KIDNEYS

AI-Assisted Detection Of Early Renal Dysfunction: Advancing Precision Medicine In Kidney Care

Sat, 24 Jan 2026 00:00:00 +0000

Early renal dysfunction frequently progresses without overt clinical manifestations, limiting opportunities for timely nephroprotective intervention. Conventional diagnostic indicators, including serum creatinine and estimated glomerular filtration rate, often reflect renal impairment only after substantial functional loss has occurred. This study evaluated the role of an artificial intelligence–assisted analytical framework for the early identification of renal dysfunction using routinely available clinical and laboratory data. A retrospective analytical design was applied to electronic medical records of adult patients undergoing routine renal evaluation at a tertiary nephrology center. Structured variables encompassing renal biomarkers, blood pressure measurements, and key comorbid conditions were analyzed through parallel conventional clinical assessment and AI-assisted risk stratification. The AI-based approach assessed nonlinear interactions among renal parameters to classify patients into renal risk categories, enabling comparison with standard clinical classification. The findings demonstrated substantial concordance between AI-assisted and clinician-based risk assessment, with the AI model exhibiting heightened sensitivity in identifying individuals with moderate and subclinical renal risk who may be overlooked by fixed threshold–based evaluation. Predictive patterns generated by the model aligned with established nephropathological mechanisms, supporting clinical interpretability. Overall, the study highlights the potential of AI-assisted diagnostics to enhance early renal risk detection, refine stratification accuracy, and support precision-oriented kidney care, while complementing rather than replacing clinical judgment.

Psychological and Neurocognitive Dimensions of Kidney Disease: Mental Health Impacts of Chronic Hypertension and Systemic Illness

Mon, 26 Jan 2026 00:00:00 +0000

Background:
Hypertension and chronic kidney disease are now considered systemic disorders associated with vascular, metabolic, and inflammatory dysfunction, which may also cause depressive symptoms and cognitive impairment in the elderly. In this study, the researchers assessed how kidney disease indicators, hypertension status, depressive symptoms and neurocognitive performance were related in a nationally representative ageing population.

Methods:
Secondary analysis was performed based on the 2013-2014 National Health and Nutrition Examination Survey. The key inclusion criteria were participants aged 60 to 80 years and full data on blood pressure, estimated glomerular filtration rate, urine albumin-to-creatinine ratio, and depressive symptoms measured by the Patient Health Questionnaire-9 and standardized cognitive tests. Associations between kidney markers, hypertension status, depressive symptoms and cognitive outcomes were investigated using multivariable linear regression models after adjusting for age and sex.

Results:
The poorer cognitive performance was linked to higher albuminuria, especially in the processing speed and executive ability. Estimated glomerular filtration rate was not independently associated with cognitive outcomes after adjustment. Greater depressive symptom burden was consistently associated with lower cognitive scores across all domains. Both lower estimated glomerular filtration rate and higher albuminuria were associated with increased depressive symptoms. Hypertension status demonstrated domain-specific associations with cognitive performance.

Conclusions:
Albuminuria and depressive symptoms are independently associated with neurocognitive performance in older adults, highlighting the importance of integrated renal, mental health, and cognitive screening strategies in aging populations.

Diagnostic and Therapeutic Innovations in Renal Cell Carcinoma: A Urologic Oncology Review

Wed, 28 Jan 2026 00:00:00 +0000

Renal cell carcinoma (RCC) is a biologically heterogeneous disease. In the recent past, the clinical management of RCC has been redefined by the new development of diagnostic imaging, molecular and genetic profiling. The following review attempts to provide the current events in diagnosing, risk stratification, and management of RCC through the lens of nephrology. A literature review was performed thoroughly with the emphasis on the developments in imaging modalities, molecular and genetic diagnostics, prognostic models, and novel therapeutic methods. Literary evidence of clinical trials, systematic reviews, and international guidelines was analyzed. The result showed that imaging and radiomics advances have enhanced the characterization of tumors and the assessment of risks associated with RCC, whereas molecular and genetic diagnostics have allowed a fine classification of the disease. The Therapeutic interventions, such as setting up targeted therapy, immunotherapy and minimally invasive surgery procedures, have taken a huge step forward in oncologic outcomes. The changes in the management of RCC over the years, the concept of advanced diagnostics, along with the modern modalities, have revolutionized the management process of this cancer. Oncologic efficacy should be offset with renal preservation by using multidisciplinary nephrology-centered approaches. Additional studies and fair practice of precision medicine is also essential to ensure better outcomes and life of patients with RCC.

Pharmacotherapeutic Advances in Protecting Renal Function: Emerging Drug Strategies for Kidney Disease Management

Fri, 30 Jan 2026 00:00:00 +0000

Chronic kidney disease (CKD) is a progressive condition associated with substantial morbidity, mortality, and healthcare burden worldwide. Although the traditional renoprotective treatment methods, including renin-angiotensin-aldosterone system blockage and glycemic regulation, have been used long ago, a substantial number of patients still report progressive deterioration of kidney function. The pharmacotherapy over the last few years has transformed how kidney disease should be treated with new drug classes with novel approaches towards alternative and understudied pathogenic pathways. This is a holistic narrative literature review that combines the existing information on proven and novel pharmacotherapeutic methods to guard against renal dysfunction. Such innovative agents as sodium-glucose cotransporter-2 inhibitors, non-steroidal mineralocortin receptor antagonists, endothelin receptor antagonists, anti-inflammatory and anti-fibrotic agents have become available, and each of them targets hemodynamic, metabolic, inflammatory, and fibrotic pathways of renal injury. Also, the recent developments of precision pharmacotherapy, such as targeted biologics, RNA-based therapeutic options, and pharmacogenomics, also point to the individualised approach to treatment. In the review, clinical issues concerning the safety of drugs, translation gaps, and their real-world practice are also mentioned. Altogether, the available pharmacotherapeutic approaches can be of rich potential to reduce the CKD progression rate and enhance renal outcomes in the long term, which could contribute to a paradigm shift in favour of multi-pathway and individual renoprotective therapy.

Structural Anatomy of the Nephron and Its Clinical Implications in Early Kidney Disease Detection

Fri, 23 Jan 2026 00:00:00 +0000

The structural alterations in the nephron, which form the functional unit of the kidney, are closely related to chronic kidney disease (CKD) progression. The cross-sectional design was used, and the healthy individuals and patients with CKD in stages 1-3 participated. The structure of nephrons was determined by non-invasive imaging (ultrasound and Computed Tomography, CT), and biopsies were performed when needed. Clinical data such as serum creatinine and estimated glomerular filtration rate (eGFR) were taken to be able to correlate structural changes with the kidney function. The findings showed that there is substantial structural damage in early stages of kidney disease, where glomerulosclerosis and tubular atrophy were present in 5% and 10% of the participants at mild stages, respectively. The higher the disease severity, the higher the percentage of affected persons by 35% of the glomerulosclerosis and 50% of the tubular atrophy. In severe CKD, nephron size has reduced to 120 μm compared to the normal kidney of 150 μm. There was also no interstitial fibrosis in normal kidneys, but in 8% of mild cases of the disease and 45% of severe disease. It was found that the nephron structural changes were strongly correlated with the markers of kidney function, which indicates that early changes in the nephron could be used to be reliable biomarkers to diagnose CKD at the early stages. These results highlight the significance of the nephron structural analysis in the early detection and management of kidney disease.

