Ｏｂｊｅｃｔｉｖｅ：To observe the efficacy of sacubactril valsartan and the change of inflammatory factors in chronic kidney disease (CKD) complicated with hypertension and non-heart failure.
Ｍｅｔｈｏｄｏｌｏｇｙ：CKD patients with hypertension and non-heart failure in our hospital from January 2021 to June 2023 were collected. The control group was treated with Valsartan, and the treatment group was treated with sacubactril valsartan. The cardiac indicators, renal indicators and inflammatory cytokines, early deterioration of renal function(eGFR decreased by more than 20% from baseline) were followed up after 6 months.
Ｒｅｓｕｌｔｓ：A total of 60 CKD(the percentage of CKD 3～4 stage is 76.7%) patients were included. (1)There was no significant difference of the clinical data, cardiac and renal parameters between the treatment group (n=30) and the control group (n=30) before treatment (P>0.05). (2) Compared with baseline, the blood pressure of both groups decreased, and the decline was even greater in treatment group (P<0.05). Compared with baseline, 24-hour urinary protein, serum creatinine and N-terminal pro-B-type natriuretic peptide (NT-proBNP) decreased; estimated glomeruar filtration rate (eGFR), left ventricular ejection fraction (LVEF) and serum albumin increased in the treatment group (P<0.05), While serum creatinine increased and eGFR decreased after 6 months of Valsartan treatment (P<0.05). The change percentage of serum creatinine, eGFR, NT-proBNP and LVEF between two groups have statistical significance (P<0.05). (3) In the treatment group, IL-1β, IL-2R, IL-6 and IL-8 decreased (P<0.05), while IL-10 and TNF-α had no change (P>0.05). The above inflammatory factors had no significant difference after treatment in the control group. (4) The renal function deterioration incidence of renal function of treatment group was significantly lower than that control group (3.3% vs 33.3%,P<0.05). Sacubactril valsartan treatment (OR=0.013 95%CI 0.000,0.562) and the baseline 24-hour urinary protein quantity (OR=2.268, 95%CI 1.313,3.919) were independent influencing factors for renal function deterioration events. (5)There was no significant difference in the incidence of hyperkalemia between two groups (10% vs 6.7%, P>0.05). No obvious adverse reactions such as hypotension, cough and angioneurotic edema occured in both groups.
Ｃｏｎｃｌｕｓｉｏｎ：Sacubactril valsartan can effectively induce blood pressure, proteinuria and inflammation, improve the cardiac function, renal function and renal prognosis in CKD 1～4 stage with hypertension and non-heart failure patients.

Objective:To  investigate  to  the  efficacy  and  safety  of  obinutuzumab  in  the  treatment  of  high  risk  or refractory phospholipase A2 receptor associated membranous nephropathy.    Methodology:Patients with biopsy-proven MN or serum anti-phospholipase A2 receptor antibody （aPLA2Rab） titers≥14 RU/ml treated with obinutuzumab （1 g× 2） in the National Clinical  Medical  Research  Center  for  Renal  Diseases  at  Jinling  Hospital  from  September  2022  to  December 2023 were  retrospectively  analyzed.  High  risk  was  classified  according  to  kidney  disease:  Improving  Global  Outcomes guideline and expert recommendation. Refractory disease was termed as patients received immunosuppressive agents such as cyclophosphamide，  calcineurin  inhibitors  or  Rituximab  with  or  without  steroids  for  more  than  6  months  but  have  not  yet achieved remission  （proteinuria  decline < 50%  and > 3.5  g/24h）.      Results: Our  analysis  included  72  patients  （56 refractory， 16 high risk MN）， baseline proteinuria was 10.2 g/24h. 70 （97%） patients achieved remission at month 12， including 24 （33%） achieved complete remission （CR）. The median time to remission was 3 （3 ~ 6） months.  Remission  

rate， CR rate of high risk and refractory MN was 100% and 96%， 56% and 27% respectively. CR rate was significantly high in high-risk group than refractory group （HR = 2.497，95%CI 1.041~ 5.989）. Obinutuzumab significantly reduced 24- hour proteinuria  and  increased  serum  albumin，  estimated  glomerular  filtration  rate  since  week  6.  Complete  depletion  of circulating B cell was maintained in all patients within 3 months and the median time to B cell reconstitution （CD20+ cells

