Frontiers in nephrology最新文献

{"title":"Intradialytic blood pressure instability and associated factors among hemodialysis patients in Somalia: a retrospective study.","authors":"Abdulrashid Hashi Mohamed, Mohamud Mire Waberi, Feyza Aksu, Nurto Abdulkadir Said, Said Abdirahman Ahmed","doi":"10.3389/fneph.2026.1822440","DOIUrl":"10.3389/fneph.2026.1822440","url":null,"abstract":"<p><strong>Background: </strong>Intradialytic blood pressure (BP) instability-manifesting as intradialytic hypotension (IDH) or hypertension (IDHT)-is increasingly recognized as a contributor to cardiovascular morbidity in hemodialysis patients. Despite its clinical significance, data on intradialytic BP behavior from sub-Saharan Africa remain scarce.</p><p><strong>Objective: </strong>To determine the prevalence and clinical factors associated with intradialytic BP changes among chronic kidney disease (CKD) patients on maintenance hemodialysis in a tertiary hospital in Somalia.</p><p><strong>Methods: </strong>We conducted a retrospective observational study of adult patients undergoing maintenance hemodialysis at Mogadishu Somali Turkish Training and Research Hospital between June and September 2022. Intradialytic hypotension was defined as a ≥20 mmHg drop in systolic BP and/or ≥10 mmHg drop in mean arterial pressure (MAP), while IDHT was defined as a >10 mmHg increase in systolic BP and/or ≥15 mmHg increase in MAP from pre- to post-dialysis. Demographic, clinical, dialysis, and laboratory variables were extracted. Logistic regression models were used to evaluate factors associated with IDH and IDHT, with reduced modeling for IDHT because of the small number of events.</p><p><strong>Results: </strong>Among 149 patients (mean age 51.1 ± 16.4 years; 57.7% female), the prevalence of IDH and IDHT was 55.0% and 12.1%, respectively. Most patients (74.5%) had hypertension and 96.5% used an arteriovenous fistula. In multivariable analysis, higher pre-dialysis systolic BP (OR 1.037; 95% CI 1.018-1.056) and ultrafiltration goal (OR 1.537; 95% CI 1.002-2.357) were associated with IDH. Because pre-dialysis systolic BP contributed to the outcome definition, this association should be interpreted cautiously. In the reduced IDHT model, ultrafiltration goal was inversely associated with IDHT (OR 0.543; 95% CI 0.298-0.990), while antihypertensive medication burden was not statistically significant. Exploratory electrolyte tertile analysis showed a higher proportion of IDH among patients in lower calcium and higher phosphate tertiles.</p><p><strong>Conclusion: </strong>Intradialytic BP instability was common among hemodialysis patients in Somalia, particularly IDH. Given the retrospective design, reliance on pre- and post-dialysis BP measurements, and limited number of IDHT events, the findings should be interpreted as associative and hypothesis-generating. Routine BP monitoring and further prospective studies are warranted to better characterize hemodynamic instability in resource-constrained dialysis settings.</p>","PeriodicalId":73091,"journal":{"name":"Frontiers in nephrology","volume":"6 ","pages":"1822440"},"PeriodicalIF":2.9,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13337759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148407266","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":"Correction: Successful reintegration of a very elderly patient with rapidly progressive glomerulonephritis due to microscopic polyangiitis after multidisciplinary treatment: a case report.","authors":"Tatsuo Tsukamoto, Yui Fukuda, Kaoru Ohue, Atsuto Niwa, Sanae Ogura, Takuya Ishimura, Takaya Handa, Tomomi Endo, Takeshi Matsubara","doi":"10.3389/fneph.2026.1895403","DOIUrl":"https://doi.org/10.3389/fneph.2026.1895403","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.3389/fneph.2026.1803876.].</p>","PeriodicalId":73091,"journal":{"name":"Frontiers in nephrology","volume":"6 ","pages":"1895403"},"PeriodicalIF":2.9,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13329341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148392653","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":"Plasma asymmetric dimethylarginine and its association with cardiovascular risk factors in Vietnamese patients before and after kidney transplantation, 2018-2022.","authors":"Nguyen Thi Thuy, Le Viet Thang","doi":"10.3389/fneph.2026.1773762","DOIUrl":"10.3389/fneph.2026.1773762","url":null,"abstract":"<p><strong>Background: </strong>Asymmetric dimethylarginine (ADMA) levels in patients with chronic kidney disease (CKD) are associated with cardiovascular events and mortality following kidney transplantation (KT). Therefore, ADMA may serve as a risk factor for cardiovascular complications in kidney transplant recipients. This study aimed to evaluate plasma ADMA concentrations and their association with cardiovascular risk factors in Vietnamese patients with end-stage renal disease (ESRD) before and after KT.