World journal of nephrology最新文献

{"title":"Depression in chronic kidney disease and dialysis: A psychonephrology narrative review.","authors":"Monika Yadav, Adarsh Kumar, Abhinav Pandey, Swarndeep Singh, Rajesh Kumar, Himanshu Verma, Sanjiv Mahajan, Sourabh Sharma, Pallavi Prasad, Anupam Agarwal","doi":"10.5527/wjn.121696","DOIUrl":"10.5527/wjn.121696","url":null,"abstract":"<p><p>Depression is one of the most prevalent yet under-recognized comorbidities in patients with chronic kidney disease (CKD), particularly among those receiving maintenance dialysis. Its presence adversely affects quality of life, treatment adherence, hospitalization rates, and survival, yet it frequently remains masked by overlapping somatic symptoms of uremia and chronic illness. Psychonephrology, an emerging interdisciplinary field, provides a framework to understand the complex bidirectional interactions between psychological health and kidney disease. This narrative review explores the epidemiology, pathophysiological mechanisms, clinical manifestations, and consequences of depression across the CKD spectrum, with a focus on patients undergoing hemodialysis and peritoneal dialysis. We discuss biological contributors including inflammation, neuroendocrine dysregulation, uremic toxin accumulation, and cerebrovascular changes, alongside psychosocial stressors such as illness chronicity, dependency, financial burden, and altered social roles. Challenges in screening and diagnosis, including the limitations of conventional depression scales in CKD populations, are highlighted. The review further examines the impact of depression on clinical outcomes, dialysis adequacy, nutritional status, and mortality. Finally, we summarize current evidence on pharmacological and non-pharmacological management strategies, emphasizing the role of integrated, multidisciplinary care models. Recognizing and addressing depression as a core component of CKD management is essential to improving holistic patient outcomes and advancing the practice of psychonephrology.</p>","PeriodicalId":94272,"journal":{"name":"World journal of nephrology","volume":"15 3","pages":"121696"},"PeriodicalIF":0.0,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804142","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":"Integrated biomarkers and renal Doppler for early acute kidney injury diagnosis in hepatitis C virus cirrhosis.","authors":"Amira A A Othman, Magy Magdy Mohamed, Mona Mahmoud Eladl, Fatma M Attia Elsayed","doi":"10.5527/wjn.119581","DOIUrl":"10.5527/wjn.119581","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Acute kidney injury (AKI) complicates up to 65% of hospitalizations for decompensated cirrhosis and is associated with high short-term mortality. Traditional markers such as serum creatinine are unreliable in cirrhosis, while novel biomarkers like neutrophil gelatinase-associated lipocalin (NGAL), cystatin C, and Doppler renal resistive index (RRI) show promise but have not been systematically validated in hepatitis C virus-endemic, resource-limited settings such as Egypt.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To evaluate the diagnostic and prognostic utility of NGAL, cystatin C, and RRI for early AKI detection, subtyping [pre-renal, hepatorenal syndrome (HRS), acute tubular necrosis (ATN)], and mortality risk stratification in cirrhotic patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this prospective cohort study, 120 cirrhotic patients with ascites were enrolled and categorized into three groups: Non-AKI (&lt;i&gt;n&lt;/i&gt; = 42), pre-renal AKI (&lt;i&gt;n&lt;/i&gt; = 43), and intrinsic AKI (&lt;i&gt;n&lt;/i&gt; = 35), the latter subdivided into HRS (&lt;i&gt;n&lt;/i&gt; = 20) and ATN (&lt;i&gt;n&lt;/i&gt; = 15). Serum NGAL and cystatin C were quantified using commercially available enzyme-linked immunosorbent assay kits; RRI was obtained &lt;i&gt;via&lt;/i&gt; standardized Doppler ultrasonography. AKI was staged per International Club of Ascites-Kidney Disease Improving Global Outcomes guidelines. To reflect real-world presentation, the cohort included both prevalent (present at admission) and incident (developing postadmission) AKI cases. Diagnostic performance was assessed using receiver operating characteristic analysis, and Cox regression models evaluated 30-day mortality. An NGAL-RRI-based machine-learning model (XGBoost) was developed for AKI subtyping, and a decision-tree model was constructed. Point-of-care ultrasound was associated with the reclassification of 42% of diagnostically ambiguous AKI cases.