≥5/μL） was  9  （8 ~ 12） months.  67  patients  presented  with  serum  aPLA2Rab≥14  RU/mL  at  baseline  and  complete immunological remission （aPLA2Rab<2 RU/mL）was achieved in 87% and 99% at month 6 and 12 respectively. Infusion- related adverse event was revealed in 28% patients and mostly mild. Pulmonary infections occurred in 2 （2.8%） patients. No patients died or progression into end stage kidney disease.    Conclusion:Obinutuzumab is a promising treatment option for both high risk and refractory  membranous  nephropathy， charactered  by  long  duration  of  B  cell  depletion， high  rate  of clinical and immunological remission. Large prospective studies are needed to validate these preliminary findings.

Objective: To  investigate  the  gene  mutation  characteristics  and  clinicopathological  manifestations  of patients with TRPC6  gene  mutation.     Methodology: We  screened  our  patients  with  TRPC6  gene  mutation  confirmed  by whole exon or  nephropathy  panel  gene  detection  in  the  National  Clinical  Research  Center  for  kidney  Disease,  and  then analyzed the gene mutation characteristics, clinicopathology and prognosis of the patients.    Results:A total of 10 patients were included in the study, of which 50%  were male and 50% were female. 8 heterozygous mutations of TRPC6 gene were detected in the 10 patients, of which 6 were missense mutations, and c.2683C>T(p.R895C) was the most common.  There were 9 cases with positive family history of kidney disease.  The onset age of the patients was 16- 35 years old, and all of them were onset with proteinuria, even 4 cases showed nephrotic syndrome (NS). All patients were treated with angiotensin II receptor blockers (ARB), of which 5 patients were treated with hormone combined with calcineurin inhibitors (CNI), and 2 patients were treated with moderate hormone. 6 patients progressed to end⁃stage kidney disease (ESKD) in the course of 1 - 17  years.  The  pathological  manifestations  of  renal  biopsy  in  6  patients  were  focal  segmental  glomerulosclerosis  (FSGS), with 4 cases of foot process extensive fusion (50%-80%) and 2 cases of segmental fusion (30%-50%), and no glomerular basement membrane lesions.    Conclusion:The mutation of TRPC6 gene is mainly missense mutation, and the most common mutation site is c.2683C> T (p.R895C). The clinical manifestations of patients with related nephropathy are mainly proteinuria, most of which are NS. Renal pathology was mainly FSGS, and podocyte foot process fusion was obvious. Most patients  have  poor  efficacy  on  ARB  and  CNIs,  and  eventually  progress  to  ESKD.  The  early  diagnosis  and  timely specific intervention of the disease may be the key to improve the prognosis of patients.

Objective: To  evaluate  the  efficacy  and  safety  of  cyclophosphamide⁃thalidomide⁃dexamethasone (CTD)  therapy  in patients  with proliferative  glomerulonephritis  with monoclonal  immunoglobulin deposits  (PGNMID). Methodology:The clinicopathological data of PGNMID patients who were treated with CTD protocol from January 2018 to January 2024 were retrospectively analyzed.    Results:22 patients were included in the CTD treatment protocol, consisting of 16 patients in the first episode, first⁃treatment group, and 6 patients in the relapsed⁃refractory group. The median follow⁃ up period was 21 months, with a median remission time of approximately 9 months. During the follow⁃up period, 90.9% of patients achieved  renal  remission,  45.5%  complete  remission.  Median  urine  protein  quantification  decreased  from  3.53 (2.10, 6.41)  g/24h to 0.71 (0.41, 2.15)  g/24h  in  all  patients,  and  median  serum  creatinine  decreased  from 122.5 (84.4,150.3) μmol/L to 99.9(70.7,124.0) μmol/L. Of these patients, two relapsed, and one went into end stage kidney disease. The median thalidomide dose  in  the  CTD  group  was  75  (50,  100)  mg/d,  with  an  overall  incidence  of  serious adverse reactions of 9%  (2/22), including one case each of myelosuppression and peripheral neuropathy.    Conclusion: The CTD regimen is effective in treating patients with PGNMID, with a  low incidence  of  serious  adverse  effects  and good tolerability. Further observations are needed regarding the impact on long⁃term efficacy and safety.

