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        <title>Frontiers in Nephrology | New and Recent Articles</title>
        <link>https://www.frontiersin.org/journals/nephrology</link>
        <description>RSS Feed for Frontiers in Nephrology | New and Recent Articles</description>
        <language>en-us</language>
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        <pubDate>2026-04-16T14:24:23.728+00:00</pubDate>
        <ttl>60</ttl>
        <item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fneph.2026.1776371</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fneph.2026.1776371</link>
        <title><![CDATA[Telemonitoring post-renal transplantation and role of advanced practice nurses: a single center experience]]></title>
        <pubdate>2026-04-07T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Delphine Bailly</author><author>Maher Abdessater</author><author>Ramy Touma Sawaya</author><author>Benoit Barrou</author><author>Sarah Drouin</author>
        <description><![CDATA[IntroductionTelemonitoring has the potential to improve access to care and continuity of follow-up after kidney transplantation. Advanced practice nurses (APNs) play an increasingly important role in coordinating remote care pathways. This study evaluated patient experience with telemonitoring after renal transplantation, identified determinants of adherence, and clarified the role of APNs in this model.MethodsWe conducted a single-center retrospective observational study including adult kidney transplant recipients enrolled in a telemonitoring program between April 2020 and April 2022. Patients were classified as active users (TOUCO), discontinued users (STOPCO), or never users (JAMCO). Satisfaction and experience were assessed through questionnaires. Platform activity and APN workload were analyzed using descriptive statistics.ResultsAmong 207 eligible patients, 110 responded to the survey (53%): 64 TOUCO (71%), 11 STOPCO (47%), and 35 JAMCO (37%). Active users reported high satisfaction with response time (89%), improved access to care (81%), and increased reassurance (75%). Ease of use (86%) and adequate information at enrollment were significantly associated with continued use. Major barriers included technical difficulties (≈80%) and loss of login credentials (>50%). During the study period, 5,214 platform events and more than 4,000 secure messages were recorded, reflecting sustained engagement. APNs required a mean workload of 3 hours per day to manage all active users on a daily basis.ConclusionTelemonitoring after kidney transplantation is feasible and well accepted, improving perceived access to care and enhancing patient reassurance without measured clinical outcome differences. Adherence is driven primarily by organizational and technological factors rather than patient characteristics. APNs play a central role in ensuring continuity of care, triaging data, and maintaining patient engagement. Future studies should evaluate clinical outcomes and cost-effectiveness to support broader implementation.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fneph.2026.1773415</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fneph.2026.1773415</link>
        <title><![CDATA[Electrolyte homeostasis in pregnancy: from physiological adaptations to clinical disturbances — a nephrologist’s perspective]]></title>
        <pubdate>2026-03-26T00:00:00Z</pubdate>
        <category>Mini Review</category>
        <author>Priti Meena</author><author>Aisha Batool</author>
        <description><![CDATA[Electrolyte homeostasis in pregnancy undergoes several important remodellings driven by systemic vasodilation, activation of neurohormonal pathways, increased glomerular filtration, altered tubular transport, and active maternal–fetal mineral exchange. These coordinated adaptations enable plasma volume expansion, maintain uteroplacental perfusion, and support fetal growth, yet they narrow compensatory reserves and shift normal biochemical reference thresholds. As a result, reliance on non-pregnant laboratory norms can misclassify abnormalities, delaying recognition of clinically important disturbances. Understanding pregnancy-specific physiology is therefore essential for accurate diagnosis, monitoring, and therapeutic decision-making. This review provides an integrated nephrology-focused synthesis of normal adaptive mechanisms and disorder-specific pathophysiology across sodium–water, potassium, magnesium, and calcium balance. We summarize expected gestational changes, including the reset osmostat and AVP-mediated free-water retention causing a physiological fall in serum sodium, changes in potassium homeostasis and magnesium homeostasis, and the doubling of intestinal calcium absorption driven by increased calcitriol to meet third-trimester skeletal mineralization. We further review common clinical disorders of water and sodium, potassium, calcium, and magnesium. The review provides a comprehensive pregnancy-specific interpretation of electrolyte values, diagnostic evaluation strategies, and targeted management tailored to maternal and fetal safety aimed at improving clinical vigilance and optimizing outcomes.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fneph.2026.1762265</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fneph.2026.1762265</link>
        <title><![CDATA[Safety Net kidney after liver transplantation: unexpected renal recovery in a liver transplant recipient after more than 10 months on maintenance hemodialysis – a case report]]></title>
        <pubdate>2026-03-19T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Phuong-Thu T. Pham</author><author>Phuong-Chi T. Pham</author>
