International Journal of Nephrology
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Acceptance rate29%
Submission to final decision74 days
Acceptance to publication20 days
CiteScore2.400
Journal Citation Indicator0.500
Impact Factor-

Article of the Year 2021

Impact of National Economy and Policies on End-Stage Kidney Care in South Asia and Southeast Asia

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 Journal profile

International Journal of Nephrology publishes original research articles and review articles on the prevention, diagnosis, and management of kidney diseases and associated disorders.

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International Journal of Nephrology maintains an Editorial Board of practicing researchers from around the world, to ensure manuscripts are handled by editors who are experts in the field of study.

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Research Article

Challenging, Safe, and Effective Use of External Iliac Vein for Insertion of Tunneled Cuffed Hemodialysis Catheters: A Single-Center Prospective Study

Background. Providing well-functioning vascular access is crucial for patients undergoing chronic hemodialysis. Peripheral arteriovenous fistulas and grafts are the preferred accesses in hemodialysis patients. Patients with bilateral obstruction of internal jugular veins and subclavian veins require a suitable vascular access. Thus, the insertion of iliac vein tunneled cuffed catheters (TCCs) by interventional nephrologists may be a good option for these patients. We aimed to evaluate the outcomes of iliac vein TCCs in patients lacking other vascular options. Methods. 80 tunneled cuffed hemodialysis catheters were inserted through the iliac veins of 80 patients with an end-stage kidney disease. Catheter insertion was guided by Doppler ultrasonography followed by plain radiography to detect the catheter tip and exclude complications. Results. The insertion success rate was 100%. 25 patients developed catheter-related infections. The mean survival time per catheter was 328 days. At the end of the study, 40 catheters were still functioning, 15 patients were shifted to continuous ambulatory peritoneal dialysis and 5 patients were referred to the interventional radiology department for insertion of transhepatic inferior vena cava tunneled catheters. Resistant catheter-related infection was the main cause of catheter removal in 11 patients (17.5%) in this study. Catheter malfunction was the second most common cause of catheter removal in 9 patients (11.25%). Conclusion. This study concluded that iliac vein TCCs can provide suitable vascular access in hemodialysis patients with bilateral obstruction of internal jugular veins and subclavian veins.

Research Article

Early, Noninvasive Clinical Indicators of Kidney Prognosis in Primary Nephrotic Syndrome: A Retrospective Exploratory Study

This retrospective exploratory study aimed to identify early clinical indicators of kidney prognosis in primary nephrotic syndrome (NS). Univariate Cox proportional hazards regression analysis identified clinical parameters in the 2-month period after initiating immunosuppressive therapy (IST); it predicted 40% reduction in the estimated glomerular filtration rate (eGFR) in 36 patients with primary NS. Time-dependent receiver operating characteristic curve analysis was used to evaluate the performance of the predictors for the cumulative incidence of 40% reduction in the eGFR up to 8 years after initiating IST. The mean follow-up period was 71.9 months. The eGFR was reduced by 40% in four patients. Significant predictors for time to 40% reduction in the eGFR were as follows: an increase in the serum soluble urokinase plasminogen activator receptor (s-suPAR) 2 months after initiating IST (Δs-suPAR (2M); hazard ratio (HR) for every 500 pg/mL increase: 1.36, ), s-suPAR at 2 months after initiating IST (s-suPAR (2M); HR for every 500 pg/mL increase: 1.13, ), urinary protein-to-creatinine ratio (u-PCR) (u-PCR (2M); HR for every 1.0 g/gCr increase: 2.94, ), and urinary liver-type fatty acid-binding protein (u-L-FABP) (u-L-FABP (2M); HR for every 1.0 μg/gCr increase: 1.14, ). All four factors exhibited high predictive accuracy for cumulative incidence of 40% reduction in the eGFR up to 8 years after initiating IST, with areas under the receiver operating characteristic curve of 0.92 for Δs-suPAR (2M), 0.87 for s-suPAR (2M), 0.93 for u-PCR (2M), and 0.93 for u-L-FABP (2M). These findings suggest that Δs-suPAR (2M), s-suPAR (2M), u-PCR (2M), and u-L-FABP (2M) could be useful indicators of initial therapeutic response for predicting kidney prognosis in primary NS.

Research Article

Anti-Phospholipase A2 Receptor Antibody Expression at Different Stages of Idiopathic Membranous Nephropathy

The significance of blood anti-phospholipase A2 receptor (PLA2R) antibodies in the diagnosis of different stages of idiopathic membranous nephropathy (IMN) was investigated. The expression and distribution of anti-PLA2R antibodies in renal biopsy tissue of patients with different stages of IMN were examined by immunohistochemistry. In addition, blood anti-PLA2R antibodies were determined by indirect immunofluorescence for the same patients, and the results were compared with the anti-PLA2R antibody expression in renal biopsy tissue. The positive fluorescence intensities of IMN stages I, IV, and V were mostly ± or + (40/80). There was no significant difference in fluorescence titer between these stages (). These results were consistent with the immunohistochemistry results, and the kappa statistic was 0.95. The positive fluorescence intensities of IMN stages II and III were mostly ++ to ++++ (33/60). There was no significant difference in fluorescence intensities between these two stages (), but there was a significant difference in fluorescence intensities between stages II and III and stages I, IV, and V (). These results were consistent with the immunohistochemistry results, and the kappa statistic was 0.97 (). Therefore, blood anti-PLA2R levels were positively correlated with anti-PLA2R expression in renal biopsy tissue in patients with different stages of IMN. In addition, the fluorescence intensities of IMN stages II and III were significantly different from those of stages I, IV, and V. Therefore, blood anti-PLA2R levels can be used for in vitro differential diagnosis and the monitoring of treatment, as it can distinguish stage II; and III; from stage I, IV, and V IMN.

