World journal of nephrology最新文献

{"title":"Integrating Modified National Early Warning Score 2, computed tomography staging, and laboratory markers for enhanced prognostic stratification in emphysematous pyelonephritis.","authors":"Cagri Sevik, Akif Erbin, Halil Lutfi Canat","doi":"10.5527/wjn.v15.i1.113952","DOIUrl":"10.5527/wjn.v15.i1.113952","url":null,"abstract":"<p><p>Emphysematous pyelonephritis (EPN) is a rare but life-threatening urological emergency with no universally accepted management protocol. The Modified National Early Warning Score 2 (mNEWS2), derived exclusively from six physiological parameters, has recently been proposed as a reliable tool for predicting treatment outcomes in EPN. Although higher mNEWS2 scores are associated with increased morbidity and mortality, clinical deterioration typically manifests only after substantial disease progression. In contrast, computed tomography-based classification systems and laboratory parameters - such as anemia, leukocytosis, thrombocytopenia, and hyperglycemia - may offer earlier prognostic insights before physiological deterioration occurs. Evidence from recent multicenter studies has identified these factors as independent predictors of mortality. Therefore, integrating mNEWS2 with computed tomography-based staging and relevant laboratory markers may allow more accurate risk stratification and facilitate timely decision-making, including consideration of early nephrectomy in high-risk patients with extensive paranephric involvement, ultimately improving clinical outcomes in EPN management.</p>","PeriodicalId":94272,"journal":{"name":"World journal of nephrology","volume":"15 1","pages":"113952"},"PeriodicalIF":0.0,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147518040","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":"Endocrine disorders linked to chronic kidney disease: Mechanisms and clinical implications.","authors":"Marcio J Concepción-Zavaleta, Jenyfer M Fuentes-Mendoza, Elida P López-Ramírez, Jesús A Martínez-García, Luis A Concepción-Urteaga, José Paz-Ibarra","doi":"10.5527/wjn.v15.i1.113875","DOIUrl":"10.5527/wjn.v15.i1.113875","url":null,"abstract":"<p><p>Chronic kidney disease (CKD) is a progressive condition that disrupts multiple endocrine axes, contributing to a broad range of hormonal imbalances, including mineral and bone disorder, gonadal dysfunction, thyroid abnormalities, insulin resistance, and elevated prolactin levels. These disturbances not only exacerbate comorbidities such as cardiovascular disease, anemia, diabetes, and sarcopenia, but may also accelerate the decline of renal function. This article aims to provide a comprehensive overview of the pathophysiology, clinical impact, and management strategies for endocrine disorders in CKD. A narrative literature search was conducted using PubMed, EMBASE, the Cochrane Library, and Scielo through July 2025, focusing on 141 studies addressing endocrine complications in CKD. The prevalence of hormonal dysfunction increases with CKD progression, affecting over 70% of patients in advanced stages. Disruptions in calcium and phosphate homeostasis lead to secondary hyperparathyroidism, vascular calcification, and bone fragility. Thyroid hormone alterations and testosterone deficiency contribute to reduced muscle mass, fatigue, and cardiovascular risk. Impaired glucose metabolism complicates glycemic control, particularly in dialysis and post-transplant populations. Diagnostic interpretation is often challenged by altered hormone clearance and protein binding. Therapeutic approaches require individualized strategies, including dietary and pharmacological correction of mineral imbalances, cautious hormone replacement, and use of agents such as dopamine agonists or sodium-glucose cotransporter-2 inhibitors. A multidisciplinary approach integrating nephrology and endocrinology is essential to improve outcomes and quality of life in this population.</p>","PeriodicalId":94272,"journal":{"name":"World journal of nephrology","volume":"15 1","pages":"113875"},"PeriodicalIF":0.0,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517937","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":"Vaccination gaps in incident hemodialysis patients: An opportunity for preventive nephrology, a prospective, cross-sectional study.","authors":"Saurabh Puri, Anand Naveen Thakur, Hari Shankar Meshram, Chandani Bhagat, Bhavin Modasia, Vishal Batheja, Rajendra Prasad Mathur","doi":"10.5527/wjn.v15.i1.114748","DOIUrl":"10.5527/wjn.v15.i1.114748","url":null,"abstract":"<p><strong>Background: </strong>Patients initiating hemodialysis face heightened infection risks due to immunodeficiency and frequent healthcare exposure. Vaccinations against hepatitis B virus (HBV), Streptococcus pneumoniae, and influenza are recommended but often underutilized, particularly in resource-constrained settings.