Nefrologia最新文献

{"title":"Tacrolimus formulations in de novo kidney transplantation: Evidence from a paired kidney study","authors":"Verónica López , Juan Pablo Gámez , Myriam León , Juana Alonso-Titos , Cristina Gutiérrez , Carolina Polo , Teresa Vázquez , Pedro Ruiz-Esteban , Domingo Hernández","doi":"10.1016/j.nefro.2025.501351","DOIUrl":"10.1016/j.nefro.2025.501351","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 8","pages":"Article 501351"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145183735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relevancia de las interacciones entre el complemento y el sistema de contacto de la coagulación en la enfermedad renal","authors":"Alberto López-Lera ,&nbsp;Fernando Corvillo ,&nbsp;Laura González-Sánchez ,&nbsp;Marta Melgosa ,&nbsp;Pilar Sánchez-Corral","doi":"10.1016/j.nefro.2025.501347","DOIUrl":"10.1016/j.nefro.2025.501347","url":null,"abstract":"<div><div>The complement system is a network of soluble and cell surface proteins primarily involved in innate immune responses. Complement signalling is essential for pathogen defence and homeostasis, but an activation-regulation imbalance can lead to tissue damage. This phenomenon has been implicated in kidney diseases such as atypical Haemolytic Uraemic Syndrome (aHUS), frequently associated with dysfunction of the complement regulator Factor H (FH). Physiologically, complement interacts with the coagulation, fibrinolysis, renin-angiotensin and kallikrein-kinin systems (KKS). The KKS is a proinflammatory and procoagulant cascade comprised of the protease prekallikrein, the coagulation factors XI (FXI) and XII (FXII), and the cofactor/substrate high-molecular-weight kininogen. KKS can be activated conformationally or proteolytically. KKS activation <em>in vitro</em> triggers a number of biochemical interactions between FXI, FXII, FH and other complement proteins that result in direct or secondary complement activation. These functional links point to an overall complement pro-activating role for the KKS that has implications for coagulation and immunity, but whose physiological consequences <em>in vivo</em> remain largely unexplored. This review aims to summarize the main physiopathological events of KKS activation in the context of complement-mediated kidney disease, with particular emphasis in aHUS.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 8","pages":"Article 501347"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145183777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Promoviendo giros en el manejo de la enfermedad renal del paciente con obesidad","authors":"Albert Lecube ,&nbsp;Jorge Iván Zamora ,&nbsp;Sharona Azriel ,&nbsp;Esther Barreiro ,&nbsp;Guadalupe Blay ,&nbsp;Juana Carretero-Gómez ,&nbsp;Andreea Ciudin ,&nbsp;José Manuel Fernández-García ,&nbsp;Lilliam Flores ,&nbsp;Ana de Hollanda ,&nbsp;Marina López-Martínez ,&nbsp;Eva Martínez ,&nbsp;Inka Miñambres ,&nbsp;Violeta Moizé ,&nbsp;Cristóbal Morales ,&nbsp;Violeta Ramírez ,&nbsp;Javier Salvador ,&nbsp;Marta Supervía ,&nbsp;Víctor Valentí ,&nbsp;Germán Vicente-Rodríguez ,&nbsp;María José Soler","doi":"10.1016/j.nefro.2025.501358","DOIUrl":"10.1016/j.nefro.2025.501358","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 8","pages":"Article 501358"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145183867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between single nucleotide polymorphisms in NLRP gene and diabetic nephropathy","authors":"Eman A.E. Badr ,&nbsp;Safwa O. Toulan ,&nbsp;Yasser A. El Ghobashy ,&nbsp;Ahmed Mostafa Nofal ,&nbsp;Mohamed F.A. Assar","doi":"10.1016/j.nefro.2025.501339","DOIUrl":"10.1016/j.nefro.2025.501339","url":null,"abstract":"<div><h3>Background</h3><div>Diabetic nephropathy (DN) is a major cause of chronic kidney disease, influenced by genetic and inflammatory factors. SNPs in NLRP1 and NLRP3 genes, key regulators of inflammation, may contribute to DN susceptibility, offering insights into its pathogenesis and potential therapeutic targets. This study aims to investigate the association between single nucleotide polymorphisms (SNPs) in NLRP1 and NLRP3 genes and the susceptibility to diabetic nephropathy.