Nephrotic syndrome is a clinical syndrome characterized by massive proteinuria, called nephrotic range proteinuria (over 3.5 g per day in adults or 40 mg/m² per hour in children), hypoalbuminemia, oncotic edema, and hyperlipidemia, with an increasing incidence over several years. Nephrotic syndrome carries severe morbidity and mortality risk. The main pathophysiological event in nephrotic syndrome is increased glomerular permeability due to immunological, paraneoplastic, genetic, or infective triggers. Because of the marked increase in the glomerular permeability to macromolecules and the associated urinary loss of albumins and hormone-binding proteins, many metabolic and endocrine abnormalities are present. Some of them are well known, such as overt or subclinical hypothyroidism, growth hormone depletion, lack of testosterone, vitamin D, and calcium deficiency. The exact prevalence of these disorders is unknown because of the complexity of the human endocrine system and the differences in their prevalence. This review aims to comprehensively analyze all potential endocrine and hormonal complications of nephrotic syndrome and, vice versa, possible kidney complications of endocrine diseases that might remain unrecognized in everyday clinical practice.

Background: Postoperative macular edema may limit visual recovery following cataract surgery. Although smoking is recognized as a risk factor for ocular inflammation, its impact on early postoperative macular morphology following cataract surgery has not been investigated. Methods: This prospective cohort study enrolled 88 elderly patients undergoing elective cataract surgery in a single university teaching hospital. The patients were divided into long-term smokers and lifelong non-smokers. Spectral-domain optical coherence tomography (OCT) was used to assess the central subfoveal thickness (CST), cube volume (CV), cube average thickness (CAT), retinal nerve fiber layer (RNFL), and cup-to-disk ratio (CDR) preoperatively and on the 1st, 7th, and 14th postoperative days (PODs). The phacoemulsification time and cumulative dissipated energy were recorded. Linear mixed-effects models were used to assess group-by-time interactions, and multivariable regression, adjusted for baseline covariates, was employed for analyses. Results: Eighty patients were included in the final analysis. Smokers had significantly thinner baseline CST than non-smokers. Both groups showed early postoperative CST increases, but only smokers exhibited sustained and significantly greater increases in CV and CAT on POD 14 (CV Δ +0.30 mm³ vs. +0.04 mm³; p = 0.026; CAT Δ +6.5 µm vs. +1.2 µm; p = 0.037). The RNFL and CDR changes did not differ significantly at earlier timepoints. However, smokers showed a notably greater RNFL thickening on POD 14 (Δ +4.2 µm; p = 0.001). Smoking status remained the strongest independent predictor of these changes (p < 0.001), while phacoemulsification parameters showed no significant interaction effects. Conclusions: Cigarette consumption independently predicts pronounced postoperative macular and RNFL thickening after uncomplicated elective cataract surgery. These transient structural changes could complicate early glaucoma assessment and should be considered when interpreting postoperative OCT findings in smokers.

Background: Allergic rhinitis (AR) is commonly treated with intranasal and oral pharmacotherapy or allergen immunotherapy (AIT), each associated with distinct safety considerations. This study aimed to systematically evaluate and compare the safety profiles of these therapeutic approaches by analysing adverse events (AEs) reported in completed randomised controlled trials (RCTs). Methods: A meta-epidemiological analysis was conducted using completed RCTs registered in ClinicalTrials.gov up to 20 October 2023. Trials investigating intranasal drugs, oral medications, or AIT for AR were identified using predefined search terms. Adverse events were manually extracted and categorised according to treatment class and dosage. Other adverse events (OAEs) were classified using Common Terminology Criteria for Adverse Events version 5.0 (CTCAE v5.0) and Medical Dictionary for Regulatory Activities (MedDRA) terminology. Meta-analyses compared OAE incidence across treatment groups, including standard-dose, higher-dose, and placebo arms. Results: A total of 216 RCTs were included. Intranasal therapies accounted for 55.56% of trials, predominantly intranasal corticosteroids (INCS) and intranasal antihistamines (INAH). OAE incidence was 16.37% for INCS, 29.43% for INAH, and 8.71% for combination therapy. INAH was associated with higher rates of dysgeusia and nasal discomfort, while higher INCS doses were linked to an increased risk of urinary tract infections. AIT trials comprised 22.69% of studies and demonstrated higher OAE rates, particularly for sublingual immunotherapy (64.96%), followed by subcutaneous (53.98%) and intralymphatic immunotherapy (62.50%). Oropharyngeal AEs were most frequent with sublingual immunotherapy. Oral medications (18.06%) showed the lowest OAE incidence, with upper respiratory tract infections occurring more frequently with oral antihistamines. Conclusions: Among intranasal therapies, INCS demonstrated the most favourable safety profile. Sublingual immunotherapy was associated with a higher frequency of OAEs compared with other AIT modalities. Combination oral antihistamine and leukotriene receptor antagonist therapy appeared to be the safest oral treatment option. Further well-designed studies are needed to refine comparative safety assessments across AR treatments.