Abstract: Background/ aim: Fibrillary glomerulonephritis (FGN) is a rare glomerular disease characterized by non-amyloid fibrillary deposits in the glomeruli, and positive staining for DNAJB9. We aimed to investigate the clinical, pathological characteristics and the outcomes of FGN patients from a tertiary nephrology center. Methods: Retrospective cohort study of eleven patients with a diagnosis of FGN between 2016 and 2025. Results: At diagnosis, nine patients had nephrotic-range proteinuria and eight patients had microscopic haematuria. The mean serum creatinine was 1.6 mg/dL and the mean proteinuria was 3.78 g/24h. In terms of comorbidities, one patient had systemic lupus erythematosus (SLE), one had sarcoidosis and one had lung cancer. Histologically, the most common pattern was a mesangial proliferative pattern, observed in six patients. DNAJB9 staining was performed in 5 patients and was strongly positive. 10 out of 11 patients were positive for both IgG immunofluorescence and C3. All patients received renin-angiotensin-aldosterone system blockade and immunosuppression. In 80% of patients, proteinuria was reduced by more than 50% with stable renal function. Partial remission was observed in 73% of patients with a median follow-up of 24 months. Conclusion: The disease is very heterogeneous and associated with co-morbidities. There is no standard therapy and outcomes are questionable.

Abstract: We examined the efficacy of the lung immune prognostic index (LIPI) for predicting the progression of pathological T3 renal cell carcinoma (RCC). The LIPI scores of patients with pathological T3 RCC were calculated in the pre-operative and post-operative phases. Patients were divided into the zero-points, one-point, and two-points groups according to their LIPI score and into the upstage and non-upstage groups according to the pre- and post-operative increase in LIPI score. Overall survival (OS) was evaluated using Kaplan–Meier curves stratified by group. Univariate and multivariate analyses of OS was performed via Cox proportional hazard regression analysis. LIPI scores were calculated in 80 patients for whom blood sampling data were available. The upstage and non-upstage groups comprised 8 and 72 patients, respectively. Kaplan–Meier curves showed a significant difference in the pre- to post-operative LIPI score upstage group. LIPI score change was a poor prognostic factor in univariate analysis (OS: hazard ratio [HR] = 4.10, 95% confidence interval [CI] = 1.07–15.61, P = 0.038) and multivariate analysis (OS: HR = 4.38, 95% CI = 1.13–16.89, P = 0.031). An increase in LIPI score in the pre-operative phase is a poor prognostic factor in pathological T3 RCC.

Abstract: The 2025 EuDial Consensus systematically compared hemodiafiltration (HDF) to high-flux hemodialysis (HD), highlighting HDF's superior removal of middle-molecular-weight uremic toxins, potential survival advantages, and immunomodulatory properties. High-volume HDF (HV-HDF), defined by a substitution volume exceeding 23 L per session, was associated with improved cardiovascular outcomes, reduced infection-related mortality, and decreased systemic inflammation. Background/Objectives: Nevertheless, the consensus refrains from endorsing HDF as the standard of care, citing insufficient evidence to prevent sudden cardiac death, reduce intradialytic hypotension, or significantly lower hospitalization rates compared to HD. Methods: This review critically evaluates the EuDial Consensus, highlighting its methodological strengths while noting potential limitations stemming from an exclusive reliance on randomized controlled trials (RCTs). The exclusion of real-world evidence (RWE) and mechanistic studies may have led to an underestimation of HDF's broader clinical benefits, particularly in cardiovascular stability, inflammation control, and anemia management. Results: Multiple studies have demonstrated HDF’s capacity to enhance immune function, improve erythropoiesis, and increase clearance of beta-2 microglobulin (β2M) and other pro-inflammatory toxins. Furthermore, the CONVINCE trial’s economic analysis supports HDF’s cost-effectiveness, especially when considering improved survival and reduced dependency on erythropoiesis-stimulating agents. Conclusions: Future research should integrate RWE and mechanistic insights to define better HDF’s therapeutic potential, particularly concerning anemia control, infection mitigation, and hemodynamic stability. While the EuDial Consensus provides valuable clinical guidance, its conclusions should be contextualized within a broader and evolving evidence base. Given its multidimensional benefits, post-dilution High-Volume HDF is increasingly viewed as a preferred renal replacement therapy modality, warranting wider clinical practice adoption.

