Frontiers in nephrology最新文献

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Editorial: Early diagnosis of kidney disease in young adulthood. 编辑:早期诊断肾脏疾病在青年成年。
Frontiers in nephrology Pub Date : 2025-10-06 eCollection Date: 2025-01-01 DOI: 10.3389/fneph.2025.1700226
Antonino Sidoti, Vincenzo Panichi
{"title":"Editorial: Early diagnosis of kidney disease in young adulthood.","authors":"Antonino Sidoti, Vincenzo Panichi","doi":"10.3389/fneph.2025.1700226","DOIUrl":"10.3389/fneph.2025.1700226","url":null,"abstract":"","PeriodicalId":73091,"journal":{"name":"Frontiers in nephrology","volume":"5 ","pages":"1700226"},"PeriodicalIF":0.0,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12535871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145350499","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}
引用次数: 0
Quality of life and depression among chronic kidney disease patients: a tertiary care center cross-sectional study. 慢性肾病患者的生活质量和抑郁:一项三级保健中心的横断面研究。
Frontiers in nephrology Pub Date : 2025-10-02 eCollection Date: 2025-01-01 DOI: 10.3389/fneph.2025.1600296
Rana A Nablawi, Lama S Alghamdi, Adnan E Alshaikh, Abdullah M Alagha, Nada T Alharbi, Abdulah H Ali, Hassan A Khafaji, Essam W E Zarei, Nabil A Alzahrani
{"title":"Quality of life and depression among chronic kidney disease patients: a tertiary care center cross-sectional study.","authors":"Rana A Nablawi, Lama S Alghamdi, Adnan E Alshaikh, Abdullah M Alagha, Nada T Alharbi, Abdulah H Ali, Hassan A Khafaji, Essam W E Zarei, Nabil A Alzahrani","doi":"10.3389/fneph.2025.1600296","DOIUrl":"10.3389/fneph.2025.1600296","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease (CKD) is a severe health condition that involves a decline in kidney function, leading to high mortality rates in Saudi Arabia and globally. It often coexists with chronic non-communicable conditions such as hypertension and diabetes. As CKD progresses, patients experience psychological distress, anxiety, and depression, which can negatively impact their health and quality of life. This can lead to reduced treatment adherence, increased mortality, and poor quality of life.</p><p><strong>Objective: </strong>This study sought to assess the prevalence of depression among CKD patients, investigate how quality of life (QoL) and depression vary across CKD stages, and examine the relationship between depression and QoL at different disease stages. This study was conducted at a tertiary care center in Jeddah, Saudi Arabia.</p><p><strong>Methods: </strong>This cross-sectional research, conducted in Jeddah, Saudi Arabia, from February to May 2024, included 95 CKD patients who met the CKD diagnostic criteria as confirmed by a nephrologist. Pregnant women, dialysis patients, and patients under the age of 18 were excluded from the research. Patients' contact information was gathered from electronic medical records at King Abdulaziz University Hospital (KAUH), and consent was sought over the phone. Depression was assessed in non-dialysis CKD patients using the Patient Health Questionnaire (PHQ-9), and health-related quality of life (HRQoL) was assessed using the 12-Item Short-Form Health Survey (SF-12) score. Demographic information, previous medical comorbidities, and estimated glomerular filtration rate (eGFR) were also considered. The 2012 Kidney Disease: Improving Global Outcomes (KDIGO) CKD classification was used to classify patients into stages. The research sought to give a full evaluation of patients' mental and physical health.</p><p><strong>Results: </strong>A total of 95 patients were included in this study, with a predominance of male gender (58.9%) and those who were aged 60 years and above (50.5%). Most patients were non-smokers (78.9%), and 45.3% were classified as non-obese patients. Comorbidities were widespread among these patients, especially hypertension (82.1%) and diabetes (74.7%). Regarding severity level measured by PHQ-9, the median score was 12.0, 28.4% of the patients were classified as having moderate depression, and the correlation between depression and physical activity (PCS12) and mental health (MCS12) was significantly negative. Multiple linear regression analysis showed that depression was significantly associated with lower physical and mental capacity scores, alongside older age and female gender.</p><p><strong>Conclusion: </strong>This study emphasized the substantial impact of depressive symptoms among obese patients, highlighting the interplay between mental health and chronic physical conditions. Our findings suggest that specific risk factors such as fatigue, chron","PeriodicalId":73091,"journal":{"name":"Frontiers in nephrology","volume":"5 ","pages":"1600296"},"PeriodicalIF":0.0,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12527898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145330970","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}
引用次数: 0
Case Report: Exostosin 1-associated membranous nephropathy and Guillain-Barré syndrome: a common autoimmune etiology? 病例报告:外泌素1相关性膜性肾病和格林-巴勒综合征:一种常见的自身免疫性病因?
