Objective To analyze the relationship between social function and family support in young and middle-aged patients undergoing peritoneal dialysis (PD). Methods In this cross-sectional study, the patients undergoing maintenance PD therapy for more than 3 months at the Department of Nephrology, the First Affiliated Hospital of Sun Yat-sen University, from May to October 2023 were recruited retrospectively. The social dysfunction screening scale and family support self-rating scale were used to evaluate the social dysfunction and family support of PD patients, respectively. The social demographic and clinical data of the patients were collected. Logistic regression analysis model was used to identify associated factors of social dysfunction in PD patients. Results A total of 359 PD patients were recruited with age of (42.6±9.5) years old. Among them, 197 patients (54.9%) were males, and 33 patients (9.2%) were complicated with diabetes. The dialysis age was 28.8 (13.5, 56.3) months. The score of social function was 2 (1, 4), and the score of family support was (10.5±2.2). There were 199 patients (55.4%) having social dysfunction. There were 224 patients (62.4%) employed after PD. Compared with the normal social function group, the social dysfunction group had significantly lower score in family support (Z=-2.613, P=0.009), serum potassium (t=-2.725, P=0.007), urea clearance index (Z=-2.346, P=0.019) and proportions of married status (χ²=6.847, P=0.009), pre-dialysis employment (χ²=3.996, P=0.046) and post-dialysis employment (χ²=8.331, P=0.004), and higher serum creatinine (Z=2.175, P=0.030), and proportions of annual household income < 100 000 yuan (χ²=6.270, P=0.012) and diabetes mellitus (χ²=4.400, P=0.036). Multivariate logistic regression analysis revealed that family support (OR=0.828, 95% CI 0.733-0.935, P=0.002), diabetes mellitus (OR=3.551, 95% CI 1.456-8.658, P=0.005) and serum potassium (OR=0.559, 95% CI 0.374-0.835, P=0.005) were independent correlated factors of social dysfunction in young and middle-aged PD patients. Conclusions The prevalence of social dysfunction is 55.4%, and the employment rate is 62.4% in young and middle-aged PD patients. Poor family support, diabetes mellitus and decreased serum potassium level are independently associated with social dysfunction in young and middle-aged PD patients.

Objective To explore the choice willingness and related factors of peritoneal dialysis patients regarding automated peritoneal dialysis (APD), in order to provide a basis for future technological improvements and enhancing the application rate of APD. Methods This was a single-center cross-sectional study. Patients newly initiated on peritoneal dialysis due to end-stage renal disease in the Renal Division, Peking University First Hospital between January 1, 2021 and May 30, 2023 were enrolled. Demographic characteristics, clinical information, and laboratory data were collected. After completing initial training on APD and providing hands-on experience, a self- designed semi-quantitative questionnaire survey was administered to assess patients' willingness to adopt APD and to evaluate potential barriers to its implementation. Factors associated with patients' choice of APD were further analyzed. Results A total of 203 newly enrolled peritoneal dialysis patients were included in the study, with an age of (53.40±15.86) years, and 57.1% (116 patients) of the participants were male. Among them, 71 patients (35.0%) chose APD, while 132 (65.0%) did not. There were no significant differences in the clinical characteristics between the APD group and the non-APD group (all P>0.05). Compared with the non-APD group, the APD group had a higher proportion of individuals who frequently traveled for business (χ²=11.442, P<0.001) and a higher proportion with smaller peritoneal cavity volumes (χ²=5.639, P=0.018). Among patients in the two group, significant differences were observed in self-rated difficulty of APD operation (χ²=22.291, P<0.001), availability of space for APD setup (χ²=21.773, P<0.001), 8-hour nocturnal APD treatment (χ²=17.540, P<0.001), learning difficulty of machine operation (P<0.001), learning difficulty of machine setting (P<0.001), impact of APD on sleep (χ²=6.826, P=0.033), impact of APD on nocturnal urination (χ²=19.428, P<0.001), and annual cost of APD equipment (χ²=39.066, P<0.001). Multivariate logistic regression analysis indicated that reimbursement for APD supplies (OR=3.736, 95% CI 1.655-8.435, P=0.002), with smaller abdominal cavity volume (OR=58.610, 95% CI 5.000-687.007, P=0.001), the acceptability of 8-hour nocturnal APD treatment (OR=5.312, 95% CI 1.256-22.461, P=0.023), the low degree of difficulty in learning machine setting (OR=29.299, 95% CI 2.025-423.812, P=0.013) and the annual cost of accessible APD equipment (OR=3.643, 95% CI 1.348-9.842, P=0.011) were independent factors associated with patients' choice of APD treatment. Conclusion Reimbursement for APD supplies, smaller abdominal cavity volume, the acceptability of 8-hour nocturnal APD treatment, the low degree of difficulty in learning machine setting, and the annual cost of accessible APD equipment are the main factors related patients' decision to choose APD treatment.