Abstract: The COVID-19 pandemic has presented a serious challenge to Nephrologists as it led to severe kidney injury in the form of acute tubular necrosis, many of whom required renal replacement therapy. This was predominantly seen in people who developed severe respiratory manifestations like ARDS from the viral infection, cytokine storm and septic shock with unstable hemodynamics. It has also presented with various Glomerular injuries mainly collapsing glomerulopathy in high risk APOL1 genotype patient's, thrombotic microangiopathy related renal failure due to hyper coagulopathy and occasionally pauci-immune glomerulonephritis due to immune dysregulation. All the glomerular disorders due to COVID 19 infection have been described under an entity named COVAN (covid 19 associated nephropathy). Proteinuria was a predominant presentation in Glomerular disorders. Gross hematuria and AKI without any respiratory symptoms from COVID-19 infection have not been described so far in the literature. We have encountered a rare case of gross hematuria and severe acute renal failure who was found to have infection related crescentic glomerulonephritis due to active COVID-19 infections on kidney biopsy without any respiratory symptoms clinically. He has responded well to treatment with steroid taper and antiviral (Remdesivir). This is a very rare Renal manifestation of COVID-19 infection.

Abstract: Background and Objectives: Prostate cancer (PCa) is a common disease with a significant amount of patients first diagnose with locoregional or distant metastases. This is why it is essential to have imaging tests with sufficient sensitivity and specificity. Having traditional imaging methods with recognized limitations, PET-PSMA is born as a weapon to revolutionize the management of PCa. Material and Methods: We made a comprehensive literature review from August to October 2023 using databases and also a review of key clinical guidelines with the topic, focusing on sensitivity and specificity on PSMA-PET, its use in detecting lymph node metastases (LNm), integration into nomograms, comparison with conventional imaging and current guideline recommendations. Results: After considering search strategy, inclusion and exclusion criteria; 4 articles and 5 guidelines were particularly taken into account in this review. Most of them conclude with high specificity and limited sensitivity for 68Ga-PSMA-PET, increasing detection rates with respect to conventional imaging modalities, specially in high-risk PCa patients; but it cannot replace an extended pelvic lymph node dissection (ePLND) at this time. Conclusions: Although PSMA-PET enhanced sensitivity and specificity over conventional imaging modalities offer a more precise evaluation of disease extent; currently, prospective studies demonstrating a survival benefit are lacking, so caution is advised when making therapeutic decisions.

Abstract: Background: Papillary urothelial carcinoma (transitional cell carcinoma) is one of the most common malignant tumors of the urinary tract. Urothelial carcinomas are classified into muscle-invasive and non-muscle-invasive types. Among the latter, papillary urothelial carcinoma is further categorized into low-grade and high-grade forms. The aggressiveness of bladder cancer depends on the stage and grade of the disease. CacyBP/SIP protein and MAP kinases play key roles in various cellular processes and signaling pathways that determine cell survival or death. This study aimed to assess the expression of CacyBP/SIP, ERK1/2, and p38 in low- and high-grade papillary urothelial carcinoma using immunohistochemical and molecular analysis. Materials and Methods: Tissue samples were obtained from 20 patients with high-grade urothelial carcinoma and 20 patients with low-grade urothelial carcinoma. Adjacent non-cancerous tissues served as comparative controls. Immunohistochemistry and qRT-PCR were used to evaluate the expression of CacyBP/SIP, ERK1/2, and p38. Results: The strongest expression of the CACYBP/SIP gene was observed in tumor tissues with high malignant potential, predominantly in the nuclear compartment. Similarly, p38 kinase expression was elevated, whereas ERK1/2 expression was reduced in bladder tumor tissues compared to adjacent normal bladder tissues. Conclusions: These findings suggest that CacyBP/SIP may play a critical role in urothelial carcinoma progression by modulating ERK1/2 and p38 kinase activity.