        <description><![CDATA[The incidence and likelihood of kidney function recovery in liver transplant recipients with acute kidney injury (AKI) due to hepatorenal syndrome (HRS) or acute tubular necrosis (ATN) requiring maintenance dialysis remain undefined. Nonetheless, it has been suggested that dependence on dialysis for more than 6 months diminishes the likelihood of renal function recovery. We report a liver transplant recipient with pre-transplantation AKI attributed to HRS with or without ATN who recovered kidney function after more than 10 months on dialysis.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fneph.2026.1608421</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fneph.2026.1608421</link>
        <title><![CDATA[A behavioral and electrophysiological investigation of conflict monitoring in cystinosis (CTNS gene mutations) using the flanker paradigm]]></title>
        <pubdate>2026-03-12T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Sophie Molholm</author><author>Ana A. Francisco</author><author>Douwe J. Horsthuis</author><author>Tringa Lecaj</author><author>Dennis Cregin</author><author>Chloe Brittenham</author><author>John J. Foxe</author>
        <description><![CDATA[Cystinosis, a rare lysosomal storage disease, is characterized by cystine crystallization and accumulation within tissues and organs, including the kidneys and brain. Its impact on neural function appears mild relative to its effects on other organs, but therapeutic advances have led to substantially increased life expectancy, necessitating deeper understanding of its impact on neurocognitive function. Behaviorally, some deficits in executive function have been noted in this population, but the underlying neural processes are not understood. Using standardized cognitive assessments and a Flanker task in conjunction with high-density electrophysiological recordings (EEG), we investigated the neural dynamics of conflict monitoring in individuals with cystinosis, when compared to age-matched controls. Thirty-six individuals diagnosed with cystinosis (8–38 years old, 25 women) and 39 age-matched controls (23 women) participated in this study. As expected, slower reaction times and larger amplitudes were observed in incongruent vs congruent trials in both groups, suggesting largely maintained conflict monitoring in cystinosis. However, when compared to their age-matched peers, individuals with cystinosis presented larger differences between congruent and incongruent trials both behaviorally (reaction times) and electrophysiologically (N2, P3). Our findings suggest that individuals with cystinosis are able to monitor and adapt to conflict, even if slower, less accurately, and more effortfully than their age-matched peers.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fneph.2026.1734903</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fneph.2026.1734903</link>
        <title><![CDATA[Effect of preexisting human leukocyte antigen donor-specific antibodies especially human leukocyte antigen-DQ on kidney transplant outcome]]></title>
        <pubdate>2026-03-12T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Sonia Mehrotra</author><author>Raj Kumar Sharma</author><author>Rakesh Kapoor</author><author>Rajesh Kumar Jaiswal</author><author>Rohit Kapoor</author>
        <description><![CDATA[BackgroundAnti-HLA-DQ donor-specific antibodies are increasingly recognized for their role in early rejection and compromised graft function following kidney transplantation.MethodsA total of 119 prospective kidney transplant recipients were evaluated for pre-transplant HLA sensitization using single antigen bead (SAB) assays for class I and class II donor-specific antibodies (DSAs). All patients had negative complement-dependent cytotoxicity (CDC) crossmatch results; however, flow cytometry crossmatch was positive for T cells in three patients and showed borderline B-cell positivity in one patient. Of these patients, 100 proceeded to kidney transplantation, including 19 ABO-incompatible transplants. All recipients were followed for a minimum of 4 years post-transplant, and induction immunosuppression was administered using either anti-thymocyte globulin (ATG) or ATLG (Grafalon®).ResultsA total of 100 patients underwent kidney transplant. Among them, 34 recipients (34%) had class I HLA antibodies (MFI range: 9,057 to 757) and 5 had class I DSAs (MFI range: 2,084 to 822) without any rejection episodes. Thirty-eight patients (38%) tested positive for class II HLA antibodies, including 20 with anti-HLA-DQ (MFI range: 7,725 to 766); of these, eight had donor-specific anti-DQ antibodies. Only one patient, who underwent an ABO-incompatible transplant and had pre-transplant DQ DSA with MFI 7,725, developed biopsy-proven antibody-mediated rejection (ABMR) but recovered following treatment. All eight DQ DSA-positive recipients showed post-transplant MFI decline within 1 month. Rejection was notably infrequent in recipients who received Grafalon® induction.ConclusionsPreformed anti-HLA-DQ DSAs, especially with MFI >5,000 and in the context of ABO incompatibility, may predispose to AMR. DQ DSAs with lower MFI require vigilant monitoring due to the risk of post-transplant rebound. ATLG-based induction was associated with low rejection incidence and favorable short-term outcomes.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fneph.2026.1772736</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fneph.2026.1772736</link>
        <title><![CDATA[Successful use of obinutuzumab in focal segmental glomerulosclerosis with inadequate response to rituximab: a case report]]></title>
        <pubdate>2026-03-03T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Andreia Rita Henriques</author><author>João Venda</author><author>Emanuel Ferreira</author><author>Nuno Oliveira</author><author>Helena Sá</author>