</p><p><strong>Aim: </strong>To evaluate the baseline vaccination status and associated factors of patients starting hemodialysis in a tertiary nephrology center in North India, with the goal of identifying any overlooked opportunities for preventive care.</p><p><strong>Methods: </strong>A prospective cross-sectional study was conducted at the Institute of Liver and Biliary Sciences, New Delhi, from June 2023 to December 2024. Adult patients (≥ 18 years) initiating hemodialysis were evaluated for vaccination status (HBV, pneumococcal, influenza), comorbidities, prior nephrology consultation, transplant evaluation, and nutritional status. Statistical comparisons were made using <i>χ</i> ² and <i>t</i>-tests, with <i>P</i> < 0.05 considered significant.</p><p><strong>Results: </strong>Among 132 patients (mean age 52.6 years; 72.7% male), 63 (47.7%) completed HBV vaccination, 37 (28.0%) received pneumococcal and influenza vaccines, and 73 (55.3%) were unvaccinated. Prior nephrology consultation significantly predicted vaccine uptake for HBV (72.1% <i>vs</i> 21.9%, <i>P</i> < 0.001), pneumococcal (47.1% <i>vs</i> 7.8%, <i>P</i> < 0.001), and influenza (47.1% <i>vs</i> 7.8%, <i>P</i> < 0.001). Protective anti-HBs titers were observed in 66.7% of vaccinated individuals. Vaccinated patients had higher rates of arteriovenous fistula creation and transplant evaluation.</p><p><strong>Conclusion: </strong>Vaccination coverage at dialysis initiation remains suboptimal. Early nephrology referral and structured chronic kidney disease (CKD) care pathways are critical to improving vaccine uptake. Integrating adult immunization into routine CKD management may reduce infection-related morbidity and improve outcomes.</p>","PeriodicalId":94272,"journal":{"name":"World journal of nephrology","volume":"15 1","pages":"114748"},"PeriodicalIF":0.0,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147518127","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 elasticity assessment in patients of glomerulonephritis by shear-wave elastography and its correlation with histopathology and renal biomarkers.","authors":"Raghunandan Prasad, Robin Verma, Anuradha Singh, Manas R Behera, Monika Yachha, Ravi S Kushwaha, Manoj Jain, Vinita Agrawal, Priyank Yadav, Hira Lal","doi":"10.5527/wjn.v15.i1.116148","DOIUrl":"10.5527/wjn.v15.i1.116148","url":null,"abstract":"<p><strong>Background: </strong>Glomerulonephritis (GN) is a major cause of chronic kidney disease and end-stage renal disease. Renal biopsy remains the gold standard for assessing interstitial fibrosis and tubular atrophy (IF/TA), but it is invasive and unsuitable for repeated assessments. Shear-wave elastography (SWE) is a promising non-invasive technique for quantifying renal cortical stiffness.</p><p><strong>Aim: </strong>To evaluate renal elasticity using SWE in patients with GN and correlate SWE values with histopathology and serum transforming growth factor-β1 (TGF-β1) levels.</p><p><strong>Methods: </strong>This prospective study included 201 consecutive adults with suspected GN undergoing renal biopsy. SWE was performed using a standardized protocol (6 cortical measurements per kidney). Histopathological IF/TA grade served as the reference standard. Serum TGF-β1 was measured using ELISA. Receiver operating characteristic analysis, analysis of variance, and Pearson correlation were applied. Additionally, 53 patients underwent follow-up SWE after 3-6 months.</p><p><strong>Results: </strong>Patients were classified as: No fibrosis (<i>n</i> = 22), mild (<i>n</i> = 96), moderate (<i>n</i> = 74), and marked fibrosis (<i>n</i> = 9). Mean SWE values increased progressively with IF/TA severity: 13.38 ± 1.36 kPa, 21.66 ± 4.49 kPa, 28.57 ± 4.91 kPa, and 40.31 ± 5.06 kPa, respectively (<i>P</i> < 0.001). SWE accurately detected any fibrosis (area under the curve = 0.986); an optimal cutoff of 13.98 kPa achieved 98% sensitivity and 73% specificity. Serum TGF-β1 levels showed an increasing trend across groups but were not statistically significant (<i>P</i> = 1.0). Etiology-wise, diabetic nephropathy exhibited the highest stiffness, while minimal change disease showed values comparable to the no-fibrosis group. Follow-up SWE revealed a small but statistically significant increase (23.48 ± 6.83 <i>vs</i> 24.04 ± 6.58 kPa, <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>SWE correlates strongly with histological fibrosis in GN, outperforming conventional ultrasound and serum TGF-β1. It may serve as a non-invasive surrogate marker for moderate-to-marked fibrosis and assist in minimizing unnecessary biopsies. SWE also demonstrates potential for monitoring disease progression.