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 May 2025 | Viewed by 3491

Special Issue Editor


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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
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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

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Keywords

  • kidney disease
  • nephropathy
  • diagnosis management
  • renal disease

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Published Papers (2 papers)

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Research

15 pages, 771 KiB  
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
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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 KiB  
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 1583
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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