BMC Nephrology最新文献

{"title":"Case report of glomerular histiocytosis associated with non-crystalline IgG-kappa paraproteinemia.","authors":"Aditya Kishore, Susanna A McRae, David Telio, Monica C Beaulieu","doi":"10.1186/s12882-025-03986-8","DOIUrl":"10.1186/s12882-025-03986-8","url":null,"abstract":"<p><strong>Background: </strong>Monoclonal gammopathy of renal significance (MGRS) represents a range of disease processes arising from monoclonal proteins depositing in the kidney. These deposits vary and can be broadly grouped as containing a substructure or being non-organised. Their clinical phenotype can include proteinuria, haematuria, kidney injury and tubulopathies resulting in electrolyte changes.</p><p><strong>Case presentation: </strong>Crystal storing histiocytosis (CSH) is a rare form of MGRS that typically deposits in the interstitium but rarely in the glomerulus to cause progressive kidney disease. We report a case of a male with known monoclonal protein and progressive proteinuria, whose biopsy showed glomerular histiocytosis with non-crystallizing IgG kappa inclusions.</p><p><strong>Conclusion: </strong>This case reviews an unusual case of a glomerular histiocytosis with non-crystallizing IgG kappa inclusions.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"56"},"PeriodicalIF":2.2,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11796192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143254994","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":"Associations between depressive and anxiety symptoms and incident kidney failure in patients with diabetic nephropathy.","authors":"Chunmei Qin, Yucheng Wu, Yutong Zou, Yuancheng Zhao, Deying Kang, Fang Liu","doi":"10.1186/s12882-025-03983-x","DOIUrl":"10.1186/s12882-025-03983-x","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to analyze the associations between depressive and anxiety symptoms and risk of incident kidney failure in patients with biopsy-proven diabetic nephropathy (DN).</p><p><strong>Methods: </strong>This retrospective study enrolled 241 type 2 diabetic patients with biopsy-proven DN. Huaxi Emotional-Distress Index (HEI) was used to evaluate the depression and anxiety status of patients on admission. According to the HEI score, DN patients were divided into HEI score ≤ 8 group (without depression and anxiety) and HEI score > 8 group (with depression and anxiety). The study endpoint was defined as progression to kidney failure. The cox proportional hazard analysis was performed to investigate the risk factors for progression to kidney failure in DN patients.</p><p><strong>Results: </strong>Twenty-three patients had HEI score > 8, accounting for about 9.5% of all patients. Compared with HEI score ≤ 8 group, those with HEI score > 8 had more severe proteinuria, higher systolic blood pressure, and lower baseline eGFR and serum albumin levels. During a median follow-up of 28 months, the outcome event occurred in 89 (36.9%) of all the patients. After multivariable adjustment, HEI score > 8 (HR 1.825, 95% CI 1.050-3.172) was associated with an increased risk of progression to kidney failure.</p><p><strong>Conclusion: </strong>Depressive and anxiety symptoms might be associated with an increased risk of progression to kidney failure in patients with DN, which implied psychosocial issues should be early screened, assessed and intervened to delay the progression of DN.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"54"},"PeriodicalIF":2.2,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11796097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188218","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":"Dose-response relationship between lipids and all-cause mortality in the dialysis population: a meta-analysis.","authors":"Ye Yao, Jing Xiong, Mi-Yuan Wang","doi":"10.1186/s12882-025-03981-z","DOIUrl":"10.1186/s12882-025-03981-z","url":null,"abstract":"<p><strong>Background: </strong>The use of lipid-lowering drugs in the dialysis population has been controversial and there is no target for the dialysis population.</p><p><strong>Objectives: </strong>To elucidate the dose-response relationship between lipids and all-cause mortality in the dialysis population.</p><p><strong>Methods: </strong>Computer searches of PubMed, Embase, Web of Science, CNKI, and Wanfang. Data were conducted to collect published cohort studies on lipids and all-cause mortality in the dialysis population from home and abroad up to February 2023. Meta-analysis was applied to calculate the combined effect size (Hazard ratio) and its 95% confidence interval and dose-response relationship by applying Stata17.0.