1. Lost and not found : randomized controlled trial of cognitive behavioural therapy for weight-loss in patients with chronic kidney diseaseKatja Kurnik Mesarič, Jana Kodrič, Špela Bogataj, Andreja Marn-Pernat, Aljoša Kuzmanovski, Bernarda Logar Zakrajšek, Jernej Pajek, 2025, original scientific article Abstract: Introduction: Managing obesity in patients with chronic kidney disease is crucial for managing disease progression. Psychological interventions, particularly cognitive behavioral therapy, can support lifestyle changes. This study aimed to evaluate the efficacy of a cognitive behavioral therapy intervention for obesity management in patients with chronic kidney disease. Methods: Forty patients with chronic kidney disease (stages 2–4) were randomized to either an intervention group (nutritional and physical activity counseling and 16-week cognitive behavioral therapy) or a control group (nutritional and physical activity counseling only). Primary outcomes were body mass index (BMI) and proteinuria. Results: The intervention group lost an average of 5.42 kg (BMI decrease: 1.82 kg/m²), compared to 1.53 kg (BMI decrease: 0.53 kg/m²) in the control group. A significant group-by-time interaction was observed for BMI (F(1,36) = 32.24, p = 0.004, ŋ²=0.21), favoring the intervention group. Effects remained significant at three-month follow-up, with an average weight loss of 4.63 kg (BMI decrease: 1.59 kg/m²) in the intervention group and 2.51 kg (BMI decrease: 0.87 kg/m²) in control group (F(2,70) = 5.54, p = 0.026, ŋ²=0.12). Changes in proteinuria did not differ between groups. Conclusion: Cognitive behavioral therapy was effective and well-tolerated for promoting weight loss with most of the lost weight maintained at the three-month follow-up. This intervention may offer a valuable non-pharmacological treatment option for weight management in patients with chronic kidney disease.
Keywords: sport, chronic kidney disease, cognitive behavioral therapy, obesity, weight management, improve patient well-being, weight-loss
Published in DiRROS: 20.01.2026; Views: 26; Downloads: 21
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2. Improving the histologic detection of DSA-negative antibody-mediated rejection in kidney transplantsLuis G. Hidalgo, Katelynn Madill-Thomsen, Jeff Reeve, Martina Mackova, Philippe Gauthier, Zachary Demko, Adam Prewett, Miha Arnol, Nika Kojc, Željka Večerić-Haler, 2026, original scientific article Abstract: Emerging treatments for antibody-mediated rejection (ABMR, NEJM391(2):122-132) have increased the importance of ABMR detection when donor-specific antibody (DSA) is negative. We addressed this issue in the Trifecta-Kidney study (ClinicalTrials.gov #NCT04239703) using three centralized tests in 690 kidney transplant biopsies: DSA (One Lambda Inc.), blood donor-derived cell-free DNA (dd-cfDNA, Prospera™ test, Natera, Inc.), and molecular biopsy assessment (MMDx). We used an “AutoBanff 2022” algorithm to model the impact of alternative DSA interpretations on the histologic diagnosis of “DSA-negative” ABMR following Banff guidelines, including agreement with dd-cfDNA and molecular ABMR. Lowering MFI cutoffs for DSA-positivity did not improve detection of DSA-negative ABMR. However, simply calling all DSA positive allowed Banff 2022 guidelines to identify 46% more ABMR cases with no measurable DSA, and per Net Reclassification Improvement increased agreement between histologic diagnoses and both dd-cfDNA (P=7.72E-7) and molecular ABMR (P=7.69E-7). New ABMR cases were as strongly positive for dd-cfDNA and molecular ABMR as those found using the conventional DSA interpretation. A validation set analysis using INTERCOMEX study data (ClinicalTrials.gov NCT#01299168) confirmed these findings, and found that the new DSA-negative ABMR cases identified by calling all DSA positive had the same risk for graft loss as those found with conventional DSA interpretation.
