BMC Nephrology最新文献

{"title":"Patients' transition experience and care from predialysis to dialysis: a theory-guided integrative review.","authors":"Xuefei Wang, Ke Tian, Jin Hu, Shengqin Kang, Shunzhi Deng, Xueyan Gao, Yongzhen Mo","doi":"10.1186/s12882-025-04104-4","DOIUrl":"https://doi.org/10.1186/s12882-025-04104-4","url":null,"abstract":"<p><strong>Background: </strong>A smooth transition to dialysis is essential for survival and quality of life in patients with advanced chronic kidney disease (CKD).</p><p><strong>Objective: </strong>To develop a transition framework for patients with advanced CKD based on the existing research and transition theory, which aims to illuminate patients' transition experience and provide potential intervention strategies.</p><p><strong>Methods: </strong>An integrative review methodology was employed, with searches conducted in ten Chinese and English databases (PubMed, Web of Science, CINAHL, Embase, etc.). Articles were screened and selected based on predefined criteria independently by two authors, with reference lists of included studies reviewed for further studies. Data analysis followed the approach proposed by Whittemore and Knafl.</p><p><strong>Results: </strong>13 qualitative, 7 quantitative and 1 mixed methods articles were extracted and evaluated. This review develops the transition framework for patients with advanced CKD, including the concepts of transition nature, conditions, intervention strategies, and response patterns. It provides a comprehensive understanding of how personal, dialysis-related, interpersonal, community, and societal factors shape patients' transition experiences and identifies actionable strategies to enhance transitional care.</p><p><strong>Conclusion: </strong>The transition of patients with advanced CKD from predialysis to dialysis is multiple and dynamic. Healthcare professionals should take into account diverse factors influencing this process and formulate tailored strategies to support patients in achieving a smooth and healthy transition.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"182"},"PeriodicalIF":2.2,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel insights into kidney disease: the scRNA-seq and spatial transcriptomics approaches: a literature review.","authors":"Mingming Ma, Qiao Luo, Liangmei Chen, Fanna Liu, Lianghong Yin, Baozhang Guan","doi":"10.1186/s12882-025-04103-5","DOIUrl":"https://doi.org/10.1186/s12882-025-04103-5","url":null,"abstract":"<p><p>Over the past decade, single-cell RNA sequencing (scRNA-seq) and spatial transcriptomics (ST) have revolutionized biomedical research, particularly in understanding cellular heterogeneity in kidney diseases. This review summarizes the application and development of scRNA-seq combined with ST in the context of kidney disease. By dissecting cellular heterogeneity at an unprecedented resolution, these advanced techniques have identified novel cell subpopulations and their dynamic interactions within the renal microenvironment. The integration of scRNA-seq with ST has been instrumental in elucidating the cellular and molecular mechanisms underlying kidney development, homeostasis, and disease progression. This approach has not only identified key cellular players in renal pathophysiology but also revealed the spatial organization of cells within the kidney, which is crucial for understanding their functional specialization. This paper highlights the transformative impact of these techniques on renal research that have paved the way for targeted therapeutic interventions and personalized medicine in the management of kidney disease.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"181"},"PeriodicalIF":2.2,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Semaglutide reverses the chronic myopathy of hyperkalemic periodic paralysis: a case report.","authors":"Kenneth Brand, Daniel Landry, Jeffrey Mulhern, Gregory Braden","doi":"10.1186/s12882-025-04068-5","DOIUrl":"10.1186/s12882-025-04068-5","url":null,"abstract":"<p><strong>Background: </strong>Hyperkalemic Periodic Paralysis (hyperPP) is an autosomal dominant genetic disorder where high extracellular potassium is associated with skeletal muscle depolarization and both flaccid muscle weakness as well as delayed muscle relaxation that can lead to myotonia and myopathy. Interventions have typically relied on avoidance of triggers, low potassium diets, and diuretics like acetazolamide and diclofenamide with limited success.