BMC Nephrology

Sirolimus-induced pulmonary toxicity without recurrence more than 8 years after everolimus replacement in a renal transplant patient with recurrent skin SCC: a case report
Ghasemi G and Shahidi S
Interstitial Pneumonitis (IP) is one of the pulmonary complications associated with mammalian Target of Rapamycin-Inhibitors (mTOR-Is). Sirolimus and everolimus belong to mTOR-Is. According to studies, IP is caused by both.
Factors and machine learning models for predicting successful discontinuation of continuous renal replacement therapy in critically ill patients with acute kidney injury: a retrospective cohort study based on MIMIC-IV database
Sheng S, Li A, Liu X, Shen T, Zhou W, Lv X, Shen Y, Wang C, Ma Q, Qu L, Ma S and Zhu F
For critically ill patients with acute kidney injury (AKI), there remains controversy regarding the predictive factors affecting the discontinuation of continuous renal replacement therapy (CRRT). This study aims to explore factors associated with successful CRRT discontinuation in AKI patients and to develop predictive models for successful discontinuation.
Study protocol of the ALMA-CKD trial; an electronic triggering decision-support system to improve the detection, recognition, and management of patients with chronic kidney disease in primary care
Andersson-Emad J, Thunholm A, Nash S, Evans M, Lind Af Hageby S, Ärnlöv J, Hilderman M, Forseth M, Sjölander A, Jacobson SH and Carrero JJ
Chronic kidney disease (CKD) is a global health problem affected by under-recognition and under-treatment in primary care settings. Electronic clinical decision support (CDS) triggering systems have the potential to improve detection and management of people with CKD by assisting clinicians in adhering to guideline recommendations. We aimed to test whether an electronic CDS triggering system would improve the detection, recognition, and management of patients with CKD in primary care.
Improved kidney function is associated with Colchicine treatment in COVID-19 patients
Bayram YE, Bardakci MI and Albayrak GA
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 virus) has been a major cause of significant morbidity and mortality. Acute kidney injury (AKI) has been seen in COVID-19-infected subjects, and it has frequently resulted in an abnormal estimated glomerular filtration rate. Colchicine, an immunomodulatory drug, was used in several studies in the early stages of the pandemic. Colchicine has been shown to prevent the development of renal failure in patients with Familial Mediterranean Fever (FMF). It has also been reported to reduce fibrosis, which plays a role in chronic kidney disease. We, therefore, aimed to investigate whether using Colchicine, in addition to standard care, was associated with better renal function in patients with severe COVID-19 infection.
Understanding the heterogeneity and dysfunction of HDL in chronic kidney disease: insights from recent reviews
Xu Z, Yang S and Cui L
Chronic kidney disease (CKD) is a complex disease that affects the global population's health, with dyslipidemia being one of its major complications. High density lipoprotein (HDL) is regarded as the "hero" in the bloodstream due to its role in reverse cholesterol transport, which lowers cholesterol levels in the blood and prevents atherosclerosis. However, in the complex internal environment of CKD, even this "hero" may struggle to perform its beneficial functions and could potentially become harmful. This article reviews HDL heterogeneity, HDL subclasses, functional changes in HDL during the progression of CKD, and the application of HDL in CKD treatment. This review aims to deepen understanding of lipid metabolism abnormalities in CKD patients and provide a basis for new therapeutic strategies.
Point of care creatinine testing for early detection of renal dysfunction in Tanzanian HIV patients: a study protocol
Msilanga D, Muiru A, Balandya E and Liu K
Renal dysfunction (RD) is more prevalent among people living with HIV (PLHIV) in sub-Saharan Africa (SSA) due to factors such as co-infections, hypertension, diabetes, and nephrotoxic antiretroviral drugs like tenofovir. Early detection of RD is critical but limited by resource constraints in many SSA countries, including Tanzania. Point-of-care (POC) tests, such as the Stat-Sensor Creatinine test by Nova Biomedical, present a cost-effective and non-invasive option for early detection. This study will evaluate the diagnostic performance of the Stat-Sensor creatinine test in detecting renal dysfunction in HIV care and treatment clinics (CTCs) in Tanzania. It will be conducted for a period of six months, from November 2024 to April 2025.