</p><p><strong>Results: </strong>A total of 11 publications with a cumulative total of 106,808 individuals were included. All-cause mortality was statistically different between the highest dose total cholesterol (TC) group and the low TC group (HR = 0.82, 95% CI = 0.75-0.90, P < 0.05). The TC range for lower all-cause mortality is > 140.5 mg/dL, and on this basis, TC in the range of 180-220 mg/dL may have a better prognosis for dialysis population. There was a nonlinear relationship between Non-high-density lipoprotein cholesterol (NHDL-C) cholesterol and all-cause mortality, with no statistical difference between the high and low dose group. In contrast, Low-density lipoprotein cholesterol (LDL-C) masked its association with all-cause mortality due to changes in death spectrum, differences in relative time risks, and other factors. In the 50-450 mg/dL range, all-cause mortality in the dialysis population was positively associated with triglycerides (TG), with a 2.5% increase in all-cause mortality per 50 mg/dL increase in TG (HR = 1.025, 95% CI = 1.003-1.048, P = 0.01).</p><p><strong>Conclusion: </strong>TC is a target for monitoring the dialysis population, which has the lowest all-cause mortality in the range of 180-220 mg/dL. However, NHDL-C and LDL-C monitoring is not clinically meaningful. Increased TG can contribute to the risk of higher all-cause mortality in dialysis patients.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"55"},"PeriodicalIF":2.2,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11796159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188219","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":"Successful management of catheter injury or refractory infection by partial replantation of peritoneal dialysis catheters: a retrospective observational study.","authors":"Seyoung Ryou, Eun Jeong Ko, Hoon Suk Park, Byung Ha Chung, Cheol Whee Park, Chul Woo Yang, Yong-Soo Kim, Hyung Duk Kim, Yaeni Kim","doi":"10.1186/s12882-024-03847-w","DOIUrl":"10.1186/s12882-024-03847-w","url":null,"abstract":"<p><strong>Background: </strong>The revised 2023 guidelines from the International Society for Peritoneal Dialysis (ISPD) emphasize salvage methods for treating refractory catheter-related infections, or mechanical catheter damage. This approach preserves the existing catheter by manipulating only the outer cuff above the peritoneum, avoiding hemodialysis transfer. We investigated the effectiveness of the partial replantation technique.</p><p><strong>Methods: </strong>In this retrospective single-center study (January 2021 - December 2023), outcomes for nine patients undergoing salvage methods were compared with 58 patients receiving de novo catheter insertion. We assessed exit-site infection (ESI), tunnel infection (TI), peritonitis, and catheter dysfunction. The salvage method entailed distal cutting of the impaired catheter and attaching a new segment using a connector with a PD adaptor and transfer set.</p><p><strong>Results: </strong>Nine patients (four males, mean age 56 years, average PD duration 66 months) employed the salvage method. Post-procedure, one patient (11.1%) reported ESI, one (11.1%) experienced TI, three (33.3%) developed peritonitis, and two (22.2%) required catheter removal. No procedural complications or catheter dysfunctions were observed. In the control group, ESI occurred in six patients (10.3%), TI in one (1.7%), peritonitis in 11 (19.0%), catheter removal in seven (12.1%), and catheter dysfunction in one (1.7%). Kaplan-Meier analysis showed no statistical difference between the groups: ESI (p = 0.306), TI (p = 0.094), peritonitis (p = 0.838), catheter dysfunction (p = 0.694), and catheter removal (p = 0.393).</p><p><strong>Conclusions: </strong>This study supports the non-inferiority and effectiveness of the salvage method compared to de novo insertion in managing ESI or TI and mechanical catheter damage.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"52"},"PeriodicalIF":2.2,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11792682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122254","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":"Recurrent secondary hyperparathyroidism due to a gradually increasing intrathyroidal parathyroid adenoma in a fifth parathyroid gland of a patient undergoing long-term haemodialysis: Road to evil.","authors":"Jun Yang, Ninghu Liu, Jili Wang, Xinhui Su","doi":"10.1186/s12882-024-03878-3","DOIUrl":"10.1186/s12882-024-03878-3","url":null,"abstract":"<p><strong>Background: </strong>An intrathyroidal parathyroid adenoma (IPA) is a very rare cause of recurrent hyperparathyroidism after parathyroidectomy in patients undergoing long-term haemodialysis. An IPA is often difficult to localize preoperatively, making diagnosis and treatment challenging. We herein report a rare case of recurrent hyperparathyroidism due to a gradually increasing IPA in a fifth parathyroid gland.