Objective To compare the differences of long-term survival rates between hemodialysis (HD) and peritoneal dialysis (PD) in the oldest old end?stage renal disease (ESRD) patients, and analyze the influencing factors of mortality. Methods It was a retrospective cohort study. The clinical data from the oldest old patients (≥80 years old) who underwent HD or PD for the first time and maintained dialysis treatment for ≥3 months in the Zhejiang Dialysis Registration System from January 1, 2008 to December 31, 2021 were collected. The follow?up endpoint was until the patients' death or December 31, 2022. The propensity score matching method was used to match groups. Kaplan-Meier method and log-rank test were used to compare the differences of long-term survival rates between the two groups. Cox regression analysis was used to analyze the risk factors of mortality. Results A total of 5 880 the oldest old dialysis patients were included in this study, with 5 363 patients in the initial HD group and 517 patients in the initial PD group. After matching, there were 517 patients in the HD group and 517 patients in the PD group. The median survival time of HD group before matching was 39.9 months, with 1-year, 3-year, and 5?year survival rates of 85.4%, 54.9%, and 30.0%, respectively. The median survival time of PD group was 32.9 months, with 1?year, 3-year, and 5?year survival rates of 82.5%, 47.1%, and 22.3%, respectively. After matching, the median survival time of HD group was 40.3 months, and the 1-year, 3-year, and 5-year survival rates were 86.1%, 57.8%, and 29.1%, respectively. The survival rate of PD group remained unchanged. The difference of 1-year survival rate between the two groups was not statistically significant, but the 2-year, 3-year, 4-year, 5-year, and overall survival rates in HD group were higher than those in PD group (Log‐rank test, χ²=4.897, P=0.027; χ²=9.693, P=0.002; χ²=10.194, P=0.001; χ²=7.868, P=0.005; χ²=12.510, P<0.001). Multivariate Cox regression analysis showed that HD (HD/PD, HR=0.794, 95% CI 0.669-0.943, P=0.009), increasing age (HR=1.069, 95% CI 1.038-1.110, P<0.001), comorbidity with chronic obstructive pulmonary disease (HR=1.510, 95% CI 1.065-2.139, P=0.021) and serum albumin <35 g/L (HR=1.393, 95% CI 1.165-1.665, P<0.001) were independent correlated factors of mortality. Conclusions There is no significant difference in the 1-year survival rate between HD and PD groups. The survival rate for more than 1 year in HD patients is higher than that in PD patients. HD is an independent protective factor of survival, and increasing age, comorbidities of chronic obstructive pulmonary disease, and serum albumin <35 g/L are independent risk factors affecting the survival in the oldest old dialysis patients.

