BMC Nephrology最新文献

{"title":"The essential role of electron microscopy in the diagnosis of collagen type III glomerulopathy superimposed with membranous nephropathy or diabetic nephropathy.","authors":"Fangcheng Zhang, Qi Shen, Xiaoling Sun, Xiao Long, Dan Cheng","doi":"10.1186/s12882-025-04315-9","DOIUrl":"10.1186/s12882-025-04315-9","url":null,"abstract":"<p><strong>Background: </strong>Collagen type III glomerulopathy (CG) is a rare idiopathic nephropathy characterized by the massive deposition of dense, fractured, curved, band-like fibers in the mesangial and subendothelial regions. Ultrastructural pathological examination confirms that these deposits are composed of type III collagen. Here, we report two rare cases of CG: Patient I was superimposed with membranous nephropathy (MN), and Patient II was superimposed with diabetic nephropathy (DN), both confirmed by transmission electron microscopy (EM).</p><p><strong>Case presentation: </strong>Both patients presented with bilateral lower extremity edema of unknown etiology. Patient I was admitted to the hospital multiple times due to persistent proteinuria. The phospholipase A2 receptor (PLA2R) test was positive, but there was no response to steroid treatment. Patient II has a 10-year history of hypertension and fasting hyperglycemia. Renal biopsies revealed segmental aggregation of homogeneous substances beneath the mesangium and endothelial cells. To obtain a definitive diagnosis, biopsy specimens were transferred to our department for electron microscopic evaluation.</p><p><strong>Conclusion: </strong>This study highlights the ultrastructural characteristics of CG and emphasizes the indispensable role of electron microscopy in the diagnosis of CG, particularly when coexisting with other glomerular diseases. The Early EM examination in renal biopsies is crucial for a clear diagnosis and prognosis prediction.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"364"},"PeriodicalIF":2.2,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590404","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":"Prevalence and influencing factors of cognitive frailty in Chinese maintenance hemodialysis patients: a systematic review and meta-analysis.","authors":"Xinghong Wei, Junjie Peng, Renjie Chang, Qin Liu","doi":"10.1186/s12882-025-04288-9","DOIUrl":"10.1186/s12882-025-04288-9","url":null,"abstract":"<p><strong>Objective: </strong>Chronic kidney disease (CKD) has become a major challenge in global public health, and China has one of the heaviest burdens of CKD in the world, approximately 89.5% of patients require hemodialysis. Cognitive frailty (CF) is a condition characterized by physical frailty and cognitive impairment while excluding Alzheimer's disease and other dementias. CF is associated with adverse clinical outcomes, including hospitalization, disability, and increased mortality. The purpose of this study was to explore the prevalence and influencing factors of CF in Chinese maintenance hemodialysis (MHD) patients through systematic review and meta-analysis.</p><p><strong>Methods: </strong>We searched PubMed, Cochrane Library, Web of Science, EMBASE, China National Knowledge Infrastructure (CNKI), Wanfang Database, Chinese Scientific Journal Database (VIP) and Chinese Biomedical Database (CBM) for epidemiological data on CF in Chinese patients undergoing MHD from inception to December 2024. A random-effects model was used to estimate the overall prevalence of CF in Chinese patients undergoing MHD. Odds ratios (OR) and 95% confidence intervals (CI) were used to estimate factors associated with CF in Chinese patients undergoing MHD. Stata 15.0 software was used to conduct systematic review and meta-analysis of the prevalence and influencing factors of CF in Chinese patients undergoing MHD.</p><p><strong>Results: </strong>A total of 16 studies with 5690 Chinese patients undergoing MHD were included. The results of this meta-analysis showed that the prevalence of CF in Chinese patients undergoing MHD was 25%. The results of subgroup analyses showed that the frailty assessment tool (TFI) and education level (≥ College) may be sources of heterogeneity in the prevalence of CF in Chinese patients undergoing MHD. The meta-analysis results indicate that age (> 60, > 75), female, depression (HADS scale), malnutrition, triglycerides, waist circumference, stroke history, fall history, complications, CCI, comorbidities and dialysis age were risk factors for CF. High education level, calf circumference and serum creatinine level were protective factors for CF.</p><p><strong>Conclusions: </strong>The prevalence of CF in Chinese patients undergoing MHD is high (25%). Therefore, this patient population necessitates early screening and targeted interventions with influencing factors.</p><p><strong>Prospero registration number for this study: </strong>CRD42023493122CRD42023475424.