Frontiers in nephrology最新文献

{"title":"Editorial: Rising stars in nephrology 2024: illuminating the future of kidney health.","authors":"Peter Kotanko","doi":"10.3389/fneph.2026.1985175","DOIUrl":"https://doi.org/10.3389/fneph.2026.1985175","url":null,"abstract":"","PeriodicalId":73091,"journal":{"name":"Frontiers in nephrology","volume":"6 ","pages":"1985175"},"PeriodicalIF":2.9,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13623589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119122","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":"Case Report: A rare complication easily misdiagnosed as bacterial peritonitis: a case of sterile peritoneal dialysis-chemical peritonitis induced by amino-acid-based dialysate and literature review.","authors":"Dongmei Liu, Juan Mou, Hongmei Dai","doi":"10.3389/fneph.2026.1917133","DOIUrl":"10.3389/fneph.2026.1917133","url":null,"abstract":"<p><p>Peritoneal dialysis-chemical peritonitis induced by amino acid-based peritoneal dialysis solution is extremely rare. There are only a few reported case series of this condition. It can occur at any time during the use of amino acid dialysate, and most cases present with abdominal pain, cloudy effluent, and elevated peritoneal leukocyte counts, closely mimicking infectious peritonitis. This similarity poses a significant diagnostic challenge, as it is difficult to distinguish from bacterial peritonitis. Here, we report a case of peritoneal dialysis-chemical peritonitis associated with amino acid dialysate in a patient on peritoneal dialysis, aiming to raise awareness among clinicians of this rare entity that can be easily confused with infectious peritonitis. We also review its clinical characteristics, differential diagnosis, and management.</p>","PeriodicalId":73091,"journal":{"name":"Frontiers in nephrology","volume":"6 ","pages":"1917133"},"PeriodicalIF":2.9,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13616646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076984","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":"Case Report: Advanced IgA nephropathy with psoriasis and a complex clinicopathologic course.","authors":"Lerui Wang, Minxia Li, Boyang Xu, Dan Shu","doi":"10.3389/fneph.2026.1932773","DOIUrl":"10.3389/fneph.2026.1932773","url":null,"abstract":"<p><p>Psoriasis and IgA nephropathy are immune-mediated disorders that may coexist, but the clinical meaning of this association remains uncertain. We report a 45-year-old man with psoriasis and progressive kidney dysfunction whose biopsy-proven IgA nephropathy presented with severe impairment of kidney function, heavy proteinuria, and mixed active and chronic histologic injury. At reassessment, serum creatinine was 463 μmol/L, estimated glomerular filtration rate was 12.1 mL/min/1.73 m², and pretreatment 24-hour urinary protein excretion ranged from 2.90 to 4.70 g. Kidney biopsy showed proliferative sclerosing IgA nephropathy, Oxford classification M1E1S1T2C0, with ischemic glomerular injury, microangiopathy, tubular atrophy, and interstitial fibrosis. Targeted-release budesonide and deucravacitinib were started together. Proteinuria fell to 0.62 g, serum creatinine decreased to 323 μmol/L, and a modest improvement in cutaneous disease activity was observed, with PASI decreasing from 2.4 to 1.6. After patient-initiated discontinuation of deucravacitinib, proteinuria increased and later declined after reintroduction. Following completion of the planned budesonide course, proteinuria continued to fall during deucravacitinib monotherapy, while kidney function deteriorated. This case is best interpreted as a clinicopathologic observation rather than proof of drug efficacy. Biopsy-defined activity and chronicity helped explain the discordant changes in proteinuria and kidney function, while the longitudinal course generated a testable but unproven hypothesis of a possible inflammatory connection between psoriasis and IgA nephropathy.</p>","PeriodicalId":73091,"journal":{"name":"Frontiers in nephrology","volume":"6 ","pages":"1932773"},"PeriodicalIF":2.9,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13593464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026681","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":"Real-world use of pegylated erythropoietin in CKD-related anemia: an Indian modified Delphi consensus.","authors":"Vijay Kher, Jatin Kothari, Jitendra Kumar, Sanjay Srinivasa, Prashant Kedlaya, Sivalingam M, Rammohan Bhat, Rajesh Nair, Mallikarjuna Hm, Reetesh Sharma, Vijay Kumar Sinha, Sreedhara C G, Jay Kumar Sharma, Iain C Macdougall","doi":"10.3389/fneph.2026.1864394","DOIUrl":"10.3389/fneph.2026.1864394","url":null,"abstract":"<p><p>Anemia is a common and clinically significant complication of chronic kidney disease (CKD), contributing to impaired quality of life, increased cardiovascular risk, and higher mortality. Although erythropoiesis-stimulating agents (ESAs) remain the cornerstone of anemia management, conventional short- and intermediate-acting ESAs are associated