World journal of nephrology最新文献

{"title":"Diagnostic challenges and treatment approaches for hydatid cysts in atypical localizations.","authors":"Konstantin Semash, Mikhail Voskanov","doi":"10.5527/wjn.v14.i3.107955","DOIUrl":"10.5527/wjn.v14.i3.107955","url":null,"abstract":"<p><p>Hydatid disease, caused by the Echinococcus granulosus parasite, is traditionally associated with liver and lung involvement. However, recent years have seen an increase in cases with atypical localizations, such as the kidneys, thyroid, soft tissues, and bones. The study by Celik <i>et al</i> presents a series of five clinical cases where hydatid cysts were found in these rare anatomical regions, challenging conventional diagnostic and therapeutic approaches. The paper emphasizes the importance of differential diagnosis, as these cases can mimic other conditions, such as cancer, abscesses, or cysts. Advanced imaging techniques, such as computed tomography, magnetic resonance imaging, and ultrasound, play a crucial role in accurate diagnosis and help avoid misdiagnosis. The study demonstrates that early diagnosis and appropriate treatment of echinococosis in atypical localizations are critical for preventing complications like cyst rupture and secondary infections. The use of albendazole and surgical intervention, especially in combination with modern imaging techniques, yields good outcomes in these patients. However, several unanswered questions remain: What are the precise criteria for selecting the optimal treatment method in each case? What is the long-term effectiveness of different approaches? Do patients with hydatid cysts in atypical locations require additional monitoring and preventive treatment to avoid recurrence? Addressing these questions requires further research, and a multidisciplinary approach involving radiologists, surgeons, and infectious disease specialists is essential to optimize diagnosis and treatment. Early and accurate diagnostic methods based on differential diagnosis play a key role in improving treatment outcomes and reducing morbidity.</p>","PeriodicalId":94272,"journal":{"name":"World journal of nephrology","volume":"14 3","pages":"107955"},"PeriodicalIF":0.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modified National Early Warning Score 2, warning system for predicting treatment outcomes in patients with emphysematous pyelonephritis.","authors":"Mohammad S Al-Haggar, Zahraa A Abdelmoneim","doi":"10.5527/wjn.v14.i3.107879","DOIUrl":"10.5527/wjn.v14.i3.107879","url":null,"abstract":"<p><p>Emphysematous pyelonephritis (EPN) is a severe, a lethal necrotizing upper urinary tract infection, characterized by gas production within the renal parenchyma, collecting system, or perinephric tissue. EPN is emerging as a significant concern, necessitating early diagnosis, severity assessment, and timely intervention to improve outcomes. This study proposes a modified National Early Warning Score 2 (mNEWS 2) to enhance risk stratification and predictive accuracy in EPN management. The mNEWS 2 refines the original NEWS 2 system, which aggregates 6 physiological indicators (body temperature, systolic blood pressure, pulse rate, oxygen saturation, breathing rate, and degree of consciousness), by incorporating weighted risk stratification indices and specific cutoff values derived from clinical observations, statistical modeling, and predictive performance analysis. A pilot study identified optimal thresholds, with a score of 15 maximizing predictive performance for mortality risk and intervention needs, validated through receiver operating characteristic curve analysis. So, the mNEWS 2 score represents a significant advancement in EPN management, offering improved risk stratification and treatment outcomes.</p>","PeriodicalId":94272,"journal":{"name":"World journal of nephrology","volume":"14 3","pages":"107879"},"PeriodicalIF":0.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adipose-derived mesenchymal stromal cell secretome protects against kidney injury through induction of heme oxygenase 1 upregulation <i>in vitro</i>.","authors":"Hanan Jafar, Nidaa A Ababneh, Dana Alhattab, Renata M Alatoom, Suzan Zalloum, Bareqa Salah, Hussein Alhawari, Abdalla Awidi","doi":"10.5527/wjn.v14.i3.108534","DOIUrl":"10.5527/wjn.v14.i3.108534","url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury is characterized by a sudden decline in renal function, often due to ischemia or nephrotoxins, leading to increased oxidative stress and inflammation.