The advance of single cell transcriptome to study kidney immune cells in diabetic kidney disease
Wang M, Yao F, Chen N, Wu T, Yan J, Du L, Zeng S and Du C
Diabetic kidney disease (DKD) is a prevalent microvascular complication of diabetes mellitus and a primary cause of end-stage renal disease (ESRD). Increasing studies suggest that immune cells are involved in regulating renal inflammation, which contributes to the progression of DKD. Compared with conventional methods, single-cell sequencing technology is more developed technique that has advantages in resolving cellular heterogeneity, parallel multi-omics studies, and discovering new cell types. ScRNA-seq helps researchers to analyze specifically gene expressions, signaling pathways, intercellular communication as well as their regulations in various immune cells of kidney biopsy and urine samples. It is still challenging to investigate the function of each cell type in the pathophysiology of kidney due to its complex and heterogeneous structure and function. Here, we discuss the application of single-cell transcriptomics in the field of DKD and highlight several recent studies that explore the important role of immune cells including macrophage, T cells, B cells etc. in DKD through scRNA-seq analyses. Through combing the researches of scRNA-seq on immune cells in DKD, this review provides novel perspectives on the pathogenesis and immune therapeutic strategy for DKD.
Gitelman syndrome patient managed with amiloride during pregnancy and lactation
Ibrahim A, Rodan AR, Westenfelder C and Al-Rabadi L
Gitelman Syndrome (GS) is a rare autosomal-recessive tubular disorder characterized by hypokalemia, hypomagnesemia, metabolic alkalosis, hyperreninemic hyperaldosteronism, and normotension. Management of GS during pregnancy is particularly challenging due to pregnancy-associated renal physiological changes and due to controversial safety profiles regarding teratogenicity of medications commonly used for GS management in non-pregnant patients. We report a case of a 20-year-old female patient diagnosed of GS who was treated with amiloride during pregnancy and lactation due to persistent hypokalemia resistant to oral supplementation therapy. Use of amiloride facilitated control of hypokalemia and hypomagnesemia in the mother without causing any noticeable side effects in the newborn.
Associations of anaemia and iron deficiency with health-related quality of life in patients with chronic kidney disease stage G3b-5 in Japan: sub analysis of the Reach-J CKD cohort study
Okubo R, Ohigashi T, Kondo M, Tsunoda R, Kai H, Saito C, Hoshino J, Okada H, Narita I, Maruyama S, Wada T and Yamagata K
Iron deficiency is a major contributor to anaemia in chronic kidney diseases. The association of anaemia and iron deficiency with health-related quality of life in Japanese patients with non-dialysis chronic kidney disease has not been examined. In this study, we evaluated anaemia and iron deficiency in patients with chronic kidney disease G3b-5 and examined their associations with health-related quality of life.
Association between chronic kidney disease and cardiovascular disease risk factors in elderly: results from the first phase of Fasa and Shahedieh cohort studies
Zarshenas F, Dehghan A and Mirzaei M
Chronic kidney disease (CKD) is associated with increased cardiovascular disease (CVD) risk factors and morbidity in the elderly population. This study aimed to examine the association between CKD and CVD risk factors in the elderly population of Fasa and Yazd (Shahdieh), Iran, using the data from the enrolment phase of Fasa and Shahedieh cohort studies.
Correction: Emphysematous pyelonephritis caused by Raoultella ornithinolytica: a case report
Sun M, Wei X, Xiang X, Zhang T, Zhang Y, Miao J, Wei J, Cao W, Yao Q, Zhu L, Zhou Y and Zhang L
Association between iron metabolism and acute kidney injury in cardiac surgery with cardiopulmonary bypass: a retrospective analysis from two datasets
Li Q, Lv H, Chen Y, Shen J, Shi J and Zhou C
We sought to explore the linear or nonlinear relationship between preoperative iron metabolism and acute kidney injury following cardiac surgery (CSA-AKI) with cardiopulmonary bypass (CPB).
Communicating treatment options to older patients with advanced kidney disease: a conversation analysis study
Selman LE, Shaw CB, Sowden R, Murtagh FEM, Tulsky JA, Parry R, Caskey FJ and Barnes RK
Choosing to have dialysis or conservative kidney management is often challenging for older people with advanced kidney disease. While we know that clinical communication has a major impact on patients' treatment decision-making, little is known about how this occurs in practice. The OSCAR study (Optimising Staff-Patient Communication in Advanced Renal disease) aimed to identify how clinicians present kidney failure treatment options in consultations with older patients and the implications of this for patient engagement.
Current status and influencing factors of kinesiophobia in patients with peritoneal dialysis: a multicenter cross-sectional study
Xie M, Yin L, Guo Y, Zhang X and Zhao R
Kinesiophobia, an irrational fear-avoidance behaviour, can significantly impact the quality of life and prognosis of peritoneal dialysis patients. This study aimed to assess the prevalence of kinesiophobia in patients undergoing peritoneal dialysis and to analyse its influencing factors.