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"365"},"PeriodicalIF":2.2,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590402","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":"Different management methods for tunnel abscess in tunneled cuffed catheters with catheter-related bloodstream infections and central venous stenosis: two case reports.","authors":"Yafei Bai, Chunli Wang, Mingzhi Xu, Hong Li, Na An, Ruman Chen","doi":"10.1186/s12882-025-04279-w","DOIUrl":"10.1186/s12882-025-04279-w","url":null,"abstract":"<p><strong>Background: </strong>Tunneled cuffed catheters (TCCs) are critical vascular access tools for hemodialysis patients, but they are associated with complications such as tunnel infections (TIs) and catheter-related bloodstream infections (CRBSIs). Current guidelines recommend removing infected TCCs, but this can exacerbate central venous stenosis (CVS) and complicate subsequent catheter reinsertion. This case series proposes a staged management protocol for complex TCC tunnel abscess infections complicated by CVS.</p><p><strong>Case presentation: </strong>We present two cases of complex TCC tunnel abscess infections with concurrent CVS. In case 1, a 67-year-old female with ANCA-associated vasculitis had a TCC tunnel abscess and CRBSI. After TCC removal, CT angiography(CTA) revealed occlusion of the right internal jugular vein and right brachiocephalic vein, along with in-stent stenosis of the superior vena cava. Endovascular interventions, including balloon angioplasty, facilitated successful TCC reinsertion. In case 2, a 71-year-old female with diabetic nephropathy underwent a staged strategy: the infected TCC was removed and replaced with a non-cuffed catheter (NCC) in situ. After infection control, balloon angioplasty resolved CVS, and a new TCC was reinserted. Both patients achieved infection control and preserved functional vascular access.</p><p><strong>Conclusions: </strong>Both patients achieved infection control and preserved functional vascular access. However, Case 1 required technically demanding multistep endovascular procedures with elevated procedural risks, while Case 2 simplified reinsertion through NCC bridging. A staged management protocol (infection control → NCC transition → endovascular salvage) effectively addresses complex TCC infections with concurrent CVS, mitigates post-removal vascular injury, and enhances reinsertion success. Larger cohort studies are warranted to validate the efficacy and long-term safety of this approach.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"363"},"PeriodicalIF":2.2,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590401","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":"Trends in vascular access among patients on hemodialysis; a nationwide survey from Egypt.","authors":"Eman Nagy, Karem Salem, Mostafa Abdelsalam, Rasha Shemies, Nehal Elshabrawy, Ahmed M Abd Elwahab, Alaa Sabry, Alaa A Elsawi, Ahmed Albeyaly, Hamed Eleraky, Hala Mahmoud, Mohamed Elsayed, Nayel Zaki, Ahmed Noureldin, Ahmed Megahed, Hassan Foula, Basma Sultan, Mohamed Hamed Brawy, Walaa H Ibrahim, Alshaimaa S Mubarak, Bishoy Tanagho, Aber-Halim Attallah, Mohamed Ellawag, Hazem Abo Shousha, Emad Samaan","doi":"10.1186/s12882-025-04296-9","DOIUrl":"10.1186/s12882-025-04296-9","url":null,"abstract":"<p><strong>Problem statement: </strong>Vascular Access (VA) in hemodialysis (HD) patients is vital for treatment efficiency and is influenced by Egypt's healthcare system and socioeconomic factors. It is a complex issue, shaped by both challenges and opportunities within the nation's healthcare infrastructure.</p><p><strong>Aim: </strong>To examine trends in VA use and associated characteristics in patients on HD based on data from a nationwide survey in Egypt.</p><p><strong>Methods: </strong>This cross-sectional study targeted patients on maintenance hemodialysis across Egypt, using stratified cluster sampling from 11 representative governorates. Medical personnel collected data using a structured electronic Google Form questionnaire, which gathered data on patient demographics, clinical details, VA creation and complications, and healthcare access.</p><p><strong>Results: </strong>The study included 3,582 chronic HD patients. Data were collected over a one-year period from May 2023 to May 2024. An arteriovenous fistula (AVF) was the initial VA for 669 patients (18.7%), while a temporary catheter was used as the initial access in 2,861 patients (79.9%). AVF thrombosis was the primary cause of AVF failure, occurring in 69.7% of cases. Pre-HD VA creation was associated with substantially better fistula maturation, fewer VA numbers, and lower VA-related complications.</p><p><strong>Conclusion: </strong>Significant regional and sociodemographic variations in VA practices were observed across Egypt. The findings revealed persistent reliance on temporary catheters at HD initiation, with encouraging but limited progress in pre-HD AVF planning. These trends underscore the need for early referral strategies and targeted interventions to optimize vascular access outcomes nationwide.