</p>","PeriodicalId":94272,"journal":{"name":"World journal of nephrology","volume":"15 1","pages":"116148"},"PeriodicalIF":0.0,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010448/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147518038","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":"Clinical profile and outcome of primary membranous nephropathy: A tertiary care center experience from North India.","authors":"Muzamil Ahmad Wani, Imran Khan, Jawad Iqbal Rather, Mohammad Ashraf Bhat, Muzafar Maqsood Wani, Imtiyaz Ahmad Wani, Rayees Yousuf Sheikh, Manzoor Ahmad Parry","doi":"10.5527/wjn.v15.i1.113303","DOIUrl":"10.5527/wjn.v15.i1.113303","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Primary membranous nephropathy (MN) is a major cause of nephrotic syndrome in adults, characterized by immune complex formation on the outer side of the glomerular basement membrane. Primary MN accounts for 80% of the cases, and 20% cases are associated with a secondary etiology. While immunosuppressive therapy has improved patient outcomes in MN, the clinical profile and treatment outcomes of MN in our patient population have not been previously studied.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;To investigate the clinicopathological profile and outcomes of primary MN patients. We included consenting patients aged ≥ 18 years with primary MN and excluded those with end-stage kidney disease, pregnancy, or secondary MN.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This study approved by the institutional ethics committee, was conducted at the Department of Nephrology, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, India. Detailed history, physical examination, laboratory investigations [including 24-hour urinary protein, kidney and liver function tests, and anti-phospholipase A2 receptor (PLA2R) antibody levels], and screening for secondary etiologies were performed. Renal biopsy tissues were examined using light microscopy, immunofluorescence, immunohistochemistry for PLA2R, thrombospondin type 1 domain-containing 7A, neural epidermal growth factor-like 1 (NELL-1), exostosin 1, exostosin 2, and electron microscopy. Patients were risk-stratified based on proteinuria, kidney function, and serum anti-PLA2R antibody levels. Remission, relapse, and resistant disease were defined by specific proteinuria and albumin criteria.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of 46 patients, 60.9% were female, with a mean age of 43.8 ± 13.7 years. The mean proteinuria was 5.8 ± 3.2 g/day, mean serum albumin was 2.5 ± 0.39 g/dL, and mean estimated glomerular filtration rate was 99.8 ± 26.6 mL/minute/1.73 m&lt;sup&gt;2&lt;/sup&gt;. Edema was the most common symptom (100%), and hypertension was the most frequent comorbidity (37%). Serum anti-PLA2R antibodies were positive in 39.1% of patients. On immunohistochemistry, 58.7% were tissue PLA2R positive and 17.4% were NELL-1 positive. At baseline, 71.1% of patients were in the high-risk category. Initial non-immunosuppressive supportive care was given to 84.8% of patients, with 23.08% achieving remission. Among those receiving immunosuppressive therapy, 72.2% on modified Ponticelli regimen and 85.7% on other regimens achieved remission at 6 months (&lt;i&gt;P&lt;/i&gt; = 0.432). At 12 months, 82.9% of patients on immunosuppressive therapy achieved remission. Both modified Ponticelli and other immunosuppressive regimens significantly improved proteinuria and serum albumin at 12 months (&lt;i&gt;P&lt;/i&gt; &lt; 0.0001).