BMC Nephrology最新文献

{"title":"Relation between bone mineral density and oxidative stress in Egyptian patients with chronic kidney disease: a cross sectional study.","authors":"Samah M Akab, Hanaa Elsayed Abozeid, Seham A Elazab, Sherien Abdallh Fathy Elazab, Noran ElBazzar, Eman Refaat Youness, Mohamed Ahmed Shahba, Hisham A Orban, Hanaa Reyad Abdallah, Moushira Zaki","doi":"10.1186/s12882-025-04099-y","DOIUrl":"https://doi.org/10.1186/s12882-025-04099-y","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease (CKD) patients are prone to osteoporosis (OP) and they had significant oxidative stress. The relationship between oxidative stress (OS) and bone mineral density (BMD) in CKD is not entirely clear. The investigation of this relation is of pronounced importance in decreasing the occurrence of osteoporosis among CKD cases.</p><p><strong>Objectives: </strong>To evaluate the association between BMD and OS in CKD patients.</p><p><strong>Methods: </strong>We performed a case-control study, including 150 adults with CKD (stage 1-5 according to Kidney Disease Improving Global Outcomes (KDIGO) classification, 2024) and 150 healthy controls. CKD patients were further subdivided to 3 subgroups based on estimated glomerular filtration rate: stage 1-2, stage 3-4 and stage 5. BMD at the lumbar spine (LS), femur neck (FN), and distal radius (DR) were measured using DEXA. Vitamin D and OS biomarkers including; 8-Hydroxy-2'-deoxyguanosine (8-OHdG) and Malondialdehyde (MDA) were measured. Paraoxonase1 (PON1) as a biomarker of antioxidant response was assessed. Statistical analysis was performed using the appropriate tests.</p><p><strong>Results: </strong>The CKD cases showed lower BMD T-Scores than healthy controls. Moreover, LS, DR, and FN BMDs were significantly different between CKD stages. Post hoc analyses showed higher LS, DR, and FN T-Scores in Stage I-II vs. Stage III-IV and Stage V. However, no significant differences were noted between stage III-IV and stage V for all sites. Significant increase in OS biomarkers (8-OHdG and MDA) while decreasing antioxidant activity (PON-1) with CKD severity were observed. There was a significant positive correlation between PON1and BMD while 8-OHdG and MDA had a negative correlation with BMD. We also observed significant positive correlations between 8-OHdG and MDA with alkaline phosphatase and phosphorus, while these markers had significant negative correlations with vitamin D and calcium. PON1 had a significantly positive correlation with vitamin D & calcium.</p><p><strong>Conclusion: </strong>CKD patients suffer of OS. OS positively correlated with CKD severity. There is a negative relation between OS and BMD in CKD. OS might participate in the occurrence of OP in CKD.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"197"},"PeriodicalIF":2.2,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12007136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143973796","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":"Calycosin ameliorates albuminuria in nephrotic syndrome by targeting Notch1/Snail pathway.","authors":"Xiaohong Ma, Binghe Guan, Linrong Pang","doi":"10.1186/s12882-025-04113-3","DOIUrl":"https://doi.org/10.1186/s12882-025-04113-3","url":null,"abstract":"<p><strong>Background: </strong>Heavy proteinuria is an important hallmark for kidney disease including nephrotic syndrome. Astragali Radix, a traditional Chinese herb, holds the potential to alleviate nephrotic syndrome; however, the underlying mechanism has not been completely clarified. The study aimed to explore the role of calycosin (C₁₆H₁₂O₅), a major active component of Astragali Radix, in regulating adriamycin-induced proteinuria.</p><p><strong>Methods: </strong>A rat model of nephrotic syndrome was established through two adriamycin injections within two weeks (4 mg/kg for the first week and 2 mg/kg for the second week). After the induction of renal injury, 10 mg/kg or 20 mg/kg calycosin was intraperitoneally injected into rats for four weeks. Before euthanasia of rats, urine and blood samples were collected, and body weight was recorded. Then, 24 h urine protein content, kidney index, total cholesterol (TC), triglyceride (TG), as well as renal function indicators including blood urea nitrogen (BUN), serum creatinine (SCR), and urine albumin excretory rate (UAE) were measured. Hematoxylin-eosin staining for renal cortex tissues was performed to evaluate glomerular structural damage. TUNEL assay was performed to evaluate renal cell apoptosis. Western blotting was conducted to measure protein levels of podocyte-specific markers (podocin and nephrin), Notch1, and Snail in rat renal tissues.