BMC Nephrology最新文献

{"title":"A comparative study on the clinicopathological features and short-term prognosis of IgA-dominant infection-related glomerulonephritis and IgA nephropathy.","authors":"Junfeng Zhong, Dheji Yangzong, Yina Wang, Bao Dong, Meishun Cai, Chunying Shao, Xin Li, Yu Yan, Li Zuo","doi":"10.1186/s12882-026-05208-1","DOIUrl":"10.1186/s12882-026-05208-1","url":null,"abstract":"<p><strong>Background: </strong>IgA-dominant infection-related glomerulonephritis (IgA-IRGN) and primary IgA nephropathy (IgAN) share similar clinicopathological features, making differentiation challenging despite distinct therapeutic strategies. This study compares the clinicopathological characteristics and short-term prognoses of the two conditions to identify diagnostic differentiators.</p><p><strong>Methods: </strong>This retrospective study included patients diagnosed with IgA-IRGN (n = 30) and IgAN (n = 120). We comparatively analyzed their clinical and pathological features, as well as the short-term prognostic differences. Univariate and multivariable logistic regression analyses were conducted to evaluate independent associations. Different pathological scoring systems were utilized to assess their diagnostic value. Short-term prognosis was evaluated at a 6-month follow-up, based on changes in the estimated glomerular filtration rate (eGFR) and the remission rate of proteinuria.</p><p><strong>Results: </strong>Compared to IgAN, IgA-IRGN patients had higher mean arterial pressure, incidences of edema, acute kidney injury (AKI), and hypertension. Serum albumin, eGFR, and complement C3 were lower, while 24-hour proteinuria, neutrophil-to-albumin ratio (NAR), and neutrophil-to-C3 ratio (NC3r) were higher. Pathologically, IgA-IRGN showed diffuse endocapillary hypercellularity (100% vs. 2.5%) and universal subepithelial \"hump-like\" deposits (100% vs. 0.89%). Multivariable analysis revealed hypocomplementemia C3, AKI, and serum albumin could serve as non-invasive differentiating indicators. After incorporating pathological factors, hypocomplementemia C3, the Lupus Nephritis Activity Index (AI) score, and diffuse foot process effacement emerged as independent differentiating factors. IgA-IRGN patients demonstrated better short-term renal function recovery and higher proteinuria remission rate (P < 0.05).</p><p><strong>Conclusions: </strong>Significant clinicopathological differences exist between IgA-IRGN and IgAN. Hypocomplementemia C3, AKI, low serum albumin, diffuse foot process effacement, and the AI score were independent indicators for differentiation. IgA-IRGN patients experience better short-term renal recovery and proteinuria remission than IgAN patients.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"27 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13508348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148817519","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":"Digital self-management application for patients undergoing hemodialysis: influences on health awareness and frailty.","authors":"Chieko Hamada, Mitsumine Fukui, Yasuhiko Tomino, Reo Kanda, Atsuko Urita","doi":"10.1186/s12882-026-05174-8","DOIUrl":"10.1186/s12882-026-05174-8","url":null,"abstract":"<p><strong>Background: </strong>Digital health interventions are increasingly used to support self-management in chronic kidney disease; however, their effects on patient-centered outcomes in maintenance hemodialysis (HD) patients remain unclear. This pilot feasibility study investigated the potential impact of a digital self-management application on health awareness, frailty, and eHealth literacy.</p><p><strong>Methods: </strong>This single-group before-and-after observational study included 12 patients undergoing HD. Participants used a researcher-developed digital self-management application (\"eCare\") for 3 months. Clinical parameters, Health Consciousness Scale (HCS) scores, eHealth literacy, and frailty assessed using the Kihon Checklist were evaluated before and after the intervention. Participants were also categorized as active or passive users according to application engagement.</p><p><strong>Results: </strong>Hemoglobin levels significantly increased after the intervention, whereas other biochemical and dialysis-related parameters remained stable. Total HCS scores significantly changed, with notable improvements in prevention-related awareness and dependence on treatment. Frailty scores showed a trend toward improvement, particularly depressive symptoms. eHealth literacy scores remained stable throughout the study period. Active users demonstrated greater improvements in prevention-related awareness and cognitive function than passive users.</p><p><strong>Conclusions: </strong>This pilot feasibility study suggests that digital self-management applications may influence health awareness and selected patient-centered outcomes in HD patients, particularly psychological aspects of frailty. Larger controlled multicenter studies are needed to further evaluate the long-term clinical and psychosocial effects of digital health interventions in dialysis care.