</p><p><strong>Case presentation: </strong>A 24-year-old Chinese woman had end-stage renal disease secondary to chronic glomerulonephritis and started regular haemodialysis in March 2007. She was diagnosed with renal hyperparathyroidism as indicated by elevated parathyroid hormone and calcium levels in 2011. One year later, the parathyroidectomy with right forearm autotransplantation was performed in January 2012. Pathology revealed parathyroid nodular hyperplasia in four of the nodules. Twelve years after surgery, the nodule in the right thyroid was detected by multiple imaging modalities. In addition to the recurrence of renal hyperparathyroidism, the nodule gradually increased in size. Total right thyroid lobectomy was performed, and the patient was diagnosed with an IPA. At the 3-month follow-up examination, she had no signs of recurrence despite regular haemodialysis, and her PTH and serum calcium levels were stable.</p><p><strong>Conclusions: </strong>This is a rare case of recurrent hyperparathyroidism due to a gradually increasing fifth parathyroid gland in a patient who underwent long-term haemodialysis after parathyroidectomy. We suggest vigilant postoperative monitoring for prompt and early identification of culprit parathyroid lesions, even if the four parathyroid glands have been dissected.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"53"},"PeriodicalIF":2.2,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11792684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122251","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":"Enhancing diagnostic outcomes in kidney genetic disorders: the KidGen national kidney genomics study protocol.","authors":"Amali Mallawaarachchi, Hugh McCarthy, Thomas A Forbes, Kushani Jayasinghe, Chirag Patel, Stephen I Alexander, Tiffany Boughtwood, Jeffrey Braithwaite, Aron Chakera, Sam Crafter, Ira W Deveson, Randall Faull, Trudie Harris, Lilian Johnstone, Matthew Jose, Anna Leaver, Melissa H Little, Daniel MacArthur, Tessa Mattiske, Christine Mincham, Kathy Nicholls, Catherine Quinlan, Michael C J Quinn, Gopala Rangan, Jessica Ryan, Cas Simons, Ian Smyth, Madhivanan Sundaram, Peter Trnka, Laura Wedd, Erik Biros, Zornitza Stark, Andrew Mallett","doi":"10.1186/s12882-024-03926-y","DOIUrl":"10.1186/s12882-024-03926-y","url":null,"abstract":"<p><strong>Background: </strong>Genetic kidney disease (GKD) significantly affects the community and is responsible for a notable portion of adult kidney disease cases and about half of cases in paediatric patients. It substantially impacts the quality of life and life expectancy for affected children and adults across all stages of kidney disease. Precise genetic diagnosis in GKD promises to improve patient outcomes, provide access to targeted treatments, and reduce the disease burden for individuals, families, and healthcare systems. Genetic investigations are increasingly used in nephrology practice; however, many patients who undergo testing still lack a definitive diagnosis.</p><p><strong>Methods: </strong>The KidGen National Kidney Genomics Study aims to increase diagnostic yield for those with suspected monogenic kidney disease without a diagnosis after standard diagnostic genetic testing. The program will seek to enrol up to 200 families from KidGen Collaborative kidney genetics clinics across Australia who have yet to receive conclusive diagnoses despite prior testing. Participants will undergo a personalised pathway of research genomic investigations. These include re-analysing existing data and/or undergoing advanced genomic testing methods, including short and long-read whole-genome sequencing, RNA sequencing, and functional genomics strategies using mouse modelling or kidney organoids.</p><p><strong>Discussion: </strong>The KidGen National Kidney Genomics Study is a coordinated, multidisciplinary extension of previous research projects that aims to assess the diagnostic yield of advanced genomic approaches. The study's evidence will drive changes to current diagnostic pathways, including identifying which chronic kidney disease patients are most likely to benefit from a more comprehensive genomic approach to diagnosis.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"51"},"PeriodicalIF":2.2,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11792728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122248","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 two-person collaborative repositioning approach for high peritoneal dialysis catheter migration: case reports and literature review.","authors":"F Zhuangyan Yao, S Yanqing Li, T Liping Zhai","doi":"10.1186/s12882-025-03975-x","DOIUrl":"10.1186/s12882-025-03975-x","url":null,"abstract":"<p><strong>Background: </strong>Peritoneal dialysis catheter migration, a common complication in patients undergoing peritoneal dialysis, often leads to poor dialysate drainage, infection, and abdominal pain. Timely and effective treatment of catheter migration is essential to ensure uninterrupted dialysis.