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UROLOGY, NEPHROLOGY AND ANDROLOGY (159 journals)                     

Showing 1 - 159 of 159 Journals sorted alphabetically
Acta Urológica Portuguesa     Open Access   (Followers: 1)
Actas Urológicas Españolas     Full-text available via subscription   (Followers: 3)
Actas Urológicas Españolas (English Edition)     Full-text available via subscription   (Followers: 1)
Advances in Chronic Kidney Disease     Full-text available via subscription   (Followers: 11)
Advances in Urology     Open Access   (Followers: 13)
African Journal of Nephrology     Open Access  
African Journal of Urology     Open Access   (Followers: 7)
AJP Renal Physiology     Hybrid Journal   (Followers: 8)
Aktuelle Urologie     Hybrid Journal   (Followers: 4)
American Journal of Kidney Diseases     Hybrid Journal   (Followers: 42)
American Journal of Men's Health     Open Access   (Followers: 9)
American Journal of Nephrology     Full-text available via subscription   (Followers: 38)
Andrologia     Hybrid Journal   (Followers: 2)
Andrology     Hybrid Journal   (Followers: 4)
Andrology & Gynecology : Current Research     Hybrid Journal   (Followers: 4)
Andrology and Genital Surgery     Open Access   (Followers: 7)
Andrology-Open Access     Open Access  
Annales d'Urologie     Full-text available via subscription  
Arab Journal of Nephrology and Transplantation     Open Access   (Followers: 1)
Arab Journal of Urology     Open Access   (Followers: 7)
Archives of Clinical Nephrology     Open Access   (Followers: 2)
Archivio Italiano di Urologia e Andrologia     Open Access   (Followers: 1)
Archivos Españoles de Urología     Open Access  
Asian Journal of Andrology     Open Access   (Followers: 1)
Asian Journal of Urology     Open Access   (Followers: 3)
Bangladesh Journal of Urology     Open Access   (Followers: 5)
BANTAO Journal     Open Access  
Basic and Clinical Andrology     Open Access  
BJU International     Hybrid Journal   (Followers: 34)
BJUI Compass     Open Access   (Followers: 2)
BMC Nephrology     Open Access   (Followers: 11)
BMC Urology     Open Access   (Followers: 14)
Canadian Journal of Kidney Health and Disease     Open Access   (Followers: 8)
Canadian Urological Association Journal     Open Access   (Followers: 2)
Cancer Urology     Open Access   (Followers: 2)
Cardiorenal Medicine     Full-text available via subscription   (Followers: 1)
Case Reports in Nephrology     Open Access   (Followers: 5)
Case Reports in Nephrology and Dialysis     Open Access   (Followers: 9)
Case Reports in Urology     Open Access   (Followers: 12)
Clinical and Experimental Nephrology     Hybrid Journal   (Followers: 4)
Clinical Journal of the American Society of Nephrology     Full-text available via subscription   (Followers: 22)
Clinical Kidney Journal     Open Access   (Followers: 4)
Clinical Medicine Insights : Urology     Open Access   (Followers: 3)
Clinical Nephrology     Full-text available via subscription   (Followers: 8)
Clinical Nephrology and Urology Science     Open Access   (Followers: 6)
Clinical Queries: Nephrology     Hybrid Journal   (Followers: 1)
Cuadernos de Cirugía     Open Access   (Followers: 3)
Current Opinion in Nephrology & Hypertension     Hybrid Journal   (Followers: 10)
Current Opinion in Urology     Hybrid Journal   (Followers: 12)
Current Urology     Open Access   (Followers: 10)
Current Urology Reports     Hybrid Journal   (Followers: 5)
Der Nephrologe     Hybrid Journal  
Der Urologe     Hybrid Journal   (Followers: 1)
Diabetic Nephropathy     Open Access   (Followers: 1)
EMC - Urología     Full-text available via subscription  
Enfermería Nefrológica     Open Access   (Followers: 1)
European Urology     Full-text available via subscription   (Followers: 33)
European Urology Focus     Hybrid Journal   (Followers: 5)
European Urology Oncology     Hybrid Journal   (Followers: 1)
European Urology Open Science     Open Access   (Followers: 10)
Forum Nefrologiczne     Full-text available via subscription  
Geriatric Nephrology and Urology     Hybrid Journal   (Followers: 7)
Giornale di Clinica Nefrologica e Dialisi     Open Access  
Herald Urology     Open Access   (Followers: 2)
Hong Kong Journal of Nephrology     Open Access   (Followers: 3)
Human Andrology     Partially Free   (Followers: 2)
IJU Case Reports     Open Access  
Indian Journal of Nephrology     Open Access   (Followers: 2)
Indian Journal of Urology     Open Access   (Followers: 5)
International Brazilian Journal of Urology     Open Access   (Followers: 5)
