Acute intermittent porphyria (AIP) is a rare disorder with diverse clinical presentations, ranging from latent at-risk individuals to recurrent acute attacks with severe complications. Differences between clinical states and risk factors for severe outcomes remain incompletely defined. In this cross-sectional study, personal, biochemical and clinical data were recorded for non-givosiran treated AIP patients across all clinical states by European porphyria expert centres into the European Porphyria Registry during 2012-2018. Logistic regression models assessed associations between clinical factors and outcomes, with disease states defined according to clinical practice at study initiation. Urinary δ-aminolevulinic acid (u-ALA) and porphobilinogen (u-PBG) were normalized to each centre's upper reference limits. Data from 239 participants were included and patients were classified as sporadic attack(s) (n = 61), recurrent (n = 49), in-remission (n = 58), asymptomatic high excreters (n = 23) and latent at-risk (n = 48). Hospitalization for an acute attack was associated with ≥ 10-fold u-PBG increase (adjusted Odds Ratios [aOR] = 22.40, 95% CI = 5.34-94.03), 4-9-fold (6.35 [2.87-14.02]) and ≥ 10-fold (177.50 [8.03-3923]) u-ALA increase, BMI < 18.5 (12.68 [2.86-56.23]) and age 20-39 (4.35 [1.82-10.42]). A 10-fold u-PBG increase (8.22 [2.31-29.28]) and a positive family history at diagnosis (0.30 [0.14-0.64]) were associated with recurrent classification. Recurrent AIP (7.28 [2.77-19.14]) and sporadic heme-treated acute attacks (5.30 [1.89-14.91]) were associated with reduced work capacity and unemployment. Chronic hypertension, chronic kidney disease and primary liver cancer were observed across all clinical groups. In this multicentre European study, we describe disease burden across all clinical AIP states including non-givosiran treated recurrent patients and identify risk factors associated with hospitalization and recurrent disease.

G-560 Development and Validation of a Nutrition Knowledge, Attitudes, and Practices Survey for Adults With Chronic Kidney Disease

Chronic Obstructive Pulmonary Disease (COPD) is a major cause of healthcare system use and related cost. While pulmonary rehabilitation (PR) is efficient, maintenance programs (PR-MA) can maintain the benefits over time. Yet, the long-term impact (>36 months) of PR-MA on healthcare resource and cost has never been assessed. Recently, a PR-MA program based on self-help associations has shown a clinical efficacy beyond 36 months, Thus, we aimed to assess the effect of this PR-MA program on long-term hospitalizations and costs versus usual care (PR-UC). We performed an ancillary analysis of the post-rehabilitation LTAir+R cohort study, which compared a PR-MA group (n=144) to a matched PR-UC group (n=137) of COPD patients. Data were collected in 82 PR-MA and 93 PR-UC patients, from the Montpellier University Hospital database and patient records over 60 months, including hospitalizations, consultations, emergency visits, and associated costs. In PR-AM vs. PR-UC group, the hospitalization probability reduction almost reached significance (hazard ratio: 1.68; p=0.05). The costs of each hospitalization day (867±116 vs. 1213±138 euros/day; p<0.05), emergency visits (8±5 euros/year vs. 12±3 euros/year) and medical consultations (110±3 vs. 174±3 euros/year; p<0.01) were significantly lower in the PR-AM vs. PR-UC group. Last, PR-MA mitigated the increase in total hospitalizations (p<0.001) associated with the follow-up duration. In addition to its long-term clinical efficacy, this PR-MA program showed a positive impact on hospitalization and healthcare use costs. The effect on hospitalization number and costs could be larger in patients with the longest PR-MA adherence.

Α-Hederin alleviates psoriasiform skin inflammation by inhibiting NF-κB p65/CXCL2 Axis.

The degree to which computerized methods, such as artificial intelligence (AI), will aid in the assessment of kidney histopathology is undergoing intense study and application; and this is particularly true for interstitial fibrosis, which is often used as a surrogate measure of chronic kidney disease progression, since interobserver variability among human pathologists has been demonstrated in the assessment of interstitial fibrosis and other features. Computerized assessment of interstitial fibrosis, including with AI, has been assessed alongside pathologists. Computerized methods such as AI have shown direct interstitial fibrosis measurement and indirect assessment through kidney compartment segmentation; however, some studies have shown lack of complete concordance among computerized methods and humans; and studies have still shown the persistent value of human assessment in many circumstances. Computerized methods, including AI, are showing increased application in kidney pathology for a wide variety of clinical and histopathologic parameter assessment, including interstitial fibrosis; however, further studies are needed to characterize the performance of AI and handcrafted methods; and additional work is needed to fully integrate computerized methods into routine pathology practice. Ultimately, humans working with AI ("humans + AI") may provide enhanced analysis for more effective patient care.