with frequent dosing requirements, treatment burden, and variability in haemoglobin (Hb) control. Methoxy polyethylene glycol epoetin beta (MPG-EPO; PegEPO), a long-acting ESA with an extended half-life, enables less frequent administration and may offer advantages in Hb stabilization, treatment adherence, and patient convenience. Despite evidence supporting its efficacy and safety, the utilization of PegEPO in India remains limited. To provide practical guidance for the use of PegEPO in Indian clinical practice, a panel of 12 experienced Indian nephrologists participated in a three round modified Delphi consensus process. A comprehensive review of the available literature informed the development of consensus statements covering key domains, including patient selection, treatment initiation and dose adjustment, iron management, conversion from other ESAs, Hb targets and monitoring, safety considerations, and economic aspects of therapy. Consensus was achieved through iterative rounds of expert evaluation and discussion. The expert panel agreed that PegEPO offers efficacy and safety comparable to conventional ESAs in patients with CKD-associated anemia while providing additional advantages such as reduced dosing frequency, improved Hb stability, and the potential to enhance treatment adherence. The panel also identified practical considerations for optimizing PegEPO use in both dialysis-dependent and non-dialysis-dependent CKD populations within the Indian healthcare setting. This modified Delphi consensus provides evidence-informed, expert-driven recommendations to support individualized and pragmatic use of PegEPO in routine clinical practice. However, these statements represent expert consensus and are not intended as clinical guidelines; therefore, they should be adapted based on individual patient context and local clinical practice.</p>","PeriodicalId":73091,"journal":{"name":"Frontiers in nephrology","volume":"6 ","pages":"1864394"},"PeriodicalIF":2.9,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13595928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149026771","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":"Construction and evaluation of risk prediction model for major adverse cardiovascular events in peritoneal dialysis patients.","authors":"Jing Han, Xiaoli Guo, Xuejiao Liu, Jiping Sun, Fang Li, Yi Gao","doi":"10.3389/fneph.2026.1871318","DOIUrl":"10.3389/fneph.2026.1871318","url":null,"abstract":"<p><strong>Background and objectives: </strong>This study developed and validated a robust, clinically applicable risk prediction model for cardiovascular mortality in high-risk peritoneal dialysis patients. The model enables precise individualized risk stratification, supports evidence-based clinical decisions, and facilitates targeted preventive interventions to improve long-term outcomes.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on peritoneal dialysis patients at the Department of Nephrology, First Affiliated Hospital of Xi'an Jiaotong University, from June 2018 to May 2025. Cardiovascular disease served as the primary endpoint. Baseline characteristics and laboratory parameters were compared between groups. Univariate and multivariate regression analyses identified predictors of major adverse cardiovascular events. The predictive model was developed and validated using a 7:3 split after bootstrap resampling.</p><p><strong>Results: </strong>Multivariate analysis identified age, fasting blood glucose, absolute handgrip strength, and left ventricular ejection fraction as significant predictors. ROC curves (AUC > 0.6) and Kaplan-Meier curves (P < 0.05) confirmed their diagnostic and discriminatory value for major adverse cardiovascular events. A nomogram incorporating these four variables was developed. Its AUCs for predicting 3-, 5-, and 8-year cardiovascular event incidence were 0.828 (95% CI: 0.744-0.912), 0.785 (95% CI: 0.702-0.868), and 0.836 (95% CI: 0.744-0.929), respectively-indicating strong predictive discrimination. Using the optimal cut-off, patients were stratified into low- and high-risk groups. Kaplan-Meier analysis showed significant differences in cumulative event incidence at all three time points (P < 0.001), confirming good discrimination. Calibration demonstrated close agreement between predicted and observed outcomes; decision curve analysis supported robust clinical utility.</p><p><strong>Conclusion: </strong>Age, fasting blood glucose, absolute handgrip strength, and left ventricular ejection fraction are independent predictors of MACE in patients receiving PD. We have developed and internally validated a novel, interpretable nomogram-based risk prediction model that demonstrates high discriminative accuracy, calibration fidelity, and clinical utility. This tool holds substantial promise for early identification of high-risk individuals at PD initiation, thereby facilitating timely, personalized cardiovascular risk mitigation strategies.