International Journal of Nephrology     Open Access   (Followers: 2)
International Journal of Nephrology and Renovascular Disease     Open Access   (Followers: 2)
International Journal of Urology     Hybrid Journal   (Followers: 12)
International Urology and Nephrology     Hybrid Journal   (Followers: 7)
Jornal Brasileiro de Nefrologia     Open Access  
Journal für Urologie und Urogynäkologie/Österreich     Hybrid Journal  
Journal of Clinical Nephrology     Open Access   (Followers: 2)
Journal of Clinical Urology     Hybrid Journal   (Followers: 14)
Journal of Endoluminal Endourology     Open Access  
Journal of Endourology     Hybrid Journal   (Followers: 2)
Journal of Endourology Case Reports     Hybrid Journal  
Journal of Genital System & Disorders     Hybrid Journal   (Followers: 3)
Journal of Integrative Nephrology and Andrology     Open Access   (Followers: 2)
Journal of Kidney Cancer and VHL     Open Access  
Journal of Lower Genital Tract Disease     Hybrid Journal  
Journal of Nephrology     Hybrid Journal   (Followers: 4)
Journal of Nephrology Research     Open Access   (Followers: 3)
Journal of Pediatric Nephrology     Open Access   (Followers: 5)
Journal of Renal Care     Hybrid Journal   (Followers: 8)
Journal of Renal Nursing     Full-text available via subscription   (Followers: 12)
Journal of Renal Nutrition     Hybrid Journal   (Followers: 28)
Journal of Renal Nutrition and Metabolism     Open Access   (Followers: 1)
Journal of the American Society of Nephrology     Full-text available via subscription   (Followers: 31)
Journal of The Egyptian Society of Nephrology and Transplantation     Open Access  
Journal of Translational Neurosciences     Open Access  
Journal of Urology     Full-text available via subscription   (Followers: 46)
Journal of Urology & Nephrology     Open Access   (Followers: 2)
Kidney Disease and Transplantation     Open Access   (Followers: 4)
Kidney Diseases     Open Access   (Followers: 3)
Kidney International     Hybrid Journal   (Followers: 46)
Kidney International Reports     Open Access   (Followers: 3)
Kidney Medicine     Open Access  
Kidney Research Journal     Open Access   (Followers: 6)
Kidneys (Počki)     Open Access   (Followers: 1)
Nature Reviews Nephrology     Full-text available via subscription   (Followers: 22)
Nature Reviews Urology     Full-text available via subscription   (Followers: 13)
Nefrología (English Edition)     Open Access  
Nefrología (Madrid)     Open Access  
Nephro-Urology Monthly     Open Access   (Followers: 1)
Nephrology     Hybrid Journal   (Followers: 13)
Nephrology Dialysis Transplantation     Hybrid Journal   (Followers: 27)
Nephron     Hybrid Journal   (Followers: 4)
Nephron Clinical Practice     Full-text available via subscription   (Followers: 4)
Nephron Experimental Nephrology     Full-text available via subscription   (Followers: 4)
Nephron Extra     Open Access   (Followers: 1)
Nephron Physiology     Full-text available via subscription   (Followers: 4)
Neurourology and Urodynamics     Hybrid Journal   (Followers: 1)
OA Nephrology     Open Access   (Followers: 2)
Open Access Journal of Urology     Open Access   (Followers: 6)
Open Journal of Nephrology     Open Access   (Followers: 5)
Open Journal of Urology     Open Access   (Followers: 6)
Open Urology & Nephrology Journal     Open Access  
Pediatric Urology Case Reports     Open Access   (Followers: 7)
Portuguese Journal of Nephrology & Hypertension     Open Access   (Followers: 1)
Progrès en Urologie     Full-text available via subscription  
Progrès en Urologie - FMC     Full-text available via subscription  
Prostate Cancer and Prostatic Diseases     Hybrid Journal   (Followers: 6)
Renal Failure     Open Access   (Followers: 12)
Renal Replacement Therapy     Open Access   (Followers: 4)
Research and Reports in Urology     Open Access   (Followers: 4)
Revista de Nefrología, Diálisis y Trasplante     Open Access   (Followers: 1)
Revista Mexicana de Urología     Open Access   (Followers: 1)
Revista Urologia Colombiana     Open Access  
Saudi Journal of Kidney Diseases and Transplantation     Open Access   (Followers: 2)
Scandinavian Journal of Urology     Hybrid Journal   (Followers: 7)
Seminars in Nephrology     Hybrid Journal   (Followers: 11)
The Prostate     Hybrid Journal   (Followers: 8)
Therapeutic Advances in Urology     Open Access   (Followers: 4)
Trends in Urology & Men's Health     Partially Free   (Followers: 1)
Ukrainian Journal of Nephrology and Dialysis     Open Access   (Followers: 1)