Objective To compare the effect of empirical cefazolin and vancomycin on the adverse outcomes in peritoneal dialysis (PD)-associated peritonitis patients. Methods This was a retrospective analysis of a single-centre prospective cohort. Clinical data of consecutive PD-related peritonitis episodes occurring for the first time in patients (≥18 years) between January 1, 2008 and December 31, 2021 were reviewed. Patients were classified into a cefazolin group or a vancomycin group according to the empirical antibiotic regimen. The primary endpoint was peritonitis-related death within 1 month of onset and the secondary endpoint was transfer to haemodialysis for peritonitis-related reasons within the same period. Differences in both endpoints between the two regimens were analysed in the overall population and in the Gram-positive peritonitis subgroup. Univariable and multivariable logistic regression models were used to estimate the risk of adverse outcomes associated with antibiotic choice. Propensity-score matching was performed to control for confounding bias. Results A total of 516 eligible PD patients developed peritonitis during the study period were included, among whom 138 received empirical cefazolin and 322 received vancomycin. Baseline characteristics were significantly different between the cefazolin and vancomycin groups, including annual income >50 000 yuan (χ2=17.854, P<0.001), cardiovascular disease history (χ2=3.909, P=0.048), prior peritonitis history (χ2=18.327, P<0.001), serum albumin (t=2.430, P=0.013), triglycerides (Z=-3.108, P=0.002), total cholesterol (t=3.752, P<0.001), phosphate (t=3.362, P=0.002) and sodium (t=3.021, P=0.004). Neither peritonitis-related mortality nor transfer to haemodialysis differed between the cefazolin and vancomycin groups in the overall cohort or in the Gram-positive peritonitis subgroup (all P>0.05). Logistic regression analysis (univariable and multivariable) showed that empirical vancomycin was not associated with a higher risk of adverse outcome when compared with cefazolin in the overall cohort or in the Gram-positive peritonitis subgroup (all P>0.05). After propensity-score matching, results remained consistent (all P>0.05). Conclusion Empirical cefazolin and vancomycin yield similar rates of short-term adverse outcomes in patients with PD-associated peritonitis, including those caused by Gram-positive organisms.

Objective To explore the association between serum magnesium levels during catheterization in peritoneal dialysis (PD) patients and the failure of PD technology. Methods It was a retrospective study. The baseline data, laboratory tests and clinical events of inpatients with end-stage renal disease aged ≥18 years who received PD catheterization for the first time from April 1, 2005 to February 29, 2024 were collected, and the follow-up was conducted until June 1, 2024. PD technique failure was defined as extubation for conversion to hemodialysis or patient death. The optimal cut-off value of serum magnesium (0.782 mmol/L) was determined based on the Youden index of the receiver operating characteristic curve for predicting the failure of PD technology. The patients were divided into high serum magnesium group and low serum magnesium group, and differences of baseline clinical data and follow-up outcomes between the two groups were compared. Kaplan-Meier method was used to compare the differences of PD technical survival rates between the two groups. Logistic regression model was used to analyze the related factors of baseline increased serum magnesium levels (0.785 mmol/L) in PD patients. Cox proportional hazards regression model was used to analyze the risk factors for the failure of PD technology. Results A total of 706 PD patients were included in this study, with age of 43.89 (33.43, 53.70) years. Among them, 339 (48.02%) patients were male. The serum creatinine was (800.45±238.81) μmol/L. The follow-up time was 726.00 (216.00, 1 344.00) days. The incidence of peritonitis was 0.072 times per patient-year, and the failure rate of PD technique was 15.58% (110/706). There were 551 patients (78.05%) in the high serum magnesium group and 155 patients (21.95%) in the low serum magnesium group. Compared with the high serum magnesium group, the low serum magnesium group had significantly lower levels of serum creatinine (t=-2.743, P=0.006), blood urea nitrogen (t=-2.428, P=0.004), serum uric acid (t=-2.346, P=0.005), red blood cell count (t=-4.100, P<0.001), hemoglobin (Z=-4.195, P<0.001), serum albumin (t=-4.400, P<0.001), platelet count (Z=-2.428, P=0.015), platelet?to?monocyte ratio (Z=-2.541, P=0.011), serum calcium (t=-7.463, P<0.001), serum phosphorus (t=-3.052, P=0.001), prothrombin activity (t=-3.052, P=0.005) and proportion of hyperphosphatemia (χ2=6.924, P=0.009), and higher male proportion (χ2=8.984, P=0.030), proportion of conversion to hemodialysis (χ2=6.098, P=0.014), neutrophil percentage?to?albumin ratio (Z=2.875, P=0.004), serum chloride (Z=4.011, P<0.001), alkaline phosphatase (Z=2.850, P=0.040), D-dimer (Z=3.166, P=0.002), proportion of hypoalbuminemia (χ2=7.543, P=0.006), and proportion of hypocalcemia (χ2=39.836, P<0.001). Kaplan-Meier survival analysis showed that the PD technical survival rates in the peritonitis group and the low serum magnesium group were significantly lower than those in the control group and the high serum magnesium group, respectively (Log-rank test, χ2=9.332, P=0.002; χ2=7.856, P=0.005). Multivariate logistic regression analysis showed that the serum calcium (OR=23.237, 95% CI 3.807-141.845) and serum chlorine level (OR=0.919, 95% CI 0.858-0.985) were independently correlated with the increased serum magnesium. Multivariate Cox regression analysis showed that elevated baseline serum magnesium was an independent protective factor of PD technique failure (HR=0.351, 95% CI 0.188-0.653). Conclusions Elevated serum magnesium is an independent protective factor of PD technology failure. Maintaining an appropriate serum magnesium level may improve the prognosis of PD patients.