        <description><![CDATA[IntroductionPodocytopathies such as minimal change disease (MCD) and focal segmental glomerulosclerosis (FSGS) remain therapeutic challenges in adults. Although corticosteroids and rituximab (RTX), a chimeric anti-CD20 monoclonal antibody, are effective in most patients, up to 10% show resistance or relapse despite B-cell depletion. Obinutuzumab (OBZ), a humanized type II anti-CD20 monoclonal antibody, achieves deeper and more sustained B-cell depletion and may overcome RTX inadequate response.Case reportA 33-year-old woman presented with nephrotic syndrome (proteinuria 7.1 g/24 h, serum albumin 2.6 g/dL, preserved renal function). Kidney biopsy revealed primary FSGS. She achieved only partial remission with corticosteroids and cyclosporine. RTX (1 g × 2 doses) induced transient peripheral B-cell depletion but no complete remission. A second biopsy excluded chronic changes, and genetic testing for hereditary podocytopathy was negative. Thus 67 weeks after diagnosis and initial treatment with persistent proteinuria > 1g/24 h and hypoalbuminemia, the patient received OBZ (1 g × 2 doses, two weeks apart). Two months later, she achieved complete remission (proteinuria 0.2 g/24 h, serum albumin 3.7 g/dL), with sustained B-cell depletion and no adverse events. A repeat administration of OBZ (1 g) was performed 10 months later due to B-cell repopulation, rising proteinuria (0.6 g/24 h), and mild hypoalbuminemia (serum albumin 3.4 g/dL), successfully re-inducing complete remission (proteinuria 0.2 g/24 h, serum albumin 3.8 g/dL).DiscussionThis case illustrates the potential of OBZ as an effective therapeutic option in podocytopathies with RTX inadequate response. The superior efficacy of OBZ may result from enhanced antibody-dependent cellular cytotoxicity, depletion of tissue-resident B cells, and reduced immunogenicity compared with RTX. OBZ may thus offer an alternative in refractory MCD/FSGS.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fneph.2026.1648950</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fneph.2026.1648950</link>
        <title><![CDATA[Treatment practices, characteristics and outcome of immunoglobulin A nephropathy – a Swiss single center experience]]></title>
        <pubdate>2026-02-27T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Danny Thieny Taing</author><author>Bruno Vogt</author><author>Laila-Yasmin Mani</author>
        <description><![CDATA[IntroductionImmunoglobulin A nephropathy (IgAN) is the most common primary glomerulonephritis worldwide. Geographic differences in disease course and treatment response are well recognized. The purpose of this analysis was to study clinical and histological characteristics, treatment practices and outcome of IgAN cases from a Swiss tertiary center.MethodsThis retrospective cohort analysis identified 158 cases of adult biopsy-proven IgAN by chart review diagnosed between 1980 and 2016. Following detailed phenotyping, standard descriptive methods and univariate analysis were applied.ResultsThe majority of patients was male and of European ancestry. At diagnosis, mean estimated glomerular filtration rate (eGFR) was 55.7 ml/min/1.73 m2, mean proteinuria was 2.4 g/d and 69.9% of the patients were hypertensive. Clinical presentation varied according to age. Initial biopsies showed moderate to severe tubular atrophy and interstitial fibrosis (IFTA) in 29.1% and crescents in 36.7% of cases. Therapy included renin-angiotensin-aldosterone-inhibitors in 86.7% as well as immunosuppressive therapy in 46.8% including steroids and other immunosuppressive drugs (28.7%), mainly azathioprin. Outcome included 34.1% complete and 22.2% partial remissions, relapses in 32.0% of patients, while 43.0% of patients progressed to ESKD during follow-up (median 100.0 months). Recurrence rate after transplantation was 18.8%. Immunosuppressive therapy was more frequently used in patients with higher proteinuria level, higher hematuria grade, lower eGFR, more intense IgA and complement C3 staining and crescents. Predictors of progression were higher age, lower eGFR, higher proteinuria and blood pressure as well as crescents and higher extent of IFTA on the initial biopsy.ConclusionsThis retrospective cohort analysis gives insight into characteristics and outcome of patients with IgAN from a Swiss tertiary center, treatment practices as well as predictors of outcome and therapy choices. A comparatively high use of immunosuppressive treatment including non-steroid-based regimens was found along with a high rate of progression to ESKD.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fneph.2026.1707170</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fneph.2026.1707170</link>
        <title><![CDATA[Xeno kidney: revolutionizing kidney disease treatment]]></title>
        <pubdate>2026-02-20T00:00:00Z</pubdate>
        <category>Review</category>
        <author>Diksha Makkar</author><author>Diksha Gakhar</author><author>Aruna Rakha</author>
        <description><![CDATA[The prevalence of end-stage kidney failure has been exponentially increasing, leading to a gross mismatch between the number of patients who may benefit from transplantation and the limited supply of suitable donor organs. As renal transplantation remains a viable and the most effective option for end-stage kidney disease, the fact remains that the availability of eligible human donor organs is highly unlikely to meet the projected demand. This undermines the need for alternative strategies, including therapies and the development of transplant substitutes. In this context, xenotransplantation has emerged as a lucrative avenue for patients with renal failure who struggle to obtain a suitable graft promptly. The pig is currently the most preferred animal donor for kidney due to its physiological analogy to humans. Nevertheless, xenotransplantation is