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"361"},"PeriodicalIF":2.2,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590405","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":"Unveiling hidden contaminants: a systematic quantification and characterization of microplastics in hemodialysis and peritoneal dialysis fluids.","authors":"Ekrem Kara, Kamil Konur, Yasemen Şentürk Koca, Ülgen Aytan","doi":"10.1186/s12882-025-04281-2","DOIUrl":"10.1186/s12882-025-04281-2","url":null,"abstract":"<p><p>Microplastics (MPs) are an emerging environmental and biomedical concern due to their potential bioaccumulation and toxic effects. Given the extensive exposure of dialysis patients to large volumes of dialysate and water, the presence of MPs in dialysis solutions raises concerns regarding chronic exposure and systemic implications. This study systematically quantifies and characterizes MPs in hemodialysis (HD) and peritoneal dialysis (PD) fluids, investigating their sources and potential health risks. A total of 30 dialysis solution samples were analysed (revealing 36 suspect particles) using advanced spectroscopic techniques, including Fourier-transform infrared (FT-IR) spectroscopy, to identify polymer compositions. MPs predominantly fibers, were detected in all tested solutions, with polyethylene (PE), polyvinyl chloride (PVC), and ethylene-vinyl acetate (EVA) as the primary polymers. Statistical analyses confirmed significant variability in MP contamination across different dialysis fluids. Hemodialysis and peritoneal dialysis solutions show no statistically significant difference in MP concentration (HD: 0.29 ± 0.16 mp.L⁻¹, PD: 0.34 ± 0.02 mp.L⁻¹, p = 0.86). MP particles in HD solutions (1.31 ± 0.98 mm) are significantly larger than those in PD solutions (0.64 ± 0.43 mm) (p = 0.030). Despite similar MP concentrations, PD patients are estimated to be exposed to ~ 50% more MPs weekly than HD patients (9.57 ± 5.28 vs. 14.28 ± 0.84 mp. L⁻¹, p < 0.001). These findings highlight a potential, yet underrecognized, source of MP exposure in dialysis patients, necessitating further investigation into the implications of chronic MP absorption on renal function and systemic health. Regulatory policies should prioritize improved filtration techniques, alternative polymer-free materials, and stricter quality control measures to mitigate MP contamination in medical solutions. Future research should explore the long-term effects of MP exposure in dialysis-dependent individuals and refine analytical methodologies for contamination assessment.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"359"},"PeriodicalIF":2.2,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144583035","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":"Psychometric evaluation of the Persian version of the adult chronic kidney disease self-management instrument in the Iranian population.","authors":"Simin Alasvand, Mehrnaz Ahmadi, Hamid Sharif-Nia, Marziyeh Asadizaker","doi":"10.1186/s12882-025-04299-6","DOIUrl":"10.1186/s12882-025-04299-6","url":null,"abstract":"<p><strong>Background: </strong>Increasing evidence suggests that self-management practices can enhance the results for individuals with chronic kidney disease (CKD). Nevertheless, there are currently no tools in Iran to adequately evaluate self-management in CKD patients. This study aimed to validate and psychometrically evaluate the Persian Chronic Kidney Disease Self-Management for Iranian healthcare professionals and patients.</p><p><strong>Methods: </strong>In this cross-sectional study, after the scale translation, the adaptation and validation were assessed in a sample of 400 patients with CKD who were receiving treatment at nephrology wards and clinic centers affiliated with Ahvaz Jundishapur University of Medical Sciences in Iran. Face and content validity were evaluated using both quantitative and qualitative methods. Construct validity was established through exploratory and confirmatory factor analysis. The reliability of the instrument was assessed through measures of internal consistency, as well as relative and absolute reliability.</p><p><strong>Results: </strong>Following the completion of construct validity and factor analysis, a 15-item instrument with three key factors was identified: self-efficacy, ability to acquire knowledge and problem-solve, and knowledge. These factors accounted for a total variance of 44.18%. The results of the confirmatory factor analysis indicated a strong fit for the model. Each factor demonstrated acceptable internal reliability, with Cronbach's α values ranging from 0.73 to 0.83. Furthermore, the scales exhibited strong stability, as evidenced by an overall Intraclass Correlation Coefficient result of 0.961. The absolute reliability, as determined by Standard Error of Measurement results, was 3.16. Additionally, the Minimum Detectable Change was estimated to be 8.75.</p><p><strong>Conclusions: </strong>The findings of this study demonstrate that the CKD-SM Instrument is both valid and reliable for use in tailoring interventions for Iranian patients with CKD. Additionally, the concept being studied has three subconcepts that show sufficient reliability and applicability within the Iranian population.