Abstract: Background and Objectives: Peritoneal dialysis (PD) requires well-functioning medical de-vices (MDs). PD complications can result in significant adverse events, including discon-tinuation of PD, hospitalization, and death. This study aimed to evaluate the feasibility of detecting various PD complications and data related to MDs. Materials and Methods: A retrospective study was conducted on patients who received PD catheter insertions between January 2001 and March 2021 to evaluate PD-related compli-cations. PD complications were evaluated through diagnostic, procedural, and MD codes using a common data model (CDM) and compared with those from electronic health rec-ords (EHR). The results from one CDM database were compared with those from another CDM database. Results: A total of 342 patients were enrolled. One hundred ninety-five patients experi-enced PD complications more than once. Nineteen prescription codes and 20 diagnostic codes from the EHR were identified, covering 11 procedures, 3 MDs, and 7 complications related to PD. Infectious complications were detected using the CDM, whereas mechanical complications were missed. Although data on PD catheters and adaptors were available in the EHR, they were not detected by the CDM. Some infectious and mechanical compli-cations were identified by CDM in the other database. After implementing amended matching, these data were detected. Conclusions: While some PD-related medical data recorded in EHR were misrepresented or omitted during the CDM database extract, transform, and load process, the CDM still pro-vides valuable real-world data.

Abstract: Background: Molecular analysis in patients with nephrolithiasis (NL) and/or nephrocalcinosis (NC) enables an accurate evaluation. The existing clinical evidence regarding genetic testing in adults with NL is comprised of only a few cohort studies. Materials and methods: We retrospectively analyzed 49 adult patients diagnosed with NL and/or NC from a single center, on whom we performed a genetic test using a nephrolithiasis panel. We reviewed the phenotype of the patients and compared the cases with positive and negative molecular diagnosis. Results: 49 adult patients with NL and/or NC underwent genetic testing. Of the tested patients, 29 (59.2%) patients had 24 abnormal variants in 14 genes. Mendelian diseases were diagnosed in 14 (28.6%) cases: cystinuria (SLC3A1, SLC7A9; n=4), hereditary distal renal tubular acidosis (SLC4A1; n=3), Dent disease (CLCN5; n=2), familial hypomagnesaemia with hypercalciuria and nephrocalcinosis (CLDN16; n=1), infantile hypercalcemia type 1 (CYP24A1; n=1), primary hyperoxaluria type 1 (AGXT; n=1), Bartter syndrome type 2 (KCNJ1; n=1) and autosomal dominant tubulointerstitial kidney disease (UMOD; n=1); 8 (16.3%) patients had pathogenic or likely pathogenic monoallelic variants as predisposing factors for NL and/or NC, and 7 (14.3%) had biallelic or monoallelic variants of uncertain significance (VUS). Patients with positive genetic tests had a lower estimated glomerular filtration rate (p=0.03), had more frequently NL associated with NC (p=0.007), and were unlikely to have arterial hypertension (p=0.03) when compared with patients with negative test. Conclusions: Our study shows an increased effectiveness of molecular diagnosis and highlights the benefits of genetic testing. NL associated with NC and the presence of chronic kidney disease are the characteristics that should prompt the clinician to suspect an inherited form of NL and/or NC.

Abstract: Background/Objectives: Buccal mucosa graft (BMG) is increasingly utilized in reconstructive urological surgeries due to its versatility, robust integration, histological characteristics and low morbidity at the donor site. Initially employed in urethral surgery, BMG use has expanded to complex ureteral and penile reconstructive procedures. This narrative review examines BMG applications in various urological surgeries, comparing its outcomes to other graft types, with a focus on surgical techniques and patient outcomes. Methods: A narrative review was conducted using PubMed and Scopus to identify relevant studies published over the last three decades on the use of BMG in urological reconstructive surgery. Articles in English addressing BMG harvesting, applications, and functional outcomes were analyzed. Results: BMG has demonstrated high success rates in every field of its application, especially in urethral reconstruction with an 83-91% efficacy rate in intermediate follow-up. Studies have also reported positive outcomes in complex ureteral and penile curvature surgeries, with patient satisfaction rates reaching up to 85%. Conclusions: BMG is an adaptable tissue graft for urological reconstructive surgeries, offering favorable outcomes with minimal morbidity. Although current results are encouraging, larger prospective studies with standardized protocols are necessary to fully validate its long-term efficacy and optimize treatment approaches for complex urological reconstructions.

