Frontiers in nephrology最新文献

{"title":"Telemonitoring post-renal transplantation and role of advanced practice nurses: a single center experience.","authors":"Delphine Bailly, Maher Abdessater, Ramy Touma Sawaya, Benoit Barrou, Sarah Drouin","doi":"10.3389/fneph.2026.1776371","DOIUrl":"https://doi.org/10.3389/fneph.2026.1776371","url":null,"abstract":"<p><strong>Introduction: </strong>Telemonitoring has the potential to improve access to care and continuity of follow-up after kidney transplantation. Advanced practice nurses (APNs) play an increasingly important role in coordinating remote care pathways. This study evaluated patient experience with telemonitoring after renal transplantation, identified determinants of adherence, and clarified the role of APNs in this model.</p><p><strong>Methods: </strong>We conducted a single-center retrospective observational study including adult kidney transplant recipients enrolled in a telemonitoring program between April 2020 and April 2022. Patients were classified as active users (TOUCO), discontinued users (STOPCO), or never users (JAMCO). Satisfaction and experience were assessed through questionnaires. Platform activity and APN workload were analyzed using descriptive statistics.</p><p><strong>Results: </strong>Among 207 eligible patients, 110 responded to the survey (53%): 64 TOUCO (71%), 11 STOPCO (47%), and 35 JAMCO (37%). Active users reported high satisfaction with response time (89%), improved access to care (81%), and increased reassurance (75%). Ease of use (86%) and adequate information at enrollment were significantly associated with continued use. Major barriers included technical difficulties (≈80%) and loss of login credentials (>50%). During the study period, 5,214 platform events and more than 4,000 secure messages were recorded, reflecting sustained engagement. APNs required a mean workload of 3 hours per day to manage all active users on a daily basis.</p><p><strong>Conclusion: </strong>Telemonitoring after kidney transplantation is feasible and well accepted, improving perceived access to care and enhancing patient reassurance without measured clinical outcome differences. Adherence is driven primarily by organizational and technological factors rather than patient characteristics. APNs play a central role in ensuring continuity of care, triaging data, and maintaining patient engagement. Future studies should evaluate clinical outcomes and cost-effectiveness to support broader implementation.</p>","PeriodicalId":73091,"journal":{"name":"Frontiers in nephrology","volume":"6 ","pages":"1776371"},"PeriodicalIF":0.0,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13104594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790568","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":"Electrolyte homeostasis in pregnancy: from physiological adaptations to clinical disturbances - a nephrologist's perspective.","authors":"Priti Meena, Aisha Batool","doi":"10.3389/fneph.2026.1773415","DOIUrl":"https://doi.org/10.3389/fneph.2026.1773415","url":null,"abstract":"<p><p>Electrolyte homeostasis in pregnancy undergoes several important remodellings driven by systemic vasodilation, activation of neurohormonal pathways, increased glomerular filtration, altered tubular transport, and active maternal-fetal mineral exchange. These coordinated adaptations enable plasma volume expansion, mainta<i>in utero</i>placental perfusion, and support fetal growth, yet they narrow compensatory reserves and shift normal biochemical reference thresholds. As a result, reliance on non-pregnant laboratory norms can misclassify abnormalities, delaying recognition of clinically important disturbances. Understanding pregnancy-specific physiology is therefore essential for accurate diagnosis, monitoring, and therapeutic decision-making. This review provides an integrated nephrology-focused synthesis of normal adaptive mechanisms and disorder-specific pathophysiology across sodium-water, potassium, magnesium, and calcium balance. We summarize expected gestational changes, including the reset osmostat and AVP-mediated free-water retention causing a physiological fall in serum sodium, changes in potassium homeostasis and magnesium homeostasis, and the doubling of intestinal calcium absorption driven by increased calcitriol to meet third-trimester skeletal mineralization. We further review common clinical disorders of water and sodium, potassium, calcium, and magnesium. The review provides a comprehensive pregnancy-specific interpretation of electrolyte values, diagnostic evaluation strategies, and targeted management tailored to maternal and fetal safety aimed at improving clinical vigilance and optimizing outcomes.