associated with certain complications as well, which broadly include the risk of hyperacute rejection mediated by preexisting antibodies to xenogeneic antigens, the stimulation of innate immune responses, and thereby the possibility of chronic rejection. Recent advances in xenotransplantation research have offered hope in overcoming these roadblocks and transforming the field of nephrology in the coming years. Genetic engineering has enabled creating low-immunogenicity grafts from donor pigs, including GalTKO (lacking α-Gal epitopes/galactose-α-1,3-galactose knockout) and gene knockouts that limit the complement system activation and clot formation. Furthermore, advances in immunosuppressive regimens, such as co-stimulation blockade and anti-complement treatment, hold great promise for xenograft acceptance and long-term results. In addition, numerous strategies are being explored to induce tolerance, such as mixed chimerism or regulatory T-cell therapy, to achieve a condition of acceptable graft tolerance without dependency on lifelong immunosuppressive treatments. Collectively, these developments support the translational potential of xenotransplantation as a stand-alone treatment or as an adjunct to standard renal replacement therapies. Despite the setbacks, ongoing preclinical research and early clinical trials are expected to refine the safety, durability, and clinical applicability in a xenotransplantation setting.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fneph.2026.1747678</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fneph.2026.1747678</link>
        <title><![CDATA[Primary membranoproliferative glomerulonephritis: natural history, pathogenesis, and treatment]]></title>
        <pubdate>2026-02-13T00:00:00Z</pubdate>
        <category>Review</category>
        <author>Edward J. Filippone</author><author>John L. Farber</author>
        <description><![CDATA[Primary membranoproliferative glomerulonephritis (MPGN) is an ultrarare disease characterized by immunofluorescence microscopy as either immune-complex mediated (IC-MPGN) or C3 glomerulopathy (C3), the latter subdivided by electron microscopy to C3 glomerulonephritis (C3GN) and dense deposit disease (DDD). Both IC-MPGN and C3G typically have obvious C3 staining differentiating them from other causes of MPGN histology. Secondary causes must be excluded, including infections, autoimmune disease, and neoplasia. Clinical presentations are variable, including urinary sediment abnormalities, nephrotic syndrome, or a rapidly progressive course. The prognosis is unfavorable with about 50% reaching kidney failure by 10 years. Recurrence following transplantation is frequent, and allograft survival is shortened. The pathogenesis involves dysregulation of the alternate pathway (AP) of complement. Possibly 20% of patients harbor pathogenic mutations in AP proteins or their regulators, and up to 80% have autoantibodies impairing normal regulation. Paraproteins are found in 20 – 40% of otherwise primary MPGN, either directly detectable on biopsy (IC-MPGN) or as dysregulators of the AP. Therapy of MPGN begins with supportive care as for all glomerulopathies. Paraproteins require clone-directed therapy. When immunosuppression is considered, complement inhibition should be first line. Two agents are now FDA approved for C3G, the oral Factor B inhibitor iptacopan and the subcutaneous C3-inhibitor pegcetacoplan, the latter also approved for IC-MPGN. If complement inhibition is unavailable, MMF/steroids may be considered. Following transplantation, protocol biopsies are needed to detect early recurrence with the intent of complement inhibition.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fneph.2026.1735217</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fneph.2026.1735217</link>
        <title><![CDATA[Chronic kidney disease in hypertensive patients: the urgent need for targeted interventions in Arab countries: a systematic review]]></title>
        <pubdate>2026-02-09T00:00:00Z</pubdate>
        <category>Systematic Review</category>
        <author>Fakhria Al Rashdi</author><author>Celine Tabche</author><author>Zeenah Atwan</author><author>Hamed Al-Qanubi</author><author>Samiya Al Khaldi</author><author>Nasrin Al-Zadjali</author><author>Salman Rawaf</author>
        <description><![CDATA[BackgroundChronic kidney disease (CKD) is expected to be the 5th leading cause of years of life lost by 2040. Recently, it emerged as a significant cause of mortality and morbidity, with a high prevalence in Arab countries.ObjectiveAssess CKD among hypertensive (HTN) people in Arab Countries through evaluation of the existing literature on CKD prevalence, risk factors, screening programmes and prevention.Study designA systematic review till April 2024 following PRISMA guidelines. The search strategy was registered in PROSPERO under the identification code CRD42024486068.MethodsDatabases searched were Medline, Embase, Scopus, PubMed, Cochrane Library. Screening was done using Covidence by three independent reviewers.ResultsOut of 63 studies screened, 11 were selected for extraction. The prevalence of CKD was higher among elderly, HTN and diabetic patients, with 38.8% having unrecognised CKD. Nearly 39% of the 400 participants in one study had undiagnosed stages 3–5 CKD. Two studies showed that 55.8% and 75% of identified CKD patients had HTN. Physicians reported suboptimal screening rates, with about 77% relying on the estimated glomerular filtration rate as a diagnostic tool. Risk factors for CKD include old age, HTN, dyslipidaemia, family history of CKD, and obesity. Among physicians, 85% recommended a target blood pressure of ≤130/80, 80% advised smoking cessation, 66% prescribed anti-lipids, and 67% recommended weight loss. All studies support the fact that HTN is a risk factor for CKD.ConclusionCKD is an escalating problem in Arab countries, with hypertension as a major risk factor. Many patients remain undiagnosed. A region-specific CKD screening and HTN control programme is urgently needed. The findings are essential for policymakers in strengthening primary care for systematic screening of HTN and CKD.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42024486068.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fneph.2026.1730580</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fneph.2026.1730580</link>
