BMC Nephrology最新文献

{"title":"Serum metabolites in relation to kidney function in non-transplant and kidney transplant settings using gas chromatography-mass spectrometry.","authors":"Yamei Li, Xingxin Gong, Yangjuan Bai, Lin Yan, Yunfei An, Hanjing Liu, Hua Zhang, Xinhua Dai","doi":"10.1186/s12882-026-05000-1","DOIUrl":"https://doi.org/10.1186/s12882-026-05000-1","url":null,"abstract":"<p><strong>Background: </strong>Metabolic disorders are highly prevalent in patients with native and transplanted chronic kidney disease (CKD). However, little is known about the metabolic similarities and differences associated with declining kidney function between non-transplant patients and kidney transplant recipients (KTRs).</p><p><strong>Methods: </strong>This cross-sectional study employed gas chromatography-mass spectrometry to compare serum metabolomic profiles among native CKD subgroups and KTR subgroups, aiming to identify differential metabolites associated with kidney dysfunction in both clinical settings.</p><p><strong>Results: </strong>11 and 13 metabolites were associated with kidney dysfunction in native CKD patients and KTRs, respectively. Among these, L-tryptophan, D-lyxose, xylitol, erythritol, 3,4-dihydroxybutanoic acid and 2,4-dihydroxybutanoic acid were selected as common differential metabolites in both cohorts. Pathway analysis revealed that the pentose and glucuronate interconversions pathway was significantly affected in native CKD patients, whereas phenylalanine, tyrosine, and tryptophan biosynthesis pathway and tyrosine metabolism pathway were the most affected pathways in KTRs. Further comparisons between native CKD and KTRs who were at the same kidney dysfunction stages demonstrated that KTRs showed significantly higher levels of malic acid, but lower levels of D-allose compared to native CKD patients.</p><p><strong>Conclusions: </strong>Our study not only identified the 6 metabolites associated with kidney function in both non-transplant patients and KTRs, but also determined 5 and 7 metabolites that were specifically associated with kidney dysfunction in native CKD patients and KTRs, respectively. These data suggest that the metabolic process may be influenced by the unique characteristics of kidney transplantation, such as allogeneic immunity and immunosuppressive drugs, in KTRs.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147762114","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":"Renal salt-wasting syndrome with tubular copper deposition in a heterozygous ATP7B carrier: a case report.","authors":"Lin Lin, Jian Zhang, Qiwen Xie, Caifeng Li, Shi Jin, Xiaoqiang Ding, Jie Teng, Jialin Wang","doi":"10.1186/s12882-026-04993-z","DOIUrl":"https://doi.org/10.1186/s12882-026-04993-z","url":null,"abstract":"","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147762057","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":"Parallel metabolomic and transcriptomic profiling reveals the cytotoxic mechanism of protein-bound uremic toxin p-cresol sulfate via disruption of glutathione and glycerophospholipid metabolism in MC3T3-E1 osteoblasts.","authors":"Qiong Wu, Jinhua Lan, Zhipeng Wan, Yu Liang, Kai Nie, Jielong Zhou, Bo Ji, Qiang Zhang, Zhihui Jiang, Xuefeng Huang, ZhiGuo Pan, Yu Shao","doi":"10.1186/s12882-026-05004-x","DOIUrl":"https://doi.org/10.1186/s12882-026-05004-x","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease-mineral bone disorder (CKD-MBD), a common complication of chronic kidney disease (CKD), leads to vascular calcification, osteoporosis, and electrolyte disturbances, impacting patient survival and quality of life. Conventional dialysis poorly removes protein-bound uremic toxins like p-cresyl sulfate (PCS), which are linked to CKD-MBD. This study combined metabolomics and transcriptomics to explore PCS's cytotoxic mechanisms in CKD-MBD for better clinical management.</p><p><strong>Methods: </strong>Using MC3T3-E1 osteoblasts treated with or without PCS, metabolic changes were analyzed via ultra-high performance liquid chromatography and quadrupole time-of-flight mass spectrometry (UHPLC-QTOF/MS), and transcriptomic changes through RNA sequencing (RNA-seq).