Ｏｂｊｅｃｔｉｖｅ：To analyse efficacy of short-term use of complement C5 inhibitor eculizumab, and adverse reactions in patients with atypical haemolytic uremic syndrome (aHUS).
Ｍｅｔｈｏｄｏｌｏｇｙ：Five patients with aHUS who were regularly treated in Sichuan Provincial Peoples Hospital between January 2023 and May 2024 were retrospectively collected and analysed for clinical manifestations, laboratory examinations, renal pathological examinations, genetic test results, the therapeutic efficacy of eculizumab and the adverse reactions.
Ｒｅｓｕｌｔｓ：One of the five patients with aHUS was male, with a median age of 40 (17～66) years, etiologu included renal transplantation, malignant hypertension, autoimmune disease, and primary aHUS. All presented clinically with acute renal failure, proteinuria, haematuria, anaemia and thrombocytopenia,dicrease of complement C3. Renal biopsy was performed in 3 cases and showed endothelial cell damage and microthrombosis. 3 cases received dialysis, 3 cases had renal biopsies, all 4 patients were treated with steroids (2 received methylprednisolone pulse therapy), 1 kidney transplant-related case was treated with rabbit anti-human thymus immunoglobulin (ATG), intravenous gammaglobulin, and 1 with CD20 monoclonal antibody (with systemic lupus erythematosus in the primary disease). The median time from diagnosis of aHUS to treatment with eculizumab was 20 (2～37.5) days, with 4～20 times of eculizumab, and a mean of 7(4.5～8.5)days post-treatment all patients achieved haematological remission, 3 patients achieved nephrological remission, and 1 patient was taken off dialysis. At 8~24 weeks months of follow-up creatinine and LDH were significantly lower and eGFR, haemoglobin and platelets were significantly higher than before treatment (P<0.001). No significant adverse reactions were found.
Ｃｏｎｃｌｕｓｉｏｎ：aHUS has diverse clinical manifestations, rapid progression, and poor prognosis, and eculizumab is the first-line treatment option for aHUS. Once diagnosed, treatment can be initiated immediately, which can rapidly improve the haematological indexes and renal function, and the long-term clinical benefits still need to be further studied.

A 17-year-old female with systemic lupus erythematosus, who presented with nephrotic syndrome at onset, developed lupus encephalopathy, mesenteric vasculitis, and acute pancreatitis during treatment. She received methylprednisolone pulses and cyclophosphamide, plasma exchange, and hemofiltration and sequential B cell-targeting therapies, and achieved complete remission. Identification of T cell subpopulation changes is helpful in this case for the differential diagnosis of severe SLE complicated with multi-system involvement and other complications, such as infection and adverse drug reactions.

The rapid development of the field of kidney organoids has provided important model support for the study of human kidney development and kidney diseases. The research on kidney organoids has evolved from early establishment of nephron organoids to ureteric bud／collecting duct organoids，which can more comprehensively simulate human kidneys and better apply them in the fields of kidney development simulation，disease modeling，and drug screening. In addition，the cross fusion of new technologies such as single-cell sequencing，multi omics combination，gene editing，and organ-chips has also enabled researchers to have a more comprehensive and in-depth understanding of kidney organoids. This article will introduce the induction methods for nephron organoids and ureteric bud／collecting duct organoids，optimization of cell and structure for kidney organoids，relevant applications and improvement measures for kidney organoids.

Acute kidney injury (AKI) is an acute and critical illness with high morbidity and mortality. In recent years, a growing body of studies have shown that renal maladaptation following AKI results in chronic kidney disease (CKD). Ferroptosis, a novel form of non-apoptotic cell death characterized by iron overload and lipid peroxidation, is believed to play a significant role in the progression of AKI to CKD. This article provides a review of the classical regulatory mechanisms of ferroptosis and its potential involvement in the pathological mechanisms in the progression of AKI to CKD.