        <title><![CDATA[Case Report: Kidney injury following non-medical massage]]></title>
        <pubdate>2026-02-06T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Michael Hieu Truong</author><author>Vanessa Quynh Tran</author><author>Spencer Doan Tran</author><author>Calvin Tuan Nguyen</author><author>Phuong Chi Pham</author><author>Quynh Giao Pham</author>
        <description><![CDATA[BackgroundDeep tissue massage is widely used for musculoskeletal pain and is generally considered safe. We report a case of acute kidney injury following non-medical deep tissue massage.Case presentationA 50-year-old healthy man presented with acute right lower quadrant abdominal pain 4 h after receiving a deep tissue massage for low back pain from an unlicensed therapist. CT angiography revealed a segmental acute infarction of the right kidney with occlusion of the superior segmental artery. The patient was successfully treated with anticoagulation therapy with gradual resolution of symptoms.ConclusionsThis case highlights the potential for severe vascular complications from deep tissue massage, even in healthy individuals. The proposed mechanism is direct mechanical trauma to the renal artery. Prompt evaluation of abdominal pain following massage is essential.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fneph.2026.1718842</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fneph.2026.1718842</link>
        <title><![CDATA[Beyond the resistive index: value of color-coded duplex sonography parameters in kidney transplantation]]></title>
        <pubdate>2026-02-04T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Katharina Konzett</author><author>Sabrina Neururer</author><author>Martin Tiefenthaler</author>
        <description><![CDATA[Sonography is a key method in examining kidney transplants. Recent reports on the limited diagnostic value of an elevated resistive index (RI) in detecting rejection have cast doubt on the overall utility of color-coded duplex sonography (CCDS). This study evaluated additional CCDS parameters – percentage of vascularization (POV) and periphery vessel distance (PVD) – and investigated their association with histopathologic findings in allograft dysfunction. In a retrospective single-center study, 350 kidney transplant biopsies performed between 2013 and 2022 were analyzed. Standardized sonographic evaluation, including POV, PVD, and RI, was conducted at biopsy request. Histopathologic lesions were scored according to Banff criteria. Multivariable logistic regression identified independent predictors of abnormal CCDS parameters. Recipient age, severe tubular atrophy (ct), and arterial intimal fibrosis (cv) were independent negative predictors of POV > 50%. PVD ≥ 0.25 cm was associated with recipient age and moderate tubular atrophy (ct). RI showed no association with histopathologic lesions. These findings identify POV and PVD as non-invasive markers of chronic injury in kidney allografts, highlighting their potential adjunctive role in detecting parenchymal damage. As such, CCDS may support – but not replace – biopsy, which remains essential for establishing a definitive diagnosis in graft dysfunction.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fneph.2025.1719394</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fneph.2025.1719394</link>
        <title><![CDATA[The border between progenitor cell recruitment and nephron shaping in the fetal human kidney during late gestation: a basic but understudied region]]></title>
        <pubdate>2026-02-03T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Will W. Minuth</author>
        <description><![CDATA[IntroductionThe last 3 months of pregnancy are formative for the development of the fetal human kidney. Clinical experience with preterm and low birth weight infants indicates particular vulnerability during this period, as different noxae can terminate the development of new nephrons. This leads to oligonephropathy, which is associated with serious health consequences later in life. While the clinical aspects have been intensely investigated, few data point to the traces left by these noxae. In the nephrogenic zone, a reduction in its width and the absence of S-shaped bodies have been reported.PurposeNot only the targets of noxae but also the site and early links of nephron formation remain poorly investigated. This concerns the individual compartments of the nephrogenic zone and the border between the district of progenitor cell recruitment (DPCR) and the area of nephron shaping (ANS) as a potential target of noxae.MethodsTo shed initial light on this issue, the border between the DPCR and ANS was recorded using microanatomical criteria.ResultsNephron morphogenesis is shown to start at the far end of a cap mesenchyme, with the condensate opposite the head of a collecting duct (CD) ampulla still located within the DPCR. Driven by the mesenchymal-to-epithelial transition, the pretubular aggregate also arises at this site. Its proximal end remains adjacent to the connecting tubule of a previously formed nephron. Subsequently, it converts into the primitive renal vesicle, which thereafter expands within the ANS. Although separation is incomplete, the medial part of the distal pole adheres to the CD ampulla at the section border between its head and conus. This linkage of the future connecting tubule suggests that the conus of the CD ampulla co-elongates with the medial aspect of the shaping nephron stages.ConclusionsClosely related key points during early nephron formation are identified. Damage to only one of these points may result in either developmental arrest. Knowledge of these structural details is vital for pathological screening, interpretation of cell biological labeling, and identification of imprints left by noxae.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fneph.2025.1749827</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fneph.2025.1749827</link>