Abstract: Laparoscopic urological surgery has become a cornerstone in the treatment of various urological conditions, offering significant advantages over traditional open surgical approaches. These include smaller incisions, less tissue trauma, reduced intraoperative bleeding, less postoperative pain, shorter hospital stays, better cosmetic outcomes, and faster recovery times. Despite these benefits, laparoscopic surgery is not without risks, and major vascular injury (MVI) is one of the most severe and potentially life-threatening complications. This review explores the incidence, causes, and management strategies for MVI in laparoscopic urological surgery, highlighting the importance of early recognition, standardized protocols, and surgical expertise to optimize patient outcomes.

Abstract: Introduction: Retroperitoneal lymph node dissection (RPLND) plays a crucial role in the staging and treatment of testicular cancer, and is often mandatory. RPLND is associated with a high risk of morbidity. The use of minimally invasive techniques have significantly increased the number of robotic procedures performed over the last few years. This study aimed to analyze the perioperative and postoperative outcomes and trends of an increasing number of surgeries performed. Materials and Methods: We retrospectively analyzed 30 robotic-RPLNDs (R-RPLND) performed at our testicular cancer center between 2020 and 2024. Logistic regression analyses were used to analyze the independent variables of operative time (OT), hospital stay (HS), estimated blood loss, lymph node yield, and complications according to the Clavien-Dindo classification system. The independent predictors included case number, clinical stage, post-chemotherapy status, preoperative retroperitoneal tumor mass, and body mass index. Furthermore, the patients were categorized into three groups: group A (cases 1-10), group B (cases 11-20), and group C (cases 21-30). A Kruskal-Wallis test was performed to assess differences among the groups concerning OT, HS, and lymph node yield. Results: OT significantly decreased with an increasing number of cases ( p <0.001), and HS was significantly affected by overall complications (p = 0.0006). There were two major perioperative complications (6.6%). No factors predicted overall complications or Clavien-Dindo grades I-II or III-V. The Kruskal-Wallis test showed a significant difference (p < 0.05) in OT and HS for group C. Conclusion: R-RPLND for GCT demonstrates a clear learning curve, with significant improvements in OT, HS, and complication rates as surgeons gain experience. Overall, the low complication rates for R-RPLND did not indicate predictive factors for perioperative or postoperative complications. RPLND presents promising potential as a safe and effective treatment for GCT, especially when performed by experienced surgeons in specialized centers.

Abstract: Objective: To assess the outcomes of upfront Optilume drug-coated balloon (DCB) treatment in patients after failed treatment for complex recurrent urethral stricture disease. All patients presented with acute urinary retention, and were treated with DCB dilation regardless of stricture site/length. Patients and Methods: We retrospectively evaluated patients with acute urinary retention and known complex recurrent urethral strictures. Patients presented at the urology emergency room of our tertiary centre with an inability to void or a post-void residual (PVR) exceeding 400 ml between August 2021 and February 2024. Urinary tract infection was immediately excluded, and urethrography and/or endoscopic imaging confirmed the diagnosis of urethral stricture. Urethral dilation to 20 Fr was performed, followed by drug-coated balloon dilation (30 Fr, 10 bar, 10 minutes). The primary endpoints were anatomical success (≥14 Fr by cystoscopy/calibration) at 12 months and freedom from repeat interventions. Patients requiring suprapubic catheterisation for UTI/sepsis and those with neurological disease were excluded. Results: Thirty-one consecutive male patients were evaluated, with 26 patients followed for ≥ 12 months (mean age 65 ± 16.8 years). Stricture sites: seven bulbopenile, seven bulbomembranous, seven anastomotic, three bladder neck, one penile, and one panurethral. The median number of prior urethral/surgical interventions was 2 [IQR: 1-3] (range: 1-31). The median stricture length was 3 [IQR: 2-4] cm. (range: 1-8). At 12 months 65.4% (17/26) of subjects voided satisfactorily, free of recurrence and reoperation. Conclusions: Nearly two-thirds of multimorbid patients with previously treated complex recurrent urethral strictures had a patent urethra at 12 months after a single treatment with DCB dilatation. Optilume dilation offers a viable treatment option for patients with complex recurrent urethral strictures and urinary retention, particularly those who are unable or unwilling to undergo surgical reconstruction and prefer to avoid indwelling urethral catheters.

