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The Long and the Short of it: How Cubilin Isoforms are Affected by Genetic Variants 长与短：Cubilin同工型如何受到遗传变异的影响。

IF 5.7 2区医学 Q1 UROLOGY & NEPHROLOGY

Kidney International Reports

Pub Date : 2026-03-01 Epub Date: 2026-01-30 DOI: 10.1016/j.ekir.2026.103803

Matias Simons

引用次数: 0

Access-Related Hand Dysfunction After Hemodialysis Access Placement 血液透析后通路相关的手部功能障碍

IF 5.7 2区医学 Q1 UROLOGY & NEPHROLOGY

Kidney International Reports

Pub Date : 2026-03-01 Epub Date: 2026-01-02 DOI: 10.1016/j.ekir.2025.103765

Kyoungrae Kim , Trace Thome , Lauren Stone , Nicholas Vugman , Eric M. Kunz , Samuel Alvarez , Qingping Yang , Kerri A. O’Malley , Erik M. Anderson , Brian Fazzone , Pavel Mazirka , Jesseca Antoine , Scott A. Berceli , Terence E. Ryan , Salvatore T. Scali

Introduction

Patients with chronic kidney disease (CKD) or end-stage kidney disease (ESKD) frequently experience access-related hand dysfunction (ARHD) following hemodialysis access placement, negatively impacting clinical outcomes and quality of life. Despite its prevalence, the mechanisms underlying ARHD remain poorly understood, and its impact on subsequent access maturation failure has not been well-characterized.

Methods

We conducted a longitudinal study of 39 patients with CKD or ESKD undergoing hemodialysis access surgery. Functional assessments, including grip strength, finger pressure, patient-reported hand or arm disability, dexterity, and sensory testing were performed preoperatively and 6 weeks postoperatively. Brachioradialis muscle biopsies were analyzed for morphological changes, mitochondrial function, and transcriptomic profiles. Dialysis access maturation failure was evaluated at 6-month follow-up.

Results

Six weeks after surgery, grip strength declined by 13.5 ± 19.4% (P = 0.0001), finger pressure decreased by 30.6 ± 38.0 mm Hg (P = 0.0008), and patient-reported limb disability scores worsened (P = 0.0213). Dexterity and sensation showed no changes. Histological analysis revealed an approximately 12% reduction in myofiber cross-sectional area (P = 0.0340), which is significantly correlated with grip strength (P = 0.0488). Mitochondrial content increased (P = 0.0683) and was inversely correlated with finger pressure (P = 0.0321), whereas mitochondrial respiration and antioxidant capacity remained unchanged. RNA sequencing revealed alterations in the genes regulating myofiber development. Notably, patients with ARHD had an approximately 20% higher incidence of unassisted maturation failure at 6 months (P = 0.0046).

Conclusion

In patients with CKD or ESKD, hemodialysis access surgery results in ARHD, which is associated with muscle atrophy, altered transcriptomic profiles, and higher incidence of access maturation failure. These findings underscore the need for early identification and targeted interventions to prevent ARHD and improve dialysis-access surgery outcomes.

慢性肾脏疾病（CKD）或终末期肾脏疾病（ESKD）患者在血液透析通路放置后经常出现通路相关性手功能障碍（ARHD），对临床结果和生活质量产生负面影响。尽管ARHD很普遍，但其潜在的机制仍然知之甚少，其对随后的通路成熟失败的影响也没有很好地表征。方法对39例接受血液透析通路手术的CKD或ESKD患者进行了纵向研究。术前和术后6周进行功能评估，包括握力、手指压力、患者报告的手或手臂残疾、灵活性和感觉测试。对肱桡肌活检进行形态学变化、线粒体功能和转录组学分析。在6个月的随访中评估透析通路成熟失败。结果术后6周握力下降13.5±19.4% (P = 0.0001)，指压下降30.6±38.0 mm Hg (P = 0.0008)，患者肢体残疾评分加重（P = 0.0213）。灵巧性和感觉没有变化。组织学分析显示肌纤维横截面积减少约12% (P = 0.0340)，这与握力显著相关（P = 0.0488）。线粒体含量增加（P = 0.0683），与指压呈负相关（P = 0.0321），而线粒体呼吸和抗氧化能力保持不变。RNA测序显示调节肌纤维发育的基因发生了变化。值得注意的是，ARHD患者在6个月时的无辅助成熟衰竭发生率高出约20% （P = 0.0046）。结论在CKD或ESKD患者中，血液透析通路手术导致ARHD，其与肌肉萎缩、转录组谱改变和通路成熟失败发生率升高有关。这些发现强调了早期识别和有针对性的干预以预防ARHD和改善透析手术结果的必要性。