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"360"},"PeriodicalIF":2.2,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144583034","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":"Evaluation of intradialytic hypoxemia development in intensive care patients.","authors":"Uğur Uzun, Sibel Ersan, Işıl Köse Güldoğan, Aykut Sarıtaş, Nimet Şenoğlu","doi":"10.1186/s12882-025-04302-0","DOIUrl":"10.1186/s12882-025-04302-0","url":null,"abstract":"<p><strong>Introduction: </strong>Hypoxemia is a significant factor contributing to increased mortality in intensive care patients and remains a prevalent issue. Although numerous conditions are well documented to lead to hypoxemia, intradialytic hypoxemia (IDH) occurring during dialysis is often overlooked. IDH is characterized by a decrease in arterial oxygen saturation below 90% or partial oxygen pressure (PaO₂) below 80 mmHg, and it may compromise tissue perfusion, adversely affecting patient prognosis. This study aims to enhance awareness of IDH in critically ill patients and to propose proactive strategies for the prevention of associated complications.</p><p><strong>Method: </strong>The single-center observational study included 93 intensive care patients. Patients' arterial and central venous blood gas values were measured before dialysis (baseline), at the third hour of dialysis (3rd hour), and one-hour post-dialysis (5th hour). The study evaluated PaO₂, partial pressure of carbon dioxide (PaCO₂), central venous oxygen saturation (ScvO₂), mean arterial pressure (MAP), perfusion index (PI) and the temperature gradient between the forearm and fingertip. Statistical analyses were conducted using the SPSS 26 software.</p><p><strong>Findings: </strong>In patients who did not survive, a significant decrease was observed in PaO₂, ScvO₂, and perfusion index (PI) values at the third hour, while PaCO₂ levels and the central venous-to-arterial temperature gradient increased. No significant change was detected in mean arterial pressure (MAP) values. A partial trend toward improvement in these parameters was observed following dialysis. Survival rates among these patients were low, and survival duration was found to be short.</p><p><strong>Discussion and conclusion: </strong>These changes indicate a deterioration in oxygen delivery and tissue perfusion. Therefore, close monitoring of these parameters during dialysis is of critical importance for the early identification of intradialytic hypotension (IDH) and the prevention of potential complications. Moreover, the observed low survival rates and short survival duration suggest that intradialytic pathophysiological changes may have a markedly adverse impact on patient prognosis.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"358"},"PeriodicalIF":2.2,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12236041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144583033","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":"Prognostic value of the triglyceride-glucose index for continuous ambulatory peritoneal dialysis patients.","authors":"Sheng Wan, Hong Zhu, Da He, Yanglin Hu, Zengsi Wang, Yanmin Zhang","doi":"10.1186/s12882-025-04305-x","DOIUrl":"10.1186/s12882-025-04305-x","url":null,"abstract":"<p><strong>Objective: </strong>We are committed to demonstrating that the initial triglyceride-glucose (TyG) index possesses prognostic importance for patients undergoing continuous ambulatory peritoneal dialysis (CAPD).</p><p><strong>Methods: </strong>354 patients who utilized continuous CAPD at Wuhan No.1 Hospital were recruited. The participants were classified into three unique groups according to the tertiles of the TyG index. The main endpoints were overall and cardiovascular (CVD) mortality, whereas the secondary outcomes were peritonitis, technical failure, and early-onset peritonitis. The association between the TyG index and outcomes utilizing Cox proportional hazard and restricted cubic spline analysis.</p><p><strong>Results: </strong>Over a median follow-up of 72 months, 92 patients (26.0%) and 60 patients (16.9%) succumbed to all-cause and CVD mortality, respectively. The three groups exhibited significant differences for all-cause death (16.8% in tertile 1, 24.8% in tertile 2, and 36.4% in tertile 3). After full adjustment, patients with the highest TyG index demonstrated a significantly increased all-cause death relative to those in the lowest tertile (hazard ratio, HR, 2.31, 95% confidence interval, 95%CI 1.18-4.56, P = 0.015). Similarly, each unit increase in the TyG index was associated with a 1.32-fold elevated risk of all-cause death (HR 1.32, 95% CI 1.06-1.87, P = 0.031). Restricted cubic spline analysis indicated a relationship between the TyG index and all-cause mortality (P for nonlinearity > 0.05). Furthermore, the same findings were also seen with CVD mortality and secondary outcomes.