A comparative study on outcomes of ABO-incompatible kidney transplants between robot-assisted vs. open surgery-propensity score-matched analysis: a retrospective cohort study
Kim JM, Kwon HE, Ko Y, Jung JH, Kwon H, Kim YH and Shin S
Robot-assisted kidney transplantation (RAKT) is increasingly being adopted worldwide. Despite this growing interest, there remains a notable gap in the literature, especially concerning its effectiveness in immunologically high-risk patients compared to conventional open kidney transplantation (OKT). This study investigates the viability and success of RAKT in comparison with OKT, particularly for recipients with ABO incompatibility (ABOi).
Sacituzumab-govitecan-induced severe acute tubulointerstitial nephritis requiring hemodialysis
Guarin G, Netzel A, Flores KM, Cumpelik A and Bose R
Sacituzumab govitecan is an antibody-drug conjugate that is FDA approved for refractory metastatic triple-negative breast cancer. It targets the human trophoblastic cell-surface antigen 2 (Trop-2) with SN-38, a topoisomerase I inhibitor, attached to the antibody [1]. SN-38 breaks DNA strands and induces tumor apoptosis [2]. Acute kidney injury (AKI) is one of its adverse effects mainly prerenal due to gastrointestinal toxicity, but it has not been reported to cause acute tubulointerstitial nephritis (ATIN).
Treatment discontinuation in adults with atypical hemolytic uremic syndrome (aHUS): a qualitative study of international experts' perspectives with associated cost-consequence analysis
Germeni E, Cooper J, Briggs A and Laurence J
Atypical hemolytic uremic syndrome (aHUS) is a rare, life-threatening thrombotic microangiopathy (TMA) related to congenital mutations impeding control of the alternative pathway of complement. Following approval of the complement C5 inhibitor eculizumab by the European Medicines Agency and the US Food and Drug Administration, initial guidelines suggested lifelong therapy. Yet, growing evidence indicates that discontinuation of eculizumab, or its long-acting form ravulizumab, is possible for many patients. This mixed-methods study sought to explore international experts' perspectives and experiences related to treatment duration in adult patients with aHUS, while also estimating the financial and potential health consequences of early discontinuation.
Urinary sediment mRNA as a potent biomarker of IgA nephropathy
Kim JS, Kim GW, Hwang HS, Kim YG, Moon JY, Lee SH, Seok J, Tae D and Jeong KH
The quantification of mRNA expression in urinary sediments is a reliable biomarker for various diseases. However, few studies have investigated the clinical relevance of urinary mRNA levels in IgA nephropathy (IgAN). Thus, we investigated the expression of urinary mRNAs and their clinical significance in IgAN.
A case of karyomegalic interstitial nephritis without FAN1 mutations in the setting of brentuximab, ifosfamide, and carboplatin exposure
Leong M, Dai T, Tong L and Nast CC
Karyomegalic interstitial nephritis (KIN) is a rare renal diagnosis associated with both genetic and medication etiologies. The primary gene associated with KIN is the FAN1 gene which encodes a protein responsible for DNA interstrand repair. Common medication triggers of KIN are chemotherapeutic agents, especially those which disrupt DNA structure such as carboplatin. Despite overlap between these mechanisms, it has not clearly been established if medication usage requires an underlying genetic predisposition for triggering KIN or if medications alone are sufficient. This ambiguous pathogenesis can make it difficult to appropriately assess risk of KIN development when starting patients on one of the known KIN-inducing therapies. Additionally, brentuximab vedotin, an antibody-drug conjugate directed against CD30, has not been previously implicated in KIN development.
Centre-level fluid management practices in the BISTRO trial and their lack of association with participant fluid status and blood pressure in non-anuric haemodialysis patients
Johal N, Sharma R, Belcher J, Coyle D, Lindley EJ, Keane D, Caskey FJ, Dasgupta I, Davenport A, Farrington K, Mitra S, Ormandy P, Wilkie M, Macdonald J, Solis-Trapala I, Sim J and Davies SJ
Fluid assessment and management is a key aspect of good dialysis care and is affected by patient-level characteristics and potentially centre-level practices. In this secondary analysis of the BISTRO trial we wished to establish whether centre-level practices with the potential to affect fluid status were stable over the course of the trial and explore if they had any residual associations with participant's fluid status.
The urine protein/creatinine ratio as a reliable indicator of 24-h urine protein excretion across different levels of renal function and proteinuria: the TUNARI prospective study
Gutiérrez-Peredo GB, Montaño-Castellón I, Gutiérrez-Peredo AJ, Lopes MB, Tapioca FPM, Guimaraes MGM, Montaño-Castellón S, Guedes SA, da Costa FPM, Mattoso RJC, Filho JCBO, Norris KC, de Almeida ARP and Lopes AA
The 24-h urine protein (24-hUP) excretion is the gold standard for evaluating proteinuria. This study aimed to evaluate the diagnostic efficacy of protein/creatinine ratio (PCR) for estimating 24-hUP at various levels of renal function and proteinuria levels.