Abstract: Introduction: The advances in urological surgery across the decade has continued to burgeon, particularly in the pursuit of minimally invasive approaches for major operations. Robotic-assisted surgery has gradually established its role in uro-oncological cases that demand a high level of precision, optimising surgeon ergonomics and decreasing fatigue whilst maintaining optimal clinical outcomes. With the novel Hinotori surgical robot (Medicaroid Corporation (Kobe, Hyogo, Japan) launched in Japan back in 2019, it has now demonstrated its use case across various clinical series of different surgeries. We sought to narratively synthesise the initial feasibility of the Hinotori robotic system in Urology. Methods and Results: A non-systematic, comprehensive literature search was conducted across various databases from September 2024 to October 2024. Relevant keywords within the scope of this study were generated for a more accurate search. After exclusion and removal of duplicates, a total of nine articles that encompassed a diverse range of urological surgeries were included for review. Among the included studies, one study reported data solely on radical prostatectomy for prostate cancer, two studies reported on robotic-assisted nephroureterectomy for renal tumors, two studies on partial nephrectomy performed for renal masses, two studies reported on radical nephrectomy carried out for renal malignancies and one study on robotic-assisted adrenalectomy for adrenal cancer. Lastly, one study collectively reported on outcomes pertaining to partial nephrectomy, partial nephrectomy, vesicourethral anastomosis and pelvic lymph node dissection in porcine, as well as partial nephrectomy, radical prostatectomy and pelvic lymph node dissection in cadavers. Conclusion: The new Hinotori robotic system offers unique three-dimensional features as a non-inferior robotic platform alternative that has proven clinically safe thus far in its use. Larger scale studies and randomised trials are eagerly awaited to assess and validate more holistically its clinical utility.

Abstract: Background and objectives CKD-associated pruritus (CKD-aP) is a serious, systemic comorbidity occurring in CKD patients. Despite the burden of CKD-aP, there are limited efficacious treatments available for its management; difelikefalin is the only approved treatment based on efficacy and safety demonstrated in the KALM-1 and KALM-2 clinical trials. The objective of this study was to assess the cost-effectiveness of difelikefalin with best supportive care (BSC) versus BSC alone for the treatment of moderate-to-severe CKD-aP in patients receiving in-centre haemodialysis from a UK NHS perspective. Methodology A de novo lifetime Markov health economic model was developed to assess the cost-effectiveness of difelikefalin. Modelled treatment efficacy was based on patient-level data from the pooled KALM-1 and KALM-2 trials. Total 5-D Itch scale score was used as the main efficacy driver in the model. Transition matrices were derived from per-cycle probabilities of changing health states defined by CKD-aP severity, estimated using the mean change from baseline in total 5-D Itch score. Time-dependent annual probabilities of death and transplant were estimated for people on haemodialysis. An increased risk of mortality for modelled patients with very severe, severe, or moderate CKD-aP was applied. Health state utilities and management costs were based on published evidence. Results Modelled patients treated with difelikefalin were estimated to have a reduced severity of CKD-aP. Consequently, treatment with difelikefalin and BSC compared with BSC alone was associated with increased life expectancy (0.11 years per person), and improved HRQoL which translated to in-creased quality adjusted life years (QALYs, 0.26 per person) gained compared with BSC alone. Improved patient outcomes were achieved at an incremental cost of £7,814 per person. Conclusion Overall, at a price of £31.90/vial, difelikefalin was estimated to be a cost-effective treatment for CKD-aP at a willingness-to-pay threshold of £30,000/QALY, with conclusions robust to sensitivity analysis.

