding: the relationship between insomnia and nocturia: a systematic review\".","authors":"Katharina Lederer, Orestis Briasoulis, Antonio Olivieri","doi":"10.23736/S2724-6051.25.06633-9","DOIUrl":"10.23736/S2724-6051.25.06633-9","url":null,"abstract":"","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":"283-284"},"PeriodicalIF":4.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145543870","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":"The data dividend: how AI turns robotic surgery into measurable value. Insight from EAU-YAU Urotechnology and Digital Health Working Group.","authors":"Pieter DE Backer, Severin Rodler, Karl F Kowalewski, Ines Rivero Belenchon, Stefano Puliatti, Pietro Piazza, Loic Baekelandt, Mark Taratkin, Antonio A Grosso, Mieszko Kozikowski, Stessy Kutchukian, Alessandro Veccia, Riccardo Lombardo, Enrico Checcucci","doi":"10.23736/S2724-6051.26.06984-3","DOIUrl":"https://doi.org/10.23736/S2724-6051.26.06984-3","url":null,"abstract":"","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":"78 2","pages":"161-163"},"PeriodicalIF":4.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147788970","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":"Are we ready for stereotactic body radiotherapy in unfavorable intermediate and high-risk prostate patient cancer?","authors":"Fernando Munoz","doi":"10.23736/S2724-6051.25.06747-3","DOIUrl":"10.23736/S2724-6051.25.06747-3","url":null,"abstract":"","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":"298-299"},"PeriodicalIF":4.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145642571","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":"The burden of Prostate Cancer in Italy from 1990 to 2023, compared to the GBD Regions: results from the Global Burden of Disease Study 2023.","authors":"Roberto Passera, Lorenzo Monasta, Giulia Zamagni","doi":"10.23736/S2724-6051.25.06804-1","DOIUrl":"10.23736/S2724-6051.25.06804-1","url":null,"abstract":"","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":"295-297"},"PeriodicalIF":4.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745696","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":"Machine learning methods for predicting early recurrence in Ta stage bladder cancer and comparison with conventional statistical methods.","authors":"Ubeyd Sungur, Alper Bitkin, Mithat Ekşi, Hakan Polat, Ali I Taşçi","doi":"10.23736/S2724-6051.25.06385-2","DOIUrl":"10.23736/S2724-6051.25.06385-2","url":null,"abstract":"<p><strong>Background: </strong>Predicting whether recurrence will occur during follow-up in bladder cancer cases confined to the mucosa (Ta-stage) is one of the crucial aspects of management. In this study, we aimed to compare the models obtained by conventional statistical methods and machine learning (ML) methods in order to predict the development of recurrence in the 2-year postoperative period in Ta stage Non-Muscle Invasive Bladder Cancers.</p><p><strong>Methods: </strong>The data of patients who underwent complete transurethral resection of the bladder and were found to have Ta pathologies due to primary bladder cancer between 2018-2021 was retrospectively screened. Patients with no recurrence during the two-year follow-up were classified as Group 1 (N.=107, 58.2%), and those with recurrence were classified as Group 2 (N.=77, 41.8%). The demographic, clinical, imaging and pathological data were recorded. These parameters were analyzed using a conventional statistical method and ML methods to construct prediction models.</p><p><strong>Results: </strong>Body Mass Index, American Society of Anesthesiologists (ASA) score, and the presence of macroscopic hematuria were found to be significant variables to predict early recurrence (P<0.05). The prediction model created by Cox-regression analysis was determined to have a sensitivity of 65%, specificity of 63.6%, and an area under the curve (AUC) value of 66%, while the AUC values achieved by the ML methods, namely random forest, logistic regression, and k-nearest neighbors, were calculated to be 0.75, 0.87 and 0.74, respectively.</p><p><strong>Conclusions: </strong>Models developed using ML can provide more accurate predictions than conventional statistical methods in predicting the recurrence of Ta bladder cancer.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":"232-240"},"PeriodicalIF":5.