</p><p><strong>Methods: </strong>From January 2018 to December 2022, 75 patients with ESRD who underwent KT were clinically evaluated using Doppler ultrasound, laboratory tests, and ADMA quantification both before and 6 months after KT. Additionally, 80 healthy people were selected as a control group. ADMA levels before and after KT were statistically analyzed to identify associations with cardiovascular risk factors.</p><p><strong>Results: </strong>The findings indicate that 100% of patients with ESRD before KT exhibited elevated levels of urea, creatinine, proteinuria, a long with a decreased glomerular filtration rate (GFR)< 60 ml/min. After KT, these abnormalities decreased to 17.3%, 41.3%, 5.3%, and 9.3%, respectively. Clinical indices such as hypertension, elevated CRP, anemia, left ventricular hypertrophy, and EF%< 50% were observed after KT at rates of 29.3%, 21.3%, 61.4%, and 34.7%, respectively. However, dyslipidemia and AIP > 0.11 increased by 2.6% and 10.7%, respectively, after KT compared to before. The average ADMA concentrations of patients before KT, after KT, and in healthy controls were 0.62 µmol/L, 0.57 µmol/L vs 0.17 µmol/L, respectively. Before KT, 93.3% of patients exhibited elevated ADMA levels, which decreased to 32.0% after KT. Males presented higher ADMA levels than females both before and after KT, as well as in healthy controls. ADMA levels showed minimal variation across different age groups. Before KT, dyslipidemia (cholesterol), AIP (> 0.11), and LA diameter were associated with increased ADMA levels. Lower hemoglobin and lower HDL-C levels at 6 months post-transplant were independently associated with an increased risk of ADMA elevation from pre-transplant to 6 months post-transplant.</p><p><strong>Conclusion: </strong>ADMA levels in patients with end-stage renal disease were 3.65 times higher than those in healthy controls. Although ADMA levels decreased after KT, they remained elevated compared to healthy controls. Hemoglobin and LDL-C were independent factors associated with changes in ADMA concentration between the pre-transplant and six-month post-transplant periods.</p>","PeriodicalId":73091,"journal":{"name":"Frontiers in nephrology","volume":"6 ","pages":"1773762"},"PeriodicalIF":2.9,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13294190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148347296","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":"Exploring the relationship between serum vitamin D and atherosclerosis in hemodialysis patients: a cross-sectional study.","authors":"Ashraf Hassan Abd El Mobdy, Saeed Abdelwahab Saeed, Walid Ahmed Bichari, Omaira Ahmed Osman, Shereen Yousef Salah","doi":"10.3389/fneph.2026.1738155","DOIUrl":"10.3389/fneph.2026.1738155","url":null,"abstract":"<p><strong>Objective: </strong>To check if there is a link between good vitamin D levels in the blood and subclinical atherosclerosis in people on hemodialysis.</p><p><strong>Methods: </strong>Ninety end-stage renal disease patients undergoing regular hemodialysis were included in a cross-sectional study. Based on carotid intima-media thickness (CIMT), patients were grouped into Group A (n = 44) with normal CIMT and Group B (n = 46) with increased CIMT. Clinical assessments, laboratory parameters (serum vitamin D, lipid profiles, and inflammatory markers), and CIMT were measured using carotid ultrasound. The researcher compared students' t-tests with quantitative variables, while employing the Chi-square or Fisher's exact test with qualitative variables.