To examine the longitudinal association between medicinal plants consumption and the risk of incident self-reported chronic nephritis in older Chinese adults. This prospective cohort study included 13,451 participants aged ≥65 years without chronic nephritis at baseline from the Chinese Longitudinal Healthy Longevity Survey (2008–2018). Baseline medicinal plants consumption was categorized as rare/never (n = 11,244), occasional (n = 1778), or frequent (n = 429) use. The primary outcome was incident self-reported chronic nephritis over 10 years of follow-up, with death as a competing risk. Fine-Gray subdistribution hazard models (sHR) and cause-specific Cox models (csHR) were used to estimate associations. Incident chronic nephritis occurred in 609 (5.4
Finerenone, a non-steroidal mineralocorticoid receptor antagonist (nsMRA), reduces composite kidney, and cardiovascular endpoints in diabetic CKD. Its efficacy and safety across non-diabetic CKD aetiologies remain uncharacterised in prior meta-analyses. Four databases were searched to May 2026. RCTs and observational studies enrolling adults with non-diabetic CKD receiving finerenone were eligible. Two streams were used: Stream A (single-arm) and Stream B (comparative, finerenone vs. controls). The primary outcomes were eGFR slope/12-month change and proteinuria reduction; safety outcomes were hyperkalaemia, hypotension, adverse events, and discontinuation. Random-effects models (Hartung-Knapp), ROB-2, Newcastle–Ottawa Scale, GRADE, and TSA were applied. Nine studies (N = 2020) met eligibility, including two RCTs (the placebo-controlled FIND-CKD trial (n = 1584) and an open-label crossover pilot), alongside seven observational studies. Finerenone significantly slowed eGFR decline in the RCT (slope difference +0.70 mL/min/1.73m2/year, 95
Chronic kidney disease (CKD) leads to multiple metabolic disorders which raise both the cardiovascular and non-cardiovascular mortality, especially in end-stage kidney disease (ESKD) patients. Among the dysmetabolic CKD-associated patterns, dyslipidemia shows a wide spectrum of clinical concurrent presentations, involving high serum levels of triglycerides, cholesterol, and lipoproteins such as Lp(a). International consensus statements and guidelines have highlighted the increased cardiovascular risk associated with higher serum Lp(a) levels > 105 nmol/L due to its pro-atherosclerotic and pro-thrombotic effects. Therefore, its assessment should be recommended at least once in a lifetime, due to the relative stability of Lp(a) serum levels over time. CKD is associated with increased Lp(a) concentrations, which rise as the estimated glomerular filtration rate (eGFR) and/or urinary albumin-to-creatinine ratio (UACR) worsen. Consequently, Lp(a) levels may be five-to-tenfold higher in patients with ESKD than in those with mild-to-moderate CKD. This alteration is mainly attributable to impaired renal clearance of Lp(a) and apolipoprotein(a) [Apo(a)] particles and, under specific conditions, to increased hepatic Lp(a) production, as observed in severe proteinuric diseases. Conversely, Lp(a) genetic determinants of elevated Lp(a) levels and increased serum Lp(a) concentrations have been investigated as potential causes of CKD onset, through Mendelian randomization (MR) and prospective studies, respectively. However, uncertainty and important gaps in the available evidence still remain. The aim of this review is to summarize and discuss the most recent and relevant clinical and experimental evidence on this topic through a defined research among the scientific literature.
Piezo1, a crucial mechanosensitive cation channel, plays a central role in mechanoreception and signal transduction within the urinary system. Owing to its distinctive three-dimensional propeller-like structure, this channel converts mechanical stimuli (e.g. urodynamics, bladder pressure, and urethral tension) into bioelectrical and chemical signals, thereby contributing to the regulation of physiological functions across multiple components of the urinary tract. This review first examines the biophysical properties and structural mechanisms of Piezo1, with particular emphasis on its sophisticated “force-from-lipid” gating mechanism and its modulation by the lipid membrane environment and the cytoskeleton. We then discuss the expression profiles of Piezo1 throughout the urinary system. In the kidney, Piezo1 contributes to the regulation of filtration and reabsorption by sensing shear stress from tubular fluid, and its dysregulation has been associated with pathological conditions such as renal fibrosis. In the bladder, it functions as a primary mechanosensor in the urothelium, mediating the perception of bladder filling and initiating the micturition reflex. Additionally, the roles of Piezo1 in the urethra and prostate have garnered significant attention. Dysfunction of this channel is associated with the occurrence and progression of various urinary diseases, including renal injury and bladder dysfunction, making Piezo1 a highly promising therapeutic target. The development of specific modulators (e.g. GsMTx4 and Yoda1), together with interventions targeting related Ca2⁺-signalling pathways, offers new directions for the diagnosis and treatment of urinary system diseases.
Prostate Imaging after Focal Ablation (PI-FAB) and Transatlantic Recommendations for Prostate Gland Evaluation with Magnetic Resonance Imaging After Focal Therapy (TARGET) scoring systems have been recently developed to improve detection of post-ablation recurrence of clinically significant prostate cancer (csPCa). However, it is unknown how these two scoring systems compare in clinical practice. Patients who underwent focal therapy (FT) for prostate cancer (PCa) and had post-FT MRI and biopsy were identified from a prospective registry. Post-FT MRIs were reviewed by two radiologists blinded to biopsy results using the PI-FAB and TARGET systems with scores of 3 and ≥ 4, respectively considered positive for csPCa. csPCa recurrence was defined as ≥ Gleason 3+4 (Grade Group [GG] 2) on biopsy. Diagnostic performance metrics, including sensitivity/specificity/positive predictive value (PPV)/negative predictive value (NPV)/accuracy, were calculated. Area under the receiver operating characteristic curve (AUC) was generated using logistic regression and compared using DeLong’s tests. Inter-reader agreement was assessed with Cohen’s Kappa (κ). 90 patients were eligible. Radiologist #1 showed PI-FAB sensitivity/specificity/PPV/NPV/accuracy/AUC of 67