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"27 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13682101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223392","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":"External evaluation of population pharmacokinetic models for tacrolimus in kidney transplant recipients: implications for model-informed precision dosing.","authors":"Arun Prasath Raju, Priyanka Naithani, Deepesh Kenwar, Sarbpreet Singh, Shiva Kumar Sp, Savita Verma Atri, Vivek Kumar, Anjali Agarwal, Ravindra Prabhu Attur, Mahadev Rao, Ashish Sharma, Smita Pattanaik, Surulivelrajan Mallayasamy","doi":"10.1186/s12882-026-05214-3","DOIUrl":"10.1186/s12882-026-05214-3","url":null,"abstract":"<p><strong>Background: </strong>Tacrolimus, a primary immunosuppressant in kidney transplantation, exhibits variable pharmacokinetics. While model-informed precision dosing (MIPD) using population pharmacokinetic (PopPK) models improve dosing accuracy, models developed in specific populations lack applicability in other populations. We aimed to evaluate the predictive performance of published models integrated in clinical decision support systems (CDSS) in Indian adult renal transplant recipients.</p><p><strong>Methods: </strong>Predictive performance of four published PopPK models were evaluated using an independent dataset of 120 trough concentrations from 60 adult renal transplant recipients. Models were assessed using prediction based and simulation-based diagnostics. Maximum a posteriori (MAP) Bayesian prediction was also used to evaluate the model performance.</p><p><strong>Results: </strong>A priori predictions (PRED) for all four models demonstrated systematic underprediction, with relative mean prediction error (rME) ranging from - 25.0% to -64.0%, failing clinical acceptability thresholds. However, integrating patient-specific data via MAP Bayesian estimation corrected this bias and improved precision. Notably, all models achieved higher accuracy and precision, with more than 60% of individual predictions falling within [Formula: see text] ([Formula: see text]) of the observed values. Additionally, scaling down the clearance parameter by 30% mitigated the systematic bias observed in the initial a priori predictions.</p><p><strong>Conclusions: </strong>Published PopPK models exhibited significant systematic bias when applied to Indian renal transplant recipients, posing a substantial risk of overdosing if used without adjustment for initial dose selection. However, these models adapted using MAP Bayesian approach or scaling of clearance parameter demonstrate better predictive performance in this cohort, suggesting they can guide proactive precision dosing in the Indian cohort. Prospective studies evaluating the target attainment and clinical outcomes are required to establish their clinical applicability.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"27 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13678889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223415","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 immunosuppressive therapy in low-risk and intermediate- risk idiopathic membranous nephropathy patients : a 2-year follow-up study.","authors":"Yan Jin, Yan Zhang, Wei Chen, Lei Lan, Chaoyi Chen, Jun Jiang, Jielong Jiang","doi":"10.1186/s12882-026-05195-3","DOIUrl":"10.1186/s12882-026-05195-3","url":null,"abstract":"<p><strong>Background: </strong>The efficacy and safety of immunosuppressive therapy for low- and intermediate-risk idiopathic membranous nephropathy (IMN) remain unclear.</p><p><strong>Method: </strong>A total of 117 renal biopsy-confirmed idiopathic membranous nephropathy (IMN) patients were retrospectively enrolled from the Department of Nephrology, First Affiliated Hospital of USTC (2021-2023). Participants were stratified by baseline urinary protein-to-creatinine ratio (uPCR): low-risk group (≤ 3.0 g/gCr) vs. intermediate-risk group (> 3.0 g/gCr). The low-risk group included 57 patients, 26 of whom received immunosuppressive agents after a minimum of 3 months of supportive care due to persistent proteinuria. All remaining patients initiated immunosuppressive therapy at enrollment. Total remission rates (TRR, including complete remission rate [CRR] and partial remission rate [PRR]) and CRR were compared at 6, 12, and 24 months, with infectious events documented. Binary logistic regression identified risk factors for remission.</p><p><strong>Results: </strong>A total of 117 IMN patients were stratified into low-risk (n = 57) and intermediate-risk (n = 60) groups. During the 2-year follow-up, the low-risk group exhibited significantly higher complete remission rates than the intermediate-risk group at 6 months (P < 0.01), 12 months (P < 0.01), and 24 months (P = 0.01). No significant between-group differences in total remission rates were observed at any time point. Binary logistic regression revealed intermediate-risk classification as an independent risk factor for non-remission across all follow-up points (6, 12, and 24 months; all P < 0.05). Male sex was positively associated with complete remission (CR) only at 12 months (OR = 3.24, P = 0.04), whereas no significant associations were detected at 6 and 24 months. Serum triglyceride levels, anti-PLA2R antibody status, and specific immunosuppressive regimens showed no significant correlations with CR at any follow-up time point (all P > 0.05). The overall incidence of infections was comparable between the two groups (P > 0.05), and no deaths occurred throughout follow-up.