        <title><![CDATA[The potential of neutrophil gelatinase-associated lipocalin in management of acute kidney injury and peritoneal dialysis-related peritonitis: a narrative review]]></title>
        <pubdate>2026-01-27T00:00:00Z</pubdate>
        <category>Review</category>
        <author>Xiao Fu</author><author>Yiting Shu</author><author>Yun Zhang</author>
        <description><![CDATA[Neutrophil gelatinase-associated lipocalin (NGAL) is a biomarker extensively studied in multiple diseases. While its application in chronic kidney disease (CKD) and kidney transplant patients is relatively limited, NGAL has shown significant promise in the early detection and diagnosis of acute kidney injury (AKI), which may improve more timely management and potentially better clinical outcomes. In addition, NGAL has demonstrated promising utility in identifying peritoneal dialysis-related peritonitis (PDRP) and monitoring the treatment response. This review aims to provide an in-depth overview of the available research findings of NGAL in the management of AKI and PDRP, having these two conditions discussed together is particularly important for nephrologists who manage both conditions, especially to explore the potential of more specific NGAL forms, such as monomer NGAL and homodimer NGAL, to enhance early diagnosis and effective management of AKI and PDRP.]]></description>
      </item><item>
        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fneph.2025.1681679</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fneph.2025.1681679</link>
        <title><![CDATA[Reflective versus predictive value of urinary podocin, nephrin, and their ratio in diabetic kidney disease: a 12-month retrospective cohort study]]></title>
        <pubdate>2026-01-21T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Pringgodigdo Nugroho</author><author>Jeremia Siregar</author><author>Tri Juli Edi Tarigan</author><author>Kuntjoro Harimurti</author><author>Aida Lydia</author><author>Evy Yunihastuti</author><author>Pradana Soewondo</author><author>Hamzah Shatri</author>
        <description><![CDATA[IntroductionPodocyte injury plays a central role in the development of diabetic kidney disease (DKD). Urinary podocin, nephrin, and the podocin–nephrin ratio (PNR) have been proposed as early indicators of glomerular injury, but their prognostic value remains uncertain. This study aimed to evaluate whether baseline urinary podocyte biomarkers reflect current disease severity and predict DKD progression.MethodsWe conducted a retrospective cohort study involving 119 adults with type 2 diabetes and DKD. Baseline urinary podocin, nephrin, and PNR were measured using ELISA. Kidney outcomes were assessed over 12 months. DKD progression was defined as ≥5 mL/min/1.73 m² decline in estimated glomerular filtration rate (eGFR) and/or ≥30% increase in urine albumin-creatinine ratio (uACR). Follow-up uACR data were available for 52 participants. ROC analyses evaluated predictive performance.ResultsAt baseline, median eGFR was 68.1 mL/min/1.73 m² and median uACR was 112 mg/g. Over 12 months, eGFR declined significantly, while uACR showed high variability without consistent change. Among participants with complete outcome data, 19 (36.5%) experienced eGFR decline and 17 (32.7%) showed uACR progression. Baseline podocin, nephrin, and PNR were numerically higher in progressors but showed no significant group differences (all p > 0.3). Predictive performance was poor: AUCs for eGFR decline were 0.504 (podocin), 0.512 (nephrin), and 0.523 (PNR). For albuminuria progression, AUCs were 0.563, 0.524, and 0.544, respectively. Subgroup analyses similarly showed no significant predictive value.DiscussionThese results suggest that single baseline measurements of podocin, nephrin, or PNR may have limited short-term prognostic value in DKD. However, the presence of these markers, even in patients with only moderate disease, supports their role as early indicators of podocyte stress.ConclusionWhile urinary podocyte-associated proteins reflect early glomerular injury, their utility as stand-alone prognostic biomarkers over a one-year period may be limited. Larger longitudinal studies assessing biomarker trajectories and integrating additional molecular markers are warranted.]]></description>
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        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fneph.2025.1582775</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fneph.2025.1582775</link>
        <title><![CDATA[New insights into contrast-associated acute kidney injury: the key role of endothelial dysfunction]]></title>
        <pubdate>2026-01-20T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Mohamed Fakhfakh</author><author>Taha Lassoued</author><author>Firas Nouri</author><author>Nizar Ibn El Mechri</author><author>Ala Daly</author><author>Salem Abdessalem</author><author>Souad Ferjani</author><author>Sami Milouchi</author>