</p><p><strong>Results: </strong>Calycosin reversed adriamycin-induced increase in proteinuria content, kidney index, and concentrations of renal function indicators. Calycosin ameliorated glomerular structural damage, inflammatory cell infiltration, and basement membrane thickening in model rats. In addition, calycosin rescued the suppressive impact of adriamycin on renal cell apoptosis and protein levels of podocyte markers. The activated Notch1/Snail signaling in model rats was suppressed by calycosin intervention.</p><p><strong>Conclusion: </strong>Calycosin exerts a protective role against adriamycin-induced nephrotic syndrome via inhibition of the Notch1/Snail signaling.</p><p><strong>Clinical trial details: </strong>Not applicable.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"198"},"PeriodicalIF":2.2,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12008911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961091","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":"Does combining urine sediment examination to renal cell arrest and damage biomarkers improve prediction of progression and mortality of sepsis associated acute kidney injury?","authors":"Mohamed Mamdouh Elsayed, Ahmed Elsayed Eldeeb, Mona Moustafa Tahoun, Hala Saddik El-Wakil, Salah Said Naga","doi":"10.1186/s12882-025-04096-1","DOIUrl":"https://doi.org/10.1186/s12882-025-04096-1","url":null,"abstract":"<p><strong>Background: </strong>Sepsis associated acute kidney injury (SA-AKI) among hospitalized patients is common with higher morbidity and mortality. There is a need to discover new methods that allow better prediction of its outcomes and prognosis. We aimed to evaluate if combining serial examination of urine sediment to renal cell damage (KIM-1) and arrest (TIMP-2, IGFBP7) biomarkers could improve the prediction of progression and mortality of SA-AKI.</p><p><strong>Methods: </strong>This prospective study enrolled 96 patients with stage 1 or 2 SA-AKI. Measuring of urinary TIMP-2, IGFBP7 and KIM-1 was done at time of AKI diagnosis and examination of urine sediment was performed by calculating Chawla score (CS) and Perazella score (PS) at days 1, 3 and 7. Main study outcomes included AKI progression to stage 3 and mortality.</p><p><strong>Results: </strong>Ninety-six patients were included in the study. 48% of them progressed to AKI stage 3 and 33.3% died. uTIMP2*IGFBP7 and uKIM-1 showed an area under the curve (AUC) of 0.837 and 0.657 respectively for predicting AKI progression and an AUC of 0.679 and 0.626 respectively for predicting mortality. Combining urine sediment examination at day 3 (P2 and C2) to uTIMP2*IGFBP7, uKIM-1 and both biomarkers significantly improved their prediction ability to an AUC of to 0.977, 0.951 and 0.979 respectively to predict AKI progression, and to an AUC of 0.807, 0.796 and 0.803 respectively to predict mortality.</p><p><strong>Conclusions: </strong>Combining urine sediment examination with renal cell damage and arrest biomarkers significantly improved their performance of predicting AKI progression and mortality in patients with SA-AKI.</p><p><strong>Clinical trials registration: </strong>ClinicalTrials.gov Identifier: NCT06064487. First registration date: 21/09/2023.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"195"},"PeriodicalIF":2.2,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974151","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":"Study on effect of pancreatic kininogenase on diabetic nephropathy-induced fibrosis via Notch1/Hes1/Pten/Akt signaling pathway.","authors":"Mingjie Qing, Ximei Zhang, Qiangxiang Li, Canqun Yan","doi":"10.1186/s12882-025-04050-1","DOIUrl":"https://doi.org/10.1186/s12882-025-04050-1","url":null,"abstract":"<p><strong>Objective: </strong>To elucidate the mechanism by which pancreatic kininogenase (PKase) impacts renal fibrosis in diabetic nephropathy through modulation of the Notch1/Hes1 and Pten/Akt pathways.</p><p><strong>Methods: </strong>This study employed in vivo models and cellular assays to investigate PKase's effects on cellular viability, apoptosis, and oxidative stress. Assay kits were used to assess these parameters, while protein expression levels were measured via Western Blot and RT-qPCR. Histological changes in kidney tissues were analyzed using HE and Masson's staining. Fibrosis markers-including E-cadherin, vimentin, α-SMA, Collagen I, TGF-β, and fibronectin-were evaluated through immunofluorescence and immunohistochemistry.