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;AKI was present in 65% (78/120) of patients. Of these, 52 (66.7%) had AKI at admission, and 26 (33.3%) developed AKI during hospitalization. NGAL distinguished AKI with area under the curve (AUC) of 0.91 (95%CI: 0.87-0.95) [cutoff &gt; 150 ng/mL, sensitivity of 90% (85%-94%), specificity of 85% (78%-90%)]. RRI &gt; 0.74 identified HRS with AUC of 0.89 (95%CI: 0.83-0.94) with sensitivity of 82%, specificity of 88%. Cystatin C showed moderate diagnostic value [AUC of 0.86 (95%CI: 0.81-0.91)]. Urinary granular casts were specific for ATN (100%), while renin and aldosterone levels were highest in HRS. NGAL &gt; 150 ng/mL was independently associated with higher 30-day mortality (hazard ratio = 3.1, 95%CI: 1.7-5.5), while RRI &gt; 0.74 was associated with poor renal recovery (hazard ratio = 2.2, &lt;i&gt;P&lt;/i&gt; = 0.003). The internally validated NGAL-RRI XGBoost model achieved a cross-validated AUC of 0.92 for AKI subtyping. Excluding borderline fractional excretion of sodium cases improved HRS AUC from 0.91 to 0.93. Implementation of an NGAL-guided triage protocol corresponded ","PeriodicalId":94272,"journal":{"name":"World journal of nephrology","volume":"15 3","pages":"119581"},"PeriodicalIF":0.0,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804200","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":"Shadows of infection: Post-coronavirus disease condition and outcome patterns in patients receiving dialysis and kidney transplant recipients.","authors":"Pranesh Jain, Henry H L Wu, Weaam Ali, Varun Mamidi, Rajkumar Chinnadurai","doi":"10.5527/wjn.118018","DOIUrl":"10.5527/wjn.118018","url":null,"abstract":"<p><p>Post-coronavirus disease 2019 (COVID-19) condition describes a constellation of persistent or fluctuating symptoms and organ dysfunction following severe acute respiratory syndrome coronavirus 2 infection. Patients with end-stage kidney disease (ESKD) on dialysis and kidney transplant recipients (KTR) inhabit a landscape of immune dysfunction, multimorbidity, and high healthcare interaction, which may amplify both the risk and consequences of post-COVID condition (PCC). In this article, we aimed to review current evidence on PCC and related post-acute sequelae in dialysis patients and KTR-focusing on symptom burden, risk factors, functional outcomes, health-related quality of life (HRQoL), kidney and graft outcomes, and recovery trajectories. It was found that dialysis patients and KTR experience a substantial burden of PCC superimposed on already complex symptoms and risk profiles. Long COVID in these groups encompasses not only fatigue, dyspnea and a \"brain fog\" phenomenon but also impaired HRQoL, reduced functional recovery, and potential acceleration of kidney and graft decline. Harmonized PCC definitions, kidney-specific outcome measures, and prospective multicentre studies in ESKD and kidney transplant populations are urgently required to inform prevention and management strategies embedded within the dialysis and kidney transplantation pathways.</p>","PeriodicalId":94272,"journal":{"name":"World journal of nephrology","volume":"15 3","pages":"118018"},"PeriodicalIF":0.0,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148803959","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":"Renal replacement therapies in the prevention of contrast-induced acute kidney injury.","authors":"Filippo Trombara, Nicola Cosentino, Gianluca Pontone, Giancarlo Marenzi","doi":"10.5527/wjn.v15.i3.119548","DOIUrl":"10.5527/wjn.v15.i3.119548","url":null,"abstract":"<p><p>Contrast-associated acute kidney injury (CA-AKI) remains a significant cause of hospital-acquired acute kidney injury, particularly in patients undergoing interventional radiology and cardiology procedures. Despite the implementation of preventive measures, such as intravenous hydration, pharmacologic prophylaxis, and minimization of contrast exposure, CA-AKI continues to be associated with increased morbidity, prolonged