</p><p><strong>Case presentation: </strong>The patient is a 48 year old man with hyperPP from a familial autosomal dominant sodium channel point mutation in the SCN4A gene at position 704 with a Threonine to Methionine substitution that lead to symptoms starting in early childhood. By age 30 he developed permanent muscle weakness and neither acetazolamide nor diclofenamide as interventions had improved his myopathy. In the spring of 2023, semaglutide was initiated for weight loss. Before the semaglutide he could not rise out of a chair without help and his gait was very slow. Over the next year his strength and quality of life returned to levels he had not had in decades.</p><p><strong>Conclusion: </strong>This is a promising alternative treatment for hyperPP. By directly acting on skeletal muscle both dependent and independent of insulin, Semaglutide and likely other Glucagon-like peptide agonists show promise as a novel once weekly option that may treat not just the hyperkalemic periodic paralysis but also the skeletal muscle atrophy in a multimodal way.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"179"},"PeriodicalIF":2.2,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: Medication non-adherence and its associated factors among kidney transplant patients in a large teaching hospital in Ethiopia.","authors":"Meskerem Nimani Derejie, Erimas Nimane Dereje, Dirijit Mamo Alemu, Yemane Gebremedhin Tesfay, Fufa Hunduma, Negash Miniwye Temie","doi":"10.1186/s12882-025-04098-z","DOIUrl":"https://doi.org/10.1186/s12882-025-04098-z","url":null,"abstract":"","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"180"},"PeriodicalIF":2.2,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Twice against thrice-weekly hemodialysis (TATH): a multicenter nonrandomized trial.","authors":"Mabel Aoun, Serge Finianos, Chadia Beaini, Ghassan Sleilaty, Rita Ghaleb, Nicole Nourie, Sami Kais, Joseph El Hajal, Rachad Alameddine, Celine Boueri, Balsam El Ghoul, Sandy Zeidan, Hiba Azar, Antoine Dfouni, Jenny Hawi, Zeina Mechref, Valerie Hage, Dania Chelala","doi":"10.1186/s12882-025-04105-3","DOIUrl":"10.1186/s12882-025-04105-3","url":null,"abstract":"<p><strong>Background: </strong>The optimal frequency of maintenance hemodialysis remains a subject of debate. In many countries, twice-weekly hemodialysis is still commonly practiced. This trial aimed to compare the outcomes of patients undergoing twice-weekly versus thrice-weekly hemodialysis.</p><p><strong>Methods: </strong>This prospective, multicenter, nonrandomized trial included incident adult patients, with chronic kidney disease stage 5, initiating hemodialysis between January 2018 and August 2021. Patients were allocated to either a twice-weekly or thrice-weekly regimen, and monitored at 1, 3, 6, 12 and 24 months. This trial was terminated before reaching the required sample size due to the COVID-19 pandemic and economic factors. Recruitment achieved 25% of the projected number. Missing baseline factors were imputed using multiple imputation algorithms, then entered in a logistic regression model to estimate propensity scores. The primary outcome was two-year survival analyzed using a Cox regression survival model adjusted for propensity scores and baseline residual urine output. Secondary outcomes included hospitalization rates, uncontrolled hypertension and cumulative erythropoietin dose at two years, analyzed using regression models adjusted for propensity scores and baseline residual urine output. All analyses were conducted on an intention-to-treat basis.</p><p><strong>Results: </strong>A total of 132 patients on thrice-weekly hemodialysis and 71 on twice-weekly hemodialysis were included. The mean age was 67 ± 15 years and the median eGFR at dialysis initiation was 6 (4,8) mL/min/1.73 m². At one year, patients in the twice-weekly group had greater residual urine output. At two years, there was no significant difference in survival (HR = 0.84; 95% CI: 0.37, 1.90), hospitalization rates (P = 0.515) or uncontrolled hypertension (P = 0.442). The twice-weekly group showed a trend toward higher erythropoietin requirements (P = 0.08). Serum potassium levels and the number of antihypertensive medications were greater in the twice-weekly group.