</p><p><strong>Aim: </strong>To investigate the protective effects of adipose-derived mesenchymal stromal cell (ADMSC) secretome on renal tubular epithelial cells (NRK-52E) as an <i>in vitro</i> model of oxidative stress-associated kidney injury.</p><p><strong>Methods: </strong>ADMSCs were isolated from human adipose tissue and characterized for mesenchymal markers and differentiation potential. Conditioned media (CM) was collected after 48-hour serum-free culture and applied to serum-deprived NRK-52E cells for 48 hours. Cell viability was assessed using the MTT assay, apoptosis was assessed by Annexin V-FITC/PI staining and flow cytometry, reactive oxygen species (ROS) levels <i>via</i> H2DCFDA staining, and mitochondrial membrane potential by the tetramethylrhodamine ethyl ester assay. The expression of heme oxygenase-1 (HO-1), nuclear factor erythroid 2-related factor 2 (Nrf2), and NAD(P)H quinone dehydrogenase 1 (Nqo1) genes was quantified by quantitative polymerase chain reaction. Comparative transcriptomic analysis was performed on ADMSCs and bone marrow-derived MSCs (BM-MSCs) using publicly available microarray data (GSE108511).</p><p><strong>Results: </strong>ADMSC secretome significantly reduced ROS production and enhanced mitochondrial membrane potential in NRK cells. Gene expression analysis revealed a significant upregulation of HO-1 mRNA levels in ADMSC-CM treated cells. However, no significant changes were observed in Nrf2 and Nqo1 mRNA levels. Transcriptome analysis of ADMSCs against BM-MSCs revealed significant differences in the expression of genes related to oxidative stress response, antioxidant activity, and mitochondrial function.</p><p><strong>Conclusion: </strong>The results of this study suggest that the ADMSC secretome exerts multifaceted protective effects on NRK cells by reducing oxidative stress and enhancing mitochondrial function. The study demonstrates the potential beneficial applications of the ADMSC secretome in treating oxidative stress-related kidney injuries.</p>","PeriodicalId":94272,"journal":{"name":"World journal of nephrology","volume":"14 3","pages":"108534"},"PeriodicalIF":0.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Avacopan in the treatment of relapsing polychondritis with myeloperoxidase-antineutrophil cytoplasmic antibody associated vasculitis: A case report.","authors":"Jack Tang Nguyen, Manish Anand","doi":"10.5527/wjn.v14.i3.109400","DOIUrl":"10.5527/wjn.v14.i3.109400","url":null,"abstract":"<p><strong>Background: </strong>This case report describes myeloperoxidase-anti-neutrophil cytoplasmic antibody associated vasculitis with kidney involvement in a patient with relapsing polychondritis, which was successfully treated with Avacopan. Although relapsing polychondritis has been associated with anti-neutrophil cytoplasmic antibody-associated vasculitis, overlap can result in severe organ involvement, particularly renal damage progressing to end-stage kidney disease. This case presents a unique opportunity to evaluate the potential role of Avacopan as an alternative therapeutic option in managing myeloperoxidase-anti-neutrophil cytoplasmic antibody-associated vasculitis in the context of relapsing polychondritis highlighting a positive renal response despite treatment challenges.</p><p><strong>Case summary: </strong>This is a case of a 69-year-old Caucasian woman who presented to our hospital's emergency department with a 4 week history of inflammatory polychondritis affecting the auricular cartilage, accompanied by acute kidney injury. On admission, serum creatinine was elevated at 4.0 mg/dL, which progressively increased to 6.07 mg/dL on day 6. The renal biopsy revealed necrotizing and crescentic glomerulonephritis affecting more than 50% of the glomeruli. She was treated with a total of 2500 mg intravenous methylprednisolone over 3 days followed by oral prednisone. Induction treatment included intravenous cyclophosphamide induction, with plans for a total of 2 doses followed by transition to rituximab. However the patient was unable to tolerate rituximab due to allergic reaction so intravenous cyclophosphamide was continued for a total of 6 doses (cumulative dose 3000 mg). In the setting of persistent acute kidney injury, Avacopan was added to the regimen 3 months after diagnosis. Maintenance therapy included azathioprine in addition to Avacopan. Prednisone gradually tapered off at 6 months.