Clinical and Experimental Nephrology临床与实验肾脏病学
Clinical and Experimental Nephrology(英文缩写 CLIN EXP NEPHROL),ISSN 1342-1751,eISSN 1437-7799,中文译名:临床与实验肾脏病学 是一本学术期刊。本页汇总该期刊的最新影响因子、分区信息以及最新收录于 PubMed 的文献,帮助您快速了解期刊全貌。
发文量统计区间：2025-10-01 至 2026-09-30，按本站收录文献的发表日期统计。
期刊介绍
历年影响因子趋势
| JCR 数据年份 | 影响因子 | JCR 分区 |
|---|---|---|
| 2021 | 2.621 | Q3 |
| 2022 | 2.300 | Q3 |
| 2023 | 2.200 | Q2 |
| 2024 | 1.700 | Q3 |
| 2025 | 2.400 | Q2 |
Clinical and Experimental Nephrology 最新收录文献
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1. A new frontier in edema management: the potential of tolvaptan for refractory edema with hyponatremia in pediatric nephrotic syndrome.
PMID:日期:2026-09-19Severe nephrotic edema in children often necessitates use of one or more diuretics. Moderate to severe hyponatremia co-exist in such patients. Tolvaptan, a vasopressin receptor antagonist, has shown promise in treating edema in adult as well as pediatric cases, however in children there is not much data. This study aims to explore the use of tolvaptan in severe nephrotic edema with hyponatremia in children. Children with Nephrotic syndrome (1-12 years) with severe edema were screened for eligibility and received furosemide (2-4 mg/kg/d) for 48 h, those refractory to furosemide (weight loss < 3%) with hyponatremia (Na < 130mEq/L) were administered tolvaptan (0.3-1 mg/kg/d) for 48 h after excluding hypovolaemia, elevated liver enzyme and reduced eGFR (< 60 ml/min/1.73m2). Parameters were compared before and after 48 h of tolvaptan. A total of 60 (44 males, 16 females) patients were enrolled with mean age of 5.71 ± 2.16 years. After 48 h of tolvaptan administration, there was significant reduction in body weight (21.98 ± 6.33 to 21.02 ± 6.28 p < 0.001). and increase in 24-hour urine volume from 700 (400-1060) mL/day [1.56 ± 0.91 mL/kg/hour] to 1200 (900-1637.5) mL/day [3.17 ± 2.53 mL/kg/hour] (p < 0.001). The mean serum sodium level increased significantly from 125.87 ± 3.77 mEq/L to 131.18 ± 4 mEq/L (p < 0.0001). There was no significant change in liver enzymes after tolvaptan. Tolvaptan effectively reduces edema, increases urine output while improving serum sodium levels in pediatric nephrotic syndrome with refractory edema without any significant side effects.
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2. Associations between erythropoietin resistance and iron metabolism markers in patients undergoing extended-hours and conventional hemodialysis.
PMID:日期:2026-09-19Extended-hours hemodialysis, defined as ≥6 h/session, three or four times per week, has been associated with lower erythropoietin resistance index (ERI), although the biological mechanisms remain unclear. We aimed to compare the associations between ERI and iron metabolism markers in patients undergoing extended-hours versus conventional hemodialysis. We included patients who received either extended-hours or conventional hemodialysis between January and March 2020. The ERI was calculated by dividing the weekly erythropoiesis-stimulating agent (ESA) dose, expressed as epoetin equivalents divided by body weight and hemoglobin level. Linear and non-linear associations were evaluated using multivariable linear regression and restricted cubic spline (RCS) analyses. We analyzed 366 patients (178 receiving extended-hours hemodialysis and 188 receiving conventional hemodialysis). Hemoglobin levels were 10.9 and 11.2 g/dL, median ferritin levels were 34.8 and 63.6 ng/mL, and median transferrin saturation (TSAT) values were 16.9% and 20.5%, respectively. Extended-hours hemodialysis was associated with a lower ERI after multivariable adjustment (coefficient, -4.49 IU/kg/week per g/dL; 95% confidence interval, -6.76 to -2.22). In the RCS analysis, ERI increased with decreasing ferritin levels in the conventional hemodialysis group, whereas no increase was observed at lower ferritin levels in the extended-hours group. A similar trend was observed with respect to TSAT. Extended-hours hemodialysis was associated with lower ERI. Exploratory RCS analyses suggested potential modality-related differences in the relationships between ERI and ferritin or TSAT. These findings suggest that the association between iron status and ESA responsiveness may differ by dialysis modality and warrants further investigation.