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;PLA2R-associated MN was the most common form of MN, followed by NELL-1. Primary MN prevalence was highest in the fifth and sixth decades of life, with a slight female preponderance observed in this study","PeriodicalId":94272,"journal":{"name":"World journal of nephrology","volume":"15 1","pages":"113303"},"PeriodicalIF":0.0,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517893","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":"Gut-kidney axis: Dysbiosis and renal disease.","authors":"Maurizio Salvadori, Giuseppina Rosso","doi":"10.5527/wjn.v15.i1.115357","DOIUrl":"10.5527/wjn.v15.i1.115357","url":null,"abstract":"<p><p>According United States renal data system the morbidity rate for chronic kidney disease (CKD) is 2.5 times than patients not affected by CKD and the mortality rate is 144.9 per 1000 persons-years. The gut microbiota is involved in uremic toxins (UTs) production. This fact was demonstrated by experiments in rats, which revealed better survival in CKD rats that were deprived of the gut microbiota. In men, UT levels are low in CKD patients without a colon. Diet may affect the gut microbiota through food additives such as prebiotics, probiotics and post biotics. Conservation processes and food processing may also affect the gut microbiota. Other factors are food quantity and composition. The gut microbiota may be the cause of UTs production and accumulation in the blood. Additionally, there is interplay among different organs such as liver, kidney and gut. Several theories have been formulated to justify the interplay between the metabolic dysfunctions. In particular, the increase of species such as <i>Eggerthelia lenta</i>, <i>Fusobacterium nucleatum</i> and <i>Alistipes shahii</i> leads to an increase of the aromatic amino acids degradation, and secondary bile acids and trimethyamine oxide biosynthesis in the intestine. This fact determines an increase of the levels of UT precursors such as indole, p-cresol, phenol, phenylacetaleyde, benzoic acid and trimethylamine. Recent studies document the following. The human microbiome project revealed that the gut microbiota may play an important role in both human health and diseases, including kidney disease. Recently, several studies have shown a strict correlation between the gut microbiota and CKD. Probiotics, prebiotics and synbiotics are possible therapies. Probiotics are living microorganisms that, consumed in adequate quantities, are beneficial for the patient, and act on the intestinal microbiome equilibrium. <i>Lactobacilli</i> and <i>Bifidobacteria</i> are common examples of probiotics. Prebiotics are generally fibers not absorbed by the gut, representing a selective nutrient for the microbiome already present in the gut, which favors their growth and activity. Inulin, fructo-oligosaccharides and other fibers are examples of prebiotics. The association and synergism between probiotics and prebiotics is symbiotic.</p>","PeriodicalId":94272,"journal":{"name":"World journal of nephrology","volume":"15 1","pages":"115357"},"PeriodicalIF":0.0,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517989","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":"Effect of focused nursing training on infection control measures on nurses' practice for patients undergoing percutaneous nephrolithotomy.","authors":"Rabea A Gadelkareem, Kamilia F Abdelfatah, Shalabia E Abozead, Samia Y Sayed, Waheed Fawzy","doi":"10.5527/wjn.v15.i1.116965","DOIUrl":"10.5527/wjn.v15.i1.116965","url":null,"abstract":"<p><strong>Background: </strong>Nursing care for patients undergoing percutaneous nephrolithotomy (PNL) is a crucial step in reducing complications and promoting recovery. Infection control procedures are vital tools for preventing most complications. Proper nursing education and training for managing these patients can provide sufficient protection against urinary tract infections and related issues, such as secondary hemorrhage and hospital readmission.</p><p><strong>Aim: </strong>To evaluate nurses' performance after receiving nursing instructions regarding the infection control measures for patients with PNL.</p><p><strong>Methods: </strong>A quasi-experimental research design (pretest-posttest) was employed. The study was conducted at Assiut University Urology Hospital, Assiut University, Egypt. The participant nurses worked in units providing healthcare for patients who underwent PNL and received focused nursing instructions on infection control measures. The tools used included a structured questionnaire assessing their knowledge of PNL healthcare and a nurses' practice observation checklist. The researchers completed these tools before and after the nurses received focused education on infection control measures. The focused education was provided through an illustrated booklet. The local ethics committee approved this study.