Endothelin is closely associated with kidney diseases. Activation of endothelin receptor A promotes vasoconstriction, inflammation, fibrosis, and cell proliferation, leading to kidney damage. By antagonizing the endothelin receptors, renal function can be protected. Currently, endothelin receptor antagonists are primarily used to treat pulmonary arterial hypertension. However, numerous clinical trials have confirmed that endothelin receptor antagonists are significantly effective in reducing proteinuria and protecting renal function. They are promising as a new type of medication for the treatment of various kidney diseases.

Ｏｂｊｅｃｔｉｖｅ：To explore the role and mechanism of bone marrow mesenchymal stem cells-derived exosomes （BMSC-exos） in protecting against cisplatin （CDDP）-induced acute kidney injury （AKI）.
Ｍｅｔｈｏｄｏｌｏｇｙ：48 C57BL／6 mice were randomly divided into 4 groups: control （CN） group，cisplatin-induced AKI model （CDDP） group，CDDP+BMSC-exos （CDDP+EXO） group，and CDDP+EXO+PI3K inhibitor （LY294002） （CDDP+EXO+LY294002） group. Saline，cisplatin，cisplatin+BMSC-exos and cisplatin+BMSC-exos+LY294002 were injected intraperitoneally or Caudal vein，respectively. blood was retained for measurement of creatinine （SCr） and urea nitrogen （BUN）； renal tissues were taken for pathological analyses； renal tubular epithelial cells （RTEC） were observed for apoptosis by TUNEL； and immunohistochemical staining was performed to detect Cleaved caspase-3，GRP-78，caspase-12 and CHOP expression localisation； Cleaved caspase-3，GRP-78，caspase-12，CHOP，PI3K and p-AKT expression were determined by Western Blot.
Ｒｅｓｕｌｔｓ：In the CDDP-induced AKI model，the number of TUNEL-positive cells in renal tissues was significantly increased （P<0.05），and the area of immunohistochemically immunised Cleaved caspase-3，GRP-78，caspase-12 and CHOP positivity was significantly increased （P<0.05），and the Western Blot method confirmed the expression of Cleaved caspase-3，GRP-78，caspase-12 and CHOP expression levels were significantly up-regulated （P<0.05），and p-AKT expression levels were significantly down-regulated （P<0.05）； the number of TUNEL-positive cells in renal tissues was significantly reduced by treatment with BMSC-exos （P<0.05），and the number of immunohistochemistry-immunoconjugated Cleaved caspase-3，GRP-78，caspase-12 and CHOP positive area was significantly reduced （P<0.05），Western Blot method confirmed that Cleaved caspase-3，GRP-78，caspase-12 and CHOP expression levels were significantly down-regulated （P<0.05），and the p-AKT expression level were significantly up-regulated （P<0.05）； the number of TUNEL-positive cells in renal tissues was significantly increased （P<0.05），and the immunohistochemical immunoconjugate area of Cleaved caspase-3，GRP-78，caspase-12 and CHOP positivity was significantly increased （P<0.05） with the application of LY294002 prior to the treatment of BMSC-exos. Western Blot method confirmed that Cleaved caspase-3，GRP-78，caspase-12 and CHOP expression levels were significantly up-regulated （P<0.05） and p-AKT expression levels were significantly down-regulated （P<0.05）.
Ｃｏｎｃｌｕｓｉｏｎ：The mechanism of CDDP-AKI protection by BMSC-exos may be achieved by inhibiting Endoplasmic reticulum stress and activating PI3K／Akt signalling pathway.