Keywords: donor-derived cell-free DNA, kidney biopsy, donor-specific antibody, microarrays antibody-mediated rejection, kidney transplant rejection
Published in DiRROS: 13.01.2026; Views: 71; Downloads: 35
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3. Mental health in adults with chronic kidney disease and obesityDora Mališ, Jana Kodrič, Jernej Pajek, Urška Fekonja, Bernarda Logar Zakrajšek, Katja Kurnik Mesarič, 2026, complete scientific database of research data Abstract: This dataset contains data from a study examining mental health and quality of life in adults with early-stage chronic kidney disease (CKD stages 2–4) and overweight or obesity. Data were collected from 40 patients using standardized questionnaires assessing symptoms of depression, anxiety, and quality of life, and were analyzed using descriptive statistics and correlation analyses.
Keywords: chronic kidney disease, obesity, mental health, lifestyle changes
Published in DiRROS: 09.01.2026; Views: 280; Downloads: 61
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4. The use of machine learning in the diagnosis of kidney allograft rejection : current knowledge and applicationsTanja Belčič Mikič, Miha Arnol, 2024, review article Abstract: Abstract: Kidney allograft rejection is one of the main limitations to long-term kidney transplant survival. The diagnostic gold standard for detecting rejection is a kidney biopsy, an invasive procedure that can often give imprecise results due to complex diagnostic criteria and high interobserver variability. In recent years, several additional diagnostic approaches to rejection have been investigated, some of them with the aid of machine learning (ML). In this review, we addressed studies that investigated the detection of kidney allograft rejection over the last decade using various ML algorithms. Various ML techniques were used in three main categories: (a) histopathologic assessment of kidney tissue with the aim to improve the diagnostic accuracy of a kidney biopsy, (b) assessment of gene expression in rejected kidney tissue or peripheral blood and the development of diagnostic classifiers based on these data, (c) radiologic assessment of kidney tissue using diffusion-weighted magnetic resonance imaging and the construction of a computer-aided diagnostic system. In histopathology, ML algorithms could serve as a support to the pathologist to avoid misclassifications and overcome interobserver variability. Diagnostic platforms based on biopsy-based transcripts serve as a supplement to a kidney biopsy, especially in cases where histopathologic diagnosis is inconclusive. ML models based on radiologic evaluation or gene signature in peripheral blood may be useful in cases where kidney biopsy is contraindicated in addition to other non-invasive biomarkers. The implementation of ML-based diagnostic methods is usually slow and undertaken with caution considering ethical and legal issues. In summary, the approach to the diagnosis of rejection should be individualized and based on all available diagnostic tools (including ML-based), leaving the responsibility for over- and under-treatment in the hands of the clinician.
Keywords: kidney transplantation, rejection, diagnosis, machine learning, kidney biopsy
Published in DiRROS: 08.12.2025; Views: 241; Downloads: 80
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5. Bisphenol A in the urine : association with urinary creatinine, impaired kidney function, use of plastic food and beverage storage products but not with serum anti-müllerian hormone in ovarian malignanciesMateja Sladič, Špela Smrkolj, Gorazd Kavšek, Senka Imamović-Kumalić, Ivan Verdenik, Irma Virant-Klun, 2025, original scientific article Abstract: Bisphenol A (BPA) is a high-production-volume industrial chemical and component of commonly used plastic products. However, it is also an endocrine-disrupting chemical that can negatively affect human health. It is not yet known whether it is associated with the development of epithelial ovarian cancer (EOC), a severe and highly fatal human disease. Therefore, the purpose of this study was to determine the concentrations of BPA in the urine of women with EOC or epithelial borderline ovarian tumors (EBOTs) using gas chromatography tandem mass spectrometry (GC-MS/MS) and find their possible associations with kidney function at the molecular level, urine and blood biochemical parameters related to metabolism, anti-Müllerian hormone (AMH) (a marker of ovarian reserve/fertility), and lifestyle habits determined via a questionnaire in comparison to healthy controls. The results suggest that the unadjusted or urine-specific-gravity-adjusted BPA levels were significantly increased in women with EOC/EBOT. The unadjusted BPA was significantly positively associated with urinary creatinine (p = 0.007) in all women with EOC/EBOT after adjustment for age, body mass index, and pregnancy using multiple linear regression analysis. This may be related to kidney injury. However, no association was found between urinary BPA and serum AMH levels in women. Women with ovarian malignancies were more exposed to plastic products for storing foods and drinks. Some lifestyle habits, including refilling plastic bottles, correlate with higher urinary BPA levels across the entire cohort of women. When considering EOC or EBOT, it is necessary to consider the potential higher exposure of women to BPA, as reflected in their urine and lifestyle habits.
