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Analysis of the association between Healthy Eating Index (HEI)-2020 and diabetic kidney disease in type 2 diabetes patients: Based on the NHANES database 健康饮食指数(HEI)-2020与2型糖尿病患者糖尿病肾病的相关性分析:基于NHANES数据库
IF 2.6 4区 医学 Q2 UROLOGY & NEPHROLOGY Pub Date : 2026-03-01 Epub Date: 2025-11-13 DOI: 10.1016/j.nefro.2025.501452
Chunping Dong, Hui Li, Jing Li, Yuan Qiao, Shan Gao

Background

A rise in the Healthy Eating Index (HEI) 2020 is associated with a reduced risk of chronic kidney disease. However, it remains unclear whether HEI-2020 exhibits a similar positive effect in diabetic patients.

Objectives

This work aimed to investigate the relationship between HEI-2020 and the prevalence of diabetic kidney disease (DKD) in type 2 diabetes (T2D) patients.

Methods

A cross-sectional analysis was based on the National Health and Nutrition Survey database from 2007 to 2018. A weighted logistic regression model, restricted cubic splines, and subgroup analysis were undertaken to assess the relationship between HEI-2020 and the prevalence of DKD in T2D patients. A weighted logistic regression model and a weighted quantile sum (WQS) regression model were employed. The independent impact of HEI-2020-related components on the prevalence of DKD among T2D patients was analyzed. In addition, sensitivity analysis was conducted.

Results

A total of 4255 participants with T2D were enrolled, with a DKD prevalence rate of 34.7%. The logistics regression analysis demonstrated a significant inverse relation between the HEI-2020 score and the prevalence of DKD in fully adjusted models (OR = 0.982, 95% CI: 0.973–0.992, P < 0.001). No nonlinear relationship was detected (P-non-linear = 0.970). No subgroup with significant interaction was identified. The WQS regression indicated that in fully adjusted models, the WQS index for HEI-2020 was significantly negatively correlated with the prevalence of DKD among T2D patients (OR = 0.765, 95% CI: 0.621–0.943, P = 0.012), with dairy products, total protein foods, and total vegetables as the most influential components. In addition, HEI-2020 was significantly negatively correlated with DKD in previously diagnosed T2D patients (OR = 0.979, 95% CI: 0.967–0.990, P < 0.001), while no significant association was observed in newly diagnosed patients. The sensitivity analysis yielded similar results, indicating that our results were robust.

Conclusion

This research revealed a relationship between an increase in the HEI-2020 score and a lower prevalence of DKD among T2D patients, emphasizing the importance of the intake of dairy products, total protein foods, and total vegetables. This finding provides new scientific grounds for dietary management in T2D patients.
健康饮食指数(HEI) 2020的上升与慢性肾脏疾病风险的降低有关。然而,HEI-2020是否在糖尿病患者中表现出类似的积极作用尚不清楚。目的探讨HEI-2020与2型糖尿病(T2D)患者糖尿病肾病(DKD)患病率的关系。方法基于2007 - 2018年全国健康与营养调查数据库进行横断面分析。采用加权logistic回归模型、受限三次样条和亚组分析来评估HEI-2020与T2D患者DKD患病率之间的关系。采用加权logistic回归模型和加权分位数和(WQS)回归模型。分析了hei -2020相关成分对T2D患者DKD患病率的独立影响。并进行敏感性分析。结果共纳入T2D患者4255例,DKD患病率为34.7%。logistic回归分析显示,在完全调整模型中,HEI-2020评分与DKD患病率呈显著负相关(OR = 0.982, 95% CI: 0.973-0.992, P < 0.001)。无非线性关系(p -非线性= 0.970)。没有发现有显著相互作用的亚组。WQS回归显示,在完全调整模型中,HEI-2020的WQS指数与T2D患者DKD患病率呈显著负相关(OR = 0.765, 95% CI: 0.621-0.943, P = 0.012),其中乳制品、总蛋白食品和总蔬菜是影响最大的成分。此外,HEI-2020与先前诊断的T2D患者的DKD呈显著负相关(OR = 0.979, 95% CI: 0.967 ~ 0.990, P < 0.001),而在新诊断的患者中未见显著相关。敏感性分析得出了类似的结果,表明我们的结果是稳健的。结论本研究揭示了t2dm患者HEI-2020评分升高与DKD患病率降低之间的关系,强调了乳制品、总蛋白食品和总蔬菜摄入的重要性。这一发现为t2dm患者的饮食管理提供了新的科学依据。
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引用次数: 0
Uso en vida real de patirómero en pacientes con hiperpotasemia: estudio retrospectivo en la Comunidad Valenciana 高钾血症患者的实际使用:瓦伦西亚社区回顾性研究
IF 2.6 4区 医学 Q2 UROLOGY & NEPHROLOGY Pub Date : 2026-03-01 Epub Date: 2025-11-15 DOI: 10.1016/j.nefro.2025.501454
Francesc Moncho-Francés , Boris Gonzales-Candia , José Perez-Silvestre , Miriam Sandin , Pilar Sanchez-Perez , Rafael Garcia-Maset , Jonay Pantoja , Juan Antonio Carbonell-Asins , Elena Gimenez-Civera , Rafael De la Espriella , María Jesús Puchades , Julio Nuñez , José Luis Górriz