Ｏｂｊｅｃｔｉｖｅ：We aimed to explore whether the functional magnetic resonance imaging（fMRI），an noninvasive technique，could judge the nature of kidney lesions and predict recovery of kidney function in acute kidney injury （AKI） patients.
Ｍｅｔｈｏｄｏｌｏｇｙ：13 AKI patients who underwent fMRI and renal biopsy in the National Clinical Research Center of Kidney Diseases were enrolled in this study. The routine pathological data，including immunofluorescence，light microscopy，and electron microscopy，and pathology diagnoses were collected for each patient. Apparent diffusion coefficient of intravoxel incoherent motion diffusion weighted imaging（IVIM Standard-ADC） and magnetic resonance elastography （MRE）-derived stiffness，as well as baseline estimated glomerular filtration rate （eGFR） and follow-up data within 12 months after discharge were recorded for each patient. The relationship between IVIM Standard-ADC and MRE-derived stiffness and the rate of eGFR change during the follow-up period was analyzed.
Ｒｅｓｕｌｔｓ：Of the 13 patients（8 males，5 females），the median age was 33 （21～44） years. Mean baseline eGFR was 31（16.5～43.5） mL／（min·1.73 m2），and mean annual eGFR slope was 12.29（4.42～25.66）.The results of histology shows that 7 cases had chronic lesions and 6 cases were simple AKI. First，the slope of eGFR change over the 12 months follow-up period was not significantly correlated with the values of IVIM Standard-ADC and 45 Hz MRE-derived stiffness，but was significantly positively correlated with 60 Hz MRE-derived stiffness （rs=0.709； P=0.022）. Moreover，increased kidney stiffness was associated with better prognosis in kidney function in AKI（regression r2=0.456； P=0.032）. Second，we can see the same result in 45 Hz MRE-derived stiffness，the value of 45 Hz MRE-derived stiffness also could be a predictor of annual eGFR slope （regression r2=0.44； P=0.036）. That is，MRE-derived stiffness can relatively distinguish kidney injury degree and different eGFR recovery slope.
Ｃｏｎｃｌｕｓｉｏｎ：The study indicates that MRE can predict the change of kidney function in the future in AKI patients as a powerful noninvasive tool. Compared with the pure AKI patients，kidney function in patients with AKI combined with CKD is difficult to completely return to normal，and the baseline MRE-derived stiffness of the two patients are significantly different.

Hepatorenal syndrome （HRS） is a type of cirrhosis-related renal damage with a unique pathophysiological mechanism. HRS-AKI is the subtype that needs special attention. In addition to the classical mechanisms of hemodynamic disorders，the occurrence of HRS-AKI also involves a variety of pathophysiological mechanisms such as intestinal bacterial translocation，systemic inflammation，renal microcirculation disorders and cirrhotic cardiomyopathy and so on. Early diagnosis and treatment can improve the poor prognosis of HRS-AKI. Albumin plus terlipressin is a widely recommended first-line treatment，nevertheless liver transplantation is the only definitive treatment for HRS. This article reviews the new definition，diagnostic and grading criteria，pathogenesis，and treatment of HRS-AKI.

Antibody-mediated rejection （ABMR） is considered a common cause of long-term graft damage and a significant determinant of transplant failure. Donor-specific antibodies （DSA） are closely associated with ABMR. Follicular helper T （Tfh） cells are the key effector cells in promoting B cell proliferation and differentiation into plasma cells and memory B cells，contributing to the induction of DSAs and participating in the humoral immune response against allografts. This article reviews the biological characteristics and functions of Tfh cells，describes the driving and regulatory role of Tfh cells in DSA production and ABMR immunity of kidney transplant recipients，and discusses the effects of conventional transplantation immunotherapy on Tfh cells and the biological targeted therapy.