</p><p><strong>Conclusion: </strong>Avacopan may be beneficial in treating anti-neutrophil cytoplasmic antibody-associated vasculitis with coexisting relapsing polychondritis, especially in cases where preservation of kidney function is critical. Further research will be essential to validate these findings and refine treatment protocols for such complex cases.</p>","PeriodicalId":94272,"journal":{"name":"World journal of nephrology","volume":"14 3","pages":"109400"},"PeriodicalIF":0.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unmasking the silent epidemic: Mortality trends in diabetic nephropathy.","authors":"Mauricio Alvarez","doi":"10.5527/wjn.v14.i3.108099","DOIUrl":"10.5527/wjn.v14.i3.108099","url":null,"abstract":"<p><p>Diabetes mellitus is a major contributor to kidney failure, with diabetic nephropathy being a common microvascular complication. The increasing prevalence of diabetes and its complications suggests a rise in associated morbidity and mortality. Recent studies highlight increased mortality related to diabetic kidney disease, with disparities across demographic and geographic groups. Novel pharmacological treatments, including sodium-glucose cotransporter 2 inhibitors, non-steroidal mineralocorticoid receptor antagonists, and glucagon-like peptide-1 agonists, offer promise in slowing disease progression and reducing renal mortality. However, the growing epidemics of obesity and diabetes necessitate prioritizing public health policies focused on primary and secondary prevention, along with comprehensive multidisciplinary care.</p>","PeriodicalId":94272,"journal":{"name":"World journal of nephrology","volume":"14 3","pages":"108099"},"PeriodicalIF":0.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476721/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Saliva as a non-invasive biomarker for chronic kidney disease: Challenges and potential in disease monitoring.","authors":"Mohammad Abu Raihan Uddin, Tuan Salwani Tuan Ismail, Wan Nor Fazila Hafizan Wan Nik, Wan Nor Arifin, Salbiah Isa","doi":"10.5527/wjn.v14.i3.108406","DOIUrl":"10.5527/wjn.v14.i3.108406","url":null,"abstract":"<p><p>Chronic kidney disease (CKD) is a degenerative disorder that affects millions of people throughout the world, causing considerable morbidity and healthcare burden. Frequent blood sampling is the current gold standard for monitoring CKD to evaluate biochemical and mineral indicators. However, there are drawbacks to frequent blood draws, such as pain for patients, the possibility of infection, and higher medical expenses. Saliva-based diagnostics offer advantages such as ease of collection, reduced invasiveness, and improved patient compliance. A comprehensive literature review was conducted to analyze studies evaluating the diagnostic utility of salivary creatinine, urea, calcium, and parathyroid hormone (PTH) in patients with CKD. Various saliva collection methods, including stimulated and unstimulated approaches, were investigated for efficiency and reliability, and a correlation was shown between serum and salivary creatinine, urea, PTH, and calcium levels, indicating their potential as CKD biomarkers. Despite these promising findings, challenges such as standardization of collection methods, variability in salivary flow rates, and predictive value in association with blood parameters are addressed to ensure clinical applicability. This review explores the potential and challenges of saliva as a non-invasive alternative for CKD diagnostics.</p>","PeriodicalId":94272,"journal":{"name":"World journal of nephrology","volume":"14 3","pages":"108406"},"PeriodicalIF":0.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complex role of insurance in living donor kidney transplantation: Perspectives from the affordable care act era.","authors":"Guido Gembillo, Giuseppe Lanfranchi, Domenico Santoro","doi":"10.5527/wjn.v14.i3.105768","DOIUrl":"10.5527/wjn.v14.i3.105768","url":null,"abstract":"<p><p>The landscape of organ transplantation in the United States reflects a complex and multifaceted reality. According to the latest OPTN/UNOS statistics on kidney transplants, 20446 deceased organ donors contributed to these life-saving procedures, alongside 5798 living donor kidney transplants (LDKT). Despite these advancements, the transplant waiting list remains alarmingly long, with approximately 140165 individuals still awaiting a kidney. In addition, there are still inequalities in access to LDKT. As of December 31, 2022, Black adults