</p><p><strong>Results: </strong>UHPLC-QTOF/MS identified 74 significantly altered metabolites and 15 disrupted metabolic pathways in PCS-treated osteoblasts. RNA-seq revealed 3,679 differentially expressed genes, with pathway analysis indicating significant disruptions in glutathione and glycerophospholipid metabolism, and alterations in cell apoptosis, cell cycle, and DNA repair processes.</p><p><strong>Conclusions: </strong>Parallel metabolomics and transcriptomics profiling showed PCS-induced disruptions in glutathione and glycerophospholipid pathways are central to cellular metabolic dysfunction in CKD-MBD. These insights highlight the potential of multi-omics to elucidate uremic toxin pathophysiology, providing a foundation for improved CKD-MBD management.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147762120","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":"Multi-organ single-cell analysis of preferential expression of CAKUT genes.","authors":"Mara Pflugfelder, Antonia Eberts, Vera Koch, Illya Martynov, Carlo Maj, Guido Seitz, Johannes Schumacher, Mohammad Reza Vahdad, Pouria Dasmeh","doi":"10.1186/s12882-026-05003-y","DOIUrl":"10.1186/s12882-026-05003-y","url":null,"abstract":"<p><strong>Background: </strong>Congenital anomalies of the kidney and urinary tract (CAKUT) comprise a heterogeneous group of developmental disorders with diverse genetic etiologies. However, it remains unclear whether these genetic factors converge on shared cellular programs across development and tissues.</p><p><strong>Methods: </strong>We analyzed the expression of 91 curated CAKUT-associated genes across publicly available single-cell RNA sequencing datasets from human fetal and adult kidney, ureter, and bladder. These data were complemented by early embryonic transcriptomic profiles to characterize temporal expression dynamics and cell-type specificity.</p><p><strong>Results: </strong>During kidney development, key CAKUT genes, including EYA1, SIX1, PAX2, and FOXC1, showed strong preferential expression in mesangial and mesonephric nephron tubule epithelial cells, highlighting early roles in ureteric bud induction and branching morphogenesis. Temporal analysis identified two distinct expression patterns: an early-peak group (EYA1, SIX1, SIX2, PAX2, ITGA8) with maximal expression during early nephrogenesis followed by decline, and a late-rise group, including MUC1, with increasing expression toward adult stages. Across tissues, CAKUT genes exhibited a conserved enrichment in stromal and mesenchymal cell populations.</p><p><strong>Conclusions: </strong>Our findings reveal a shared stromal-mesenchymal gene expression signature underlying CAKUT pathogenesis. These results suggest that diverse genetic perturbations may converge on early mesodermal lineage programs that are critical for ureteric bud formation and kidney patterning, providing a unifying cellular framework for understanding CAKUT.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13134259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147762122","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":"Hyperuricemia accelerates renal dysfunction due to hypertensive nephrosclerosis: the TAMA MED Project-CKD.","authors":"Tomohiro Kaneko, Eitaro Kodani, Hitomi Fujii, Kenta Sugino, Yuri Kudo, Norihiro Shibasaki, Harufumi Ogino, Hiroyuki Nakamura, Hajime Sasabe, Yutaka Tamura, Masato Iwabu","doi":"10.1186/s12882-026-05012-x","DOIUrl":"https://doi.org/10.1186/s12882-026-05012-x","url":null,"abstract":"","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147762022","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":"CD71⁺ erythroid progenitor cells with mitochondrial retention were associated with inferior prognosis among patients with end-stage renal disease.","authors":"Lin-Jiao Peng, Jian-Hua Ren, Ze-Xuan Huang, Qiao Zhang, Yong-Hui Fu, Yuan Zhang, Jun-Jian Qin, Li Wei, Yang-Yang Zuo, Xing Li, Yan-Fang Xing","doi":"10.1186/s12882-026-05009-6","DOIUrl":"https://doi.org/10.1186/s12882-026-05009-6","url":null,"abstract":"","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147761971","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":"Kidney function among adult sickle cell disease patients at Ahmadu Bello University Teaching Hospital, Zaria, Nigeria.","authors":"Oguche Sunday Musa, Kwaifa Salihu Ibrahim, Istifanus Bala Bosan, Abubakar Ibrahim, Hassan Abdul-Aziz, Tuko Tari