Frontiers in nephrology最新文献

{"title":"Lower proteinuria is better for patients with IgA nephropathy: a systematic review.","authors":"Ankit Shah, Manish Maski, Ogo Egbuna, Whitney Longstaff, Janice Stricker-Shaver, Beth Barber","doi":"10.3389/fneph.2025.1722582","DOIUrl":"10.3389/fneph.2025.1722582","url":null,"abstract":"<p><strong>Background: </strong>Proteinuria is a well-established and recommended biomarker for disease activity in patients with IgAN. In the most recent version of the KDIGO guideline, the target level of proteinuria changed from < 1.0 g/day to < 0.5 g/day. The objective of this systematic literature review (SLR) is to identify, synthesize, and critically evaluate the evidence from peer-reviewed publications that inform the significance of achieving different proteinuria levels.</p><p><strong>Methods: </strong>We searched PubMed and Embase (2005-2025) for studies in adult patients diagnosed with IgAN that examined the relationship between proteinuria measured by any method (e.g., uPCR, 24-hour protein excretion) and key kidney outcomes. The review used an <i>a priori</i> protocol following established methodological guidance for systematic reviews. Additionally, the quality of all studies included in the SLR was assessed based on standardized appraisal tools. The evidence was narratively synthesized reporting frequencies and percentages.</p><p><strong>Results: </strong>Twenty-one unique studies were included (representing 13,006 patients with IgAN). The studies captured in the SLR were mostly observational and they encompassed diverse patient populations, timing of proteinuria assessment, methods of proteinuria measurement and classification, and clinical management strategies, reflecting real-world heterogeneity in IgAN. Despite the differences in individual study methods, results across studies consistently found that lower proteinuria was associated with better kidney outcomes. Specifically, it was clearly established that <0.5 g/day achieved better outcomes than higher proteinuria thresholds.</p><p><strong>Conclusion: </strong>The evidence identified in this SLR affirms the updated KDIGO recommendation to achieve at least a proteinuria level of < 0.5 g/day.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/prospero/, identifier CRD420251062821.</p>","PeriodicalId":73091,"journal":{"name":"Frontiers in nephrology","volume":"5 ","pages":"1722582"},"PeriodicalIF":0.0,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12819803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146031826","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 retrospective cohort study on the bidirectional association between depression and chronic kidney disease.","authors":"Ki Jin Jeun, Todd Brothers, Khaled Shawwa, Mohammad A Al-Mamun","doi":"10.3389/fneph.2025.1743594","DOIUrl":"10.3389/fneph.2025.1743594","url":null,"abstract":"<p><strong>Rationale and objectives: </strong>Depression has been associated with worse clinical outcomes in individuals with chronic kidney disease (CKD), yet its influence on kidney disease progression in earlier CKD stages remains underexplored. Thus, this study investigates the role of depression on CKD progression by stages, and bidirectional relationship using real-world data.</p><p><strong>Methods: </strong>This was a retrospective cohort analysis. Data was extracted from the TriNetX EMR database from 2007 to 2022. Patients (>18 years of age) with diagnosis of CKD were selected for the study. Key independent variables were diagnosis of depression or anxiety, identified by ICD codes, for the primary objective, and CKD stages (i.e., >3, 4, and 5) defined by KDIGO for the secondary objective. Primary outcome was progression to kidney disease (eGFR < 60 ml/min/bsa and > 40% decline in eGFR from the initial screening), and the secondary outcome was diagnosis of depression. Kaplan-Meier analysis and Cox proportional hazards model were used to evaluate the relationship between the dependent and independent variables while adjusting for covariates (sex, race, ethnicity, and age).</p><p><strong>Results: </strong>Depression was significantly associated with a higher risk of kidney disease progression (HR = 1.94 [1.77-2.11], p<0.001). Among patients with CKD, patients with CKD stages 4 and 5 had significantly higher risks (HR = 1.26 [1.17-1.35] and 1.38 [1.23-1.54], p<0.001) of new diagnosis of depression than those in stage ≤3, respectively. These associations remained statistically significant after matching and adjusting for age, sex, race, and comorbidities.