</p><p><strong>Conclusions: </strong>Patients on twice-weekly hemodialysis showed comparable overall survival at two years to those on thrice-weekly hemodialysis. While a twice-weekly regimen may be a viable option during the first year of dialysis, especially in low-resource settings, it carries potential risks that necessitate careful monitoring after the first year.</p><p><strong>Trial registration: </strong>The trial was registered on ClinicalTrials.gov on January 16, 2018 (Identifier NCT03415776).</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"176"},"PeriodicalIF":2.2,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11972488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk prediction of cardiovascular events in peritoneal dialysis patients.","authors":"Liang Liu, Liu Zhang, Daohai Zhang, Tao Guan, Ting He, Bo Liang, Jinghong Zhao","doi":"10.1186/s12882-025-04091-6","DOIUrl":"10.1186/s12882-025-04091-6","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular events (CVEs), which refer to a spectrum of conditions including heart attacks, stroke and peripheral vascular disease, are the primary cause of death among peritoneal dialysis (PD) patients, accounting for nearly 40% of deaths. Early identification of high-risk individuals is essential to lessen this burden. Machine learning is particularly suited for this task due to its ability to discern complex, non-linear relationships between various clinical variables, which is essential for accurately predicting CVEs in the context of PD. Our study aimed to develop a predictive machine learning model to identify PD patients at risk of CVEs, offering healthcare providers a tool for proactive intervention.</p><p><strong>Methods: </strong>A total of 251 PD patients were enrolled in the study, with an additional 42 patients included for external validation. Initially, 37 variables were collected but reduced to 25 via Lasso regression. Six supervised machine learning algorithms were evaluated, and XGBoost was chosen as the optimal model based on AUC. Both internal and external validation confirmed the model's efficacy, and a web application was developed using the final XGBoost model, which utilized 12 selected variables.</p><p><strong>Results: </strong>Among the 251 patients, 40 (15.94%) developed CVEs. The XGBoost model demonstrated an AUC of 0.94 in 5-fold cross-validation. A simplified XGBoost model using 12 variables demonstrated robust prediction capabilities with an AUC of 0.88 in 5-fold cross-validation and 0.78 in external validation. The top five predictors of CVEs were age at catheterization, height, HDL, gender and hemoglobin. According to the SHAP summary plot, older age at catheterization, shorter height, male gender, higher serum HDL and lower hemoglobin levels correlated with increased CVEs risk in PD patients.</p><p><strong>Conclusions: </strong>The machine learning model, based on 12 key variables, offers an effective tool for predicting CVEs in PD patients, enabling early identification of high-risk cases. This model has been integrated into a web application.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"177"},"PeriodicalIF":2.2,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11972494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical activity and sedentary behavior in peritoneal dialysis patients: a comparative analysis of ActiGraph GT3X data collected via wrist and waist with placement-specific cut-points.","authors":"Mingzi Chu, Chun Hu, Lin Zhu, Jiajia Lyu, Feng Wang, Xingjuan Tao","doi":"10.1186/s12882-025-04100-8","DOIUrl":"10.1186/s12882-025-04100-8","url":null,"abstract":"<p><strong>Background: </strong>The increasing adoption of accelerometers for the assessment of sedentary behaviour and physical activity among dialysis patients demands robust validation of these monitoring devices. This study aims to determine the comparability of wrist- versus waist-worn ActiGraph GT3X accelerometers, using placement-specific cut-points for peritoneal dialysis patients, to refine research and clinical practices.</p><p><strong>Methods: </strong>This was a cross-sectional study. Thirty-one participants wore two ActiGraph GT3X accelerometers, positioned on the right waist and nondominant wrist, and monitored over a seven-day period in a naturalistic setting. Data were processed with ActiLife v6.13.3 and analysed using intraclass correlation coefficients (ICC), limits of agreement, and pairwise 90% equivalence test within a ± 10% threshold.