</p>","PeriodicalId":73091,"journal":{"name":"Frontiers in nephrology","volume":"6 ","pages":"1871318"},"PeriodicalIF":2.9,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13581586/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992929","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":"Serum uric acid in pediatric metabolic assessment: the scientific rationale for routine screening and the urgent need for age- and sex-specific diagnostic thresholds.","authors":"Izere Salomon, Yves Ndamukunda, Mukanoheli Solange, Eden Enyew Zeleke","doi":"10.3389/fneph.2026.1908272","DOIUrl":"10.3389/fneph.2026.1908272","url":null,"abstract":"","PeriodicalId":73091,"journal":{"name":"Frontiers in nephrology","volume":"6 ","pages":"1908272"},"PeriodicalIF":2.9,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13581962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992890","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":"Assessment of patient perspectives in the CONVINCE trial in end-stage kidney disease - a domain-guided approach.","authors":"Kathrin I Fischer, Krister Cromm, Peter J Blankestijn, Bernard Canaud, Jörgen Hegbrant, Claudia Barth, Mark Woodward, Giovanni F M Strippoli, Andrew Davenport, Michiel L Bots, Matthias Rose","doi":"10.3389/fneph.2026.1767603","DOIUrl":"10.3389/fneph.2026.1767603","url":null,"abstract":"<p><strong>Background: </strong>Patient-reported outcome (PRO) measures are increasingly used in clinical trials and clinical care to assess symptoms, functioning, and health-related quality of life (HRQoL). In dialysis research, instrument-driven approaches that rely on legacy measures may not fully capture outcomes that matter most to patients or treatment-related experiences such as dialysis-specific fatigue and recovery. Therefore, a patient-informed, domain-guided PRO toolbox for adults with end-stage kidney disease (ESKD) receiving maintenance dialysis was developed and applied in the CONVINCE trial.</p><p><strong>Methods: </strong>A multi-method, triangulation approach was used, comprising: 1) a targeted literature review of PROMs and symptom concepts used in maintenance dialysis research, 2) review of international core outcome initiatives relevant to kidney disease and haemodialysis, 3) semi-structured interviews and focus groups with patients (<i>n</i> = 13) and health care professionals (<i>n</i> = 4). Concepts identified across sources were compiled, compared, and prioritized based on recurrence across evidence sources, salience to patients, anticipated sensitivity to dialysis modality, and feasibility of repeated assessment within the CONVINCE trial.</p><p><strong>Results: </strong>The literature review identified 97 PROMs. Domains and symptom content were extracted from these instruments and mapped against concepts covered by international core outcome initiatives and qualitative data. Triangulation resulted in an ESKD PRO toolbox comprising nine prioritized health domains: general health/health perception, fatigue, physical function, social roles, depression, anxiety, pain, sleep, and cognitive function. Most of these domains could be assessed within the PROMIS^® health domain framework. To complement these generic domain measures, a dialysis-specific symptom list and additional items to assess dialysis-related fatigue, treatment-related recovery time were included.</p><p><strong>Conclusion: </strong>The ESKD PRO toolbox provides a patient-informed, domain-guided framework for repeated longitudinal assessment of outcomes relevant to patients receiving maintenance dialysis. Its application in CONVINCE illustrates how PROMIS^® -based domain assessment can be combined with dialysis-specific symptom and fatigue measures to capture treatment-related patient experiences.</p>","PeriodicalId":73091,"journal":{"name":"Frontiers in nephrology","volume":"6 ","pages":"1767603"},"PeriodicalIF":2.9,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13553382/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148922026","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":"Association of neutrophil-to-lymphocyte-platelet ratio with residual renal function in early-stage peritoneal dialysis patients.","authors":"Fei Tian, Tingting Li, Jiayu Duan, Jia Li, Guangpu Li, Dongwei Liu","doi":"10.3389/fneph.2026.1896689","DOIUrl":"10.3389/fneph.2026.1896689","url":null,"abstract":"<p><strong>Background: </strong>To investigate the association between the neutrophil-to-lymphocyte-platelet ratio (NLPR) and residual renal function (RRF) in early-stage peritoneal dialysis (PD) patients, and to evaluate its association with for RRF decline.</p><p><strong>Methods: </strong>This retrospective study included PD patients treated between January 2025 and February 2026. Patients were divided into an early group (dialysis duration 3-12 months) and a late group (>12 months). One extreme NLPR outlier was excluded from the early group, resulting in 23 patients in the early group and 49 in the late group. Spearman's correlation, linear regression, and ROC curve analysis were used.