Evaluation of serum CXCL16 as an inflammatory marker in chronic kidney disease

AISF practice guidance on pharmacological treatment of metabolic-dysfunction associated steatotic liver disease and steatohepatitis (MASLD/MASH): A 2026 Update.

Eurycomanol alleviates hyperuricemia-induced cortisol disorders by upregulating SRD5A1 via IKKβ-IκBα-NF-κB-DNMT pathway.

Pharmacological basis of Codonopsis Radix in COPD: Lobetyolin modulates Nrf2/NF-κB-mediated inflammation and oxidative stress.

Ambulatory blood pressure monitoring (ABPM) is recommended as the gold standard for assessing blood pressure (BP) in patients with chronic kidney disease (CKD) on hemodialysis, as it enables detection of masked and nocturnal hypertension, phenomena linked to adverse outcomes. However, the real-world feasibility and tolerability of extended ABPM protocols in this frail population remain unclear. We conducted a multicenter, international survey inviting 440 consecutive adult in-center hemodialysis patients from eight nephrology units in Italy, Greece, and Slovenia. All patients were consecutively invited to undergo 48-h ABPM, with reasons for refusal or noncompletion systematically recorded. Tolerability and sleep disturbance were assessed using standardized questionnaires. ABPM was considered valid if at least 70% of measurements were obtained. Of 440 invited patients, 119 (27%) refused ABPM or could not undergo recording. Among the 321 who initiated ABPM, 29 (9%) did not complete the protocol, and 35 (11%) had inadequate recordings, so that 257 patients (80% of those starting ABPM and 58% of all invited) successfully completed valid 48-h ABPM. The most common symptoms reported were sleep interruption (32%), itching (24%), and pain during BP measurements (20%). Continuous pain and inability to sleep were significantly associated with the "dipping" BP phenotype. Despite strong guideline recommendations, 48-h ABPM is feasible in only about half of hemodialysis patients, with discomfort and sleep disturbance being the most frequently cited reasons for refusal among those declining ABPM and important barriers to both acceptance and completion in a subset of patients. These findings highlight the need for patient-centered approaches, supportive measures, and careful selection when implementing ABPM in the hemodialysis population, as well as the importance of integrating patient perspectives into clinical practice guidelines.

Association of Metabolic Dysfunction-Associated Steatotic Liver Disease and Kidney Failure in the CKD Population

Antiglomerular basement membrane (anti-GBM) disease is a rare, small-vessel vasculitis because of antibodies targeting the glomerular and alveolar capillaries, leading to rapidly progressive glomerulonephritis and/or pulmonary hemorrhage. Data on children with anti-GBM are scarce. We collected clinical and biochemical data from European pediatric and adult patients diagnosed with anti-GBM disease between 2020 and 2024. A total of 72 patients (35% children) with anti-GBM disease and with a median follow-up of 18 months were analyzed. Pediatric cases were more often female and had higher estimated glomerular filtration rate (eGFR) at the time of diagnosis (each P < 0.01), whereas the percentage of patients requiring dialysis, presence of pulmonary hemorrhage, and immunological findings did not statistically differ between groups. Treatment consisted mainly of daily plasma exchanges (PEXs)and corticosteroids at higher weight-based doses in children (P < 0.0001), in combination with cyclophosphamide (CYC) or, preferably in children (P < 0.05), with rituximab (RTX) and mycophenolate mofetil (MMF). Final eGFR was higher in children than in adults (P < 0.0001), although the frequency of kidney failure did not significantly differ between children (24%) and adults (38%). Adult patients and patients who required dialysis at the time of diagnosis had a 16-fold and 11-fold increased risk of chronic kidney disease (CKD) stage 3 or higher, respectively. Our study indicates that girls predominate among children with anti-GBM disease and that children have a better outcome in terms of eGFR than adults, which is at least partly because of better eGFR values at diagnosis. The need for dialysis is a strong predictor of outcome, regardless of age.

Development of a long-term survival prediction model for patients undergoing invasive coronary angiography using ensemble-based machine learning in time-to-event analysis.

Scoping Review of Interventions to Prevent CKD of Unknown Origin in Working Populations.

