Wenpeng Cui

Background: Diabetes and malnutrition are critical prognostic indicators for individuals undergoing peritoneal dialysis (PD). Nevertheless, prior research has predominantly focused on initial nutritional assessments, which may not adequately reflect the cumulative burden of long-term nutritional exposure. Consequently, the combined influence of diabetes and longitudinal nutritional changes on mortality risk remains largely unexplored. Methods: This study retrospectively collected longitudinal follow-up data from patients who underwent PD at the Second Hospital of Jilin University between January 2016 and July 2024, with follow-up continued until July 30, 2025. Utilizing a landmark analysis framework, longitudinal nutritional status was evaluated through Time-Weighted Average (TWA) multidimensional nutritional indices. These indices included the TWA-Controlling Nutritional Status (CONUT) score, TWA-Prognostic Nutritional Index (PNI), and TWA-hemoglobin, albumin, lymphocyte, and platelet (HALP) score. Cox proportional hazards models were employed to determine the associations between diabetes status, longitudinal nutritional indices, and their joint effects with both all-cause and cardiovascular mortality. Furthermore, interaction analyses and restricted cubic spline models were applied to ascertain whether diabetes modulated the relationship between longitudinal nutritional status and mortality risk. Results: The study cohort comprised 229 patients undergoing PD, with an average age of 48.68 ± 13.42 years; 87 of these patients had diabetes. Among the longitudinal nutritional indices evaluated, the TWA-CONUT score demonstrated the highest predictive accuracy for both all-cause and cardiovascular mortality. Both diabetes and a poorer long-term nutritional status were independently linked to an elevated risk of death. Patients presenting with both diabetes and malnutrition experienced substantially higher risks of all-cause mortality and cardiovascular mortality, with HRs of 5.10 (95% CI, 2.08–12.48) and 6.86 (95% CI, 1.93–24.32), respectively. A statistically significant interaction was observed between diabetes status and the TWA-CONUT score concerning all-cause mortality ( P for interaction = 0.0037). Conclusion: The integration of the TWA-CONUT score with diabetes status holds potential for identifying PD patients at an elevated risk of mortality. Specifically, individuals with both diabetes and chronic malnutrition faced significantly increased risks of all-cause and cardiovascular mortality.

Primary Sjögren’s disease (pSjD) is a chronic systemic autoimmune disease in which immune-mediated pathology is not confined to exocrine glands but also affects multiple organ systems. Renal involvement constitutes a clinically meaningful manifestation of pSjD and may exert a considerable impact on disease progression, prognosis, and treatment selection. However, the pathogenic basis of renal injury in pSjD is still incompletely understood, and existing therapeutic approaches remain largely empirical. Available studies suggest that renal involvement in pSjD arises from the interaction of multiple determinants, including inherited susceptibility, environmental factors, and endocrine dysregulation. At the core of these pathogenic mechanisms lies persistent activation of the type I interferon (IFN-I) system and immune dysregulation driven by excessive responses of T and B lymphocytes. Such immune abnormalities favor sustained autoantibody production and ectopic germinal center (EGC) formation, thereby amplifying autoimmune inflammation and promoting renal structural and functional injury. Here, this review integrates relevant literature to examine the multifactorial pathogenic mechanisms described above and to systematically elucidate how these mechanisms drive autoimmune responses through diverse immune cell populations. In addition, the potential application prospects of relevant novel targeted therapeutic strategies in pSjD-related renal damage are discussed.

Purpose Approximately 850 million individuals worldwide are diagnosed with kidney disease; however, current therapeutic options remain limited, and patient prognosis is still suboptimal. The Apelin system comprising the G protein-coupled receptor APJ and the ligands Apelin and Elabela, plays a critical role in the physiological and pathological regulation of renal function. However, the full involvement of the Apelin system in kidney disease remains unclear. This study aimed to characterize the current research on Apelin in renal diseases and validate the robustness of the findings through a multi-database comparative approach. Methods We searched the Web of Science Core Collection (SCI-EXPANDED) for publications from January 1, 2006, to October 18, 2025, and performed equivalent searches in Scopus and PubMed using the same keywords, timeframes, and eligibility criteria to ensure result stability and generalizability. Analyses were visualized using CiteSpace, the Bibliometrix R package, online bibliometric tools, and Excel software. Key elements included publication trends, contributions from countries, institutions, journals, highly global cited documents, and emerging research themes. Results The number of related publications has increased rapidly, reflecting growing interest in the role of the Apelin system in kidney diseases. Of the top ten journals publishing on this topic, seven were in the Q1 category of Journal Citation Reports, indicating strong academic influence. Current research focuses on acute kidney injury, diabetic kidney disease, and chronic kidney disease. Mechanistically, studies have predominantly focused on factors such as inflammation, apoptosis, oxidative stress, blood pressure, and fibrosis. Cross-database validation revealed high consistency in annual publication trends, substantial keyword overlap, and stable geographical disease distribution. Conclusion This study offers a comprehensive overview of Apelin system research in kidney disease and provides key insights for future investigations.