Uro-News     Hybrid Journal   (Followers: 1)
Urolithiasis     Hybrid Journal   (Followers: 2)
Urologia Internationalis     Full-text available via subscription   (Followers: 2)
Urologia Journal     Hybrid Journal  
Urologic Clinics of North America     Full-text available via subscription   (Followers: 4)
Urologic Nursing     Full-text available via subscription   (Followers: 4)
Urologic Radiology     Hybrid Journal  
Urological Science     Open Access  
Urologicheskie Vedomosti     Open Access  
Urologie in der Praxis     Hybrid Journal  
Urologie Scan     Hybrid Journal  
Urology     Hybrid Journal   (Followers: 33)
Urology Annals     Open Access   (Followers: 4)
Urology Case Reports     Open Access   (Followers: 3)
Urology Practice     Full-text available via subscription   (Followers: 2)
Urology Times     Free   (Followers: 3)
Urology Video Journal     Open Access   (Followers: 1)
World Journal of Nephrology and Urology     Open Access   (Followers: 15)
World Journal of Urology     Hybrid Journal   (Followers: 11)


Similar Journals
Journal Cover
Journal of Nephrology
Journal Prestige (SJR): 1.003
Citation Impact (citeScore): 2
Number of Followers: 4  
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 1121-8428 - ISSN (Online) 1724-6059
Published by Springer-Verlag Homepage  [2656 journals]
  • Kidney transplant in patients with atypical hemolytic uremic syndrome in
           the anti-C5 era: single-center experience with tailored Eculizumab
    • Abstract: Rationale and objective Patients with atypical hemolytic uremic syndrome (aHUS) have long been considered ineligible for kidney transplantation (KTx) in several centers due to the high risk of disease recurrence, graft loss and life-threatening complications. The availability of Eculizumab (ECU) has now overcome this problem. However, the best approach towards timing, maintenance schedule, the possibility of discontinuation and patient monitoring has not yet been clearly established. Study design This is a single center case series presenting our experience with KTx in aHUS. Setting and participants This study included 26 patients (16 females) with a diagnosis of aHUS, who spent a median of 5.5 years on kidney replacement therapy before undergoing KTx. We compared the aHUS relapse rate in three groups of patients who underwent KTx: patients who received no prophylaxis, patients who underwent plasma exchange, those who received Eculizumab prophylaxis. Complement factor H-related disease was by far the most frequent etiology (n = 19 patients). Results Untreated patients and patients undergoing pre-KTx plasma exchange prophylaxis had a relapse rate of 0.81 (CI 0.30–1.76) and 3.1 (CI 0.64–9.16) events per 10 years cumulative observation, respectively, as opposed to 0 events among patients receiving Eculizumab prophylaxis. The time between Eculizumab doses was tailored based on classic complement pathway activity (target to < 30%). Using this strategy, 12 patients are currently receiving  Eculizumab every 28 days, 5 every 24–25 days, and 3 every 21 days. Conclusion Our experience supports the prophylactic use of Eculizumab in patients with a previous history of aHUS undergoing KTx, especially when complement dysregulation is well documented by molecular biology. Graphic abstract
      PubDate: 2021-05-06
  • A forgotten trailblazing Italian nephrologist: Giovanni Ferro-Luzzi
           (1903–2000) and the first measurement of endogenous creatinine clearance
    • PubDate: 2021-05-04
  • FSGS in Chinese twins with a de novo PAX2 mutation: a case report and
           review of the literature
    • PubDate: 2021-05-04
  • Impact of self-reported walking habit on slower decline in renal function
           among the general population in a longitudinal study: the Japan Specific
           Health Checkups (J-SHC) Study