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145953842","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":"Real-world multicenter adherence to international guidelines in the management of upper tract urothelial carcinoma: insights from the ROBUUST 2.0 Registry.","authors":"Mariaconsiglia Ferriero, Gabriele Tuderti, Flavia Proietti, Giuseppe Chiacchio, Gabriele Bignante, Zhenjie Wu, Linhui Wang, Vitaly Margulis, Raj Bhanvadia, Firas Abdollah, Nicholas B Cusumano, Alessandro Antonelli, Francesco Ditonno, Alessandro Veccia, Nirmish Singla, Stephan Brönimann, Ithaar H Derweesh, Dhruv Puri, Margaret F Meagher, Soroush Rais-Bahrami, Sol C Moon, Matteo Ferro, Ottavio DE Cobelli, Francesco Porpiglia, Daniele Amparore, Enrico Checcucci, Randall Lee, Andres F Correa, Daniel D Eun, Mark L Gonzalgo, Omri F Nativ, Sisto Perdonà, Antonio Tufano, Ahmed Eraky, Reza Mehrazin, Courtney Yong, Chandru P Sundaram, Takashi Yoshida, Hidefumi Kinoshita, Alireza Ghoreifi, Farshad S Moghaddam, Hooman Djaladat, Riccardo Autorino, Giuseppe Simone","doi":"10.23736/S2724-6051.26.06684-X","DOIUrl":"10.23736/S2724-6051.26.06684-X","url":null,"abstract":"<p><strong>Background: </strong>The European Association of Urology (EAU), American Urological Association (AUA) and National Comprehensive Cancer Network (NCCN) guidelines (GL) represent key international standards for clinical practice. We assessed the adherence to EAU-AUA- NCCN GL in a large real-world multicenter cohort of patients with Upper Tract Urothelial Carcinoma (UTUC), treated with nephroureterectomy.</p><p><strong>Methods: </strong>A multicenter retrospective analysis from the ROBUUST (ROBotic surgery for Upper tract Urothelial cancer STudy) registry was performed to assess the region-specific adherence rates to guidelines (GL) for perioperative treatments and their impact on oncological outcomes was evaluated with the Kaplan-Meier method.</p><p><strong>Results: </strong>Out of 2307 patients, excision was the most adopted approach for bladder cuff management world-wide (USA 88.6%, EU 90.5%, Asia 89.8%). Postoperative bladder instillation (intravesical chemotherapy) was implemented in 28.4% of all cases and did not impact bladder recurrence-free survival (log rank P=0.45). Lymphadenectomy (LND) in high-risk disease was underused in both locally advanced (cT3-4: USA 35.8%, EU 46.8%, A 25%) and cN+ stages (USA 41.9%, EU 47.9%, A 43%). LND was not associated with better cancer-specific survival (CSS) across all stages (log rank P≥0.53). Adjuvant chemotherapy (AdCHT) was administered overall in 27.8% of pT2-T4 cases, with a significantly higher adoption in Asia (P=0.03); while in pN+ disease, AdCHT rate was 30.2% and did not convey any advantage in CSS (P=0.58). Retrospective design is the main limitation of the present study.</p><p><strong>Conclusions: </strong>The present contemporary \"real world\" data suggests poor adherence to current EAU-AUA guidelines for key indicators of quality care such as perioperative bladder instillation of chemotherapy, performance of LND and administration of adjuvant chemotherapy for advanced disease. These findings highlight the need of improving the implementation of these guideline driven treatment strategies.</p>","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":"78 2","pages":"241-248"},"PeriodicalIF":5.1,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147788987","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":"The burden of prostate cancer in Italy from 1990 to 2023, compared to the European Union and the Socio-Demographic Index (SDI) quintile countries: results from the Global Burden of Disease Study 2023.","authors":"Roberto Passera, Lorenzo Monasta, Giulia Zamagni","doi":"10.23736/S2724-6051.25.06802-8","DOIUrl":"10.23736/S2724-6051.25.06802-8","url":null,"abstract":"","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":"288-291"},"PeriodicalIF":4.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145598009","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":"The burden of prostate cancer in Italy from 1990 to 2023, compared to the GBD Super Regions: results from the Global Burden of Disease Study 2023.","authors":"Roberto Passera, Lorenzo Monasta, Giulia Zamagni","doi":"10.23736/S2724-6051.25.06803-X","DOIUrl":"10.23736/S2724-6051.25.06803-X","url":null,"abstract":"","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":" ","pages":"291-294"},"PeriodicalIF":4.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745720","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":"Retroperitoneal robotic partial nephrectomy with the Versius system: a case series.","authors":"Nazario Foschi, Mauro Ragonese, Pierluigi Russo, S Koosha Moosavi, Rocco Ruocco, Giovanni B Filomena, Francesco Rossi, Savio D Pandolfo, Filippo Gavi, Maria C Sighinolfi, Bernardo Rocco","doi":"10.23736/S2724-6051.26.06818-7","DOIUrl":"https://doi.org/10.23736/S2724-6051.26.06818-7","url":null,"abstract":"","PeriodicalId":53228,"journal":{"name":"Minerva Urology and Nephrology","volume":"78 2","pages":"299-301"},"PeriodicalIF":4.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789048","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}