Int Urol Nephrol [JOURNAL]
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200 papers
Comment on "Glucagon like peptide-1 receptor agonist therapy and long-term renal outcomes after radical nephrectomy: a propensity-matched cohort analysis".
Tribhuvan M, Phatke SN
Int Urol Nephrol · 2026 May · PMID 42189463 · Publisher ↗
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Serum C3 in CKD: a promising stage-associated signal, but not yet a progression-monitoring biomarker.
Yan D, Chen H
Int Urol Nephrol · 2026 May · PMID 42189462 · Publisher ↗
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Overdiagnosis in renal cancer: the hidden consequence of modern imaging.
Vallecilla Valencia K, Garcia-Perdomo HA
Int Urol Nephrol · 2026 May · PMID 42185723 · Publisher ↗
The global burden of renal cell carcinoma (RCC) has risen substantially over the past three decades, while mortality rates have remained largely stable. This epidemiologic paradox suggests that a significant proportion o...
The global burden of renal cell carcinoma (RCC) has risen substantially over the past three decades, while mortality rates have remained largely stable. This epidemiologic paradox suggests that a significant proportion of detected renal tumors may reflect overdiagnosis. This review synthesizes current evidence on the magnitude, drivers, and implications of overdiagnosis in RCC, integrating epidemiologic trends, tumor biology, imaging practices, and translational advances. The widespread use of cross-sectional imaging, particularly computed tomography (CT) and magnetic resonance imaging (MRI), has markedly increased the incidental detection of RCCs, with more than 50% now diagnosed incidentally. Many of these small renal masses (SRMs) are benign or biologically indolent. While early detection may benefit patients with aggressive disease, it can also lead to overtreatment, psychological burden, and increased healthcare costs. Emerging strategies, such as active surveillance, radiomics, and artificial intelligence (AI)-based risk stratification, offer potential pathways to reduce harm. Addressing overdiagnosis is essential to advancing a more precise and clinically meaningful approach to RCC detection and management.
Letter to the editor: telemedicine-supported assisted home hemodialysis in elderly and multimorbid patients: a real-world cohort study in a public healthcare system.
Imran A, Tooba, Saeed MH
Int Urol Nephrol · 2026 May · PMID 42184084 · Publisher ↗
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On interpreting renal safety signals with finerenone in FAERS.
Yan D, Chen H
Int Urol Nephrol · 2026 May · PMID 42184083 · Publisher ↗
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Critical appraisal of "Blood pressure effects of SGLT2 inhibitors in kidney transplant recipients: a systematic review and meta-analysis".
Tahir A, Faiz MU, Zaib M … +3 more , Haider MZ, Zahur M, Gohar K
Int Urol Nephrol · 2026 May · PMID 42184082 · Publisher ↗
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Beyond the stone: nephrolithiasis as a metabolic sentinel in upper tract urothelial carcinoma and papillary renal cell carcinoma: toward a risk-stratified management framework.
Wan S, Gao S, Huang K … +1 more , Bai Y
Int Urol Nephrol · 2026 May · PMID 42184081 · Publisher ↗
CONTEXT: Nephrolithiasis is increasingly recognized as a recurrent disorder that often coexists with broader metabolic vulnerability. Observational studies have also raised the possibility that stone disease may identify...
