Urology & Nephrology

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Review Urology & Nephrology

European Association of Urology Guidelines on Non-muscle-invasive Bladder Cancer (Ta, T1, and Carcinoma in Situ)

Marko Babjuk, Maximilian Burger, Otakar Capoun, Daniel Cohen, Eva M. Comperat, Jose L. Dominguez Escrig, Paolo Gontero, Fredrik Liedberg, Alexandra Masson-Lecomte, A. Hugh Mostafid, Joan Palou, Bas W. G. van Rhijn, Morgan Roupret, Shahrokh F. Shariat, Thomas Seisen, Viktor Soukup, Richard J. Sylvester

Summary: The updated EAU guidelines provide new information on the diagnosis and treatment of NMIBC for clinical practice. Individual risk assessment is crucial in determining the appropriate treatment for patients with different risk levels. Surgical intervention, including radical cystectomy, may be necessary for cases unresponsive to BCG treatment or with high risk of progression.

EUROPEAN UROLOGY (2022)

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Review Urology & Nephrology

Epidemiology of chronic kidney disease: an update 2022

Csaba P. Kovesdy

Summary: Chronic kidney disease affects over 800 million individuals worldwide, especially prevalent in older individuals, women, racial minorities, and people with diabetes and hypertension. It has become a major cause of mortality globally, particularly in low- and middle-income countries.

KIDNEY INTERNATIONAL SUPPLEMENTS (2022)

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Review Urology & Nephrology

European Association of Urology Guidelines on Renal Cell Carcinoma: The 2022 Update

Borje Ljungberg, Laurence Albiges, Yasmin Abu-Ghanem, Jens Bedke, Umberto Capitanio, Saeed Dabestani, Sergio Fernandez-Pello, Rachel H. Giles, Fabian Hofmann, Milan Hora, Tobias Klatte, Teele Kuusk, Thomas B. Lam, Lorenzo Marconi, Thomas Powles, Rana Tahbaz, Alessandro Volpe, Axel Bex

Summary: The European Association of Urology has prepared evidence-based guidelines for the management of RCC, which were updated in 2022 using a standardized methodology. The guidelines provide transparent and reliable evidence for the management of RCC, based on a thorough literature assessment and clinical practice recommendations.

EUROPEAN UROLOGY (2022)

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Article Urology & Nephrology

A Unifying Approach for GFR Estimation: Recommendations of the NKF-ASN Task Force on Reassessing the Inclusion of Race in Diagnosing Kidney Disease

Cynthia Delgado, Mukta Baweja, Deidra C. Crews, Nwamaka D. Eneanya, Crystal A. Gadegbeku, Lesley A. Inker, Mallika L. Mendu, W. Greg Miller, Marva M. Moxey-Mims, Glenda V. Roberts, Wendy L. St. Peter, Curtis Warfield, Neil R. Powe

Summary: The National Kidney Foundation and the American Society of Nephrology have made recommendations regarding the consideration of race in GFR estimation. They suggest implementing the CKD-EPI creatinine equation without the race variable in all US laboratories and promoting the use of cystatin C for more accurate estimation. They also encourage research on new filtration markers and interventions to eliminate racial disparities. The unified approach should be adopted nationwide.

AMERICAN JOURNAL OF KIDNEY DISEASES (2022)

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Review Urology & Nephrology

KDIGO 2022 CLINICAL PRACTICE GUIDELINE FOR DIABETES MANAGEMENT IN CHRONIC KIDNEY DISEASE

Ian H. de Boer, Peter Rossing, M. Luiza Caramori, Juliana C. N. Chan, Hiddo J. L. Heerspink, Clint Hurst, Kamlesh Khunti, Adrian Liew, Erin D. Michos, Sankar D. Navaneethan, Wasiu A. Olowu, Tami Sadusky, Nikhil Tandon, Katherine R. Tuttle, Christoph Wanner, Katy G. Wilkens, Sophia Zoungas, Michel Jadoul, Wolfgang C. Winkelmayer, Marcello A. Tonelli, Jonathan C. Craig, Giovanni F. M. Strippoli, David J. Tunnicliffe, Gail Y. Higgins, Patrizia Natale, Tess E. Cooper, Narelle S. Willis

Summary: The Kidney Disease: Improving Global Outcomes (KDIGO) 2022 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease (CKD) is a focused update of the 2020 guideline, providing treatment recommendations for clinicians treating diabetes and CKD based on systematic reviews of relevant studies.

