BMC Nephrology最新文献

{"title":"Albumin redox status in the context of kidney transplantation - an observational, pilot study.","authors":"Lea Marie Berntsen, Margret Paar, Katja Waterstradt, Kerstin Schnurr, Gerd Klinkmann, Steffen Mitzner, Karl Oettl, Andreas Kribben, Kristina Boss","doi":"10.1186/s12882-026-05316-y","DOIUrl":"10.1186/s12882-026-05316-y","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>The albumin redox status (ARS) is altered in patients with chronic kidney disease (CKD), shifting towards a higher degree of oxidation. Oxidative Stress leads to persistent microinflammation and increased morbidity and mortality. An improvement in renal function following kidney transplantation (KTX) could lead to an improvement in ARS. Aim of this study was to evaluate the effects of KTX on ARS.</p><p><strong>Methods: </strong>In an observational, monocentric feasibility study design, ARS was determined before and eight times up to 180 days after KTX by fractionation of albumin into reduced human mercaptalbumin (HMA), reversibly oxidized human nonmercaptalbumin 1 (HNA-1) and irreversibly oxidized human nonmercaptalbumin 2 (HNA-2) by high-performance liquid chromatography (HPLC) with fluorescence detection. In healthy individuals, HMA accounts for 70-80%, HNA-1 for 20-30% and HNA-2 for about 2-5% of total albumin.</p><p><strong>Results: </strong>42 patients (62% male, median age of 43.5 years) were included in the study. Before KTX, HMA was reduced (median 63.5%, interquartile range [IQR] 59.6-67.3%), while HNA-1 (28.9%, IQR 25.9-33.2%) and HNA-2 (7.1%, IQR 6.0-8.1%) were elevated compared to a healthy population. Within the first week post-KTX, HMA declined further (57.9%, IQR 53.1-63.6%) and HNA-2 peaked (9.2%, IQR 7.3-11.4%). In most patients, the ARS returned to pre-KTX level by day 60. At day 180, 31% of patients still showed HNA-1 and HNA-2 levels above the respective reference ranges reported for healthy individuals, despite substantial recovery of kidney function.</p><p><strong>Conclusion: </strong>While kidney function was restored rapidly after kidney transplantation, ARS followed a slower and more variable recovery pattern, suggesting that factors beyond renal function may influence albumin redox state. Further research is needed to determine its clinical relevance and potential implications for transplant care.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"27 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148849741","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 postoperative renal function is associated with long-term outcomes in living kidney donors.","authors":"Banu Yılmaz, Adam Uslu, Murat Karataş, Halil Yıldız, Hamza Ekmel Nazlı, Gamze İçaçan, Gözde Buhur, Mehmet Alperen Uğur, Gökalp Okut, Hatice Şehnaz Emil","doi":"10.1186/s12882-026-05330-0","DOIUrl":"10.1186/s12882-026-05330-0","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Living kidney donation is generally considered safe; however, it results in a reduction in renal function, and the determinants of long-term outcomes remain incompletely understood. While baseline donor characteristics have been associated with post-donation renal function, the association between early postoperative renal changes and long-term renal outcomes remains less well established.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this retrospective cohort study, 473 living kidney donors who underwent donor nephrectomy between 1998 and 2025 were evaluated. A total of 336 donors with complete baseline and long-term follow-up data were included in the final analysis. Donors were categorized as low-risk or high-risk according to baseline characteristics. Early postoperative renal response was assessed using the change in serum creatinine on postoperative day 1 (Δcreatinine). The primary outcome was estimated glomerular filtration rate (eGFR) at the last available follow-up. Multivariable linear and logistic regression analyses were performed to identify factors independently associated with long-term renal outcomes. Sensitivity analyses were performed using 1-year eGFR and percentage change in postoperative day 1 creatinine.