hospital stays, elevated mortality rates, and greater healthcare costs. Renal replacement therapies (RRT), including haemodialysis and hemofiltration, have been explored as potential strategies to prevent CA-AKI in high-risk populations. However, the existing evidence is inconclusive. While certain studies report a reduced incidence of CA-AKI with early hemofiltration in select patient groups, others have found no significant advantage over standard hydration protocols. Furthermore, practical concerns, including procedural risks, cost implications, and logistical constraints, limit the routine use of prophylactic RRTs in clinical practice. Current clinical guidelines do not endorse the widespread use of RRTs for CA-AKI prevention, though selective application in very high-risk patients may be considered. Robust, large-scale randomized controlled trials are needed to identify patient subgroups that might derive benefit from this intervention. In the interim, optimized hydration and contrast minimization remain the cornerstone strategies for CA-AKI prevention.</p>","PeriodicalId":94272,"journal":{"name":"World journal of nephrology","volume":"15 3","pages":"119548"},"PeriodicalIF":0.0,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491174/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148803870","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":"Renal diseases and blood pressure dysregulation in acute care: Pathophysiology, clinical patterns.","authors":"Yu-Jang Su","doi":"10.5527/wjn.121561","DOIUrl":"10.5527/wjn.121561","url":null,"abstract":"<p><p>Blood pressure (BP) abnormalities are clues to make differential diagnosis and prognostic indicators in various renal diseases in the emergency department (ED), arising from and contributing to kidney dysfunction <i>via</i> activation of the renin-angiotensin-aldosterone system, impaired perfusion, volume overload in chronic kidney disease (CKD) patients, inflammatory processes, and traumatic structural injury. This narrative review summarizes BP patterns and pathophysiology across common renal conditions in the ED, including acute kidney injury, CKD, end-stage renal disease, glomerulonephritis, renal trauma, pyelonephritis, renal artery stenosis, nephrolithiasis, renal infarction, and renal tubular acidosis. Distinct BP profiles are observed: Hypotension often indicates prerenal, septic, or shock-associated acute kidney injury, severe infection, trauma, or shock, while hypertension predominates in CKD, end-stage renal disease, and ischemic or obstructive conditions due to renin-angiotensin-aldosterone system activation and sodium retention. Some disorders show variable BP patterns depending on stages, severity, and comorbidities. Overall, BP abnormalities provide valuable diagnostic and management guidance. Recognizing these predictable hemodynamic responses supports timely diagnosis, risk stratification, and targeted ED management.</p>","PeriodicalId":94272,"journal":{"name":"World journal of nephrology","volume":"15 3","pages":"121561"},"PeriodicalIF":0.0,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491213/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148803898","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":"Immunofluorescence-based reclassification of idiopathic membranoproliferative glomerulonephritis: Insights from a single-center cohort.","authors":"Rahma Rashid, Ranil H Shrestha, Tabassum Elahi, Shaheera Shakeel, Muhammed Mubarak","doi":"10.5527/wjn.121887","DOIUrl":"10.5527/wjn.121887","url":null,"abstract":"<p><strong>Background: </strong>Membranoproliferative glomerulonephritis (MPGN) is a rare form of glomerular injury with variable prognosis, defined by immunoglobulin and/or complement deposits in the mesangium and basement membranes on immunofluorescence microscopy.</p><p><strong>Aim: </strong>To categorize it into immune complex-mediated MPGN (IC-MPGN) or complement-mediated MPGN (C-MPGN) types and to evaluate the clinical significance of this classification.</p><p><strong>Methods: </strong>This retrospective cohort study evaluated biopsy-confirmed primary MPGN cases in adults diagnosed between January 2010 and December 2021 at the Department of Nephrology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan. Patients were followed for at least 36 months post-biopsy, and secondary causes were excluded. Based on immunofluorescence microscopy findings, cases were categorized as IC-MPGN or C-MPGN. Clinicopathological features and renal outcomes were compared between the two groups.