</p><p><strong>Conclusion: </strong>An observational association was identified between early immunosuppressive therapy and higher CRRs at all follow-up time points in patients with low-risk IMN, with no marked elevation in infectious risk observed. However, this correlation cannot be interpreted as definitive therapeutic benefit due to major confounding factors including unassessed spontaneous remission and absence of a supportive-care-only control group.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13678869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148547826","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":"Short-term exposure to ambient air pollutants increases the mortality risk of chronic kidney disease: a time-stratified case-crossover study in Zhejiang Province.","authors":"Pinyuan Dai, Xiaoyan Zhou, Weiwei Gong, Jin Pan, Yunqi Guan, Hao Wang, Na Li, Jieming Zhong","doi":"10.1186/s12882-026-05103-9","DOIUrl":"10.1186/s12882-026-05103-9","url":null,"abstract":"<p><strong>Background: </strong>The association between air pollutants and mortality from chronic kidney disease (CKD) remains to be further investigated. This study aims to examine the impact of air pollutant exposure on CKD mortality in individuals.</p><p><strong>Methods: </strong>This study utilized an individual-level, time-stratified case-crossover design to evaluate the association between short-term exposure to air pollutants (PM_2.5, SO₂, O₃, and NO₂) and mortality from CKD. The deceased population was identified from the mortality surveillance data of the Zhejiang Provincial Center for Disease Control and Prevention. For each decedent, we collected air pollutant concentrations on the day of death (case day) and on matched control days within the same month. This design inherently controls confounding factors such as age, place of residence, and seasonality.</p><p><strong>Results: </strong>The study found that short-term exposure to all four air pollutants was associated with an increased risk of CKD mortality. The excess risk (ER) per interquartile range (IQR) increase in pollutant concentrations was evaluated across different lag periods. Using multi-day moving average lags (calculated as the mean exposure from the current day up to the specified preceding day), the most prominent ERs were observed for PM2.5 at lag02 (ER: 15.16%, 95% CI: 12.69-17.68), SO₂ at lag03 (ER: 8.80%, 95% CI: 5.95-11.72), O₃ at lag01 (ER: 5.67%, 95% CI: 2.07-9.39), and NO₂ at lag03 (ER: 13.66%, 95% CI: 9.12-18.39). After adjusting for interactions with other pollutants, the associations for SO₂ and PM_2.5 remained significant. Additionally, the study found that this association was influenced by factors such as marriage, and season (cold vs. warm).</p><p><strong>Conclusions: </strong>This study revealed a significant association between short-term exposure to air pollutants and CKD mortality in the population of Zhejiang Province. These findings provide novel evidence for understanding the impact of environmental factors on kidney disease and suggest a need for governmental authorities to enhance the monitoring and control of air pollution to mitigate the health burden on the elderly.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13654209/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148547832","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":"Kidney biopsy during pregnancy or wait postpartum: two decades experience from a single center.","authors":"Aisha Batool, Mukoso Ozieh, Alexander J Gallan, Jack Kleinman, Ashraf El-Meanawy, Anna Palatnik","doi":"10.1186/s12882-026-05211-6","DOIUrl":"10.1186/s12882-026-05211-6","url":null,"abstract":"<p><strong>Background: </strong>Kidney biopsy is the gold standard for diagnosing kidney disease, yet its use during pregnancy remains controversial due to concerns about procedure related complications and limited contemporary evidence. This study evaluates long term kidney outcomes with biopsy timing in pregnant and postpartum females.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study spanning over 22-years including females aged ≥ 18 years who underwent native kidney biopsy during pregnancy or within three months postpartum. Demographic, clinical, histopathological, maternal, fetal, and long-term kidney outcomes were abstracted from electronic health records. Kaplan-Meier analysis evaluated kidney survival, defined as time to dialysis initiation and statistical significance was set at p-value < 0.05.</p><p><strong>Results: </strong>In our cohort, 29 females met inclusion criteria: 13 biopsied during pregnancy and 16 postpartum. Long term kidney survival did not differ significantly between groups (log rank p = 0.3). Complication rates were comparable between groups; low, limited to small, and self-limiting hematomas. Lupus nephritis was the most frequent diagnosis in both groups.