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Chronic Kidney Disease Management: Integrating Pharmacotherapy, Biomarkers, and Lifestyle Interventions...
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Chronic Kidney Disease Management: Integrating Pharmacotherapy, Biomarkers, and Lifestyle Interventions for Improved Outcomes

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Nephrology & Urology".

Deadline for manuscript submissions: 15 October 2025 | Viewed by 865

Special Issue Editor

Dr. Ioannis Bellos

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Guest Editor
1. Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 75, Mikras Asias Str., 115 27 Athens, Greece
2. Department of Nephrology and Renal Transplantation, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 75, Mikras Asias Str., 115 27 Athens, Greece
Interests: nephrology; transplantation; clinical epidemiology; meta-analysis
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Special Issue Information

Dear Colleagues,

Chronic kidney disease (CKD) is an escalating global health challenge and one of the leading non-communicable causes of death. Despite advances in research and clinical care, effective CKD management remains hindered by delayed diagnosis, insufficient early nephrology referrals, and limited access to proven treatments. Consequently, patients with CKD continue to face substantial risks of cardiovascular complications and disease progression.

To address these pressing challenges, there is an urgent need for robust, multidisciplinary evidence that enables a holistic approach to CKD management. Such an approach could improve patient quality of life, reduce mortality rates, and mitigate kidney failure progression.

This Special Issue invites original research articles and meta-research studies (including meta-analyses, network meta-analyses, umbrella reviews, and meta-epidemiological studies) that explore innovative strategies for CKD management. We welcome submissions focusing on, but not limited to, the following topics:

  • Novel biomarkers for risk stratification in kidney disease progression and cardiovascular complications.
  • Dietary interventions and their impact on long-term CKD outcomes.
  • Physical activity recommendations and the comparative efficacy of different exercise regimens in CKD patients.
  • Efficacy and safety of emerging pharmacological therapies, such as SGLT2 inhibitors, GLP-1 receptor agonists, and non-steroidal mineralocorticoid receptor antagonists.
  • Management of metabolic risk factors and complications, including obesity, diabetes mellitus, and dyslipidemia.
  • Addressing disparities in CKD care, including strategies to promote equitable access to novel treatments, dialysis modalities, and kidney transplantation.

We aim to advance the understanding and management of CKD by fostering dialogue across pharmacotherapy, biomarker research, and lifestyle interventions. Submissions that bridge these domains and propose integrative, patient-centered strategies are particularly encouraged.

We look forward to receiving your contributions to this important discussion and to shaping the future of CKD management together.

Dr. Ioannis Bellos
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. Journal of Clinical Medicine 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

  • nephrology
  • chronic kidney disease
  • cardiovascular risk
  • risk stratification
  • biomarkers
  • evidence-based treatment

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Published Papers (2 papers)

