Chenopodium album, commonly known as “lambsquarters,” is a plant consumed as food and used in traditional medicine. Its popularity is increasing due to the belief that it has fewer side effects compared to synthetic drugs. However, its use can lead to acute or chronic poisoning. The growing interest in herbal remedies, along with uncontrolled usage and disregard for expert recommendations, contributes to adverse effects. : A 68-year-old female patient presented to the emergency department with nausea, vomiting, and flank pain following the use of lambsquarters. Impaired kidney function was detected in the patient. A biopsy performed after Chenopodium album usage led to the diagnosis of tubulointerstitial nephritis (TIN). The patient responded positively to corticosteroid and hemodialysis treatment. Caution is necessary in the use of herbal medicines and traditional treatments. A thorough evaluation of factors such as patients’ nutritional status, herbal product usage, medication history, and genetic background is crucial. Chenopodium album can cause tubulointerstitial nephritis, resulting in kidney damage. Similarly, heavy metal poisoning through herbal products can lead to kidney damage. Adopting a multidisciplinary approach in the diagnosis and treatment process can contribute to better patient management. This case presents a rare instance of tubulointerstitial nephritis developed due to the use of herbal products. Physicians should inquire about patients’ history of exogenous substance use and conduct a comprehensive assessment, keeping such situations in mind. Conscious use of herbal medicines and traditional treatments can help prevent serious complications like kidney damage.

Autosomal dominant polycystic kidney disease (ADPKD) is a most common hereditary kidney disorder and a major contributor to end-stage kidney disease (ESKD), but its molecular progression mechanisms are unclear. We performed metabolomic and transcriptomic profiling on a longitudinal cohort of 254 and 47 ADPKD patients, respectively, to identify molecular alterations and then applied Multi-Omics Factor Analysis (MOFA) to uncover coordinated signatures. Disease progression was associated with a marked shift in dysregulated lipids profile, increased acylcarnitines, and increased glycolytic metabolites, suggesting a shift from fatty acid oxidation (FAO) toward glycolysis. Transcriptomic analysis revealed enrichment of PPAR signaling, cytoskeletal remodeling, and cystogenesis, providing a mechanistic link between metabolic alterations and structural dysregulation. Integrative analysis identified a central axis where inflammation, metabolic reprogramming, and cytoskeletal remodeling converges. Our integrated multi-omics analysis defines a molecular framework where transcriptomic dysregulation drives metabolic reprogramming contribute to cystogenesis, providing potential biomarkers and insights to guide precision therapy in ADPKD progression.

Background/Aims: Cardiovascular diseases constitute a significant cause of morbidity and mortality in individuals with autosomal dominant polycystic kidney disease (ADPKD). This study aims to assess the long-term effects of tolvaptan on the kidneys and heart in rapidly progressing ADPKD. Methods: Among 354 patients diagnosed with ADPKD, 58 meeting the eligibility criteria for tolvaptan were included in the study. The study comprised two groups with similar demographic and clinical characteristics: 29 patients receiving tolvaptan treatment and 29 in the control group. Several included genetic analysis, magnetic resonance imaging (MRI), and echocardiography. Clinical and cardiac changes were recorded in both groups after a three year follow-up. Results: Tolvaptan treatment demonstrated a significant reduction in the rate of eGFR decline compared to the control group. Furthermore, it was observed that tolvaptan could prevent the development of cardiac arrhythmias by inhibiting an increase in QTc interval and heart rate. Conclusion: These findings suggest that, in addition to slowing kidney progression in ADPKD management, tolvaptan may potentially benefit in preventing cardiac complications.

The primary effect of tolvaptan therapy in autosomal dominant polycystic kidney disease (ADPKD) is to slow the rate of kidney volume increase and thereby delay progression to end-stage renal disease; however, an actual reduction in kidney volume has rarely been reported. We evaluated four patients with ADPKD who demonstrated a decrease in kidney volume on magnetic resonance (MR) imaging during tolvaptan treatment. This observational case series included four patients who underwent regular clinical and MR evaluations between 2020 and 2025. The diagnosis was confirmed by radiological findings and/or genetic analysis. Total kidney volume was calculated as height-adjusted total kidney volume (htTKV), and renal function was assessed using the estimated glomerular filtration rate (eGFR) calculated by the CKD-EPI equation. The most pronounced reduction in kidney volume was observed in the patient with the highest baseline htTKV. In contrast, biochemical changes were limited, with minimal differences in eGFR ranging from −9 to 0 mL/min/1.73 m2. None of the patients had a history of additional medication use, dialysis, transplantation, or interventional procedures during follow-up. These findings suggest that a decrease in kidney volume may occur in some patients with ADPKD during tolvaptan therapy, highlighting the heterogeneity of treatment response and indicating that changes in kidney volume do not always parallel other clinical parameters. Larger studies are needed to better elucidate the variability in treatment response among patients.

Introduction: This study investigated the clinical characteristics, causative microorganisms, and antibiotic resistance patterns of catheter-related bloodstream infections (CRBSIs) in hemodialysis patients at a tertiary healthcare institution. Methodology: A retrospective analysis of 300 patients treated for CRBSIs between January 2018 and December 2023 was conducted. Patients were divided into two groups: those with less than 1 year of hemodialysis (Group 1) and those with more than 1 year of hemodialysis (Group 2). Risk factors for intensive care unit (ICU) transfer and 28-day mortality were analyzed. Results: The median age was 68 years. Gram-positive bacteria were the predominant pathogens (69%), with Staphylococcus aureus being the most frequent. Group 1 had significantly higher rates of recent hospitalization (p = 0.014) and a history of previous ICU admission (p = 0.001). However, no significant differences were found in causative microorganisms or antimicrobial resistance between the two groups. Risk factors for ICU transfer included carbapenem resistance (OR: 7.657, p = 0.013), history of catheter revision (OR: 4.632, p = 0.022), and leukocytosis (OR: 1.150, p = 0.004). The 28-day mortality rate was 8%. Significant risk factors for mortality were ICU transfer (OR: 17.29; p = 0.001) and Vancomycin-Resistant Enterococcus (VRE) infection (OR: 14.10; p = 0.002). Conclusions: Despite shorter-term dialysis patients having more frequent hospitalizations, the distribution and resistance of pathogens remain similar regardless of hemodialysis duration. Empirical therapy should prioritize broad anti-staphylococcal coverage and be tailored to specific risk factors such as VRE or carbapenem resistance rather than hemodialysis duration.