</p>","PeriodicalId":73091,"journal":{"name":"Frontiers in nephrology","volume":"6 ","pages":"1773415"},"PeriodicalIF":0.0,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13061682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679055","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":"Safety Net kidney after liver transplantation: unexpected renal recovery in a liver transplant recipient after more than 10 months on maintenance hemodialysis - a case report.","authors":"Phuong-Thu T Pham, Phuong-Chi T Pham","doi":"10.3389/fneph.2026.1762265","DOIUrl":"https://doi.org/10.3389/fneph.2026.1762265","url":null,"abstract":"<p><p>The incidence and likelihood of kidney function recovery in liver transplant recipients with acute kidney injury (AKI) due to hepatorenal syndrome (HRS) or acute tubular necrosis (ATN) requiring maintenance dialysis remain undefined. Nonetheless, it has been suggested that dependence on dialysis for more than 6 months diminishes the likelihood of renal function recovery. We report a liver transplant recipient with pre-transplantation AKI attributed to HRS with or without ATN who recovered kidney function after more than 10 months on dialysis.</p>","PeriodicalId":73091,"journal":{"name":"Frontiers in nephrology","volume":"6 ","pages":"1762265"},"PeriodicalIF":0.0,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13043353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147624637","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":"A behavioral and electrophysiological investigation of conflict monitoring in cystinosis (CTNS gene mutations) using the flanker paradigm.","authors":"Sophie Molholm, Ana A Francisco, Douwe J Horsthuis, Tringa Lecaj, Dennis Cregin, Chloe Brittenham, John J Foxe","doi":"10.3389/fneph.2026.1608421","DOIUrl":"10.3389/fneph.2026.1608421","url":null,"abstract":"<p><p>Cystinosis, a rare lysosomal storage disease, is characterized by cystine crystallization and accumulation within tissues and organs, including the kidneys and brain. Its impact on neural function appears mild relative to its effects on other organs, but therapeutic advances have led to substantially increased life expectancy, necessitating deeper understanding of its impact on neurocognitive function. Behaviorally, some deficits in executive function have been noted in this population, but the underlying neural processes are not understood. Using standardized cognitive assessments and a Flanker task in conjunction with high-density electrophysiological recordings (EEG), we investigated the neural dynamics of conflict monitoring in individuals with cystinosis, when compared to age-matched controls. Thirty-six individuals diagnosed with cystinosis (8-38 years old, 25 women) and 39 age-matched controls (23 women) participated in this study. As expected, slower reaction times and larger amplitudes were observed in incongruent vs congruent trials in both groups, suggesting largely maintained conflict monitoring in cystinosis. However, when compared to their age-matched peers, individuals with cystinosis presented larger differences between congruent and incongruent trials both behaviorally (reaction times) and electrophysiologically (N2, P3). Our findings suggest that individuals with cystinosis are able to monitor and adapt to conflict, even if slower, less accurately, and more effortfully than their age-matched peers.</p>","PeriodicalId":73091,"journal":{"name":"Frontiers in nephrology","volume":"6 ","pages":"1608421"},"PeriodicalIF":0.0,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13017271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147576775","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":"Effect of preexisting human leukocyte antigen donor-specific antibodies especially human leukocyte antigen-DQ on kidney transplant outcome.","authors":"Sonia Mehrotra, Raj Kumar Sharma, Rakesh Kapoor, Rajesh Kumar Jaiswal, Rohit Kapoor","doi":"10.3389/fneph.2026.1734903","DOIUrl":"10.3389/fneph.2026.1734903","url":null,"abstract":"<p><strong>Background: </strong>Anti-HLA-DQ donor-specific antibodies are increasingly recognized for their role in early rejection and compromised graft function following kidney transplantation.</p><p><strong>Methods: </strong>A total of 119 prospective kidney transplant recipients were evaluated for pre-transplant HLA sensitization using single antigen bead (SAB) assays for class I and class II donor-specific antibodies (DSAs). All patients had negative complement-dependent cytotoxicity (CDC) crossmatch results; however, flow cytometry crossmatch was positive for T cells in three patients and showed borderline B-cell positivity in one patient. Of these patients, 100 proceeded to kidney transplantation, including 19 ABO-incompatible transplants. All recipients were followed for a minimum of 4 years post-transplant, and induction immunosuppression was administered using either anti-thymocyte globulin (ATG) or ATLG (Grafalon^®).