Molecular Mechanisms of Renal Cancer Stem Cells and Tumor Heterogeneity: Genetic Drivers of Resistance, Relapse, and Therapeutic Challenges

Sat, 24 Jan 2026 00:00:00 +0000

Renal cell carcinoma (RCC) is a very aggressive form of cancer which is the most common malignancy of kidneys. RCC has proven to be a problem despite modern surgical practices and systemic therapy, since it has a high rate of relapse and is very resistant to therapy, which is usually caused by cancer stem cells (CSCs). CSCs comprise a subgroup of tumor cells that induce tumor initiation, tumor progression, tumor metastasis and tumor resistance to traditional therapies, which play an important role in tumor heterogeneity. The genetic changes and activation of important pathways were evaluated by the use of molecular assays, such as flow cytometry, gene expression analysis, and next-generation sequencing (NGS). They were conducted to measure the sensitizing of CSCs populations to chemotherapy agents through drug resistance assays. It was found that high CSC population is more prevalent in higher stages of tumor (Stage III and IV) and in the clear cell subtype. Significant genetic changes were seen in high populations of CSC and encompassed Von Hippel-Lindau (VHL) gene mutations and two signaling pathways: Wnt/b-catenin signaling pathway and Notch. The large CSCs population is strongly linked to high-stage levels of RCC, genetic mutations, and high-level resistance to chemotherapy. The inhibition of CSC pathways can become a solution to resistance and better patient outcomes. Future research must aim at establishing accurate CSC biomarkers to use in personalised therapy in addition to development of new CSC-targeting therapy.

Advancing Diagnostic Approaches For Urinary Tract Infections In Pregnancy: A Clinical Intervention Study

Mon, 26 Jan 2026 00:00:00 +0000

UTIs in pregnancy are a common clinical problem that has significant consequences to maternal renal health and pregnancy outcomes, especially when they are diagnosed late or incorrectly. Although there are established guidelines in the diagnosis, any knowledge gap in the field of diagnosis in pregnant women could result in under-recognition and subsequent delay in clinical involvement. The study aligns with the United Nations Sustainable Development Goals (SDGs), particularly SDG 3: Good Health and Well-Being, by promoting improved maternal health care outcomes through enhanced education of future healthcare providers The study aimed to assess the baseline diagnostic knowledge of urinary tract infections in pregnant women and assess the efficacy of a structured educational intervention in enhancing this diagnostic knowledge. The study was a pre- post intervention, questionnaire-based study that was carried out on 110 pregnant women who were aged between 24 and 35 years and received antenatal care. A well-established Likert-scale questionnaire was used to evaluate the level of knowledge of the participants regarding symptoms, risk factors, diagnostic strategies, and management techniques at the beginning and end of a systematic learning activity centred around evidence-based diagnostic techniques. The results of pre-intervention showed uneven knowledge levels, specifically in the area of haematuria, diagnostic criteria and urgency to receive treatment. The post-intervention analysis revealed that there were significant improvements in all areas, and the mean knowledge scores increased significantly and theSre were large effect sizes that showed that the intervention had a strong educational impact. The results reveal the importance of patient-centred educational interventions in the form of structured strategies as a form of complementary diagnostic supportive activity in antenatal care.

Biochemical Markers of Diabetic Kidney Injury: A Pharmacological Perspective on Early Intervention

Tue, 27 Jan 2026 00:00:00 +0000

Diabetic kidney injury represented a major contributor to chronic kidney disease progression and was driven by early biochemical and molecular disturbances that preceded overt functional decline. Conventional diagnostic markers often detected renal damage at advanced stages, limiting opportunities for timely therapeutic intervention. Emerging biochemical markers offered enhanced sensitivity for early detection and provided a potential framework for biomarker-guided pharmacological nephroprotection. This study aimed to synthesize clinician perspectives on biochemical markers associated with early diabetic kidney injury and to evaluate the perceived role of biomarker-guided pharmacological strategies in early renal protection. A cross-sectional, questionnaire-based observational study was conducted among 200 healthcare professionals, including nephrologists, endocrinologists, internal medicine physicians, and clinical pharmacologists. A structured, validated questionnaire assessed awareness of biochemical markers, clinical utilization patterns, and the influence of early biomarker changes on pharmacological decision-making. Descriptive and selective inferential statistical analyses were performed. Respondents demonstrated strong agreement regarding the diagnostic value of emerging biomarkers and routine biochemical monitoring for early renal injury detection. Elevated mean perception scores indicated high clinician confidence in biomarker-based approaches. Early biochemical changes were consistently perceived to influence pharmacological intervention, disease progression control, and patient outcomes. Inferential analyses revealed uniform perceptions across medical specializations and knowledge levels, suggesting consensus-driven clinical practice. The findings supported a unified biochemical–pharmacological framework for early diabetic kidney injury management. Integration of biochemical markers into routine clinical pathways was perceived to enhance early diagnosis, guide timely pharmacological intervention, and promote sustained renal preservation within preventive nephrology paradigms.

Evaluating the Renoprotective Effects of Pharmacological Interventions in Diabetic Kidney Disease: A Comparative Study

Fri, 30 Jan 2026 00:00:00 +0000

Background: Diabetic kidney disease (DKD) is a leading cause of chronic kidney disease and end-stage renal failure. Multiple pharmacological classes are used for renoprotection, but direct comparative evidence across established therapies remains limited. The study aims to compare the renoprotective effects of ACE inhibitors (ACEi), angiotensin receptor blockers (ARB), SGLT2 inhibitors (SGLT2i), GLP-1 receptor agonists (GLP-1 RA), and mineralocorticoid receptor antagonists (MRA) in patients with DKD, using standardized renal outcomes. Methods: In this comparative observational study, 50 adults with DKD were allocated to five treatment groups (n = 10 per group) based on their ongoing pharmacotherapy. eGFR and urinary albumin-to-creatinine ratio (UACR) were recorded at baseline and after 10–13 months of follow-up. Primary outcomes were changes in eGFR (ΔeGFR) and UACR (ΔUACR). Between-group differences were assessed using one-way ANOVA. Results: All groups showed some change in renal parameters over follow-up, but the magnitude differed substantially by treatment class. SGLT2i and GLP-1 RA groups exhibited minimal decline in eGFR and the largest reductions in UACR, while ACEi, ARB, and MRA showed more pronounced eGFR loss and smaller albuminuria reductions. ANOVA revealed statistically significant differences between groups for both ΔeGFR and ΔUACR (p < 0.001). Conclusions: Pharmacological class significantly influences renal outcomes in DKD. SGLT2 inhibitors and GLP-1 receptor agonists demonstrated superior short-term renoprotective effects and should be prioritized in eligible patients, although validation in larger, longer-term studies is warranted.

