Introduction:Although genetic testing is increasingly used in evaluating living kidney donor (LKD) candidates and recipients, objective data on genetic testing practices are limited. This study aimed to describe current genetic testing practices in LKD evaluation using data from the international living donor genetic registry. Methods:A research electronic data capture (REDCap) registry was developed to collect cross-sectional, deidentified information on LKD candidates and genetic test results. Participating centers registered candidates meeting at least 1 of the following criteria: (i) underwent genetic testing; (ii) family history of genetic kidney disease; and/or (iii) were evaluated to donate to a biologically related recipient with kidney disease of unknown etiology. Data were collected between June 1, 2023 and November 10, 2025. Results:Among 1259 LKD evaluations from 24 centers (10 US, 14 international), genetic testing was performed in 295 (23.4%). US donor candidates were younger (median 39 vs. 48 years, P < 0.001). Testing strategies differed by region as follows: international centers predominantly used recipient-first testing (92.1%), whereas US centers more often performed direct LKD testing (61.5%; P < 0.001). These differences persisted after excluding apolipoprotein L-1 (APOL1) testing, with direct LKD candidate testing remaining more common in US (34.0% vs. 7.9%; P < 0.001). Among tested LKD candidates, 20.7% (61/295) were not approved for donation, with 7.8% (23/295) attributed to genetic findings. In multivariable analysis, younger donor age was independently associated with LKD nonacceptance (adjusted odds ratio [OR]: 0.89 per-year; 95% confidence interval [CI]: 0.83-0.95; P < 0.001). Conclusion:Genetic testing practices vary substantially across regions, with US centers favoring direct LKD testing and international centers using recipient-first approaches. Younger donor candidate age was independently associated with nonacceptance.

INTRODUCTION:Arterial stiffness, typically measured by pulse wave velocity (PWV), is a recognized biomarker of cardiovascular (CV) risk and mortality. Our study assesses the predictive value of arterial stiffness measured by estimated pulse wave velocity (ePWV) for fatal and nonfatal outcomes in a general rural adult population. METHODS:This prospective observational cohort study was conducted within the ENAH project, which initially included 3,305 adults, with 2,232 participants followed up over a median of 11.3 years. Baseline demographic, clinical, and laboratory data, including blood pressure, anthropometry, and biochemical analyses of blood and urine, were collected using standardized protocols. The primary outcome was all-cause mortality, while secondary outcomes comprised nonfatal CV, cerebrovascular, and renal events, analyzed using Kaplan-Meier survival curves and multivariable regression models. RESULTS:In this cohort of 1,175 adults followed for a mean of 11.3 years, 263 participants died (22.4%), and 171 (14.5%) experienced a nonfatal event (myocardial infarction, atrial fibrillation, heart failure, stroke, transient ischemic attack, or dialysis). Kaplan-Meier analysis showed lower survival in participants with ePWV of >10 m/s compared to those with ePWV of <10 m/s (hazard ratio [HR] = 12.8, 95% CI 9.9-16.6, p < 0.001). Similarly, event-free survival was lower for nonfatal outcomes in the higher ePWV group (HR = 1.50, 95% CI 1.0-2.1, p = 0.008). In multivariable analysis for mortality, male sex and ePWV remained significant predictors (HR 1.75, 95% CI 1.18-2.61, p = 0.006; HR 1.81, 95% CI 1.08-3.04, p = 0.030). No independent predictors were found for nonfatal outcomes. However, for the composite endpoint, both male sex (HR = 1.54, 95% CI 1.14-2.08, p = 0.006) and ePWV (HR = 1.94, 95% CI 1.50-2.51, p < 0.001) were associated with increased risk. CONCLUSION:ePWV was an independent predictor of overall mortality as well as composite fatal and nonfatal outcomes. These findings suggest that this simple measure of arterial stiffness may be useful in clinical practice, particularly in rural settings where direct measurements are not available.