Ｏｂｊｅｃｔｉｖｅ：Use machine learning method to analyze the impact of two continuous assessment methods of dialysis quality indicators on the prognosis of maintenance hemodialysis (HD) patients.
Ｍｅｔｈｏｄｏｌｏｇｙ：A total of 240 patients who received HD treatment at the Eastern Theater Command General Hospital in January 2016 were screened, and dialysis quality was assessed more than three times a year. The follow-up period ends in October 2022, and the endpoint is death from all causes. The indicator time-to-standard ratio and indicator fluctuation value were used as the evaluation methods for the continuous achievement of nine dialysis quality indicators. Dialysis quality indicators include interdialytic weight gain、pre-dialysis systolic blood pressure、hemoglobin、albumin、total carbon dioxide、calcium、phosphorus、parathyroid hormone and spKt／V.A prediction model for survival or death of HD patients after 1 year was constructed based on a machine learning algorithm, and the optimal probability threshold of the model was obtained.
Ｒｅｓｕｌｔｓ：After 94 months of follow-up, 60 patients (25.0%) died. Six machine learning methods, KNN, RandomForest, ExtraTrees, XGBoost, AdaBoost and DecisionTree, are used to build prediction models based on the indicator time-to-standard ratio and the indicator fluctuation value. The ExtraTrees model based on the indicator time-to-standard ratio has the best prediction effect, with its accuracy, precision, recall, F1 score and area under the receiver operating curve reaching 0.92, 0.86, 0.96, 0.91 and 0.9 respectively, while confirming 0.65 as the optimal probability threshold for the model.
Ｃｏｎｃｌｕｓｉｏｎ：The machine learning model based on the indicator time-to-standard ratio has a good prediction effect on the prognosis of HD patients.

A 26-year-old young woman was admitted to the hospital with "peritoneal dialysis(PD) for more than 5 years and 26+weeks of menolipsis". After continuously adjusting the dialysis prescription, improving anemia, controlling hypertension, and collaborating with a multidisciplinary team, a premature baby was delivered by cesarean section at 30+weeks of pregnancy. Currently, the mother and baby are in good condition. This article reports the diagnosis and treatment of this case, in order to provide reference for the management of pregnancy in dialysis patients.

Ｏｂｊｅｃｔｉｖｅ：To investigate the clinicopathological features and prognosis of patients with mesangial proliferative diabetic nephropathy，and analyze the factors affecting estimated glomerular filtration rate slope.
Ｍｅｔｈｏｄｏｌｏｇｙ：Among patients with type 2 diabetes mellitus and diagnosed as diabetic nephropathy by renal biopsy at the National Clinical Medical Research Center for Kidney Diseases from January 2006 to January 2020，patients presenting with pathologic manifestations of mesangial proliferative lesions were included and retrospective studied. According to the quartiles of the dccline rate in estimated glomerular filtration rate（ΔeGFR），they were divided into group Q1～Q4. The clinicopathological data and prognosis differences in the four groups were compared. According to the KDIGO guidelines，rapid decline in renal function was defined as ΔeGFR>5 mL／（min·1.73 m2·year），and the factors influencing the rate of rapid decline in renal function and its impact on prognosis were analyzed.
Ｒｅｓｕｌｔｓ：Of the 183 patients who met the inclusion criteria，76 （41.5%） were male with a mean age of 47.8±9.2 years. At the time of renal biopsy，patients with more rapid ΔeGFR had a higher proportion of peripheral neuropathy，higher baseline urine protein，blood urea nitrogen，serum creatinine，glycosylated hemoglobin（HbA1c） levels，and lower serum albumin and calcium levels （P<0.05）. Also they had a more severe mesangial proliferative lesions （P=0.005），higher interstitial inflammation score （P=0.029） and higher interstitial fibrosis and renal tubular atrophy score （P=0.029）. Baseline blood calcium，baseline HbA1c，and interstitial inflammation score of kidney were independent predictors of rapid decline in renal function. Model equation for predicting rapid decline in renal function: logit （rapid decline）=0.876×interstitial inflammation-4.122×blood calcium+0.347×HbA1c+4.778 （AUC=0.736，95%CI 0.645～0.828，P<0.001）.
Ｃｏｎｃｌｕｓｉｏｎ：Rapid progression of renal function in patients with mesangial proliferative diabetic nephropathy correlates with renal interstitial inflammation scores，baseline serum calcium，and HbA1c levels. It suggests that the control of blood glucose and renal inflammation may help to delay the progression of renal function in the patients.