KIDNEY INTERNATIONAL (2022)

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Article Urology & Nephrology

ISPD peritonitis guideline recommendations: 2022 update on prevention and treatment

Philip Kam-Tao Li, Kai Ming Chow, Yeoungjee Cho, Stanley Fan, Ana E. Figueiredo, Tess Harris, Talerngsak Kanjanabuch, Yong-Lim Kim, Magdalena Madero, Jolanta Malyszko, Rajnish Mehrotra, Ikechi G. Okpechi, Jeff Perl, Beth Piraino, Naomi Runnegar, Isaac Teitelbaum, Jennifer Ka-Wah Wong, Xueqing Yu, David W. Johnson

Summary: Peritoneal dialysis (PD)-associated peritonitis is a serious complication of PD, and its prevention and treatment are crucial for reducing patient morbidity and mortality. The ISPD 2022 updated recommendations provide revised definitions, new peritonitis categories and outcomes, and updated targets for overall peritonitis rate and percentage of patients free of peritonitis. The recommendations also cover management of contamination, antibiotic prophylaxis, PD training, and modifiable peritonitis risk factors. Additionally, there are specific recommendations for antibiotic selection, treatment of peritonitis due to specific microorganisms, and adjunctive therapy.

PERITONEAL DIALYSIS INTERNATIONAL (2022)

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Review Urology & Nephrology

The 2022 World Health Organization Classification of Tumours of the Urinary System and Male Genital Organs-Part A: Renal, Penile, and Testicular Tumours

Holger Moch, Mahul B. Amin, Daniel M. Berney, Eva M. Comperat, Anthony J. Gill, Arndt Hartmann, Santosh Menon, Maria R. Raspollini, Mark A. Rubin, John R. Srigley, Puay Hoon Tan, Satish K. Tickoo, Toyonori Tsuzuki, Samra Turajlic, Ian Cree, George J. Netto

Summary: The fifth edition of the WHO classification of urogenital tumours has made significant revisions, including the introduction of molecular-driven renal tumour classification and simplification of the morphologic classification of penile squamous cell carcinomas. A new chapter has also been added for tumours of the scrotum. The main nomenclature for testicular tumours remains the same, but there have been changes in some terms.

EUROPEAN UROLOGY (2022)

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Article Urology & Nephrology

SARS-CoV-2 Antibody Response After a Third Dose of the BNT162b2 Vaccine in Patients Receiving Maintenance Hemodialysis or Peritoneal Dialysis

Ilias Bensouna, Valerie Caudwell, Sabah Kubab, Sandra Acquaviva, Agathe Pardon, Nathalie Vittoz, Dogan-Firat Bozman, Latifa Hanafi, Anne -Laure Faucon, Pierre Housset

Summary: The effectiveness of a third dose of the BNT162b2 vaccine in patients undergoing dialysis treatment was investigated, and it was found that the third dose significantly increased antibody levels.

AMERICAN JOURNAL OF KIDNEY DISEASES (2022)

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Review Urology & Nephrology

The 2021 Updated European Association of Urology Guidelines on Metastatic Urothelial Carcinoma

Richard Cathomas, Anja Lorch, Harman M. Bruins, Eva M. Comperat, Nigel C. Cowan, Jason A. Efstathiou, Rainer Fietkau, Georgios Gakis, Virginia Hernandez, Estefania Linares Espinos, Yann Neuzillet, Maria J. Ribal, Matthieu Rouanne, George N. Thalmann, Antoine G. van der Heijden, Erik Veskimae, J. Alfred Witjes, Matthew I. Milowsky

Summary: The latest EAU guideline recommends platinum-based chemotherapy as the first-line standard therapy, with immunotherapy considered for PD-L1-positive patients who are ineligible for cisplatin, and maintenance immunotherapy recommended for those with nonprogressive disease.