</p><p><strong>Results: </strong>The sedentary time measurements from both wrist- and waist-worn GT3X accelerometers were deemed equivalent, with high ICC values (0.98, 95% confidence intervals (CI) 0.97-0.99) and a ratio of 1.0 within the 90% CI of 0.9 to 1.0. Although agreement between accelerometers was good for classification of light-intensity activity (ICC = 0.76), the waist-worn device's estimates exceeded the equivalence criteria compared to the wrist-worn device (ratio 1.4; 90% CI 1.2-1.6). Conversely, the waist-worn device reported a significantly lower duration of moderate-to-vigorous physical activity (MVPA) than the wrist-worn device (Ln transformed ratio 0.3; 90% CI 0.1-0.4).</p><p><strong>Conclusions: </strong>The use of placement-specific cut-points did not ensure equivalence in physical activity parameter estimates between wrist- and waist-worn ActiGraph GT3X devices. The findings underscore the necessity for consistent accelerometer placement for reliable monitoring of physical activity in peritoneal dialysis patients.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"178"},"PeriodicalIF":2.2,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11972474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A clinical study of efficacy and safety of the Carry Life UF system in continuous ambulatory peritoneal dialysis patients: protocol for a prospective, multicenter, randomized, crossover study.","authors":"Martin Wilkie, Charlotte de Leon, Ola Carlsson, Jörgen Hegbrant, Olof Heimbürger","doi":"10.1186/s12882-025-04095-2","DOIUrl":"10.1186/s12882-025-04095-2","url":null,"abstract":"<p><strong>Background: </strong>Carry Life UF is a novel peritoneal dialysis (PD) technology for improved fluid management using steady concentration PD (SCPD). The Carry Life UF treatment starts with a manual peritoneal fill of 1.36% glucose PD fluid, followed by a 5-hour treatment where small amounts of glucose are continuously added to maintain a stable intraperitoneal glucose concentration. A recent in-center clinical study using the Carry Life UF system demonstrated higher ultrafiltration (UF) rates, more efficient use of glucose (increased UF volume/gram of glucose absorbed), and greater sodium removal with the Carry Life UF treatments compared with a 2.27% glucose continuous ambulatory PD (CAPD) dwell. The aim of this study is to compare efficacy and safety of the Carry Life UF system with a standard CAPD prescription in the home setting.</p><p><strong>Methods: </strong>A prospective, multicenter, randomized, crossover study of 19 adult subjects at up to 12 sites in Italy, Sweden and the UK will complete the investigation. End-stage kidney disease patients with a CAPD prescription of 2-4 exchanges per day, including at least one 2.27% glucose dwell, will be included. After a Carry Life UF glucose dose determination phase performed in-clinic, subjects will be randomized to start the home treatment part of the study with either the control arm (2.27% glucose CAPD dwell) or the Carry Life UF arm (11 or 15 g/h glucose dose), each for four weeks. The primary endpoint is UF volume comparing the control CAPD 2.27% glucose dwell with the Carry Life UF treatment. Secondary endpoints include adverse event rates, peritoneal sodium removal, glucose UF efficiency, and peak dialysate glucose concentration.</p><p><strong>Discussion: </strong>This study will evaluate a novel PD technology in the home environment. Challenging aspects include the need to accurately measure UF volumes at home and to support subjects in using a novel technology. The study design considers important parameters for precise UF volume measurements and provides detailed weighing instructions to the study team to ensure consistency between study centers. Research nursing support will be provided for training of subjects and to support endpoint data collection in the subjects' home. Due to the significant burden associated with the study, subjects will be offered a fair compensation, in accordance with local regulations.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT05874804 Registration date: 18th of April 2023.