</p><p><strong>Results: </strong>In the early group, NLPR was significantly negatively correlated with residual renal Ccr (<i>r</i> = -0.559), residual renal Kt/V (<i>r</i> = -0.465), eGFR (<i>r</i> = -0.471), nPCR (<i>r</i> = -0.515), and target Kt/V achievement (<i>r</i> = -0.448) (all <i>p</i> < 0.05). Univariate linear regression showed that NLPR significantly predicted residual renal Ccr (B = -1.502, <i>p</i> = 0.006), and it remained independently predictive after adjusting for nPCR (B = -1.592, <i>p</i> = 0.011). ROC curve analysis demonstrated good discriminatory ability for predicting lower RRF, with an AUC of 0.818 (95% CI 0.640-0.996, <i>p</i> = 0.010). The optimal cut-off was 10.372, with 81.8% sensitivity and 58.3% specificity. Subgroup analysis showed a stronger association in males (r = -0.796, <i>p</i> = 0.006).</p><p><strong>Conclusions: </strong>NLPR is significantly associated with RRF in early-stage PD patients. Although it demonstrated good discriminatory ability for RRF status in this cross-sectional study, its predictive value for RRF decline warrants further validation in longitudinal cohort studies.</p>","PeriodicalId":73091,"journal":{"name":"Frontiers in nephrology","volume":"6 ","pages":"1896689"},"PeriodicalIF":2.9,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13553526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148922029","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":"Ultrasound-guided kidney biopsy: a review of what operators need to know.","authors":"Husain Alturkistani","doi":"10.3389/fneph.2026.1861024","DOIUrl":"10.3389/fneph.2026.1861024","url":null,"abstract":"<p><p>Ultrasound-guided kidney biopsy is a key procedure for diagnosing renal parenchymal disease and assessing renal involvement in systemic disorders. This review summarizes indications and contraindications, patient preparation, procedural technique, and post-biopsy monitoring, with emphasis on complication prevention and risk mitigation. Pre-biopsy ultrasound is essential to assess renal size, morphology, and anatomic variants and to plan a safe needle trajectory. Biopsy is typically performed from the lower pole renal cortex in the prone position using a spring-loaded core needle after local anesthesia. Bleeding is the principal complication, so structured observation after the procedure is mandatory.</p>","PeriodicalId":73091,"journal":{"name":"Frontiers in nephrology","volume":"6 ","pages":"1861024"},"PeriodicalIF":2.9,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13548393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907620","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":"Acute kidney injury, baseline renal function, troponin, and survival after myocardial infarction.","authors":"Bing Lu, Jacqueline P Honerlaw, Yuk-Lam Ho, Daniel Posner, David R Gagnon, Xuan-Mai T Nguyen, Jason L Vassy, J Michael Gaziano, Kelly Cho, Luc Djousse, Peter W F Wilson","doi":"10.3389/fneph.2026.1761672","DOIUrl":"10.3389/fneph.2026.1761672","url":null,"abstract":"<p><strong>Background: </strong>The roles of chronic kidney disease and acute kidney injury (AKI) as determinants of short- and long-term survival following myocardial infarction (MI) have not been well investigated.</p><p><strong>Methods: </strong>A retrospective analysis of electronic health record data was conducted for U.S. veterans between 2002 and 2015, with up to 15 years of follow-up after MI. Eligible participants included 49,150 veterans with a serum creatinine measurement prior to MI hospitalization. AKI stage was determined by the change between the pre-hospitalization creatinine level and the peak in-hospital measurement. The associations of AKI, estimated glomerular filtration rate (eGFR), and troponin I ratios with survival were evaluated using Cox proportional hazards models.</p><p><strong>Results: </strong>Compared to the no-AKI group, the hazard ratios (HRs) and 95% confidence intervals (CIs) for 30-day mortality were 3.12 (2.87-3.39), 5.12 (4.65-5.65), and 7.81 (6.93-8.81) across worsening stages of AKI. For 15-year mortality, the HRs were 1.76 (1.68-1.85), 2.33 (2.17-2.50), and 2.66 (2.37-2.99). Compared to those with eGFR >60 mL/min/1.73 m², HRs (95% CI) for 30-day mortality were 1.23 (1.13-1.33), 1.46 (1.33-1.59), and 1.92 (1.72-2.13) across decreasing eGFR levels. For 15-year mortality, HRs were 1.21 (1.17-1.25), 1.55 (1.49-1.61), and 2.13 (2.03-2.24). Mortality rates increased with rising troponin I (cTnI) ratios, particularly for 30-day mortality.</p><p><strong>Conclusions: </strong>AKI, baseline eGFR, and troponin levels were associated with both short- and long-term survival following MI. AKI during MI hospitalization was a particularly strong determinant of short-term mortality.</p>","PeriodicalId":73091,"journal":{"name":"Frontiers in nephrology","volume":"6 ","pages":"1761672"},"PeriodicalIF":2.9,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13533685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882663","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}