Objective To evaluate the efficacy of peritoneal dialysis (PD) in the treatment of acute kidney injury (AKI) in critically ill neonates. Methods It was a retrospective study. The baseline characteristic data, PD protocols, PD catheter placement methods and clinical outcomes of AKI neonates who underwent PD in the General Hospital of Ningxia Medical University between July 2015 and December 2024 were collected and analyzed. Results (1) Among the 8 neonates with AKI, gestational age was (30.38±6.02) weeks, and birth weight was 1 397.5 (839.0, 2 312.5) g, with 6 premature infants. The time from birth to AKI onset was 144 (48, 294) hours. The leading cause of AKI was sepsis (6/8). The treatment time of PD was (93.12±37.20) hours. (2) Renal function recovery: After PD treatment, urine output was significantly increased (Z=-3.29, P<0.001), and serum creatinine was significantly decreased (t=2.66, P=0.032). (3) Hyperkalemia: Six out of 8 patients presented with hyperkalemia, which significantly decreased after PD treatment (t=3.37, P=0.008). (4) Acid-base balance:Five out of 8 neonates had metabolic acidosis, and 3 of 5 neonates achieved basically complete correction (including lactic acidosis). There was no statistically significant difference in acid-base balance indicators before and after PD treatment (all P>0.05). (5) PD-related complications: Two out of 8 patients experienced peritoneal dialysate leakage, and no other PD-related complications occurred. (6) Outcomes: The hospital stay was 27.0 (8.0, 57.5) days. Four out of 8 neonates survived, while the other 4 neonates died after withdrawal of treatment. The primary cause was multiple organ failure. Conclusions PD is a safe and effective treatment for neonatal AKI, facilitating early renal recovery and correction of electrolyte and acid-base imbalances.

A total of 269 non-diabetic chronic kidney disease (CKD) patients were enrolled in this study. Among them, 175 patients (65.1%) were assigned to the control group and received conventional therapy with maximally tolerated doses of renin-angiotensin-aldosterone system inhibitors, while 94 patients (34.9%) were assigned to the dapagliflozin group and received oral dapagliflozin 10 mg/day in addition to the conventional therapy. The results showed that the urine protein quantity in the dapagliflozin group was lower than those in the control group at 3, 6, 12, 18, and 24 months of follow-up (all P<0.05), and the blood albumin level was higher than those in the control group at 18 and 24 months of follow-up (all P<0.05). The Kaplan-Meier survival curve analysis results showed that the cumulative renal survival rate of the dapagliflozin group was significantly higher than that of the control group (Log-rank test, χ ²=5.078, P=0.024). Multivariable Cox regression analysis results revealed that using dapagliflozin was independently associated with a reduced risk of the composite endpoint in non-diabetic CKD patients (HR=0.400, 95%CI 0.163-0.983, P=0.046). There was no statistical difference in adverse reactions between the two groups (all P>0.05). It is indicated that dapagliflozin has a renal protective effect independent of hypoglycemic action and good safety.