HPV-Associated Cervical and Lower Urinary–Genitourinary Cancer Precursors Among Female Commercial Sex Workers: Urological Implications for Urinary Tract Health

Gloria S Agrawal, Dr. (Mrs.) Jyoti A. Salunkhe, Dr. Satish V. Kakade — Fri, 23 Jan 2026 00:00:00 +0000

Women commercial sex workers (CSWs) remain a high-risk group of people with cervical abnormalities and lower genitourinary (GU) diseases, but integrated screening of both has been minimal. Infection with human papillomavirus (HPV) is a cause of lesions in the cervix and can also cause peri-urethral and lower urinary tract inflammation, and thus this group is especially important to the urological research. The aim of the study was to find out the incidence of HPV-related cervical abnormalities and the evaluation of GU inflammatory disease with a possible urological implication among female CSWs. A total of 307 CSWs who were aged 30-65 years in Budhwar Peth, Pune, were involved in a descriptive cross-sectional study. Pap smear results were done and results with suspicious cytology were sent out to testing of HPV DNA. The cervical lesions, HPV positivity and GU abnormalities were identified using descriptive statistics. Aboriginal cytology was found in 214 women (70%). The pre-cancerous lesions (HSIL and LSIL) contribute 9% and 1 case of cervix cancer proved. Major GU-abnormalities were cervicitis (46%), squamous metaplasia (24%), and ASCUS (22%). Of the 23 women who had been tested on HPV, 6 (26%) were found to be the high-risk HPV positive, and four of them were HIV co-infected. LSIL was more common in women of younger age, whereas HPV positivity was more common in older ages. The presence of inflammatory and epithelial lesion is a significant burden, which raises the need to examine the cervical and lower urinary tract as a whole.

Improving Pediatric Renal Health: Clinical Public Health Strategies and Nephrology-Focused Nursing Interventions for Long-Term Outcomes

Sat, 31 Jan 2026 00:00:00 +0000

Pediatric kidney diseases present a significant clinical and societal health burden in terms of frequent morbidity, impaired function and threat of enduring morbidity. This study compared integrated clinical public health approaches and nephrology-oriented nursing care to the outcome of pediatric renal disease. A descriptive observational study involved children aged 0-18 years old with chronic kidney disease (CKD), acute kidney injury (AKI), and nephrotic syndrome. Outcome patterns and predictors of renal improvement were studied using descriptive statistics, comparative statistics, and regression modelling. This cohort involved 120 children (mean age of 9.4 years, 32% AKI, 48% CKD, 20% nephrotic syndrome). Mean estimated glomerular filtration rate (eGFR) rose to 45% at 6 months and 52% at 12 months; baseline eGFR 38mL/min/m². The adherence rate also improved to 84% versus 62% and the quality of life improved to 71/100 compared to 48/100. The episodes of AKI reduced from 32% to 14%, infections from 41% to 19%, hypertension from 36% to 22%, nephrotic-syndrome-relapse from 28% to 12%, and the hospitalisation rate from 1.8 to 0.9 per patient-year. The regression analysis revealed that the following factors were significant predictors of renal improvement: nursing intensity (β = 0.41, p < 0.01), early screening participation (β = 0.36, p < 0.01), tele-support frequency (β = 0.33, p < 0.05), and home-care engagement (β = 0.29, p < 0.05). The long-term renal health of pediatric patients can be enhanced by a multidisciplinary approach and effective nursing leadership, screening in the early stages, and structured home-based instruction.

Molecular Mechanisms of Early Renal Fibrosis: Integrating Multi-Omics Evidence for Translational Nephrology

Sat, 24 Jan 2026 00:00:00 +0000

Early renal fibrosis represents a critical and potentially reversible stage in the progression of chronic kidney disease, yet its complex molecular underpinnings remain incompletely understood. Traditional histopathological and single-pathway approaches have provided limited insight into the dynamic and heterogeneous processes driving fibrotic initiation. Recent advances in high-throughput omics technologies have enabled comprehensive interrogation of molecular alterations across multiple regulatory layers, offering new opportunities to elucidate early fibrogenic mechanisms. This comprehensive review synthesizes evidence from genomic, epigenomic, transcriptomic, proteomic, and metabolomic studies to define the molecular landscape of early renal fibrosis from a systems biology perspective. Integrated multi-omics analyses reveal that early fibrogenesis arises from coordinated dysregulation of profibrotic signaling pathways, metabolic reprogramming, inflammatory activation, and extracellular matrix remodeling rather than isolated molecular events. Single-cell and spatial transcriptomic studies further demonstrate that distinct cell-state transitions and spatially restricted interactions among epithelial, stromal, endothelial, and immune cells shape fibrotic niches prior to overt structural damage. Network-based integration identifies convergent molecular modules and key regulatory hubs that govern fibrosis initiation and progression, providing mechanistic insights with translational relevance. Collectively, these findings underscore the value of multi-omics integration for advancing early detection strategies, therapeutic target prioritization, and precision nephrology. While challenges remain, including limited longitudinal human datasets and technical barriers to data integration, multi-omics approaches are poised to transform understanding and management of early renal fibrosis by enabling mechanism-driven, individualized intervention strategies.

Pre-Analytical Errors in Renal Diagnostics: Implications for Kidney Disease Evaluation, Patient Safety, and Clinical Decision-Making

Alka Katiyar, Munish Rastogi, Pradeep Kumar Tiwari, Dheeraj Kumar — Thu, 29 Jan 2026 00:00:00 +0000

Renal diagnostics are central to modern nephrology, guiding the evaluation, staging, and management of chronic kidney disease (CKD) and acute kidney injury (AKI). However, most laboratory errors occur in the pre-analytical phase, including patient preparation, specimen collection, labeling, handling, transport, and storage. Such upstream failures can significantly compromise the accuracy of kidney biomarkers such as serum creatinine, estimated glomerular filtration rate (eGFR), albuminuria, and electrolytes. This review examines the classification, burden, and clinical impact of pre-analytical errors in renal diagnostic testing, emphasizing their implications for kidney disease evaluation, patient safety, and evidence-based clinical decision-making. A narrative synthesis of recent nephrology and laboratory medicine literature was conducted, focusing on major categories of pre-analytical failure, including identification errors, specimen collection problems, sample interferences, transport instability, and medication- or physiology-related confounders. Specialized nephrology populations and emerging quality improvement strategies were also reviewed. Pre-analytical errors may lead to CKD misclassification, inaccurate eGFR estimation, unreliable urine albumin-to-creatinine ratio testing, and delayed AKI recognition. High-risk groups such as pediatric patients, lupus nephritis populations, oncology-associated kidney injury cases, and perioperative surgical patients are particularly vulnerable. Clinical consequences include inappropriate drug dosing, avoidable dialysis initiation, unnecessary hospital admissions, and increased healthcare resource utilization. Standardization initiatives, quality indicators, harmonization frameworks, and innovations such as artificial intelligence, delta checks, and smart sample tracking offer promising approaches to reduce preventable diagnostic variability. Strengthening pre-analytical integrity is essential for accurate renal biomarker interpretation, guideline-concordant CKD management, and improved patient outcomes.

Modified SQEU-Net: An Enhanced U-Net Architecture With Federated Learning For Urolithiasis Segmentation And Type Classification

M Kishore Kumar, A V L N Sujith — Wed, 21 Jan 2026 00:00:00 +0000

The precise segmentation of Urolithiasis on the basis of the computed tomography (CT) images is a key requirement to consistent diagnosis, treatment planning, and quantitative evaluation in urology. The large range of variability in stone size, shape, and distribution of intensities and the existence of the surrounding structures of the anatomy create serious problems in automated segmentation procedures, though. In order to overcome these shortcomings, this paper has suggested a new improved version of U-Net, SQEU-Net, a deep learning network, especially tailored to kidney stone segmentation. The proposed model incorporates dilated convolutions in the encoder to allow multi-scale contextualization without much spatial decrease, residual learning to enhance its ability to optimize the deep networks, and squeeze-and-excitation (SE) to recalibrate channel-wise feature responses in a dynamic manner. Besides, attention-gated skip connections are used to selectively pass clinically relevant features between the encoder and the decoder, eliminating background noise and irrelevant anatomical structures. Using the CT kidney stone data, the model is trained and tested on the data with standard segmentation measures of Dice Similarity Coefficient (DSC), Intersection over Union (IoU), accuracy, precision, recall, and F1-score measures. Comparative experiments with the state-of-the-art in the recent past show that SQEU-Net always performs better in terms of segmentation especially with regard to defining small and irregularly shaped stones. The findings confirm the usefulness of integrating contextual features learning, channel-wise attention, and spatial attention systems to achieve powerful kidney stone segmentation, one of the roles that SQEU-Net can play is a clinical reliable decision-support system.