    • Abstract: Background Association between physical activity and decline in renal function among the general population is not fully understood. Methods This is a longitudinal study on subjects who participated in the Japanese nationwide Specific Health Checkup program between 2008 and 2014. The exposure of interest was baseline self-reported walking habit. The outcomes were annual change and incidence of 30% decline in estimated glomerular filtration rate (eGFR). Changes in eGFR were compared using a linear mixed-effects model. Cox proportional hazard models were used to examine the association between self-reported walking habit and 30% decline in eGFR. Results Among 332,166 subjects, 168,574 reported walking habit at baseline. The annual changes in eGFR [95% confidence interval (CI)] among subjects with and without baseline self-reported walking habit were − 0.17 (− 0.19 to − 0.16) and − 0.26 (− 0.27 to − 0.24) mL/min/1.73 m2/year, respectively (P for interaction between time and baseline self-reported walking habit, < 0.001). During a median follow-up of 3.3 years, 9166 of 314,489 subjects exhibited 30% decline in eGFR. The incidence of 30% decline in eGFR was significantly lower among subjects with self-reported walking habit after adjustment for potential confounders including time-varying blood pressure, body mass index, lipid profile, and hemoglobin A1c, with hazard ratio (95% CI) of 0.93 (0.89–0.97). Sensitivity analysis restricted to subjects with unchanged self-reported walking habit from baseline or analysis with time-varying self-reported walking habit yielded similar results. Conclusions Self-reported walking habit was associated with significantly slower decline in eGFR. This association appeared to be independent of its effects on metabolic improvement. Graphic abstract
      PubDate: 2021-04-30
  • Heterogeneity is a common ground in familial hypomagnesemia with
           hypercalciuria and nephrocalcinosis caused by CLDN19 gene mutations
    • Abstract: Background Familial hypomagnesemia with hypercalciuria and nephrocalcinosis (FHHNC) is a rare tubulopathy caused by mutations in the CLDN16 or CLDN19 genes. Patients usually develop hypomagnesemia, hypercalciuria, nephrocalcinosis and renal failure early in life. Patients with CLDN19 mutations may also have ocular abnormalities. Despite clinical variability, factors associated with kidney function impairment, especially in patients with CLDN19 mutations, have not been addressed. Methods Retrospective multicenter study of 30 genetically confirmed FHHNC Spanish patients. We analyzed kidney function impairment considering as outcomes chronic kidney disease (CKD) stage 3 and annual estimated glomerular filtration rate (eGFR) decline, to identify factors associated with the different phenotypes. Results Of thirty patients, 27 had mutations in the CLDN19 gene (20 homozygous for the p.G20D mutation) and 3 in the CLDN16. Age at diagnosis was 1.71 (0.67–6.04) years and follow-up time was 8.34 ± 4.30 years. No differences in CKD stage 3-free survival based on CLDN19 mutation (p.G20D homozygous vs. other mutations) or gender were found, although females seemed to progress faster than males. Patients with more pronounced eGFR decline had higher PTH levels at diagnosis than those with stable kidney function, despite similar initial eGFR. Approximately 60% of CLDN19 patients presented ocular abnormalities. Furthermore, we confirmed high phenotypic intrafamilial variability. Conclusions In a contemporary cohort of FHHNC patients with CLDN19 mutations, females seemed to progress to CKD-stage 3 faster than males. Increased PTH levels at baseline may indicate a more severe renal course. There was high phenotype variability among patients with CLDN19 mutations and kidney function impairment  differed even between siblings. Graphical abstract
      PubDate: 2021-04-30
  • Recovering histological sections for ultrastructural diagnosis of
           glomerular diseases through the pop-off technique
    • Abstract: Introduction Electron microscopy (EM) represents an indispensable technique for the diagnosis of kidney glomerular diseases. When dedicated tissue is not available, histological and cryostat sections can be reprocessed for EM using the pop-off technique. Here the practical value of this technique is analysed with emphasis on its accuracy in measuring basement membrane thickness and detecting immune deposits. Methods Ninety-four histological sections of kidney tissues fixed in Serra’s solution, stained with H&E, PAS, and Masson's Trichrome; for EM analysis, the sections were recovered from either treated or untreated microscope slides through the pop-off technique. Some sections were recovered from cryosections allocated for immunofluorescence. Results The ultrastructural details were sufficiently maintained on tissues fixed with Serra's solution despite being considered disadvantageous for EM. The type of microscope slides and the time of biopsy storage did not affect the quality of section recovery. The histological stains had only moderate effects on the electron-density of the glomerular basement membrane (GBM). The pop-off technique reduced the GBM thickness when compared to the conventional EM processing but preserved the electron density of immune deposits. Conclusions The application of the pop-off method to renal biopsy is a useful recovery method that produces limited but satisfactory results when there is no suitable material for EM. The ultrastructural morphology was retained even from tissues fixed with Serra's solution, and deposits maintained the expected electron density, however, we observed an overall thickness reduction of the GBM that could have a potential impact on thin membrane disease diagnosis. Graphic abstract