</p><p><strong>Results: </strong>A positive correlation was observed between serum vitamin D and calcium (p = 0.010) and triglycerides (p = 0.025). Serum vitamin D showed a negative correlation with weight, serum alkaline phosphatase, and urea. No significant differences were found between the two groups in terms of demographic factors, BMI, hemodialysis duration, diabetes prevalence, or vitamin D supplementation. Group B exhibited elevated serum calcium levels (p = 0.008). Multivariate analysis found weight as an independent predictor of low vitamin D levels (p = 0.016).</p><p><strong>Conclusion: </strong>Serum calcium levels were significantly associated with CIMT; however, no correlation was seen between vitamin D levels and CIMT.</p><p><strong>Trial registration: </strong>registered at clinicaltrials.gov (ID: NCT07200804).</p>","PeriodicalId":73091,"journal":{"name":"Frontiers in nephrology","volume":"6 ","pages":"1738155"},"PeriodicalIF":2.9,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13291148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148335116","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":"Comparative bioequivalence of 1 mg and 4 mg tacrolimus extended-release tablets: randomized, open label, fully replicate, crossover trials in healthy adult subjects.","authors":"Jay Kumar Sharma, Deepak Bunger, Hemant Zaveri, Alok Chaturvedi","doi":"10.3389/fneph.2026.1838510","DOIUrl":"10.3389/fneph.2026.1838510","url":null,"abstract":"<p><strong>Introduction: </strong>These studies were planned to establish bioequivalence between two doses (1-mg and 4-mg) of test product (tacrolimus extended-release tablets manufactured by Intas Pharmaceuticals Ltd., India) with reference product (Envarsus XR^® manufactured for Veloxis Pharmaceuticals, Inc., USA).</p><p><strong>Methods: </strong>These were open-label, randomized, two-treatments, four-periods, two-sequence, oral single-dose, fully-replicate, crossover trials in healthy subjects under fasting and fed conditions. The study included subjects aged 18-45 years, with a body mass index of 18.5-29.9 kg/m². Bioequivalence was assessed based on key pharmacokinetic parameters (AUC, C_max, T_max and t_1/2). Safety and tolerability were assessed by monitoring adverse events (AEs), serious AEs and death.</p><p><strong>Results: </strong>The analysis set included a total of 85 (1-mg fasting), 83 (1-mg fed), 85 (4-mg fasting), and 85 (4-mg fed) subjects. Similar demographics were observed across all subjects. Results showed comparable C_max, T_max, AUC_0-t, AUC_0-∞ and t_½ for 1-mg and 4mg mg test vs. reference product under fasting and fed conditions. The upper limit of 90% confidence intervals for within subject standard deviation for test product/within subject standard deviation for reference product (σWT/σWR), 95% upper confidence bound, and 90% confidence intervals for C_max, AUC_0-t, and AUC_0-∞ were within the corresponding acceptance criteria as per EMA and met all the bioequivalence criteria.</p><p><strong>Conclusion: </strong>The developed tacrolimus test product (1-mg and 4-mg) was bioequivalent to the reference product, was well-tolerated, and provided a well-acceptable alternative to the reference product. These studies were performed in healthy individuals, further studies in transplant patient populations to confirm clinical applicability are warranted.</p><p><strong>Ctri number: </strong>These studies have not been registered on the CTRI portal. The studies are routine BA/BE studies conducted in healthy volunteers. As per prevailing regulatory guidance, CTRI registration is not mandatory for such normal BA/BE studies. Additionally, the product under evaluation is already approved worldwide, and the studies do not constitute interventional clinical trials in patients.</p>","PeriodicalId":73091,"journal":{"name":"Frontiers in nephrology","volume":"6 ","pages":"1838510"},"PeriodicalIF":2.9,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13284695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148310679","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":"Prevalence of psychological and metabolic concerns in children with white coat and ambulatory hypertension.","authors":"Anne E Dawson, Vanessa Thiel, Andrew H Tran, Camille S Wilson, Mahmoud Kallash","doi":"10.3389/fneph.2026.1699959","DOIUrl":"10.3389/fneph.2026.1699959","url":null,"abstract":"<p><strong>Background: </strong>White Coat Hypertension (WCH), or elevated blood pressure in response to stress, is common in childhood. While studies showed that hypertension (HTN) can be associated with psychological and neurocognitive impairments, the prevalence of such concerns in children with WCH is not well studied. This study aimed to evaluate prevalence of metabolic and positive mental health screening in patients with WCH and hypothesized that those concerns are higher in patients with WCH compared to HTN, while they have less frequency of metabolic risk factors.