Integrated Health Science Approaches for Early Detection of Chronic Kidney Disease: A Multi-Clinical Model

Fri, 30 Jan 2026 00:00:00 +0000

Early detection of chronic kidney disease (CKD) remains a major clinical challenge due to the asymptomatic nature of early disease and the limitations of conventional screening strategies that rely on single-point laboratory measurements. Delayed recognition of CKD contributes to disease progression, increased morbidity, and higher healthcare costs. Integrated health science approaches that combine clinical risk factors, routine laboratory data, and longitudinal assessment of kidney function may enhance early disease identification. This study evaluated the diagnostic performance, generalizability, and clinical effectiveness of an integrated CKD detection approach in comparison with standard screening methods. A multi-clinical, observational design was employed, utilizing routinely collected clinical and laboratory data to assess early-stage CKD detection and time to disease recognition. Diagnostic accuracy metrics were calculated, and performance was compared between approaches across different care settings and patient subgroups. The integrated approach demonstrated higher sensitivity and improved overall diagnostic accuracy for early-stage CKD detection while maintaining comparable specificity relative to standard screening. Diagnostic performance remained consistent across diverse clinical contexts, supporting the generalizability of the approach. Importantly, application of the integrated detection strategy was associated with a marked reduction in time to CKD recognition, indicating improved effectiveness in identifying disease earlier in its clinical course. These findings suggest that integrating longitudinal kidney function trends with clinical information addresses key limitations of conventional screening and reduces delayed diagnosis. In conclusion, integrated health science approaches offer a practical, scalable, and clinically grounded strategy for improving early CKD detection and supporting timely intervention in routine healthcare settings.

Psychological Drivers Of Pro-Environmental Behaviour In Healthcare Organizations: Implications For Sustainable Renal Care

Sukriti Khanna, Dr. Raskirat Kaur — Fri, 23 Jan 2026 00:00:00 +0000

Healthcare organisations play a critical role in protecting human health, yet contribute substantially to environmental degradation through intensive energy use, water consumption, and waste generation. Renal care—particularly dialysis—is among the most resource-intensive domains within healthcare, making sustainability in kidney care both urgent and complex. Although healthcare systems increasingly adopt environmental policies and technological innovations, these initiatives often underperform because they insufficiently address the psychological and behavioural factors shaping everyday clinical practice. This narrative review synthesises evidence on the psychological drivers of pro-environmental behaviour (PEB) in healthcare organisations and examines their implications for kidney health and sustainable renal care. Drawing on established psychological frameworks, including the Norm Activation Model, the Theory of Planned Behaviour, and value-based theories, the review highlights the roles of personal values, lifestyle orientation, perceived behavioural capability, and organisational climate in shaping discretionary sustainability behaviours. The evidence consistently indicates that green lifestyle orientation and value congruence are stronger predictors of workplace pro-environmental behaviour than environmental commitment, awareness, or green human resource management alone. In renal care settings—where clinical protocols, workload pressures, and patient safety concerns constrain action—effective sustainability depends on behaviourally informed strategies that align environmental responsibility with professional ethics and routine practice. The review concludes that sustainable renal care is not solely a technological challenge but a behavioural one, underscoring the need to embed psychological insights into healthcare sustainability efforts to advance both planetary health and long-term kidney care resilience.

Comparative Evaluation of Renoprotective Drug Regimens in Patients With Early-Stage Diabetic Kidney Disease

Fri, 23 Jan 2026 00:00:00 +0000

A conceptual framework is presented to compare the mechanisms and theoretical effects of major renoprotective drug regimens used in the early stages of diabetic kidney disease. The condition develops through interconnected hemodynamic, metabolic, inflammatory, and fibrotic processes, and the therapeutic agents examined here influence different components of these pathways. The framework brings together established scientific knowledge on drug actions and the biological factors that drive early renal injury, offering a structured perspective on how each therapy may contribute to renal protection. Emphasis is placed on the importance of early therapeutic intervention, since kidney damage frequently begins before measurable declines in kidney function appear. The analysis also highlights the potential value of combining therapeutic agents to address multiple disease pathways at once. Overall, the framework supports improved treatment decision-making, encourages personalized therapeutic strategies, and identifies future research needs for empirical validation and comparative assessment of integrated drug regimens for early diabetic kidney disease.

Targeted Nano-Drug Delivery Systems for Renal Disorders: A Molecular Medicine Perspective

Sat, 24 Jan 2026 00:00:00 +0000

Kidney diseases, including acute kidney injury (AKI) and chronic kidney disease (CKD), remain significant health issues in the world, which often leads to end-stage renal disease (ESRD) that ultimately causes kidney transplantation or dialysis. Treatments that remain available currently lack effectiveness since renal disorders remain complex. A new type of nano-drug delivery systems (NDDS) has been proposed as one of the best alternatives to improve the therapeutic specificity and minimize the systemic toxicity in the context of kidney disease treatment. This was done in a prospective and experimental design that evaluated the effectiveness of different nano-carriers (liposomes, dendrimers, and polymeric nanoparticles) in delivering drugs to the kidneys. Targeted nano-formulations were AKI and CKD experimental models, their bioavailability, targeting efficiency to kidneys and therapeutic effects were compared to standard treatment. Nanoparticles made of liposomes had the greatest accumulation of drugs in the kidney resulting in great changes in kidney functions, as measured by the decrease in serum creatinine and Blood Urea Nitrogen (BUN) levels. Histological examination also established a significant tissue healing and a decrease in fibrosis in the groups receiving nanoparticle therapy than the traditional methods. The nano-drug delivery systems that remain focused remain effective in the treatment of kidney diseases by improving the targeting of the drug to the renal tissues, minimizing off-target effects, and facilitating tissue regeneration. These results indicate that nanomedicine has a bright future in the treatment of AKI and CKD, and there is a prospect of individualized treatment that is not as toxic.

Modern Urological Approaches to Renal Stone Disease: Diagnostic Advances and Therapeutic Innovations

Indurani M S, ALPHONES.D, P. Rubi, Dr. Ashish Kumar Shukla, AKSHAY AWASTHI — Mon, 26 Jan 2026 00:00:00 +0000

Renal stone disease is a highly prevalent and recurrent urological condition with a growing global burden. Advances in imaging, endourological technology, and metabolic understanding have significantly transformed diagnostic and therapeutic strategies, necessitating an updated synthesis of contemporary management approaches. To review recent advances in the diagnosis and treatment of renal stone disease, with particular emphasis on imaging innovations, therapeutic technologies, and emerging trends toward personalised and value-based care. A narrative review of the literature was conducted, focusing on high-quality clinical trials, meta-analyses, guideline documents, and recent translational studies addressing diagnostic advances, medical and surgical therapies, and emerging technologies in renal stone disease. Modern diagnostic strategies emphasise low- and ultra-low-dose computed tomography, dual-energy imaging for stone characterisation, and the growing role of artificial intelligence in image interpretation and risk prediction. Therapeutic innovations include advancements in laser lithotripsy, miniaturised percutaneous nephrolithotomy, and refined ureteroscopic techniques, alongside optimised use of extracorporeal shock wave lithotripsy. Emerging non-invasive therapies, particularly burst wave lithotripsy, highlight a paradigm shift toward anaesthesia-free stone treatment. Personalised management incorporating metabolic evaluation, recurrence risk stratification, and preventive strategies has gained prominence, supported by predictive analytics and value-based care models. Contemporary management of renal stone disease reflects a transition toward precision medicine, minimally invasive therapy, and prevention-focused care. Ongoing research, equitable technology implementation, and high-quality clinical trials are essential to optimise outcomes and ensure sustainable, patient-centred stone management.