CONTEXT: Nephrolithiasis is increasingly recognized as a recurrent disorder that often coexists with broader metabolic vulnerability. Observational studies have also raised the possibility that stone disease may identify patients with a higher subsequent risk of upper tract urothelial carcinoma (UTUC) and, less consistently, renal cell carcinoma (RCC), particularly papillary RCC (pRCC). OBJECTIVE: To critically review the epidemiologic and mechanistic literature linking nephrolithiasis to UTUC and RCC, distinguish association from causation, and outline a clinically practical risk-stratified framework. EVIDENCE ACQUISITION: This narrative review was informed by targeted searches of population-based cohort studies, meta-analyses, guideline documents, and mechanistic studies relevant to nephrolithiasis, UTUC, RCC, obstruction, infection, inflammation, and metabolic dysregulation. Greater weight was given to subtype-specific epidemiologic studies and directly relevant upper-tract biology, whereas indirect mechanistic data were interpreted as emerging or hypothesis-generating. EVIDENCE SYNTHESIS: The available literature supports three main conclusions. First, epidemiologic studies suggest an association between nephrolithiasis and increased risk of UTUC, with more limited and lower-specificity evidence for RCC, especially pRCC. Second, shared metabolic abnormalities-including obesity, diabetes, hypertension, dyslipidemia, smoking, and hyperuricemia-may contribute both to lithogenesis and to a pro-inflammatory milieu relevant to carcinogenesis. Third, mechanistic data support biologic plausibility through chronic obstruction, recurrent epithelial injury, crystal toxicity, inflammasome activation, and infection-related inflammation. However, surveillance bias, reverse causation, and heterogeneous endpoint definitions limit causal inference. Current evidence, therefore, supports nephrolithiasis as a clinically relevant marker of metabolic vulnerability and a possible biological contributor in selected contexts, rather than an established causal driver. CONCLUSIONS: Current evidence does not support universal proactive intervention or routine oncologic surveillance for all stone formers. A more defensible clinical approach is risk stratification. Patients with recurrent, early-onset, infection-related, obstructive, or metabolically complicated stone disease may warrant intensified metabolic assessment, a lower threshold for selective stone-directed intervention in defined scenarios, and individualized follow-up. Dedicated cancer surveillance should remain selective and investigational pending prospective validation.
Percutaneous nephrolithotomy among patients with upper urinary system anomalies: evaluating the prevalence, types, characteristics and comparing its outcomes with other patients: a prospective, comparative study of 1485 patients.
Djafari AA, Javanmard B, Seifipoor M … +1 more , Samenezhad S
Int Urol Nephrol · 2026 May · PMID 42178459 · Publisher ↗
BACKGROUND AND PURPOSE: PCNL plays an important role in the treatment of kidney stones, but since it is less defined for patients with anomalous urinary system, their management is challenging. This study attempts to res...
BACKGROUND AND PURPOSE: PCNL plays an important role in the treatment of kidney stones, but since it is less defined for patients with anomalous urinary system, their management is challenging. This study attempts to resolve this issue to help the urologist to properly assess the patients before, during, and after surgery. MATERIALS AND METHODS: A prospective study data were collected for 1485 PCNL candidates treated over 3 years (Sep 2022-Dec 2025). According to preoperative and intraoperative imaging, the samples were divided into two groups: abnormal (n = 121) and normal (n = 1364) groups and compared. RESULTS: The prevalence of anomalies was 8.1%, with bifid or trifid pelvis 4.5%, mal-rotation 1.3%, duplex system 1.1%, infundibulum stenosis 0.5%, and horseshoe kidney 0.4% being the most common, and others being rare. In the anomaly group, the stones were mostly mixed (73.5%) with a dominant calcium component. Uric acid and struvite types were slightly more common than in the normal group. There was no statistically significant gender difference between the two groups. (P = 0.54) The mean age of the normal group was 40.8 ± 8.6 years and the anomaly group was 37.9 ± 8.8 years. The mean length of hospitalization in the anomaly group was 3.60 ± 0.89 days which was significantly longer than the normal group (P < 0.0001). There was no difference in body mass index (BMI) between the groups (P = 0.144). In the anomaly group, 84.3% had a history of related procedures. Number of access in the anomaly group was more than in the normal group (1.09 ± 0.28 vs. 1.18 ± 0.39 and P = 0.01). There were more upper access and puncture sites. In the anomaly group, the surgical duration was 66.5 ± 28.1 min, which was more than in the normal group. (P = 0.0003) In the anomaly group, 73.6% were stone-free in the first operation, compared to 82.2% in the normal group. (P = 0.019) Postoperative complications in the anomaly group occurred in 47.1% and more than in normal individuals, but major complications in the anomaly group were comparable to the normal group. (P = 0.43). CONCLUSION: Types of urinary system anomalies and their prevalence in PCNL candidate patients and postoperative outcomes indicate the importance of the subject. It seems necessary to achieve appropriate criteria for comparison and correct understanding of future studies. Ultimately, PCNL in patients with upper urinary tract anomalies is associated with increased technical complexity, reduced stone-free rates, and higher overall complication rates. Although it remains a viable treatment modality, these outcomes should be carefully considered during preoperative counseling and surgical planning.