</p><p><strong>Case presentation: </strong>This study presents three cases of peritoneal dialysis (PD) catheter displacement in patients with end-stage renal disease (ESRD), involving three elderly individuals aged 80, 81, and 76 years. All instances of catheter displacement were primarily localized to the upper abdominal region. Following unsuccessful attempts with traditional repositioning methods (such as positional adjustments, ambulation, and saline infusion), a two-person collaborative repositioning technique was employed, combining external manual pressure with rapid saline injection. Consequently, all catheters were successfully repositioned to the pelvic area and remained stable throughout the follow-up period.</p><p><strong>Conclusions: </strong>This re-port preliminarily demonstrated the feasibility and effectiveness of two-person collaborative repositioning approach in elderly patients with PD catheter displacement. Although the results have potential application value, further studies are needed to verify their generality and long-term efficacy in larger samples.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"50"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143073827","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":"Exploration of rituximab treatment strategies for membranous nephropathy adapted to the Chinese healthcare environment.","authors":"Xiaolong Wang, Xueying Cao, Jie Wu, Shuang Liang, Jian Yang, Hong Wang","doi":"10.1186/s12882-025-03980-0","DOIUrl":"10.1186/s12882-025-03980-0","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;This study aimed to explore the specific efficacy of rituximab (RTX) in the treatment of membranous nephropathy (MN) and compare and analyze the differences in effectiveness among various treatment regimens, with the objective of identifying the optimal treatment protocol suitable for the medical environment in China.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Patients and methods: &lt;/strong&gt;This retrospective study focused on patients with MN who were treated with RTX and hospitalized at the First Medical Center of PLA General Hospital between January 1, 2019, and December 30, 2022. These patients were followed up for more than one year. We collected clinical data from these patients and categorized them into three groups on the basis of their RTX treatment background: the combined glucocorticoids (GCs) and/or immunosuppressants (IMS) and RTX monotherapy treatment groups, the initial and non-initial treatment groups, and the standard RTX and non-standard RTX treatment groups. The study evaluated the comprehensive outcomes of complete or partial remission during follow-up, as well as relapses after remission. Additionally, Cox regression analysis was conducted to identify risk factors influencing patient remission and relapse.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 126 patients were enrolled in this study, with an average age of 49.0 ± 13.4 years. Among them, males accounted for up to 77.8%, with an average BMI of 26.7 ± 4.0. Among these patients, 59.5% (75/126) received RTX combined with GCs and/or IMS. Statistical results revealed that the combined use of GCs and/or the IMS had no significant effect on renal remission (P = 0.439), but it accelerated the process of renal remission (P = 0.010). A total of 34.9% (42/126) of patients chose RTX as the initial treatment. Compared with the non-initial treatment group, this choice did not significantly differ in terms of efficacy or faster remission speed (all P &gt; 0.05). On the other hand, 39.7% (50/126) of patients received the standard RTX treatment regimen. Compared with the non-standard group, the standard RTX treatment group presented a better remission rate (P &lt; 0.001) and a faster remission speed (P = 0.027). During 13.0 (12.0, 20.0) months of follow-up, the cumulative remission rate reached 73% (92/126), including 47.6% (60/126) of patients with partial remission (PR) and 25.4% (32/126) of patients with complete remission (CR). The cumulative relapse rate was 20.7% (26/126). In addition, 17.5% (22/126) of patients experienced adverse reactions. Multivariate Cox regression analysis revealed that the standard RTX treatment regimen was associated with a better remission rate, whereas comorbid diabetes reduced the remission rate. Older age and higher white blood cell counts may lead to a higher relapse rate.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This study revealed that RTX treatment has a high remission rate and a low relapse rate in MN patients. The standard RTX treatment regimen can provide bett","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"49"},"PeriodicalIF":2.2,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143073828","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 prevalence and its risk factors in uremic patients undergoing maintenance hemodialysis.","authors":"Meng Zhang, Gaoqiankun Huang, Xiaorong Bao, Qingmei Yang","doi":"10.1186/s12882-025-03978-8","DOIUrl":"10.1186/s12882-025-03978-8","url":null,"abstract":"<p><strong>Background: </strong>To explore the prevalence of hyperuricemia and its associated factors in uremic patients undergoing maintenance hemodialysis (MHD).