Background and objective

Hyperkalaemia is common in patients with chronic kidney disease (CKD) treated with renin-angiotensin-aldosterone system inhibitors (RAASi) and mineralocorticoid receptor antagonists (MRAs). Although new potassium binders have demonstrated efficacy in clinical trials, evidence from real-world clinical practice remains limited.

Materials and methods

We present a retrospective, observational, multicentre, non-interventional study aimed at evaluating the use of patiromer in patients with hyperkalaemia under routine clinical conditions in the Valencian Community. Patients who received patiromer for at least 3 months due to hyperkalaemia were included. The primary objective was to assess the evolution of serum potassium at 1, 3, 6, and 12 months after initiation of treatment. Secondary objectives included describing baseline patient characteristics, changes in RAASi and MRA therapy, and patiromer-related adverse events.

Results

A total of 59 patients were included. The baseline serum potassium level was 5.72 mmol/L, showing significant reductions at 1, 3, 6, and 12 months (5.02, 5.17, 5.11, and 5.01 mmol/L, respectively; all p < 0.001). Patiromer treatment enabled continuation of RAASi in 94.9% of patients and MRAs in 98.3%. The most frequent adverse events were gastrointestinal. Patiromer was discontinued in 8 patients (13.5%), with adverse effects accounting for half of these cases.