</div></div><div><h3>Methods</h3><div>This cross-sectional study was conducted on 192 subjects, comprising 96 DN patients and 96 healthy controls. Diabetic nephropathy was diagnosed with albumin creatinine ratio in urine. Genotyping of SNPs rs878329 in NLRP1 and rs10754558 in NLRP3 was performed using the TaqMan® Allelic Discrimination assay.</div></div><div><h3>Results</h3><div>Significant differences were found in the distribution of both rs878329 and rs10754558 genotypes between cases and controls. The GG genotype of rs878329 and the CG genotype of rs10754558 were significantly more prevalent among DN patients (<em>p</em> <!-->=<!--> <!-->0.002 and <em>p</em> <!-->=<!--> <!-->0.005, respectively). Allelic analysis revealed a higher frequency of the G allele in both SNPs among DN cases (<em>p</em> <!-->=<!--> <!-->0.001 and <em>p</em> <!-->=<!--> <!-->0.002, respectively).</div></div><div><h3>Conclusion</h3><div>Our study supports the involvement of NLRP gene polymorphisms in the pathogenesis of DN, potentially offering new insights into genetic predispositions to this condition.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 8","pages":"Article 501339"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145183778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dos casos de remisión de nefritis lúpica refractaria con voclosporina","authors":"Juan A. Martín Navarro ,&nbsp;Ana S. Pareja Martínez ,&nbsp;M. Angeles Matías de la Mano ,&nbsp;M. Teresa Navío Marco ,&nbsp;Eva M. Chavarría Mur ,&nbsp;Elena Conde Montero ,&nbsp;Santos Esteban Casado ,&nbsp;Laura Medina Zahonero ,&nbsp;Fabio L. Procaccini ,&nbsp;Patricia Muñoz Ramos ,&nbsp;Roberto Alcázar Arroyo ,&nbsp;Patricia de Sequera Ortiz","doi":"10.1016/j.nefro.2025.501361","DOIUrl":"10.1016/j.nefro.2025.501361","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 8","pages":"Article 501361"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145183863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validación multicéntrica de la fórmula Kidney Failure Risk Equation (KFRE) en pacientes españoles con enfermedad renal crónica avanzada","authors":"Marco Montomoli","doi":"10.1016/j.nefro.2025.501389","DOIUrl":"10.1016/j.nefro.2025.501389","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 8","pages":"Article 501389"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145183865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and efficacy of sodium-glucose co-transporter-2 inhibitors and aldosterone inhibitors combinations in chronic kidney disease: A systematic review and meta-analysis","authors":"Ahmed W. Hageen ,&nbsp;Reem Sayad ,&nbsp;Alyaa Khaled Abdelmonem ,&nbsp;Katia Latifa ,&nbsp;Lina Musallam ,&nbsp;Moustafa Abouelkheir ,&nbsp;Sherif Mira ,&nbsp;Ahmed Awad ,&nbsp;Ahmed Afsa ,&nbsp;Waleed Nassar ,&nbsp;Gehad El Ashal ,&nbsp;Mohamed Elmasry ,&nbsp;Eshak I. Bahbah","doi":"10.1016/j.nefro.2025.501345","DOIUrl":"10.1016/j.nefro.2025.501345","url":null,"abstract":"<div><div>Sodium-glucose co-transporter-2 inhibitors (SGLT2i) and aldosterone inhibitors show promise for treating chronic kidney disease (CKD). This systematic review and meta-analysis explored the efficacy and safety of aldosterone inhibitors plus SGLT2i combination compared to their effects. We searched PubMed, Scopus, Web of Science, Cochrane Central Register of Controlled Trials [CENTRAL], and EBSCOhost. We reported dichotomous outcomes as pooled relative ratios and continuous outcomes as standardized mean differences with a 95% confidence interval. Three studies were included in this meta-analysis. The combination therapy was associated with a significantly higher rate of 30% reduction of urine albumin creatinine ratio (UACR) compared to SGLT2i (RR<!