</p><p><strong>Results: </strong>After eight weeks of PKase treatment, significant improvements in blood glucose levels and associated symptoms were observed in diabetic nephropathy rats. Both in vivo and in vitro results demonstrated that PKase treatment inhibited the expression of diabetic nephropathy markers, including vimentin, α-SMA, FN, Collagen I, and TGF-β, while increasing the expression of E-cadherin. Additionally, the expression of Notch1, Hes1, and phosphorylated Akt (p-Akt) was upregulated, and Pten expression was suppressed, all of which were reversed by PKase treatment. Furthermore, both analyses indicated that PKase alleviated Jagged1-induced apoptosis and oxidative stress, and mitigated tubulointerstitial fibrosis.</p><p><strong>Conclusion: </strong>PKase appears to ameliorate diabetic nephropathy-induced renal fibrosis by activating the Pten/Akt pathway and inhibiting the Notch1/Hes1 pathway, suggesting its potential as a therapeutic agent in diabetic nephropathy.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"196"},"PeriodicalIF":2.2,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12007155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977412","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":"UK kidney association clinical practice guideline: update of anaemia of chronic kidney disease.","authors":"Sunil Bhandari, Sebastian Spencer, Ben Oliveira, Ashraf Mikhail, Owain Brooks, Gareth Bryant, Michelle Willicombe, Richard Baines, Louise Alldridge, Sally Haslam-England","doi":"10.1186/s12882-025-04115-1","DOIUrl":"https://doi.org/10.1186/s12882-025-04115-1","url":null,"abstract":"<p><p>Anaemia is common in chronic kidney disease (CKD) encompassing non-dialysis dependent CKD (NDD-CKD) and dialysis dependent CKD (DD-CKD); people on peritoneal dialysis (PD) and haemodialysis (HD); and kidney transplant recipients (KTR). Iron deficiency and erythropoietin deficiency are the most common causes of anaemia in people with CKD, especially those requiring kidney replacement therapy (KRT). The Renal National Service Framework and National Institute for Health and Clinical Excellence in the UK, and Kidney Disease Improving Global Outcomes (KDIGO), all advocate treatment of anaemia in people with CKD. Blood transfusions are infrequently required, and newer therapies such as Hypoxia-Inducible Factor (HIF-PHI) stabilisers are now in current use. This guideline provides evidence based graded practice guidance on the use of iron; comments on iron deficiency without anaemia in people with CKD; provide further information on anaemia management in people with a transplant and provide guidance in the use of the new HIF-PHI drugs. It also provides audit and research recommendations.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"193"},"PeriodicalIF":2.2,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969499","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":"Symptom reduction in kidney transplant patients from 20-minute mindful breathing: a randomized controlled trial.","authors":"Kai Wei Lim, Kok Peng Ng, Shok Hoon Ooi, Wei San Siow, Seng Beng Tan","doi":"10.1186/s12882-024-03820-7","DOIUrl":"https://doi.org/10.1186/s12882-024-03820-7","url":null,"abstract":"<p><strong>Background: </strong>Many kidney transplant recipients continue to be affected by multiple symptoms even after their transplant. Mindfulness may be helpful to alleviate some of the symptoms.</p><p><strong>Objectives: </strong>Our current study aimed to determine the efficacy of a single session of 20-minute mindful breathing in alleviating multiple symptoms in kidney transplant patients.</p><p><strong>Methods: </strong>Adult kidney transplant patients with at least one symptom scoring ≥ 4/10 based on the Edmonton Symptom Assessment Scale (ESAS) were recruited from November 2020 to May 2021. Participants were randomly assigned to either 20-minute mindful breathing or control.</p><p><strong>Results: </strong>Sixty participants were recruited and randomly assigned to intervention (N = 30) or control (N = 30). There was statistically significant greater reduction of the total ESAS score in the intervention group compared with the control group (mean difference = -4.833, confidence interval = -7.837, -1.830, t = -3.251, p = 0002).</p><p><strong>Conclusion: </strong>Our results provided evidence that 20-minute mindful breathing could reduce multiple symptoms rapidly in kidney transplant recipients.