This study was a single-center retrospective study, to investigate the correlation between the relative level of miR-200a in exfoliated cells of peritoneal dialysis (PD) effluent and clinical indicators of peritoneal function in PD patients. Clinical data of PD patients who underwent treatment in the Department of Nephrology, the First Affiliated Hospital of Nanchang University, from January 2024 to December 2024 were collected, and the relative level of miR-200a in exfoliated cells of PD effluent was assessed. Patients were divided into three groups according to dialysis duration (Group A:≤1 year; Group B:>1 to <5 years; Group C:≥5 years), and differences in clinical data among the groups were compared. The correlation between the relative level of miR-200a and serum albumin, serum calcium, serum phosphorus, serum creatinine, hemoglobin, the neutrophil/high-density lipoprotein cholesterol ratio, the monocyte/high-density lipoprotein cholesterol ratio, the lymphocyte/high-density lipoprotein cholesterol ratio, and 24-hour urine volume in PD patients was analyzed. The results showed that there were no statistically significant differences among the three groups in gender, age, creatinine clearance rate, or Kt/V (all P>0.05). However, statistically significant differences were found among the three groups in peritoneal transport type (χ ²=13.518, P=0.001) and ultrafiltration volume (H=6.905, P=0.032). Based on the 4-hour PD effluent creatinine/blood creatinine in the peritoneal equilibration test, patients were divided into the low transporter/low average transporter group (L group) and the high transporter/high average transporter group (H group). A statistically significant difference in the relative level of miR-200a was observed between the two groups [11.70 (1.09, 20.49) vs. 0.73 (0.46, 1.98), t=4.545, P<0.001]. The relative level of miR-200a was positively correlated with ultrafiltration volume and 24-hour urine output (r=0.328, P=0.030; r=0.516, P<0.001), and negatively correlated with dialysis vintage (r=-0.496, P<0.001). These results indicate that miR-200a level in PD effluent may, to some extent, reflect patients' peritoneal membrane function.

Central venous lesions are challenging in the maintenance of hemodialysis vascular access, with endovascular therapy as the preferred treatment. Coated stent grafts, with superior primary patency rates and the ability to mitigate the risk of vascular rupture and bleeding, have become one of the clinical options. However, they pose a risk of occluding important tributary veins. This report describes a case of right innominate vein occlusion treated with a small-caliber coated stent graft, resulting in postoperative symptoms of intracranial venous hypertension. This case highlights the need to pay attention to neurological symptoms caused by central venous lesions and conduct a more meticulous assessment of contralateral venous return before placing coated stent grafts, to avoid irreversible neurological symptoms.

This article reports a case of peritoneal dialysis (PD)-associated peritonitis caused by Streptococcus dysgalactiae subspecies dysgalactiae. The patient was an elderly female with a previous diagnosis of anti-neutrophil cytoplasmic antibody-associated vasculitis with renal involvement and chronic kidney disease stage 5. She had been receiving regular PD therapy for 8 years. She was admitted to the hospital due to abdominal pain and cloudy peritoneal dialysate for 10 hours, and the peritoneal dialysate culture result was positive for Streptococcus dysgalactiae subspecies dysgalactiae. She was treated with intraperitoneal vancomycin and intravenous ampicillin for anti-infection, but the therapeutic effect was poor. Therefore, the PD catheter was removed and the patient was discharged after the condition was improved.