Frontiers in nephrology Pub Date : 2025-10-02 eCollection Date: 2025-01-01 DOI: 10.3389/fneph.2025.1667619
Mariana León-Póo, Eva López-Melero, Amir Shabaka, Carmen Guerrero-Márquez, María Barcenilla-López, Clara Cases-Corona, Enrique Gruss, Deborah Roldán
{"title":"Case Report: Exostosin 1-associated membranous nephropathy and Guillain-Barré syndrome: a common autoimmune etiology?","authors":"Mariana León-Póo, Eva López-Melero, Amir Shabaka, Carmen Guerrero-Márquez, María Barcenilla-López, Clara Cases-Corona, Enrique Gruss, Deborah Roldán","doi":"10.3389/fneph.2025.1667619","DOIUrl":"10.3389/fneph.2025.1667619","url":null,"abstract":"<p><p>Membranous nephropathy is one of the most common causes of nephrotic syndrome in adults and is caused by the deposition of immune complexes in the subepithelial space of the glomerular basement membranes. On the other hand, Guillain-Barré syndrome is a type of acute, potentially fatal polyneuropathy, which is generally associated with an infection that serves as the initial immunological event and triggers immune-mediated disruption of the axon and/or myelin. We present the case of a 70-year-old patient with concurrent membranous nephropathy and Guillain-Barré syndrome, with subepithelial deposits in the renal biopsy positive for Exostosin 1, and who reached complete renal remission after treatment of Guillain-Barré syndrome with plasmapheresis and systemic corticosteroids, suggesting a common autoimmune origin for both entities.</p>","PeriodicalId":73091,"journal":{"name":"Frontiers in nephrology","volume":"5 ","pages":"1667619"},"PeriodicalIF":0.0,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12527833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145330951","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}
引用次数: 0
Development and validation of a comprehensive machine learning framework for a diagnostic model of uremia based on genes involved in major depressive disorder. 基于重度抑郁症相关基因的尿毒症诊断模型的综合机器学习框架的开发和验证。
Frontiers in nephrology Pub Date : 2025-10-02 eCollection Date: 2025-01-01 DOI: 10.3389/fneph.2025.1576349
Kaiyao Jiang, Chi Zhang, Cheng Shen, Xingxing Fang, Huaxing Huang, Bing Zheng
{"title":"Development and validation of a comprehensive machine learning framework for a diagnostic model of uremia based on genes involved in major depressive disorder.","authors":"Kaiyao Jiang, Chi Zhang, Cheng Shen, Xingxing Fang, Huaxing Huang, Bing Zheng","doi":"10.3389/fneph.2025.1576349","DOIUrl":"10.3389/fneph.2025.1576349","url":null,"abstract":"<p><strong>Background: </strong>Major depressive disorder (MDD) and uremia are two chronic wasting diseases that have interactive effects and significantly aggravate patients' distress. However, the molecular basis linking these diseases remains poorly investigated.</p><p><strong>Methods: </strong>Various machine learning algorithms were used to analyze transcriptome data from the Gene Expression Omnibus (GEO) datasets, including those from MDD and uremia patients, to develop and validate our model. After removing batch effects, differentially expressed genes (DEGs) were identified between each disease group and the control group. Functional enrichment analysis was then performed at the intersection of DEGs from the two diseases. In addition, single-sample gene set enrichment analysis (ssGSEA) quantitative immune infiltration analysis was conducted. The optimal diagnostic model of uremia was constructed by analyzing and verifying the training set with multiple combinations of 12 machine learning algorithms. Finally, potential drugs for uremia were identified using the \"Enrichr\" platform.</p><p><strong>Results: </strong>According to enrichment analysis, a total of seven key genes closely related to MDD and uremia, mainly involved in the immune process, were identified. Immune infiltration analysis showed that MDD and uremia had different profiles of immune cell infiltration compared to healthy controls. Powerful diagnostic markers of seven genes (IL7R, CD3D, RETN, RAB13, TNNT1, HP, and S100A12) were constructed from these genes, and all showed better performance than published uremia diagnostic models. In addition, decitabine and nine other agents were found to be potential agents for the treatment of uremia.