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5. Systematic review and network meta-analysis for the 2026 update of the evidence-based clinical practice guidelines for the management with immunosuppressive therapies and biologic agents of membranous nephropathy.
PMID:日期:2026-09-19Multiple immunosuppressive therapies are used to induce remission in membranous nephropathy, but differences in study populations, treatment regimens, and outcome definitions complicate comparisons of their relative efficacy and safety. We aimed to synthesize randomized evidence comparing immunosuppressive therapies, including rituximab. We conducted a systematic review and network meta-analysis of randomized controlled trials for adult patients with idiopathic membranous nephropathy. Outcomes included mortality, kidney failure, remission of nephrotic syndrome, decline in kidney function, infections, and adverse events. Random-effects network meta-analyses were performed, and the certainty of evidence for each comparison was assessed using the Confidence in Network Meta-Analysis (CINeMA) framework. A total of 52 randomized controlled trials involving multiple immunosuppressive strategies were included. Several treatments, including adrenocorticotropic hormone, tacrolimus, intravenous cyclophosphamide, and oral cyclophosphamide, were associated with higher complete or partial remission rates compared with placebo, standard treatment, or no treatment. Oral cyclophosphamide was also associated with a lower risk of kidney failure in some comparisons, whereas azathioprine, cyclosporine, and glucocorticoids were associated with lower relapse rates. However, the certainty of evidence across most efficacy and safety outcomes was low to very low because of risk of bias, imprecision, heterogeneity, and incoherence. Infection outcomes were inconsistently reported and estimates were generally imprecise. Treatment effects differed across interventions, but the overall certainty of the evidence was limited, highlighting the need for well-designed, adequately powered randomized trials with standardized methodologies.
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7. Clinicopathological analyses of nephrotic syndrome after liver transplantation.
7. 肝移植术后肾病综合征的临床病理分析PMID:日期:2026-09-12Pathological renal injuries after liver transplantation are multifactorial, yet the clinicopathological characteristics of glomerulonephritis presenting as nephrotic syndrome remain unclear. This study aimed to investigate its clinicopathological features, treatment, and outcomes. We retrospectively identified 12 patients with NS who underwent kidney biopsy after liver transplantation and investigated their clinicopathological findings, treatment, and clinical course. At the time of biopsy, the mean time after liver transplantation was 3.4 years, and mean age was 58.9 years. Mean estimated glomerular filtration rate (eGFR) and urinary protein-to-creatinine ratio (UP/UCr) were 40.1 ± 15.6 mL/min/1.73 m and 6.74 ± 3.01 g/gCr, respectively. The pathological diagnoses were: IgA nephropathy (IgA-N) in 5 patients (42%), membranoproliferative glomerulonephritis (MPGN) in 2 patients, diabetic nephropathy in 2 patients, thrombotic microangiopathy in 1 patient, pauci-immune crescentic glomerulonephritis (CrGN) in 1 patient, and membranous nephropathy in 1 patient. All patients were treated with induction or dose escalation of angiotensin II receptor blockers, and patients with IgA-N or CrGN received steroid pulse therapy; In patients with IgA-N, mean UP/UCr significantly decreased from 9.01 ± 3.32 g/gCr to 1.45 ± 1.40 g/gCr after 2 years. During the 5.8-year follow-up period, 8 patients (67%) achieved incomplete remission (< 3.5 g/gCr), but 3 patients (one each with IgA-N, MPGN and CrGN) progressed to end-stage kidney disease. The pathological findings of NS after liver transplantation in this selected cohort are heterogeneous, therefore kidney biopsy might be valuable for evaluating the condition and guiding the selection of appropriate therapeutic strategies.
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8. Risks of arteriovenous fistula failure in hemodialysis patients older than 75 years.