--> <!-->=<!--> <!-->2.38, 95% CI, 1.46–3.46, <em>P</em> <!-->&lt;<!--> <!-->0.001; <em>I</em>² <!-->=<!--> <!-->0%, <em>P</em> <!-->=<!--> <!-->0.54) and compared to MRA (RR<!--> <!-->=<!--> <!-->1.34, 95% CI, 1.12–1.60, <em>P</em> <!-->=<!--> <!-->0.001; <em>I</em>² <!-->=<!--> <!-->13%, <em>P</em> <!-->=<!--> <!-->0.28). It also showed a significant reduction in the UACR compared to SGLT2i (SMD<!--> <!-->=<!--> <!-->−1.47, 95% CI, −2.25 to −0.68, <em>P</em> <!-->=<!--> <!-->0.0003; <em>I</em>² <!-->=<!--> <!-->78%, <em>P</em> <!-->=<!--> <!-->0.03) but no significant reduction compared to aldosterone inhibitors (SMD<!--> <!-->=<!--> <!-->−0.10, 95% CI, −0.38 to 0.19, <em>P</em> <!-->=<!--> <!-->0.51; <em>I</em>² <!-->=<!--> <!-->67%, <em>P</em> <!-->=<!--> <!-->0.05). The pooled data showed no significant difference in the incidence of serious adverse events between the combination therapy and SGLT2i (RR<!--> <!-->=<!--> <!-->1.01, 95% CI, 0.72–1.41, <em>P</em> <!-->=<!--> <!-->0.96; <em>I</em>² <!-->=<!--> <!-->0%, <em>P</em> <!-->=<!--> <!-->0.58) or MRA (RR<!--> <!-->=<!--> <!-->1.01, 95% CI, 0.79–1.30, <em>P</em> <!-->=<!--> <!-->0.92; <em>I</em>² <!-->=<!--> <!-->0%, <em>P</em> <!-->=<!--> <!-->0.90). In conclusion, combining SGLT2i and aldosterone inhibitors may offer a promising approach for managing albuminuria and potentially slowing kidney disease progression in CKD patients.</div><div>We registered the protocol in PROSPERO CRD42024511675.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 8","pages":"Article 501345"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145183779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comentarios al artículo: «Validación multicéntrica de la fórmula Kidney Failure Risk Equation (KFRE) en pacientes españoles con enfermedad renal crónica avanzada»","authors":"Eduardo Gallego-Valcarce ,&nbsp;Amir Shabaka ,&nbsp;Ana Tato-Ribera ,&nbsp;Enrique Gruss","doi":"10.1016/j.nefro.2025.501364","DOIUrl":"10.1016/j.nefro.2025.501364","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 8","pages":"Article 501364"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145183864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of renal denervation with and without antihypertensives in patients with resistant hypertension: A systematic review and meta-analysis","authors":"Maryam Adnan ,&nbsp;Hamza Naveed ,&nbsp;Mohammad Hamza ,&nbsp;Burhan Khalid ,&nbsp;Wasif Safdar ,&nbsp;Jawad Basit ,&nbsp;Sameh Nassar ,&nbsp;Prakash Upreti ,&nbsp;Maha Zafar ,&nbsp;Zainab Javeed ,&nbsp;Marloe Prince ,&nbsp;Yasar Sattar ,&nbsp;M. Chadi Alraies","doi":"10.1016/j.nefro.2025.501333","DOIUrl":"10.1016/j.nefro.2025.501333","url":null,"abstract":"<div><h3>Background</h3><div>Resistant hypertension presents a clinical challenge. The efficacy of renal denervation (RDN) as a potential treatment has conflicting data. Multiple randomized controlled trials have been conducted to assess the impact of RDN.</div></div><div><h3>Methods</h3><div>We performed systematic search of the PubMed and EMBASE from inception to April 2024 to identify studies comparing various interventions for resistant hypertension. We employed a frequentist network meta-analysis model, utilizing the <em>net</em>-<em>meta</em> module and applying a random effects model in CRAN-R software.