Summary at a glance Retrospective analysis of 427 immunoglobulin A nephropathy (IgAN) children in this study demonstrated renal tubular microcysts (rTMA) in children with IgAN may serve as an indicator of a more severe form of the disease, and rTMA is an risk factor for end-stage renal disease (ESRD) in children with IgAN. Abstract Aim The aim of this study was to examine the clinical and pathological characteristics as well as the prognosis of immunoglobulin A nephropathy (IgAN) accompanied by renal thrombotic microangiopathy (rTMA) in paediatric patients. Methods After balancing epidemiolog ..read more

Summary at a glance The slope of eGFR decline was slower after nephrology referral. The improvement in eGFR slope was more prominent among those with hypoalbuminemia, diabetes and anaemia. The improvement in eGFR slope after nephrology referral did not seem to be through improvement in anaemia, or addition of anti-hypertensives or antidiabetics. Abstract Background The Kidney Disease Improving Global Outcomes guidelines recommend nephrology referral for patients with chronic kidney disease (CKD) stages 4 to 5, significant proteinuria and persistent microscopic haematuria. However, the recomme ..read more

Summary at a glance The meta-analysis analyses 28 eligible studies containing 310 530 kidney transplant recipients. The pooled incidence of fracture is 10% (95% CI: 7%–13%). Age of recipient, female sex, pretransplantation diabetes or fracture history, dialysis duration and decease donor are risk factors of fracture. Abstract Aim Kidney transplant recipients are at high risk of fracture due to many factors such as nutritional status, hyperparathyroidism, acidosis and steroid administration. The current meta-analysis aimed to comprehensively analyse the incidence and risk factors of fracture i ..read more

Abstract Aim People with chronic kidney disease experience high rates of cardiovascular disease. Cholesterol-lowering therapy is a mainstay in the management but there is uncertainty in the treatment effects on patient-important outcomes, such as fatigue and rhabdomyolysis. Here, we summarise the updated CARI Australian and New Zealand Living Guidelines on cholesterol-lowering therapy in chronic kidney disease. Methods We updated a Cochrane review and monitored newly published studies weekly to inform guideline development according to international standards. The Working Group included expert ..read more

Nephrology, EarlyView ..read more

Abstract Haemodialysis facilities have a large environmental impact due to high energy, water and consumable usage by haemodialysis equipment. As climate change and natural resource scarcity escalate, all the while the number of people requiring dialysis increases, there is an urgent need for dialysis facilities that meet care needs while minimising environmental impact. To address this, the Australian and New Zealand Society of Nephrology engaged an environmental sustainability consulting practise to develop a best practise guide for the environmentally sustainable design and operation of hae ..read more

Abstract Aim Saliva can reflect an individual's physiological status or susceptibility to systemic disease. However, little attention has been given to salivary analysis in children with idiopathic nephrotic syndrome (INS). We aimed to perform a comprehensive analysis of saliva from INS children. Methods A total of 18 children (9 children with INS and 9 normal controls) were recruited. Saliva was collected from each INS patient in the acute and remission phases. 16S rRNA gene sequencing, widely targeted metabolomics, and 4D-DIA proteomics were performed. Results Actinobacteria and Firmicutes w ..read more

Abstract Gout affects 15%–30% of individuals with advanced kidney disease. Allopurinol which is rapidly and extensively metabolised to an active metabolite, oxypurinol, is the most commonly prescribed urate-lowering therapy. Oxypurinol is almost entirely eliminated by the kidneys (>95%) and has an elimination half-life of 18–30 h in those with normal kidney function. However, oxypurinol pharmacokinetics are poorly understood in individuals with kidney failure on peritoneal dialysis. This study characterised the elimination of oxypurinol and urate in people with gout receiving peritoneal dia ..read more

Nephrology, Volume 29, Issue 5, Page 241-244, May 2024 ..read more

Abstract Here we present a case of complement-mediated thrombotic microangiopathy (TMA) in a patient who has a background of Stage 5 chronic kidney disease secondary to Alport syndrome. We explain our approach to the diagnosis of TMA, especially the reliance on non-renal manifestations of TMA and the role of kidney biopsy given there was a background of advanced kidney impairment at baseline ..read more