Anti-nephrolithiatic activity of Garcinia lanceifolia Roxb: An in vitro Study

Wed, 28 Jan 2026 00:00:00 +0000

Urolithiasis is a chronic kidney disease characterized by the development of calculi inside the kidneys in a complicated sequence of supersaturation, nucleation, aggregation, crystal development, and retention. The purpose of the current study was to screen the in vitro anti-nephrolithiatic effects of Garcinia lanceifolia Roxb. var. Oxyphylla fruit extract (GLE), which is a potent medicinal plant, against calcium oxalate crystallization. To determine the effect of GLE to prevent calcium oxalate nucleation and aggregation, in vitro studies were carried out. The results demonstrated that GLE may be used as a therapeutic agent for urolithiasis since it significantly (P < 0.001) inhibited the nucleation and aggregation of calcium oxalate crystal. Phytochemical examination indicated GLE has a high amount of total phenolics and flavonoids and also contain reported bioactive compounds like hydroxycitric acid in the fruit of G. lanceifolia. This combined approach may explain the reported anti-nephrolithiatic effects. The findings support the traditional use of G. lanceifolia and the need for additional in vivo studies to determine its therapeutic usefulness and safety.

Blockchain Solutions In Nephrology: Transforming Patient Satisfaction And Clinical Outcomes

Sachin C Narwadiya, Dr. Manish Mohan Gore, Dr. Dharmapuri Raghunatha Rao — Fri, 23 Jan 2026 00:00:00 +0000

Blockchain technology holds transformative potential for nephrology by addressing critical challenges in patient data management, treatment adherence, and care coordination. Kidney diseases such as chronic kidney disease (CKD), acute kidney injury (AKI), and end-stage renal disease (ESRD) are leading causes of morbidity worldwide, requiring long-term management and interdisciplinary care. Traditional healthcare systems face difficulties with fragmented patient data, inefficient communication, and delayed decision-making, which can compromise patient outcomes. Blockchain’s decentralized, immutable, and transparent nature ensures secure data storage and sharing across healthcare providers, reducing errors, enhancing data integrity, and improving coordination among nephrologists, dialysis centers, and transplant specialists. In nephrology, blockchain can streamline patient data management, reduce duplication, and enable real-time access to medical histories, improving diagnosis and treatment decisions. Moreover, blockchain’s support for patient-centric care models empowers individuals to control and share their health data, fostering trust and increasing patient satisfaction. Blockchain also enables the integration of advanced technologies like artificial intelligence (AI) and the Internet of Things (IoT), which can enhance kidney disease diagnosis, early detection, and continuous monitoring. By improving data transparency, security, and accessibility, blockchain has the potential to revolutionize care delivery in nephrology. This study highlights how blockchain can transform nephrology by overcoming barriers in patient data management, facilitating more coordinated care, and improving clinical outcomes, ultimately leading to better patient satisfaction and long-term health improvements.

Analysing potential phytoconstituents from Viscum album (Suvarnabandaaka) targeting RAAS-mediated hypertension and renal protection: An in-silico approach

Fri, 23 Jan 2026 00:00:00 +0000

Background and Aim: Hypertension is a significant health issue in the world that demands that natural options to synthetic drugs should be explored because of their side effects. One of the key causes of chronic kidney disease (CKD) is hypertension, which mainly causes dysregulation of renal RAAS signalling and vascular injury. This paper examines the antihypertensive effects of Viscum album by using in-silico molecular docking.

Material and Methods: Phytoconstituents of Viscum album were identified using seven phytoconstituents based on the scores of their oral bioavailability and drug-likeness. AutoDock 4.5.6 molecular docking was done against the following key hypertensive targets: ACE, Angiotensin-II receptor, β-1 adrenergic receptor, and calcium channel. Biovia Discovery Studio was used to visualise the interactions. Result: The phytoconstituents had better binding affinities with the target proteins than the standard drugs. It was worth noting that Chlorogenic acid, Oleanolic acid and Betulinic acid displayed a high interaction with ACE as the binding energy of the substance was -11.90, -11.84 and -11.65 kcal/mol, which exceeded that of Captopril of -5.89 kcal/mol. In the case of the Angiotensin-II receptor, Oleanolic acid, Chlorogenic acid, and Syringin demonstrated binding energies of -11.66, -10.67 and -10.05 kcal/mol, outperforming losartan’s -9.21 kcal/mol. Syringin, Chlorogenic acid, and Quercetin exhibited robust binding with the β-1 adrenergic receptor, with energies of -13.82, 13.59, and -12.05 kcal/mol, respectively, compared to Propranolol’s -7.48 kcal/mol. Additionally,

Chlorogenic acid, Oleanolic acid, and Quercetin interacted strongly with the calcium channel, with binding energies of -7.24, -7.06, and -7.00 kcal/mol, respectively, exceeding amlodipine’s -4.59 kcal/mol.

Conclusion: Such results indicate that Viscum album phytoconstituents can have a dual antihypertensive and nephroprotective action of regulating major renal targets.

AI-Enhanced Medication Management for Acute Kidney Injury in Critical Care Settings

Mon, 26 Jan 2026 00:00:00 +0000

Background: Acute kidney injury (AKI) is a frequent complication in critically ill patients and is often exacerbated by inappropriate medication dosing and exposure to nephrotoxic drugs. Rapid renal function changes and high medication burden in the intensive care unit (ICU) make renal-safe prescribing challenging. Artificial intelligence (AI)-assisted clinical decision support systems may aid medication optimisation during AKI.

Objective: To evaluate the association between AI-assisted medication review and renal dose appropriateness in critically ill patients with AKI, and to assess AKI progression and renal recovery during ICU admission.

Methods: A single-centre observational study was conducted in an adult ICU. Adult patients diagnosed with AKI using the Kidney Disease: Improving Global Outcomes (KDIGO) criteria and receiving at least one medication were included. Renal function was monitored using serum creatinine and urine output. Medications were assessed for renal dose appropriateness. An AI-assisted decision support tool provided dosing and nephrotoxicity recommendations without autonomous prescribing during routine clinical care settings.

Results: Patients had a mean age of 63 ± 12 years and received multiple medications during AKI. Renal dose appropriateness improved from 66% to 85% following AI-assisted review. Renal function improved in 44% of patients, while 23% experienced worsening AKI.

Conclusions: AI-assisted medication review was associated with improved renal-safe prescribing in critically ill patients with AKI, supporting its role as a clinician-centred adjunct in intensive care.