</div></div><div><h3>Results</h3><div>Data of 2553 patients from 20 RCTs was analyzed. Standard mean differences (SMDs) for diastolic blood pressure (DBP) and systolic blood pressure (SBP) were assessed at different time points, including daytime, nighttime, over 24<!--> <!-->h, and during office visits. Our results demonstrate an improvement in various BP parameters when comparing RDN with sham: daytime DBP (3.46, 95%CI: [1.89–5.02], <em>P</em> <!-->&lt;<!--> <!-->0.0001), nighttime SBP (2.87, 95%CI: [1.43–4.31], <em>P</em> <!-->&lt;<!--> <!-->0.0001), 24-h SBP (2.82, 95%CI: [1.24–4.41], <em>P</em> <!-->=<!--> <!-->0.001), and in-office DBP (2.70, 95%CI: [1.04–4.36], <em>P</em> <!-->=<!--> <!-->0.002). However, no statistically significant difference was found in daytime SBP (3.60, 95% CI: [−0.67–7.87], <em>P</em> <!-->=<!--> <!-->0.10), nighttime DBP (1.65, 95% CI: [−0.57–3.86], <em>P</em> <!-->=<!--> <!-->0.15) and in-office SBP (3.89, 95% CI: [−10.07–17.86], <em>P</em> <!-->=<!--> <!-->0.60) and in 24-h DBP.</div></div><div><h3>Conclusion</h3><div>Our study supports the efficacy of RDN, when combined with antihypertensive treatment when compared to sham treatment, in the management of resistant hypertension.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 8","pages":"Article 501333"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145183731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular and renal outcomes according to KDIGO stages of chronic kidney disease in the Spanish population: Insights from real-world evidence","authors":"Rafael Santamaria ,&nbsp;Carlos Escobar ,&nbsp;Unai Aranda ,&nbsp;Beatriz Palacios ,&nbsp;Margarita Capel ,&nbsp;Ignacio Hernández ,&nbsp;Ana Cebrián ,&nbsp;Roberto Alcázar ,&nbsp;Manuel Gorostidi","doi":"10.1016/j.nefro.2025.501340","DOIUrl":"10.1016/j.nefro.2025.501340","url":null,"abstract":"<div><h3>Objective</h3><div>Real-world analysis of the clinical profile, treatments, major adverse cardiovascular and renal events (MACE and MARE) in patients with different stages of chronic kidney disease (CKD) as defined by KDIGO guidelines.</div></div><div><h3>Methods</h3><div>This was an observational, retrospective study using the BIG-PAC database. Adults with ≥1 measurement of estimated glomerular filtration rate (eGFR) and albumin-to-creatinine ratio (UACR) closest to 1st January 2018 (up to 6 months) were included. Patients were followed for two years.</div></div><div><h3>Results</h3><div>Among 70,385 subjects, 21,127 (30.0%) had CKD based on impaired renal function or increased albuminuria. Age and prevalence of diabetes and cardiovascular disease increased as kidney function decreased, or albuminuria rose. Renin–angiotensin system inhibitors were prescribed in 47.1–76.4% patients classified as G3a–G5 and mildly increased albuminuria (A1), 63.2–79.6% in G1–G5 and moderately increased albuminuria (A2), and 51.2–85.9% in G1–G5 and severely increased albuminuria (A3). The prescription of sodium-glucose cotransporter-2 inhibitors was marginal across KDIGO categories. The incidence rates (per 1000 patient-year) of MACE ranged 102.9–245.2 in patients classified as G3a–G5 A1, 40.7–261.1 in G1–G5 A2, and 69.1–362.3 in G1–G5 A3. Incidence rates of MARE ranged 14.9–454.4 in G3a–G5 A1, 29.8–588.5 in G1–5 A2, and 11.8–637.2 in G1–5 A3.</div></div><div><h3>Conclusions</h3><div>In real-world, the risk of cardiovascular and renal complications rises as kidney function declines and albuminuria worsens. Guideline-recommended therapies remain underused.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 8","pages":"Article 501340"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145183732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}