      PubDate: 2021-04-30
  • Low-dose aspirin for the prevention of severe preeclampsia in patients
           with chronic kidney disease: a retrospective study
    • Abstract: Objective The objective of the study was to investigate the effects of low-dose aspirin (LDA) during pregnancy on the prevention of preeclampsia in patients with chronic kidney disease (CKD). Methods The clinical data of pregnant women with CKD were retrospectively analyzed at Peking University First Hospital between January 2013 and January 2020. Among 287 pregnant women with stage 1–2 CKD, 63 patients who were treated with LDA were included in study group 1, and 63 patients who were not treated with aspirin were allocated to control group 1. Among 41 pregnant women with stage 3–5 CKD, 22 patients who were treated with LDA were included in study group 2, and 19 patients were allocated to control group 2. Pregnancy outcomes of the patients with stage 1–2 and stage 3–5 CKD who received LDA during pregnancy and those who did not were compared. Results No significant difference was observed in the incidence of preeclampsia or severe preeclampsia between study and control group 1. The patients in study group 2 had a lower incidence of severe preeclampsia than those in control group 2 (3/22 [13.6%] vs. 8/19 [42.1%], P = 0.04). Among the patients with stage 3–5 CKD, LDA therapy during pregnancy was associated with a lower risk of severe preeclampsia (odds ratio = 0.22, 95% confidence interval: 0.074–0.993; P = 0.049). Conclusions LDA therapy during pregnancy can reduce the risk of severe preeclampsia in patients with stage 3–5 CKD. Prospective studies are  needed to further explore the preventive effects of aspirin on preeclampsia in patients with stage 1–2 CKD. Graphic abstract
      PubDate: 2021-04-29
  • Destructuring glomerular diseases with structured deposits: challenges in
           the precision medicine era
    • PubDate: 2021-04-27
  • A deep-learning model to continuously predict severe acute kidney injury
           based on urine output changes in critically ill patients
    • Abstract: Background Acute Kidney Injury (AKI), a frequent complication of pateints in the Intensive Care Unit (ICU), is associated with a high mortality rate. Early prediction of AKI is essential in order to trigger the use of preventive care actions. Methods The aim of this study was to ascertain the accuracy of two mathematical analysis models in obtaining a predictive score for AKI development. A deep learning model based on a urine output trends was compared with a logistic regression analysis for AKI prediction in stages 2 and 3 (defined as the simultaneous increase of serum creatinine and decrease of urine output, according to  the Acute Kidney Injury Network (AKIN) guidelines). Two retrospective datasets including 35,573 ICU patients were analyzed. Urine output data were used to train and test the logistic regression and the deep learning model. Results The deep learning model defined an area under the curve (AUC) of 0.89 (± 0.01), sensitivity = 0.8 and specificity = 0.84, which was higher than the logistic regression analysis. The deep learning model was able to predict 88% of AKI cases more than 12 h before their onset: for every 6 patients identified as being at risk of AKI by the deep learning model, 5 experienced the event. On the contrary, for every 12 patients not considered to be at risk by the model, 2 developed AKI. Conclusion In conclusion, by using urine output trends, deep learning analysis was able to predict AKI episodes more than 12 h in advance, and with a higher accuracy than the classical urine output thresholds. We suggest that this algorithm could be integrated in the ICU setting to better manage, and potentially prevent, AKI episodes. Graphic abstract
      PubDate: 2021-04-26
  • Unexplained life-threatening high anion gap metabolic acidosis: the answer
           is in the urine!