Chamomile Mouthwash As A Supportive Care Intervention For Chemotherapy-Associated Oral Mucositis In Kidney Transplant Patients

S. Shalini, Padmapriya D, Dr.Marydasan Francis — Mon, 26 Jan 2026 00:00:00 +0000

Chemotherapy-associated oral mucositis remains a common and debilitating complication that significantly affects quality of life, treatment continuity, and hospitalisation outcomes. Kidney transplant patients represent a particularly vulnerable population due to chronic immunosuppression, impaired mucosal healing, and heightened infection risk. Safe and effective supportive care strategies suitable for renal transplant settings remain limited. Exploring safe, accessible, and cost-effective interventions aligns with Sustainable Development Goal (SDG) 3: Good Health and Well-Being, which emphasizes improving healthy lifestyle and ensuring universal access to effective treatments in improving the health. To evaluate the effectiveness of chamomile mouthwash in reducing the severity of chemotherapy-associated oral mucositis in kidney transplant patients and to assess its impact on pain intensity and oral functional outcomes during hospitalisation. A prospective, controlled, hospital-based interventional study was conducted among 120 hospitalised adult kidney transplant recipients receiving chemotherapy. Participants were allocated to either a chamomile mouthwash group (n = 60) or a standard oral care group (n = 60). Oral mucositis severity, pain intensity, oral intake tolerance, treatment compliance, and adverse events were assessed at baseline and during follow-up. Data were analysed using appropriate inferential statistical methods, including independent samples t-tests, chi-square tests, repeated-measures analysis of variance, and Kaplan–Meier survival analysis. Patients receiving chamomile mouthwash demonstrated a significant reduction in oral mucositis severity compared with controls (p = 0.003). Pain intensity decreased more rapidly in the intervention group (p < 0.001), and mucositis resolution occurred earlier (log-rank p = 0.01). Treatment compliance was high, and no serious adverse events were reported. Chamomile mouthwash appears to be a safe and effective supportive care intervention for managing chemotherapy-associated oral mucositis in kidney transplant patients, with potential benefits for patient comfort, treatment continuity, and inpatient outcomes.

Novel Biomarkers for Early Detection and Risk Stratification in Chronic Kidney Disease

Sat, 31 Jan 2026 00:00:00 +0000

Background: Chronic kidney disease (CKD) is a progressive condition characterized by largely irreversible structural and functional kidney damage, representing a major global public health burden and affecting approximately 13% of the world’s population. Its asymptomatic nature in early stages and close association with cardiovascular morbidity and mortality often lead to delayed diagnosis and poor clinical outcomes.

Methods: This narrative review summarizes current evidence on emerging biomarkers for early detection and risk stratification in CKD. Peer-reviewed studies were examined focusing on biomarkers of tubular injury, inflammation, fibrosis, metabolic dysregulation, multi-omics integration, and the application of artificial intelligence and machine learning in biomarker-based risk prediction.

Results: Novel biomarkers such as neutrophil gelatinase-associated lipocalin, liver-type fatty acid-binding protein, monocyte chemoattractant protein-1, soluble tumor necrosis factor receptors, fibroblast growth factor 23, and uromodulin can detect kidney damage earlier and predict disease progression more accurately than traditional tests. New proteomic and metabolomic techniques allow multiple biomarkers to be combined into panels, improving the prediction of kidney and cardiovascular outcomes. The use of artificial intelligence further supports ongoing risk assessment and personalized monitoring of disease progression.

Conclusions: Biomarker-driven approaches offer significant potential to improve early diagnosis, risk stratification, and individualized management of CKD. Addressing translational barriers through large-scale validation and global collaboration is essential to improve patient outcomes.

Experience with Intravesical Botox in Meningomyelocele-Related Bladder Dysfunction-A Single-Center Experience

Dr Sonali Bijjargi, Vishal Kadeli — Fri, 23 Jan 2026 00:00:00 +0000

Neurogenic bladder dysfunction as a secondary effect of meningomyelocele (MMC) is a serious risk factor of urinary incontinence, vesicoureteral reflux, and progressive upper urinary tract degradation. This was a prospective, single-centre, study that assessed the short-term effectiveness of intravesical onabotulinumtoxinA (Botulinum toxin type A) in children with refractory neurogenic bladder related to MMC. Ten hyper-reflexive neurogenic bladder children who were unresponsive or intolerant to anticholinergic treatment and clean intermittent catheterization were injected with intrapetrous onabotulinumtoxinA (10 IU/kg) under cystoscopic guidance. The baseline and 3 and 6 months post-treatment assessments were conducted on the urodynamic parameters, the state of continence, bowel symptoms, and vesicoureteral reflux. Three months later, the detrusor sphincter dyssynergia was reduced significantly, the maximum detrusor pressure also decreased significantly, the bladder capacity was higher, the post-void residual volumes were lower, and the grades of continence were better. The moderate grades of vesicoureteral reflux had significant improvement on follow-up voiding cystourethrography. In spite of the fact that partial attenuation of therapeutic effects was observed at 6 months, the results were better than baseline. Also, constipation was improved in most of the patients. These results justify the use of intravesical onabotulinumtoxinA as a safe and useful minimally invasive therapeutic intervention in the short-term management of the bladder in children with MMC-related neurogenic bladder, which may delay or prevent more invasive surgical procedures.

Evaluating Glomerular Filtration Rate Variability: A Clinical Medicine Approach to Early Kidney Dysfunction Detection

Fri, 23 Jan 2026 00:00:00 +0000

Background:
Early detection of kidney dysfunction is essential for improving clinical outcomes, yet conventional single-measure estimated glomerular filtration rate (eGFR) assessments may fail to identify early physiological instability. This study evaluates the performance of major variability indices using a computational modelling framework designed to simulate realistic renal function trajectories.

Methods:
A synthetic cohort of 150 simulated subjects (75 stable renal function, 75 early dysfunction) was generated using calibrated epidemiological parameters and validated renal physiology distributions. Each subject provided eight longitudinal eGFR measurements over a two-year period. Variability metrics, including standard deviation (SD), coefficient of variation (CV), variability independent of the mean, and visit-to-visit variability, were calculated. Logistic regression assessed associations with early dysfunction, and receiver operating characteristic (ROC) analysis evaluated diagnostic performance.

Results:
Early dysfunction trajectories demonstrated significantly greater variability than stable trajectories. SD values ranged from 5.9-9.6 mL/min/1.73 m² in the dysfunction group versus 3.8-4.6 mL/min/1.73 m² in stable subjects. CV also showed clear separation (0.075 vs. 0.045). Both SD and CV significantly predicted early dysfunction (p < 0.001). CV exhibited the highest diagnostic accuracy (AUC = 0.93), outperforming SD (AUC = 0.86) and slope-based decline metrics (AUC = 0.72).

Conclusions:
GFR variability metrics, particularly CV, demonstrate strong discriminatory ability for identifying early renal dysfunction. These findings support integrating variability-based assessments into early CKD detection frameworks and highlight the need for future clinical validation.