</p><p><strong>Methods: </strong>Two hundred two uremic patients undergoing MHD for ≥ 3 months, in Jinshan Hospital, Fudan University, were enrolled. Pre-dialysis blood samples were tested during March 1st, 2023 to April 30th, 2023. Demographic characteristics were recorded. The prevalence of hyperuricemia, defined as serum uric acid (SUA) ≥ 420 μmol/L, was investigated. Individuals were divided into hyperuricemia (HUA) and non-hyperuricemia (n-HUA) groups. The demographic characteristics, residual kidney function, nutritional status, acid-base metabolism, electrolyte and lipid metabolism were compared between groups. The associated factors for hyperuricemia in MHD patients were identified by logistic regression.</p><p><strong>Results: </strong>The median SUA level of the enrolled patients was 458.50 (392.25, 510.75) μmol/L. 134 (66.34%) candidates met the diagnostic criteria of hyperuricemia. The median SUA level in HUA group was 491.00 (459.50, 543.50) μmol/L. Compared to those in n-HUA group, subjects in HUA group showed lower estimated glomerular filtration rate and blood CO₂ level, but higher levels of body mass index, geriatric nutritional risk index, plasma phosphate, potassium, pre-albumin, albumin, serum creatinine (Scr) and urea nitrogen. Logistic regression indicated that Scr (OR 1.002, 95% CI 1.001-1.004, P = 0.003), albumin (OR 1.165, 95%CI 1.011-1.342, P = 0.035), and blood potassium (OR 1.673, 95% CI 1.009-2.773, P = 0.046) were associated factors for hyperuricemia in uremic patients undergoing MHD.</p><p><strong>Conclusion: </strong>Hyperuricemia was highly prevalent among uremic MHD patients. Elevated levels of Scr, albumin and plasma potassium were independent associated factors for hyperuricemia.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"46"},"PeriodicalIF":2.2,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11780984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063583","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":"Ursodeoxycholic acid protects against sepsis-induced acute kidney injury by activating Nrf2/HO-1 and inhibiting NF-κB pathway.","authors":"Yunpeng Lou, Hongguang Shi, Ning Sha, Feifei Li, Xiaofeng Gu, Huiyan Lin","doi":"10.1186/s12882-025-03977-9","DOIUrl":"10.1186/s12882-025-03977-9","url":null,"abstract":"<p><strong>Background: </strong>Ursodeoxycholic acid (UDCA), traditionally recognized for its hepatoprotective effects, has also shown potential in protecting kidney injury. This study aimed to evaluate the protective effects of UDCA against sepsis-induced acute kidney injury (AKI) and to elucidate the underlying mechanisms.</p><p><strong>Methods: </strong>Sixty male C57BL/6 N mice were utilized to establish a sepsis-induced AKI model through intravenous injection of lipopolysaccharides (LPS, 10 mg/kg). UDCA (15, 30, and 60 mg/kg) was administered intraperitoneally once daily for 7 days before LPS injection. Kidney injury was evaluated by HE staining and biochemical markers, including serum creatinine (Cr), blood urea nitrogen (BUN), urinary protein, neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), N-acetyl-β-D-glucosaminidase (NAG), and retinol binding protein (RBP). Oxidative stress parameters and nuclear factor erythroid 2-related factor 2 (Nrf2)/ heme oxygenase-1 (HO-1) pathway, pro-inflammatory cytokines and nuclear factor-kappa B (NF-κB) pathway were also evaluated. Additionally, HK-2 cells were treated with LPS in vitro, and cell viability and apoptosis were detected using CCK-8 kit and flow cytometer, respectively.</p><p><strong>Results: </strong>UDCA significantly attenuated LPS-induced renal histopathological damage and improved renal function, as evidenced by reduction in serum Cr, BUN, and urinary protein levels. UDCA also up-regulated the protein expression of zonula occludens-1 (ZO-1) and Ezrin in the kidney, and reduced the urinary levels of NGAL, KIM-1, NAG, and RBP. Moreover, UDCA inhibited NF-κB p65 phosphorylation and reduced pro-inflammatory cytokines levels (TNF-α, IL-1β, and IL-6) in both serum and kidney. UDCA alleviated oxidative stress by activating the Nrf2/HO-1 pathway in the kidney. In vitro, UDCA reduced LPS-induced cell injury and apoptosis in HK-2 cells, with these protective effects being blocked by the Nrf2 inhibitor ML385.</p><p><strong>Conclusions: </strong>Our present study demonstrated that UDCA exerts protective effects against sepsis-induced AKI by attenuating oxidative stress and inflammation, primarily through the activation of the Nrf2/HO-1 pathway and inhibition of the NF-κB pathway. These findings highlight the therapeutic potential of UDCA in preventing sepsis-induced AKI.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"45"},"PeriodicalIF":2.2,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11780800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063632","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}