A study on the association between polycyclic aromatic hydrocarbon (PAH) exposure and kidney function indicators in adolescents: an integrated research combining statistical mediation analysis and network toxicology.
Yao H, Wang S, Zhang Y
Int Urol Nephrol · 2026 May · PMID 42162532 · Publisher ↗
Polycyclic aromatic hydrocarbons (PAHs) are a class of environmental pollutants widely present in daily life. However, the association between mixed exposure to PAHs and kidney function remains unclear. This study aimed...
Polycyclic aromatic hydrocarbons (PAHs) are a class of environmental pollutants widely present in daily life. However, the association between mixed exposure to PAHs and kidney function remains unclear. This study aimed to analyze and evaluate the relationship between urinary PAH metabolite levels and multiple kidney function parameters in adolescents. Data were obtained from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2016. The cross-sectional associations between urinary PAH metabolites and kidney parameters were examined using multiple linear regression models. In addition, weighted quantile sum (WQS) regression and Bayesian kernel machine regression (BKMR) models were applied to evaluate the effects of mixed exposure to PAH metabolites on kidney function indicators. Statistical mediation analysis suggested that alkaline phosphatase (ALP) may play a potential mediating role. Furthermore, hypothesis-generating bioinformatics analyses were conducted using network toxicology and molecular docking approaches. A total of 1428 adolescents were included in this study. The results showed that all PAH metabolites were negatively associated with serum creatinine (Scr) (P < 0.05) and positively associated with estimated glomerular filtration rate (eGFR) (P < 0.05). Both WQS and BKMR models consistently indicated that mixed exposure to PAHs was positively associated with eGFR and negatively associated with Scr, urinary creatinine (Ucr), and serum uric acid (SUA). Bioinformatics analysis further identified five potential target proteins: albumin (ALB), epidermal growth factor receptor (EGFR), estrogen receptor 1 (ESR1), insulin-like growth factor 1 (IGF1), and peroxisome proliferator-activated receptor gamma (PPARG). Molecular docking was subsequently performed to predict the binding affinities between PAH metabolites and these candidate proteins. Our study identified an association between PAH exposure and kidney function in adolescents. These findings suggest that PAH exposure may be related to early alterations in kidney function among adolescents. However, the clinical significance and long-term health effects of these associations require further validation through longitudinal studies and mechanistic investigations. Nevertheless, our findings highlight concerns regarding the potential adverse effects of PAH metabolite exposure on adolescent kidney function and underscore its relevance for public health.
Composite metabolic indices and calcium oxalate stone formation: a multicenter comparative study of HOMA-IR, PAI, TyG, and METS-IR.
Ibis MA, Ergul RB, Soytürk S … +8 more , Yitgin Y, Akpinar C, Tefik T, Cakır OO, Kiremit MC, Guven S, Sarica K, Gokce MI
Int Urol Nephrol · 2026 May · PMID 42162531 · Publisher ↗
Urolithiasis has been increasingly recognized as a manifestation of systemic metabolic dysfunction rather than solely a local urinary disorder. In this multicenter cross-sectional study, we evaluated and compared the ass...
Urolithiasis has been increasingly recognized as a manifestation of systemic metabolic dysfunction rather than solely a local urinary disorder. In this multicenter cross-sectional study, we evaluated and compared the associations and discriminatory performance of four commonly used metabolic indices, homeostasis model assessment of insulin resistance (HOMA-IR), plasma atherogenic index (PAI), triglyceride-glucose (TyG) index, and metabolic score for insulin resistance (METS-IR), in relation to calcium oxalate stone formation. A total of 1206 adults (666 stone formers and 540 non-stone formers) were enrolled across seven tertiary centers, and calcium oxalate stone composition was confirmed by stone analysis. Metabolic indices were calculated using established formulas. Receiver-operating characteristic analyses and multivariable logistic regression models adjusted for age, sex, body mass index, hypertension, and diabetes mellitus were performed. HOMA-IR, PAI, and METS-IR demonstrated statistically significant but very limited discriminatory capacity, with AUC values only marginally exceeding 0.50, whereas TyG did not show significant discriminatory performance. In adjusted analyses, PAI (OR 1.72, 95%CI 1.09-2.71) and METS-IR (OR 1.05, 95%CI 1.01-1.08) were independently associated with stone formation, while HOMA-IR and TyG were not. These findings suggest that composite metabolic indices integrating lipid metabolism and adiposity may better reflect the metabolic milieu associated with calcium oxalate stone disease than glucose-centered insulin resistance markers alone. Although their standalone discriminatory performance is very limited, these indices may provide pathophysiological insights and serve as hypothesis-generating tools for future research.