</p><p><strong>Conclusion: </strong>Our study combined bioinformatics techniques and machine learning methods to develop a diagnostic model for uremia, focusing on common genes between MDD and uremia.</p>","PeriodicalId":73091,"journal":{"name":"Frontiers in nephrology","volume":"5 ","pages":"1576349"},"PeriodicalIF":0.0,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12527841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145330942","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}
引用次数: 0
The assessment and treatment of the musculoskeletal manifestations of cystinosis. 胱氨酸病肌肉骨骼表现的评估与治疗。
Frontiers in nephrology Pub Date : 2025-09-25 eCollection Date: 2025-01-01 DOI: 10.3389/fneph.2025.1624586
Priya Singh, D'Arcy Marsh, Melinda Sharkey
{"title":"The assessment and treatment of the musculoskeletal manifestations of cystinosis.","authors":"Priya Singh, D'Arcy Marsh, Melinda Sharkey","doi":"10.3389/fneph.2025.1624586","DOIUrl":"10.3389/fneph.2025.1624586","url":null,"abstract":"<p><p>Cystinosis is a rare autosomal recessive lysosomal storage disease caused by a defective lysosomal cystine carrier protein, cystinosin, resulting in formation and deposition of cystine crystals throughout the body. The renal manifestations of the disease have long been studied, but the musculoskeletal consequences of the disease are generally less well understood. Limb deformities, scoliosis, myopathy and low bone mineral density are associated with cystinosis and can lead to pain, fragility fractures, bone deformity, and difficulty ambulating. Although potentially exacerbated by renal disease and post-transplant medications, it has been found that the musculoskeletal manifestations of cystinosis are also due to inherent dysfunction caused by the mutation of cystinosin. Surgical intervention can provide solutions to the bony symptoms of cystinosis. Early referral to an orthopedic surgeon and evaluation for corrective scoliosis surgery, guided growth for growing children with lower extremity deformity and formal osteotomies for deformity correction in skeletally mature individuals may improve physical function and decrease pain. Standard principles of operative treatment of scoliosis and of bone deformity correction utilized for the treatment of bone deformity in other metabolic bone disease may be applied to patients with cystinosis in the absence of cystinosis-specific studies of the efficacy and outcomes of orthopedic surgery.</p>","PeriodicalId":73091,"journal":{"name":"Frontiers in nephrology","volume":"5 ","pages":"1624586"},"PeriodicalIF":0.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12507550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145281957","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}
引用次数: 0
Monocyte-to-lymphocyte ratio is a promising biomarker in patients initially receiving hemodialysis. 单核细胞与淋巴细胞比率是一种有希望的生物标志物,用于初次接受血液透析的患者。
Frontiers in nephrology Pub Date : 2025-09-23 eCollection Date: 2025-01-01 DOI: 10.3389/fneph.2025.1638388
Aihua Xie, Anna Tang, Man Yang, Yuwan Xiong, Jieshan Lin