CLFC: Contrastive Learning with Feature Concatenation Framework for Chronic Kidney Disease

Mrs. T. Durga Aparna, Dr. A.V.L.N Sujith — Wed, 21 Jan 2026 00:00:00 +0000

Patients with thyroid dysfunction have a high likelihood of underdiagnosis of Chronic Kidney Disease (CKD) and Acute Kidney Injury (AKI) because the relationship between endocrine, renal, and metabolic biomarkers are complex and nonlinear. Conventional risk predictive models are unable to model these heterogeneous relationships, which leads to delayed nephroprotective interventions. To overcome this hurdle, this paper suggests the Contrastive Learning with Feature Concatenation (CLFC) model on the stratification of CKD/AKI disease at early and precise stages during the management of thyroid disease patients. The model uses modality-specific encoders, which learn latent representations using thyroid, renal, and metabolic data, but a self-supervised contrastive learning module uses the NT-Xent loss to ensure consistency of the representations. The trained multimodal embeddings are then combined with late-stage concatenation of features and trained with the help of supervised classification. Empirical analysis of a multimodal clinical dataset proves that the presented solution performs much better than the traditional machine learning and deep learning baselines, with higher accuracy, F1-score, and AUC. The importance of contrastive learning, and renal biomarkers in heightening the risk discrimination is further supported by the ablation studies. The suggested framework provides a clinically interpretable scalable robust solution to the assessment of CKD/AKI risk that can be used to make early nephroprotective decisions in thyroid-impacted populations.

Evaluating The Role Of Deep Learning In Enhancing Renal Health Assessment: A Comprehensive Review

Fri, 23 Jan 2026 00:00:00 +0000

Kidney diseases, including chronic kidney disease (CKD) and acute kidney injury (AKI), pose a substantial global health burden and are associated with high morbidity, mortality, and healthcare costs. Conventional methods for renal health assessment are limited by delayed detection, inter-observer variability, and restricted capacity to integrate complex, longitudinal data. Recent advances in deep learning have created new opportunities to enhance renal disease assessment through data-driven, automated, and scalable approaches. This review aims to evaluate the role of deep learning in improving renal health assessment across structural, functional, and clinical domains, with a focus on its potential to support early diagnosis, risk stratification, and personalized renal care. A comprehensive narrative review of the literature was conducted, focusing on peer-reviewed studies that apply deep learning techniques to renal imaging, functional assessment, disease classification, renal replacement therapy, and transplantation. Key challenges related to data quality, interpretability, ethical considerations, and clinical implementation were also examined. Deep learning has demonstrated strong performance in structural renal assessment, including kidney segmentation, cyst quantification, and tumor classification. Functional applications include early prediction of AKI, estimation of renal function decline, and imaging-based glomerular filtration rate assessment. Integration with electronic health records has enabled improved disease classification, risk stratification, and outcome prediction. Emerging applications in dialysis and transplantation show promise for optimizing advanced renal care. Deep learning offers significant potential to enhance renal health assessment and clinical decision-making. Continued advances in explainability, data integration, and ethical deployment will be critical for successful clinical translation and widespread adoption in nephrology practice.

Occupational Stress And Job Satisfaction Among Women Professionals In Urology Services: A Review

Sukriti Khanna, Dr. Raskirat Kaur — Fri, 23 Jan 2026 00:00:00 +0000

Background: Occupational stress presents an ongoing challenge for workforce stability and service continuity in specialised healthcare environments. Urology services involve high procedural intensity, emotional labour, and sustained performance demands, increasing vulnerability to stress among healthcare professionals. Job satisfaction has gained attention as a key organisational factor influencing professional well-being and service effectiveness.

Objective: This review synthesises evidence on occupational stress and job satisfaction in healthcare settings with specific relevance to urology services, emphasising organisational and gender-related determinants that shape workforce well-being and sustainability.

Methods: A narrative review approach was adopted. Peer-reviewed studies published in English between 2018 and 2025 were identified through searches of PubMed, Scopus, Web of Science, and Google Scholar. Eligible studies examined occupational stress, job satisfaction, or related organisational factors among healthcare professionals in specialised or comparable clinical settings. Findings were synthesised qualitatively.

Results: Occupational stress in urology services is influenced by workload intensity, role complexity, supervisory practices, and perceived job security. Job satisfaction derived from supportive supervision, stable employment conditions, and positive workplace relationships demonstrates a buffering effect against stress. Gender-related role demands further shape stress experiences. Elevated stress is associated with absenteeism, reduced engagement, and workforce instability.

Conclusions: Job satisfaction functions as a protective mechanism against occupational stress in urology services. Organisational strategies focused on leadership support, employment stability, and inclusive workplace practices may enhance workforce resilience, service continuity, and long-term sustainability of urology healthcare delivery.

Sequential Therapy For Advanced Renal Cell Carcinoma: Systematic Review Of Comparative Efficacy, Safety, And Emerging Molecular Predictors

Dr. Suhena Sarkar, Dr. Birupaksha Biswas — Fri, 23 Jan 2026 00:00:00 +0000

Advanced renal cell carcinoma has undergone a profound therapeutic evolution with the sequential integration of vascular endothelial growth factor targeted therapies mammalian target of rapamycin inhibition and immune checkpoint blockade. Although contemporary first line regimens are increasingly standardized treatment selection beyond progression remains heterogeneous and largely empiric. Cabozantinib and the combination of lenvatinib plus everolimus are both guideline endorsed subsequent line options supported by randomized evidence against everolimus yet no definitive head to head comparison or validated predictive biomarkers currently exist to guide optimal choice. This review synthesizes data from pivotal randomized trials real world observational cohorts translational studies and international clinical practice guidelines evaluating these two regimens in advanced renal cell carcinoma. The phase three METEOR trial established cabozantinib as a standard of care with durable improvements in progression free and overall survival and preserved quality of life across prognostic subgroups. The randomized phase two lenvatinib plus everolimus study demonstrated substantial progression free survival benefit and objective response but with higher toxicity requiring individualized dose management. The widespread adoption of immune checkpoint inhibitor based frontline combinations has further complicated sequencing decisions and increased reliance on both regimens in the post immune setting despite limited prospective validation. Emerging translational evidence suggests biologically plausible distinctions including mesenchymal epithelial transition factor driven invasive phenotypes favoring cabozantinib and mammalian target of rapamycin pathway dependence potentially relevant to lenvatinib plus everolimus although such associations remain retrospective and exploratory. Ongoing comparative trials including NCT05012371 are expected to inform relative efficacy but lack mandatory tissue based molecular or spatial profiling. Collectively available evidence confirms the indispensable role of both regimens while underscoring a critical unmet need for prospective biopsy anchored trials integrating genomic and spatial analyses to enable precision guided treatment sequencing.

Hematologic Alterations In Renal Disease: Pathological Mechanisms And Clinical Correlates

Mon, 26 Jan 2026 00:00:00 +0000

Hematologic abnormalities are common and clinically significant complications of renal disease, contributing to increased morbidity, mortality, and reduced quality of life. Anaemia, iron dysregulation, platelet dysfunction, and immune abnormalities arise from complex interactions between impaired kidney function, chronic inflammation, and disrupted haematopoiesis. Advances in molecular and clinical research have expanded understanding of these processes and reshaped therapeutic strategies. This review aims to synthesise current evidence on hematologic alterations in renal disease, focusing on underlying pathological mechanisms and their clinical correlates, while highlighting emerging biomarkers and therapeutic innovations. A narrative review of recent experimental, translational, and clinical literature was conducted, with emphasis on studies published between 2021 and 2025. Key areas examined include anaemia pathophysiology, iron metabolism disorders, platelet and coagulation abnormalities, immune cell dysfunction, disease-specific hematologic complications, prognostic biomarkers, and novel therapeutic approaches. Renal disease disrupts the kidney-bone marrow-immune axis, leading to impaired erythropoietin production, inflammation-driven iron sequestration, reduced erythrocyte lifespan, platelet dysfunction, and immune dysregulation. These abnormalities contribute to cardiovascular disease, infection susceptibility, thrombotic and bleeding risks, and progression of kidney dysfunction. Emerging therapies, particularly hypoxia-inducible factor-based agents and strategies targeting inflammatory and iron-regulatory pathways, offer mechanism-based alternatives to traditional treatments. Hematologic biomarkers such as anaemia severity and leukocyte-derived indices show promise for prognostic stratification. Hematologic alterations in renal disease reflect interconnected pathophysiological processes with significant clinical implications. Integrating mechanistic insights, biomarker-driven risk assessment, and precision therapeutic strategies is essential to improving outcomes and advancing holistic management of patients with renal disease.