Retraction Note: Revisiting risk prediction tools for death and end-stage renal disease in older patients with advanced chronic kidney disease: a prospective study.
Nastasa A, Hussien H, Apetrii M … +5 more , Nistor I, Onofriescu M, Voroneanu L, Hogas S, Covic A
Int Urol Nephrol · 2026 May · PMID 42159641 · Publisher ↗
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Therapeutic efficacy and predictive factors for a successful outcome after platelet-rich plasma injections in men with post-prostatectomy urinary incontinence.
Yang CC, Jiang YH, Kuo HC
Int Urol Nephrol · 2026 May · PMID 42159640 · Publisher ↗
PURPOSE: Post-prostatectomy incontinence (PPI) is a well-recognized complication of transurethral or radical prostatectomy. Platelet-rich plasma (PRP) has been used in regenerative medicine. This study aimed to evaluate...
PURPOSE: Post-prostatectomy incontinence (PPI) is a well-recognized complication of transurethral or radical prostatectomy. Platelet-rich plasma (PRP) has been used in regenerative medicine. This study aimed to evaluate the therapeutic efficacy of repeated PRP injections into the urethral sphincter for PPI. METHODS: Totally 71 patients with PPI refractory to conservative treatments. Each patient received four monthly PRP injections into the urethral sphincter. The primary endpoint was the Global Response Assessment (GRA) score for urinary incontinence improvement. Secondary endpoints included changes in the visual analog scale (VAS) for urinary incontinence, the Urogenital Distress Inventory (UDI-6), the Incontinence Impact Questionnaire (IIQ-7), daily pad usage, and urodynamic parameters three months after the fourth PRP injection. RESULTS: The mean age was 71.0 ± 7.2 years, with a mean PPI duration of 35.5 ± 36.8 months. After PRP injections, the mean GRA score was 1.30 ± 1.23. A GRA score of 2 or 3 was reported in 29 (40.8%) patients, and a GRA score of = 1 was reported in 27 (38.0%), and 15 (21.1%) showed no improvement or reported worsening. Significant improvements were observed in the VAS score, UDI-6 score, and abdominal leak point pressure (ALPP). The increase in ALPP was significantly greater in the successful group than in the failed group (49.3 ± 78.3 vs. 4.9 ± 52.4 cmH2O, p = 0.028). Baseline cystometric bladder capacity (CBC) was identified as a significant predictor of a successful outcome (p = 0.047). CONCLUSIONS: Repeated urethral sphincter PRP injections can reduce the severity of PPI and increase ALPP in 40.8% patients with PPI. The results of this study support PRP as an exceptional therapy with low success but few complications.
Interstitial lung disease associated with antiandrogen agents: a pharmacovigilance study based on FDA adverse event reporting system.
Li G, Zhang X, Ma Z … +2 more , Ma C, An Z
Int Urol Nephrol · 2026 May · PMID 42154420 · Publisher ↗
BACKGROUND: This study aims to detect potential signals of interstitial lung disease (ILD) associated with antiandrogen agents by employing a multi-algorithm, dual-level (Standardized MedDRA Query [SMQ] and Preferred Ter...