</p><p><strong>Conclusion: </strong>Depression significantly accelerates CKD progression and patients with stage 5 CKD had the highest risk of developing depression. Our study advocates for integrating frequent mental health screenings for patients with CKD. This could improve patient outcomes and minimize negative consequences associated with depression.</p>","PeriodicalId":73091,"journal":{"name":"Frontiers in nephrology","volume":"5 ","pages":"1743594"},"PeriodicalIF":0.0,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12812636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146013508","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":"Has the time come to change the treatment criteria for patients with chronic kidney disease? The \"hypofiltering nephron\" hypothesis.","authors":"Giulio Romano, Gianfranco Ferraccioli, GianLuca Colussi","doi":"10.3389/fneph.2025.1713215","DOIUrl":"10.3389/fneph.2025.1713215","url":null,"abstract":"","PeriodicalId":73091,"journal":{"name":"Frontiers in nephrology","volume":"5 ","pages":"1713215"},"PeriodicalIF":0.0,"publicationDate":"2025-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12757207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145901829","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 hemodialysis on high-sensitivity cardiac troponin T levels in patients with hypervolemia.","authors":"Mohammad Tinawi, Bahar Bastani","doi":"10.3389/fneph.2025.1717448","DOIUrl":"10.3389/fneph.2025.1717448","url":null,"abstract":"<p><strong>Background: </strong>High-sensitivity cardiac troponin T (hs-cTnT) is widely used in the diagnosis of acute coronary syndrome (ACS) because it is a marker of myocardial damage. Most patients with end-stage kidney disease (ESKD) on renal replacement therapy have elevated plasma hs-cTnT levels at baseline. The impact of hemodialysis (HD) on hs-cTnT levels remains unclear. This study aimed to determine the effect of HD in patients with ESKD and hypervolemia on plasma hs-cTnT levels.</p><p><strong>Methods: </strong>We conducted a retrospective study of ESKD patients admitted to two community hospitals over a three-year period (from January 1, 2020, to December 31, 2022). All patients had hypervolemia on admission. Plasma hs-cTnT levels were measured at admission and repeated 5.5 ± 0.75 hours after HD. Over the study period, 20 patients with ESKD and hypervolemia fulfilled the inclusion criteria. Two patients were diagnosed with ACS.</p><p><strong>Results: </strong>Pre-HD and post-HD hs-cTnT were elevated in 85% of patients. The data did not follow normal distribution. The median and interquartile range (IRQ) for pre-HD hs-cTnT was 126 (154) ng/L, and for post-HD hs-cTnT was 155 (234) ng/L. Following a single HD session with a high-flux dialyzer, hs-cTnT levels increased in 80% of the cohort, with a mean rise of 25.6% (p = 0.0042). Mean volume removal was 2.4 L, range (1-5 L). Two patients were diagnosed with ACS. Mortality over the study period was 40%, with cardiovascular disease as the leading cause of death.</p><p><strong>Conclusion: </strong>In ESKD patients with hypervolemia, a single HD session using a high-flux dialyzer significantly increased hs-cTnT plasma level. Pre-dialysis hs-cTnT measurements should be used as a clinical baseline when evaluating for ACS, and post-dialysis elevations should be interpreted with caution. Serial measurements may improve diagnostic accuracy. Further prospective studies are needed to clarify the mechanisms and clinical implications of these findings.</p>","PeriodicalId":73091,"journal":{"name":"Frontiers in nephrology","volume":"5 ","pages":"1717448"},"PeriodicalIF":0.0,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12756117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145901784","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":"Use of oXiris^® hemoadsorption in sepsis and acute kidney injury: a retrospective cohort study in a resource-limited Colombian ICU.","authors":"David Ballesteros, Andrea Cristina Mantilla Villarreal, Sandra Cecilia Narváez Martínez, Isabel Saravia, Susan Martínez","doi":"10.3389/fneph.2025.1628181","DOIUrl":"10.3389/fneph.2025.1628181","url":null,"abstract":"<p><strong>Background: </strong>Septic shock with acute kidney injury (AKI) carries high mortality in resource-limited settings. The oXiris^® membrane enables continuous renal replacement therapy (CRRT) with endotoxin and cytokine adsorption, but data from low- and middle-income countries are scarce.</p><p><strong>Methods: </strong>We conducted a single-center retrospective cohort of adults with septic shock and KDIGO stage 2-3 AKI treated with CRRT using oXiris^® in a Colombian public tertiary hospital (January 2021-March 2023). The primary outcome was renal recovery, defined as dialysis independence at discharge. Secondary outcomes included in-hospital mortality, vasopressor trajectories and hemodynamics over 72 hours, intensive care unit (ICU) length of stay, and outcomes stratified by COVID-19 status.