</p><p><strong>Methods: </strong>This is a single-center cross- sectional study of patients referred to the pediatric nephrology outpatient clinics to assess hypertension. All patients completed a 24-hour ambulatory blood pressure monitor and classified as HTN vs WCH. Various patient and parent-reported psychosocial screening surveys were self-administered. Results of kidney function, lipid panel, and echocardiogram were collected (if available). Descriptive analyses were used to assess psychological and metabolic factors across patients, with specific focus on assessing the differences between patients with HTN versus WCH.</p><p><strong>Results: </strong>The study enrolled 552 patients (56.3% had HTN; 43.7% had WCH), and of the included patients: 472 completed the screening surveys (54.2% with HTN; 43.8% with WCH). There were no significant differences between groups across metabolic risk factors of primary HTN. Furthermore, there were no significant differences in prevalence of psychological markers between the groups; however, the general prevalence across all patients with screening positive for at least one mental health concern was high at 50.1%.</p><p><strong>Conclusions: </strong>Metabolic and mental health concerns, including inattention, anxiety, and depression are common in patients with WCH at a similar rate to HTN. This highlights the importance of considering psychosocial functioning testing when treating pediatric patients with hypertension disorders.</p>","PeriodicalId":73091,"journal":{"name":"Frontiers in nephrology","volume":"6 ","pages":"1699959"},"PeriodicalIF":2.9,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13284145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148310786","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":"Severity of restless leg syndrome in patients undergoing hemodialysis: assessing its burden on quality of life and knowledge.","authors":"Esraa Samir Mohamed, Hanan Said Ali, Fatma Mostafa Mahrous","doi":"10.3389/fneph.2026.1850856","DOIUrl":"10.3389/fneph.2026.1850856","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to assess the severity of restless legs syndrome (RLS) among patients undergoing hemodialysis and to evaluate its burden on quality of life (QoL), as well as its relationship with knowledge regarding end-stage renal disease (ESRD), RLS, and hemodialysis (HD).</p><p><strong>Methods: </strong>In 2025, a descriptive correlation study was used. A purposive sample of (75) patients was recruited from the hemodialysis unit of Banha University Hospital in Qalyubia, Egypt. Self-administered questionnaires included: 1) socio-demographic characteristics; 2) a questionnaire assessing patient's knowledge regarding ESRD, RLS, and HD; 3) the International Restless Legs Syndrome study group (IRLSSG) rating scale; and 4) A Quality of life (QoL) scale. Statistical analysis was analyzed using SPSS version 27.</p><p><strong>Results: </strong>A total of 75 patients were included, with a mean age of 47.6 ± 9.2 years; Of them, 65.3% were males, and 56% had been on dialysis for 5-10 years. Overall, 62.7% of the studied patients had an unsatisfactory level of knowledge regarding ESRD and RLS in the setting of hemodialysis. Regarding RLS severity, 10.7% had mild, 28.0% had moderate, 42.7% had severe, and 18.6% had very severe RLS. Overall, 48.0% of participants had poor total QoL. Overall RLS severity and QoL showed a statistically significant inverse association (p < 0.001). Overall RLS severity and QoL showed an inverse association with high statistical significance (p < 0.001). In addition, overall knowledge was inversely associated with overall RLS severity, though this did not reach statistical significance (p=0.056). However, QoL showed a statistically significant direct association with the overall level of knowledge (p < 0.029). Regarding QoL subdimensions, 52.0%, 54.7%, 49.3%, and 37.3% of patients reported poor QoL across the physical, psychological, social, and spiritual domains, respectively. Overall, 48.0% of participants had poor total QoL, 37.3% had average QoL, and 14.7% had good QoL.