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引用次数: 0

Evaluating Chronicity Scores for Outcomes in Patients With Lupus Nephritis 评估狼疮性肾炎患者的慢性评分结果

IF 5.7 2区医学 Q1 UROLOGY & NEPHROLOGY

Kidney International Reports

Pub Date : 2026-03-01 Epub Date: 2026-01-13 DOI: 10.1016/j.ekir.2026.103778

María C. Cuéllar-Gutiérrez , Erika Navarro-Mendoza , Jaime Flores-Gouyonnet , Gabriel Figueroa-Parra , Katrina A. Williamson , Marta Casal Moura , Fernando C. Fervenza , Andrew C. Hanson , Cynthia S. Crowson , Alí Duarte-García , Sanjeev Sethi

Introduction

The aim of this study was to evaluate the prognostic value of the Mayo Clinic Chronicity Score (MCCS) compared with the National Institutes of Health (NIH) Chronicity Index (NIH-CI) in lupus nephritis (LN).

Methods

We conducted a retrospective cohort study of 307 patients with biopsy-proven LN evaluated at Mayo Clinic (1992–2023). Chronic histologic injury was graded using the NIH-CI and MCCS. Outcomes were proteinuria remission < 500 mg/d (PR500), complete renal response (CRR), end-stage kidney disease (ESKD), and all-cause mortality. Sex-stratified, age-adjusted Cox models were used. Prognostic performance was evaluated using change in Harrell’s C-index (ΔC over a clinical model) and decision-curve analysis was used to assess clinical utility for 5-year ESKD. Subgroup analyses were used to test for effect modification by baseline estimated glomerular filtration rate (eGFR) (< 60 vs. ≥ 60 ml/min per 1.73 m²) and histologic class (proliferative vs. nonproliferative).

Results

Higher NIH-CI and MCCS scores were associated with lower likelihood of PR500 and CRR (hazard ratio [HR]: 0.75 for both) and greater risk of ESKD (HR: 1.40 for NIH-CI; 1.33 for MCCS). Adding either score to a clinical model improved discrimination for PR500 (C-index: 0.65 to 0.71), CRR (0.64 to 0.71), and ESKD (0.81 to 0.85), but not mortality (ΔC = 0.00). Decision-curve analysis showed similar net benefits for NIH-CI and MCCS. Interstitial fibrosis (IF) and tubular atrophy (TA) (IF/TA) were the only components independently predictive of renal outcomes. Our findings support applicability of both scores in nonproliferative LN and in patients with reduced baseline kidney function.

Conclusion

The MCCS and NIH-CI provide comparable and additive prognostic information in LN. MCCS captured the chronic lesions most strongly associated with renal outcomes, with IF/TA as the principal determinant of prognosis.