BACKGROUND: This study aims to detect potential signals of interstitial lung disease (ILD) associated with antiandrogen agents by employing a multi-algorithm, dual-level (Standardized MedDRA Query [SMQ] and Preferred Term [PT]) framework combined with the updated FDA Adverse Event Reporting System (FAERS) dataset (through 2024). METHODS: We analyzed data from the fourth quarter of 2003 through the fourth quarter of 2024. Disproportionality analysis employed four complementary methods: reporting odds ratio (ROR), proportional reporting ratio (PRR), Bayesian confidence propagation neural network (BCPNN), and empirical Bayes geometric mean (EBGM). Signals were evaluated at both the SMQ and PT levels. RESULTS: A total of 761 cases of ILD associated with antiandrogen agents were analyzed. We identified seven agents showing positive ILD signals in FAERS. They were apalutamide, bicalutamide, degarelix, darolutamide, flutamide, goserelin, and nilutamide. Among them, darolutamide stood out with a newly identified pharmacovigilance signal, whereas no such signal had been detected in prior FAERS analyses. Bicalutamide exhibited positive signals for both "Interstitial lung disease" and "Pulmonary fibrosis" at the PT level, a pattern not seen with the other drugs. Japan contributed the most reports (61.37%); death and hospitalization were the most common outcomes (54.80%). Female-related ILD reports were mainly observed with goserelin and leuprolide used for breast cancer. CONCLUSION: This study identified seven antiandrogens with pharmacovigilance signals, among which the signal for darolutamide was detected for the first time. The dual-level analysis generated the hypothesis that bicalutamide-associated ILD may have a greater tendency to evolve into a fibrotic phenotype. The observed Japanese predominance in reporting likely reflects regulatory and reporting-related factors rather than a true biologic excess risk. Female-related ILD reports represent solely a signal-generating observation. These findings are exploratory and require further validation.
Establishment and characterization of a rat model of ureteral scar stricture induced by mechanical injury.
Mei A, Cheng Q, Cai M … +5 more , Pu C, Liu L, Hu T, Wu X, Sun X
Int Urol Nephrol · 2026 May · PMID 42154419 · Publisher ↗
Ureteral stricture is a common complication in urological practice. However, many existing animal models cause excessive tissue damage or exhibit inconsistent healing; consequently, the pathogenesis of clinical ureteral...
Ureteral stricture is a common complication in urological practice. However, many existing animal models cause excessive tissue damage or exhibit inconsistent healing; consequently, the pathogenesis of clinical ureteral stricture of mechanical origin is not accurately reproduced. This study aimed to establish a rat model of ureteral scar stricture induced by mechanical injury and to characterize its morphological and molecular features. Adult male Sprague-Dawley rats underwent left ureteral occlusion using a micro-hemostatic clamp for 12 h. Renal morphology and function were evaluated by color Doppler ultrasound at 4, 6, and 8 weeks after surgery. Pathological and molecular changes in the injured ureter and ipsilateral kidney were assessed by histopathology, immunohistochemistry, reverse transcription quantitative PCR (RT-qPCR), and Western blot (WB). Progressive hydronephrosis of the left renal pelvis was observed over time. Marked fibroblast proliferation and collagen deposition were noted in the injured ureteral segment. Expression levels of alpha-smooth muscle actin (α-SMA), collagen type I (Col Ⅰ) and collagen type III (Col Ⅲ), fibronectin (FN), and SMAD3/p-SMAD3 were significantly increased. These findings suggest that mechanical ureteral injury induces a typical fibrotic response and leads to scar stricture formation. This model appears to reliably mimic the development and progression of ureteral stricture and may provide a useful platform for further studies on the mechanisms of ureteral scar formation, as well as for the development of preventive and therapeutic strategies.
Efficacy and safety of non-steroidal mineralocorticoid receptor antagonist and SGLT2 inhibitor combination therapy versus SGLT2-inhibitor monotherapy in patients with chronic kidney disease with albuminuria: a systematic review and meta-analysis of randomized controlled trials.
Murtafa KM, Khanday SS, Vondivillu Srinivasan R … +7 more , Majeed MW, Arumapperuma HA, Anilkumar A, Mohammed S, Arshad MR, Chishti ML, Andrabi S
Int Urol Nephrol · 2026 May · PMID 42154418 · Publisher ↗
INTRODUCTION: Sodium-glucose cotransporter 2 inhibitors (SGLT2 inhibitors) and non-steroidal mineralocorticoid receptor antagonists (nsMRAs) exert complementary renoprotective effects in chronic kidney disease (CKD). How...