    • PubDate: 2021-04-24
  • Cat on a hot tin roof (a nephrology zebra)
    • PubDate: 2021-04-23
  • Routine assessment of kidney urea clearance, dialysis dose and protein
           catabolic rate in the once-weekly haemodialysis regimen
    • Abstract: Background The dialysis dose (Kt/V) and normalized protein catabolic rate (PCRn) are the most useful indices derived from the urea kinetic model (UKM) in haemodialysis (HD) patients. The kidney urea clearance (Kru) is another important UKM parameter which plays a key role in the prescription of incremental HD. Ideally, the three kinetic parameters should be assessed using the complex software Solute Solver based on the double pool UKM. In the clinical setting, however, the three indices are estimated with simplified formulae. The recently introduced software SPEEDY assembles the aforementioned equations in a plain spreadsheet, to produce quite accurate results of Kru, Kt/V and PCRn. Unfortunately, specific equations to compute Kt/V and PCRn for patients on a once-weekly HD regimen (1HD/wk) were not available at the time SPEEDY was built-up. We devised a new version of SPEEDY (SPEEDY-1) and an even simpler variant (SPEEDY-1S), using two recently published equations for the 1HD/wk schedule . Moreover, we also added a published equation to estimate the equivalent renal clearance (EKR) normalized to urea distribution volume (V) of 35 L (EKR35) from Kru and Kt/V . Aim of the present study was to compare the results obtained using the new methods (SPEEDY-1 and SPEEDY-1S) with those provided by the reference method Solute Solver. Subjects and methods One hundred historical patients being treated with the once-weekly HD regimen were enrolled. A total of 500 HD sessions associated to the availability of monthly UKM studies were analysed in order to obtain Kru, single pool Kt/V (spKt/V), equilibrated Kt/V (eKt/V), V, PCRn and EKR35 values by using Solute Solver, SPEEDY-1 and SPEEDY-1S. Results When comparing the paired values of the above UKM parameters, as computed by SPEEDY-1 and Solute Solver, respectively, all differences but one were statistically significant at the one-sample t-test; however, the agreement limits at Bland–Altman analysis showed that all differences were negligible. When comparing the paired values of the above UKM parameters, as computed by SPEEDY-1S and Solute Solver, respectively, all differences were statistically significant; however, the agreement limits showed that the differences were negligible as far as Kru, spKt/V and eKt/V are concerned, though much larger regarding V, PCRn and EKR35. Conclusions We implemented SPEEDY with a new version specific for the once-weekly HD regimen, SPEEDY-1. It provides accurate results and is presently the best alternative to Solute Solver. Using SPEEDY-1S led to a larger difference in PCRn and EKR35, which could be acceptable for clinical practice if SPEEDY-1 is not available. Graphic abstract
      PubDate: 2021-04-23
  • More than ancillary records: clinical implications of renal pathology
           examination in tumor nephrectomy specimens
    • Abstract: Background Nephrectomy is the management of choice for the treatment of renal tumors. Surgical pathologists primarily focus on tumor diagnosis and investigations relating to prognosis or therapy. Pathological changes in non-neoplastic tissue may, however, be relevant for further management and should be thoroughly assessed. Methods Here, we examined the non-neoplastic renal parenchyma in 206 tumor nephrectomy specimens for the presence of glomerular, tubulo-interstitial, or vascular lesions, and correlated them with clinical parameters and outcome of renal function. Results We analyzed 188 malignant and 18 benign or pseudo-tumorous lesions. The most common tumor type was clear cell renal cell carcinoma (CCRCC, n = 106) followed by papillary or urothelial carcinomas (n = 25). Renal pathology examination revealed the presence of kidney disease in 39 cases (18.9%). Glomerulonephritis was found in 15 cases (7.3%), and the most frequent was IgA nephropathy (n = 6; 2.9%). Vasculitis was found in two cases (0.9%). In 15 cases we found tubulo-interstitial nephritis, and in 9 severe diabetic or hypertensive nephropathy. Partial nephrectomy was not linked to better eGFR at follow-up. Age, vascular nephropathy, glomerular scarring and interstitial fibrosis were the leading independent negative factors influencing eGFR at time of surgery, whereas proteinuria was associated with reduced eGFR at 1 year. Conclusion Our large study population indicates a high incidence of renal diseases potentially relevant for the postoperative management of patients with renal neoplasia. Consistent and systematic reporting of non-neoplastic renal pathology in tumor nephrectomy specimens should therefore be mandatory.