Moses","doi":"10.1186/s12882-026-04999-7","DOIUrl":"https://doi.org/10.1186/s12882-026-04999-7","url":null,"abstract":"","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147762086","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":"The value of pleth variability index in predicting hypotension during maintenance hemodialysis: a prospective observational multicenter study (PVi-HD study).","authors":"Juan Li, Qiancheng Xu, Fangxia Li, Tingting Yang, Chaoqing Gao, Yang Li, Jiajun Zhou, Yuhan Cao, Changjun Tong, Weihua Lu, Yonggui Wu","doi":"10.1186/s12882-026-04883-4","DOIUrl":"https://doi.org/10.1186/s12882-026-04883-4","url":null,"abstract":"<p><strong>Background: </strong>Intradialytic hypotension (IDH) is a frequent and serious complication of hemodialysis, and existing prediction tools are inadequate. The Pleth Variability Index (PVi), a non-invasive dynamic parameter that reflects cardiorespiratory interactions and fluid responsiveness, has shown promise in acute care settings, but its value in hemodialysis remains unexplored. We prospectively assessed PVi and its dynamic changes as predictors of IDH in a multicenter maintenance hemodialysis cohort.</p><p><strong>Methods: </strong>In this prospective, multicenter observational study, we enrolled 200 patients on chronic hemodialysis. PVi was measured at baseline (PVi baseline) and 60 min into the session (PVi 1 h). We calculated the absolute change (ΔPVi) and percentage change (ΔPVi%). The primary outcome was the predictive performance of these parameters for IDH, assessed using receiver operating characteristic (ROC) curve analysis. Multivariate logistic regression was used to identify independent predictors.</p><p><strong>Results: </strong>IDH occurred in 61 patients (30.5%). While baseline PVi was similar between groups, PVi 1 h, ΔPVi, and ΔPVi% were all significantly higher in patients who developed IDH (all P < 0.001). Dynamic PVi parameters demonstrated excellent predictive value, with ΔPVi showing the highest area under the ROC curve (AUC) at 0.84 (95% CI: 0.78-0.89). Followed closely by ΔPVi% (AUC 0.83), for which the optimal cutoff of 23.53% yielded a sensitivity of 78.69% and a specificity of 74.82% for predicting IDH. These significantly outperformed traditional predictors, including baseline mean arterial pressure (AUC 0.71) and ultrafiltration volume (AUC 0.68) (all P < 0.001 for comparison). In multivariate logistic regression, both ΔPVi% (OR 1.02, 95% CI 1.01-1.03) and ΔPVi (OR 1.22, 95% CI 1.16-1.28) were identified as robust independent predictors for IDH (both P < 0.001). This association was held in a sensitivity analysis using a more stringent definition of IDH based on symptomatic episodes. Using an optimal cutoff, Cox regression analysis revealed that patients with a ΔPVi% > 23.53% had a 7.15-fold higher risk of developing IDH (HR 7.15, 95% CI 3.86-13.22).</p><p><strong>Conclusions: </strong>Dynamic changes in PVi during the first hour of hemodialysis are strong, independent predictors of subsequent IDH. Monitoring PVi changes offers a promising and practical non-invasive tool for early risk stratification.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147761278","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":"Association of 24-hour urinary parameters with renal function and other comorbidities in autosomal dominant polycystic kidney disease.","authors":"Hüseyin Aykut, Sabahat Alışır Ecder, Tevfik Ecder","doi":"10.1186/s12882-026-05011-y","DOIUrl":"https://doi.org/10.1186/s12882-026-05011-y","url":null,"abstract":"<p><strong>Background: </strong>Autosomal dominant polycystic kidney disease (ADPKD) is a leading hereditary cause of chronic kidney disease (CKD) and end-stage kidney disease (ESKD). While several clinical and genetic predictors of disease progression have been identified, the significance of urinary metabolic profile in ADPKD remains insufficiently explored. This study aimed to evaluate the association between 24-hour urinary parameters, renal function, and clinically relevant comorbidities in patients with ADPKD, and to explore whether these urinary alterations are specific to ADPKD or associated with declining kidney function.</p><p><strong>Methods: </strong>In this retrospective study, 42 adult patients with ADPKD were analyzed. Patients were stratified according to estimated glomerular filtration rate (eGFR) (< 60 vs. ≥60 mL/min/1.73 m²). Clinical characteristics, comorbidities, and laboratory data were obtained from medical records. 