Hemophagocytic lymphohistiocytosis is a rare, severe, and potentially fatal disease, mainly encountered in individuals with immunologic diseases. Early diagnosis and prompt intervention may be life-saving. Herein, we report a case of a 52-year-old man who had undergone kidney transplantation nine years previously, presenting with persistent fever of unknown origin and graft function impairment. Despite receiving broad-spectrum antimicrobials and undergoing an exhaustive work-up for infectious, autoimmune, and oncologic diseases, he developed pancytopenia, hepatosplenomegaly, and respiratory failure. A bone marrow biopsy revealed florid hemophagocytosis, hyperferritinemia, hypertriglyceridemia, elevated serum soluble CD25, and cytopenia. These findings fulfilled seven of the Hemophagocytic lymphohistiocytosis 2004 criteria. High dose dexamethasone induced a partial, transitory response and lowered the fever, but multiorgan failure progressed, and the patient died three weeks after ICU admission. This case underscores that hemophagocytic lymphohistiocytosis should be considered whenever kidney transplant recipients develop unexplained fever, cytopenia, and hyperferritinemia, and suggests that early bone marrow evaluation with targeted immunomodulation may improve outcomes in this vulnerable population.

Significant differences in kidney disease-related mortality persist among Italian regions, even after adjusting for age and education level, suggesting a role of contextual factors. The study aimed to assess whether these differences are attributable to the availability of economic and structural resources for healthcare.

Arteriovenous fistulas (AVF) and arteriovenous grafts (AVG) are the preferred options for establishing vascular access in adult patients undergoing haemodialysis treatment. Although various official recommendations exist for AVF and AVG cannulation, a comprehensive, personalised approach to cannulation has yet to be proposed. This systematic review highlights existing knowledge gaps and identifies best practices by synthesising quality evidence on all components involved in AVF and AVG cannulation for haemodialysis.

Glomerular diseases are a major contributor to chronic kidney disease (CKD) and kidney failure worldwide. The prevalence and spectrum of these diseases vary substantially across geographic regions, reflecting differences in genetic predisposition, environmental exposures, and healthcare practices. Although numerous kidney biopsy registries have been established globally, synthesizing their findings is required. The present systematic review aimed to integrate data from national and regional kidney biopsy registries to evaluate the global distribution of biopsy-proven glomerular diseases.

Belimumab is approved for treating systemic lupus erythematosus (SLE) in children over 5 years old; however, its efficacy and safety in pediatric SLE patients require further validation. This study aimed to evaluate the impact of belimumab on the long-term cumulative probability of sustained renal response and disease flare in children with lupus nephritis (LN), to inform clinical decision-making.

Accurate methods of assessing fluid status in patients with  kidney failure in need of dialysis are pivotal to preventing volume overload. Unidentified volume overload can lead to cardiac complications such as left ventricular hypertrophy, hypertension, and, ultimately, heart failure. Currently, there is no gold standard for determining the hydration status of this patient group. This systematic review aims to synthesise studies that have assessed the diagnostic accuracy of lung ultrasound in evaluating fluid status and the use of lung ultrasound to improve long-term endpoints in chronic dialysis patients.

Haemodialysis (HD) has a significant environmental footprint due to its high resource consumption  and waste generation. A key component is dialysate production, which typically involves mixing water, bicarbonate, and a single-use acid concentrate bag for each session. An alternative method is the central delivery of acid concentrate, prepared on-site using dry powder formulations. This study compares the environmental impact of these two delivery systems, focusing on waste reduction, elimination of single-use plastic, and decreased transport-related emissions.

Lack of data regarding pregnancy post-kidney transplantation challenges clinicians who are faced with complex, high-risk cases. Aiming at tackling knowledge gaps and limited cross-cultural data on pregnancy in kidney transplant recipients (KTRs), we compared the methodologies and pregnancy outcomes of three registries based in three continents.

There are unexplained sex differences regarding prevalence, morbidity, and mortality in chronic kidney disease (CKD). Of note, females are less likely to be waitlisted and experience longer waiting times for kidney transplant (KTx). Recently, interest in cognitive impairment among CKD patients has increased due to its potential negative impact on therapeutic outcomes. This study aimed to investigate the influence of sex on cognitive impairment prevalence and patterns, as well as modifiable dementia risk factors, in KTx recipients.

Chronic Kidney Disease (CKD) is a significant public health issue due to its increasing prevalence and associated high morbidity and mortality rates.

Disruption of the gut microbiota in kidney transplant recipients has been linked to an increased risk of post-transplant infections and gastrointestinal symptoms, including diarrhoea. Dietary supplementation with resistant starch may mitigate these risks by promoting the growth of commensal gut bacteria that produce beneficial bioactive metabolites.

Atypical haemolytic uraemic syndrome (aHUS) leads to acute kidney injury, necessitating dialysis in about half of patients. A certain proportion of patients treated with C5 inhibitors discontinue dialysis; however, little is known about the patient characteristics and clinical courses relating to discontinuation.

Anaemia is a common complication of chronic kidney disease (CKD) impacting clinical outcomes and quality of life (QoL). Despite available treatment options, unmet needs exist, especially in relation to QoL. We aimed to develop a consensus of European nephrologists' opinion on the management of anaemia of CKD.

The current definition of acute kidney injury (AKI) using Kidney Disease Improving Global Outcomes (KDIGO) does not account for within-subject biological variation or reference change value (RCV) of serum creatinine (sCr),which may affect its reliability. The aim of this study was to derive and estimate the reference change value of sCr in children and evaluate the impact of using the reference change value-optimized creatinine criteria (KDIGO) on the burden, severity, and outcome of AKI compared to KDIGO creatinine criteria.

The safety of sodium-glucose co-transporter 2 inhibitors (SGLT2i) during fasting in patients with chronic kidney disease (CKD) remains underexplored. This study investigates the risk of acute kidney injury (AKI) in patients with CKD who are fasting and taking SGLT2i, and also examines the long-term estimated glomerular filtration rate (eGFR) outcomes over 6 months after fasting.

Frailty, a geriatric syndrome marked by reduced physiological reserves, has been linked to organ dysfunction. However, the specific contribution of kidney function to frailty remains underexplored. This study aims to assess the impact of kidney function on frailty in a large population of older adults.

Peritoneal dialysis (PD)-related peritonitis is a common complication with high morbidity and mortality, and empirical antibiotic regimens vary across countries. Despite some research, inconsistent results and design limitations highlight the need to reassess the association between these regimens and outcomes.

Gout, a disease already described in the "Anonymus Parisinus Darembergii sive Fuchsii", one of the two surviving Greek medical manuscripts of the first century CE, is reviewed in an effort to trace the timeline of the knowledge of the disease between the Corpus Hippocraticum and the Renaissance.