INTRODUCTION: Sodium-glucose cotransporter 2 inhibitors (SGLT2 inhibitors) and non-steroidal mineralocorticoid receptor antagonists (nsMRAs) exert complementary renoprotective effects in chronic kidney disease (CKD). However, the efficacy and safety of nsMRA plus SGLT2 inhibitor combination therapy compared with SGLT2 inhibitor monotherapy in patients with albuminuria remain uncertain. METHODS: We systematically searched for randomized controlled trials (RCTs) comparing nsMRA plus SGLT2 inhibitor therapy with SGLT2 inhibitor monotherapy in adults with CKD with albuminuria. Outcomes included changes in albumin-creatinine ratio (ACR), estimated glomerular filtration rate (eGFR), serum potassium, categorical ACR response (≥ 30% and ≥ 50% reduction), and short- and long-term safety outcomes, including hyperkalemia, adverse events (AEs), and serious adverse events (SAEs). Random-effects models were used to pool ratio of means (ROM), mean differences (MD), and risk ratios (RR). RESULTS: Four RCTs including 1835 patients were analyzed. Combination therapy was associated with a greater reduction in ACR compared with monotherapy (ROM = 0.67, 95% CI 0.63-0.72), corresponding to an approximate 33% reduction. The likelihood of achieving ≥ 30% (RR = 1.36) and ≥ 50% (RR = 1.76) ACR reduction was significantly higher with combination therapy, however, with a modest increase in serum potassium (MD = 0.11 mmol/L) and a significantly higher risk of hyperkalemia both short term (RR = 1.55) and long-term. There was no overall effect on eGFR, the risk of AEs and SAEs were comparable. CONCLUSION: In patients with CKD with albuminuria, nsMRA plus SGLT2 inhibitor therapy may provide clinically meaningful albuminuria reduction, however with an increased risk of hyperkalemia. Given reliance on surrogate endpoints, heterogeneity and limited long-term data, these findings should be interpreted cautiously and require confirmation in larger, long-term clinical outcome trials.
A study of perirenal and epicardial fat thickness, oxidative stress, inflammation, and metabolic risk in pre-dialysis diabetic and non-diabetic CKD patients.
Kamat N, Thotanolla SP, Jaya Janardhanan J … +5 more , Lakshmi AY, Bitla AR, Vanajakshamma V, Rapur R, Vishnubhotla S
Int Urol Nephrol · 2026 May · PMID 42149464 · Publisher ↗
AIM AND OBJECTIVES: This study aimed to evaluate perirenal and epicardial fat thickness and examine their associations with oxidative stress, inflammation, and metabolic markers in pre-dialysis CKD patients (diabetic and...
AIM AND OBJECTIVES: This study aimed to evaluate perirenal and epicardial fat thickness and examine their associations with oxidative stress, inflammation, and metabolic markers in pre-dialysis CKD patients (diabetic and non-diabetic) compared with healthy controls. MATERIAL AND METHODS: This cross-sectional study included 90 participants (30 diabetic CKD, 30 non-diabetic CKD, and 30 controls). Perirenal fat thickness was assessed by ultrasonography and epicardial fat thickness by echocardiography. Biochemical parameters including renal function, lipid profile, hs-CRP, malondialdehyde (MDA), and ferric reducing antioxidant power (FRAP) were measured. Statistical analysis was performed using parametric or non-parametric tests based on data distribution, with multivariate regression adjusting for age, sex, and BMI. RESULTS: DKD patients had significantly higher perirenal (32.1 ± 5.0 mm) and epicardial (8.72 ± 1.89 mm) fat thickness compared to non-DKD patients and controls. DKD patients also exhibited increased oxidative stress (MDA 4.65 ± 3.39 µmol/L) and decreased antioxidant capacity (FRAP 0.25 ± 0.16 mmol/L). The inflammatory marker hs-CRP was significantly elevated in DKD patients [8.53 (12.64) mg/L]. No significant differences were observed in lipid profiles or atherogenic indices between groups; however, visceral adiposity showed significant positive correlations with atherogenic indices. CONCLUSION: Pre-dialysis CKD patients, particularly those with diabetes, exhibit increased visceral adiposity along with higher oxidative stress and inflammation. Although atherogenic indices were not significantly different between groups, their association with visceral fat suggests a potential role of regional adiposity as a marker of metabolic risk; however, longitudinal studies are required to establish the prognostic significance.
Incremental peritoneal dialysis with days off vs standard-dose peritoneal dialysis: a propensity-matched study (PD holiday).