24-hour urinary excretion of calcium, citrate, uric acid, and protein was assessed. Comparative analyses and logistic regression models were used to evaluate associations between urinary parameters and renal insufficiency.</p><p><strong>Results: </strong>Hypertension (76.2%) and hepatic cysts (71.4%) were the most common clinical findings. Patients with eGFR < 60 mL/min/1.73 m² showed significantly lower 24-hour urinary excretion of calcium (44 vs. 94.5 mg/day), uric acid (307 vs. 492.3 mg/day), and citrate (110 vs. 550 mg/day) (all p < 0.05). Logistic regression analysis demonstrated that reduced urinary calcium and uric acid excretion were associated with renal insufficiency, while low citrate excretion was linked to nephrolithiasis history.</p><p><strong>Conclusions: </strong>Reduced urinary excretion of calcium and uric acid is significantly associated with impaired renal function in ADPKD. These findings parallel the metabolic alterations observed in general CKD populations, suggesting that the decline in urinary parameters is likely driven by renal function loss. Monitoring 24-hour urinary metabolic profiles may provide adjunctive clinical insights for the management of ADPKD. Prospective studies are needed to clarify their prognostic value in early disease stages.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147761873","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":"Association between frailty and MACE and all-cause mortality in Chinese maintenance haemodialysis patients: a retrospective cohort study.","authors":"Jinping Ying, Linglin Chen, Jia Liang, Liuqian Zhang, Junshuang Ye, Huimin Bao, Jiayu Zhu, Yujiao Zhang, Genlian Cai, Ping Zhang","doi":"10.1186/s12882-026-04984-0","DOIUrl":"https://doi.org/10.1186/s12882-026-04984-0","url":null,"abstract":"<p><strong>Background: </strong>Frailty is common among patients undergoing maintenance haemodialysis (MHD) and is linked to multiple adverse outcomes, including increased mortality. However, large-scale cohort studies in China on the associations between frailty and major adverse cardiovascular events (MACE) as well as all-cause mortality in patients undergoing haemodialysis are lacking. This study aimed to investigate the associations between frailty and MACE and all-cause mortality in this population.</p><p><strong>Methods: </strong>This single-centre retrospective cohort study enrolled patients on haemodialysis at the First Affiliated Hospital, Zhejiang University School of Medicine, from August 2020 to December 2021, with follow-up until August 31, 2025. Frailty status was assessed using the Fried Frailty Scale. Endpoints included the occurrence of all-cause mortality and MACE. A competing risk model was used to examine the associations between frailty and both MACE and all-cause mortality. Additionally, multidimensional sensitivity analyses were performed to assess the robustness of the findings.</p><p><strong>Results: </strong>This study encompassed a cohort of 810 patients undergoing maintenance haemodialysis (MHD). The cumulative incidence of major adverse cardiovascular events (MACE) over five years was 33.0% (95% CI: 26.1-39.8%), while the cumulative incidence of all-cause mortality was 61.0% (95% CI: 53.4-68.7%). Both incidences were significantly elevated in the frail patient group compared to their non-frail counterparts (P < 0.001). Following multivariable adjustment, the Fine-Gray competing risk model revealed that frail patients exhibited a 4.96-fold increased risk of MACE (95% CI: 2.50-9.85; P < 0.001) and a 3.35-fold increased risk of all-cause mortality (95% CI: 2.10-5.35; P < 0.001), underscoring a significant positive association. Sensitivity analyses corroborated that frailty remained significantly associated with both MACE and all-cause mortality.</p><p><strong>Conclusion: </strong>Frailty demonstrated a significant correlation with an increased risk of MACE and all-cause mortality in patients undergoing MHD, with the risk escalating in a linear manner in accordance with the severity of frailty.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147761942","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}