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"194"},"PeriodicalIF":2.2,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970352","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":"Efficacy of the ALL YOU NEED IS LOVE healthcare transition syllabus among pre- and posttransplant adolescents in Cali, Colombia.","authors":"Jessica M Forero-Delgadillo, Vanessa A Ochoa Jiménez, Alejandro Padilla-Guzmán, María Del Pilar Santamaría-Suarez, María C González-Fernández, Mara Medeiros, Pierina Parraga, María E Díaz-González de Ferris, Mario Miguel Barbosa, Ana María Portilla-Buenaventura, Jaime M Restrepo","doi":"10.1186/s12882-025-04092-5","DOIUrl":"https://doi.org/10.1186/s12882-025-04092-5","url":null,"abstract":"<p><strong>Background: </strong>To achieve optimal outcomes, adolescents with chronic or end-stage kidney disease must undergo healthcare transition (HCT) preparation from a pediatric- to an adult-focused setting. The pediatric nephrology group at the Fundación Valle del Líli in Cali, Colombia, collaborated with the University of North Carolina Chapel Hill STAR_x Program and Hospital Infantil de México Federico Gómez to start an HCT preparation program using their tools. The objective of this study was to evaluate the efficacy of the \"ALL YOU NEED IS LOVE\" syllabus (Spanish version) and its effects on HCT readiness in young patients with kidney failure, including renal transplants.</p><p><strong>Methods: </strong>We conducted a pre-test/post-test quasi-experimental study without control group in 11- to 21-year-old consecutive patients with kidney failure followed at the Fundación Valle de Lili. Using the TRxANSITION Index, we measured HCT readiness skills before and after implementing the \"ALL YOU NEED IS LOVE\" syllabus, an educational curriculum delivered in three monthly 2-hour sessions. Analysis was performed using linear mixed models in R Studio software to evaluate intervention effects while accounting for participant characteristics.</p><p><strong>Results: </strong>We enrolled 35 patients (57% female, median age 15.4 years [IQR: 12.6-17.1]). Most patients (77%) had received dialysis pre-transplant and 68% had congenital anomalies of the kidneys and urinary tract. Mothers were primary caregivers for 85% of patients. Linear mixed models showed that post-intervention scores increased significantly across all measures (β = 3.28, 95% CI 2.64-3.92, p < 0.001 for transition scores; β = 1.93, 95% CI 1.48-2.38, p < 0.001 for parent scores; β = 9.31, 95% CI 7.66-10.96, p < 0.001 for total scores). College education was associated with higher baseline scores (β = 2.38, 95% CI 0.42-4.35, p = 0.019 for transition scores; β = 7.58, 95% CI 1.23-13.93, p = 0.021 for total scores). Male participants showed slightly lower initial scores (β = - 0.88, 95% CI - 1.76 to 0.00, p = 0.051).</p><p><strong>Conclusion: </strong>In this cohort of youth with kidney failure from Cali, Colombia, implementation of the Spanish version of the \"ALL YOU NEED IS LOVE\" syllabus was associated with significant improvements in HCT readiness. Linear mixed models demonstrated robust intervention effects across all domains, with educational level emerging as a significant moderator of intervention effectiveness. Further longitudinal studies are needed to evaluate the long-term impact and sustainability of these improvements in transition readiness scores.</p><p><strong>Trial registration: </strong>This study was retrospectively registered at ClinicalTrials.gov (NCT06836544, https://clinicaltrials.gov/ct2/show/NCT06836544 ) on February 10, 2025.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"192"},"PeriodicalIF":2.2,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11998162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970351","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":"Correction: Safety and efficacy of mini-percutaneous nephrolithotomy in management of renal stones in pediatric age group.","authors":"Sarwar Noori Mahmood, Shakhawan Hama Amin Said, Rawa O Mohammed, Mzhda Sahib Jaafar","doi":"10.1186/s12882-025-04112-4","DOIUrl":"https://doi.org/10.1186/s12882-025-04112-4","url":null,"abstract":"","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"190"},"PeriodicalIF":2.2,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11998375/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143980276","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":"Early detection of cognitive impairment in end-stage renal disease patients undergoing hemodialysis: insights from Resting-State functional connectivity analysis.","authors":"Mengchen Liu, Rujin Li, Man Liang, Jiejing Li, Shandong Meng, Weizhao Lin, Zhihua Zhou, Kanghui Yu, Yanying Chen, Yi Yin, Shoujun Xu, Wenqing Xiao, Zichao Chen, Guihua Jiang, Yunfan Wu","doi":"10.1186/s12882-025-04109-z","DOIUrl":"https://doi.org/10.1186/s12882-025-04109-z","url":null,"abstract":"<p><strong>Background: </strong>This study aims to investigate the characteristics of functional connectivity (FC) in neurologically asymptomatic patients with end-stage renal disease (ESRD) undergoing hemodialysis (HD) and experiencing cognitive impairment (CI).