Conclusions

Our study provides real-world evidence on the effectiveness, safety, and RAASi/MRA maintenance potential of patiromer in patients with CKD and hyperkalaemia under routine care. In this setting, patiromer proved effective and well tolerated for managing hyperkalaemia and preserving RAASi/MRA therapy.
背景与目的高钾血症在肾素-血管紧张素-醛固酮系统抑制剂(RAASi)和矿皮质激素受体拮抗剂(MRAs)治疗的慢性肾脏疾病(CKD)患者中很常见。尽管新的钾结合剂已经在临床试验中证明了有效性,但来自现实世界临床实践的证据仍然有限。材料和方法我们提出了一项回顾性、观察性、多中心、非介入性研究,旨在评估在瓦伦西亚社区常规临床条件下高钾血症患者使用帕利莫的情况。包括因高血钾而接受帕利莫治疗至少3个月的患者。主要目的是评估治疗开始后1、3、6和12个月血清钾的变化。次要目标包括描述基线患者特征,RAASi和MRA治疗的变化,以及患者相关的不良事件。结果共纳入59例患者。基线血清钾水平为5.72 mmol/L,在1、3、6和12个月时显著降低(分别为5.02、5.17、5.11和5.01 mmol/L, p均为0.001)。在94.9%的患者和98.3%的患者中,parromer治疗使RAASi得以延续。最常见的不良反应是胃肠道。8例患者(13.5%)停药,不良反应占这些病例的一半。结论我们的研究为CKD合并高钾血症患者在常规护理下使用patiromer的有效性、安全性和RAASi/MRA维持潜力提供了现实证据。在这种情况下,patiromer被证明对治疗高钾血症和维持RAASi/MRA治疗有效且耐受性良好。
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引用次数: 0
Deficiencia de lecitina colesterol aciltransferasa con hallazgo de «cuerpos de cebra»: un reto diagnóstico frente a la sospecha de enfermedad de Fabry 发现“斑马体”缺乏卵磷脂胆固醇酰转移酶:对Fabry疑似疾病的诊断挑战
IF 2.6 4区 医学 Q2 UROLOGY & NEPHROLOGY Pub Date : 2026-03-01 Epub Date: 2025-10-28 DOI: 10.1016/j.nefro.2025.501444
Juan Enrique Rodriguez Mori , Milagros del Pilar Dapello Jimenez , Julia Sumire Umeres , Roxana Maybor Lipa Chancolla
Lecithin–cholesterol acyltransferase (LCAT) deficiency is a rare autosomal recessive disorder resulting from mutations in the LCAT gene, which leads to abnormal lipoprotein metabolism. This results in markedly reduced high-density lipoprotein cholesterol and the accumulation of lipoprotein X, leading to renal, corneal, and hemolytic damage. Two clinical variants have been described: familial LCAT deficiency (FLD) and fish-eye disease (FED).
We report the case of a 41-year-old male with a history of hypertension, tinnitus, and progressive hearing loss, who presented with bilateral corneal opacity since childhood. Laboratory studies revealed significant proteinuria (2.56 g/24 h), preserved renal function (creatinine 0.85 mg/dl), mild anemia (Hb 10.2 g/dl), and extremely low HDL cholesterol (1.3 mg/dl). Renal biopsy showed focal segmental glomerulosclerosis and mesangial expansion. Electron microscopy demonstrated concentric lamellar inclusions known as “zebra bodies,” a finding typically associated with Fabry disease. However, α-galactosidase A activity was normal, and genetic testing for Fabry disease was negative. Further genetic analysis identified the variant c.757 p.(Gln253Argfs*11) in the LCAT gene, confirming the diagnosis of familial LCAT deficiency.
This case highlights the importance of differentiating LCAT deficiency from Fabry disease, given their overlapping clinical and histological features. Moreover, it represents the first description of “zebra bodies” in LCAT deficiency, emphasizing the diagnostic complexity and the need for a multidisciplinary approach to ensure accurate diagnosis and appropriate management.
卵磷脂-胆固醇酰基转移酶(LCAT)缺乏症是一种罕见的常染色体隐性遗传病,由LCAT基因突变引起,导致脂蛋白代谢异常。这导致高密度脂蛋白胆固醇的显著降低和脂蛋白X的积累,导致肾脏、角膜和溶血性损伤。已经描述了两种临床变体:家族性LCAT缺乏症(FLD)和鱼眼病(FED)。我们报告一例41岁男性,有高血压、耳鸣和进行性听力丧失的病史,从小就表现为双侧角膜混浊。实验室研究显示明显的蛋白尿(2.56 g/24 h),肾功能保存(肌酐0.85 mg/dl),轻度贫血(Hb 10.2 g/dl)和极低的高密度脂蛋白胆固醇(1.3 mg/dl)。肾活检显示局灶性节段性肾小球硬化和系膜扩张。电子显微镜显示同心片层内含物称为“斑马体”,这一发现通常与法布里病有关。但α-半乳糖苷酶A活性正常,法布里病基因检测阴性。进一步的遗传分析在LCAT基因中发现了c.757 p.(Gln253Argfs*11)变异,证实了家族性LCAT缺乏症的诊断。本病例强调了区分LCAT缺乏症与Fabry病的重要性,因为它们具有重叠的临床和组织学特征。此外,它代表了LCAT缺乏症中“斑马体”的首次描述,强调了诊断的复杂性和多学科方法的必要性,以确保准确的诊断和适当的管理。
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引用次数: 0
Masked alterations of glucose metabolism among patients awaiting kidney transplantation: Metabolic phenotyping and screening strategies 等待肾移植的患者糖代谢的隐性改变:代谢表型和筛选策略
IF 2.6 4区 医学 Q2 UROLOGY & NEPHROLOGY Pub Date : 2026-03-01 Epub Date: 2025-11-26 DOI: 10.1016/j.nefro.2025.501465
Elena Terán-García , Lourdes Perez-Tamajón , Celia R. Rodríguez-López , Arminda Fariña-Hernández , Estefanía Perez-Carreño , Domingo Marrero-Miranda , Cristian Acosta-Sorensen , Antonia María de Vera-González , Alejandra González-Delgado , Ana Elena Rodríguez-Rodríguez , Sagrario García-Rebollo , Concepción Rodríguez-Adanero , Alejandra Álvarez-González , Ana Gonzalez-Rinne , Antonio Manuel Rivero-González , Manuel Luis Macia-Heras , Aurelio P. Rodríguez-Hernández , Eduardo De Bonis-Redondo , Esteban Porrini , Domingo Hernández-Marrero , Armando Torres

Background

Patients awaiting kidney transplantation are recommended to undergo systematic oral glucose tolerance tests (OGTT) to detect glucose metabolic alterations (GMA) that heighten the risk of posttransplant diabetes.