</p><p><strong>Results: </strong>A total of 100 patients underwent kidney transplant. Among them, 34 recipients (34%) had class I HLA antibodies (MFI range: 9,057 to 757) and 5 had class I DSAs (MFI range: 2,084 to 822) without any rejection episodes. Thirty-eight patients (38%) tested positive for class II HLA antibodies, including 20 with anti-HLA-DQ (MFI range: 7,725 to 766); of these, eight had donor-specific anti-DQ antibodies. Only one patient, who underwent an ABO-incompatible transplant and had pre-transplant DQ DSA with MFI 7,725, developed biopsy-proven antibody-mediated rejection (ABMR) but recovered following treatment. All eight DQ DSA-positive recipients showed post-transplant MFI decline within 1 month. Rejection was notably infrequent in recipients who received Grafalon^® induction.</p><p><strong>Conclusions: </strong>Preformed anti-HLA-DQ DSAs, especially with MFI >5,000 and in the context of ABO incompatibility, may predispose to AMR. DQ DSAs with lower MFI require vigilant monitoring due to the risk of post-transplant rebound. ATLG-based induction was associated with low rejection incidence and favorable short-term outcomes.</p>","PeriodicalId":73091,"journal":{"name":"Frontiers in nephrology","volume":"6 ","pages":"1734903"},"PeriodicalIF":0.0,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13017241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147576854","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":"Successful use of obinutuzumab in focal segmental glomerulosclerosis with inadequate response to rituximab: a case report.","authors":"Andreia Rita Henriques, João Venda, Emanuel Ferreira, Nuno Oliveira, Helena Sá","doi":"10.3389/fneph.2026.1772736","DOIUrl":"https://doi.org/10.3389/fneph.2026.1772736","url":null,"abstract":"<p><strong>Introduction: </strong>Podocytopathies such as minimal change disease (MCD) and focal segmental glomerulosclerosis (FSGS) remain therapeutic challenges in adults. Although corticosteroids and rituximab (RTX), a chimeric anti-CD20 monoclonal antibody, are effective in most patients, up to 10% show resistance or relapse despite B-cell depletion. Obinutuzumab (OBZ), a humanized type II anti-CD20 monoclonal antibody, achieves deeper and more sustained B-cell depletion and may overcome RTX inadequate response.</p><p><strong>Case report: </strong>A 33-year-old woman presented with nephrotic syndrome (proteinuria 7.1 g/24 h, serum albumin 2.6 g/dL, preserved renal function). Kidney biopsy revealed primary FSGS. She achieved only partial remission with corticosteroids and cyclosporine. RTX (1 g × 2 doses) induced transient peripheral B-cell depletion but no complete remission. A second biopsy excluded chronic changes, and genetic testing for hereditary podocytopathy was negative. Thus 67 weeks after diagnosis and initial treatment with persistent proteinuria > 1g/24 h and hypoalbuminemia, the patient received OBZ (1 g × 2 doses, two weeks apart). Two months later, she achieved complete remission (proteinuria 0.2 g/24 h, serum albumin 3.7 g/dL), with sustained B-cell depletion and no adverse events. A repeat administration of OBZ (1 g) was performed 10 months later due to B-cell repopulation, rising proteinuria (0.6 g/24 h), and mild hypoalbuminemia (serum albumin 3.4 g/dL), successfully re-inducing complete remission (proteinuria 0.2 g/24 h, serum albumin 3.8 g/dL).</p><p><strong>Discussion: </strong>This case illustrates the potential of OBZ as an effective therapeutic option in podocytopathies with RTX inadequate response. The superior efficacy of OBZ may result from enhanced antibody-dependent cellular cytotoxicity, depletion of tissue-resident B cells, and reduced immunogenicity compared with RTX. OBZ may thus offer an alternative in refractory MCD/FSGS.</p>","PeriodicalId":73091,"journal":{"name":"Frontiers in nephrology","volume":"6 ","pages":"1772736"},"PeriodicalIF":0.0,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12992063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147481560","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":"Treatment practices, characteristics and outcome of immunoglobulin A nephropathy - a Swiss single center experience.","authors":"Danny Thieny Taing, Bruno Vogt, Laila-Yasmin Mani","doi":"10.3389/fneph.2026.1648950","DOIUrl":"10.3389/fneph.2026.1648950","url":null,"abstract":"<p><strong>Introduction: </strong>Immunoglobulin A nephropathy (IgAN) is the most common primary glomerulonephritis worldwide. Geographic differences in disease course and treatment response are well recognized. The purpose of this analysis was to study clinical and histological characteristics, treatment practices and outcome of IgAN cases from a Swiss tertiary center.</p><p><strong>Methods: </strong>This retrospective cohort analysis identified 158 cases of adult biopsy-proven IgAN by chart review diagnosed between 1980 and 2016. Following detailed phenotyping, standard descriptive methods and univariate analysis were applied.