Background: Rejection continues to be the main cause of renal graft loss. Currently, the gold standard for diagnosis is an allograft biopsy; however, because it is time-consuming, costly, and invasive, the pursuit of novel biomarkers has gained interest. Variation in the expressions of miRNAs is currently considered a probable biomarker for the diagnosis of acute rejection. This study aimed to determine whether miR-150-5p in serum is related to microvascular damage in patients with acute antibody-mediated rejection (ABMR). Methods: A total of 27 patients who underwent renal transplantation (RT) with and without ABMR were included in the study. We performed the quantification of hsa-miR-150-5p, hsa-miR-155, hsa-miR-21, hsa-miR-126, and hsa-miR-1 in plasma by RT-qPCR. The expressions between the groups and their correlations with the histological characteristics of the patients with ABMR were also investigated. Results: miR-150-5p significantly increased in the plasma of patients with rejection (p < 0.05), and the changes in miR-150-5p were directly correlated with microvascular inflammation in the allograft biopsies. Clinical utility was determined by ROC analysis with an area under the curve of 0.873. Conclusions: Our results show that the patients with RT with ABMR exhibited increased expression of miR-150-5p compared to patients without rejection, which could have clinical consequences, as well as probable utility in the diagnosis of ABMR, and bioinformatics may help in unraveling the molecular mechanisms underlying ABMR conditions.

Fungal peritonitis secondary to non-albicans Candida is reported less frequently. There are uncertainties regarding the treatment of non-albicans Candida infection (i.e., preferred route or initial drug). The objective of this study is to determine the clinical characteristics and treatment used in cases of peritoneal dialysis associated fungal peritonitis secondary to non-albicans Candida. We report four cases with different clinical characteristics and different routes of administration of the antifungal drug, with no deaths. In all four patients, there were risk factors similar to those reported worldwide, without presenting the route of administration of the antifungal drug as a risk factor, suggesting that the mainstay of treatment is early initiation of the antifungal drug and early removal of the catheter.

Antibody-mediated rejection (ABMR) remains a major cause of renal graft dysfunction and loss. The histological hallmark of antibody-mediated rejection is progressive tissue damage, in which extracellular matrix turnover plays an important role. This turnover is mainly regulated by matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs). Recent studies suggest that MMP/TIMP imbalance may favor the progression of renal damage, inflammation, and fibrosis, but the utility of these molecules as a biomarker of antibody-mediated turnover has not been fully explored. We measured plasma MMP and TIMP levels by ELISA in 15 patients with antibody-mediated renal transplant rejection and 12 patients without rejection. There was a significant increase in MMP-1, MMP-2, and MMP-3 concentrations in the plasma of patients with rejection, directly correlating with the severity of different renal lesions. In contrast, TIMP-3 levels were elevated in patients without rejection, showing a negative correlation with the severity of histopathological lesions. The concentrations of these molecules demonstrated good diagnostic capacity for patients with rejection. Our results show that MMP-1, MMP-2, MMP-3, and TIMP-3 could be potential biomarkers of rejection.

Background: Urgent-start peritoneal dialysis (UPD) has emerged as an alternative modality for initiating kidney replacement therapy when immediate hemodialysis is not available. However, early initiation after catheter placement may increase the risk of mechanical complications. Evidence from real-world settings, particularly in resource-limited healthcare systems, remains limited. Objective: To determine the frequency of early complications associated with urgent-start peritoneal dialysis and to identify clinical factors associated with their occurrence. Methods: We conducted a prospective observational cohort study including adult patients with chronic kidney disease who initiated peritoneal dialysis within 14 days after catheter placement at a public hospital in Mexico. Patients were followed for 30 days after dialysis initiation. The primary outcome was the occurrence of any dialysis-related complication within 30 days after initiation of peritoneal dialysis. Comparisons were performed according to dialysis initiation timing (<72 h vs. ≥72 h). Multivariable logistic regression was used to identify independent predictors of complications. Results: Sixty-five patients were included, of whom 29 (44.6%) developed complications within the first 30 days. Mechanical complications predominated, particularly pericatheter leakage (18.5%) and drainage failure (10.8%). Patients who initiated dialysis within 72 h after catheter placement experienced a significantly higher complication rate. In multivariable analysis, initiation of peritoneal dialysis within <72 h remained independently associated with complications (OR 5.75, 95% CI 1.06–31.29, p = 0.043). Conclusions: Initiating peritoneal dialysis within 72 h after catheter placement was associated with a significantly increased risk of early complications. When clinically feasible, delaying dialysis initiation beyond 72 h may reduce mechanical complications in urgent-start peritoneal dialysis programs.

Background Acute lymphoblastic leukemia is relatively rare in adults and kidney manifestations are extremely infrequent. Acquired bilateral nephromegaly is a rare condition with many differential diagnoses. We describe the case of a patient with bilateral nephromegaly and spontaneous tumor lysis syndrome secondary to pre-T ALL, who required renal replacement therapy with recovery of renal function following treatment. Case presentation: A 29-year-old man with an unintentional weight loss of 15 kilograms approximately, intermittent fever (one to two episodes per month), right flank pain radiating to the ipsilateral inguinal region, hyporexia and fatigue. An abdominal ultrasound revealed splenomegaly of 15.7 cm and bilateral nephromegaly (right kidney 144 x 105 x 88 mm and left kidney 143 x 82 x 60 mm). After an extensive approach, etiologies like tuberculosis, human immunodeficiency virus infection, hepatitis B, hepatitis C, toxoplasmosis, cytomegalovirus, herpes virus, and Epstein-Barr were excluded. After retroperitoneal lymph node biopsy, pre-T acute lymphoblastic leukemia and also a spontaneous tumor lysis syndrome were diagnosed. After chemotherapy there was improvement and he presented decrease in renal size is observed by imaging study. Conclusion The association between nephromegaly with pre-T acute lymphoblastic leukemia and spontaneous tumor lysis syndrome is very rare. In these cases, a multidisciplinary and integrated approach is required to improve outcomes, especially in terms of disease-free survival and recovery of renal function.