Parapiboon W, Pattanapongpaibool A, Sanprasert S
Int Urol Nephrol · 2026 May · PMID 42144488 · Publisher ↗
PURPOSE: The benefits of incremental peritoneal dialysis (IPD) with days off remain controversial. This study aimed to compare the survival rate between IPD with days off and standard-dose peritoneal dialysis (PD). METHO...
PURPOSE: The benefits of incremental peritoneal dialysis (IPD) with days off remain controversial. This study aimed to compare the survival rate between IPD with days off and standard-dose peritoneal dialysis (PD). METHODS: Participants who started continuous peritoneal dialysis (CAPD) between October 1, 2020 and November 30, 2021, in a tertiary hospital in Thailand were enrolled. IPD with two days off (performed 5 days a week) and standard-dose PD (performed every day) were compared using propensity score matching at a 1:1 ratio for baseline characteristics. The primary outcome was 1-year patient survival. One-year PD continuation rate, PD-associated peritonitis rate, admission rate, and weekly Kt/V at 6 weeks, 6 months, and 12 months were analyzed. RESULTS: The 118 eligible patients (37 IPD and 81 standard-dose PD) were included. After propensity score matching, the groups were compared. One-year patient survival rates were comparable between groups, with no statistically significant difference (94.3% vs. 97.4% in the IPD and standard-dose PD groups, respectively; hazard ratio (HR) 2.15, 95% confidence interval (CI) 0.19-23.75). The 1-year PD continuation, PD-associated peritonitis rate, and admission rate were comparable between groups. Total weekly Kt/V over the 12 months showed no significant change over time. CONCLUSION: IPD with days off appears to be safe and comparable to standard-dose PD in terms of short-term patient survival.
Dynamic changes in FGF-21 and their association with inflammation and pulmonary function in ESRD patients undergoing peritoneal dialysis: a prospective cohort study.
Lin C, Che L, Zhang Y … +2 more , Li Y, Chen J
Int Urol Nephrol · 2026 May · PMID 42141316 · Publisher ↗
BACKGROUND: End-stage renal disease (ESRD) is frequently accompanied by systemic inflammation and pulmonary dysfunction. Fibroblast growth factor-21 (FGF-21), an emerging metabolic and inflammatory biomarker, may be invo...
BACKGROUND: End-stage renal disease (ESRD) is frequently accompanied by systemic inflammation and pulmonary dysfunction. Fibroblast growth factor-21 (FGF-21), an emerging metabolic and inflammatory biomarker, may be involved in these pathological processes. This study aimed to evaluate dynamic changes in FGF-21 and their association with inflammatory markers-including C-reactive protein (CRP) and interleukin-6 (IL-6)-as well as pulmonary function in ESRD patients receiving peritoneal dialysis (PD). METHODS: In this prospective cohort study, 150 ESRD patients initiating PD were enrolled. Serum FGF-21, CRP, and IL-6 levels were measured at baseline and at 1, 3, and 6 months after PD initiation. Pulmonary function parameters, including forced expiratory volume in one second (FEV), forced vital capacity (FVC), diffusing capacity for carbon monoxide (DL) and maximal voluntary ventilation (MVV), were assessed at baseline and 6 months. Longitudinal changes in FGF-21, CRP, and IL-6 were analyzed using linear mixed-effects models and correlation analyses were used to examine associations among FGF-21, inflammatory markers, and lung function. RESULTS: Over 6 months of PD, FGF-21, CRP, and IL-6 levels significantly decreased (p < 0.01). Mixed-effects linear time models demonstrated a significant decline in FGF-21 (Estimate = - 0.0457, p < 0.001), which remained significant after adjusting for residual renal function, dialysis adequacy (Kt/V), BMI, and smoking status (p < 0.001). Pulmonary function improved, with FEV₁ increasing by 0.098 L (p < 0.001), FVC by 0.101 L (p < 0.001), and DL by 0.47 mL/min/mmHg (p < 0.001). However, MVV did not show a significant change (p = 0.320). However, correlations between FGF-21 and pulmonary function and inflammatory factors were weak and non-significant (all p > 0.05). Subgroup analyses showed that age and baseline CRP did not significantly affect FEV₁ improvement, but patients with lower baseline FGF-21 showed slightly better recovery. CONCLUSION: FGF-21 demonstrates consistent associations with inflammatory markers including CRP and IL-6, and inversely relates to pulmonary function in ESRD patients undergoing PD. These findings support the potential role of FGF-21 as an integrative biomarker for systemic inflammation, renal impairment, and respiratory dysfunction in this population.