</p><p><strong>Conclusion: </strong>Among the investigated patients, QoL showed a negative association with overall RLS severity with high statistical significance. Moreover, overall knowledge was negatively and meaningfully associated with overall RLS severity. However, QoL was meaningfully and positively associated with the overall level of knowledge.</p>","PeriodicalId":73091,"journal":{"name":"Frontiers in nephrology","volume":"6 ","pages":"1850856"},"PeriodicalIF":2.9,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13275394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148297570","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":"Accuracy, readability, and health information quality of AI chatbot responses for patient education on intermittent fasting in chronic kidney disease: a prospective structured evaluation.","authors":"Joel Shah, William Wells-Gatnik, Biff Palmer, Prakrati Acharya, Wisit Cheungpasitporn","doi":"10.3389/fneph.2026.1857793","DOIUrl":"10.3389/fneph.2026.1857793","url":null,"abstract":"<p><strong>Background: </strong>Intermittent fasting (IF) represents a dietary strategy with known metabolic benefits, however its safety and applicability in patients with chronic kidney disease (CKD) remains poorly understood. AI chatbots' reliability for clinical and dietary guidance in clinically complex areas remains underexplored. No study has examined AI performance on IF in patients with CKD. This study evaluated the accuracy, consistency, readability, and quality of responses generated by ChatGPT-5 and Claude 4.5 Sonnet regarding IF in CKD.</p><p><strong>Methods: </strong>Twenty-five patient-centered questions spanning seven clinical domains were developed by two board-certified nephrologists and submitted independently to ChatGPT-5 and Claude 4.5 Sonnet twice per model. Prompts were submitted under standard and unmodified user conditions without customized system instructions to represent a zero-shot evaluation that is illustrative of typical patient use. Responses were evaluated for accuracy, consistency (comparatively between responses), and appropriateness by the evaluators. Response readability and quality were assessed using the Flesch-Kincaid Grade Level (FKGL) formula and the DISCERN instrument respectively.</p><p><strong>Results: </strong>Both ChatGPT-5 and Claude 4.5 Sonnet demonstrated identical accuracy scores during the first question prompts with notable improvement upon re-prompting after 24-hours. Both models demonstrated an identical internal consistency at 90%. ChatGPT-5 produced responses at the middle school level, better aligned with the US adult health literacy benchmark, while Claude 4.5 Sonnet generated responses at the high school level. DISCERN scoring was comparable between chatbots indicative of good response quality. Both chatbots had similar performance regarding individual subdomains.</p><p><strong>Conclusions: </strong>Both chatbots illustrated clinically accurate and cautious responses to questions regarding IF in CKD. ChatGPT-5 responses were better suited to the average health literacy of the general United States adult population. Despite our findings, we do not recommend either chatbot be used as the primary source for clinical counseling regarding IF in CKD. It is important for clinicians to help to guide patients toward evidence-based clinical information.</p>","PeriodicalId":73091,"journal":{"name":"Frontiers in nephrology","volume":"6 ","pages":"1857793"},"PeriodicalIF":2.9,"publicationDate":"2026-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13259986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148254749","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":"Factors associated with transplant workup completion in a regional kidney program in Ontario, Canada: a retrospective cohort study.","authors":"Abdelrahman Elsebaie, Natalie Witton, Wilma Hopman, Arezou Shahmoradi, David Holland, M Khaled Shamseddin","doi":"10.3389/fneph.2026.1789895","DOIUrl":"10.3389/fneph.2026.1789895","url":null,"abstract":"<p><strong>Introduction: </strong>Minimizing delays during the pre-kidney transplant workup is critical for patients and providers. We evaluated the factors associated with workup completion times across the processes and key investigations in our program.