本研究的目的是评价梅奥临床慢性评分（MCCS）与美国国立卫生研究院（NIH）慢性指数（NIH- ci）在狼疮性肾炎（LN）中的预后价值。方法：我们对梅奥诊所（Mayo Clinic）的307例经活检证实的LN患者进行了回顾性队列研究（1992-2023）。采用NIH-CI和mcs对慢性组织损伤进行分级。结果是蛋白尿缓解（PR500），完全肾脏缓解（CRR），终末期肾病（ESKD）和全因死亡率。采用性别分层、年龄校正的Cox模型。预后表现通过Harrell 's c指数的变化（ΔC在临床模型上）进行评估，决策曲线分析用于评估5年ESKD的临床效用。亚组分析通过基线估计肾小球滤过率（eGFR）（< 60 vs.≥60 ml/min / 1.73 m2）和组织学分类（增生性vs.非增生性）来检验效果的改变。结果较高的NIH-CI和MCCS评分与较低的PR500和CRR可能性（两者的风险比[HR]均为0.75）和较高的ESKD风险相关（NIH-CI的风险比为1.40，MCCS的风险比为1.33）。在临床模型中加入任一评分均可提高对PR500 （C-index: 0.65 - 0.71）、CRR（0.64 - 0.71）和ESKD（0.81 - 0.85）的区分，但不能提高死亡率（ΔC = 0.00）。决策曲线分析显示NIH-CI和mcs的净收益相似。间质纤维化（IF）和肾小管萎缩（TA）（IF/TA）是唯一独立预测肾脏预后的成分。我们的研究结果支持两种评分在非增殖性LN和基线肾功能降低患者中的适用性。结论mcs和NIH-CI为LN的预后提供了可比性和累加性信息。mcs捕获了与肾脏预后最密切相关的慢性病变，IF/TA是预后的主要决定因素。

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引用次数: 0

Response to the Letter to the Editor Entitled “SGLT2 Inhibitors in ADPKD: Time to Integrate Cardiovascular Outcomes” 对题为“SGLT2抑制剂治疗ADPKD：是时候整合心血管结局了”的致编辑的回复

IF 5.7 2区医学 Q1 UROLOGY & NEPHROLOGY

Kidney International Reports

Pub Date : 2026-03-01 Epub Date: 2025-12-31 DOI: 10.1016/j.ekir.2025.103761

Kiyotaka Uchiyama

引用次数: 0

Gaps in Dialysis Staff Knowledge of the Kidney Transplantation Process 透析人员在肾移植过程知识上的差距

IF 5.7 2区医学 Q1 UROLOGY & NEPHROLOGY

Kidney International Reports

Pub Date : 2026-03-01 Epub Date: 2025-12-12 DOI: 10.1016/j.ekir.2025.103720

Catherine E. Kelty , Kelsey M. Drewry , Jade Buford , Mengyu Di , Megan Urbanski , Adam S. Wilk , Stephen O. Pastan , Amy Waterman , Rachel E. Patzer

Introduction

For patients receiving dialysis, education from dialysis staff is vital to make informed treatment decisions. Effective education practices are predicated on dialysis staff being well-informed about the kidney transplant process. We assessed dialysis staff knowledge of the transplant process and described staff and facility characteristics associated with knowledge.

Methods

A 17-item adaptation of the Knowledge Assessment of Renal Transplantation (KART) instrument was used to assess dialysis staff knowledge of the kidney transplantation process. Surveys were emailed to 2000 dialysis centers across 4 US regions (August 2021–August 2022). Associations between staff and facility characteristics and correct response scores were assessed using analysis of variance and by ordinal regression for score quartiles.

Results

Of the 630 responses assessed (among 33.5% response rate), respondents were mostly female (91.4%), social workers (81.1%), and worked at chain-owned facilities (86.2%). The average correct response score was 11.8 (69%). Correct responses for individual items ranged from 9.4% to 95.9%. In the adjusted regressions, the odds of scoring highly was reduced for non–social workers (vs. social workers; adjusted odds ratio [aOR]: 0.39; 95% confidence interval [CI]: 0.25–0.63), time working in role (vs. 8–10 years; < 1 year aOR: 0.11 [95% CI: 0.04–0.25], 1–3 years aOR: 0.21 [95% CI: 0.10–0.43], 4–7 years aOR: 0.38 [95% CI: 0.19–0.78], > 10 years aOR: 0.42 [95% CI: 0.21–0.85]), and region (vs. Southeast; New York aOR: 0.52 [95% CI: 0.29–0.94]).

Conclusion

The adapted-KART assessment revealed significant gaps and variation in dialysis staff knowledge of transplantation processes. Interventions to improve staff training and reduce gaps in staff knowledge are needed to ensure appropriate patient education regarding kidney transplantation for patients receiving dialysis.

