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Nephrology

Kidney diseases and disorders, including chronic kidney disease, acute kidney injury, dialysis, kidney transplantation, electrolyte disorders, and hypertension

25 papers

Papers

2025 Update on Resistant Hypertension in CKD: Where Do We Stand and Where Do We Go?

This review summarizes current guidelines and emerging treatments for resistant hypertension in chronic kidney disease (CKD), advocating for individualized, evidence-based management. While novel agents and procedures show promise in blood pressure control and renal benefits, the paper highlights significant limitations, including adverse effects, poor long-term adherence, and high costs that may hinder their widespread use.

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Nephrology Sep 29, 12:52 PM

Placement of tunnelled haemodialysis catheters—interventional standard

This review article discusses the current standard for creating tunnelled haemodialysis catheters (tHDCs), including patient selection, placement techniques, and strategies to minimize infection and thrombosis. It focuses on novel developments like ultrasound and ECG-guided positioning and offers a decision-making approach for choosing the appropriate insertion method based on patient and resource factors.

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Nephrology Sep 22, 03:23 PM

Guidelines for the management of hypertension in CKD patients: where do we stand in 2024?

This review summarizes the 2023 European Society of Hypertension (ESH) guidelines for managing high blood pressure in patients with chronic kidney disease (CKD), highlighting key updates and comparing them with the 2021 KDIGO guidelines. The ESH guidelines offer detailed algorithms for antihypertensive agent selection and address treatment of resistant hypertension in CKD, emphasizing a holistic approach to cardioprotection and nephroprotection.

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Nephrology Sep 13, 09:49 AM

Frequency and clinical characteristics of kidney involvement in children with suspected COVID-19 infection: a single-center cross-sectional study

This single-center cross-sectional study found that 18.3% of hospitalized children with suspected or confirmed COVID-19 developed acute kidney injury (AKI). AKI was associated with more severe disease, gastrointestinal symptoms, and lab abnormalities like low platelets, high CRP, hypocalcemia, and hyperphosphatemia.

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Nephrology Sep 07, 06:54 PM

Pathophysiology of chronic kidney disease-mineral bone disorder (CKD-MBD): from adaptive to maladaptive mineral homeostasis

This review discusses chronic kidney disease-mineral bone disorder (CKD-MBD), a complex condition affecting people with reduced kidney function. It explores the interplay between disrupted mineral balance, bone health issues, and cardiovascular problems in CKD, emphasizing the roles of fibroblast growth factor 23 (FGF-23), parathyroid hormone (PTH), and other factors.

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Nephrology Sep 04, 07:29 PM

Simultaneous initiation of finerenone and empagliflozin across the spectrum of kidney risk in the CONFIDENCE trial

A study of patients with type 2 diabetes and chronic kidney disease found that taking finerenone and empagliflozin together worked better than either drug alone for reducing a key marker of kidney damage (UACR). The benefits were seen across a range of kidney disease severity, but the study only lasted six months, so longer-term outcomes are unknown. The study was sponsored by the company that makes finerenone, and multiple authors reported ties to pharmaceutical companies.

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Nephrology Sep 03, 05:11 PM

Simultaneous initiation of finerenone and empagliflozin across the spectrum of kidney risk in the CONFIDENCE trial

In a study of patients with type 2 diabetes and chronic kidney disease, combining finerenone and empagliflozin led to better kidney function improvement compared to either drug alone, across a range of baseline kidney risk levels. However, the study only followed participants for six months and further long-term research is needed to confirm lasting benefits and safety.

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Nephrology Sep 03, 05:11 PM

Ten Tips to Teach Learners to Love Nephrology (and Recruit the Next Generation)

This article offers ten actionable tips for nephrologists to engage learners and promote interest in their specialty. These tips focus on practical strategies like involving the wider healthcare team, utilizing patient interactions, sharing recent advances, and leveraging online resources. While not based on rigorous research, the advice offers a valuable starting point for boosting recruitment.

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Nephrology Sep 01, 04:05 PM

The true cost of phosphate control in chronic kidney disease

This review finds that high phosphate levels in patients with chronic kidney disease (CKD), even within the normal range, are associated with inflammation, vascular calcification, and faster disease progression. The authors recommend early interventions to reduce phosphate levels, like dietary changes and phosphate binders, even before hyperphosphatemia becomes clinically evident. Several studies cited are based on animal models, limiting direct translation to humans, and more robust clinical trial data are needed to confirm the benefits of early interventions.

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Nephrology Aug 29, 04:36 PM

Predicting Prognosis in ANCA-Associated Vasculitis with Kidney Involvement

In patients with ANCA-associated vasculitis, incorporating data on dialysis at presentation, kidney function, and urine protein levels after initial treatment slightly improved the accuracy of an existing kidney failure risk score. The study also confirmed the score's strong ability to predict kidney failure risk. Notably, a significant portion of patients on dialysis at presentation recovered kidney function.