      PubDate: 2021-04-22
  • Analysis of the association between emergency dialysis start in patients
           with end-stage kidney disease and non-steroidal anti-inflammatory drugs,
           proton-pump inhibitors, and iodinated contrast agents
    • Abstract: Background The association between the use of potentially nephrotoxic drugs [Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), Iodinated Contrast Agents, Proton Pump Inhibitors (PPIs)] and emergency start of dialysis in patients with chronic kidney disease has not been well explored, although these compounds are commonly prescribed or available without prescription. Methods In this study, the Renal Epidemiology Information Network (REIN) registry data of all patients ≥ 18 years of age who started dialysis in France in 2015 were matched with those in the French National Health Insurance Database. The association between clinical characteristics, nephrotoxic drug exposure and emergency dialysis start was investigated. Patients were categorized into four classes of NSAID and PPI exposure (new, current, past, no user) on the basis of the pre-dialysis exposure period (1–30, 31–90, and 91–365 days). For iodinated contrast agents, exposure in the 72 h and 7 days before dialysis was analyzed. Results Among the 8805 matched patients, 30.2% needed to start dialysis in emergency. After adjustment for socio-demographic and clinical variables, new NSAID users were more likely to experience emergency dialysis start [OR = 1.95; 95% CI (1.1–3.4)]. This association was higher for new than for current users [OR: 1.44; 95% CI (1.08–1.92)]. Emergency dialysis start was also associated with iodinated contrast agent exposure in the previous 7 days [OR: 1.44; 95% CI (1.2–1.7)]. No significant relationship was detected between PPIs and emergency dialysis start. Conclusions Using both clinical and healthcare data, this study shows that emergency dialysis start is independently associated with recent exposure to NSAIDs and iodinated contrast agents. This suggests the need to strengthen the information given to healthcare professionals and patients with regard to nephrotoxic drugs. Graphic abstract
      PubDate: 2021-04-20
  • Biopsy findings after detection of de novo donor-specific antibodies in
           renal transplant recipients: a single center experience
    • Abstract: Background De novo donor-specific antibodies (DSA) are associated with an increased risk of antibody-mediated rejection and a substantial reduction of allograft survival. We hypothesized that detection of DSA should prompt a biopsy even in the absence of proteinuria and loss of estimated glomerular filtration rate (eGFR). However, data on a population without proteinuria or loss of kidney function is scant, and this is the main novelty of our study design. Methods Single center retrospective analysis on biopsy findings after detection of de novo DSA. One-hundred-thirty-two kidney and pancreas-kidney transplant recipients were included. Eighty-four of these patients (63.6%) underwent allograft biopsy. At the time of biopsy n = 50 (59.5%) had a protein/creatinine ratio (PCR) > 300 mg/g creatinine and/or a loss of eGFR ≥ 10 ml/min in the previous 12 months, whereas 40.5% did not. Diagnosis of rejection was performed according to Banff criteria. Results Seventy-seven (91.7%) of the biopsies had signs of rejection (47.6% antibody mediated rejection (ABMR), 13.1% cellular, 20.2% combined, 10.7% borderline). Among subjects without proteinuria or loss of eGFR ≥ 10 ml/min/a (n = 34), 29 patients (85.3%) showed signs of rejection (44.1% antibody mediated (ABMR), 14.7% cellular, 11.8% combined, 14.7% borderline). Conclusion The majority of subjects with de novo DSA have histological signs of rejection, even in the absence of proteinuria and deterioration of graft function. Thus, it appears reasonable to routinely perform an allograft biopsy after the detection of de novo DSA. Graphic abstract
      PubDate: 2021-04-17
  • Lessons for the clinical nephrologist: a midsummer night’s cluster
           of hypernatremia cases
    • PubDate: 2021-04-15