accounted for 31.7% of the transplant waiting list, yet only 12.8% of LDKT recipients, compared to 34.1% of deceased donor kidney transplant (DDKT) recipients that year. Conversely, White patients represented 35.5% of those on the list, but comprised 61.4% of LDKT recipients and 35.3% of DDKT recipients. A majority of adult LDKT recipients (54.5%) had private insurance at the time of transplantation, compared to 26.9% of DDKT recipients. In addition, 62.5% of patients with a kidney transplant from a deceased donor were covered by Medicare, in contrast to 37.6% of living donor kidney transplant recipients. In 2022, 33.3% of adult living donor kidney transplant recipients were transplanted without prior dialysis, compared to 12.1% of deceased donor kidney transplant recipients. These data highlight the critical need to dismantle barriers to transplantation, particularly those rooted in insurance coverage and socioeconomic disparities.</p>","PeriodicalId":94272,"journal":{"name":"World journal of nephrology","volume":"14 3","pages":"105768"},"PeriodicalIF":0.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardamom extract: An effective weapon in prevention of cardiorenal syndrome induced in rats by cisplatin and high-fat diet.","authors":"Doha Mohamed, Ibrahim Hamed, Hoda B Mabrok","doi":"10.5527/wjn.v14.i3.107736","DOIUrl":"10.5527/wjn.v14.i3.107736","url":null,"abstract":"<p><strong>Background: </strong>Overnutrition and unhealthy dietary habits are established risk factors for cardiovascular and renal diseases, which may lead to the development of cardiorenal syndrome (CRS).</p><p><strong>Aim: </strong>To evaluate the cardiorenal protective potential of crude ethanol extract (CEE) of green cardamom (<i>Elettaria cardamomum</i> L., Family Zingiberaceae).</p><p><strong>Methods: </strong>Rats were fed a high-fat diet to induce dyslipidemia and subsequently administered cisplatin (7.5 mg/kg) to induce CRS. CEE was administered orally to CRS rats at low (100 mg/kg) and high (200 mg/kg) doses for one month. Oxidative stress, inflammatory markers, cardiovascular disease markers, cardiac indices, and renal function (in plasma and urine) were assessed. The antioxidant activity and phenolic compound profile of CEE were evaluated. Additionally, the potential interactions of CEE phenolics with components of the Hippo signaling pathway (mammalian sterile 20-like kinase 1, large tumor suppressor kinase 1, Yes-associated protein, and transcriptional coactivator with PDZ-binding motif) were investigated using molecular docking.</p><p><strong>Results: </strong>Cisplatin administration combined with a high-fat diet effectively induced CRS, as evidenced by elevated oxidative stress, inflammation, and impaired cardiorenal parameters. Treatment with CEE at both doses improved these parameters, with the high dose demonstrating greater efficacy. CEE exhibited significant DPPH radical scavenging activity. Rosmarinic acid and gallic acid were identified as the major phenolic constituents. Molecular docking revealed strong binding affinities of rosmarinic acid and rutin with targets in the Hippo signaling pathway.</p><p><strong>Conclusion: </strong>These findings demonstrate the cardioprotective and renoprotective potential of CEE as a phenolic-rich dietary supplement. CEE mitigated inflammation and oxidative stress, key contributors to CRS pathogenesis. Furthermore, molecular docking suggests that the phenolic compounds in CEE may exert protective effects by modulating the Hippo signaling pathway. Overall, CEE shows promise as a natural therapeutic agent for the prevention and/or management of cardiorenal syndrome.</p>","PeriodicalId":94272,"journal":{"name":"World journal of nephrology","volume":"14 3","pages":"107736"},"PeriodicalIF":0.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kidney involvement and anemia in COVID-19 infection.","authors":"Guido Gembillo, Luigi Peritore, Giuseppe Spadaro, Felicia Cuzzola, Michela Calderone, Rossella Messina, Simona Di Piazza, Flavia Sudano, Maria Elsa Gambuzza, Maria Princiotto, Luca Soraci, Domenico Santoro","doi":"10.5527/wjn.v14.i3.107582","DOIUrl":"10.5527/wjn.v14.i3.107582","url":null,"abstract":"<p><p>Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is responsible for coronavirus disease 2019 (COVID-19), has infected > 700 million people and led to > 7 million deaths worldwide. Although COVID-19 primarily affects the lungs, it can also affect the kidneys through various