</p><p><strong>Results: </strong>A total of 128 patients with primary MPGN were included, of whom 100 (78.1%) were reclassified as IC-MPGN and 28 (21.9%) as C-MPGN. No statistically significant differences were observed between the groups in gender distribution, clinical presentation, biopsy indications, histopathological findings, or renal function at diagnosis, except for a modest age difference (median 33.5 years <i>vs</i> 38 years, <i>P</i> = 0.029). Vascular pathology was significantly more frequent in C-MPGN, and C3 deposition was stronger and serum C3 levels lower, consistent with complement consumption. Immunosuppressive therapy was administered to 51 (51%) IC-MPGN patients and 19 (67.8%) C-MPGN patients. At 36 months, IC-MPGN patients showed numerically higher rates of complete or partial remission (62% <i>vs</i> 60.7%), though this difference did not reach statistical significance (log-rank test: <i>P</i> = 0.40). Progression to end-stage kidney disease and dialysis dependence was comparable between the two groups.</p><p><strong>Conclusion: </strong>The majority of MPGN cases were reclassified as IC-MPGN, which showed numerically higher remission rates. Overall, the clinicopathological features at diagnosis were similar between the two groups, though C-MPGN, a less frequent subtype, was associated with vascular pathology and stronger complement deposition, and a poorer medium-term prognosis.</p>","PeriodicalId":94272,"journal":{"name":"World journal of nephrology","volume":"15 3","pages":"121887"},"PeriodicalIF":0.0,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491217/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804214","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":"Letter to the Editor: Vitamin D deficiency and post-transplant diabetes in kidney recipients - opportunity for risk stratification and intervention.","authors":"Abul Bashar Mohammad Kamrul-Hasan, Kunal Mahajan, Afm Muntahi-Reza, Deep Dutta, Lakshmi Nagendra, Joseph M Pappachan","doi":"10.5527/wjn.122852","DOIUrl":"10.5527/wjn.122852","url":null,"abstract":"<p><p>Vitamin D deficiency is highly prevalent worldwide, including in South Asia, and may contribute to dysglycemia by affecting insulin secretion, insulin sensitivity, and inflammation. Observational studies in the general population link lower 25-hydroxyvitamin D concentrations to a higher risk of incident type 2 diabetes, and emerging evidence suggests a similar relationship in kidney transplant recipients with post-transplant diabetes mellitus (PTDM). In this context, the prospective study published in the <i>World Journal of Nephrology</i> by Singh <i>et al</i> provides important evidence from a tropical setting, showing that pre-transplant 25-hydroxyvitamin D < 20 ng/mL was independently associated with PTDM at 1 year after kidney transplantation. In this correspondence, available global, regional, mechanistic, and transplant data are synthesized to argue that vitamin D deficiency should be considered a clinically relevant and potentially modifiable component of PTDM risk stratification, while acknowledging that causality remains unproven and residual confounding cannot be excluded.</p>","PeriodicalId":94272,"journal":{"name":"World journal of nephrology","volume":"15 3","pages":"122852"},"PeriodicalIF":0.0,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148803831","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":"Metabolic evaluation in first time and recurrent urinary stone formers: Study from a tertiary care center of India.","authors":"Shiv Charan Navriya, Panugothu Leela Madhav, Srinivas J, Parshika Panwar, Sourabh Sharma, Gautam R Choudhary, Mahendra Singh, Deepak P Bhirud, Arjun S Sandhu","doi":"10.5527/wjn.120119","DOIUrl":"10.5527/wjn.120119","url":null,"abstract":"<p><strong>Background: </strong>Kidney stone disease is a common and often debilitating disorder with significant recurrence rate. It is a matter of debate whether the metabolic factors responsible for renal stone formation are similar or variable in different populations around the globe.