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"174"},"PeriodicalIF":2.2,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of kidney disease progression after renal artery stenting.","authors":"Mehmet Ası Oktan, Orkun Sarioglu, Cihan Heybeli, Esra Ozdemir, Ilker Atay, Berfu Korucu, Yelda Deligöz Bildaci, Serpil Muge Deger, Caner Cavdar, Ali Celik, Aytaç Gulcu","doi":"10.1186/s12882-025-04097-0","DOIUrl":"10.1186/s12882-025-04097-0","url":null,"abstract":"<p><strong>Background: </strong>Atherosclerotic renovascular disease (ARVD) is the most common cause of renal artery stenosis (RAS). ARVD is associated with an increased risk of progression of kidney disease and high mortality. In this regard, the aim was to evaluate the effects of the factors on kidney functions in short- and long-term follow-ups.</p><p><strong>Method: </strong>Patients with RAS treated with renal artery stenting since January 2015 were evaluated retrospectively in a single center. The primary endpoint was a decline in the estimated glomerular filtration rate (eGFR) of ≥ 20 ml/min and/or evolution to end stage kidney disease. Predictors of the primary endpoint were determined using the Cox regression model.</p><p><strong>Results: </strong>Of the 95 patients included, 57 (56.4%) were male, and the mean age was 68.7 ± 10.4. Median serum creatinine (mg/dl) and eGFR (ml/min/1.73 m²) at presentation were 1.57 (IQR, 1.11-2.12) and 40 (27-58). The median follow-up was 31 months. Indications for renal artery revascularization included high blood pressure (34 patients, 35.8%), kidney failure (29 patients, 30.5%), or a mixture of these (32 patients, 33.7%). RAS was unilateral in 67 (70%) patients. In the multivariate Cox regression analysis, serum creatinine (HR 2.03, 95% CI 1.3-3.2, p = 0.002), peak systolic velocity (HR 1.005 per 10 ms, 95% CI 1.001-1.010, p = 0.007), and acute kidney injury after revascularization (HR 10.18, 95% CI 2.3-45.4, p < 0.001) were independent predictors of progression of chronic kidney disease.</p><p><strong>Conclusion: </strong>Serum creatinine level, peak systolic velocity of the renal artery before revascularization, and acute kidney injury after angiographic intervention are independent predictors of the progression of chronic kidney disease in patients who underwent renal artery stenting.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"175"},"PeriodicalIF":2.2,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11969715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Manual manipulation and ex vivo flexible ureteroscopic lithotripsy to salvage deceased donor kidneys with renal stones: a case series.","authors":"Lin Xiong, Kristine J S Kwan, Jianyong Pan, Zhen-Quan Lu, Yingxin Fu","doi":"10.1186/s12882-025-04081-8","DOIUrl":"10.1186/s12882-025-04081-8","url":null,"abstract":"<p><strong>Background: </strong>Nephrolithiasis is generally considered a relative contraindication for kidney donation. This study aimed to evaluate the feasibility and effectiveness of a surgical technique designed to salvage deceased donor kidneys with renal stones. The technique involves manual manipulation of the recovered kidney combined with flexible ureteroscopic lithotripsy (MM-FURSL) to clear the stones prior to transplantation.</p><p><strong>Case presentation: </strong>A total of nine kidneys were recovered from six deceased donors. The recipients (66.7% female; mean age 43.9 ± 12.2 years) had been on dialysis for an average of 2.6 years before undergoing renal transplantation with MM-FURSL. Donor kidneys contained 1 to 4 stones each, with a mean maximum stone diameter of 15.1 ± 10.6 mm and an average CT density of 942.0 ± 106.6 HU. The mean warm and cold ischemia times were 5 min and 480 ± 108.2 min, respectively. The average total operative duration was 57.0 ± 63.4 min. The first patient to undergo MM-FURSL had the longest operative and cold ischemia times due to the use of a reusable flexible ureteroscope, which was damaged during the procedure. She was the only patient to experience acute tubular necrosis (ATN), but her creatinine levels normalized within three weeks. No other complications were observed during a mean follow-up period of 11.7 ± 8.2 months.</p><p><strong>Conclusion: </strong>MM-FURSL is an effective method for removing renal stones in donor kidneys. Short-term outcomes were favorable, suggesting that this technique could be a viable approach to expand the donor pool by salvaging kidneys with nephrolithiasis. However, prolonged cold ischemia time may increase the risk of ATN and should be minimized.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"173"},"PeriodicalIF":2.2,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11967039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}