</p><p><strong>Results: </strong>The majority of patients was male and of European ancestry. At diagnosis, mean estimated glomerular filtration rate (eGFR) was 55.7 ml/min/1.73 m², mean proteinuria was 2.4 g/d and 69.9% of the patients were hypertensive. Clinical presentation varied according to age. Initial biopsies showed moderate to severe tubular atrophy and interstitial fibrosis (IFTA) in 29.1% and crescents in 36.7% of cases. Therapy included renin-angiotensin-aldosterone-inhibitors in 86.7% as well as immunosuppressive therapy in 46.8% including steroids and other immunosuppressive drugs (28.7%), mainly azathioprin. Outcome included 34.1% complete and 22.2% partial remissions, relapses in 32.0% of patients, while 43.0% of patients progressed to ESKD during follow-up (median 100.0 months). Recurrence rate after transplantation was 18.8%. Immunosuppressive therapy was more frequently used in patients with higher proteinuria level, higher hematuria grade, lower eGFR, more intense IgA and complement C3 staining and crescents. Predictors of progression were higher age, lower eGFR, higher proteinuria and blood pressure as well as crescents and higher extent of IFTA on the initial biopsy.</p><p><strong>Conclusions: </strong>This retrospective cohort analysis gives insight into characteristics and outcome of patients with IgAN from a Swiss tertiary center, treatment practices as well as predictors of outcome and therapy choices. A comparatively high use of immunosuppressive treatment including non-steroid-based regimens was found along with a high rate of progression to ESKD.</p>","PeriodicalId":73091,"journal":{"name":"Frontiers in nephrology","volume":"6 ","pages":"1648950"},"PeriodicalIF":0.0,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12982110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147464499","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":"Xeno kidney: revolutionizing kidney disease treatment.","authors":"Diksha Makkar, Diksha Gakhar, Aruna Rakha","doi":"10.3389/fneph.2026.1707170","DOIUrl":"10.3389/fneph.2026.1707170","url":null,"abstract":"<p><p>The prevalence of end-stage kidney failure has been exponentially increasing, leading to a gross mismatch between the number of patients who may benefit from transplantation and the limited supply of suitable donor organs. As renal transplantation remains a viable and the most effective option for end-stage kidney disease, the fact remains that the availability of eligible human donor organs is highly unlikely to meet the projected demand. This undermines the need for alternative strategies, including therapies and the development of transplant substitutes. In this context, xenotransplantation has emerged as a lucrative avenue for patients with renal failure who struggle to obtain a suitable graft promptly. The pig is currently the most preferred animal donor for kidney due to its physiological analogy to humans. Nevertheless, xenotransplantation is associated with certain complications as well, which broadly include the risk of hyperacute rejection mediated by preexisting antibodies to xenogeneic antigens, the stimulation of innate immune responses, and thereby the possibility of chronic rejection. Recent advances in xenotransplantation research have offered hope in overcoming these roadblocks and transforming the field of nephrology in the coming years. Genetic engineering has enabled creating low-immunogenicity grafts from donor pigs, including GalTKO (lacking α-Gal epitopes/galactose-α-1,3-galactose knockout) and gene knockouts that limit the complement system activation and clot formation. Furthermore, advances in immunosuppressive regimens, such as co-stimulation blockade and anti-complement treatment, hold great promise for xenograft acceptance and long-term results. In addition, numerous strategies are being explored to induce tolerance, such as mixed chimerism or regulatory T-cell therapy, to achieve a condition of acceptable graft tolerance without dependency on lifelong immunosuppressive treatments. Collectively, these developments support the translational potential of xenotransplantation as a stand-alone treatment or as an adjunct to standard renal replacement therapies. Despite the setbacks, ongoing preclinical research and early clinical trials are expected to refine the safety, durability, and clinical applicability in a xenotransplantation setting.