Nefrologia最新文献

{"title":"Assessment and prediction of diabetic kidney disease in patients with type 2 diabetes mellitus by using an advanced biomarkers","authors":"Alyaa Hliel , Huda Ahmed , Hiba Hasan","doi":"10.1016/j.nefro.2025.03.001","DOIUrl":"10.1016/j.nefro.2025.03.001","url":null,"abstract":"<div><h3>Background</h3><div>Diabetic kidney disease (DKD), is the major microvascular complication of diabetes, affecting on 40% of type 2 diabetic patients, is the leading cause of end-stage renal failure. Microalbuminuria has limited diagnostic role in early-stage diabetic kidney disease, because renal damage usually occurs before proteinuria. Therefore, more sensitive and specific biomarkers are needed for early detection of DKD.</div></div><div><h3>Aims</h3><div>The aim of this study was to determine the levels of monocyte chemoattractant protein-1 (MCP-1) and Wnt inducible signaling pathway protein 1 (WISP1) in type 2 diabetic patients and using them as a better diagnostic biomarker in the early phase of DKD.</div></div><div><h3>Materials and methods</h3><div>A case–control study involved 180 participants aged from 40 to greater than 60 years, 60 individuals are healthy, 120 person with type 2 diabetes mellitus (T2DM), they were divided in three groups by using urinary albumin/creatinine ratio (UACR): Group 1: 40 patients with normoalbuminuria (ACR<!--> <!--><<!--> <!-->30<!--> <!-->mg/g creatinine). Group 2: 40 patients with microalbuminuria (ACR 30–300<!--> <!-->mg/g creatinine). Group 3: 40 patients with proteinuria (ACR<!--> <span>></span> <!-->300<!--> <!-->mg/g creatinine). Both serum MCP-1 and WISP1 levels were measured by an enzyme-linked immunosorbent assay (ELISA) the sandwich method. The patients were also assessed for duration of disease, fasting blood glucose, glycated hemoglobin, serum creatinine and blood urea. Urine albumin/creatinine ratio was determined by measurements of albumin and creatinine in morning urine sample.</div></div><div><h3>Results</h3><div>There was a significant elevation for all parameters in diabetic patients compared to control when estimated glomerular filtration rate (eGFR) decreased. The prevalence of DKD was found higher in male than in female and the majority of patients were older than ≥60 years. A significant difference with regards to age, body mass index (BMI) and duration of DM was found <em>p</em> <!-->≤<!--> <!-->0.001. The mean of MCP-1 and WISP1 levels were higher in T2DM patients as compared with control group. MCP-1 was (152.85<!--> <!-->±<!--> <!-->129.78), (137.24<!--> <!-->±<!--> <!-->93.3), (70.93<!--> <!-->±<!--> <!-->24.34) and (20.43<!--> <!-->±<!--> <!-->6.04<!--> <!-->pg/mL) in proteinuria, microalbuminuria, normoalbuminuria and control groups respectively. WISP1 was (125.83<!--> <!-->±<!--> <!-->41.4), (94.58<!--> <!-->±<!--> <!-->26.9), (59.44<!--> <!-->±<!--> <!-->21.28) and (24.64<!--> <!-->±<!--> <!-->7.6<!--> <!-->pg/mL) in proteinuria, microalbuminuria, normoalbuminuria and control groups respectively. MCP-1 had a strong association with blood urea, serum creatinine and an inverse association with eGFR. There was significant positive correlation between the WISP1 and urea. In contrast there was positive correlations with creatinine only in microalbuminuria and prote","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 6","pages":"Article 101330"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144611909","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":"Hiperuricemia en pacientes con enfermedad renal crónica: ¿cuándo y con qué tratar?","authors":"Marian Goicoechea ,&nbsp;Rodrigo García-Marina","doi":"10.1016/j.nefro.2025.501334","DOIUrl":"10.1016/j.nefro.2025.501334","url":null,"abstract":"<div><div>Hyperuricemia is frequently associated with gout, renal disease, arterial hypertension and high cardiovascular disease. All chronic kidney disease patients with a first episode of gout should be treated with hypouricemic drugs to achieve baseline uric acid levels of less than 6<!--> <!-->mg/dl (&lt;5<!--> <!-->mg/dl if tophi are present). The hypouricemic drugs of choice in patients with chronic kidney disease are allopurinol and febuxostat, always starting treatment with low doses that can be progressively increased according to tolerance. Asymptomatic hyperuricemia increases the risk of arterial hypertension, cardiovascular disease and renal disease, but at present published clinical trials do not support the treatment of asymptomatic hyperuricemia in patients with chronic kidney disease.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 6","pages":"Article 501334"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144611863","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":"Relationship between macrophage phenotype and kidney survival in patients with lupus nephritis","authors":"Ozcan Uzun ,&nbsp;Cihan Heybeli ,&nbsp;Fatma Sema Anar Kutlu ,&nbsp;Evrim Atmaca ,&nbsp;Filiz Yıldırım ,&nbsp;Caner Cavdar ,&nbsp;Sulen Sarioglu","doi":"10.1016/j.nefro.2025.04.001","DOIUrl":"10.1016/j.nefro.2025.04.001","url":null,"abstract":"<div><h3>Aims</h3><div>To determine the possible relationship between macrophage phenotypes and the progression of kidney disease in patients with lupus nephritis (LN).