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;eGFR decreased significantly after donation and did not return to preoperative levels during long-term follow-up. High-risk donors had lower eGFR values at baseline and during follow-up; however, the magnitude of eGFR decline was similar between groups. In multivariable linear regression analysis, lower baseline eGFR (β = 0.310, p &lt; 0.001), a greater postoperative day 1 increase in serum creatinine (β = -0.270, p &lt; 0.001), and older age (β = -0.187, p = 0.002) were independently associated with lower eGFR at the last follow-up. BMI, hypertension, follow-up duration, and baseline 24-hour proteinuria were not independently associated with long-term renal function. The association between greater postoperative day 1 creatinine increase and lower eGFR remained significant in sensitivity analyses using 1-year eGFR as a standardized outcome and percentage change in creatinine from baseline instead of absolute Δcreatinine. In multivariable logistic regression analysis, a greater postoperative day 1 increase in serum creatinine (per 0.1 mg/dL increase; OR = 1.44, 95% CI 1.20-1.73, p &lt; 0.001), lower baseline eGFR (OR = 0.964, 95% CI 0.945-0.983, p &lt; 0.001), and baseline 24-hour proteinuria (p = 0.012) were independently associated with eGFR &lt; 60 mL/min/1.73 m² at the last available follow-up. Greater early postoperative creatinine increase was additionally associated with a greater relative increase in eGFR from the early postoperative period to the last available follow-up (r = 0.235, p &lt; 0.001). Overall, 85 donors (25.3%) had an eGFR &lt; 60 mL/min/1.73 m² at the last available follow-up, and two donors required dialysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Living kidney donation is","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"27 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13587443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988003","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":"Characterization of pediatric patients receiving erythropoiesis-stimulating agents for management of anemia of chronic kidney disease in the UK and US: a feasibility assessment using retrospective chart review.","authors":"Sally Mountcastle, Keele Wurst, Alice Rouleau, Neil R Brett, Jennifer McKenzie, Justyna Amelio, Kathy Fraeman, Jake Hunnicutt, Susanna Cuadripani, David Webb, Amrit Kaur, Rukshana Shroff, Eleonora Staines Urias, Anna Richards, Thomas F Hiemstra","doi":"10.1186/s12882-026-05188-2","DOIUrl":"10.1186/s12882-026-05188-2","url":null,"abstract":"<p><strong>Background: </strong>Anemia is a common complication of chronic kidney disease (CKD). We evaluated the feasibility of collecting comprehensive data from medical charts for longitudinal assessment of anemia among pediatric patients receiving erythropoiesis-stimulating agents (ESAs) for anemia of CKD in the United Kingdom (UK) and United States (US).</p><p><strong>Methods: </strong>This retrospective chart review study used an electronic case report form to collect data from medical records of pediatric patients treated with an ESA (as either an incident or a prevalent patient) from January 1, 2017-December 31, 2018. Consecutive chart reviews were conducted from November 1-December 20, 2021. Data collected included clinical characteristics, disease, and treatment management.</p><p><strong>Results: </strong>Of 50 patients enrolled, 36 (72.0%) and 14 (28.0%) were from the UK and US, respectively; median (interquartile range) age was 9.0 (4.0-11.0) years, 22 (44.0%) were female and 28 (56.0%) were male. Median follow-up was 52.1 weeks. The most common primary CKD etiology was congenital anomalies of the kidney/urinary tract (n = 14, 28.0%). Twenty-three (46.0%) patients received dialysis at the index date and eight (16.0%) had a kidney transplant post-index date. Twenty-eight (56.0%) patients received iron treatment with their index-line ESA. The mean (standard deviation) baseline hemoglobin level was 10.0 (2.0) g/dL. Twenty adverse events (AEs) were recorded in nine (18.0%) patients; all were serious and no inference was sought for attributability to treatment.</p><p><strong>Conclusions: </strong>This study demonstrates feasibility of retrospectively extracting clinical characteristics, treatment history, and AEs from medical charts of pediatric patients with anemia of CKD.