{"title":"Monocyte-to-lymphocyte ratio is a promising biomarker in patients initially receiving hemodialysis.","authors":"Aihua Xie, Anna Tang, Man Yang, Yuwan Xiong, Jieshan Lin","doi":"10.3389/fneph.2025.1638388","DOIUrl":"10.3389/fneph.2025.1638388","url":null,"abstract":"<p><strong>Aim: </strong>Inflammation is very common among dialysis patients and can lead to an increase in morbidity and mortality. Monocyte-to-lymphocyte ratio (MLR) can serve as a reliable predictor of long-term survival in hemodialysis patients. However, few studies have addressed the role of MLR in patients initially receiving hemodialysis (within 3 months). In this study, we aimed to examine the association between MLR and the risk of cardiovascular and all-cause mortality in patients initially receiving hemodialysis.</p><p><strong>Methods: </strong>In this study, a total of 216 patients newly receiving hemodialysis for at least 3 months were recruited. The associations between MLR and cardiovascular diseases (CVD) and all-cause mortality were assessed by multivariable Cox models.</p><p><strong>Results: </strong>A total of 216 patients were included (mean age 57.65 ± 15.68 years, 42.13% male patients). Patients were divided into the low MLR group (<0.49) and the high MLR group (≥0.49). The levels of neutrophil and serum iron and the number of deaths were significantly higher in the high MLR group (<i>P</i> < 0.05). Spearman's analysis showed that MLR was positively correlated with BUN (<i>R</i> = 0.210, <i>P</i> = 0.002), WBC (<i>R</i> = 0.178, <i>P</i> = 0.009), and neutrophil (<i>R</i> = 0.237, <i>P</i> < 0.001). Kaplan-Meier analysis showed that patients in the low MLR group present longer survival (64.08 ± 2.30 vs. 51.07 ± 3.12 months, <i>P</i> < 0.001). Multivariate Cox regression analysis showed that age, diabetes, and MLR (all <i>P</i> < 0.05) were factors significantly associated with a higher risk of CVD and all-cause mortality.</p><p><strong>Conclusions: </strong>Our results showed that high MLR values are an independent risk factor for CVD and all-cause mortality in patients initially receiving hemodialysis, especially in the elderly and those with a history of diabetes.</p>","PeriodicalId":73091,"journal":{"name":"Frontiers in nephrology","volume":"5 ","pages":"1638388"},"PeriodicalIF":0.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12500420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253901","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}
引用次数: 0
Route-specific effects of desmopressin on bleeding and hyponatremia after kidney biopsy: meta-analysis of intranasal vs. intravenous administration. 去氨加压素对肾活检后出血和低钠血症的特异性作用:鼻内与静脉给药的荟萃分析。
Frontiers in nephrology Pub Date : 2025-09-23 eCollection Date: 2025-01-01 DOI: 10.3389/fneph.2025.1645418
Li Zheng, Zhoujun Cai, Lina Shao, Wei Zhang, Bin Zhu, Yan Ren
{"title":"Route-specific effects of desmopressin on bleeding and hyponatremia after kidney biopsy: meta-analysis of intranasal vs. intravenous administration.","authors":"Li Zheng, Zhoujun Cai, Lina Shao, Wei Zhang, Bin Zhu, Yan Ren","doi":"10.3389/fneph.2025.1645418","DOIUrl":"10.3389/fneph.2025.1645418","url":null,"abstract":"<p><strong>Background: </strong>Hemorrhage represents the primary complication associated with kidney biopsy, with post-biopsy bleeding occurring in up to 14% of cases. Some clinicians routinely administer hemostatic agents, such as desmopressin, prior to kidney biopsy to mitigate the risk of significant bleeding. However, the efficacy of this practice remains contentious. Consequently, this meta-analysis was undertaken to assess existing studies regarding the efficacy and safety of desmopressin used before kidney biopsy.</p><p><strong>Methods: </strong>This systematic review and meta-analysis incorporated both randomized controlled trials and observational studies that examined the outcomes of desmopressin administration prior to percutaneous renal biopsy. Efficacy was measured by the incidence of bleeding events, while safety was assessed through the rate of hyponatremia. A comprehensive search of multiple databases was performed, and the risk of bias was evaluated, and statistical analyses were conducted using appropriate models.