对于接受透析的患者，透析人员的教育对于做出明智的治疗决定至关重要。有效的教育实践是建立在透析人员充分了解肾移植过程的基础上的。我们评估了透析人员对移植过程的知识，并描述了与知识相关的人员和设施特征。方法采用肾移植知识评估量表（KART）的17个项目对透析人员进行肾移植知识评估。调查通过电子邮件发送到美国4个地区的2000个透析中心（2021年8月至2022年8月）。使用方差分析和分数四分位数的有序回归来评估工作人员和设施特征与正确反应分数之间的关联。结果630份问卷（33.5%的回复率）中，女性居多（91.4%），社会工作者居多（81.1%），连锁机构工作人员居多（86.2%）。平均正确回答得分为11.8分（69%）。对个别问题的正确回答从9.4%到95.9%不等。在调整回归中，非社会工作者（相对于社会工作者，调整优势比[aOR]: 0.39； 95%可信区间[CI]: 0.25-0.63）、工作时间（相对于8-10年；1年or: 0.11 [95% CI: 0.04-0.25]、1 - 3年or: 0.21 [95% CI: 0.10-0.43]、4-7年or: 0.38 [95% CI: 0.19-0.78]、10年or: 0.42 [95% CI: 0.21 - 0.85]）和地区（相对于东南、纽约aOR: 0.52 [95% CI: 0.29-0.94]）获得高评分的几率降低。结论适应性kart评估显示透析人员对移植过程的知识存在显著差距和差异。需要采取干预措施，改善工作人员培训，缩小工作人员知识差距，以确保接受透析的患者接受适当的肾移植患者教育。

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引用次数: 0

Persistent ANCA Positivity in Granulicatella adiacens-associated Endocarditis: Diagnostic Implications of Methodological Variability 持续性ANCA阳性在棘粒霉相关的心内膜炎：方法变异的诊断意义

IF 5.7 2区医学 Q1 UROLOGY & NEPHROLOGY

Kidney International Reports

Pub Date : 2026-02-01 Epub Date: 2025-12-15 DOI: 10.1016/j.ekir.2025.103734

Vincent Linse , Kirsten De Groot , Thorsten Wiech , Ulrich J. Sachs , Bernhard Hellmich , Faeq Husain-Syed

引用次数: 0

International Environmental Impact of CKD Care 慢性肾病护理的国际环境影响

IF 5.7 2区医学 Q1 UROLOGY & NEPHROLOGY

Kidney International Reports

Pub Date : 2026-02-01 Epub Date: 2025-10-30 DOI: 10.1016/j.ekir.2025.10.019

Katherine A. Barraclough , Aleix Cases , Matthew J. Eckelman , Celine Germond-Duret , Carmine Zoccali , Nina Embleton , Antony Wright , Luke Hubbert , Lindsay Nicholson , Salvatore Barone , Claudia Cabrera , Juan Jose Garcia Sanchez , Viknesh Selvarajah , Roberto Pecoits-Filho

Introduction

Data reporting the environmental impact of the overall chronic kidney disease (CKD) care pathway are limited.

Methods

We performed a life cycle assessment (LCA) of CKD stages 1 to 5, with a primary focus on greenhouse gas (GHG) emissions and a secondary aim of quantifying broader environmental effects. The main scope estimated annual environmental impacts in the USA and UK, both per patient and for the total CKD population, with 8 additional countries included in exploratory analyses. Model inputs (annual health care resource use; travel distance; energy mix; and heating, cooling, and lighting requirements) were country-specific, where available. Environmental impacts by stage were calculated using the ReCiPe impact assessment method.

Results

In the USA and UK, annual per-patient GHG emissions increased with CKD stage, from 1.9 to 7.8 tonnes and 0.4 to 5.1 tonnes of carbon dioxide equivalents (CO₂e), respectively, with similar trends for other environmental impacts. Total annual GHG emissions were 30.6 and 1.8 megatonnes CO₂e in the USA and UK, respectively, with stage 3 contributing the greatest proportion. Hospitalization drove emissions for stages 1 to 4, for stage 5 on supportive care, and for the prevalent transplant population. For patients receiving kidney replacement therapy (KRT), choice of modality drove GHG emissions. Although only 6.7% of the US CKD population and 2.6% of the UK population received KRT, this accounted for 15.2% and 11.1% of national CKD emissions, respectively, largely from thrice-weekly in-center hemodialysis (HD).