Abstract:

Background/Objectives: Currently, the Meares-Stamey 4-glass and the 2-glass tests are used for diagnosing chronic prostatitis subtypes. Both tests include prostatic massage. Failure to extract prostatic secretions -for any reason- results in an undiagnostic test. Evidence from everyday practice and studies shows that expressed prostatic secretion is successfully recovered in less than 50% of the examined patients and an important number of post-massage urine samples are missing prostatic secretions. This study evaluated a simpler test, the 3-glass (pre-ejaculation, ejaculation, and post-ejaculation) test. We compared it with the 4-glass and the 2-glass tests to detect inflammation and bacteria in men with chronic prostatitis symptoms. Methods: The study population included patients with chronic prostatitis symptoms. Subjects were assigned in each visit to undergo either the 4-glass or the 2-glass test or the 3-glass test. The comparison among the three tests was based on the percentage of bacterial detection, the percentage of false negative diagnoses, and the percentage of shifts among chronic prostatitis subtypes in the follow-up visits of recurrent patients. Results: A total of 157 patients were finally evaluated. Fifty-nine (59) patients underwent the 4-glass test (group A), sixty-seven (67) underwent the 3-glass test (group B) and thirty-one (31) underwent the 2-glass test (group C). No statistically significant differences in the aforementioned comparisons were found. Conclusions: A comparison of the three diagnostic tests showed no superiority of the total ejaculate culture-based 3-glass test to the conventional prostatic secretions culture-based tests.

Abstract: Background: Sacral nerve stimulators (SNS) can be an effective treatment for urinary incontinence. However, with a failure rate of up to 50%, an explantation rate of up to 16%, and a cost of ~US$10,000 per implant, identification of patients at high risk for explantation is necessary to improve patient satisfaction and reduce the economic burden on the healthcare system. The objective of this retrospective cohort study was to determine predictors of SNS explantation within the first two years of device placement. Methods: The MOVER database was queried for patients with a SNS and at least two years of follow up (n = 54). Multivariate logistic regression was performed to assess risk factors for explantation. Factor optimization was used to eliminate factors with limited predictive value. Results: The model displayed excellent performance with an AUC of 0.93 and an f1-score of 0.81. Malignancy (OR: 3.88; CI: 3.84 – 3.93), female sex (OR: 3.72; CI: 3.68 – 3.76), ASA score (OR: 2.39; CI: 2.36 – 2.42), alcohol use (OR: 2.08; CI: 2.06 – 2.08), length of stay (OR: 1.92; CI: 1.90 – 1.94), peripheral neuropathy (OR: 1.86: CI: 1.83 – 1.88), and low back pain (OR: 1.82; CI: 1.79 – 1.84) displayed statistically significant increased risk of explantation. Atrial fibrillation (OR: 0.38; CI: 0.37 – 0.38) and chronic kidney disease (OR: 0.47; CI: 0.47 – 0.48) were included in the model but conferred decreased risk of explantation. Conclusions: Patient’s ASA score, medical history of malignancy, alcohol use, low back pain, and peripheral neuropathy are possible novel risk factors for SNS explantation.

Abstract: Urolithiasis is one of the most burdensome urinary tract conditions with a prevalence ranging from 1% to 20%. Approximately half of the patients experience a recurrence, while 10% face multiple stone episodes. Long before the advent of surgical treatment options, herbal therapy, or phytotherapy, had been used for both the prevention and management of urolithiasis. Recently, interest in phytotherapy has been rekindled due to the limitations associated with modern urolithiasis treatment, the limited options for conventional medical therapy and the added cost of interventions for stones. While research on phytotherapy is still limited, it is ongoing and is yielding promising results. In order to capture the current trend in phytotherapy for urolithiasis we performed a narrative review from data collected and synthesized from electronic databases, with a specific focus on randomized human studies. Our analysis revealed that the use of various herbal medicines and phytotherapy, either as mixtures or as sole plant extracts, in urolithiasis is on the rise and is mainly utilized as complementary therapy to conventional treatment. Although most studies demonstrate the effectiveness of phytotherapy in reducing stone size and facilitating stone expulsion, several questions regarding specific dosages, mechanisms of action, drug interactions, treatment duration, and types of stones that respond to phytotherapy remain unanswered. This review aims to summarize the current knowledge surrounding the role of phytotherapy in urolithiasis, as well as to determine its role as a primary or complementary treatment alongside traditional treatment options. Ultimately, further research is essential to clarify the abovementioned unresolved issues, overcome the existing challenges, and optimize the best possible phytotherapy strategies and optimal timing for dissolving specific types of stones with these regimens.