</p><p><strong>Results: </strong>Twelve studies were included. The primary meta-analysis showed no significant reduction in overall bleeding risk with desmopressin (pooled OR 0.71, 95% CI: 0.47 - 1.09; I² = 79%; p = 0.12).Statistically significant differences were observed in the intranasal administration group (pooled OR 0.41;95% CI: 0.28 to 0.60; I <sup>2</sup> = 20%; p < 0.0001)(Fixed effect), the RCT group (pooled OR 0.30; 95% CI: 0.17 to 0.53; I <sup>2</sup> = 0%; p < 0.0001)(Fixed effect), the low bias group (pooled OR 0.53; 95% CI: 0.32 to 0.87; I <sup>2</sup> = 74%; p = 0.01)(Random effect). We conducted statistical analysis on six studies with specific data on hyponatremia, and the pooled OR used fixed model was 2.14 (95% CI: 1.51 to 3.03; I <sup>2</sup> = 28%) (Fixed effect), indicating there was a statistical difference between the two groups (p < 0.0001).</p><p><strong>Conclusion: </strong>Desmopressin did not significantly reduce overall bleeding risk after kidney biopsy. While intranasal administration, RCT only and low bias group showed efficacy in subgroup analyses, it carried a significant hyponatremia risk. Route-specific protocols warrant further study.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023391915.</p>","PeriodicalId":73091,"journal":{"name":"Frontiers in nephrology","volume":"5 ","pages":"1645418"},"PeriodicalIF":0.0,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12500430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253904","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}
引用次数: 0
From slit diaphragm to autoantigen formation: a SUMOylation-based perspective on minimal change disease. 从狭缝横膈膜到自身抗原形成:基于sumoyl1的微小变化疾病视角。
Frontiers in nephrology Pub Date : 2025-09-18 eCollection Date: 2025-01-01 DOI: 10.3389/fneph.2025.1653595
Emre Leventoğlu, Bahar Büyükkaragöz, Sevcan A Bakkaloğlu
{"title":"From slit diaphragm to autoantigen formation: a SUMOylation-based perspective on minimal change disease.","authors":"Emre Leventoğlu, Bahar Büyükkaragöz, Sevcan A Bakkaloğlu","doi":"10.3389/fneph.2025.1653595","DOIUrl":"10.3389/fneph.2025.1653595","url":null,"abstract":"","PeriodicalId":73091,"journal":{"name":"Frontiers in nephrology","volume":"5 ","pages":"1653595"},"PeriodicalIF":0.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12488451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145234438","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}
引用次数: 0
Real-world implementation of the 2020 KDIGO guidelines for diabetes management in chronic kidney disease: a single-center retrospective study. 慢性肾脏疾病糖尿病管理的2020年KDIGO指南的实际实施:一项单中心回顾性研究
Frontiers in nephrology Pub Date : 2025-09-15 eCollection Date: 2025-01-01 DOI: 10.3389/fneph.2025.1664369
Nomy Levin-Iaina, Hatem El'Nasasra, Anat Reiner-Benaim
{"title":"Real-world implementation of the 2020 KDIGO guidelines for diabetes management in chronic kidney disease: a single-center retrospective study.","authors":"Nomy Levin-Iaina, Hatem El'Nasasra, Anat Reiner-Benaim","doi":"10.3389/fneph.2025.1664369","DOIUrl":"10.3389/fneph.2025.1664369","url":null,"abstract":"<p><strong>Background: </strong>Type 2 diabetes mellitus (T2DM) is an increasing global pandemic, frequently complicated by diabetic kidney disease, that may result in end stage kidney disease and increased cardiovascular morbidity and mortality. The 2020 KDIGO guidelines recommend SGLT2 inhibitors and GLP1RAs for cardio-renal protection in patients with T2DM and kidney disease. This study aimed to evaluate the implementation of the 2020 KDIGO guidelines among adult diabetic patients receiving nephrology care.</p><p><strong>Material and methods: </strong>This retrospective study included 587 patients with T2DM and chronic kidney disease treated in a single nephrology clinic between 1 May 2021 and 31 May 2022. Demographic, diabetes related, and CKD-related data was assessed. The utilization of the 2020 KDIGO recommended medications was analyzed during the study period, along with factors influencing treatment decisions.