Research Article

Laparoscopic Surgery for Pheochromocytoma in Hemodialysis Patients

Objectives. We analyzed the clinical outcomes of laparoscopic adrenalectomy for pheochromocytomas in hemodialysis compared with nonhemodialysis patients. Methods. Fifty-seven patients (7 hemodialysis and 50 nonhemodialysis) were included in the study. We analyzed the differences in clinical parameters and outcomes between the hemodialysis patient groups and nonhemodialysis patient groups as well as identified predictors for an intraoperative hypertensive spike. Results. The increasing intravascular volume before surgery in hemodialysis patients made perioperative hemodynamic management safer. No significant difference in clinical parameters between the two groups was observed except for the length of hospitalization that was significantly longer in the hemodialysis patients (9 vs. 6 days, ). An increase in systolic blood pressure at CO2 insufflation was an independent predictor of a hypertensive spike with a cutoff value of 22.5 mmHg (odds ratio 1.038, 95% confidence interval 1.012–1.078). Conclusion. Laparoscopic adrenalectomy for pheochromocytomas in hemodialysis was safe and feasible. An increase in systolic blood pressure at CO2 insufflation was a predictor of the intraoperative hypertensive spike. The research in this manuscript is not registered. This is a retrospective study.

Research Article

Renal Amyloidosis: Epidemiological, Clinical, and Laboratory Profile in Adults from One Nephrology Center

Background. Renal amyloidosis is one of the main differential diagnoses of nephrotic proteinuria in adults and the elderly. The aim of this study with the most important series in our country is to contribute to the epidemiological, clinical, and etiological study of the renal amyloidosis. Methods. In a retrospective study carried out between 1975 and 2019, 310 cases of histologically proven and typed renal amyloidosis were selected for this study. Results. There were 209 men and 101 women with a mean age of 53.8 ± 15.4 years (range, 17–84 years). Of the 310 cases, 255 (82.3%) were diagnosed with AA renal amyloidosis and 55 (17.7%) with non-AA amyloidosis. Infections were the main cause of AA amyloidosis, and tuberculosis was the most frequent etiology. The period from the onset of the underlying disease to diagnosis of the renal amyloidosis was an average of 177 months. The most frequent manifestations at the time of diagnosis were nephrotic syndrome (84%), chronic renal failure (30.3%), and end-stage renal disease (37.8%). After a medium follow-up of 16 months (range, 0–68 months), mortality occurred in 60 cases. Conclusions. Given the high frequency of AA amyloidosis in our country, awareness of the proper management of infectious and chronic inflammatory diseases remains a priority in reducing the occurrence of this serious disease.

Research Article

Common Glomerular Diseases in Adult Jordanians: A Single-Center Experience

The pattern of glomerular diseases has been reported previously with contradictory results. Our primary objective is to assess the relative frequencies of glomerular disease in adult Jordanians and compare it with other institutes. A secondary objective is to assess the contribution of environmental factors, in an industrial city Zarqa, to kidney disease patterns. Methods. A retrospective study was conducted at a referral hospital center in the central region of Jordan. Assessment of native kidney biopsies, pathological reports, and the patients’ characteristics were obtained from electronic medical records. Results. Our study assessed a total of 178 biopsies, of which 106 patients were included achieving the age criterion for adults. The mean age of our patient was 34 ± 12.7. The number of females (53.7%) was slightly more than males (46.3%). The average creatinine at presentation was 198 umol/L. Almost half of the patients had mild renal impairment (50.9%), while the remaining were divided between moderate (26.1%) and severe (27.3%). The indications of kidney biopsy were proteinuria (11.3%), proteinuria (54.7%), and unexplained renal impairment (34%). The leading common glomerular diseases were represented as a group with a relative frequency ranging between 11% and 13%. Both IgA nephropathy (13.2%) and lupus nephritis (12.2%) were the top conditions causing the nephritic syndrome, while focal segmental glomerulosclerosis (12.2%) and minimal change disease (11.3%) were the conditions leading to nephrotic syndrome. Our secondary analysis showed nonstatistically significantly higher glomerular filtration rates in the city of Zarqa, when compared to Amman (median 94 and 54, respectively, U = 469.5, r = 0.08, ). Additionally, Zarqa had higher frequency rates of interstitial/tubular nephritis (χ2(1) = 1.17, , Cramér’s  = 0.13. Conclusion. Common glomerular diseases, as reported internationally, were common among Jordanian adults.

International Journal of Nephrology
 Journal metrics
See full report
Acceptance rate29%
Submission to final decision74 days
Acceptance to publication20 days
CiteScore2.400
Journal Citation Indicator0.500
Impact Factor-
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Article of the Year Award: Outstanding research contributions of 2021, as selected by our Chief Editors. Read the winning articles.