EUROPEAN UROLOGY (2022)

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Editorial Material Urology & Nephrology

US Renal Data System 2021 Annual Data Report: Epidemiology of Kidney Disease in the United States

Kirsten L. Johansen, Glenn M. Chertow, David T. Gilbertson, Charles A. Herzog, Areef Ishani, Ajay K. Israni, Elaine Ku, Shuling Li, Suying Li, Jiannong Liu, Gregorio T. Obrador, Ann M. O'Hare, Yi Peng, Neil R. Powe, Nicholas S. Roetker, Wendy L. St Peter, Fahad Saeed, Jon Snyder, Craig Solid, Eric D. Weinhandl, Wolfgang C. Winkelmayer, James B. Wetmore

AMERICAN JOURNAL OF KIDNEY DISEASES (2022)

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Article Urology & Nephrology

Discovery of Autoantibodies Targeting Nephrin in Minimal Change Disease Supports a Novel Autoimmune Etiology

Andrew J. B. Watts, Keith H. Keller, Gabriel Lerner, Ivy Rosales, A. Bernard Collins, Miroslav Sekulic, Sushrut S. Waikar, Anil Chandraker, Leonardo V. Riella, Mariam P. Alexander, Jonathan P. Troost, Junbo Chen, Damian Fermin, Jennifer L. Yee, Matthew G. Sampson, Laurence H. H. Beck Jr, Joel M. Henderson, Anna Greka, Helmut G. Rennke, Astrid Weins

Summary: In a subset of patients with minimal change disease, circulating nephrin autoantibodies were detected during active disease but significantly reduced or absent during treatment response. These autoantibodies were correlated with podocyte-associated punctate IgG in renal biopsies. A steroid-dependent patient with childhood minimal change disease developed end stage kidney disease, with high pretransplant circulating nephrin autoantibodies associated with massive post-transplant recurrence of proteinuria.

JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY (2022)

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Review Urology & Nephrology

An introduction to inverse probability of treatment weighting in observational research

Nicholas C. Chesnaye, Vianda S. Stel, Giovanni Tripepi, Friedo W. Dekker, Edouard L. Fu, Carmine Zoccali, Kitty J. Jager

Summary: This article introduces the concept of inverse probability of treatment weighting (IPTW) and its application in adjusting for measured confounding in observational research, using a clinical example in nephrology. IPTW involves calculating the probability of exposure to the risk factor or intervention of interest based on individual characteristics (propensity score), and then calculating weights as the inverse of the propensity score. Application of these weights creates a pseudopopulation with balanced confounders across exposed and unexposed groups in studies, and it can also be applied in longitudinal studies to address informative censoring and time-dependent confounding.

CLINICAL KIDNEY JOURNAL (2022)

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Review Urology & Nephrology

Cellular senescence: the good, the bad and the unknown

Weijun Huang, LaTonya J. Hickson, Alfonso Eirin, James L. Kirkland, Lilach O. Lerman

Summary: Cellular senescence plays important roles in tissue remodeling, but excessive senescence may lead to cancer and age-related diseases. It involves cell-cycle arrest and the release of inflammatory cytokines with autocrine, paracrine, and endocrine activities. Therapeutic interventions targeting cellular senescence have shown potential benefits in extending lifespan and reducing tissue injury.

NATURE REVIEWS NEPHROLOGY (2022)

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Article Urology & Nephrology

Thulium Fibre Laser versus Holmium:YAG for Ureteroscopic Lithotripsy: Outcomes from a Prospective Randomised Clinical Trial

Oyvind Ulvik, Mathias Sorstrand Aesoy, Patrick Juliebo-Jones, Peder Gjengsto, Christian Beisland

Summary: This study evaluated and compared the outcomes of ureterorenoscopic lithotripsy using Ho:YAG and TFL lasers. The results showed that TFL was superior to Ho:YAG in terms of stone clearance and reducing operative complications.

EUROPEAN UROLOGY (2022)

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Review Urology & Nephrology

Mineralocorticoid receptor antagonists in diabetic kidney disease - mechanistic and therapeutic effects

Jonatan Barrera-Chimal, Ixchel Lima-Posada, George L. Bakris, Frederic Jaisser

Summary: Non-steroidal mineralocorticoid receptor antagonists (MRAs) show promising therapeutic effects in the treatment of diabetic kidney disease (DKD), including reducing albuminuria, slowing CKD progression, and lowering the risk of adverse cardiovascular outcomes. Compared with steroidal MRAs, non-steroidal MRAs carry a lower risk, providing potential for their use in the treatment of DKD.