</p>","PeriodicalId":73091,"journal":{"name":"Frontiers in nephrology","volume":"6 ","pages":"1707170"},"PeriodicalIF":0.0,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12962893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147379976","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":"Primary membranoproliferative glomerulonephritis: natural history, pathogenesis, and treatment.","authors":"Edward J Filippone, John L Farber","doi":"10.3389/fneph.2026.1747678","DOIUrl":"https://doi.org/10.3389/fneph.2026.1747678","url":null,"abstract":"<p><p>Primary membranoproliferative glomerulonephritis (MPGN) is an ultrarare disease characterized by immunofluorescence microscopy as either immune-complex mediated (IC-MPGN) or C3 glomerulopathy (C3), the latter subdivided by electron microscopy to C3 glomerulonephritis (C3GN) and dense deposit disease (DDD). Both IC-MPGN and C3G typically have obvious C3 staining differentiating them from other causes of MPGN histology. Secondary causes must be excluded, including infections, autoimmune disease, and neoplasia. Clinical presentations are variable, including urinary sediment abnormalities, nephrotic syndrome, or a rapidly progressive course. The prognosis is unfavorable with about 50% reaching kidney failure by 10 years. Recurrence following transplantation is frequent, and allograft survival is shortened. The pathogenesis involves dysregulation of the alternate pathway (AP) of complement. Possibly 20% of patients harbor pathogenic mutations in AP proteins or their regulators, and up to 80% have autoantibodies impairing normal regulation. Paraproteins are found in 20 - 40% of otherwise primary MPGN, either directly detectable on biopsy (IC-MPGN) or as dysregulators of the AP. Therapy of MPGN begins with supportive care as for all glomerulopathies. Paraproteins require clone-directed therapy. When immunosuppression is considered, complement inhibition should be first line. Two agents are now FDA approved for C3G, the oral Factor B inhibitor iptacopan and the subcutaneous C3-inhibitor pegcetacoplan, the latter also approved for IC-MPGN. If complement inhibition is unavailable, MMF/steroids may be considered. Following transplantation, protocol biopsies are needed to detect early recurrence with the intent of complement inhibition.</p>","PeriodicalId":73091,"journal":{"name":"Frontiers in nephrology","volume":"6 ","pages":"1747678"},"PeriodicalIF":0.0,"publicationDate":"2026-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12945820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147328379","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":"Chronic kidney disease in hypertensive patients: the urgent need for targeted interventions in Arab countries: a systematic review.","authors":"Fakhria Al Rashdi, Celine Tabche, Zeenah Atwan, Hamed Al-Qanubi, Samiya Al Khaldi, Nasrin Al-Zadjali, Salman Rawaf","doi":"10.3389/fneph.2026.1735217","DOIUrl":"https://doi.org/10.3389/fneph.2026.1735217","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease (CKD) is expected to be the 5th leading cause of years of life lost by 2040. Recently, it emerged as a significant cause of mortality and morbidity, with a high prevalence in Arab countries.</p><p><strong>Objective: </strong>Assess CKD among hypertensive (HTN) people in Arab Countries through evaluation of the existing literature on CKD prevalence, risk factors, screening programmes and prevention.</p><p><strong>Study design: </strong>A systematic review till April 2024 following PRISMA guidelines. The search strategy was registered in PROSPERO under the identification code CRD42024486068.</p><p><strong>Methods: </strong>Databases searched were Medline, Embase, Scopus, PubMed, Cochrane Library. Screening was done using Covidence by three independent reviewers.</p><p><strong>Results: </strong>Out of 63 studies screened, 11 were selected for extraction. The prevalence of CKD was higher among elderly, HTN and diabetic patients, with 38.8% having unrecognised CKD. Nearly 39% of the 400 participants in one study had undiagnosed stages 3-5 CKD. Two studies showed that 55.8% and 75% of identified CKD patients had HTN. Physicians reported suboptimal screening rates, with about 77% relying on the estimated glomerular filtration rate as a diagnostic tool. Risk factors for CKD include old age, HTN, dyslipidaemia, family history of CKD, and obesity. Among physicians, 85% recommended a target blood pressure of ≤130/80, 80% advised smoking cessation, 66% prescribed anti-lipids, and 67% recommended weight loss. All studies support the fact that HTN is a risk factor for CKD.</p><p><strong>Conclusion: </strong>CKD is an escalating problem in Arab countries, with hypertension as a major risk factor. Many patients remain undiagnosed. A region-specific CKD screening and HTN control programme is urgently needed. The findings are essential for policymakers in strengthening primary care for systematic screening of HTN and CKD.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/prospero/, identifier CRD42024486068.</p>","PeriodicalId":73091,"journal":{"name":"Frontiers in nephrology","volume":"6 ","pages":"1735217"},"PeriodicalIF":0.0,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12926114/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147286092","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}