Aims

(a) To determine GMA prevalence and metabolic phenotypes; (b) assess optimal screening strategies for abnormal OGTT detection; and (c) evaluate one-year GMA trajectory through repeated OGTT during the waiting list period.

Methods

OGTTs were conducted on 182 wait-listed patients without diabetes, with 46 undergoing a repeat test after one year.

Results

Impaired glucose tolerance (IGT) was most common (23.1%). Undiagnosed diabetes (uDM) and isolated impaired fasting glucose (IFG) were observed in 6% and 4.4%, respectively. Patients with IGT/uDM exhibited decreased insulin secretion, while isolated IFG patients showed reduced insulin sensitivity. Abnormal OGTT correlated with statin therapy [OR 2.4 (1.17–4.9); P = 0.02], fasting glucose [OR 1.03 (1.01–1.06); P = .02], and age [OR 1.03 (1–1.06); P = 0.048]. Patients below age (51 years) and fasting glucose (100 mg/dL) thresholds, not on statins, had lower odds of abnormal OGTT potentially reducing routine testing needs by 26%. Transition from normal to abnormal OGTT after one year correlated with higher baseline BMI [27.5 kg/m2 (IQR 25.6–31.7) vs. 24.1 kg/m2 (IQR 21.3–25.8); P = 0.04], lower insulin sensitivity [Matsuda index 15.7 (IQR 11.4–24.5) vs. 22.9 (IQR 15.5–37); P = 0.049], and statin use (75% vs. 32%; P = 0.047).