Keywords: anti-Müllerian hormone, kidney function, lifestyle habits, ovarian cancer, thrombocytes, urine, female exposure
Published in DiRROS: 03.12.2025; Views: 422; Downloads: 95
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6. Coronavirus disease 2019-associated thrombotic microangiopathy : a single-center experienceMarija Malgaj Vrečko, Andreja Aleš Rigler, Špela Borštnar, Željka Večerić-Haler, 2024, original scientific article Keywords: thrombotic microangiopathy, thrombotic thrombocytopenic purpura, atypical hemolytic uremic syndrome, COVID-19, acute kidney injury, pathophysiology
Published in DiRROS: 02.12.2025; Views: 221; Downloads: 90
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7. Complications on the feeding artery after an arterio-venous fistula closure in patients after kidney transplantation : a national cohort studyMatej Zrimšek, Barbara Vajdič Trampuž, Matija Jelenc, Juš Kšela, Jakob Gubenšek, 2025, original scientific article Abstract: Background: Arteriovenous fistulas (AVFs) in kidney transplant recipients are sometimes closed, either as a policy or due to complications. We collected data on the incidence of complications after AVF closure in a national cohort of transplanted patients. Methods: Patients who received a kidney transplant between 2000 and 2015 and had a functional AVF that was later ligated or extirpated were included. Medical records were searched for arterial complications on the arm with the closed AVF. Furthermore, all patients who were still alive in January 2023 were invited for a follow-up arterial ultrasound exam. Results: Sixty patients were included; mean follow-up was 9.3 ± 3.8 years. There were five (8% cumulative incidence) patients with symptomatic arterial thrombosis and three (5% incidence) with a symptomatic feeding artery aneurysm. Prospective ultrasound exams were performed in 50 patients; the mean diameter of the brachial artery was almost doubled on the arm with the closed AVF (8.1 ± 3.2 versus 4.7 ± 0.7 mm; P < .001). Additional asymptomatic complications were found in nine patients (18% incidence): seven cases (14% incidence) of arterial thrombosis, some extending up to the axillary artery, and three (6% incidence) brachial artery aneurysms. All patients in whom the thrombosis spread to the brachial artery had large brachial arteries (>10 mm) or an aneurysm. Conclusion: We observed a high cumulative incidence of arterial thrombosis (20%) and brachial artery aneurysms (10%), sometimes developing several years after AVF closure. These complications should be taken into account when contemplating closure of a well-developed AVF and an AVF-preserving approach with flow reduction surgery might be preferred in some cases.
Keywords: kidney transplantation, arterial thrombosis, arteriovenous fistula, complications, true brachial artery aneurysm, ultrasound exam
Published in DiRROS: 01.12.2025; Views: 493; Downloads: 95
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8. Severe clinical phenotype in Alport syndrome due to two COL4A4 exon skipping eventsJerica Pleško, Nika Kojc, Špela Kert, Sara Petrin, Alenka Matjašič, Anamarija Meglič, Andrej Zupan, 2025, other scientific articles Abstract: Alport syndrome (AS) is a genetically heterogeneous disorder caused by mutations in COL4A3, COL4A4, or COL4A5, leading to progressive renal dysfunction. While genetic screening has advanced, many cases remain undiagnosed due to deep intronic splice site variants. We report a male patient diagnosed with autosomal recessive AS, characterized by hematuria, proteinuria, and chronic kidney disease progression. Initial kidney biopsy at age 10 revealed glomerular basement membrane thinning and focal sclerosis, while targeted DNA sequencing failed to detect pathogenic variants. Over 15 years, renal function declined, and a second biopsy showed severe GBM abnormalities with multilamellated structures. Whole-transcriptome sequencing revealed two events of exon skipping, specifically at exons 27 and 38 of the COL4A4 gene, which were verified by exon-specific PCR and Sanger sequencing. Intronic regions analysis revealed two heterozygous variants positioned 78 bp downstream of exon 27 and 8 bp upstream of exon 38, though their role in aberrant splicing remains uncertain. Immunofluorescence analysis confirmed disrupted α3α4α5(IV) heterotrimer assembly. This is the first documented case of dual exon-skipping events in COL4A4, highlighting their contribution to disease severity. Our findings emphasize the need for RNA-based diagnostics and raise questions about potential benefit of exon-skipping therapy in autosomal recessive AS.