End-stage kidney disease (ESKD) is a growing health issue, especially among the very elderly. The optimal dialysis method for very elderly patients with ESKD remains uncertain, and there is a lack of evidence regarding the survival benefits of hemodialysis (HD) versus peritoneal dialysis (PD). This study is a multicenter cohort investigation that included 234 very elderly patients aged 75 years and older with ESKD who received HD or PD across six hospitals in China from January 2013 to December 2020. We employed Propensity Score Matching (PSM) to minimize the influence of confounding factors. Survival analyses were conducted using Kaplan-Meier curves, log-rank tests, and multivariable Cox proportional hazards regression models for the matched cohorts. In the multicenter cohort study with 234 very elderly ESKD patients, PSM was employed, with each group consisting of 56 participants, averaging 79.76 ± 4.15 years in age and having a male composition of 47.44%. Kaplan-Meier survival analysis indicated with no significant difference in survival rates (log-rank p = 0.123). Further analysis, excluding participants with less than 3 months of survival, also showed no significant differences. Cox regression with multiple variables indicated a HR of 0.73 (95% CI: 0.49, 1.10) for HD versus PD, with a p-value of 0.132. This investigation did not demonstrate a statistically significant difference in survival between PD and HD among very elderly patients with ESKD.

Urgent-start peritoneal dialysis (USPD) has been identified as the efficient approach to initiate renal replacement treatment in end-stage renal disease patients. Cardiovascular mortality of urgent dialysis is an important issue. The present work focused on assessing risk factors related to cardiovascular death in USPD patients. We carried out the present multicenter retrospective cohort study in Northeast China, included adults initiating USPD between 2013 and 2019. Follow-up was conducted in every patient till the occurrence events below: technical failure, death, loss-to-follow-up, and renal transplantation. There were altogether 1549 cases enrolled into this work. Among them, 123 encountered cardiovascular death. Upon multivariate regression, predictors of cardiovascular death included advanced age (HR 1.045, 95% CI [1.031, 1.060]; p < 0.001), higher eGFR (HR 1.084, 95% CI [1.052, 1.117]; p = 0.001), combined with DM (HR 1.471, 95% CI [1.026, 2.110]; p = 0.036), and advanced HF stage (class III versus class 0-I, HR 5.262; 95% CI [3.281, 8.437]; p < 0.001; class IV versus class 0-I, HR 6.409; 95% CI [4.145, 9.912]; p < 0.001). In addition, the predictors of cardiovascular death in diabetic USPD patients included advanced age (HR 1.052, 95% CI [1.027, 1.078]; p < 0.001) and advanced HF stages (class III versus class 0-I, HR 7.843; 95% CI [4.249, 14.476]; p < 0.001; class IV versus class 0-I, HR 5.285; 95% CI [2.880, 9.698]; p < 0.001). Moreover, the predictors of cardiovascular death in elderly USPD patients were advanced age (HR 1.045, 95% CI [1.016, 1.075]; p < 0.001) and advanced HF stages (class III versus class 0-I, HR 3.407; 95% CI [1.911, 6.073]; p < 0.001; class IV versus class 0-I, HR 5.039; 95% CI [2.982, 8.516]; p < 0.001). Risk factors related to cardiovascular death included advanced age, higher eGFR, combined with diabetes, and advanced heart failure stages among USPD patients.

To observe the efficacy and safety of Ripertamab in the treatment of Idiopathic Membranous Nephropathy (IMN). Clinical data from patients with IMN treated with Ripertamab or Rituximab were retrospectively collected from six tertiary hospitals in Jilin Province between January and December 2023. Patients were grouped based on treatment regimen into the Ripertamab and Rituximab groups and matched 1:1 by age and gender. Follow-ups were conducted over six months to assess baseline characteristics, laboratory parameters, and adverse reactions related to anti-CD20 monoclonal antibody therapy. A total of 112 patients with IMN were identified, including 52 treated with Ripertamab and 60 with Rituximab. After matching, 40 patients were included in each group. Baseline clinical characteristics were comparable between the groups (P > 0.05). There was no statistically significant difference in efficacy between the two groups (P > 0.05). At 6 months, the overall effectiveness rate of Ripertamab in the treatment of IMN was 65.0%, of which the partial and complete remission rates were 50.0% and 15.0%, respectively. The overall effectiveness rate of Rituximab was 60.0%, of which the partial and complete remission rates were 47.5% and 12.5%, respectively. Similarly, there were no significant differences in the incidence of infusion reactions, pulmonary infections, interstitial lung disease, HBV reactivation, neutropenia, or thrombocytopenia (P > 0.05). Ripertamab demonstrates a therapeutic efficacy comparable to Rituximab for IMN, with a similar incidence of infusion-related adverse reactions and complications.

Introduction: Acute kidney injury (AKI) is a key clinical condition that has puzzled clinicians for many years since there is currently no efficient drug therapy. Vitamin E is found to exert a vital antioxidant role and can protect the kidney. However, clinical studies that analyze the correlation between vitamin E and AKI are scarce, and no consistent conclusions are reported from current studies. Therefore, this study was performed to evaluate the impact of vitamin E on treating AKI.Methods: The PubMed, Embase, and Cochrane Library databases were comprehensively searched on 27 December 2023. Qualified studies were selected following the eligibility criteria. The incidence of AKI, serum creatinine, and urea nitrogen levels after vitamin E treatment were evaluated. Then, the data were combined with a fixed- or random-effects model, depending on the heterogeneity test results.Results: Six eligible randomized controlled trials that used vitamin E for the prevention of kidney injury were included. According to our pooled analysis, vitamin E elevated eGFR levels [MD: 0.36; 95% CI (0.19, 0.53), p = 0.000], reduced serum creatinine levels [MD: −0.32; 95% CI (−0.48, 0.16), p = 0.000], and effectively inhibited the occurrence of AKI [RR: 0.69; 95% CI (0.49, 0.98), p = 0.036].Conclusion: Vitamin E elevates eGFR levels, reduces serum creatinine levels, and efficiently suppresses AKI occurrence.Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO/view/CRD42024499597, identifier CRD42024499597