</p><p><strong>Conclusion: </strong>The TyG index may function as a meaningful and reliable prognostic indicator in CAPD patients, suggesting its potential importance in improving risk stratification in clinical environments.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"356"},"PeriodicalIF":2.2,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12232723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144574812","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":"CTSS and CD53: Emerging m6A methylation markers in diabetic kidney disease pathogenesis and their clinical implications.","authors":"Meng Leilei, Huang Bin, Li Rui, Wenjie Wen","doi":"10.1186/s12882-025-04314-w","DOIUrl":"10.1186/s12882-025-04314-w","url":null,"abstract":"<p><strong>Objective: </strong>Diabetic kidney disease (DKD) is increasingly recognized as a leading cause of chronic kidney disease (CKD) worldwide. Although N6-methyladenosine (m6A) mRNA modification is abundant in eukaryotes, its specific contribution to DKD pathogenesis is not well understood. This study aims to investigate the role of N6-methyladenosine (m6A) RNA modification patterns in DKD and their relationship with immune regulation.</p><p><strong>Methods: </strong>Three GEO datasets were analyzed to explore m6A modification patterns. Random forest modeling and consensus clustering were used for subtype identification. Immune cell infiltration was evaluated using ssGSEA. Key candidate genes were refined through LASSO regression and experimental verification in diabetic mouse models via qPCR.</p><p><strong>Results: </strong>Eight differentially expressed m6A regulators were identified in DKD. Two distinct m6A modification patterns were established, with cluster B showing enhanced immune cell infiltration. WTAP positively correlated with immune cell populations, while YTHDC2 showed negative correlations. CTSS and CD53 were identified as potential biomarkers and validated in diabetic mouse models, showing negative correlations with glomerular filtration rate.</p><p><strong>Conclusions: </strong>This study reveals two m6A methylation patterns in DKD, with one associated with increased immune infiltration. We identified CTSS and CD53 as hub genes and validated them in diabetic mouse kidney tissues, suggesting their potential as clinical biomarkers for DKD.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"357"},"PeriodicalIF":2.2,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12232834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144583067","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":"Comparison and prognostic analysis of focal segmental glomerulosclerosis patients with or without nephrotic syndrome at onset.","authors":"Liangliang Chen, Yanhong Ma, Xiaohan Huang, Junni Wang, Xiaoli Lin, Fanghao Cai, Huijing Wang, Huanhuan Zhu, Lan Lan, Pingping Ren, Jianghua Chen, Fei Han","doi":"10.1186/s12882-025-04292-z","DOIUrl":"10.1186/s12882-025-04292-z","url":null,"abstract":"<p><strong>Background: </strong>Focal segmental glomerulosclerosis (FSGS) constituted one of the most common causes of end-stage kidney disease. We aimed to compare the presentation and prognosis for FSGS patients based on whether they met the criteria of nephrotic syndrome (NS) at disease onset.</p><p><strong>Methods: </strong>Retrospective analysis of 291 treatment-naïve adult FSGS patients managed per clinical guidelines. Patients were categorized into non-NS-FSGS (n = 158) and NS-FSGS (n = 133) groups based on NS criteria. Immunosuppressants were administered based on KDIGO 2021 Guideline and disease progression. Kidney outcomes were analyzed in 144 patients followed up for more than 1 year.</p><p><strong>Results: </strong>A total of 291 FSGS patients were included, with 158 patients in the non-NS-FSGS group and 133 patients in NS-FSGS group. Patients in the non-NS-FSGS group exhibited higher prevalences of hypertension, along with higher body mass index, hemoglobin level, eGFR, serum albumin and immunoglobulin levels, and more severe chronic pathological changes compared to those in NS-FSGS group. Among patients followed up for more than 1 year, the annual eGFR decline rate (ADR) was 5.0 (2.4, 10.1) % in the non-NS-FSGS group and 2.1 (0.6, 6.1) % in NS-FSGS group (P = 0.922); ADR > 5% was more common in non-NS-FSGS patients than in NS-FSGS patients (49.3% vs. 29.0%, P = 0.017), especially than treatment-responsive patients in the NS-FSGS group (49.3% vs. 17.2%, P < 0.001). For the non-NS-FSGS group, multivariate Cox regression revealed that persistent urinary protein-creatinine ratio (uPCR) ≥ 0.5 during follow-up (HR 2.455, 95% CI 1.105-5.454, P = 0.027) was an independent risk factor for ADR > 5%.</p><p><strong>Conclusions: </strong>FSGS patients without NS at onset experienced a faster decline in kidney function compared to those with NS, particularly those with treatment-responsive NS.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"353"},"PeriodicalIF":2.2,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12228351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567085","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}