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"27 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13560262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918527","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":"First-year all-cause kidney allograft loss: descriptive clinical trajectories of 92 events from a 17-year German transplant center cohort.","authors":"Ulrich Jehn, Arina Lokschin, Felix Becker, Philipp Houben, Hermann Pavenstädt, Stefan Reuter","doi":"10.1186/s12882-026-05306-0","DOIUrl":"10.1186/s12882-026-05306-0","url":null,"abstract":"<p><strong>Background: </strong>First-year kidney allograft loss comprises death with a functioning graft (DWFG) and death-censored graft loss (DCGF), each arising from diverse clinical causes. Few studies have examined how endpoint-specific causes are distributed over the first post-transplant year within the same cohort.</p><p><strong>Methods: </strong>We retrospectively reviewed adult kidney transplant events performed at a German transplant center between 2007 and 2023. For each first-year all-cause graft-loss event, endpoint type and one primary cause were assigned from the documented clinical sequence; additional complications were retained as contributing events. Granular source causes were mapped into higher-order groups defined before examination of their distribution across 0-30, 31-90, and 91-365 day windows.</p><p><strong>Results: </strong>Among 1400 adult kidney transplant events, 92 first-year all-cause graft-loss events occurred (6.6%, 95% CI 5.4-8.0): 57 DCGF and 35 DWFG. The leading DCGF cause group was vascular/thrombotic or microangiopathic loss (18/57), followed by infection/sepsis (8/57), rejection (7/57), and cardiorenal decompensation/cardiac failure (6/57). Among DWFG events, cardiovascular causes (15/35) and sepsis (9/35) predominated. The proportion of events classified as DWFG increased from 5/32 in the first 30 days to 7/15 at days 31-90 and 23/45 at days 91-365. Six DCGF events were followed by recipient death within the same first year.</p><p><strong>Conclusions: </strong>First-year all-cause graft loss contained distinct cause and timing patterns. Early losses were predominantly vascular or perioperative DCGF, whereas later events increasingly reflected cardiovascular, infectious, and other medical causes, including DWFG. These findings support phase-specific surveillance and prospective multicenter validation using prespecified assessment of primary and contributing causes.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"27 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13505005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148817511","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 laboratory trajectories and short-term tolerability after finerenone initiationin diabetic kidney disease: the multicenter FINE-TURK study.","authors":"Serap Yadigar, Suat Akgür, Felemez Arslan, Mehmet Sezen, Büşra Özcan, Elif Yıldırım Ayaz, Betül Doğantekin, İlker Atay, Serpil Müge Değer, Mustafa Demir, Sümeyra Koyuncu, Üstün Yılmaz, Ayça İnci, Hülya Çolak, Bülent Demirelli, Serhan Tuğlular, Ebru Gök Oğuz, Mehmet Deniz Aylı, Ezgi Avanaz, Fatih Yılmaz, Beyza Doğan, Süleyman Karaköse, Mine Şebnem Karakan, Bahar Gürlek, Kültigin Türkmen, İsmail Baloğlu, Mehmet Batmazoğlu, Mehmet Mert, Emre Aydın, Fatma Yılmaz Aydın, Ergün Parmaksız, Pınar Özdemir, Bartu Ediz, Zeki Aydın, Mehmet Emin Demir, Siren Sezer, Suat Ünver, Öznur Baykal, Beril Akman Çakmak, Atila Altuntaş, Mahmud İslam, Fatma Sibel Koçak Yücel, Meral Mert, Belda Dursun, Necmi Eren, Simge Bardak Demir, Alper Tuna Güven, Mukadder Ayşe Bilgiç, Arda Erdut, Gülşah Keskin, Ahmet Ziya Şahin, Mehmet Horoz, Merve Tekinyıldız, Murat Durunay, Serkan Feyyaz Yalın, Murat Altunok, Funda Sarı, Ramazan Sarı, Dilek Torun, Serdar Kahvecioğlu, A Serap Yalçınkaya, Tülin Akagün, Hüseyin Çelik, Sinan Kazan, İlyas Öztürk, Mehmet Polat, Mehmet Fethullah Aydın, Meral Meşe, Melike Hazal Yavuz Umut, Asil Demirezen, Ülver Derici, Eda Altun, Serkan Bakırdöğen, Ekrem Kara, Cüneyt Akgöl, Mahmut Başar Aykent, Ali İlter, Ahmet Ekmekçi, Sena Ulu, Bilge Özlüer Başer, Mustafa Arıcı, Elif Arı Bakır, Erkan Şengül","doi":"10.1186/s12882-026-05259-4","DOIUrl":"10.1186/s12882-026-05259-4","url":null,"abstract":"<p><strong>Background: </strong>Real-world evidence describing the early laboratory course after finerenone initiation in contemporary nephrology practice remains limited, particularly in cohorts with high background use of sodium-glucose co transporter 2 inhibitors (SGLT2i). We evaluated early kidney-function, potassium, and albuminuria trajectories and short-term treatment tolerability.