        <description><![CDATA[BackgroundContrast-Associated Acute Kidney Injury (CA-AKI) is a major cause of acute kidney injury in hospitalized patients, which is triggered by the administration of iodinated contrast agents during computed tomography scans and angiographic procedures. It significantly elevates cardiovascular risk and stands as a major complication of coronary angiography, contributing to a marked deterioration in patient prognosis with elevated rates of morbidity and mortality.AimOur main goal was to assess the predictive factors of CA-AKI and investigate a possible association between pre-existing endothelial dysfunction and the occurrence of CA-AKI following Percutaneous Coronary Interventions (PCI). We also intended to explore possible preventive measures of CA-AKI.MethodsWe conducted a prospective observational longitudinal study enrolling patients with an indication for PCI. Patients underwent an assessment of renal function (baseline creatinine, 24h and 48-72h after administration of contrast agent). We also evaluated renal function at one month as a secondary endpoint. Then, we analyzed Endothelial Quality Index (EQI) by Finger Thermal Monitoring (FTM) with E4 diagnosis Polymath.ResultsWe enrolled 187 patients (134 males, 53 females) in our study with a mean age of 61.1± 11.8 years. Over half (56.7%) were type 2 diabetes. A total of 60 cases of CA-AKI were reported (33.7%). The mean EQI was 0.86 ± 0.61. The vast majority of our study population (n=178; 95.2%) had endothelial dysfunction (EQI<2), and a significant proportion (n=142; 75.9%) had severe endothelial dysfunction (EQI<1). In our study, CA-AKI incidence was significantly associated with severe endothelial dysfunction (p=0.007). It was also strongly correlated to the rescue PCI (p=0.002), contrast media volume>100ml (p=0.015) and the presence of a two-vessel coronary artery disease (p=0.008). In multivariate analysis, severe endothelial dysfunction (OR = 5.46; p = 0.014), rescue PCI (OR = 5.77; p = 0.04) and contrast medica volume equal or over 140 ml (OR = 6.96; p = 0.036) were independent risk factors of CA-AKI. We found that pre- and post-hydration with isotonic saline solution and that patients whose baseline treatment includes statins, were significantly prevented from developing CA-AKI. (p=0.007 and 0.008 respectively).ConclusionOur study showed a significant association between the presence of severe endothelial dysfunction, assessed non-invasively by FTM, and the risk of developing CA-AKI. These results appear to be relevant considering that EQI is a low-cost, non-invasive and easily reproducible marker of endothelial dysfunction.]]></description>
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        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fneph.2025.1702475</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fneph.2025.1702475</link>
        <title><![CDATA[Evanescent extraosseous calcifications in low turnover bone: management and outcomes: a case report]]></title>
        <pubdate>2026-01-14T00:00:00Z</pubdate>
        <category>Case Report</category>
        <author>Mariel Hernandez-Pérez</author><author>Daniel Enos</author>
        <description><![CDATA[IntroductionThe prevalence of bone disease in peritoneal dialysis patients has been recently shown to exceed 54%, including patients with parathormone (PTH) levels within the theoretical adequate target, yet demonstrating low bone turnover on histomorphometry. Moreover, bone disease is often associated with abnormalities in calcium and phosphate metabolism, leading to tissular deposits such as extraosseous calcifications.Case presentationWe present a 22-year-old female patient managed on peritoneal dialysis with persistent swelling of all four extremities, including the fingers, hands, and feet, accompanied by a marked decrease in PTH. Many extraosseous calcifications in the hands were seen in the X-ray images, prompting a switch from peritoneal dialysis to conventional high-flow haemodialysis and intravenous sodium thiosulphate (STS) therapy. The patient showed adequate treatment tolerance, with most calcifications disappearing after 3 months of therapy.ConclusionsOur experience suggests that the treatment of extraosseous calcifications requires timely and multi-angle intervention. At the same time, treatment with STS has proven effective and well tolerated in this patient.]]></description>
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        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fneph.2025.1684004</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fneph.2025.1684004</link>
        <title><![CDATA[Inflammatory and lipotoxicity mechanisms in obesity related CKD]]></title>
        <pubdate>2026-01-14T00:00:00Z</pubdate>
        <category>Mini Review</category>
        <author>Jorge Rico-Fontalvo</author><author>Maria Raad-Sarabia</author><author>Juan Montejo Hernández</author><author>Tomas Rodríguez Yánez</author><author>Lacides Rafael Caparroso Ramos</author><author>Paula Parra Sánchez</author><author>Ana Alexandra Ovalle Gomez</author><author>Javier Jimenez Quintero</author><author>Rodrido Daza-Arnedo</author>
        <description><![CDATA[Obesity has been a systemic disease that has been underrecognized for years. Obesity-related chronic kidney disease (Ob-CKD) is a multifaceted disorder that affects patients with CKD to varying degrees. Among the structural changes associated with obesity, obesity-related glomerulopathy (ORG) stands out (glomerular hypertrophy, podocytopathy, mesangial matrix expansion, focal segmental glomerulosclerosis, tubulointerstitial fibrosis, vascular lesions, and tubular atrophy) associated with other kidney diseases. There are direct and indirect mechanisms that affect the kidneys of obese patients. Among the direct mechanisms, several effects may occur: hyperfiltration, activation of the renin-angiotensin-aldosterone system (RAAS), inflammation, lipotoxicity, and neurohormonal activation. This is a narrative review that will detail the inflammatory and lipotoxicity mechanisms involved in the genesis of Ob-CKD.]]></description>