</p><p><strong>Results: </strong>This study comprised 30 nurses, including 19 females (63.3%). Of these, 46.7% were in the 20-25 age group, 90% had a high educational level, and 50% had less than 5 years of work experience. Significant differences were observed between pre- and post-test scores in overall performance (<i>P</i> = 0.001), total preoperative scores (<i>P</i> = 0.001), immediate postoperative scores (<i>P</i> = 0.006), infection control measures (<i>P</i> = 0.001), and respiratory hygiene practices (<i>P</i> = 0.001). In the pretest, 16.7% of the nurses demonstrated adequate practice levels of infection control measures for patients undergoing PNL, compared to 100% in the posttest (<i>P</i> = 0.001). No significant relationships were found between nurses' practice levels and their demographic variables (<i>P</i> > 0.050).</p><p><strong>Conclusion: </strong>The nurses' performance improved significantly after receiving focused nursing instructions on infection control measures for patients with PNL. Nurses should participate in ongoing training programs on infection control procedures.</p>","PeriodicalId":94272,"journal":{"name":"World journal of nephrology","volume":"15 1","pages":"116965"},"PeriodicalIF":0.0,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517689","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":"Lymphocele after kidney transplantation: Incidence, associated factors and outcomes.","authors":"Syrine Tlili, Hiba Ghabi, Ikram Mami, Hayet Kaaroud, Lamia Rais, Zouaghi Rabta Mohamed Karim","doi":"10.5527/wjn.v15.i1.111612","DOIUrl":"10.5527/wjn.v15.i1.111612","url":null,"abstract":"<p><strong>Background: </strong>The outcome of renal transplantation is influenced by the occurrence of various complications, including urological. One of the most frequently occurring complications is lymphocele with an incidence of 0.6% to 51%. In fact, Lymphocele represents a notable postoperative complication that can lead to acute dysfunction of the renal graft or compression of adjacent venous structures. Despite its clinical relevance, the risk factors associated with its development remain inconsistently reported in the literature.</p><p><strong>Aim: </strong>To evaluate the incidence, identify potential risk factors, and assess the clinical outcomes related to post-transplant lymphocele formation.</p><p><strong>Methods: </strong>We analyzed 86 consecutive renal transplant recipients from 2010 to 2019. All recipients had undergone protocol screening ultrasound scan at first week after surgery and 3 months post-transplant. We analyzed risk factors for lymphocele formation. Comparison between lymphocele and no-lymphocele groups was made with linear logistic regression analyses.</p><p><strong>Results: </strong>Among the 86 kidney transplant recipients, 15 patients (17.4%) developed a lymphocele, with a median onset of 30 days post-transplantation (range: 30-330 days). The condition was asymptomatic in the majority of cases (14 patients, 93%), while one patient (7%) presented with ipsilateral lower limb lymphedema, which led to the diagnosis. Therapeutic intervention was necessary in four cases. Sclerotherapy using a povidone-iodine solution was performed in three patients, while one patient underwent combined sclerotherapy and percutaneous drainage.Multivariate analysis identified two independent risk factors: Warm ischemia time exceeding 30 minutes [<i>P</i> = 0.011; odds ratio (OR) = 1.103; 95%CI: 1.023-1.109] and donor age over 50 years (<i>P</i> = 0.041; OR = 1.072; 95%CI: 1.023-1.146). Renal function at one year was comparable between patients who developed a lymphocele and those who did not.</p><p><strong>Conclusion: </strong>Our findings suggest that improved surgical techniques and optimized immunosuppressive management could contribute to reducing the incidence of lymphocele and enhancing post-transplant renal outcomes.</p>","PeriodicalId":94272,"journal":{"name":"World journal of nephrology","volume":"15 1","pages":"111612"},"PeriodicalIF":0.0,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517971","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":"Diabetes-related renal complications: Insights on the impact of diabetic kidney disease on mortality.","authors":"Guido Gembillo, Maria Federica Ricca, Domenico Santoro","doi":"10.5527/wjn.v15.i1.108432","DOIUrl":"10.5527/wjn.v15.i1.108432","url":null,"abstract":"<p><p>Diabetes mellitus (DM) is a major contributor to disability and mortality, accounting for nearly 10% of all deaths in people aged 20 to 79 years. In addition, the increasing prevalence