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Diagnostics
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Nephrology: Diagnosis and Management
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Nephrology: Diagnosis and Management

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: 31 December 2025 | Viewed by 6908

Special Issue Editor

Dr. Elio Antonucci

E-Mail Website
Guest Editor
Intermediate Care Unit, Ospedale Guglielmo da Saliceto, Piacenza, Italy
Interests: ICU; hemodialysis; critical care; intensive care medicine; sepsis; ventilation; hemodynamics; mechanical ventilation; dialysis; resuscitation
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

This Special Issue, titled Nephrology: Diagnosis and Management, focuses on the latest advancements in the diagnosis, treatment, and management of kidney diseases. The collection of articles explores a wide range of topics, including novel diagnostic techniques, personalized therapeutic approaches, as well as integrated management strategies for chronic kidney disease, acute kidney injury, glomerulonephritis, and other nephrological conditions. Highlighting the multidisciplinary nature of nephrology, the contributions from leading experts in the field provide insights into the complex interplay between genetic, environmental, and lifestyle factors that influence kidney health. The Special Issue also examines the role of technology in improving patient outcomes, including the utilization of big data, artificial intelligence, and telemedicine in the diagnosis and management of kidney diseases. Overall, this compilation offers a comprehensive update on the current state of nephrology, paving the way for further innovations in kidney care.

Dr. Elio Antonucci
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • kidney disease
  • nephropathy
  • diagnosis management
  • renal disease

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Published Papers (4 papers)