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14 pages, 308 KiB  
Article
High Levels of Galectin-3 and Uric Acid Are Independent Predictors of Renal Impairment in Patients with Stable Coronary Artery Disease
by Nayleth Leal-Pérez, Luis M. Blanco-Colio, José Luis Martín-Ventura, Carlos Gutiérrez-Landaluce, Ignacio Mahíllo-Fernández, María Luisa González-Casaus, Óscar Lorenzo, Jesús Egido and José Tuñón
J. Clin. Med. 2025, 14(15), 5264; https://doi.org/10.3390/jcm14155264 - 25 Jul 2025
Viewed by 169
Abstract
Background: High plasma levels of Galectin-3 (Gal-3) and uric acid (UA) are associated with a decline in renal function in different populations. However, this association has not yet been studied in patients with coronary artery disease (CAD). Methods: We included 556 patients with [...] Read more.
Background: High plasma levels of Galectin-3 (Gal-3) and uric acid (UA) are associated with a decline in renal function in different populations. However, this association has not yet been studied in patients with coronary artery disease (CAD). Methods: We included 556 patients with stable CAD. Plasma levels of Gal-3, UA, N-Terminal probrain natriuretic peptide (NT-proBNP), calcidiol, fibroblast growth factor 23, phosphate, parathormone, and klotho were assessed at baseline. The primary outcome was the percentage decrease in eGFR; the secondary outcomes were the absolute decrease in eGFR and achieving a reduction of ≥20% in this parameter. Results: Age was 63.1 ± 12.2 years, and 73.9% of patients were male. The median eGFR was 86.77 (72.27, 97.85) mL/min/1.73 m2. After 3.47 (2.10–5.72) years of follow-up, eGFR declined by 3.62% [−2.07–13.82]. Baseline UA (0.012 [CI95% 0.003, 0.020]; p = 0.008), Gal-3 (0.0153 [CI95% 0.001, 0.029]; p = 0.037), and NT-proBNP (0.017 [CI95% 0.000–0.025]; p = 0.027) were independent positive predictors of the percentage decrease in eGFR, while calcidiol (−0.005 [CI95% −0.009, −0.002]; p = 0.005) was an inverse predictor of this outcome. Similarly, UA and Gal-3 were positive independent predictors of the absolute decline in eGFR (0.009 [0.003, 0.017]; p = 0.004 and 0.012 [0.001, 0.023]; p = 0.031, respectively), while calcidiol was inversely associated (−0.003 [−0.005]–[−0.001]; p = 0.020). Uric acid (1.237 [1.046–1.463]; p = 0.013) and NT-proBNP (1.000 [1.000–1.001]; p = 0.049) levels were positive independent predictors of a ≥20% decrease in eGFR. In patients with eGFR ≥ 60 mL/min/1.73 m2, UA was the only biomarker independently associated with renal function decline. Conclusions: In patients with CAD and normal or mildly reduced renal function, UA and Gal-3 plasma levels are independent positive predictors of a future decrease in eGFR. These findings could lead to a change in the approach to patients with CAD in the future. Full article
(This article belongs to the Special Issue Chronic Kidney Disease Management: Integrating Pharmacotherapy, Biomarkers, and Lifestyle Interventions for Improved Outcomes)
20 pages, 4116 KiB  
Article
Integrative Analysis of Drug Co-Prescriptions in Peritoneal Dialysis Reveals Molecular Targets and Novel Strategies for Intervention
by Michail Evgeniou, Paul Perco, Fabian Eibensteiner, Markus Unterwurzacher, Andreas Vychytil, Rebecca Herzog and Klaus Kratochwill
J. Clin. Med. 2025, 14(11), 3733; https://doi.org/10.3390/jcm14113733 - 26 May 2025
Viewed by 461
Abstract
Background/Objectives: Peritoneal dialysis (PD) is a renal replacement therapy for patients with kidney failure. Managing PD patients often involves addressing a complex interplay of comorbidities and complications, necessitating the use of multiple medications. This study aimed to systematically characterize commonly co-prescribed drugs in [...] Read more.
Background/Objectives: Peritoneal dialysis (PD) is a renal replacement therapy for patients with kidney failure. Managing PD patients often involves addressing a complex interplay of comorbidities and complications, necessitating the use of multiple medications. This study aimed to systematically characterize commonly co-prescribed drugs in PD and to identify novel drug combinations that may target dysregulated molecular mechanisms associated with PD’s pathophysiology. Methods: We analyzed clinical records from 702 PD patients spanning 30 years, encompassing over 5500 prescription points. Using network-based modeling techniques, we assessed drug co-prescription patterns, clinical outcomes, and longitudinal treatment trends. To explore potential drug repurposing opportunities, we constructed a molecular network model of PD based on a consolidated transcriptomics dataset and integrated this with drug–target interaction information. Results: We found commonly prescribed drugs such as furosemide, sucroferric oxyhydroxide, calcitriol, darbepoetin alfa, and aluminum hydroxide to be integral components of PD patient management, prescribed in over 30% of PD patients. The molecular-network-based approach found combinations of drugs like theophylline, fluoxetine, celecoxib, and amitriptyline to possibly have synergistic effects and to target dysregulated molecules of PD-related pathomechanisms. Two further distinct categories of drugs emerged as particularly interesting in our study: selective serotonin reuptake inhibitors (SSRIs), which were found to modulate molecules implicated in peritoneal fibrosis, and vascular endothelial growth factor (VEGF) inhibitors, which exhibit anti-fibrotic properties that are potentially useful for PD. Conclusions: This comprehensive exploration of drug co-prescriptions in the context of PD-related pathomechanisms provides valuable insights for opening future therapeutic strategies and identifying new targets for drug repurposing. Full article
(This article belongs to the Special Issue Chronic Kidney Disease Management: Integrating Pharmacotherapy, Biomarkers, and Lifestyle Interventions for Improved Outcomes)
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