</p><p><strong>Results: </strong>The findings revealed a low initial utilization of recommended medications, with only 12.9% and 10.4% of patients treated with SGLT2i and GLP1RA, respectively. Only a modest, but significant, increase in SGLT2i usage was observed by the end of the study period. Factors associated with underutilization of SGLT2i and GLP1RA included older age and decreased kidney function. The study also highlights a significant gap between the recommendations given by nephrologists during the study period and the actual use of recommended medications in the last clinic visit.</p><p><strong>Conclusions: </strong>In conclusion, the study provides insights into the challenges of implementing KDIGO guidelines in real-world nephrology clinical setting. Further research is needed to explore the reasons behind low adherence to guidelines and strategies to improve compliance, ultimately enhancing patient outcomes in the management of kidney disease in T2DM.</p>","PeriodicalId":73091,"journal":{"name":"Frontiers in nephrology","volume":"5 ","pages":"1664369"},"PeriodicalIF":0.0,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145202183","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}
引用次数: 0
Epidemiological changes in anti-glomerular basement membrane disease in Madrid in the context of the COVID-19 pandemic. 新冠肺炎大流行背景下马德里地区抗肾小球基底膜病的流行病学变化
Frontiers in nephrology Pub Date : 2025-09-10 eCollection Date: 2025-01-01 DOI: 10.3389/fneph.2025.1667652
Lina León-Machado, Gonzalo Sierra-Torres, Amir Shabaka, Clara Cases-Corona, Cristina Vega, Begoña Rivas, Diana Ruiz Cabrera, Gema Fernandez-Juarez
{"title":"Epidemiological changes in anti-glomerular basement membrane disease in Madrid in the context of the COVID-19 pandemic.","authors":"Lina León-Machado, Gonzalo Sierra-Torres, Amir Shabaka, Clara Cases-Corona, Cristina Vega, Begoña Rivas, Diana Ruiz Cabrera, Gema Fernandez-Juarez","doi":"10.3389/fneph.2025.1667652","DOIUrl":"10.3389/fneph.2025.1667652","url":null,"abstract":"<p><strong>Introduction: </strong>Recent studies in Europe have reported a rising incidence in anti-glomerular basement membrane (anti-GBM) disease, potentially linked to demographic shifts or environmental factors. This study aimed to assess temporal trends in incidence, clinical presentation, and outcomes of anti-GBM disease in two urban areas of Madrid over the past two decades.</p><p><strong>Materials and methods: </strong>We conducted a retrospective observational study of patients diagnosed with anti-GBM disease between 2006 and 2022 at two urban areas covering 884,000 residents in Madrid. Inclusion required confirmed anti-GBM antibodies with clinical manifestations. Incidence was calculated per 1,000,000 person-years. Data were analyzed across six time periods and compared pre- and post-COVID-19 onset.</p><p><strong>Results: </strong>A total of 26 cases were identified (mean age 52 ± 26 years; 54% female). Incidence increased from 1.13 cases per million persons-year before 2020, to 4.53 cases per million persons-year after 2020 (p<0.001). No differences were observed in demographic data or environmental exposures over time. Post-COVID-19 cases had lower serum creatinine at presentation (5.09 ± 4 <i>vs</i>. 8.7 ± 3.9 mg/dL, p=0.037), more pulmonary involvement (83.3% <i>vs</i>. 35.7%, p=0.039), and better 1-year renal survival (50% <i>vs</i>. 14.3%, p=0.049). Overall patient survival did not differ between groups.</p><p><strong>Conclusions: </strong>Incidence of anti-GBM disease has increased in Madrid, particularly after the COVID-19 pandemic. Improved renal survival appears linked to earlier diagnosis and management, rather than changes in environmental exposure. These findings highlight the importance of heightened clinical awareness for early detection and treatment of this aggressive disease.</p>","PeriodicalId":73091,"journal":{"name":"Frontiers in nephrology","volume":"5 ","pages":"1667652"},"PeriodicalIF":0.0,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12457157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145152061","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}
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