Keywords: Alport syndrome, exon skipping, whole transcriptome sequencing, kidney, COL4A4
Published in DiRROS: 24.11.2025; Views: 294; Downloads: 79
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9. Oral Coenzyme Q10 supplementation leads to better preservation of kidney function in steroid-resistant nephrotic syndrome due to primary Coenzyme Q10 deficiencyStefania Drovandi, Beata Lipska-Zietkiewicz, Fatih Ozaltin, Francesco Emma, Bora Gülhan, Olivia Boyer, Agnes Trautmann, Hong Xu, Tanja Kersnik-Levart, 2022, original scientific article Abstract: Primary Coenzyme Q10 (CoQ(10)) deficiency is an ultra-rare disorder caused by defects in genes involved in CoQ(10) biosynthesis leading to multidrug-resistant nephrotic syndrome as the hallmark kidney manifestation. Promising early results have been reported anecdotally with oral CoQ(10) supplementation. However, the long-term efficacy and optimal prescription remain to be established. In a global effort, we collected and analyzed information from 116 patients who received CoQ(10) supplements for primary CoQ(10) deficiency due to biallelic pathogenic variants in either the COQ2, COQ6 or COQ8B genes. Median duration of follow up on treatment was two years. The effect of treatment on proteinuria was assessed, and kidney survival was analyzed in 41 patients younger than 18 years with chronic kidney disease stage 1-4 at the start of treatment compared with that of an untreated cohort matched by genotype, age, kidney function, and proteinuria. CoQ(10) supplementation was associated with a substantial and significant sustained reduction of proteinuria by 88% at 12 months. Complete remission of proteinuria was more frequently observed in COQ6 disease. CoQ(10) supplementation led to significantly better preservation of kidney function (5-year kidney failure-free survival 62% vs. 19%) with an improvement in general condition and neurological manifestations. Side effects of treatment were uncommon and mild. Thus, our findings indicate that all patients diagnosed with primary CoQ(10) deficiency should receive early and life-long CoQ(10) supplementation to decelerate the progression of kidney disease and prevent further damage to other organs.
Keywords: coenzyme Q10, deficiency, supplementation therapy, end-stage kidney disease, ESKD, genetic kidney disease, hereditary, kidney survival, outcome, proteinuria reduction
Published in DiRROS: 21.11.2025; Views: 222; Downloads: 103
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10. A risk score to predict kidney survival in patients with autosomal recessive polycystic kidney disease at the age of two monthsKathrin Burgmaier, Samuel Kilian, Klaus Arbeiter, Bahriye Atmis, Olivia Boyer, Anja Katrin Buescher, Ismail Dursun, 2025, review article Abstract: Autosomal recessive polycystic kidney disease (ARPKD) is a severe hepatorenal fibrocystic disorder. Its rareness and the variability of disease courses have been major obstacles for the establishment of clinical trials on treatment of kidney disease in ARPKD. In this observational study we characterized kidney disease progression in a very large cohort of up to 658 patients with the clinical diagnosis of ARPKD and identified risk factors associated with rapid kidney disease progression. The estimated probability of kidney failure by the age of 20 years was 50.1% (95% confidence interval 42.2%‒57.0%), with earlier kidney failure in specific subgroups. Mean yearly estimated glomerular filtration rate decline after the first year of life was 1.3 ml/min per 1.73 m2 during childhood and adolescence in the overall cohort, ranging from 0.5 to 2.2 ml/min per 1.73 m2 in various subgroups. Furthermore, we developed prediction models for the relative risk of early kidney failure to be applied at the age of two months in daily clinical life. The finally chosen predictor set for a score based on a Cox model encompassed five factors: gestational age at oligo- or anhydramnios, gestational age at birth, functional genotype, serum creatinine (mg/dl) as well as documentation of arterial hypertension at the age of two months. The derived simple prognostic score showed good prediction performance, especially in the first three years of life. It reliably identified patients who are not at risk of early kidney failure and may be helpful to identify patients at risk of more rapid disease progression that could benefit from novel therapeutic interventions.
Keywords: ciliopathies, fibrocystic hepatorenal disease, fibrocystin, kidney survival, polycystic kidney disease
Published in DiRROS: 14.11.2025; Views: 295; Downloads: 105
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