Lupus nephritis (LN) patients under immunosuppression were excluded from the main trials with SGLT2 inhibitors. This trial aims to analyze the effect and safety of dapagliflozin in inactive LN patients with residual proteinuria.

In patients with type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD), there remains a paucity of data from large high-quality real-world studies on the efficacy of weight-lowering interventions, including the glucagon-like peptide-1 based therapies semaglutide and tirzepatide, as well as bariatric surgery (BS). This retrospective cohort study evaluates these interventions on cardiorenal outcomes and mortality using health records from TriNetX US Collaborative Network.

Monoclonal gammopathy of renal significance (MGRS) is a heterogeneous group of clonal B-cell or plasma cell proliferative disorders that cause kidney injury without meeting criteria for overt malignancy. Advances in diagnostic techniques have enhanced the identification and classification of MGRS lesions. Clone-directed therapies, such as proteasome inhibitors, anti-CD38, and anti-CD20 monoclonal antibodies, are now central to treatment, targeting a deep hematologic response that is strongly associated with improved renal outcomes and reduced risk of recurrence following kidney transplantation. Despite these advances, management remains challenging in patients without detectable clones. This review highlights recent progress in the diagnosis and treatment of MGRS, with an emphasis on therapeutic strategies, transplant considerations, and evolving clinical challenges.

The estimation of glomerular filtration rate (eGFR) is central to nephrology, yet the growing number of equations often raises concern. However, only a few creatinine-based equations have gained widespread validation: Cockcroft-Gault (CG), Modification of Diet in Renal Disease (MDRD), Chronic Kidney Disease Epidemiology (CKD-EPI), and European Kidney Function Consortium (EKFC). The CG equation, introduced in 1976, was simple but imprecise. In 1999, the MDRD study equation improved GFR estimation and enabled automatic reporting by laboratories by removing weight from the formula. However, its development in patients with CKD led to GFR underestimation in healthy individuals. In 2009, the CKD-EPI equation corrected this, offering improved accuracy and less bias, except in hyperfiltration. In 2021, the CKD-EPI equation was updated to exclude race, mainly for societal reasons, though at the cost of slightly worse performance. In the same year, the EKFC equation was introduced based on European cohorts. It brought two innovations: normalization via the creatinine-to-Q ratio (Q being the median creatinine in healthy individuals), and refined age modeling. These enhancements reduced bias across both the GFR and age ranges and allowed the equation use in both adults and children. At the individual level, all equations remain estimations with similar precision, unless an additional biomarker like cystatin C is used. However, at the population level, EKFC improves bias and accuracy, especially in young adults. Switching from CKD-EPI to EKFC increases CKD prevalence moderately, as shown in European cohorts, but likely reflects better detection. Prognostic performance, particularly for cardiovascular outcomes, is maintained or improved among those reclassified to more severe CKD stages with EKFC. In summary, the EKFC equation represents a scientifically grounded progression in eGFR estimation, an evolution rather than a revolution, offering better performance and flexibility for broader clinical implementation in Europe.

End-stage renal disease patients require peritoneal dialysis (PD) as a life-saving therapy; however, they continue to experience systemic inflammation and increased cardiovascular pathology. These complications can be exacerbated by exposure to PD solutions (PDS) containing glucose. This highlights the clinical unmet need for novel osmotic agents to replace glucose. Here, we tested troxerutin, an FDA-approved drug, as a potential osmotic agent.

Standard approach to anaemia in non-dialysis chronic kidney disease (CKD) does not account for potential age- or sex-specific related risks. We assessed differences in the association between haemoglobin and major cardiovascular events (MACE+) in men and women with CKD, by age groups.

The health benefits of dietary potassium have been linked to potassium-induced natriuresis. However, it is unknown whether potassium loading in patients with chronic kidney disease (CKD) induces natriuresis and to which degree it increases plasma potassium. We hypothesize that potassium-induced natriuresis remains intact and that potassium loading is safe in patients with CKD.

Guidelines recommend using risk prediction models for predicting kidney failure in chronic kidney disease (CKD). Many people with CKD have multiple long-term conditions (multimorbidity), which influences outcomes including kidney failure and mortality. This study validated the four-variable Kidney Failure Risk Equation (KFRE) in individuals with CKD, with and without multimorbidity, comparing performance of KFRE using creatinine and cystatin C to calculate estimated glomerular filtration rate (eGFR) and updated the model to account for competing mortality risks.

Skeletal fragility has long been overlooked by the nephrology community, despite patients with chronic kidney disease (CKD) facing double the risk of hip fracture compared with the general population. Consequently, the term CKD-associated osteoporosis was recently coined to increase awareness. In this context, vertebral fractures are even less studied. Vertebral fractures predict increased fracture risk, and especially in advanced CKD show a strong association with aortic and iliac vascular calcifications, and cardiovascular events such as myocardial infarction. The scope of the present consensus paper is to comprehensively discuss the management of skeletal fragility in CKD patients, from diagnosis to treatment, with a particular focus on vertebral fractures in CKD G4-G5D.

IgA nephropathy (IgAN) is the most common form of glomerulonephritis and a common cause of end-stage kidney disease. This study aimed to evaluate the effectiveness and safety of finerenone in combination with an ACEI/ARB regimen in IgAN patients.

Body roundness index (BRI), an emerging anthropometric measure, has been shown to outperform body mass index (BMI) in predicting mortality risk in the general population. However, its prognostic value among patients with chronic kidney disease (CKD), where the obesity paradox may exist, remains unknown.

Anticancer therapies have significantly improved survival rates in patients with cancer; however, despite prophylactic measures, many conventional chemotherapeutic agents cause acute and chronic kidney injury. This review provides a comprehensive analysis of the incidence, characteristics, and management of platinum-based and anti-metabolite chemotherapeutic agent-associated nephrotoxicity based on the existing literature. Understanding the profiles of these onconephrotoxic agents is essential for optimizing anticancer treatment while minimizing kidney complications.

Cardiovascular disease (CVD), chronic kidney disease (CKD), diabetes, and obesity frequently coexist and share overlapping pathophysiological mechanisms, contributing to poor health outcomes and high mortality. Recognising this interaction, the cardiovascular-kidney-metabolic (CKM) syndrome has been proposed to advance and unify the concepts of cardiorenal syndrome and metabolic syndrome. CKM syndrome is staged from 0 to 4, reflecting disease progression tracking and risk stratification, and emphasizes life-course screening to detect early metabolic and kidney abnormalities. Early identification of albuminuria and reduced kidney function, even in youth with metabolic risk factors, may slow CKD progression and reduce long-term complications. Further development and validation of risk prediction tools for major cardiovascular and kidney failure events in patients with CKM will help to guide individual therapeutic intervention. For nephrologists, this paradigm offers an opportunity to be involved in the interdisciplinary care model. In the future CKM care model, it would be ideal to have dedicated CKM coordinators in place to enhance collaboration between primary care and all the other specialties involved to improve outcomes, and reduce the global burden of CKM syndrome.