BACKGROUND:This article compares the incidence and prevalence of kidney replacement therapy (KRT), kidney transplantation rates and mortality on KRT between Europe and the USA, including sex comparisons. METHODS:Data were derived for 2022 from the population-based European Renal Association (ERA) Registry and the United States Renal Data System (USRDS). RESULTS:In 2022, the KRT incidence in the USA [388.7 per million population (pmp)] was 2.7-fold higher than in Europe (146.2 pmp), with a greater difference for women (3.2-fold) than for men (2.4-fold). The proportion of women initiating KRT was lower in Europe (35%) than in the USA (41%). Between 2013 and 2022, the KRT incidence in Europe was stable in women (+0.1% annually) but increased in men (+1.1%). In the USA, the KRT incidence increased similarly in women (+0.2%) and men (+0.3%). On 31 December 2022, the KRT prevalence was 2-fold (women 2.2-fold, men 1.9-fold) higher in the USA (2444.2 pmp) than in Europe (1218.6 pmp). The proportion of women was lower in Europe (38%) than in the USA (41%). The kidney transplantation rate was 1.7-fold higher in the USA (79.1 pmp) than in Europe (45.4 pmp), 1.9-fold for women and 1.7-fold for men, with women accounting for 37% of the recipients versus 39% in the USA. The KRT mortality rate was 1.5 times higher in the USA [145.0 per 1000 patient-years (py)] compared with Europe (100.5 per 1000 py): 1.6-fold for women and 1.4-fold for men. In Europe, mortality was lower for women receiving KRT (93.7 per 1000 py) than for men (104.6 per 1000 py), whereas in the USA the reverse was true (women 148.9 per 1000 py, men 142.2 per 1000 py). CONCLUSION:The US had a notably higher KRT incidence, prevalence, kidney transplantation rate and mortality compared with Europe. Differences between Europe and the USA were larger for women than for men.

There is no medical field where the impact of medical evolution is more palpable than in kidney transplantation. The pioneers of this procedure, 70 years ago, laid out the foundation for organ transplantation in general and kidney transplantation in particular. Despite the incredible advancements that have been made since, huge differences exist worldwide in terms of access, equity and quality of care. Nowhere are these disparities more prominent than in developing countries with limited resources, underfunded healthcare systems and transplantation infrastructures, particularly the Western Balkans. This position paper delineates the biggest barriers hindering the development of kidney transplantation in the Western Balkans, put forth and agreed upon by a group of regional experts on the field, based on the Modified Delphi Method. Limitations in training, infrastructure, restrictive and outdated legislative practices, lack of a centralized coordination network and fragmented regional collaboration, emerged as the principal challenges. Endorsed by European Society for Organ Transplantation (ESOT), this paper outlines a pragmatic and practical framework to overcome these obstacles, towards building robust and sustainable transplantation programs that ensure high-quality and equitable access to kidney transplantation, for all patients in this region.

Although significant progress has been made in reducing salt consumption over the past decade, most Croatian adults still exceed the recommended intake. This study aimed to identify demographic, socioeconomic, lifestyle, and clinical factors associated with high salt intake in the general adult population of Croatia. We included a random sample of 1067 adults with reliable 24-h urine samples. A structured questionnaire was used to collect sociodemographic, lifestyle, and clinical data. Anthropometric and blood pressure (BP) measurements were performed. Laboratory analyses included the measurement of sodium, potassium, and creatinine in adequate 24-h urine samples, as well as relevant cardiometabolic and kidney-related biomarkers. Participants consuming > 10 g/day of salt were older and had higher systolic blood pressure, fasting glucose, serum uric acid, and triglyceride levels, lower HDL cholesterol levels, and greater BMI. High salt intake was more common among men, ex-smokers, participants with diabetes, and those with lower socioeconomic status (SES). In multinomial logistic regression analysis, male sex, diabetes, higher systolic BP, more frequent processed meat consumption, lower fish consumption, residence outside the Adriatic region, and higher ePWV were associated with high salt intake. High salt intake was associated with lower socioeconomic status, residence in rural and continental areas, obesity, former smoking, and less favorable dietary patterns. Conversely, lower salt intake was associated with residence in the Adriatic region and dietary patterns characterized by more frequent consumption of fish and olive oil.

Testicular cancer (TC) is the most common type of cancer among young men aged 25 to 45. This study represents the first population study of TC in kidney transplant recipients (KTRs). We conducted a multicentric, multinational, cross-sectional study across nine transplant centers in Croatia, Serbia, Montenegro, Slovenia, and Bosnia and Herzegovina. All KTRs over 18 years old who were regularly monitored at their transplant centers were included. Data were collected from electronic medical records at these centers. Out of the 4426 KTRs who participated in our study, six (0.14

The main aim of this study was to determine correlation between parameters of arterial stiffness measured in the office (SphygmoCor) and during 24 h (Mobil-O-Graph and Arteriograph) with hemodynamic and cardiac parameters in the group of young and middle-aged patients with stage 1 primary hypertension. This study included 154 patients (average age 38.75 ± 12.65 years, 69.5