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Research

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12 pages, 354 KB  
Article
Serum P-Cresyl Sulfate Is Associated with Peripheral Arterial Stiffness in Chronic Hemodialysis Patients
by Yahn-Bor Chern, Chih-Hsien Wang, Chin-Hung Liu, Hung-Hsiang Liou, Jen-Pi Tsai and Bang-Gee Hsu
Diagnostics 2025, 15(18), 2353; https://doi.org/10.3390/diagnostics15182353 - 16 Sep 2025
Viewed by 231
Abstract
Background/Objectives: Arterial stiffness is a major cardiovascular risk factor in patients with hemodialysis (HD). We conducted a cross-sectional study aimed at determining the relationship between serum p-Cresyl sulfate (PCS) and peripheral arterial stiffness (PAS), defined via the cardio-ankle vascular index (CAVI), in [...] Read more.
Background/Objectives: Arterial stiffness is a major cardiovascular risk factor in patients with hemodialysis (HD). We conducted a cross-sectional study aimed at determining the relationship between serum p-Cresyl sulfate (PCS) and peripheral arterial stiffness (PAS), defined via the cardio-ankle vascular index (CAVI), in 110 patients receiving chronic HD. Methods: Participants were divided into PAS (CAVI ≥ 9.0) and control (CAVI < 9.0) groups. Serum PCS level was measured by high-performance liquid chromatography-mass spectrometry. Results: PAS was detected in 37 (33.6%) patients. The PAS patients were older and had higher SBP, more diabetes, and higher serum PCS and C-reactive protein (CRP) than the control group. Upon multivariate analysis, PAS was significantly associated with PCS (adjusted odds ratio: 1.238 per 1 mg/L increase, 95% confidence interval [CI]: 1.119–1.371, p < 0.001). The CAVI, advanced age, and CRP demonstrated a significant correlation with PCS, as evidenced by the correlation analysis conducted. Area under the receiver operating characteristic curve analysis showed that PCS had a good diagnostic value for PAS (AUC: 0.872, 95% CI: 0.805–0.939; p < 0.001), and the optimal cutoff value was 24.29 mg/L. Conclusions: PCS demonstrates great potential as a biomarker in the diagnosis of arterial stiffness. Full article
(This article belongs to the Special Issue Nephrology: Diagnosis and Management)
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15 pages, 771 KB  
Article
Risk Factor Analysis in Vascular Access Complications for Hemodialysis Patients
by Cristian Dan Roşu, Sorin Lucian Bolintineanu, Bogdan Florin Căpăstraru, Roxana Iacob, Emil Robert Stoicescu and Claudia Elena Petrea
Diagnostics 2025, 15(1), 88; https://doi.org/10.3390/diagnostics15010088 - 2 Jan 2025
Cited by 2 | Viewed by 3412
Abstract
Background: Chronic kidney disease (CKD) and renal failure remain critical global health challenges, with vascular access complications posing significant obstacles in hemodialysis management. Methods: This study investigates the early and late complications associated with vascular access procedures in a cohort of 1334 patients [...] Read more.
Background: Chronic kidney disease (CKD) and renal failure remain critical global health challenges, with vascular access complications posing significant obstacles in hemodialysis management. Methods: This study investigates the early and late complications associated with vascular access procedures in a cohort of 1334 patients from Timiș County Emergency Clinical Hospital. Patients were categorized into early complications, occurring within 30 days postoperatively, and late complications, developing beyond this period. Demographic data, comorbidities, and lifestyle factors, including age, gender, body mass index (BMI), smoking status, hypertension, diabetes, and cardiovascular disease (CVD), were recorded and analyzed. Early complications included thrombosis, hemorrhage, edema, and non-maturation, while late complications involved thrombosis, aneurysmal dilation, venous hypertension, and infections. Results: Hemorrhage (32.3%) and thrombosis (30.8%) were the most prevalent early complications, influenced significantly by diabetes and hypertension. Non-maturation showed a strong association with diabetes and cardiovascular disease (odds ratio: 1.70). For late complications, thrombosis was most frequent, with hypertensive patients exhibiting increased risk (relative risk: 1.18). BMI was a significant factor in both early and late complications. Risk analysis using odds ratios and relative risks revealed distinct patterns of complication risks based on comorbidities and smoking status. Logistic regression modeling for thrombosis demonstrated moderate predictive accuracy (AUC: 0.64). Conclusions: These findings suggest that clinical interventions, such as stricter perioperative glycemic and blood pressure control, and personalized surgical strategies for patients with high BMI or comorbidities, could significantly reduce the incidence of vascular access complications and improve outcomes in this high-risk population. Full article
(This article belongs to the Special Issue Nephrology: Diagnosis and Management)
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15 pages, 1234 KB  
Article
Identification of Pathogenic Pathways for Recurrence of Focal Segmental Glomerulosclerosis after Kidney Transplantation
by Sahra Pajenda, Daniela Gerges, Ludwig Wagner, David O’Connell, Monika Aiad, Richard Imre, Karl Mechtler, Alexander Zimprich, Alice Schmidt, Guerkan Sengoelge and Wolfgang Winnicki
Diagnostics 2024, 14(15), 1591; https://doi.org/10.3390/diagnostics14151591 - 24 Jul 2024
Cited by 1 | Viewed by 1966
Abstract
Primary focal segmental glomerulosclerosis (FSGS) is a disease of the podocytes and glomerulus, leading to nephrotic syndrome and progressive loss of renal function. One of the most serious aspects is its recurrence of disease in over 30% of patients following allogeneic kidney transplantation, [...] Read more.
Primary focal segmental glomerulosclerosis (FSGS) is a disease of the podocytes and glomerulus, leading to nephrotic syndrome and progressive loss of renal function. One of the most serious aspects is its recurrence of disease in over 30% of patients following allogeneic kidney transplantation, leading to early graft loss. This research investigates the individual genetic predispositions and differences in the immune responses leading to recurrence of FSGS after transplantation. We performed exome sequencing on six patients with recurrent FSGS to identify variants in fifty-one genes and found significant variations in the alpha-2-macroglobulin (A2M). Immunoblotting was used to investigate effects of specific gene variants at the protein level. Further expression analysis identified A2M, exophilin 5 (EXPH5) and plectin (PLEC) as specific proteins linked to podocytes, endothelial cells, and the glomerulus. Subsequent protein array screening revealed the presence of non-HLA-specific antibodies, including TRIM21, after transplantation. Using Metascape for pathway and process enrichment analysis, we focused on the IL-17 signaling and chemotaxis pathways. ELISA measurements showed significantly elevated IL-17 levels in patients with recurrent FSGS (32.30 ± 9.12 pg/mL) compared to individuals with other glomerular diseases (23.16 ± 2.49 pg/mL; p < 0.01) and healthy subjects (22.28 ± 0.94 pg/mL; p < 0.01), with no significant difference in plasma CCL2/MCP-1 levels between groups. This study explores the molecular dynamics underlying recurrence of FSGS after transplantation, offering insights into potential biomarkers and therapeutic targets for the future development of individualized treatments for transplant patients. Full article
(This article belongs to the Special Issue Nephrology: Diagnosis and Management)
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9 pages, 2288 KB  
Case Report
McKittrick–Wheelock Syndrome, a Rare Cause of Nonresponsive Persistent Dyselectrolytemia
by Daniela Cana Ruiu, Mihaela Cheie, Mirela Marinela Florescu, Andreea Doriana Stanculescu, Carmen Popescu, Daniela-Teodora Maria, Sebastian Constantin Toma, Naomi Fota, Daniela Calina and Bogdan Silviu Ungureanu
Diagnostics 2025, 15(19), 2459; https://doi.org/10.3390/diagnostics15192459 - 26 Sep 2025
Abstract
Case Presentation: A 67-year-old man presented with transient loss of consciousness and dizziness after weeks of vomiting, weakness, and recurrent syncopal episodes. Initial laboratory findings showed hyponatremia (Na 125 mEq/L), severe hypokalemia (K 2.3 mEq/L), hypochloremia (Cl 77 mEq/L), metabolic alkalemia (pH 7.5; [...] Read more.
Case Presentation: A 67-year-old man presented with transient loss of consciousness and dizziness after weeks of vomiting, weakness, and recurrent syncopal episodes. Initial laboratory findings showed hyponatremia (Na 125 mEq/L), severe hypokalemia (K 2.3 mEq/L), hypochloremia (Cl 77 mEq/L), metabolic alkalemia (pH 7.5; HCO3− 34 mEq/L), low serum osmolality (263 mOsm/L) with inappropriately concentrated urine (332 mOsm/kg), and prerenal azotemia (creatinine 3.4 mg/dL; eGFR 19 mL/min/1.73 m2; blood urea 209 mg/dL). Contrast-enhanced CT, along with colonoscopy, identified a large mucus-secreting villous adenoma in the upper rectum. After fluid and electrolyte replacement, the patient underwent surgical resection with complete remission of symptoms and correction of electrolyte abnormalities on follow-up. Conclusion: Rectal villous adenomas should be considered in older adults with unexplained hypovolemia, hypokalemic hyponatremia, and metabolic alkalemia. Early recognition and definitive resection are curative and prevent kidney injury. Full article
(This article belongs to the Special Issue Nephrology: Diagnosis and Management)
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