Chronic childhood illness is an experience marked by ongoing challenges, the effects of which extend to the emotional sphere of caregivers. This study aimed to understand the meanings attributed by caregivers to their children's illness during pediatric hospitalization, based on listening to their experiences and subjective perceptions. This was a qualitative, exploratory study conducted with 24 caregivers of children with complex chronic conditions admitted to the pediatric ward of a public university hospital. Data were obtained through semi-structured interviews and analyzed using Bardin's content analysis technique. Five central categories emerged from the analysis of the narratives: (1) the unpredictability of the disease and powerlessness in the face of the unknown; (2) spirituality as a pillar of coping, highlighting the role of religiosity in coping; (3) the support network as an element of emotional support; (4) the child as a source of strength and meaning, highlighting the construction of an emotional bond and admiration for the children; and (5) the path to be followed in the construction of palliative care with these families. The discourses revealed feelings of fear, overload, and insecurity. The results highlight the complexity of the caregiving experience in chronic contexts, with an emphasis on the emotional and spiritual dimensions of the suffering experienced. The findings underscore the need to integrate emotional and spiritual support into routine care, acknowledging faith as a coping mechanism. Healthcare teams should establish clear and compassionate communication regarding palliative care from early stages.

The impact of respiratory syncytial virus (RSV) among older adults hospitalized for acute respiratory symptoms was uncertain. We compared the prevalence and clinical outcomes of RSV with those of COVID-19 and influenza in older adults hospitalized for acute respiratory symptoms. We conducted a multicentre prospective cohort study at three community hospitals, which enrolled emergently hospitalized adults aged ≥50 years with acute respiratory symptoms or signs from July 1, 2023, to December 31, 2024. RSV, COVID-19, and influenza A/B were measured using the FilmArray Respiratory panel 2.1 on a nasopharyngeal swab. The primary outcomes were lower respiratory tract infections (LRTIs), defined as presence of ≥2 lower respiratory symptoms/signs for at least 24 hours, including ≥1 lower respiratory sign or presence of ≥3 lower respiratory symptoms for at least 24 hours; modified LRTIs, incorporating chest radiography or computed tomography; and the 30-day all-cause mortality. During the 18-month study period, 3067 patients were included, with a mean age of 81 years (standard deviation: 11), and 55% of whom were male. Comorbidities included chronic pulmonary diseases (28%), chronic heart failure (32%), and diabetes (30%). The vaccination rates for RSV, COVID-19, and influenza were 0%, 62.3%, and 37.9%, respectively. The prevalence of RSV, COVID-19, and influenza A/B was 1.6%, 18.0%, and 2.3%, respectively. The rates of LRTIs were 87.8% (RSV), 82.8% (COVID-19), and 88.4% (influenza A/B). The rates of modified LRTIs exhibited a marginal increase. The 30-day mortality was highest among patients with RSV (14.3%) compared with those with COVID-19 (8.4%) and influenza A/B (2.9%) (p = 0.02). The adjusted odds ratios (95% confidence intervals) of 30-day mortality with RSV and COVID-19 relative to influenza A/B were 5.2 (1.2-36.7) and 2.9 (0.83-17.9), respectively. RSV should be recognized as a risk factor for mortality among older adults emergently hospitalized for acute respiratory symptoms.

SERCA2 dysfunction drives vascular calcification via coupling with TSPO-MCU at mitochondria-associated endoplasmic reticulum membranes.

PM2.5-induced ferroptosis via the miR-188-3p/GPX4 axis disrupts renal erythropoietin production.

Process and Cost Evaluation of a Successful Palliative Telecare Team Intervention in Heart and Lung Disease.

Cigarette smoking is a well-recognized risk factor for chronic obstructive pulmonary disease (COPD) and lung cancer, but the underlying molecular mechanisms remain the subject of intense investigation. A large body of evidence has shown the role of long noncoding RNAs (lncRNAs) in the pathogenesis of smoke-related diseases. LncRNAs are > 200 nt-long functional transcripts with limited protein-coding potential, which are emerging as critical regulators of gene expression in a variety of biological processes. Exposure to cigarette smoke (CS) is known to cause widespread dysregulation of lncRNAs in lung tissues and immune cells, thus leading to disruption of cell homeostasis, and induction of oxidative stress and chronic inflammation. This review article discusses the interplay of lncRNAs, smoking, oxidative stress, immune response, and lung disease. First, we provide an overview of the functions and modes of action of lncRNAs in the regulation of gene expression at the epigenetic, transcriptional, and post-transcriptional levels. We then examine the different mechanisms by which tobacco-induced dysregulation of lncRNAs contributes to oxidative stress, chronic inflammation, and disease pathogenesis, while focusing on COPD and lung cancer. Finally, we highlight the importance of extending lncRNA research to new and emerging tobacco products and discuss the promises and pitfalls of lncRNAs as predictive biomarkers and prognostic targets. Understanding the intricate roles of lncRNAs in the pathogenesis of COPD and lung cancer can provide new avenues for advancing diagnostic tools and therapeutic strategies in the fight against these devastating smoke-associated diseases.