Conclusions

One-third of wait-listed patients without manifest diabetes exhibit abnormal OGTT. Age, fasting glucose, and statin use increase risk. Patients below age and fasting glucose thresholds, without statins, have low abnormal OGTT likelihood, potentially reducing routine testing. Annual OGTT may benefit patients initially with normal results, if overweight/obese, or on statins.
背景:等待肾移植的患者被建议进行系统的口服葡萄糖耐量试验(OGTT),以检测葡萄糖代谢改变(GMA)是否会增加移植后糖尿病的风险。目的(a)确定GMA患病率和代谢表型;(b)评估异常OGTT检测的最佳筛查策略;(c)在等待名单期间通过重复OGTT评估一年的GMA轨迹。方法对182例非糖尿病患者进行gtt试验,其中46例在1年后进行重复试验。结果以糖耐量降低(IGT)最为常见(23.1%)。未确诊糖尿病(uDM)和孤立性空腹血糖受损(IFG)分别为6%和4.4%。IGT/uDM患者表现出胰岛素分泌减少,而分离的IFG患者表现出胰岛素敏感性降低。OGTT异常与他汀类药物治疗相关[OR 2.4 (1.17-4.9);P = 0.02],空腹血糖[OR = 1.03 (1.01-1.06);P = .02],年龄[OR 1.03 (1-1.06);p = 0.048]。年龄(51岁)以下和空腹血糖(100 mg/dL)阈值的患者,不服用他汀类药物,OGTT异常的几率较低,可能使常规检测需求减少26%。一年后OGTT从正常到异常的转变与较高的基线BMI相关[27.5 kg/m2 (IQR 25.6-31.7) vs. 24.1 kg/m2 (IQR 21.3-25.8);P = 0.04],胰岛素敏感性降低[Matsuda指数15.7 (IQR 11.4-24.5) vs. 22.9 (IQR 15.5-37);P = 0.049),他汀类药物使用(75%比32%,P = 0.047)。结论1 / 3无明显糖尿病患者OGTT异常。年龄、空腹血糖和他汀类药物的使用会增加风险。年龄和空腹血糖阈值以下的患者,不使用他汀类药物,OGTT异常可能性较低,可能减少常规检测。如果超重/肥胖或服用他汀类药物,每年一次的OGTT可能会使最初结果正常的患者受益。
{"title":"Masked alterations of glucose metabolism among patients awaiting kidney transplantation: Metabolic phenotyping and screening strategies","authors":"Elena Terán-García ,&nbsp;Lourdes Perez-Tamajón ,&nbsp;Celia R. Rodríguez-López ,&nbsp;Arminda Fariña-Hernández ,&nbsp;Estefanía Perez-Carreño ,&nbsp;Domingo Marrero-Miranda ,&nbsp;Cristian Acosta-Sorensen ,&nbsp;Antonia María de Vera-González ,&nbsp;Alejandra González-Delgado ,&nbsp;Ana Elena Rodríguez-Rodríguez ,&nbsp;Sagrario García-Rebollo ,&nbsp;Concepción Rodríguez-Adanero ,&nbsp;Alejandra Álvarez-González ,&nbsp;Ana Gonzalez-Rinne ,&nbsp;Antonio Manuel Rivero-González ,&nbsp;Manuel Luis Macia-Heras ,&nbsp;Aurelio P. Rodríguez-Hernández ,&nbsp;Eduardo De Bonis-Redondo ,&nbsp;Esteban Porrini ,&nbsp;Domingo Hernández-Marrero ,&nbsp;Armando Torres","doi":"10.1016/j.nefro.2025.501465","DOIUrl":"10.1016/j.nefro.2025.501465","url":null,"abstract":"<div><h3>Background</h3><div>Patients awaiting kidney transplantation are recommended to undergo systematic oral glucose tolerance tests (OGTT) to detect glucose metabolic alterations (GMA) that heighten the risk of posttransplant diabetes.</div></div><div><h3>Aims</h3><div>(a) To determine GMA prevalence and metabolic phenotypes; (b) assess optimal screening strategies for abnormal OGTT detection; and (c) evaluate one-year GMA trajectory through repeated OGTT during the waiting list period.</div></div><div><h3>Methods</h3><div>OGTTs were conducted on 182 wait-listed patients without diabetes, with 46 undergoing a repeat test after one year.</div></div><div><h3>Results</h3><div>Impaired glucose tolerance (IGT) was most common (23.1%). Undiagnosed diabetes (uDM) and isolated impaired fasting glucose (IFG) were observed in 6% and 4.4%, respectively. Patients with IGT/uDM exhibited decreased insulin secretion, while isolated IFG patients showed reduced insulin sensitivity. Abnormal OGTT correlated with statin therapy [OR 2.4 (1.17–4.9); <em>P</em> <!-->=<!--> <!-->0.02], fasting glucose [OR 1.03 (1.01–1.06); <em>P</em> <!-->=<!--> <!-->.02], and age [OR 1.03 (1–1.06); <em>P</em> <!-->=<!--> <!-->0.048]. Patients below age (51 years) and fasting glucose (100<!--> <!-->mg/dL) thresholds, not on statins, had lower odds of abnormal OGTT potentially reducing routine testing needs by 26%. Transition from normal to abnormal OGTT after one year correlated with higher baseline BMI [27.5<!--> <!-->kg/m<sup>2</sup> (IQR 25.6–31.7) vs. 24.1<!--> <!-->kg/m<sup>2</sup> (IQR 21.3–25.8); <em>P</em> <!-->=<!--> <!-->0.04], lower insulin sensitivity [Matsuda index 15.7 (IQR 11.4–24.5) vs. 22.9 (IQR 15.5–37); <em>P</em> <!-->=<!--> <!-->0.049], and statin use (75% vs. 32%; <em>P</em> <!-->=<!--> <!-->0.047).</div></div><div><h3>Conclusions</h3><div>One-third of wait-listed patients without manifest diabetes exhibit abnormal OGTT. Age, fasting glucose, and statin use increase risk. Patients below age and fasting glucose thresholds, without statins, have low abnormal OGTT likelihood, potentially reducing routine testing. Annual OGTT may benefit patients initially with normal results, if overweight/obese, or on statins.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"46 3","pages":"Article 501465"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147413304","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}
引用次数: 0
Concerns regarding glomerular disease in chronic graft versus host disease (cGVHD) 慢性移植物抗宿主病(cGVHD)对肾小球疾病的关注
IF 2.6 4区 医学 Q2 UROLOGY & NEPHROLOGY Pub Date : 2026-03-01 Epub Date: 2025-09-29 DOI: 10.1016/j.nefro.2025.501427
Karishma Bai , Priyanka Bansari , Sara Khan
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引用次数: 0