Conclusion

This research provides insights into the overall environmental burden of CKD and impact hotspots, enabling the development of targeted interventions that reduce emissions.

报道慢性肾脏疾病（CKD）整体护理途径的环境影响的数据有限。方法：我们对CKD阶段1至5进行了生命周期评估（LCA），主要关注温室气体（GHG）排放，次要目标是量化更广泛的环境影响。主要范围估计了美国和英国的年度环境影响，包括每位患者和整个CKD人群，另外8个国家包括在探索性分析中。模型投入（年度保健资源使用；旅行距离；能源组合；供暖、制冷和照明需求）在可能的情况下是针对具体国家的。采用ReCiPe影响评价法，分阶段计算环境影响。结果在美国和英国，每位患者的年温室气体排放量随着CKD分期的增加而增加，分别从1.9吨增加到7.8吨和0.4吨增加到5.1吨二氧化碳当量（CO2e），其他环境影响也有类似的趋势。美国和英国的年温室气体排放总量分别为3060万吨和180万吨，其中阶段3贡献的比例最大。住院治疗推动了第1至4阶段、第5阶段的支持性治疗和普遍的移植人群的排放。对于接受肾脏替代疗法（KRT）的患者，治疗方式的选择推动了温室气体的排放。尽管只有6.7%的美国CKD患者和2.6%的英国患者接受了KRT治疗，但这两组患者的CKD排放量分别占全国CKD排放量的15.2%和11.1%，主要来自每周三次的中心血液透析（HD）。本研究提供了CKD的整体环境负担和影响热点的见解，有助于制定有针对性的减少排放的干预措施。

{"title":"International Environmental Impact of CKD Care","authors":"Katherine A. Barraclough , Aleix Cases , Matthew J. Eckelman , Celine Germond-Duret , Carmine Zoccali , Nina Embleton , Antony Wright , Luke Hubbert , Lindsay Nicholson , Salvatore Barone , Claudia Cabrera , Juan Jose Garcia Sanchez , Viknesh Selvarajah , Roberto Pecoits-Filho","doi":"10.1016/j.ekir.2025.10.019","DOIUrl":"10.1016/j.ekir.2025.10.019","url":null,"abstract":"<div><h3>Introduction</h3><div>Data reporting the environmental impact of the overall chronic kidney disease (CKD) care pathway are limited.</div></div><div><h3>Methods</h3><div>We performed a life cycle assessment (LCA) of CKD stages 1 to 5, with a primary focus on greenhouse gas (GHG) emissions and a secondary aim of quantifying broader environmental effects. The main scope estimated annual environmental impacts in the USA and UK, both per patient and for the total CKD population, with 8 additional countries included in exploratory analyses. Model inputs (annual health care resource use; travel distance; energy mix; and heating, cooling, and lighting requirements) were country-specific, where available. Environmental impacts by stage were calculated using the ReCiPe impact assessment method.</div></div><div><h3>Results</h3><div>In the USA and UK, annual per-patient GHG emissions increased with CKD stage, from 1.9 to 7.8 tonnes and 0.4 to 5.1 tonnes of carbon dioxide equivalents (CO<sub>2</sub>e), respectively, with similar trends for other environmental impacts. Total annual GHG emissions were 30.6 and 1.8 megatonnes CO<sub>2</sub>e in the USA and UK, respectively, with stage 3 contributing the greatest proportion. Hospitalization drove emissions for stages 1 to 4, for stage 5 on supportive care, and for the prevalent transplant population. For patients receiving kidney replacement therapy (KRT), choice of modality drove GHG emissions. Although only 6.7% of the US CKD population and 2.6% of the UK population received KRT, this accounted for 15.2% and 11.1% of national CKD emissions, respectively, largely from thrice-weekly in-center hemodialysis (HD).</div></div><div><h3>Conclusion</h3><div>This research provides insights into the overall environmental burden of CKD and impact hotspots, enabling the development of targeted interventions that reduce emissions.</div></div>","PeriodicalId":17761,"journal":{"name":"Kidney International Reports","volume":"11 2","pages":"Article 103662"},"PeriodicalIF":5.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145881229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Phase 1B Trial of Cannabidiol for Symptom Management in Kidney Failure 大麻二酚用于肾衰竭症状管理的1B期试验