</p><p><strong>Methods: </strong>FINE-TURK was a multicenter retrospective cohort study without a comparator group. Adults with diabetes and chronic kidney disease who initiated finerenone in routine care were evaluated at baseline and using the first available values recorded in the 1-3-month follow-up fields. Primary outcomes were within-patient changes in estimated glomerular filtration rate (eGFR), serum potassium, and urinary albumin-to-creatinine ratio (UACR). Complete and incomplete follow-up groups were compared, UACR responder analyses were performed, and exploratory multivariable and subgroup models were fitted.</p><p><strong>Results: </strong>The analytic cohort contained 1,091 patients (mean age 60.6 ± 11.5 years; 55.0% male), and documented SGLT2i use was 87.0% among 1,075 patients with available data. Paired data were available for eGFR in 571 patients (52.3%), potassium in 647 (59.3%), and UACR in 476 (43.6%). Median eGFR changed from 53.5 [41.0-74.5] to 51.0 [38.0-73.0] mL/min/1.73m² (median change -2.0 [-6.0 to 1.0]; P<0.001). Median potassium changed from 4.50 [4.20-4.80] to 4.80 [4.50-5.10] mEq/L (mean change +0.30 ± 0.46; P<0.001). Median UACR changed from 777.8 [327.2-1539.5] to 461.2 [154.7-1040.0] mg/g; 297/476 (62.4%, 95% CI 58.0-66.6) achieved a ≥30% reduction and 184/476 (38.7%, 95% CI 34.4-43.1) achieved a ≥50% reduction. A recorded follow-up potassium >5.5 mEq/L occurred in 27/653 (4.1%), >6.0 mEq/L in 5/653 (0.8%), and finerenone discontinuation in 39/1,091 (3.6%).</p><p><strong>Conclusions: </strong>Early laboratory changes and treatment persistence after finerenone initiation were describable in routine specialist care, but incomplete outcome ascertainment and the absence of a comparator group preclude causal or comparative-effectiveness conclusions. The albuminuria findings apply only to patients with paired measurements and remain vulnerable to selection bias and regression to the mean.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"27 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148886373","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":"Management strategies for post-transplant IgA nephropathy in kidney transplant recipients: a scoping review.","authors":"Samuel Bell, Michael Toal, Mark McClure, Alexander P Maxwell, Gareth J McKay","doi":"10.1186/s12882-026-05260-x","DOIUrl":"10.1186/s12882-026-05260-x","url":null,"abstract":"<p><strong>Background: </strong>Post-transplant Immunoglobulin A Nephropathy (IgAN) is an important cause of premature graft loss. Management strategies are often extrapolated from native IgAN, with available evidence limited to heterogeneous, predominantly small retrospective studies.</p><p><strong>Objectives: </strong>To characterise diagnostic criteria, map management strategies, and summarise associated clinical outcomes in post-transplant IgAN.</p><p><strong>Methods: </strong>A literature search was performed in MEDLINE, Embase, Web of Science, and Scopus (1st January 2000-11th December 2025) following Joanna Briggs Institute (JBI) and PRISMA-ScR guidelines. English-language studies of adult kidney transplant recipients with biopsy-proven post-transplant IgAN and documented management strategies were included. Data on study design, cohorts, diagnostic criteria, interventions, and outcomes were charted and narratively described.</p><p><strong>Results: </strong>Twenty-seven studies met the inclusion criteria. Most were single-centre retrospective cohorts. Diagnostic criteria varied, but typically histological evidence of IgA deposition alone was sufficient. IgAN was often clinically relevant, with proteinuria > 1 g/day frequently reported. Reported treatments included renin-angiotensin-aldosterone system (RAAS)-blockade, immunosuppression adjustment, rituximab, tonsillectomy and pulsed corticosteroids. Several small case series explored emerging therapies (iptacopan, budesonide, telitacicept). Study heterogeneity precluded quantitative data synthesis.