Ｏｂｊｅｃｔｉｖｅ：To analyze the clinical characteristics of maintenance hemodialysis （MHD） patients with high-flow arteriovenous fistulas，alongside the alterations in cardiac structure and function，to evaluate the influence of high-flow arteriovenous fistulas on mortality and cardiovascular events in MHD patients.
Ｍｅｔｈｏｄｏｌｏｇｙ：This study included patients undergoing hemodialysis at department of nephrology，the second affiliated hospital of Nanjing Medical University between March and May 2022. High-flow arteriovenous fistula was defined as fistula blood flow≥1 500 mL／min. Patients were divided into two groups，high-flow arteriovenous fistula，and non-high-flow arteriovenous fistula. The study analyzed baseline clinical characteristics and echocardiographic parameters of both groups，comparing the risk of cardiovascular events and mortality between the two groups.
Ｒｅｓｕｌｔｓ：The study included 341 MHD patients of which 210 （61.6%） were male. The mean age was 57.3 ± 12.3 years，and the median duration of dialysis was 78.7 （33.0～151.1） months. Among the patients，138 （40.5%） had an internal fistula blood flow of≥1 500 mL／min. In the high-flow arteriovenous fistula group，patients had a larger right atrial diameter （P=0.005），a larger main pulmonary artery diameter （P=0.007），a faster main pulmonary artery flow velocity （P=0.042），a higher proportion of heart valve calcification （P=0.028），and a higher ratio of arteriovenous fistula flow to cardiac output （P<0.001）. Other echocardiographic parameters did not differ between the two groups. The location of the fistula in the upper arm （OR=3.503，95%CI 1.702～7.209，P<0.001） and higher diastolic blood pressure at fistula creation （OR=1.045，95%CI 1.018～1.072，P<0.001） were independent factors influencing high-flow arteriovenous fistulas. The risk of cardiovascular events did not differ between the two groups （P=0.369），but the high-flow arteriovenous fistula group had a higher risk of mortality （P=0.013）.
Ｃｏｎｃｌｕｓｉｏｎ：MHD patients with high-flow arteriovenous fistulas did experience an increased risk of all-cause mortality. The independent factors associated with high-flow arteriovenous fistulas included the location of the fistula in the upper arm and higher diastolic blood pressure at fistula creation.

Metabolic diseases such as obesity and chronic kidney disease will be an important chronic disease threatening human health, showing a rapid growth in China. Typical obesity-related glomerulopathy has its special histomorphologic features and clinical manifestations, however, there are also other chronic glomerular and tubulointerstitial kidney disease coexist with obesity. This article focuses on the epidemiologic features of obesity in CKD, possible pathogenic mechanisms, and traditional and innovative therapeutic approaches.

Renal fibrosis is a common outcome of various causes leading to the development of chronic kidney disease （CKD） to end-stage renal disease. It's crucial for the treatment of CKD patients to clarify the molecular mechanisms of renal fibrosis. There is a layer of polysaccharide protein complex （also called glycocalyx） on the endothelial cell surface，which constitutes the basic barrier between the blood and the vessel wall. Recent studies have shown that the glycocalyx degradation plays an important role in promoting renal fibrosis. This review will discuss the research progress on the mechanisms of glycocalyx involved in renal interstitial fibrosis and may provide new therapeutic strategies for CKD.

 Chronic kidney disease-mineral and bone  disorder  （CKD-MBD） refers  to  a  syndrome  of  mineral  and bone metabolism abnormalities caused by chronic kidney disease.  It can affect the  cardiovascular  system and bone  tissue， eventually leading to damage to multiple organs  and systems  throughout  the  body， making  it  a  significant  cause  of  patient mortality. Hyperphosphatemia is the initiating factor of CKD-MBD， making the  management  of  blood phosphorus  levels  in dialysis patients extremely important; however， the rate of achieving target blood phosphorus levels in these patients is not high. In recent years， a series of new phosphate-lowering drugs have been developed based on new mechanisms， including iron-based  phosphate   binders，   calcium-magnesium   composite   phosphate   binders，   and   niacinamide，   among   others. Additionally， there  are  some  novel  phosphate-lowering  drugs  undergoing  clinical  trials.  This  article  reviews  the  current status of  blood  phosphorus  management  in  dialysis  patients  and  the  effects  and  characteristics  of  these  new  phosphate- lowering drugs.