The association between body mass index (BMI) and chronic kidney disease (CKD) is well established in middle-aged and older adults. Here, we assess the association of BMI in late adolescence with CKD, kidney failure, and acute kidney injury (AKI) later in life. Population-based cohort study including data from the Swedish Conscription Database, the National Patient Register, the Cause of Death Register, and Statistics Sweden. Conscripts with no history of diabetes, cardiovascular, kidney, or rheumatic diseases enlisted between 1969 and 1997 were followed until December 31, 2019. The study examined the impact of BMI on kidney outcomes. The primary outcome was incident chronic kidney disease. Secondary outcomes were stage 5 chronic kidney disease, end-stage kidney disease, and acute kidney injury. Patients were stratified into the quintiles of BMI at conscription, and followed until events, death, or censoring, using Cox proportional hazards model, adjusted for baseline systolic and diastolic blood pressure, proteinuria, and socioeconomic factors. In total, 1,321,481 male participants with a mean age of 18.3 years and a mean BMI of 21.6 kg/m² were followed for an average of 35.6 years, generating a total of 47 million person-years of follow-up. During this period, the incidence of CKD-based on diagnosis codes was 5,590, whereas 2,357 subjects were diagnosed with end-stage kidney disease and 8,023 with AKI, respectively. The risk for CKD was increased for the fourth and fifth highest BMI quintile relative to the lowest (adjusted hazard ratio [aHR] 1.23; 95% confidence interval [CI], 1.13-1.35 for BMI 21.9-23.5 kg/m²; aHR 2.09; 95% CI, 1.93-2.26 for BMI >23.5 kg/m²). Patterns were similar for stage 5 CKD and end-stage kidney disease, whereas the risk for AKI was evident at the third and higher quintiles (aHR 1.14; 95% CI, 1.06-1.23 for BMI 20.7-21.9 kg/m²; aHR 1.31; 95% CI, 1.22-1.41 for BMI 21.9-23.5 kg/m²; and aHR 1.92; 1.79-2.05 for BMI ≥23.5 kg/m²). A retrospective observational study of male Swedish adolescents. The findings of this study indicate that, for prevention of kidney disease, the optimal BMI in adolescence with reference to kidney outcomes is likely in the low-normal range.

Dent disease is a rare renal tubular disorder that appears almost exclusively in males. The diagnosis is still challenging, and therefore Dent disease is occasionally misdiagnosed. We report a case of a 45-year-old man with Dent disease who developed renal failure. Since the age of 7 months, he persistently exhibited proteinuria. At the age of 24 years, he underwent kidney biopsy, which revealed focal segmental glomerulosclerosis. The patient’s brother was found to have proteinuria since he was 2 years old. At the age of 45 years, the patient was transferred to a tertiary care nephrologist, and Dent disease was suspected. Genetic testing revealed a CLCN5 mutation. We highlight the broad spectrum of clinical manifestations in Dent disease and the importance of having a high clinical suspicion to attain a definitive diagnosis. Furthermore, future research regarding the clinical course of the disease, prognosis, and effective treatment options is needed.

Our case series showed that eculizumab is efficacious and safe in treating thrombotic microangiopathy, as well as it has positive effects on quality of life. Further extensive studies are required to develop unified treatment guidelines.

Background/Objectives: Arteriovenous grafts (AVGs) are critical for hemodialysis access in patients with inadequate native vasculature. The Xeltis aXess graft, a novel bioresorbable vascular access conduit, promotes endogenous tissue restoration. While early outcomes have been promising, longer-term data remain limited. This report presents the longest reported, four-year follow-up on two of the first implanted aXess devices. Case Summaries: Case 1: A 64-year-old woman underwent aXess graft placement on 10 June 2021, between the right brachial artery and vein. She experienced graft thrombosis after 12 months and 18 months, both of which were successfully resolved with thrombectomy, in one instance in combination with drug-coated balloon (DCB) angioplasty. The graft remains functional. Case 2: A 76-year-old man received an aXess graft on 11 June 2021, in the left arm. After 6 months, he underwent balloon and DCB angioplasty for graft–vein (G–V) anastomosis stenosis. After 28 months, to resolve multiple pseudoaneurysms, followed by aneurysm resection and AVG reconstruction at month 29, a tunneled catheter was placed to perform dialysis sessions in the meantime. At month 44, graft-venous (G–V) angioplasty with DCB was performed to resolve G–V and axillary vein stenoses diagnosed at month 43. The graft remains in use. Results: Both patients retained functional dialysis access after four years, despite requiring multiple interventions for thrombosis, stenosis, and pseudoaneurysms. Conclusions: These cases demonstrate that the aXess graft can maintain functionality over four years with appropriate management, although close surveillance and reinterventions may be required.

Our case series showed that eculizumab is efficacious and safe in treating atypical hemolytic-uremic syndrome, as well as it has positive effects on quality of life. Further extensive studies are required to develop unified treatment guidelines.

Įgimtos širdies ydos – vienos dažniausiai diagnozuojamų raidos ydų, nustatomos 8–10 iš 1 000 kūdikių. Sudėtingų įgimtų širdies ydų diagnostika iki gimimo lemia mažesnį naujagimių sergamumą ir mirštamumą ankstyvuoju laikotarpiu. Įprastai vaisiaus širdies yda įtariama atrankinio vaisiaus ultragarsinio tyrimo metu, tikslinama atliekant detalųjį vaisiaus širdies ultragarsinį tyrimą. Vaisiaus stebėsena, gydymo taktika ir prognozė priklauso nuo teisingos ir išsamios diagnozės, todėl labai svarbu, kad vaisiaus echokardiografijos duomenys būtų kuo tikslesni. Vis dėlto, diagnostika išlieka sudėtinga dėl vaisiaus širdies ultragarsinio tyrimo specifikos, skirtingo prenatalinių ir ponatalinių ydų spektro hemodinamikos savitumų, kompleksinių ydų anatomijos sudėtingumo, ydų progresavimo galimybės nėštumo laikotarpiu, kai kuriais atvejais – gretutinių raidos ydų bei ligų. Straipsnyje išanalizuoti trys Vilniaus universiteto Santaros klinikose gydytų naujagimių, kuriems dar iki gimimo įtartos sudėtingos širdies ydos, klinikiniai atvejai (pasirinkti atvejai, kurių prenatalinė ir ponatalinė diagnozės skyrėsi). Palyginti sudėtingų įgimtų širdies ydų prenatalinės ir ponatalinės diagnozės panašumai ir skirtumai, įvertintas vaisiaus echokardiografijos tikslumas, atlikta literatūros apžvalga.