NATURE REVIEWS NEPHROLOGY (2022)

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Article Urology & Nephrology

Clinically Localized Prostate Cancer: AUA/ASTRO Guideline, Part I: Introduction, Risk Assessment, Staging, and Risk-Based Management

James A. Eastham, Gregory B. Auffenberg, Daniel A. Barocas, Roger Chou, Tony Crispino, John W. Davis, Scott Eggener, Eric M. Horwitz, Christopher J. Kane, Erin Kirkby, Daniel W. Lin, Sean M. McBride, Alicia K. Morgans, Phillip M. Pierorazio, George Rodrigues, William W. Wong, Stephen A. Boorjian

Summary: This article is part one of a three-part series dedicated to Clinically Localized Prostate Cancer: AUA/ASTRO Guideline. It discusses risk assessment, staging, and risk-based management for patients diagnosed with clinically localized prostate cancer, providing guideline statements to aid clinicians.

JOURNAL OF UROLOGY (2022)

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Review Urology & Nephrology

Cisplatin nephrotoxicity: new insights and therapeutic implications

Chengyuan Tang, Man J. Livingston, Robert Safirstein, Zheng Dong

Summary: The authors review the mechanisms of cisplatin-induced kidney injury and discuss the challenges and potential targets for renoprotection. The cellular and molecular mechanisms of cisplatin nephrotoxicity involve DNA damage, mitochondrial pathology, oxidative stress, endoplasmic reticulum stress, and stress responses such as autophagy, cell-cycle arrest, senescence, apoptosis, programmed necrosis, and inflammation. Emerging evidence suggests a contribution of epigenetic changes to cisplatin-induced kidney injury. Potential therapeutic targets have been identified, but their effects on the efficacy of cisplatin chemotherapy need further evaluation.

NATURE REVIEWS NEPHROLOGY (2023)

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Article Urology & Nephrology

Association of metabolic dysfunction-associated fatty liver disease with kidney disease

Ting-Yao Wang, Rui-Fang Wang, Zhi-Ying Bu, Giovanni Targher, Christopher D. Byrne, Dan-Qin Sun, Ming-Hua Zheng

Summary: Metabolic dysfunction-associated fatty liver disease (MAFLD) is proposed as a replacement term for non-alcoholic fatty liver disease (NAFLD) to emphasize the role of metabolic dysfunction and provide inclusive diagnostic criteria. MAFLD is associated with chronic kidney disease (CKD) and may increase the risk of CKD.

NATURE REVIEWS NEPHROLOGY (2022)

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Article Urology & Nephrology

A secondary analysis of the Belimumab International Study in Lupus Nephritis trial examined effects of belimumab on kidney outcomes and preservation of kidney function in patients with lupus nephritis

Brad H. Rovin, Richard Furie, Y. K. Onno Teng, Gabriel Contreras, Ana Malvar, Xueqing Yu, Beulah Ji, Yulia Green, Tania Gonzalez-Rivera, Damon Bass, Jennifer Gilbride, Chun-Hang Tang, David A. Roth

Summary: Belimumab was found to be most effective in improving kidney response in patients with proliferative lupus nephritis and baseline urine protein/creatinine ratio under 3 g/g. However, it did not show improvement in kidney response in patients with lupus nephritis and sub-epithelial deposits or with a baseline protein/creatinine ratio of 3 g/g or more.

KIDNEY INTERNATIONAL (2022)

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Article Urology & Nephrology

Hyperkalemia Risk with Finerenone: Results from the FIDELIO-DKD Trial

Rajiv Agarwal, Amer Joseph, Stefan D. Anker, Gerasimos Filippatos, Peter Rossing, Luis M. Ruilope, Bertram Pitt, Peter Kolkhof, Charlie Scott, Robert Lawatscheck, Daniel J. Wilson, George L. Bakris

Summary: The study reveals that treatment with finerenone is associated with an increased risk of hyperkalemia, but routine monitoring and management strategies can mitigate its impact.

JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY (2022)

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