IF 5.7 2区医学 Q1 UROLOGY & NEPHROLOGY

Kidney International Reports

Pub Date : 2026-02-01 Epub Date: 2025-11-19 DOI: 10.1016/j.ekir.2025.11.022

Brendan Smyth , Taewon Yi , Kristy P. Robledo , Rebecca Gordon , Andrew J. McLachlan , Rachael L. Morton , Iain S. McGregor , Meg Jardine

引用次数: 0

Urinary Podocyte Loss is Associated With Treatment Response in Patients With Primary Nephrotic Syndrome 原发性肾病综合征患者尿足细胞丢失与治疗反应相关

IF 5.7 2区医学 Q1 UROLOGY & NEPHROLOGY

Kidney International Reports

Pub Date : 2026-02-01 Epub Date: 2025-11-17 DOI: 10.1016/j.ekir.2025.11.017

Bartholomeus T. van den Berge , Jitske Jansen , Quinty Leusink , Sanne Kleuskens , Sharon Bootsman , Anne-Els van de Logt , Jack F.M. Wetzels , Bart Smeets , Rutger J. Maas

Introduction

The disease course of primary nephrotic syndrome (PNS) is highly variable, and is difficult to predict at onset. PNS is characterized by podocyte injury and loss. We hypothesized that measurement of urinary podocyte loss is associated with treatment response in patients with PNS.

Methods

We included 21 controls, and 59 patients with PNS (minimal change disease [MCD], n =8; focal segmental glomerulosclerosis [FSGS], n = 9; membranous nephropathy [MN]. n = 42). MCD and FSGS were considered manifestations of the same disease entity, and analyzed as one group. Patients’ baseline clinical and follow-up data were recorded. Urinary sediments were collected and stained for podocyte-specific markers, and analyzed using fluorescence-activated cell sorting (FACS).

Results

In patients with MCD/FSGS, the respective partial and complete remission rates were 24% and 59% during a median follow-up of 12.9 months, and all patients received immunosuppressive treatment. In patients with MN, the respective partial and complete remission rates were 64% and 19% during a median follow-up of 15.5 month, and the majority of patients received immunosuppressive treatment. Patients with PNS had elevated levels of podocyturia when compared with controls, and repeat measurements revealed that podocyturia follows proteinuria course over time, normalizing following complete proteinuria remission. In treatment-responsive immunosuppresive-treated patients with MCD/FSGS, podocyturia at baseline significantly differentiated between early and late treatment responders at 4 weeks, contrary to proteinuria and serum albumin. In symptomatically treated patients with MN, low levels of podocyturia at baseline were associated with spontaneous remission.

Conclusion

Patients with PNS have increased podocyturia compared with healthy individuals. Quantitative detection of podocyturia may have prognostic relevance in patients with PNS.

原发性肾病综合征（PNS）的病程变化很大，很难在发病时预测。PNS以足细胞损伤和丢失为特征。我们假设尿足细胞损失的测量与PNS患者的治疗反应有关。方法纳入21例对照组和59例PNS患者（最小改变疾病[MCD]， n =8；局灶节段性肾小球硬化[FSGS]， n = 9；膜性肾病[MN]）。N = 42)。MCD和FSGS被认为是同一疾病实体的表现，并作为一组分析。记录患者的基线临床和随访数据。收集尿液沉积物并对足细胞特异性标记物进行染色，并使用荧光活化细胞分选（FACS）进行分析。结果在中位随访12.9个月期间，MCD/FSGS患者的部分缓解率和完全缓解率分别为24%和59%，所有患者均接受免疫抑制治疗。在MN患者中，在15.5个月的中位随访期间，部分缓解率和完全缓解率分别为64%和19%，大多数患者接受了免疫抑制治疗。与对照组相比，PNS患者足尿水平升高，重复测量显示，随着时间的推移，足尿伴随着蛋白尿过程，在蛋白尿完全缓解后正常化。在治疗反应性免疫抑制剂治疗的MCD/FSGS患者中，基线时的足尿在4周的早期和晚期治疗应答者之间有显著差异，与蛋白尿和血清白蛋白相反。在对症治疗的MN患者中，基线时低水平的足尿与自发缓解有关。结论PNS患者足尿量明显高于健康人。足尿量的定量检测可能与PNS患者的预后相关。