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Nephrology Aug 27, 08:32 PM

Pathophysiology and therapies of CKD-associated secondary hyperparathyroidism

This review article discusses the increasingly complex pathophysiology of secondary hyperparathyroidism (SHP) in chronic kidney disease (CKD), moving beyond traditional factors to include FGF23, klotho, the phosphate pool, and intestinal dysbiosis. These new insights are leading to a better understanding of CKD-related mineral and bone disorder (CKD-MBD) and paving the way for novel therapies, such as targeting specific phosphate transporters or modifying the gut microbiota, which aim beyond managing elevated PTH levels. This review is supported by a grant from CSL Vifor; authors also declared individual COIs related to various pharmaceutical companies.

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Nephrology Aug 25, 02:53 PM

Management of osteoporosis in chronic kidney disease

This review summarizes the increased risk and causes of bone fractures among patients with chronic kidney disease, highlighting the interplay of factors like age, standard osteoporosis risk factors, and kidney-specific issues. The authors suggest a more proactive approach to screening and treatment for osteoporosis in these patients, including the use of various medications, and advocate for personalizing treatments based on individual bone health profiles.

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Nephrology Aug 22, 07:11 PM

Upcoming drug targets for kidney protective effects in chronic kidney disease

This review highlights several new drug targets for chronic kidney disease (CKD) that show promise in slowing disease progression, particularly in patients with type 2 diabetes. These include glucagon-like peptide-1 receptor agonists (GLP1RA), aldosterone synthase inhibitors (ASI), endothelin receptor antagonists (ERA), and soluble guanylate cyclase (SGC) activators. Further research is needed to fully understand the mechanisms of action and optimize their clinical use.

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Nephrology Aug 22, 02:02 PM

What do clinical trials teach us about the pathophysiology of human IgA nephropathy?

This review examines recent and ongoing clinical trials for IgA nephropathy (IgAN), discussing how they shed light on the disease's mechanisms and potential treatment targets. The "four-hit hypothesis" of IgAN development is discussed, along with trials evaluating treatments targeting B cells, the complement system, and non-immunomodulatory drugs that reduce kidney stress.

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Nephrology Aug 20, 02:17 PM

Identification of early predictors of clinical remission in primary membranous nephropathy: a post-hoc analysis of the STARMEN trial

In a small post-hoc analysis of a clinical trial, researchers found that a combination of 24-hour proteinuria, serum creatinine, and immunological status at 3 months after starting immunosuppressive therapy could predict clinical remission of membranous nephropathy at 2 years. The combined model performed better than individual markers, but the small sample size, limited follow-up, and potential conflicts of interest require further validation in larger studies.

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Nephrology Aug 18, 08:06 PM

Recent advances in pathogenetic concepts and disease modeling of IgA nephropathy

This review summarizes recent advances in understanding the causes and development of IgA nephropathy, the most common form of glomerulonephritis. It discusses genetic factors, the role of immune cells and the gut microbiome, the formation of autoantibodies, activation of the complement system, and the use of various animal models to study the disease. The review also highlights potential new treatments based on these findings.

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Nephrology Aug 03, 08:24 AM

Modulation of blood pressure by dietary potassium and sodium: sex differences and modeling analysis

This computational modeling study, based on rat data and extrapolated to humans, suggests that sex-specific differences in renal transporter abundance may contribute to women's attenuated blood pressure response to hypertensive stimuli, including high sodium intake. The model also predicts that high potassium intake can lower blood pressure, even in the presence of high sodium, but the magnitude of the effect differs between sexes due to variations in baseline renal sodium handling.

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Nephrology Jul 22, 01:08 PM

KDIGO 2021 Clinical Practice Guideline for the Management of Glomerular Diseases

The 2021 KDIGO Clinical Practice Guideline for the Management of Glomerular Diseases provides updated recommendations for diagnosis, treatment, and special considerations for several glomerular diseases. The guideline emphasizes minimizing adverse effects from immunosuppression while maximizing patient comfort and prioritizing the use of lower cost therapies where available. Research recommendations for all disease entities are also given.

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Nephrology Jul 14, 11:10 AM

The EANM practice guidelines for parathyroid imaging

The guidelines recommend a combination of 99mTc-MIBI SPECT/CT and cervical ultrasonography as the first-line imaging strategy for hyperfunctioning parathyroid glands. Other modalities like 18F-labeled choline PET/CT, 4D-CT, and MRI can be considered as second-line options in specific situations, particularly for patients with negative or inconclusive initial imaging or those with recurrent disease.

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Nephrology Jul 14, 11:09 AM

0.9% saline versus Plasma-Lyte as initial fluid in children with diabetic ketoacidosis (SPinK trial): a double-blind randomized controlled trial

In children with diabetic ketoacidosis (DKA), Plasma-Lyte-A and 0.9% saline showed similar rates of new or progressive acute kidney injury (AKI) and resolution of AKI. No differences were found between the two fluids for time to DKA resolution, need for renal replacement therapy, mortality, or length of ICU/hospital stay.

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Nephrology Jul 14, 11:09 AM