</div></div><div><h3>Methods</h3><div>Using immunohistochemistry, CD68⁺ and CD163⁺ cells were counted per glomerulus and per high-power field in the tubulointerstitium. Progression was defined as a doubling of the serum creatinine level and/or progression to end-stage kidney disease.</div></div><div><h3>Results</h3><div>Among the 21 patients, 52% had class III or IV LN. During the median follow-up of 88 months, 5 (23.8%) patients experienced progression. In terms of clinical and pathological markers, the only significant difference between progressors and nonprogressors was the number of interstitial CD163⁺ cells (median 4 versus 2.4, respectively; <em>p</em> <!-->=<!--> <!-->0.025). A cutoff value of 2.7 for the mean number of CD163⁺ cells in the interstitium yielded a sensitivity of 80% and specificity of 75% for progression. The estimated median time to progression among patients with ≥2.7 CD163⁺ cells was shorter (median 136 versus 202 months, <em>p</em> <!-->=<!--> <!-->0.023). A greater number of CD163⁺ cells in the kidney interstitium was associated with the progression of kidney disease (HR 2.88, 95% CI 1.22–6.80; <em>p</em> <!-->=<!--> <!-->0.016). Class III–IV LN was associated with a higher median number of glomerular CD163⁺ cells (OR 1.96, 95% CI 1.1–3.49, <em>p</em> <!-->=<!--> <!-->0.023). Endocapillary hypercellularity and extracapillary proliferation were associated with greater number of CD163⁺ cells in the glomerular area. Among patients with class III-IV LN, the number of interstitial CD68⁺ cells was greater in those who experienced progression of kidney disease (<em>p</em> <!-->=<!--> <!-->0.012).</div></div><div><h3>Conclusion</h3><div>A greater number of CD163⁺ cells in the kidney interstitium was associated with the progression of kidney disease in patients with LN, while a greater number of CD68⁺ cells in the interstitium was associated with progression in the subgroup of patients with class III-IV LN.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 6","pages":"Article 101331"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144611907","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":"Pharmacological nephrotoxicity profile in a comprehensive cancer center: What changed in two decades and predictors for the need for haemodialysis and mortality","authors":"André Ferreira,&nbsp;Marina Reis ,&nbsp;Teresa Chuva ,&nbsp;Hugo Ferreira,&nbsp;Inês Coelho,&nbsp;Ana Paiva ,&nbsp;José Maximino Costa","doi":"10.1016/j.nefro.2025.501332","DOIUrl":"10.1016/j.nefro.2025.501332","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Acute kidney injury (AKI) is a frequent and severe complication in hospitalised cancer patients. However, overall data from in-hospital drug-related AKI in cancer patients is scarce. We aim to review the profile of moderate to severe drug-induced AKI in patients admitted to an oncology hospital over the last two decades and to assess renal and overall outcomes.</div></div><div><h3>Material and methods</h3><div>410 cases of drug-induced AKI KDIGO<!--> <!-->≥<!--> <!-->2 were analyzed, comparing between two decades from 2002 to 2021 in a comprehensive cancer center.</div></div><div><h3>Results</h3><div>The main differences were the introduction of new classes of cancer therapy (e.g., immune checkpoint inhibitors [ICPI] and tyrosine kinase inhibitors [TKI]), a decrease in nephrotoxicity due to platinum-based drugs, and an increase in nephrotoxicity caused by multiple drugs without cancer-directed therapy. Mortality was similar, but the need for haemodialysis (HD) was higher in the second decade (25.5% vs 36.6%, <em>p</em> <!-->=<!--> <!-->0.02). Multivariate analysis presented invasive mechanical ventilation and sepsis as risk factors for both HD and mortality, haematologic cancer as risk factors for HD, and the need for HD and multiple drugs without cancer-directed therapy as risk factors for mortality.</div></div><div><h3>Conclusion</h3><div>Adequate drug surveillance and prophylaxis render cancer therapy as a relatively small contributor to drug-induced AKI in a comprehensive cancer center. Critically ill patients have a higher need for HD and mortality regardless of the nephrotoxic agent implied.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 6","pages":"Article 501332"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144611910","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":"Hiperaldosteronismo familiar como causa secundaria de hipertensión arterial. A propósito de un caso en edad pediátrica","authors":"Ana Roche Gómez ,&nbsp;Cristina Julia Blázquez Gómez ,&nbsp;Irene Gómez-Pastrana Pau ,&nbsp;Clara María Aymerich de Franceschi ,&nbsp;Mar Espino Hernández","doi":"10.1016/j.nefro.2025.01.002","DOIUrl":"10.1016/j.nefro.2025.01.002","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 6","pages":"Article 101316"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144611912","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":"Primera pagina","authors":"","doi":"10.1016/S0211-6995(25)00033-5","DOIUrl":"10.1016/S0211-6995(25)00033-5","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 ","pages":"Page i"},"PeriodicalIF":2.