</p><p><strong>Results: </strong>Fifty patients were analyzed (median age 56.5 [IQR 46.0-66.0] years; 32% male); 21 (42%) had confirmed SARS-CoV-2 infection. Norepinephrine requirements fell from 0.303 to 0.000 µg/kg/min over 72 hours (p<0.001), and vasopressin use declined to zero (p<0.001), while mean arterial pressure increased from 74.5 to 83.0 mmHg. In-hospital mortality was 62% (31/50) and was higher in patients with greater baseline severity (APACHE II 21.5 vs 14.5 in survivors; p=0.023). ICU length of stay was 14.0 days [5.0-22.5] and was longer in survivors than non-survivors (21.0 vs 8.0 days; p<0.001). Among survivors, 63% (12/19) were dialysis-independent at discharge. COVID-19 septic shock was associated with higher crude mortality (76% vs 52%) and lower renal recovery among survivors (9.5% vs 34%) compared with non-COVID sepsis.</p><p><strong>Conclusions: </strong>In a resource-limited ICU, oXiris^®-based CRRT was associated with rapid vasopressor de-escalation and clinically meaningful kidney recovery among survivors, but overall mortality remained high and severity-dependent. COVID-19 septic shock showed a distinct profile, with higher baseline severity, a trend toward higher mortality, and impaired renal recovery. These data support feasibility and safety of hemoadsorptive CRRT in constrained settings and justify prospective comparative evaluation.</p>","PeriodicalId":73091,"journal":{"name":"Frontiers in nephrology","volume":"5 ","pages":"1628181"},"PeriodicalIF":0.0,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12745276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145866693","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":"Tacrolimus intrapatient variability and rejection are associated with inferior allograft outcomes after kidney transplantation.","authors":"Maryam Javed, Aruna Sanghera, Azhar Ali Khan, Ria Nagpal, Katie Butler, Abigail Hobill, Alice Gage, Felix Karst, Amy Needleman, Mya Hmun, Nicola Thal, Graham Shirling, Ray Fernando, Gareth Jones, Mark Harber, Rhys D R Evans","doi":"10.3389/fneph.2025.1666191","DOIUrl":"10.3389/fneph.2025.1666191","url":null,"abstract":"<p><strong>Introduction: </strong>Early kidney transplant failure has significant negative impact for individuals and healthcare systems. Contemporary data investigating early allograft failure are lacking. We undertook a retrospective observational cohort study of adult patients who underwent kidney transplantation at a single European centre.</p><p><strong>Methods: </strong>We determined causes of allograft failure between 1 and 5 years after transplant and explored clinical variables present at 1 year that predicted allograft loss.</p><p><strong>Results: </strong>591 patients (median age 50 years, 64.1% male, and 44% white) were included; 531 (89.8%) had graft survival and 60 (10.2%) had graft loss between 1- and 5-years. Rejection was the primary cause of graft failure in 24 (40%) cases and 54% had undetectable tacrolimus levels prior to failure event. Female sex, serum creatinine at 1 year, the occurrence of rejection, and undetectable tacrolimus levels were associated with increased odds of graft loss. In subsequent analysis of 787 patients alive with a functioning graft at 1 year, recipient age, serum creatinine, proteinuria, any rejection episode, and tacrolimus intrapatient variability (IPV) at 1 yearwere associated with an increased hazard of graft loss.</p><p><strong>Discussion: </strong>Hence, graft losses were predominantly alloimmune mediated, often associated with non-adherence, and were predicted by tacrolimus IPV at 1 year.</p>","PeriodicalId":73091,"journal":{"name":"Frontiers in nephrology","volume":"5 ","pages":"1666191"},"PeriodicalIF":0.0,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12740892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145851714","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":"Decreased quadriceps muscle stiffness on ultrasound elastography is associated with sarcopenia in end-stage kidney disease.","authors":"Chien-Hua Chiu, Jia-Feng Chen, Shan-Fu Yu, Chung-Yuan Hsu, Ying-Chou Chen","doi":"10.3389/fneph.2025.1682826","DOIUrl":"10.3389/fneph.2025.1682826","url":null,"abstract":"<p><strong>Background: </strong>Sarcopenia has emerged as one of the major complications in end-stage kidney disease (ESKD), leading to greater disability and poor long-term outcomes. This study aimed to compare quadriceps muscle sonoelastographic parameters between ESKD patients with and without sarcopenia.