</p><p><strong>Discussion: </strong>Although long term dialysis rates were comparable between the two groups, the postpartum cohort had a shorter duration of follow up. Biopsies performed during pregnancy and postpartum were safe in this cohort and yielded clinically meaningful information that frequently altered acute management. Nephrotic range proteinuria and an eGFR below 60 mL/min/1.73 m² were key predictors of progression to ESKD.</p><p><strong>Conclusion: </strong>In our study, no statistically significant difference in long-term kidney survival was observed by biopsy timing during pregnancy vs. postpartum, even though pregnancy group had much longer follow-up than the postpartum group.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13673641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535311","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":"Association between platelet-to-hemoglobin ratio and contrast-induced acute kidney injury after percutaneous coronary intervention.","authors":"Qiqiang Li, Leigang Tian, Lijian Li, Yingming Shi, Yujing Li, Linxiao Deng, Yong Liu, Kedong Han","doi":"10.1186/s12882-026-05215-2","DOIUrl":"10.1186/s12882-026-05215-2","url":null,"abstract":"<p><strong>Background: </strong>In patients suffering from coronary artery disease, the measured platelet-hemoglobin ratio (PHR) is a key biomarker of prognosis. However, the association between PHR and contrast-induced acute kidney injury (CI-AKI) outcomes after percutaneous coronary intervention (PCI) are unclear.</p><p><strong>Methods: </strong>In a retrospective study, 26,479 patients (63.3 ± 11.5 years of age, 22.1% female) who underwent PCI were enrolled. CI-AKI was defined as serum creatinine levels above 0.3 mg/dL, exceeding the baseline by more than 50%, in the first 48 h following contrast exposure. The relationship between PHR and CI-AKI was clarified through univariate and multivariable logistic regression analyses.</p><p><strong>Results: </strong>In summary, CI-AKI occurred in 1,707 patients (6.4%) following PCI. The association of an increased PHR with elevated CI-AKI incidence was determined via multivariate logistic regression analysis (odds ratio for Q4 vs. Q1, 1.42; 95% confidence interval [95% CI], 1.20-1.68; P < 0.001). Restricted cubic spline analysis indicated a linear PHR-CI-AKI relationship (non-linearity P = 0.060).</p><p><strong>Conclusion: </strong>A high PHR was strongly correlated with elevated CI-AKI incidence, indicating PHR as a factor independently associated with CI-AKI.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13673682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497041","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 outcomes and prognostic factors in lupus nephritis: impact of remission on renal and overall survival in a single-center study.","authors":"Ula Qasem, Rama Rayyan, Laith Bdier, Taima Bader, Mohammad Alshqeirat, Heba Al-Lala, Ahmad Al-Tanjy, Abdulraheem Jaber, Abdel Rahman Jaber, Izzat AlAwwa, Nisreen Abu Shahin, Marwan Adwan, Randa I Farah","doi":"10.1186/s12882-026-05203-6","DOIUrl":"10.1186/s12882-026-05203-6","url":null,"abstract":"<p><strong>Background: </strong>Lupus nephritis (LN) is a severe complication of systemic lupus erythematosus. This study aimed to evaluate clinical outcomes in patients with LN, including progression to chronic kidney disease (CKD), end-stage kidney disease (ESKD), and mortality.</p><p><strong>Methods: </strong>This retrospective study included all patients diagnosed with LN via kidney biopsy between January 2010 and March 2022. Rates of cumulative renal survival and overall survival, as well as cumulative survival based on the development of ESKD, were compared according to treatment response.</p><p><strong>Results: </strong>A total of 125 patients with LN were included in the analysis, with a mean follow-up period of 59.9 ± 32.4 months. Overall, 58 patients (46.4%) achieved complete remission, 35 (28%) partial remission, and 32 (25.6%) did not respond to treatment. Baseline clinical characteristics were similar across groups. Patients in complete remission experienced significantly higher rates of cumulative renal and overall survival compared to those with partial or no treatment response (log-rank: P <0.001). Progression to ESKD occurred in 20 patients (16.0%), and 18 (14.4%) died. After multivariable adjustment, low C3 at diagnosis was independently associated with higher odds of treatment non-response (adjusted OR 5.29, 95% CI 1.52-21.3). Achieving complete remission was strongly protective against renal events (doubling of creatinine) (adjusted HR 0.11, 95% CI 0.03-0.39, p < 0.001). Additionally, non-responders were at higher risk of CKD, ESKD, and mortality, with P values of <0.001, 0.005, and 0.014, respectively.</p><p><strong>Conclusions: </strong>The findings of this study emphasize the importance of early detection, prompt treatment, and vigilant monitoring to optimize patient outcomes. Achieving complete remission is critical for improved renal and overall survival in patients with LN. In particular, low C3 levels at diagnosis was associated with poor treatment response. Future multicenter prospective research is needed to validate these findings.