  • Lessons for the clinical nephrologist: ureteric obstruction secondary to
           blood clot after kidney biopsy
    • PubDate: 2021-04-15
  • Urinary Growth Differentiation Factor-15 (GDF15) levels as a biomarker of
           adverse outcomes and biopsy findings in chronic kidney disease
    • Abstract: Background Growth Differentiation Factor-15 (GDF15) is a member of the TGF-β superfamily. Increased serum GDF15 has been associated with increased risk of chronic kidney disease (CKD) progression. However, no prior studies have addressed the significance of urinary GDF15 in adult CKD. Methods We measured serum and urinary GDF15 in a prospective cohort of 84 patients who underwent kidney biopsy and assessed their association with outcomes (survival, kidney replacement therapy) during a follow-up of 29 ± 17 months. Results There was a statistically significant correlation between serum and urine GDF15 values. However, while serum GDF15 values increased with decreasing glomerular filtration rate, urinary GDF15 did not. Immunohistochemistry located kidney GDF15 expression mainly in tubular cells, and kidney GDF15 staining correlated with urinary GDF15 values. Urine GDF15 was significantly higher in patients with a histologic diagnosis of diabetic nephropathy than in diabetic patients without diabetic nephropathy. This was not the case for serum GDF15. Both serum and urine GDF15 were negatively associated with patient survival in multivariate models. However, when both urine and serum GDF15 were present in the model, lower urine GDF15 predicted patient survival [B coefficient (SEM) − 0.395 (0.182) p 0.03], and higher urine GDF15 predicted a composite of mortality or kidney replacement therapy [0.191 (0.06) p 0.002], while serum GDF15 was not predictive. Decision tree analysis yielded similar results. The area under the curve (AUC) of the receiver operating curve (ROC) for urine GDF15 as a predictor of mortality was 0.95 (95% CI 0.89–1.00, p < 0.001). Conclusions In conclusion, urinary GDF15 is associated with kidney histology patterns, mortality and the need for renal replacement therapy (RRT) in CKD patients who underwent a kidney biopsy. Graphic abstract
      PubDate: 2021-04-13
  • Reconsidering adsorption in hemodialysis: is it just an epiphenomenon'
           A narrative review
    • Abstract: Since the first attempt at extracorporeal renal replacement therapy, renal replacement therapy has been constantly improved. In the field of hemodialysis, substantial efforts have been made to improve toxin removal and biocompatibility. The advent of hemodiafiltration (HDF) and, more recently, of mid cut-off membranes have contributed to management of patients with end-stage renal disease (ESRD). Although several uremic toxins have been discovered, we know little about the clinical impact of their clearance in hemodialysis patients. In addition, a great deal of progress has been made in the areas of filtration and diffusion, but the adsorptive properties of hemodialysis membranes remain under-studied. The mechanism of action of adsorption is based on the attraction between the polymer of the dialysis membrane and the solutes, through hydrophobic interactions, ionic or electrostatic forces, hydrogen bonds or van der Waals forces. Adsorption on the dialysis membrane depends on the membrane surface, pore size, structure and electric load. Its involvement in toxin removal and biocompatibility is significant, and is not just an epiphenomenon. Diffusive and convective properties cannot be improved indefinitely and high permeability membranes, despite their high performance in the clearance of many toxins, have several limitations for long-term use in hemodialysis. This review will discuss why adsorption should be reconsidered and better characterized to improve efficiency and adequacy of dialysis.
      PubDate: 2021-04-10
  • Neurological symptoms, acute kidney failure and electrocardiogram
           suggestive of STEMI: who is the culprit'
    • PubDate: 2021-04-08
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
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