of diabetes has significantly increased the burden of disease across multiple facets of the disease spectrum. Diabetic kidney disease (DKD) is an important factor affecting morbidity and mortality in people with diabetes. DKD is characterized by a gradual deterioration of kidney function leading to end-stage renal disease (ESRD) in up to 50% of cases in certain populations and increased susceptibility to cardiovascular events. DKD is generally characterized by chronic kidney disease (CKD) defined by persistently (at least 3 months) elevated urinary albumin excretion (albumin-to-creatinine ratio ≥ 30 mg/g) and/or decreased estimated glomerular filtration rate (estimated glomerular filtration rate < 60 mL/minute/1.73 m²) in people with diabetes. As glomerular filtration rate decreases and albuminuria increases, the likelihood of adverse outcomes such as mortality and ESRD increases. People with a GFR ≤ 30 mL/minute/1.73 m² have a significantly increased risk in all categories of albuminuria. It is of pivotal importance to understand the pathophysiology of DKD, its gradual progression and the significant impact on mortality in diabetic patients. Early detection and optimal glycemic and blood pressure control are crucial to counteract the progression of the disease. Another important aspect is to identify the population group at greatest risk of diabetic-related deterioration of kidney function and prevent disease progression. There is an urgent need for thorough treatment strategies that address both renal and cardiovascular risk factors to reduce the strikingly high mortality rate closely associated with DKD in diabetics.</p>","PeriodicalId":94272,"journal":{"name":"World journal of nephrology","volume":"15 1","pages":"108432"},"PeriodicalIF":0.0,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517624","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":"Familial <i>WT1</i>-associated nephropathy - 46, XY Frasier syndrome and 46, XX steroid-resistant nephrotic syndrome in female siblings: A case report and review of literature.","authors":"Mahipal H Khandelwal, Kiran G Piparva, Deepak Parchwani","doi":"10.5527/wjn.v15.i1.110867","DOIUrl":"10.5527/wjn.v15.i1.110867","url":null,"abstract":"<p><strong>Background: </strong>The Wilms tumor 1 (<i>WT1)</i> mutation is significantly associated with steroid-resistant nephrotic syndrome (SRNS) in children. It causes a spectrum of disorders, including Frasier and Denys-Drash syndromes. The <i>WT1</i> gene encodes a transcription factor essential for renal, gonadal, and mesothelial development. The prevalence of Frasier syndrome is 1 in 1000000. Frasier syndrome presents with childhood onset of SRNS, progressing to end-stage kidney disease, has an XY female phenotype, delayed puberty, and gonadal tumor risk. Two siblings with identical <i>WT1</i> mutations but differing phenotypes offer important clinical insights.</p><p><strong>Case summary: </strong>We report a rare familial occurrence of shared mutation of <i>WT1</i> (at intron 9 splice site: C.1432+5G>A) and <i>COL4A5</i> genes in two siblings. The elder sibling (46, XY) presented with infantile steroid-resistant nephrotic syndrome and rapidly deteriorating and progressing to end-stage kidney disease with XY karyotype. The genetic testing confirmed the diagnosis of Frasier syndrome associated with a <i>WT1</i> mutation in the elder sibling. She is currently on maintenance dialysis, awaiting renal transplantation. The younger sibling presented at age four with facial edema and SRNS with slower disease progression and no apparent gonadal anomalies. Her renal biopsy revealed minimal change disease, and she maintains stable renal function under antiproteinuric therapy. Genetic testing confirmed the diagnosis of <i>WT1</i> mutation with 46, XX karyotype in the younger sibling. Both siblings also carried a <i>COL4A5</i> gene variant of uncertain significance. Family history reveals consanguineous marriage and a similar presentation in a sibling.</p><p><strong>Conclusion: </strong>Despite identical mutations, phenotypic differences highlight complex genotype-phenotype relations, stressing the need for research, genetic counseling, and family member screening.</p>","PeriodicalId":94272,"journal":{"name":"World journal of nephrology","volume":"15 1","pages":"110867"},"PeriodicalIF":0.0,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13010728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517923","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}