</p><p><strong>Materials and methods: </strong>We prospectively enrolled 50 ESKD patients with sarcopenia and 50 ESKD patients without sarcopenia as controls. All participants underwent clinical and laboratory evaluation, sonoelastography of the quadriceps muscle, and dual-energy X-ray absorptiometry (DXA) for muscle mass assessment. Sarcopenia was diagnosed according to the revised European Working Group on Sarcopenia in Older People (EWGSOP2, 2019), which emphasizes muscle strength as the principal determinant. Handgrip strength, gait speed, and appendicular skeletal muscle mass (ASM/height²) by DXA were assessed. The elastography ratio was calculated as the stiffness of the quadriceps muscle relative to the overlying subcutaneous tissue. Comparisons were made between the sarcopenia and non-sarcopenia groups.</p><p><strong>Results: </strong>A total of 100 ESKD patients were included: 50 with sarcopenia (mean age, 63.0 ± 12.7 years) and 50 without sarcopenia (mean age, 58.3 ± 14.9 years). The sarcopenia group demonstrated a lower quadriceps-to-subcutaneous tissue elastography ratio compared with the control group. Multivariate logistic regression identified the quadriceps-to-subcutaneous tissue ratio, muscle hardness, and body mass index (BMI) as independent predictors of sarcopenia (p < 0.05). Lower BMI was associated with an increased risk of sarcopenia. The optimal quadriceps-to-subcutaneous tissue elastography ratio cut-off value was 0.885 (sensitivity 82.4%; specificity 66.7%).</p><p><strong>Conclusion: </strong>Sonoelastography provides a reliable and non-invasive assessment of quadriceps muscle stiffness and demonstrates good predictive value for detecting sarcopenia in ESKD patients. Given its accessibility, low cost, and ease of use, sonoelastography may serve as a valuable adjunct to conventional DXA in evaluating muscle quality in this high-risk population.</p>","PeriodicalId":73091,"journal":{"name":"Frontiers in nephrology","volume":"5 ","pages":"1682826"},"PeriodicalIF":0.0,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12739470/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145851628","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":"Rituximab monotherapy versus glucocorticoid therapy for adult minimal change disease: a retrospective study on noninferiority.","authors":"Xiaoyun Li, Guoxiang Yao, Yujiao Sun, Na Li, Caifeng Gao, Haiping Wang, Rong Wang, Bing Chen","doi":"10.3389/fneph.2025.1715546","DOIUrl":"10.3389/fneph.2025.1715546","url":null,"abstract":"<p><strong>Introduction: </strong>To verify whether rituximab (RTX) monotherapy is noninferior to glucocorticoids in inducing and maintaining remission in adults with minimal change disease (MCD).</p><p><strong>Method: </strong>We retrospectively analyzed the clinical data of 60 patients with minimal change disease (MCD) who were diagnosed with MCD by renal pathology biopsy and electron microscopy before their first visit to the Department of Nephrology of Shandong Provincial Hospital between 01/2020 and 01/2024, and were diagnosed with MCD at the first visit without acute kidney injury (AKI). Patients were divided into a RTX treatment group (RTX group, 20 cases) and glucocorticoids (GC) treatment group (GC group, 40 cases). None of the patients had previously received steroid/immunosuppressive therapy. The RTX group received rituximab monotherapy. At the 6-month follow-up, the RTX group received additional rituximab infusions as maintenance therapy. The primary endpoints were the time to induced remission, 12-month remission, and relapse rates in each group; the secondary endpoints were the safety and incidence of side effects.</p><p><strong>Results: </strong>After treatment during the 12-month follow-up period, 57 out of 60 patients (95%) achieved remission, of which 48 (80%) achieved complete remission; and 9 (15%) patients relapsed during the follow-up period. A total of 24 (40%) patients experienced adverse events while receiving treatment. 19 (95%) patients in the RTX group and 38 (95%) patients in the GC group achieved remission within 12 months of follow-up, respectively [the difference in rates between the two groups was 0%, 95% confidence interval (0.08, 11.73)]. In the RTX group, 14 (70%) achieved complete remission. In the GC group, 34 (85%) achieved complete remission (<i>p</i>=0.304). In the RTX group, 2 (10%) patients relapsed, and in the GC group 7 (18%) patients relapsed (<i>p</i>=0.701). 1 (5%) patient in the RTX group and 23 (58%) patients in the GC group experienced adverse events (<i>p</i>=0.000), none of which were severe.