</p><p><strong>Methods: </strong>In this single-center, retrospective cohort study, we included all candidates who initiated their pretransplant workup between January 1, 2019 - December 31, 2022. Patients were allocated, based on their consecutive referrals, alternately to an intensified pretransplant clinic follow-up process with more frequent assessment visits every 4 months during evaluation (Cohort 1), or a single initial assessment with no interim visits until full workup completion (Cohort 2). Follow-up was continued until June 1, 2025. Ethical approval was obtained with waived informed consent.</p><p><strong>Results: </strong>In total, 207 patients were allocated to Cohort 1 (n = 94, Age 52.2 ± 14.2 years, 45.7% female) and Cohort 2 (n = 113, Age 56.8 ± 12.1 years, 43.4% female), with no significant demographic differences between cohorts. Cohort 1 demonstrated a significantly shorter median workup duration (12.8 vs. 17.1 (-4.1 months), P = 0.007) and reduced dialysis vintage at the time of transplant decision (22.3 vs. 29.4 (-7.1 months), P = 0.056).</p><p><strong>Discussion: </strong>Frequent pre-transplant assessment visits were associated with expedited workup completion and reduced dialysis vintage.</p>","PeriodicalId":73091,"journal":{"name":"Frontiers in nephrology","volume":"6 ","pages":"1789895"},"PeriodicalIF":2.9,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13253244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148254778","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":"Experience and outcomes of kidney transplantation in a Colombian referral center.","authors":"Maricel Licht-Ardila, Diana Carolina Velasquez-Romero, Alexandra Hurtado-Ortiz, Alejandra Mendoza-Monsalve, Katherine Del Consuelo Camargo-Hernández, Claudia Constanza Velasco-Martínez, Adalberto Peña Wilches, Paola Andrea Parra, Anderson Bermon, Juan Sebastian Gelvez-Rueda, Edgar Fabián Manrique-Hernández, Wilmer Roberto Rivero-Rodrigez","doi":"10.3389/fneph.2026.1817080","DOIUrl":"10.3389/fneph.2026.1817080","url":null,"abstract":"<p><strong>Background: </strong>Kidney transplantation remains the most effective therapy for End-Stage Renal Disease. While global outcomes have improved, data from Latin America are limited.</p><p><strong>Objective: </strong>to describe the institutional experience of a national kidney transplant program in Colombia and to analyze patient and graft survival, acute rejection, and graft loss over time.</p><p><strong>Methods: </strong>The objective of this research was to describe the institutional experience of a national kidney transplant program in Colombia and to analyze patient, graft, and rejection-free survival across nearly two decades. A retrospective cohort study included all adults who underwent kidney transplantation at a national referral center in Colombia between April 2006 and 5 October 2025. Outcomes were overall, graft, and rejection-free survival, analyzed with Kaplan-Meier and competing-risk models, and compared across three transplant eras (2006-2011, 2012-2018, 2019-2025).</p><p><strong>Results: </strong>A total of 422 kidney transplant recipients were included (38.4% female, 61.6% male). Renal vascular disease was the leading cause of kidney failure (38.5%). Kaplan-Meier analyses showed no sex differences; 1-year patient survival was 92.1% (95% CI: 87.8-94.9) in males and 96.7% (95% CI: 92.3-98.6) in females (p = 0.082). Era-stratified analyses demonstrated significant improvement in 1-year graft survival (log-rank p = 0.015) and a trend toward higher rejection-free survival, reaching 93.8% (95% CI: 88.4-96.7) in 2019-2025 (p = 0.062). In competing-risk analysis, death was more frequent than graft failure; at 15 years, cumulative incidence was 42.2% for death versus 17.8% for graft failure.</p><p><strong>Conclusion: </strong>Over 19 years, this program achieved survival outcomes comparable to international standards, with progressive improvement and sex-equitable results. Late mortality, rather than graft failure, has emerged as the main long-term challenge.</p>","PeriodicalId":73091,"journal":{"name":"Frontiers in nephrology","volume":"6 ","pages":"1817080"},"PeriodicalIF":2.9,"publicationDate":"2026-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13246708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148221136","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}