</p><p><strong>Aim: </strong>To evaluate the metabolic abnormalities <i>via</i> 24 hours urine profiles in first-time and recurrent renal stone formers.</p><p><strong>Methods: </strong>This retrospective study was conducted at a tertiary care center between 2022 and 2024 and included 70 patients with urolithiasis, comprising 30 first-time stone formers and 40 recurrent stone formers (RSF). All patients underwent biochemical evaluation, including serum calcium, phosphorus, uric acid, creatinine, and intact parathyroid hormone levels. A 24-hour urine analysis was performed to assess urinary volume and the excretion of calcium, oxalate, citrate, uric acid, and phosphate. Metabolic abnormalities were defined according to standard criteria. Statistical analysis was performed using the independent <i>t</i>-test for continuous variables and the <i>χ</i> ² test for categorical variables, with a <i>P</i> value < 0.05 considered statistically significant.</p><p><strong>Results: </strong>Fifty-nine patients (84.2%) had at least one identifiable metabolic risk factor, with 37 patients (52.8%) having two or more metabolic abnormalities. The most common abnormalities detected were hypercalciuria 27 (38.5%) and hyper-oxaluria 19 (27.1%). Low urine volume, hypocitraturia and hyperuricemia was seen in 14 (20%), 16 (22.8%) and 4 (5.7%) patients respectively. Primary hyperparathyroidism was seen in a total of 8 (11.4%) patients. Metabolic abnormalities were seen more commonly in RSF but there was no statistically significant difference (<i>P</i> value > 0.05) in abnormalities between first time and RSF.</p><p><strong>Conclusion: </strong>Metabolic evaluation reveals they were prevalent in > 70% of both groups, supporting routine evaluation even in first-time formers in high-risk regions. Hypocitraturia, hyperoxaluria, hyperphosphatemia and hyperparathyroidism are present in a significant proportion of Indian stone former patients.</p>","PeriodicalId":94272,"journal":{"name":"World journal of nephrology","volume":"15 3","pages":"120119"},"PeriodicalIF":0.0,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148803927","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":"Potential diagnostic role of urinary exosomal microRNAs in immunoglobulin A nephropathy: A case-control study.","authors":"Mythri Shankar, Manju Moorthy, Aditya Shetty, Sreedhara C Gurusiddaiah","doi":"10.5527/wjn.119882","DOIUrl":"10.5527/wjn.119882","url":null,"abstract":"<p><strong>Background: </strong>The most common type of primary glomerulonephritis is immunoglobulin A nephropathy (IgAN), which can eventually cause end-stage kidney disease among individuals. A kidney biopsy, which is invasive and has risks of mortality or morbidity, is currently the \"gold standard\" for diagnosis. Urinary exosomes contain abundant, well-preserved microRNAs (miRNAs), which are small, non-coding endogenous RNAs that may be used as non-invasive biomarkers. Studies on urinary exosomal miRNA profiles for the diagnosis of IgAN are rare.</p><p><strong>Aim: </strong>To examine the profile of urinary exosomal miRNAs in Indian individuals diagnosed with IgAN.</p><p><strong>Methods: </strong>Over a period of 4 years (2020-2024), fifty biopsy-confirmed IgAN patients, fifty healthy controls, and fifty disease controls (DC) were recruited. Urinary exosomes were first discovered and then utilized for miRNA extraction. The nCounter^® Human v3 miRNA Expression Assay, a digital multiplex technique that evaluates 798 unique miRNA barcodes, was used to further analyze the extracted miRNAs. After the least absolute shrinkage and selection operator feature selection identified candidate miRNAs, logistic regression and the CombiROC algorithm were used.</p><p><strong>Results: </strong>The average age of patients diagnosed with IgAN was 36.32 years, with a standard deviation of 3.07 years. The average proteinuria was 2.69 ± 0.64 g/day, and the average creatinine level was 2.26 ± 0.318 mg/dL. Nine candidate miRNAs - hsa-miR-4532, hsa-miR-4488, hsa-miR-3158-3p, hsa-miR-151b, hsa-miR-3195, hsa-miR-1289, hsa-miR-20a-5p, hsa-miR-20b-5p, hsa-miR-32-5p, and hsa-miR-525-3p - successfully differentiate IgAN cases from both healthy and DC, exhibiting under the curve values of 0.7, 1, and 0.8 for healthy controls, DC, and IgAN cases, respectively. When compared to healthy and DC, a combination of just two miRNAs - hsa-miR-4532 and hsa-miR-548a-3p - was found to be sufficiently effective for detecting IgAN, with an area under the curve > 0.8.