Más allá de los libros de texto: cilindros vacuolados como marcador emergente en el sedimento urinario 教科书之外:真空钢瓶作为尿沉淀物的新兴标记
IF 2.6 4区 医学 Q2 UROLOGY & NEPHROLOGY Pub Date : 2026-03-01 Epub Date: 2025-09-29 DOI: 10.1016/j.nefro.2025.501428
Oscar D. Pons-Belda , Ana Calbet-Tur , Paloma Livianos-Arias-Camison , Emilia Moreno-Noguero , Cassandra E. Puig-Hooper
{"title":"Más allá de los libros de texto: cilindros vacuolados como marcador emergente en el sedimento urinario","authors":"Oscar D. Pons-Belda ,&nbsp;Ana Calbet-Tur ,&nbsp;Paloma Livianos-Arias-Camison ,&nbsp;Emilia Moreno-Noguero ,&nbsp;Cassandra E. Puig-Hooper","doi":"10.1016/j.nefro.2025.501428","DOIUrl":"10.1016/j.nefro.2025.501428","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"46 3","pages":"Article 501428"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147413752","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}
引用次数: 0
Correlación de parámetros de ecografía renal con grado de enfermedad renal crónica 肾脏超声参数与慢性肾脏疾病程度的相关性
IF 2.6 4区 医学 Q2 UROLOGY & NEPHROLOGY Pub Date : 2026-03-01 Epub Date: 2025-11-17 DOI: 10.1016/j.nefro.2025.501450
Verónica Rubio Menéndez , Maite Rivera Gorrín
Renal ultrasound is a fundamental tool in nephrological practice due to its non-invasive nature, accessibility, and low cost. Although it is widely used for the initial diagnosis of kidney diseases, its role as a follow-up method in chronic kidney disease (CKD) is less frequent.
This review explores the correlation between ultrasound parameters and CKD progression, considering that these may reflect kidney morphostructural changes.
Several ultrasound parameters are analyzed: renal length adjusted for height and corrected parenchymal thickness show a significant association with estimated glomerular filtration rate (eGFR). In contrast, cortical thickness and renal width present limitations and show poor correlation with eGFR.
Renal echogenicity, assessed against the liver and spleen, is related to irreversible renal damage and histological changes such as tubular atrophy and glomerulosclerosis, being one of the best ultrasound predictors of CKD progression. Of particular note is the CKD ultrasound score proposed by Yaprak, which integrates renal length, parenchymal thickness, and parenchymal echogenicity. This score has demonstrated high predictive ability to identify eGFR < 60 mL/min, with an area under the curve of 0.829, sensitivity of 81%, and positive predictive value of 92%.
Finally, intrarenal Doppler parameters are described. The resistive index (RI) and peak systolic velocity (PSV) correlate with renal histological damage.
In conclusion, when appropriately applied and interpreted, renal ultrasound can provide valuable information for a more comprehensive assessment of CKD progression.
肾脏超声由于其无创性、可及性和低成本,是肾脏学实践的基本工具。虽然它被广泛用于肾脏疾病的初始诊断,但它作为慢性肾脏疾病(CKD)随访方法的作用较少。这篇综述探讨了超声参数与CKD进展之间的关系,考虑到这些参数可能反映肾脏形态结构的变化。我们分析了几个超声参数:经高度调整的肾长度和经校正的实质厚度显示与估计的肾小球滤过率(eGFR)显著相关。相反,皮质厚度和肾宽度存在局限性,与eGFR相关性较差。与肝脏和脾脏相比,肾脏回声增强与不可逆肾损害和组织学改变(如肾小管萎缩和肾小球硬化)有关,是CKD进展的最佳超声预测指标之一。特别值得注意的是由Yaprak提出的CKD超声评分,它综合了肾脏长度、实质厚度和实质回声性。该评分对eGFR 60 mL/min具有较高的预测能力,曲线下面积为0.829,灵敏度为81%,阳性预测值为92%。最后,描述了肾内多普勒参数。阻力指数(RI)和峰值收缩速度(PSV)与肾组织损伤相关。总之,当适当应用和解释时,肾脏超声可以为更全面地评估CKD进展提供有价值的信息。
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引用次数: 0
Enhancing chronic kidney disease care through risk prediction: A review of the kidney failure risk equation 通过风险预测加强慢性肾脏疾病的护理:肾衰竭风险方程的回顾
IF 2.6 4区 医学 Q2 UROLOGY & NEPHROLOGY Pub Date : 2026-03-01 Epub Date: 2025-12-11 DOI: 10.1016/j.nefro.2025.501473
Bernardo Marques da Silva , Inês Silveira , José António Lopes , Joana Gameiro
Chronic kidney disease (CKD) is a growing global health problem, with projections indicating a significant increase in its prevalence. The kidney failure risk equation (KFRE) has emerged as a valuable predictive tool to assess the risk of kidney failure in patients with CKD stages 3–5.
This narrative review presents a comprehensive analysis of the KFRE's development, validation, and clinical applications, and highlights its role in predicting disease progression, guiding nephrology referrals, and planning vascular access creation.
慢性肾脏疾病(CKD)是一个日益严重的全球健康问题,预测表明其患病率显着增加。肾衰竭风险方程(KFRE)已成为评估CKD 3-5期患者肾衰竭风险的有价值的预测工具。本文对KFRE的发展、验证和临床应用进行了全面的分析,并强调了其在预测疾病进展、指导肾内科转诊和规划血管通路创建方面的作用。
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引用次数: 0
Resultados de una encuesta nacional sobre el diagnóstico de la insuficiencia cardiaca en las consultas de nefrología: hora de actuar 关于在肾病检查中诊断心力衰竭的全国调查结果:采取行动的时机
IF 2.6 4区 医学 Q2 UROLOGY & NEPHROLOGY Pub Date : 2026-03-01 Epub Date: 2025-10-21 DOI: 10.1016/j.nefro.2025.501433
María Marques Vidas , Javier Diez , Patricia de Sequera , Alberto Ortiz , Gregorio Romero-González , María Fernanda Slon-Roblero , Adriana Puente-García , Borja Quiroga Gili