In this single-arm prospective cohort study, the aim was to evaluate the antihypertensive efficacy and safety of the angiotensinⅡreceptor-neprilysin inhibitor sacubitril/valsartan in patients with refractory hypertension (RH) undergoing peritoneal dialysis. A total of 67 peritoneal dialysis patients with regular treatment for ≥ 3 months and confirmed RH were enrolled. Sacubitril/valsartan was added to the background antihypertensive therapy and titrated according to a standardized protocol for 6 months. Data on RH control, demographic and clinical characteristics, and adverse reactions were collected before and after intervention. The mean values of valid 24 h ambulatory blood pressure recordings, nocturnal systolic blood pressure (SBP) dipping percentage, blood pressure variability parameters, and the blood pressure control rate were compared before and after treatment. Laboratory and clinical data were also compared. After a median follow-up of 8.0 (4.0, 12.5) months, 50 patients completed the study. After treatment, all blood pressure parameters significantly decreased compared with baseline. The mean values of valid 24 h SBP decreased by 9.52 mmHg (t=4.79, P<0.001) and the mean values of valid 24 h diastolic blood pressure (DBP) decreased by 7.55 mmHg (t=5.90, P<0.001). Day-time SBP decreased by 10.82 mmHg (t=5.22, P<0.001) and day-time DBP by 8.41 mmHg (t=6.28, P<0.001). Night-time SBP decreased by 6.93 mmHg (t=2.81, P=0.007) and night-time DBP by 4.95 mmHg (t=3.12, P=0.003). The standard deviation (SD) of 24 h-SBP (t=2.43, P=0.018), 24 h DBP-SD (t=3.82, P<0.001), day-time DBP-SD (t=2.80, P=0.007), and the coefficient of variation of 24 h-DBP (t=2.04, P=0.046) were significantly reduced. The blood pressure control rate increased from 14.90% to 44.80% (χ ²=12.89, P<0.001). During follow-up, no patient experienced acute deterioration of renal function. One case of hyperkalemia returned to normal after appropriate treatment, and no serious adverse events occurred. These findings suggest that sacubitril/valsartan effectively lowers blood pressure and improves the blood pressure control rate in peritoneal dialysis patients with RH, with favorable safety and tolerability.

It was a retrospective study. The propensity score matching was applied to divide the type 2 diabetes mellitus (T2DM) patients who have underwent percutaneous coronary intervention (PCI) into two groups: short-term (<4 weeks) sodium-glucose cotransporter 2 inhibitor (SGLT2i) group (213 patients) and control group (213 patients). The occurrence of contrast-induced acute kidney injury (CIAKI) after PCI was compared between the two groups. The results showed that the incidence of CIAKI in the SGLT2i group was not significantly different from the control group [10.8% (23/213) vs. 7.5% (16/213), χ ²=1.383, P=0.313]. The incidence of CIAKI in patients with SGLT2i application time <1 week was higher than that in control patients, but the difference was not statistically significant [13.00% (16/123) vs. 7.5% (16/213), χ ²=2.734, P=0.122]. Multivariate logistic regression analysis showed that short-term (<4 weeks) use of SGLT2i would not increase the risk of CIAKI after PCI in T2DM patients (OR=0.507, 95% CI 0.238-1.077, P=0.077). Short-term application of SGLT2i before PCI may not increase the risk of CIAKI, but it is advisable to avoid initiating the application of SGLT2i before PCI as much as possible.

Artificial intelligence (AI) has been applied across numerous fields of nephrology, assisting physicians in optimizing clinical diagnosis and treatment, hemodialysis prescriptions, renal histopathology, and transplant patient management. In renal pathology, AI utilizes deep learning models to achieve precise identification and quantification of glomerular and tubulointerstitial lesions, thereby predicting disease progression. In clinical practice, AI models demonstrate significant value in the early warning of acute kidney injury, prognosis assessment of IgA nephropathy and chronic kidney disease, as well as in the management of hemodialysis processes and comorbidity treatment. Furthermore, AI is also applied in predicting transplant kidney survival, assisting in the screening of rare diseases, and accelerating drug development. However, many nephrologists remain unfamiliar with the fundamental principles of medical AI, and challenges persist in areas such as data privacy, algorithm transparency, and ethical regulation. This review aims to outline the advances in the application of AI across various domains of nephrology and to discuss its future prospects and unresolved issues.