</p><p><strong>Conclusion: </strong>Our investigation involving Indian participants revealed a marked alteration in the urinary exosomal miRNA patterns among individuals with IgAN compared to both healthy subjects and those with other kidney diseases, demonstrating the effectiveness of miRNAs in the non-invasive diagnosis of IgAN.</p>","PeriodicalId":94272,"journal":{"name":"World journal of nephrology","volume":"15 3","pages":"119882"},"PeriodicalIF":0.0,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148803895","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":"Unilateral cutaneous ureterostomy with separate stomata <i>vs</i> ileal conduit after radical cystectomy.","authors":"Mahmoud Khalil, Mina H Mahdy, Rabea A Gadelkareem, Ahmed Shahat, Mohammed A Shalaby, Mohamed A Zarzour","doi":"10.5527/wjn.v15.i2.116524","DOIUrl":"10.5527/wjn.v15.i2.116524","url":null,"abstract":"<p><strong>Background: </strong>Urinary diversion (UD) after radical cystectomy (RC) is a complex surgery that has effects on different patient aspects. The optimal UD method should be technically simple, functionally effective, and socially satisfying. The persistent controversy over the optimal method of UD is the rationale for conducting this study, given the characteristics of the population in our region. Simple UD methods include ureterocutaneous and ileal conduit (IC).</p><p><strong>Aim: </strong>To compare the surgical outcomes and to identify the factors influencing quality-of-life (QoL) after RC with cutaneous ureterostomy (CU) with separate stomata or IC.</p><p><strong>Methods: </strong>A prospective non-randomized study was performed on patients who underwent RC from October 2020 to March 2022. The demographic and clinical characteristics and QoL were compared in patients with IC and unilateral CU with separate stomata. The primary outcome was the difference in the QoL scores between patients with CU (group A) and those with IC (group B). QoL was assessed 6 months after surgery, using the validated Functional Assessment of Cancer Therapy-Bladder questionnaire.</p><p><strong>Results: </strong>This study included 32 patients with a median age (range) of 61 (48-83) years and a median (range) body mass index of 23.95 (19.2-30.2) kg/m². Wound infections (68.8%) and paralytic ileus (50%) were the commonest complications. The mortality rate was 18.8%, and the main cause was septicemia. The median time of the shunt procedure was significantly longer in group B (<i>P</i> < 0.001). Also, the postoperative anemia (<i>P</i> = 0.029), the days between appliance base changes (<i>P</i> < 0.001), and the rate of febrile urinary tract infections (<i>P</i> = 0.017) were higher in group A. However, the score of QoL (<i>P</i> = 0.025) and survival rate (<i>P</i> = 0.004) were significantly better in group B than in group A. The median QoL score for group A was 68 (52-90) while the median QoL score for group B was 80.50 (62-103) (<i>P</i> = 0.029). Serum creatinine level (<i>P</i> = 0.045), recurrent urinary tract infections (<i>P</i> = 0.025), and the number of re-interventions (<i>P</i> = 0.010) had a significant inverse association with QoL. However, the estimated glomerular filtration rate showed a significant proportional relation (<i>P</i> = 0.006).</p><p><strong>Conclusion: </strong>Unilateral CU with separate stomata may be associated with higher rates of postoperative anemia and urinary tract infections. However, IC seems to be associated with better QoL and febrile urinary tract infections. Increased serum creatinine level, recurrent infections, and re-interventions may influence the QoL score. Unilateral CU with separate stomata may still represent an option for patients undergoing RC.</p>","PeriodicalId":94272,"journal":{"name":"World journal of nephrology","volume":"15 2","pages":"116524"},"PeriodicalIF":0.0,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13324611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148378959","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}