</p><p><strong>Conclusion: </strong>Adequate RTX monotherapy is noninferior to adequate glucocorticoids in inducing and maintaining remission in adult MCD patients without AKI, with fewer adverse effects and better adherence, and may be considered as a first-line treatment option for adult MCD patients without AKI.</p>","PeriodicalId":73091,"journal":{"name":"Frontiers in nephrology","volume":"5 ","pages":"1715546"},"PeriodicalIF":0.0,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12722937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145829091","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":"Improving kidney transplant care through the application of continuous glucose monitoring - a narrative review.","authors":"Jackson Tan, Muhammad Abdul Mabood Khalil, Parizad Avari, Lalantha Leelarathna","doi":"10.3389/fneph.2025.1630597","DOIUrl":"10.3389/fneph.2025.1630597","url":null,"abstract":"<p><p>Continuous glucose monitoring (CGM) is used more frequently among patients with chronic kidney disease (CKD), including those undergoing haemodialysis and peritoneal dialysis. However, there is a lack of information and evidence regarding CGM use in kidney transplantation (KT). Dysglycaemia is commonly observed in the transplant setting; often complicated by impaired kidney function with fluctuating glomerular filtration rates and competing influences of diabetogenic immunosuppressants, perioperative surgical stress and transplant-related complications. This narrative review, the first of its kind, examines the utility, accuracy, efficacy and clinical outcomes of CGM in KT patients. It also addresses specific transplant-related issues that may necessitate future CGM usage and highlights knowledge gaps to inform future research directions.</p>","PeriodicalId":73091,"journal":{"name":"Frontiers in nephrology","volume":"5 ","pages":"1630597"},"PeriodicalIF":0.0,"publicationDate":"2025-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12698393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145758338","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":"Genetic and environmental factors associated with alteration of filtration slit proteins and their functions: a scoping review.","authors":"Aolat Adepeju Adepoju, Mubarak Abubakar Muhammad, Mubashir Mayowa Adamson, Shakirudeen Abdulqodri Adewale, Adedeji Tayyib Adekunle, Lekan Sheriff Ojulari, Abdullateef Isiaka Alagbonsi","doi":"10.3389/fneph.2025.1678502","DOIUrl":"10.3389/fneph.2025.1678502","url":null,"abstract":"<p><strong>Background: </strong>Filtration slit proteins are important for maintaining the integrity of the glomerular filtration barrier. Genetic mutations and environmental factors can disrupt their structure and functions, leading to proteinuria and kidney diseases. This scoping review aims to synthesize the available information on the genetic and environmental factors that affect the slit proteins to enhance our understanding of the (patho)physiology of glomerular filtration.</p><p><strong>Methods: </strong>Online databases such as Wiley and PubMed were used. Relevant studies were selected focusing on genetic variations, environmental influences, and their impact on filtration slit proteins. Data extraction and synthesis were conducted to highlight key themes and knowledge gaps.</p><p><strong>Results: </strong>We summarized at least 20 proteins and their genes, including nephrin, podocin, phospholipase C Epsilon 1 (PLCE1), CD2-Associated Protein (CD2AP), ITGA 3, synaptopodin, myosin 1E (<i>MYO1E</i>), flotillin-2 (Flot2), podocalyxin, FAT1, Apo Hemoglobin-Haptoglobin (Apo Hb-Hp), spermidine, P-Cadherin, ephrin B1, Zo- 1 (Zona Occluden), MAGI 1&2 (MAGUK inverted), Par- complex, IP-10 (interferon-inducible protein), neurexin 1, and liver type fatty acid binding protein. We also reported at least 8 environmental factors, including oxidative stress, inflammation, heavy metals, air-bone pollutants, high-fat diets, vitamins and micronutrient deficiency, mechanical stretch, and nephrotoxic agents.</p><p><strong>Conclusion: </strong>This review highlights various filtration slit proteins and the mechanisms of their alterations by genetic and environmental factors. It contributes to efforts toward personalized therapeutic strategies for disorders of glomerular filtration.</p>","PeriodicalId":73091,"journal":{"name":"Frontiers in nephrology","volume":"5 ","pages":"1678502"},"PeriodicalIF":0.0,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12682632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145716842","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}