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143716325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of strain wave elastography in the evaluation of renal fibrosis in patients with kidney diseases","authors":"Hanaa Ibrahim Okda ,&nbsp;Rabab Alaa Eldin Keshk ,&nbsp;Noha El-Anwar ,&nbsp;Ahmed Mohammed El Behiry ,&nbsp;Sally Maher Gamaleldin","doi":"10.1016/j.nefro.2024.10.007","DOIUrl":"10.1016/j.nefro.2024.10.007","url":null,"abstract":"<div><h3>Background</h3><div>A renal biopsy represents the gold standard in the diagnosis, prognosis and management of patients with chronic kidney disease and glomerulonephritis. Strain wave elastography (SE) is a developing technique to assess tissue elasticity. The aim of this study was to correlate between the strain index value of renal parenchyma and degree of renal fibrosis detected with renal biopsy.</div></div><div><h3>Method</h3><div>For 68 patients who were referred for a kidney biopsy, SE test was performed. The Banff scoring system was utilized to classify the IFTA grading of kidney fibrosis that assigns a severity level of mild, moderate, or severe. Receiver operating characteristic curve (ROC) was utilized to correlate between the severity of renal fibrosis and the grade of renal elasticity determined by SE.</div></div><div><h3>Results</h3><div>In total, 38 males and 30 females, the echogenicity, qualitative and semiquantitative elastography showed significant positive correlation with serum creatinine, percentage of fibrosis, <em>G</em> score and tubular atrophy and significant negative correlation with eGFR. ROC curve of SE for diagnosis of interstitial fibrosis shown that echogenicity has sensitivity 100.0%, specificity 62.5%, positive predictive value (PPV) 75.0%, negative predictive value (NPV) 100.0% with area under curve (AUC) 0.906, while qualitative elastography has sensitivity 77.8%, specificity 75.0%, PPV 77.8%, NPV 75.0%, AUC 0.833, semi quantitative elastography has sensitivity 83.3%, specificity 93.8%, PPV 93.8%, NPV 83.3% with AUC 0.915.</div></div><div><h3>Conclusion</h3><div>SE approach is simple to use, and can differentiate between varying stages of renal fibrosis. However, further research is required before it can be frequently used in clinical practice.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 3","pages":"Pages 259-270"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143528948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemodialysis vascular access in the elderly: Promising results from a tertiary center","authors":"Bruno Fraga Dias ,&nbsp;Fernanda Silva ,&nbsp;Isabel Fonseca ,&nbsp;Paulo Almeida ,&nbsp;José Queirós","doi":"10.1016/j.nefro.2024.10.005","DOIUrl":"10.1016/j.nefro.2024.10.005","url":null,"abstract":"<div><h3>Background</h3><div>Hemodialysis patients, particularly the elderly, present challenges for vascular access (VA) creation due to age-related vascular changes and comorbidities. This study aimed to characterize outcomes related to VA in elderly patients (≥75 years) and compare them with younger patients, focusing on primary failure, maturation failure, and patency rates.</div></div><div><h3>Methods</h3><div>This retrospective study included patients evaluated in VA consultations between January 2019 and December 2021; patients were evaluated through physical examination and Color Doppler Ultrasound to determine the suitability of vessels for VA construction. Demographic data, proposed and created VA types were assessed. The primary outcomes were the evaluation and comparison of primary failure and maturation failure of VA in the elderly (O) and younger (Y) groups. Secondary outcomes included the assessment of primary patency and primary assisted patency at 6, 12, and 24 months in both groups.</div></div><div><h3>Results</h3><div>Among 167 patients, 36 were elderly. There were no significant differences in proposed and created VA types between the Y and O groups and radial-cephalic AVFs were the most commonly constructed VA in both groups.</div><div>Primary and maturation failure rates were similar (Y group: 17.3% and 5.6%; O group: 9.7% and 10.7%, respectively). Primary patency and primary assisted patency rates did not significantly differ between groups at 6, 12, and 24 months.</div></div><div><h3>Conclusion</h3><div>The impact of age on the feasibility of VA should not be exaggerated. Preoperative assessment and a tailored approach enable successful autologous access creation in elderly patients, resulting in outcomes comparable to those of younger patients.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 3","pages":"Pages 228-237"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143528952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concurrent extramedullary hematopoiesis and AA amyloidosis in the kidney","authors":"Özant Helvaci ,&nbsp;Emine Merve Savaş ,&nbsp;Rahime Duran ,&nbsp;Betül Ögüt","doi":"10.1016/j.nefro.2024.12.001","DOIUrl":"10.1016/j.nefro.2024.12.001","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 3","pages":"Pages 276-277"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143528772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Twister® en el manejo aséptico de catéteres permanentes en hemodiálisis","authors":"Miguel Angel. Suárez Santisteban ,&nbsp;María Vanesa García-Bernalt Funes ,&nbsp;Pedro Dorado Hernández ,&nbsp;Antonio Gascón Mariño","doi":"10.1016/j.nefro.2024.11.006","DOIUrl":"10.1016/j.nefro.2024.11.006","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 3","pages":"Pages 273-275"},"PeriodicalIF":2.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143528773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}