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Background Primary membranous nephropathy (pMN) is one of the most common types of glomerulonephritis, with a third of patients progressing to renal insufficiency. Various prognostic factors have been reported, of which urinary protein and renal function are the most critical parameters. Fractional excretion of total protein (FETP) indicates protein leakage that accounts for creatinine kinetics and serum protein levels. In this study, we investigated the association between FETP and renal prognosis in pMN. Methods We retrospectively identified 150 patients with pMN. FETP was calculated as follows: (serum creatinine × urine protein)/(serum protein × urine creatinine) %. We divided the patients into three groups according to FETP values and compared the clinicopathological findings. The primary outcome was an estimated glomerular filtration rate (eGFR) decrease of ≥30% from the baseline level. Results FETP was associated with urinary protein and renal function, Ehrenreich and Churg stage, and global glomerulosclerosis. The primary outcome was observed in 38 patients (25.3%), and the frequency of the primary outcome was higher in the high FETP group (P  = .001). FETP is higher than protein–creatinine ratio (PCR) in the area under the curve. In the multivariate analysis adjusted for age, eGFR, PCR and treatment, FETP was significantly associated with primary outcome (adjusted hazard ratio, 8.19; P  = .019). Conclusions FETP is a valuable indicator that can reflect the pathophysiology and is more useful than PCR as a predictor of renal prognosis in patients with Japanese pMN. [ABSTRACT FROM AUTHOR]

This article explores the potential link between COVID-19 vaccination and gross hematuria (blood in urine) in patients with immunoglobulin A nephropathy (IgAN). The study included 459 adult IgAN patients who received COVID-19 mRNA vaccinations, with 37% of them having a history of gross hematuria before vaccination. The results showed that there was no significant difference in the prevalence of gross hematuria after vaccination between patients with and without a history of gross hematuria. The study suggests that the factors governing the sensitivity to gross hematuria after vaccination and the natural history of IgAN may not be identical. However, the study has limitations, such as relying on patient reports and being conducted mostly on Japanese patients, so further research is needed to understand the immunological pathways involved in the development of gross hematuria due to infection or vaccination in IgAN patients. [Extracted from the article]

Background: Few studies have addressed the efficacy of nephroureterectomy for managing upper tract urothelial carcinoma (UTUC) in very elderly patients (those aged 85 years and older). We aimed to elucidate the association between age and clinical outcomes in patients with UTUC who underwent radical nephroureterectomy., Methods: We retrospectively analyzed data from 847 patients who underwent nephroureterectomy for UTUC. These patients were classified into four age brackets: young (≤64 years, n=177), intermediate (65-74 years, n=300), elderly (75-84 years, n=312), and very elderly (≥85 years, n=58). We applied logistic regression models to ascertain predictors of postoperative complications. Cox's proportional hazards models were used to evaluate key prognostic factors affecting non-urothelial tract recurrence-free survival (NUTRFS), cancer-specific survival (CSS), and overall survival (OS)., Results: In all, 56 patients reported postoperative complications. An Eastern Cooperative Oncology Group performance status ≥2 was identified as a significant predictor for postoperative complications whereas age did not show a noteworthy correlation. Kaplan-Meier survival analyses indicated that very elderly patients had notably poorer OS than younger groups. Nevertheless, the differences in NUTRFS and CSS across the age brackets were not statistically significant. In multivariable analyses, very elderly age was a substantial independent determinant of OS but not NUTRFS or CSS., Conclusions: The therapeutic benefits of surgical procedures are relatively consistent across age groups. This underscores the potential of considering surgical treatment for UTUC in patients aged 85 and above, provided they are deemed fit to withstand the surgical rigors and associated invasiveness., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://tau.amegroups.com/article/view/10.21037/tau-24-37/coif). The authors have no conflicts of interest to declare., (2024 Translational Andrology and Urology. All rights reserved.)

Match demands in international men's lacrosse have yet to be explored. Therefore, this investigation quantified positional match demands of international men's lacrosse. This study quantified activity profiles of 50 lacrosse players [attack (AT): 11, midfield (MD): 22, defense (DF): 17] on Japan's national team, using a global positioning system (GPS), players' acceleration, and a heart rate (HR) apparatus to investigate their movement and physiological load. The study revealed that in thirteen international matches, distance, walk distance, jog distance, low-intensity acceleration, and low-intensity deceleration for the AT and DF groups was significantly greater than for the MD group, but the MD group's average speed and sprint distance were the highest. Multiple comparison tests showed that measurements for the AT and DF groups were significantly greater than the MD group for distance, low-intensity acceleration, medium-intensity decelerations, and low-intensity deceleration. This data can become the physical data for helping coaches with strength and conditioning training at the international level. For MD players, anaerobic power and load condition (long rest, high intensity) should be emphasized. In addition, coaches can decide on tactics and a running-quantity target for the next game by acquiring continuous activity data.

Introduction: Alterations in glomerular filtration can considerably influence the dynamics and functions of the Bowman capsule. Despite the potentially important role in maintaining normal renal functions, few studies have focused on Bowman capsule volume in normal human kidneys., Methods: We analyzed specimens from biopsies performed 1 hour after kidney transplantation from living donors without apparent renal disease. The measurements of all cross-sectional areas of the Bowman capsules and glomerular capillaries were used to estimate the mean Bowman capsule volume (BV) and glomerular capillary volume (GV) in each subject. The G/B ratio was defined as the ratio of GV to BV. The morphometric findings were examined in relation to the clinical findings in donors just before kidney transplantation., Results: We analyzed 37 adults with a mean creatinine clearance of 111 ml/min. The mean BV and GV of these subjects were 6.10 ± 2.46 × 10 6 μm 3 and 3.83 ± 1.52 × 10 6 μm 3 , respectively. Both the BV and GV varied up to 6-fold and were significantly higher in elderly, obese, or hypertensive subjects in comparison to nonelderly, nonobese, or normotensive subjects, whereas the renal function of each subgroup was similar. The G/B ratio (0.63 ± 0.05) was unaffected, and BV and GV were strongly correlated regardless of these clinical factors ( r  = 0.980 [95% confidence interval = 0.961-0.990], P  < 0.001)., Conclusion: In the normal adult kidney, there may be an optimal BV to GV ratio for maintaining effective filtration in a variety of clinical situations, including advanced age, obesity, and hypertension.