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        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fneph.2025.1691773</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fneph.2025.1691773</link>
        <title><![CDATA[Patient satisfaction with dialysis services provided across different providers in Saudi Arabia]]></title>
        <pubdate>2026-01-12T00:00:00Z</pubdate>
        <category>Original Research</category>
        <author>Sarah S. Monshi</author><author>Hatoon M. Alamri</author><author>Afnan M. Almuaddi</author><author>Fatemah M. Almutairi</author><author>Hala R. Aljishi</author><author>Khulud A. Alfaki</author><author>Maram S. AlTurki</author><author>Rayyan M. Saqah</author><author>Mohammed S. Aldossary</author>
        <description><![CDATA[ObjectivesThis study aimed to evaluate patient satisfaction with dialysis services provided across different healthcare sectors in Saudi Arabia, including governmental and private facilities, and to identify key determinants influencing satisfaction levels.MethodsA cross-sectional observational study was conducted using secondary data from dialysis patients attending Ministry of Health, Diaverum, and DaVita facilities between January and December 2023. Patient satisfaction data were collected through the Press Ganey survey, a validated instrument assessing six domains: registration, care, dialysis, pharmacy, personal issues, and personal experience. Descriptive statistics summarized patient demographics and satisfaction scores, while regression analysis identified factors associated with satisfaction.ResultsA total of 5,472 patients were included, with an overall satisfaction score of 89.84 ± 14.25. The mean satisfaction score was highest in the personal experience domain (91.39 ± 17.02) and lowest in the dialysis domain (88.45 ± 18.65). Private facilities had statistically significant higher satisfaction scores (90.41 ± 13.31) compared to governmental hospitals (88.57 ± 16.08). Females reported significantly higher satisfaction than males (91.96 ± 12.15 vs. 88.91 ± 14.60), respectively. Pediatric patients demonstrated significantly higher satisfaction (age ≤18 years: 93.80 ± 11.42) compared to young adults (age = 19–29 years: 89.18 ± 14.62). Regional differences were observed, with the Southern region reporting the highest satisfaction (91.37 ± 14.18) and the Eastern region the lowest (88.60 ± 15.59). Regression analysis identified gender (B = 2.943, 95% CI [2.165, 3.722], p < 0.001) and facility type (B = 1.108, 95% CI [0.243, 1.973], p = 0.012) as significant predictors of satisfaction.ConclusionPatient satisfaction with dialysis services in Saudi Arabia is generally high, with statistically significant but modest differences across regions, facility types, age groups, and genders. Improving dialysis-related education, addressing regional disparities, and enhancing patient-centered care, particularly in governmental facilities, could further optimize satisfaction outcomes.]]></description>
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        <guid isPermaLink="true">https://www.frontiersin.org/articles/10.3389/fneph.2025.1744454</guid>
        <link>https://www.frontiersin.org/articles/10.3389/fneph.2025.1744454</link>
        <title><![CDATA[Progression of immunoglobulin A nephropathy (IgAN) in a Hispanic/Latinx population in the United States]]></title>
        <pubdate>2026-01-09T00:00:00Z</pubdate>
        <category>Brief Research Report</category>
        <author>John J. Sim</author><author>Nancy T. Cannizzaro</author><author>Qiaoling Chen</author><author>Sasikiran Nunna</author><author>Mohit Mathur</author><author>Cibele Pinto</author>
        <description><![CDATA[BackgroundImmunoglobulin A nephropathy (IgAN) is a leading cause of chronic kidney disease (CKD) worldwide. While racial and ethnic differences in disease progression are well documented, the Hispanic/Latinx populations remain understudied despite their elevated risk of kidney failure among other CKD populations.ObjectiveThis study aimed to evaluate the kidney function decline and progression in Hispanic/Latinx patients with biopsy-proven IgAN within a large, integrated healthcare system and to contextualize to other racial/ethnic groups.MethodsWe conducted a retrospective case series study of 259 Hispanic/Latinx adults with biopsy-proven IgAN from the Kaiser Permanente Southern California (KPSC) health system. Patients were followed from biopsy to ≥50% decline in the estimated glomerular filtration rate (eGFR), kidney failure, mortality, the study end date of November 30, 2022, or disenrollment. Annualized eGFR decline and the incidence of composite kidney outcomes were assessed.ResultsAt diagnosis, Hispanic/Latinx patients had significant CKD and a high risk of progression to kidney failure, indicated by a median eGFR of 56 ml min−1 1.73 m−2 and a median urine protein/creatinine ratio of 1.8 g/g. Common treatments included immunosuppressive agents (41%), angiotensin-converting enzyme (ACE) inhibitors (48%), and angiotensin receptor blockers (ARBs; 20%). The mean annual eGFR decline was −4.5 ml min−1 1.73 m−2, and 30.9% experienced rapid decline (>5 ml min−1 1.73 m−2 per year). The composite kidney outcome occurred at 73.3 events per 1,000 patient-years, with a median time to event of 2.8 years and a median age at event of 46 years.ConclusionHispanic/Latinx patients with IgAN demonstrate rapid kidney function decline and early-onset kidney failure. These findings underscore the need for earlier detection and targeted management in this underserved group.]]></description>
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