</p><p><strong>Methods: </strong>36 early-stage ESRD patients undergoing HD (ESHD) and 31 healthy control subjects underwent MRI scans. Abnormal FCs and networks were identified between the two groups, and correlation analysis and Area Under the Curve (AUC) analysis were conducted between abnormal FC regions and clinical variables.</p><p><strong>Results: </strong>The ESHD group exhibited abnormal FCs in the posterior default mode network (DMN), attention network, and external visual network (VN). Significant correlations were observed between FC values of multiple brain regions and neurocognitive scores in the ESHD group. Additionally, the FC value of the right median cingulate gyrus negatively correlated with serum calcium levels. AUC analysis demonstrated that altered FC values in the left angular gyrus and the right supramarginal gyrus effectively distinguished patients with or without CI.</p><p><strong>Conclusions: </strong>In conclusion, our study reveals multiple abnormal FC regions in asymptomatic ESHD patients, affecting visual-spatial processing, short-term memory, language, attention, and executive function. Altered FCs and their negative correlation with serum calcium levels highlight a potential link between metabolic disturbances and cognitive decline, suggesting new opportunities for targeted interventions in this vulnerable population.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"191"},"PeriodicalIF":2.2,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11998435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972000","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":"Factors associated with worsening interstitial fibrosis/tubular atrophy in lupus nephritis patients undergoing clinically indicated repeat kidney biopsy.","authors":"Daming Shao, Alejandra Londoño Jimenez, Maria Salgado Guerrero, Shudan Wang, Anna Broder","doi":"10.1186/s12882-025-04108-0","DOIUrl":"https://doi.org/10.1186/s12882-025-04108-0","url":null,"abstract":"<p><strong>Background: </strong>Lupus nephritis (LN) is one of the most severe manifestations of systemic lupus erythematosus (SLE). Interstitial fibrosis/tubular atrophy (IFTA) on kidney biopsies strongly predicts progression to end-stage renal disease although factors associated with IFTA progression remained unknown. This study aimed to evaluate the demographic, clinical, and histopathological factors at the time of index kidney biopsies that are associated with worsening IFTA on repeat biopsies and identify potential biomarkers of worsening interstitial damage.</p><p><strong>Methods: </strong>Patients with LN Class I to V or mixed LN on index biopsies who underwent a clinically indicated repeat biopsy between 2004 and 2020 were identified. None-mild IFTA was defined as < 25% acreage of the interstitium affected by fibrosis and atrophy, and moderate-severe IFTA was defined as ≥ 25% of the interstitium affected. Patients with none-mild IFTA on index biopsies who progressed to moderate-severe IFTA on repeat biopsies were defined as progressors. Patients with none-mild IFTA on both biopsies were defined as non-progressors.</p><p><strong>Results: </strong>Seventy-two patients who underwent clinically indicated repeat kidney biopsies were included, and 35 (49%) were identified as progressors. Compared to non-progressors, progressors had a higher proportion of proliferative LN (26 [74%] vs. 18 [49%], p = 0.04) and crescents (9 [26%] vs. 3 [8%], p = 0.045) on index biopsies. There was no difference regarding the time to repeat biopsy or the baseline characteristics, including eGFR, presence of hypertension and diabetes, urine protein to creatinine ratio, or the initial treatments.</p><p><strong>Conclusions: </strong>Proliferative LN and the presence of crescents on index biopsies were associated with subsequent IFTA progression on repeat biopsies. This association indicates that glomerular damage is one of the major drivers of tubulointerstitial scarring in SLE. IFTA progression may, in turn, be the driving factor of poor treatment response and progression to chronic kidney disease.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"189"},"PeriodicalIF":2.2,"publicationDate":"2025-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11992855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966300","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}