Introduction

Heart failure (HF) is a common comorbidity with a major prognostic impact in patients with chronic kidney disease (CKD). However, screening and diagnostic practices for HF in nephrology clinics are not optimized. The aim was to assess routine clinical practice and identify gaps in HF diagnosis in the care of patients with CKD at any stage.

Methods

A nationwide survey of Spanish nephrologists was conducted using an electronic questionnaire. Data collection took place over a two-month period.

Results

A total of 73 centers completed the questionnaire. The estimated prevalence of HF among the patients seen was 44.1%, although only 30% of these cases were thought to be documented in the medical record. Although 55.4% of respondents reported performing active screening, the use of diagnostic tools such as echocardiography, natriuretic peptides, and electrocardiography was variable and often conditioned by the presence of symptoms.

Conclusion

These findings support a call to action based on the need to implement protocolized, multidisciplinary strategies to optimize HF diagnosis, as well as the early initiation of appropriate therapies for HF in patients with chronic kidney disease
心衰(HF)是慢性肾脏疾病(CKD)患者常见的合并症,对预后有重要影响。然而,肾脏病诊所的心衰筛查和诊断实践并没有得到优化。目的是评估常规临床实践,确定CKD患者在任何阶段的心衰诊断差距。方法采用电子问卷对西班牙肾病专家进行全国性调查。数据收集在两个月的时间内进行。结果共有73个中心完成问卷调查。所见患者中心衰的估计患病率为44.1%,尽管这些病例中只有30%被认为记录在医疗记录中。尽管55.4%的应答者报告进行了主动筛查,但超声心动图、利钠肽和心电图等诊断工具的使用是可变的,通常受症状的影响。结论:这些研究结果支持了一项行动呼吁,即需要实施协议化的多学科策略来优化心衰诊断,以及对慢性肾脏疾病患者的心衰早期启动适当的治疗
{"title":"Resultados de una encuesta nacional sobre el diagnóstico de la insuficiencia cardiaca en las consultas de nefrología: hora de actuar","authors":"María Marques Vidas ,&nbsp;Javier Diez ,&nbsp;Patricia de Sequera ,&nbsp;Alberto Ortiz ,&nbsp;Gregorio Romero-González ,&nbsp;María Fernanda Slon-Roblero ,&nbsp;Adriana Puente-García ,&nbsp;Borja Quiroga Gili","doi":"10.1016/j.nefro.2025.501433","DOIUrl":"10.1016/j.nefro.2025.501433","url":null,"abstract":"<div><h3>Introduction</h3><div>Heart failure (HF) is a common comorbidity with a major prognostic impact in patients with chronic kidney disease (CKD). However, screening and diagnostic practices for HF in nephrology clinics are not optimized. The aim was to assess routine clinical practice and identify gaps in HF diagnosis in the care of patients with CKD at any stage.</div></div><div><h3>Methods</h3><div>A nationwide survey of Spanish nephrologists was conducted using an electronic questionnaire. Data collection took place over a two-month period.</div></div><div><h3>Results</h3><div>A total of 73 centers completed the questionnaire. The estimated prevalence of HF among the patients seen was 44.1%, although only 30% of these cases were thought to be documented in the medical record. Although 55.4% of respondents reported performing active screening, the use of diagnostic tools such as echocardiography, natriuretic peptides, and electrocardiography was variable and often conditioned by the presence of symptoms.</div></div><div><h3>Conclusion</h3><div>These findings support a call to action based on the need to implement protocolized, multidisciplinary strategies to optimize HF diagnosis, as well as the early initiation of appropriate therapies for HF in patients with chronic kidney disease</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"46 3","pages":"Article 501433"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147413749","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}
引用次数: 0
Interpretation of glycaemic variability in type 2 diabetes mellitus patients on maintenance haemodialysis using continuous glucose monitoring 用连续血糖监测解释维持血液透析的2型糖尿病患者的血糖变异性
IF 2.6 4区 医学 Q2 UROLOGY & NEPHROLOGY Pub Date : 2026-03-01 Epub Date: 2025-11-29 DOI: 10.1016/j.nefro.2025.501468
Asokan Arunkumar, Varadharajan Jayaprakash, Rajendran Rajasekar, Rishabh Gupta, Mathew Gerry George