Abstract:

This study compares machine learning and logistic regression algorithms in developing a predictive model for sPCa using the seven predictive variables from the Barcelona (BCN-MRI) predictive model. A cohort of 5,005 men suspected of having PCa who underwent MRI, and targeted and/or systematic biopsies was used for training, validation and testing. A Feedforward Neural Network (FNN) SimpleNet-based model (GMV) and a logistic regression-based model (BCN) were developed. The models were evaluated for discrimination ability, net benefit and clinical utility. Both models demonstrated strong predictive performance. The GMV model achieved an area under the curve of 0.88 in training and 0.85 in test cohorts (95% CI: 0.83-0.90), while the BCN model reached 0.85 and 0.84 (95% CI: 0.82-0.87), respectively (p &gt; 0.05). The GMV model exhibited superior recall, making it more suitable for clinical scenarios prioritizing sensitivity, whereas the BCN model demonstrated higher precision and specificity, optimizing the reduction of unnecessary biopsies. Both models provided net benefit over biopsying all men, reducing unnecessary procedures by 27.5-29% and 27-27.5% of prostate biopsies at 95% sensitivity, respectively (p &gt; 0.05). Both, machine learning and logistic regression-based models exhibited high and comparable similar clinical performance in sPCa detection using a limited dataset.

Abstract: Background: Removal of large uraemic toxins is still a challenge. HDF has produced some results although large convective volume, optimal vascular access to increase the blood flow rate and strict water quality management are required. Medium Cut-Off, high Retention Onset membrane have been recently developed introducing the concept therapy called “expanded haemodialysis” (HDx). Furthermore, vitamin E-coated membrane has potential beneficial effects on inflammation and oxidative stress. Ma-terial and Methods: A prospective longitudinal multi-center study was conducted for 3 months among 24 chronic haemodialysis patients. Patients were randomly assigned into either HDF with high flux membrane or HDx with Theranova or ViE-X mem-brane. The primary goal was to assess albumin loss among the three types of dialyzers. Secondary goals included assessment of depurative efficacy for uraemic toxins and clinical outcomes. Results: Mean albumin loss was significantly higher in patients undergoing HDx with Theranova membrane (ANOVA, p< 0.001) without any differ-ence in serum albumin concentration among the three groups. Instantaneous clearance of small and middle molecules was significantly higher in patients undergoing HDF, but we didn’t find differences in removal ratio and Kt/V. Reduction of Erythropoietin resistance index was observed in patients treated with ViE-X membrane due to their lower dialysis vintage. Conclusion: The higher albumin loss during HDx has no effects on pre-dialysis serum albumin. HDx with Theranova® in presence of lower session length, lower Qb , lower convective dose and lower instantaneous clearance reached same dialysis efficacy compared to HDF.

Abstract: Vitamin D is a sterol prohormone with no intrinsic biological activity. Calcitriol, the active form of vitamin D, is synthesised in the kidneys. It has well-known pleiotropic and cytoprotective properties. In addition to regulating parathyroid hormone secretion and enhancing gut calcium absorption, it exhibits antioxidant, anti-inflammatory, antiproliferative, and antineoplastic effects. However, the role of vitamin D in AKI is unclear, unlike in CKD. Thus, this review aimed to understand how dysregulated vitamin D homeostasis occurred in AKI, as well as to explore how vitamin D deficiency and excess influenced AKI. A comprehensive literature search was conducted between January 2000 and June 2024 to uncover relevant works detailing vitamin D homeostasis in health as well as investigating the impact of vitamin D deficiency and excess in humans, animals, and in vitro cell models of AKI. According to the findings of this review, vitamin D appears to have a reciprocal relationship with AKI. Acute renal injury, among other factors, can cause hypo- or hypervitaminosis D. Conversely, AKI can also be caused by vitamin D deficiency and toxicity. Even though hypovitaminosis D is associated with AKI, it is uncertain how it impacts AKI outcomes in distinct clinical scenarios. Newer therapeutic options might emerge as a result of understanding these challenges. Vitamin D supplementation may ameliorate renal injury but needs further validation. Furthermore, hypervitaminosis D has also been implicated in AKI by causing hypercalcemia and hyperphosphatemia. It is crucial to avoid prolonged, uncontrolled, and unsupervised supraphysiological vitamin D administration, especially intramuscular injection.