The cardiovascular-kidney-metabolic syndrome (CKM) is a systemic disease caused by the interaction and mutual influence of cardiovascular diseases, chronic kidney disease, and metabolic abnormalities. It severely impairs patients' quality of life, increases the risk of death, and has become a serious global public health issue. Sodium-glucose transporter 2 inhibitor (SGLT2i) is a novel class of oral hypoglycemic agent with both cardiorenal protection and metabolic regulation effects. It has become an emerging strategy to prevent the onset, slow the progression, and improve the prognosis of CKM. This article provides a comprehensive review of the current applications of SGLT2i in CKM and their potential mechanisms for ameliorating metabolic risk factors and conferring cardio-renal protection, thereby offering a theoretical foundation for the clinical use of SGLT2i in patients with this newly defined critical clinical condition.

Primary membranous nephropathy (PMN) is one of the common causes of nephrotic syndrome in adults and is characterized by the deposition of immune complexes, resulting in thickening of basement membrane. With the identification of more autoantibodies, the understanding of the pathogenesis of PMN has expanded. Currently, supportive therapy and immunosuppressive therapy are the primary treatments for PMN, which mainly consists of cyclophosphamide, calcineurin inhibitors, rituximab, and so on. With the advent and application of an increasing number of biological agents, a subset of refractory or drug-resistant PMN patients can be effectively treated and achieve remission. This article reviews recent advances in the management of PMN. It covers pretreatment assessment, immunosuppressive therapy, complement- targeted therapy, and anticoagulant therapy and deliberates on the management of rituximab- resistant patients. The review aims to provide clinicians with an up-to-date basis for individualized clinical decision-making.

Tacrolimus is an immunosuppressant that was clinically used for organ transplantation in the 1990s. In the early 2000s, tacrolimus began to be used to treat pediatric kidney diseases in China. This article reviews the therapeutic effects, clinical dosages, and treatment methods of tacrolimus in the treatment of steroid-resistant, steroid-dependent, frequently relapsing, different pathological types, and monogenic mutation-related childhood nephrotic syndrome. It explores the clinical guiding role of machine learning in tacrolimus treatment for childhood nephrotic syndrome, aiming to provide references for the clinical research and application of tacrolimus in pediatric kidney diseases.

With the advancement of blood purification technology in China, double- filtration plasmapheresis (DFPP), a form of plasma exchange therapy, has been widely used and popularized in the fields of nephrological, rheumatological, gastroenterological and neurological diseases. The key advantages of DFPP lie in its selective removal of pathogenic substances from plasma, effective control of disease progression, and significant conservation of exogenous plasma, thereby reducing the risk of blood-borne infections. Currently, there are no unified guidelines or consensus regarding the clinical application of DFPP in kidney diseases, either domestically or internationally. To address this gap, the Expert Group of the Dialysis and Transplantation Branch of the Chinese Society of Bioengineering has developed the "Experts consensus on the clinical application of DFPP in Kidney Diseases (2025)". This consensus provides comprehensive guidance on the indications, contraindications, technical considerations, specific application recommendations for kidney diseases, and management of complications associated with DFPP. Its primary aim is to standardize the clinical use of DFPP in kidney diseases and offer practical recommendations for medical professionals in the field.

Diabetes, kidney disease, and cardiovascular disease often coexist and mutually exacerbate one another. Substantial evidence has demonstrated that finerenone, a novel nonsteroidal mineralocorticoid receptor antagonist, provides significant cardiorenal benefits—on top of onventional blood pressure and glucose control—in patients with type 2 diabetes-associated chronic kidney disease, as well as in those with mildly reduced or preserved ejection fraction, and even in non-diabetes-related chronic kidney disease. In order to make the clinical application of finerenone more reasonable and standardized, a multidisciplinary panel of experts in endocrinology, cardiology, and nephrology has developed the multidisciplinary expert consensus on the clinical application of finerenone (2025 edition). Building upon the 2023 Chinese expert consensus, this updated document integrates the latest evidence and practical experience from a multidisciplinary perspective. It puts forward 19 recommendations aimed at serving as a practical reference for the rational use of finerenone across relevant clinical disciplines.