</p><p><strong>Conclusions: </strong>RAAS-blockade was the most commonly used intervention and was associated with benefit in several studies. Tonsillectomy was associated with improved outcomes but reported only in Japanese cohorts. Other interventions (rituximab, pulsed steroids, emerging therapies) warrant prospective clinical trials. Amid evolving paradigms in native IgAN management, this review highlights heterogeneity in diagnostic criteria, outcome reporting, and interventions for the management of post-transplant IgAN. Robust prospective, multicentre studies are urgently required to define optimal management in this high-risk population.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"27 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148879038","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 to: Global burden of chronic kidney disease due to hypertension (1990-2021): a systematic analysis of epidemiological trends, risk factors, and projections to 2036 from the GBD 2021 study.","authors":"Yujun He, Weiwei Tang, Jianying Chen, Jie Tang, Yaling Zheng, Xinyuan Wang, Bowen Xing, Xiaojun Li, Yi Xu, Xiaoyi Wang","doi":"10.1186/s12882-026-05199-z","DOIUrl":"https://doi.org/10.1186/s12882-026-05199-z","url":null,"abstract":"","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"27 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788040","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":"Gender disparity in access to care across the continuum of chronic kidney disease: a systematic review.","authors":"Manudi Vidanapathirana, Dilushi Wijayaratne, Jeremy Ariadurai, Saroj Jayasinghe","doi":"10.1186/s12882-026-05288-z","DOIUrl":"10.1186/s12882-026-05288-z","url":null,"abstract":"<p><strong>Background: </strong>'Gender' as a social construct is increasingly recognized as a determinant of care inequity in chronic kidney disease (CKD). However, a systematic analysis of gender-based disparity in access to care across the continuum of CKD care is lacking. This systematic review aimed to synthesize the global evidence on gender-based disparities in access observed across sequential steps of CKD care.</p><p><strong>Methods: </strong>The review was registered in PROSPERO (CRD420251091356) and conducted following PRISMA guidelines. Four databases (PubMed, Cochrane, HINARI, Embase) were searched for publications from 2000-July 2026. Two reviewers independently screened 1,140 articles and risk of bias was assessed using ROBINS-E. Data were extracted across four aspects of CKD care: (1) diagnosis, monitoring and prescription of guideline-recommended treatment, (2) vascular access, (3) initiation and maintenance of dialysis, and (4) transplantation.</p><p><strong>Results: </strong>Thirty-five studies were included, spanning diverse geographical regions. Women faced consistent disadvantages across the continuum of CKD care. They had lower odds of receiving a diagnosis of CKD or nephrology referral, less frequent monitoring of kidney function, and lower prescription rates of guideline-recommended medications. Among those with kidney failure, women comprised only 38-41% of prevalent dialysis patients and initiated dialysis at lower estimated glomerular filtration rates (8.1-10.1 vs. 10.6 mL/min/1.73 m² in men). Women were less likely to initiate haemodialysis with arteriovenous fistulae (AVF) and less likely to transition to AVF later while prevalent on dialysis compared to men. Throughout the transplant pathway, women with CKD were less likely to have transplantation discussed as an option, referred for evaluation, waitlisted, or transplanted. Both systemic and socioeconomic mechanisms contributed to these disparities.</p><p><strong>Conclusion: </strong>Sex and gender-based inequities systematically disadvantage women across the entire CKD care continuum. These findings highlight the need to integrate policies to ensure gender-equity in the management of CKD.