pathways. SARS-CoV-2 affects the kidney via several common mechanisms, such as dysregulation of angiotensin-converting enzyme 2, transmembrane serine protease 2 and tissue proteinase L expression in kidney tissue. People with chronic kidney disease (CKD) and COVID-19 have an increased risk of mortality and hospitalization in the intensive care unit. Anemia, a common consequence of CKD, is also associated with worsening outcomes in COVID-19 patients. In these patients with multiple comorbidities, there is a sharp increase in D-dimers, inflammatory parameters, creatinine and blood urea nitrogen. COVID-19 patients also present with resistance to erythropoietin (EPO)-stimulating agents, which necessitates elevated dosages even several months post-infection. In CKD, anemia is exacerbated by decreased EPO production, red blood cell (RBC) fragmentation due to impairment of the renovascular endothelium in situations such as glomerulopathy and malignant hypertension. Other factors include iron and/or folic acid deficiency, bleeding due to platelet dysfunction, inflammation, reduced RBC lifespan, poor iron utilization, uremia, and atypical blood loss after dialysis. Excessive hepcidin synthesis impairs the absorption of dietary iron and the mobilization of iron from endogenous reserves, thus contributing significantly to anemia and poor iron regulation in CKD. These findings suggest that CKD may contribute to the occurrence of anemia in COVID-19 patients, especially in older people with comorbidities. Our review aims to explore the complex relationship between CKD, COVID-19 and anemia to improve our understanding of the underlying mechanisms of the disease and the potential cofactors that worsen outcomes in these patients.</p>","PeriodicalId":94272,"journal":{"name":"World journal of nephrology","volume":"14 3","pages":"107582"},"PeriodicalIF":0.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Automated peritoneal dialysis with shortened break-in periods in urgent-start scenarios: A retrospective cohort study.","authors":"Luis A Bastida-Castro, Jimena Martínez-Cuautle, Maria Juliana Corredor-Nassar, Bruno Eduardo Reyes-Torres, Salma Ivette Alonso-Lobato, Joana Balderas-Juarez, Mauricio A Salinas-Ramirez, Jose L Hernandez-Castillo, Froylan David Martínez-Sánchez","doi":"10.5527/wjn.v14.i3.107177","DOIUrl":"10.5527/wjn.v14.i3.107177","url":null,"abstract":"<p><strong>Background: </strong>End-stage kidney disease is a growing global health burden with many patients requiring urgent kidney replacement therapy. Urgent-start peritoneal dialysis (PD) has emerged as a viable alternative to hemodialysis particularly in resource-limited settings. However, concerns remain regarding catheter-related complications associated with early initiation of PD. Automated PD (APD) offers enhanced flexibility and fluid management, but evidence regarding its safety and outcomes in urgent-start scenarios with shortened break-in periods is limited.</p><p><strong>Aim: </strong>To evaluate the clinical outcomes and biochemical changes associated with urgent-start APD with a shortened break-in period.</p><p><strong>Methods: </strong>This was a single center, observational study that included 62 patients with end-stage kidney disease who required urgent-start dialysis, underwent PD catheter placement, and received APD. Patients were stratified based on catheter opening time (< 12 hours <i>vs</i> > 12 hours). Catheter-related complications, biochemical parameters, and dialysis efficacy were analyzed.</p><p><strong>Results: </strong>The median catheter opening time was 11 h (interquartile range: 8-14 hours). No significant differences in catheter-related complications were observed between groups (<i>P</i> > 0.05). Catheter dysfunction, migration, leakage, and replacement occurred in 14.5%, 9.7%, 12.9%, and 11.3% of patients, respectively. APD led to significant reductions in serum creatinine, blood urea nitrogen, urea, phosphorus, and potassium (<i>P</i> < 0.05), alongside correction of metabolic acidosis. No cases of peritonitis or hemoperitoneum were observed.</p><p><strong>Conclusion: </strong>Urgent-start APD with shortened break-in appears safe with low complication rates and improved biochemical outcomes.</p>","PeriodicalId":94272,"journal":{"name":"World journal of nephrology","volume":"14 3","pages":"107177"},"PeriodicalIF":0.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145194206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}