PMID:日期:2026-09-12Arteriovenous fistula (AVF) failure remains a major clinical problem in older patients undergoing hemodialysis. However, the relative contributions of risk factors and their time-dependent effects remain unclear. We retrospectively analyzed 303 patients aged ≥ 75 years in whom AVFs were created. Cox proportional hazards models were used to identify the independent predictors of AVF failure within 1 year. Relative importance was assessed using the likelihood ratio chi-square statistic, and time-dependent effects were evaluated using Schoenfeld residuals. AVF failure within 1 year occurred in 30 patients (9.9%), including 10 patients who experienced early failure. Malnutrition, prolonged surgical time, and arterial calcification were identified as independent predictors. Each factor contributed comparably, accounting for approximately one-third of the model contribution. The effect of surgical time was attenuated after approximately 6 months. AVF failure in older patients is multifactorial, with comparable contributions from vascular, nutritional, and procedural factors.
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9. Urinary albumin fraction and tubulointerstitial injury: an association shaped by diagnostic composition.
PMID:日期:2026-09-09Urinary protein composition provides qualitative information not captured by total protein excretion alone. Prior studies have linked low urinary albumin fraction to tubulointerstitial diseases and lesions, but whether this reflects pathology itself or diagnostic composition remains unclear. We investigated the association of urinary albumin fraction with tubulointerstitial lesions and diagnostic composition. We conducted a multicenter cross-sectional study of patients who underwent kidney biopsy at three referral centers. Urinary albumin fraction was obtained by urinary protein fraction analysis. Associations with interstitial fibrosis/tubular atrophy (IFTA) and inflammatory cell infiltration were examined overall and by diagnostic group. We also evaluated diagnostic composition in low urinary albumin fraction subgroups and the diagnostic performance for identifying tubulointerstitial disease. A total of 462 patients was included. In the overall cohort, urinary albumin fraction differed significantly across IFTA grades (ANOVA p <0.001). In linear regression, IFTA grade 4 was associated with a significantly lower urinary albumin fraction than IFTA grade 0 (β - 22.10, 95% CI - 29.77 to - 14.43, p <0.001), but this association was no longer evident after adjustment for diagnostic group (β 4.13, 95% CI - 2.98 to 11.23, p = 0.294). The low urinary albumin fraction subgroups included not only tubulointerstitial diseases but also a substantial number of vasculitis cases. In this study, the apparent association between low urinary albumin fraction and tubulointerstitial lesions was largely explained by diagnostic group composition. Low urinary albumin fraction may serve as a supplementary clue to tubulointerstitial disease, but is neither disease-specific nor interpretable in isolation.
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10. Inflammatory and traditional risk factors associated with the progression of chronic kidney disease in patients with rheumatoid arthritis.
PMID:日期:2026-08-29Chronic kidney disease (CKD) is a significant comorbidity in patients with rheumatoid arthritis (RA). The relative contributions of inflammatory and traditional renal risk factors to CKD progression remain unclear. We retrospectively analyzed 601 RA patients. Renal function and urinary abnormalities were assessed using creatinine-based estimated glomerular filtration rate (eGFR) and urinary albumin. We examined the factors associated with high or very high CKD risk in KDIGO heatmap and progression of CKD stage over five years using two models: logistic regression and Cox proportional hazards models. Furthermore, Propensity score methods were used to assess the association between methotrexate (MTX) use and CKD stage progression. CKD stage progression occurred in 106 patients. Both inflammatory and traditional renal risk factors were associated with high or very high CKD risk. In Cox analyses, age, lower baseline eGFR, anemia, and CRP ≥0.5 mg/dL were associated with CKD stage progression. In patients with baseline eGFR ≥60 mL/min/1.73 m, CRP ≥0.5 mg/dL was independently associated with progression, whereas proteinuria and albuminuria were more relevant in patients with baseline eGFR <60 mL/min/1.73 m. After adjusting for confounding variables using propensity score matching, there was no association between MTX use and an increased risk of kidney stage progression. Risk factors for CKD progression in RA may differ according to baseline eGFR. In patients with preserved eGFR, residual inflammation appears to be a relevant factor. In contrast, proteinuria, albuminuria, and anemia are more significant in patients with reduced eGFR.