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"27 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148849769","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":"An unusual presentation of membranous nephropathy with primary and secondary features: a case report.","authors":"Aanya Shah, Stephen Baker, Dar B Shah","doi":"10.1186/s12882-026-05290-5","DOIUrl":"10.1186/s12882-026-05290-5","url":null,"abstract":"<p><p>Membranous nephropathy (MN) is a common cause of nephrotic syndrome in adults, broadly classified as primary or secondary based on etiology and pathologic findings. We present a single unusual case report of a 75-year-old woman with an 11-year course of MN featuring concurrent characteristics of both primary and secondary disease. On two separate kidney biopsies for the same patient, she demonstrated histopathologic features consistent with Class V lupus nephropathy alongside positive PLA₂R staining - a combination that creates significant diagnostic uncertainty. Despite the overlapping features, the patient achieved remission on two separate occasions using different immunosuppressive regimens: cyclosporine initially, followed by Mycophenolate mofetil and prednisone upon relapse over a decade later. This case contributes to the emerging literature on PLA₂R positivity in lupus membranous nephropathy and highlights the diagnostic and therapeutic challenges clinicians face when primary and secondary MN features coexist. The long-term follow-up and dual treatment response on a single patient reported here add to a limited body of published cases and carry implications for management of this increasingly recognized overlap syndrome.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"27 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148878983","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":"Clinical characteristics, pain trajectories, and outcomes of peritoneal dialysis-related peritonitis: a multicenter retrospective study.","authors":"Yumei Liu, Zejin Zhang, Yuqi Liang, Xiaoling Zha, Tao Xu","doi":"10.1186/s12882-026-05277-2","DOIUrl":"10.1186/s12882-026-05277-2","url":null,"abstract":"<p><strong>Background: </strong>Peritoneal dialysis-related peritonitis (PDRP) is a common complication of peritoneal dialysis that can lead to inadequate dialysis, technical failure, or death. The distinct clinical characteristics and outcomes of gram-negative, gram-positive, and culture-negative PDRP remain unclear, limiting the development of optimal management strategies and prognostic assessment for these subtypes.</p><p><strong>Methods: </strong>This multicenter retrospective study included 156 hospitalized patients with PDRP from three centers between January 2020 and June 2025. Demographic, clinical, laboratory, and treatment data were collected and analyzed.</p><p><strong>Results: </strong>In the early phase of PDRP, patients with gram-negative infections showed more severe inflammation than those with gram-positive or culture-negative infections, including higher peritoneal dialysate white blood cell counts on day 1, 3, and 5 (P < 0.05); higher C-reactive protein (142.4 vs. 95.1 vs. 77.1 mg/L; P < 0.05) and procalcitonin (8.9 vs. 1.7 vs. 1.2 ng/mL; P < 0.05) levels, altered iron metabolism (higher serum ferritin: 425 vs. 388 vs. 223 ng/mL, P < 0.05; lower serum iron: 4.6 vs. 7.7 vs. 6.2 ng/mL, P < 0.05); and consistently higher abdominal pain scores from days 2 to 12 (4.5 vs. 3.8 vs. 4.0 to 1.0 vs. 0.4 vs. 0.3, P < 0.05). Mortality did not differ significantly among the three groups. However, treatment failure, defined as catheter removal or death, was significantly more frequent in the gram-negative group than in the other two groups (22.7% vs. 10.9% vs. 0%; P < 0.05). Multivariable analysis revealed that hypoalbuminemia was the only factor associated with mortality, whereas gram-negative infection, elevated C-reactive protein, and hypoalbuminemia were associated with treatment failure.</p><p><strong>Conclusions: </strong>Gram-negative infections are associated with greater inflammation, more severe pain, and higher rates of treatment failure. Although mortality did not differ among the three groups, treatment failure was related to infection type, inflammatory burden, and nutritional status. Further prospective studies are required to confirm these findings.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"27 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13613675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149058443","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}