Renal Biomarkers and Early Kidney Injury in Women with Polycystic Ovary Syndrome: A Narrative Review

Fri, 30 Jan 2026 00:00:00 +0000

Polycystic ovary syndrome (PCOS) has been a highly studied endocrine-metabolic condition in women of reproductive age, which is traditionally known to have reproductive and metabolic effects. There is also emerging evidence that PCOS may also have early renal involvement that may put the affected women at risk of having chronic kidney disease in them later in life. This narrative review will synthesize the existing evidence on pathophysiological connections between PCOS and renal dysfunction, critically assess the limitations of traditional renal biomarkers, and the use of emerging biomarkers in the early detection of kidney damage in women with PCOS. The synergistic effects on the development of subtle glomerulonephritis and tubular damage occur as a result of insulin resistance in PCOS, hyperandrogenism, obesity, persistent low-grade inflammation, oxidative stress, endothelial dysfunction, and renin-angiotensin-aldosterone system activation. The traditional renal markers, serum creatinine, blood urea nitrogen, and estimated glomerular filtration rate using creatinine, are commonly insensitive to such early alterations and can be observed to be within normal ranges despite continued stress to the renal system. New biomarkers, such as urinary albumin -to -creatinine ratio, cystatin C, neutrophil gelatinase-associated lipocalin, and kidney injury molecule-1, are more sensitive in detecting early glomerular permeability changes, tubular injury, and microvascular dysfunction, in contrast. Risk stratification and targeted interventions in women with PCOS could be achieved by early detection of renal involvement by sensitive biomarkers. The introduction of renal biomarker evaluation as part of the routine clinical evaluation, in combination with lifestyle modification and metabolic optimization, could aid in avoiding the development of overt renal disease. More longitudinal and mechanistic research is needed to confirm these biomarkers and determine their prognostic potential in determining renal outcomes in the long term in PCOS.

Machine Learning Algorithms for Predicting CKD Progression: A Real-World Hospital Dataset Analysis

Fri, 23 Jan 2026 00:00:00 +0000

Background. Chronic Kidney Disease (CKD) is a progressive condition associated with substantial global morbidity and mortality. Early detection remains critical for reducing complications and slowing progression to end-stage kidney disease. Traditional diagnostic approaches depend on laboratory markers that may not fully capture nonlinear interactions among clinical parameters. Machine learning offers promising capabilities for improving early identification and supporting clinical decision-making. Methods. This study developed an end-to-end machine learning framework for CKD prediction using the Early Stage CKD dataset. The workflow included rigorous data preprocessing, exploratory data analysis, and feature engineering prior to model development. A Random Forest classifier was trained using an 80/20 stratified split, and performance was assessed using accuracy, precision, recall, F1-score, confusion matrix, and ROC–AUC. To enhance transparency, SHAP (SHapley Additive exPlanations) analysis was applied to interpret feature contributions and validate clinical relevance. Results. The Random Forest model demonstrated excellent predictive performance, achieving an accuracy of 96.25% and a ROC–AUC of 1.00. The confusion matrix indicated zero false positives and only three false negatives, reflecting strong diagnostic reliability. SHAP analysis identified hemoglobin, serum creatinine, packed cell volume, and specific gravity as the most influential predictors, aligning with established CKD biomarkers. Conclusion. The proposed machine learning framework offers a robust, interpretable approach for early CKD prediction. Its strong performance and explainability make it suitable for integration into real-world clinical decision-support systems, particularly in resource-limited healthcare settings.

Ayurvedic Management of Chronic Kidney Disease: Classical Texts, Herbal Interventions, and Clinical Evidence

Fri, 30 Jan 2026 00:00:00 +0000

Chronic kidney disease (CKD) represents a growing global health challenge characterized by progressive decline in renal function and limited curative options in advanced stages. This article explores CKD through an Ayurvedic and integrative lens, emphasizing classical conceptual frameworks, therapeutic principles, herbal interventions, and contemporary clinical perspectives. Ayurveda conceptualizes renal and urinary disorders within the domain of Mutravaha Srotas dysfunction, arising from metabolic imbalance, impaired digestion (Agnimandya), accumulation of Ama, and progressive Dosha and Dhatu involvement. Such a systems-based understanding aligns closely with the chronic, multifactorial nature of CKD. The article critically examines classical textual references, principles of Ayurvedic management, and the pharmacological rationale underlying herbal and polyherbal formulations used in urinary and metabolic disorders. Emphasis is placed on Chikitsa Siddhanta such as Ama Pachana, Dosha Shamana, and Rasayana therapy, along with the central role of Pathya–Apathya in long-term disease management. Available clinical studies, case reports, and integrative healthcare models are reviewed to assess observed outcomes, safety considerations, and challenges related to evidence generation and standardization. An integrative perspective is proposed, highlighting the potential of Ayurveda to complement contemporary nephrology by offering preventive, supportive, and quality-of-life–oriented strategies for CKD management. At the same time, the article acknowledges limitations in existing evidence and underscores the need for rigorous clinical research, quality control, and interdisciplinary collaboration. Overall, the review suggests that Ayurveda, when applied judiciously and integrated responsibly with modern medical care, may contribute meaningfully to holistic and sustainable approaches for chronic kidney disease.

Renal Safety of Aspirin Versus Aspirin–Clopidogrel Therapy After Myocardial Infarction

Dr Pramod Kulkarni, Dr Yogita Kulkarni, Dr Gajanan P Kulkarni, Dr Ramanand Patil — Fri, 23 Jan 2026 00:00:00 +0000

Antiplatelet treatment is an essential part of secondary prevention following a myocardial infarction where aspirin and aspirin-clopidogrel dual therapy have become common to curb repeat attacks as well as cardiovascular deaths. Although the cardiovascular effects of these regimens are now well-known, their safety on the kidneys is a significant clinical issue, especially in patients with a pre-existing renal susceptibility. Myocardial infarction is commonly followed by hemodynamic instability, inflammation and neurohormonal activation that can put patients at risk of renal dysfunction. In that regard, antiplatelet therapy can impact the renal outcomes either directly or indirectly, particularly, bleeding-related complications. This narrative review presents the existing evidence on the harmfulness of aspirin monotherapy over aspirin-clopidogrel therapy in the aftermath of myocardial infarction. Available evidence indicates that low doses of aspirin are better tolerated renal wise when administered at the right time even in chronic kidney disease patients. Conversely, dual antiplatelet therapy has a higher level of ischemic protection, but has a higher likelihood of bleeding, potentially leading to acute renal failure and the aggravation of renal disease in vulnerable groups. The determinants of renal outcomes are strongly dependent on the initial kidney function, age and burden comorbidity, the duration of treatment, and the factors of the procedure like percutaneous coronary intervention. On the whole, this review highlights that consideration of renal safety in the decision-making of the antiplatelet treatment is essential and that patients should receive tailored therapy, active renal follow-up, and multidisciplinary care to maximize the cardiovascular outcome and reduce renal risk following the occurrence of myocardial infarction.