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13599064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148469026","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 comparative analysis of metabolic and urinary bacterial culture profiles between patients with staghorn and non-staghorn infectious renal stones.","authors":"Endi Zhang, Zhichao Chi, Xuming Zhang, Jianxing Li, Chaoyue Ji, Weiguo Hu","doi":"10.1186/s12882-026-05204-5","DOIUrl":"10.1186/s12882-026-05204-5","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the risk factors of staghorn calculus and explore the differences in the distribution of culturable urine bacteria among patients with infectious renal stones.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on the clinical data of 201 patients hospitalized in our center from January 2020 to December 2024. Patients who underwent upper urinary tract stone surgery and whose postoperative stone composition analysis indicated that the main component was infectious stones were included. The patients were divided into two groups based on the presence or absence of staghorn calculi. General data, serum biochemical parameters, 24-hour urine metabolic parameters, and urine culture results were collected and compared between the two groups. Univariate and multivariate logistic regression analyses were conducted to identify independent risk factors for staghorn calculus.</p><p><strong>Results: </strong>The two groups revealed no significant differences in terms of gender, age, or comorbidities. Serum calcium levels (P < 0.05), estimated glomerular filtration rate (eGFR) (P < 0.05), and 24-hour urinary calcium levels (P = 0.003) were significantly higher in the non-staghorn stone group than in the staghorn stone group. Multivariate logistic regression analysis indicated that lower serum calcium levels were independently associated with staghorn calculus formation (P = 0.025, OR 0.032, 95% CI [0.002, 0.649]). Urine culture analysis revealed that the detection rate of Proteus mirabilis was significantly higher in the staghorn stone group than in the non-staghorn stone group (31.5% vs. 2.4%, P = 0.001).</p><p><strong>Conclusion: </strong>This study suggests that lower serum calcium levels and Proteus mirabilis infection are associated with staghorn calculi in patients with infectious stones. Clinically, monitoring serum calcium levels and managing urinary tract infections may help reduce the risk of staghorn calculus progression and preserve renal function. However, these findings require further validation through prospective studies.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148468973","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":"Non-steroidal mineralocorticoid receptor antagonists in non-diabetic kidney disease: a narrative review of mechanisms and clinical advances.","authors":"Fei Luo, Jingjia Hu, Hongliang Fang, Xianfa Li, Caifeng Zhu, Ziyang Bao","doi":"10.1186/s12882-026-05205-4","DOIUrl":"10.1186/s12882-026-05205-4","url":null,"abstract":"<p><p>Significant advances have been made in elucidating the role of non-steroidal mineralocorticoid receptor antagonists (ns-MRAs) in non-diabetic kidney disease (NDKD). As a key downstream effector of the renin-angiotensin system (RAS), pathological overactivation of the mineralocorticoid receptor (MR) amplifies inflammatory and fibrotic signaling, thereby contributing to proteinuria, podocyte injury, and progressive damage to both the glomerular and tubulointerstitial compartments. Mechanistic studies suggest that ns-MRAs exert multi-level protective effects by targeting the inflammation-fibrosis axis, including preservation of podocyte structure and function, attenuation of acute kidney injury-to-chronic kidney disease transition, improvement of endothelial dysfunction, and suppression of cardiac and renal fibrosis. Clinically, the phase III FIND-CKD trial has provided direct randomized evidence that finerenone slows estimated glomerular filtration rate (eGFR) decline in adults with proteinuric CKD without diabetes, while a prespecified exploratory analysis further supports its potential relevance in glomerular diseases. Real-world studies in IgA nephropathy and membranous nephropathy also suggest antiproteinuric effects when finerenone is added to renin-angiotensin system inhibition. Moreover, co-administration with sodium-glucose cotransporter 2 (SGLT2) inhibitors may confer complementary antiproteinuric effects, although hyperkalemia remains an important safety consideration requiring appropriate monitoring. Collectively, current randomized and observational evidence supports consideration of ns-MRAs in selected patients with proteinuric NDKD, while highlighting the need for subtype-specific interpretation, serum potassium monitoring, and precision-stratified treatment strategies.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13662977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148468943","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}