{"title":"Urinary Podocyte Loss is Associated With Treatment Response in Patients With Primary Nephrotic Syndrome","authors":"Bartholomeus T. van den Berge , Jitske Jansen , Quinty Leusink , Sanne Kleuskens , Sharon Bootsman , Anne-Els van de Logt , Jack F.M. Wetzels , Bart Smeets , Rutger J. Maas","doi":"10.1016/j.ekir.2025.11.017","DOIUrl":"10.1016/j.ekir.2025.11.017","url":null,"abstract":"<div><h3>Introduction</h3><div>The disease course of primary nephrotic syndrome (PNS) is highly variable, and is difficult to predict at onset. PNS is characterized by podocyte injury and loss. We hypothesized that measurement of urinary podocyte loss is associated with treatment response in patients with PNS.</div></div><div><h3>Methods</h3><div>We included 21 controls, and 59 patients with PNS (minimal change disease [MCD], <em>n</em> =8; focal segmental glomerulosclerosis [FSGS], <em>n</em> = 9; membranous nephropathy [MN]. <em>n</em> = 42). MCD and FSGS were considered manifestations of the same disease entity, and analyzed as one group. Patients’ baseline clinical and follow-up data were recorded. Urinary sediments were collected and stained for podocyte-specific markers, and analyzed using fluorescence-activated cell sorting (FACS).</div></div><div><h3>Results</h3><div>In patients with MCD/FSGS, the respective partial and complete remission rates were 24% and 59% during a median follow-up of 12.9 months, and all patients received immunosuppressive treatment. In patients with MN, the respective partial and complete remission rates were 64% and 19% during a median follow-up of 15.5 month, and the majority of patients received immunosuppressive treatment. Patients with PNS had elevated levels of podocyturia when compared with controls, and repeat measurements revealed that podocyturia follows proteinuria course over time, normalizing following complete proteinuria remission. In treatment-responsive immunosuppresive-treated patients with MCD/FSGS, podocyturia at baseline significantly differentiated between early and late treatment responders at 4 weeks, contrary to proteinuria and serum albumin. In symptomatically treated patients with MN, low levels of podocyturia at baseline were associated with spontaneous remission.</div></div><div><h3>Conclusion</h3><div>Patients with PNS have increased podocyturia compared with healthy individuals. Quantitative detection of podocyturia may have prognostic relevance in patients with PNS.</div></div>","PeriodicalId":17761,"journal":{"name":"Kidney International Reports","volume":"11 2","pages":"Article 103692"},"PeriodicalIF":5.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145841122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

ACTN4 p.Ile150Met Causes FSGS With Validation in Primary Fibroblasts and Immortalized Podocytes ACTN4 p.p ile150met在原代成纤维细胞和永生化足细胞中引起FSGS

IF 5.7 2区医学 Q1 UROLOGY & NEPHROLOGY

Kidney International Reports

Pub Date : 2026-02-01 Epub Date: 2025-11-29 DOI: 10.1016/j.ekir.2025.11.030

Melanie Grosch , Jan René Haak , Cathiana Kolb , Izabela Plogmann , Mara Sanches Guaragna , Antje Wiesener , Francesca Pasutto , Florian J. Wopperer , Lena Pollinger , Felix B. Engel , Michael S. Wiesener , Mario Schiffer , Tilman Jobst-Schwan

引用次数: 0

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