Evaluation of the therapeutic effects of pelvic floor muscle training combined with electromagnetic stimulation on pelvic organ prolapse in elderly women using three-dimensional ultrasound parameters.
Que Y, Xie C
Int Urol Nephrol · 2026 May · PMID 42141315 · Publisher ↗
BACKGROUND: Pelvic organ prolapse (POP) is a common condition affecting elderly women. This study aimed to evaluate whether combining pelvic floor muscle training (PFMT) with electromagnetic stimulation (EMS) provides be...
BACKGROUND: Pelvic organ prolapse (POP) is a common condition affecting elderly women. This study aimed to evaluate whether combining pelvic floor muscle training (PFMT) with electromagnetic stimulation (EMS) provides better outcomes than PFMT alone, using objective three-dimensional (3D) ultrasound parameters. METHODS: We conducted a retrospective analysis of 240 elderly women with POP treated between January 2023 and January 2025. Based on the received treatment, patients were grouped to a PFMT group (n = 114) or a PFMT-EMS group (n = 126). All patients underwent a standardized 15 week intervention. We assessed pelvic floor 3D ultrasound parameters, Pelvic Organ Prolapse Quantification (POP-Q) stage, pelvic floor muscle strength metrics, and symptom scores pre- and post-treatment. RESULTS: This analysis included 240 patients. The PFMT-EMS group showed significantly greater improvement in key ultrasound parameters, including a smaller levator ani hiatus area on Valsalva (P < 0.001) and reduced bladder neck descent (P < 0.001). This group also achieved better POP-Q stage improvement (P = 0.013), greater enhancement in muscle strength and symptom relief (all P < 0.001), and a higher total effective rate (P = 0.027). CONCLUSION: Combining PFMT with EMS produces superior anatomical and functional outcomes in elderly women with POP than PFMT alone.
The impact of COVID-19 on sexual behavior, male sexual function, and reproductive health: an interdisciplinary narrative review from a urological perspective.
Della Rosa G, Raffo M, Tammaro S … +9 more , Morelli M, Arcaniolo D, Pandolfo SD, Sciorio C, Romano L, Manfredi C, Cindolo L, De Sio M, Spirito L
Int Urol Nephrol · 2026 May · PMID 42135534 · Publisher ↗
The COVID-19 pandemic profoundly modified daily life and interpersonal relationships, with relevant consequences on sexual health, which integrates biological, psychological, and social components. This narrative review...
The COVID-19 pandemic profoundly modified daily life and interpersonal relationships, with relevant consequences on sexual health, which integrates biological, psychological, and social components. This narrative review summarizes current evidence regarding the impact of the pandemic on sexual behavior, sexual function, and male reproductive health. A comprehensive literature search of recent studies and clinical reports was performed focusing on psychosexual wellbeing, erectile function, fertility, and healthcare access during and after infection or lockdown periods. Current evidence indicates that lockdown-related stress, anxiety, and depression were consistently associated with reduced sexual desire and frequency of sexual activity, as reported in predominantly cross-sectional, questionnaire-based studies conducted during lockdown periods, particularly among couples with children and non-cohabiting partners, whereas alternative sexual practices increased. Sexual activity generally recovered after restrictions were lifted. Emerging data suggest a possible association between COVID-19 and erectile dysfunction mediated by endothelial damage, hypogonadism, and psychological distress, while long-COVID symptoms may further worsen sexual function. Male fertility alterations related to inflammatory and oxidative stress pathways have also been reported. Overall, the pandemic primarily affected sexuality through psychosocial mechanisms, although potential organic effects of SARS-CoV-2 infection on erectile function and fertility cannot be excluded. This review provides an interdisciplinary synthesis of current evidence with a specific focus on clinically relevant urological implications, including erectile dysfunction and male reproductive health, which remain incompletely addressed in the existing literature.
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