Background

Diabetes mellitus is the leading cause of end-stage renal disease, accounting for approximately 40% of cases. Data on glycaemic metrics in diabetic population on maintenance haemodialysis is sparse. The role of continuous glucose monitoring in this population remains underexplored.

Methods

This prospective observational study aimed to comprehensively characterize glycaemic variability using continuous glucose monitoring in patients with type 2 diabetes mellitus undergoing maintenance haemodialysis. 25 patients aged between 18 and 70 years with more than 3 months of dialysis vintage were included in the study. After collecting socio-demographic and clinical data, an ambulatory glucose profile sensor was applied to the patient's upper limb before starting their scheduled dialysis session. Sensors measured the interstitial fluid glucose every 15 min, and a total of 96 readings were taken per day, continuously for 14 days (336 h).

Results

For statistical analysis, the study population was broadly divided into 2 major groups, one which required insulin for their glycaemic management and the other requiring an oral hypoglycaemic agent, linagliptin. Statistical analysis was performed using SPSS software version 26.0 (IBM Corp., Armonk, NY). In both the groups, glycaemic excursion was observed, with dialysis days having high mean glucose values than non-dialysis days, and the observation was more prominent in the insulin-treated group. The mean glucose levels were lower in the nocturnal period in both the groups. It was noticed that the overall glycaemic variability, glycaemic variability in both dialysis and non-dialysis days were lower in linagliptin-treated group.

Conclusion

This study demonstrated significant differences in glycaemic variability based on antidiabetic treatment modality in haemodialysis population. Continuous glucose monitoring is an invaluable tool to study glycaemic metrics and guide therapy in haemodialysis population.
糖尿病是导致终末期肾脏疾病的主要原因,约占40%的病例。关于维持血液透析的糖尿病人群血糖指标的数据很少。持续血糖监测在这一人群中的作用仍未得到充分探讨。方法本前瞻性观察研究旨在通过持续血糖监测全面表征2型糖尿病维持性血液透析患者的血糖变异性。25例患者年龄在18岁至70岁之间,透析时间超过3个月。在收集了社会人口统计学和临床数据后,在患者开始预定的透析疗程之前,将动态葡萄糖剖面传感器应用于患者的上肢。传感器每15分钟测量一次间质液葡萄糖,每天共采集96个读数,连续14天(336小时)。结果为了进行统计分析,研究人群大致分为两大组,一组需要胰岛素来控制血糖,另一组需要口服降糖药利格列汀。采用SPSS 26.0 (IBM Corp., Armonk, NY)软件进行统计分析。两组均出现血糖偏移,透析日的平均血糖值高于非透析日,且在胰岛素治疗组中更为明显。两组小鼠夜间的平均血糖水平都较低。我们注意到,利格列汀治疗组的总体血糖变异性、透析和非透析期间的血糖变异性均较低。结论血液透析人群中不同治疗方式的血糖变异性存在显著差异。连续血糖监测是研究血液透析人群血糖指标和指导治疗的宝贵工具。
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Nefrologia
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