Recurrent IgA nephropathy (rIgAN) after kidney transplantation threatens long-term graft survival, yet contemporary clinicopathological descriptions are limited. We describe clinical, histological, and outcome features of rIgAN and compare them with native IgAN (nIgAN) in a single-center retrospective case series. Adults with biopsy-proven IgAN between 2010 and 2022 were included, comprising 21 adults with rIgAN and 63 with nIgAN. Demographic, clinical, and histopathological data, including Oxford MEST-C scores, were used, and patients were followed until kidney failure, death, or end of study. Patients with rIgAN were older at diagnosis and more frequently men. Kidney dysfunction at diagnosis was more advanced in rIgAN (creatinine was 227 μmol/L vs 128 μmol/L). Active inflammatory lesions mesangial and endocapillary hypercellularity were comparable between groups whereas chronic damage (segmental sclerosis and tubular atrophy) were more prevalent in rIgAN. Over follow-up, 52% of rIgAN patients progressed to kidney failure, with at a shorter median time (17 vs 50 months). Renal survival curves illustrated reduced graft survival in rIgAN. rIgAN was associated with a more aggressive clinical course and earlier graft failure. These findings underline the need for risk-adapted posttransplant surveillance and support evaluation of emerging nIgAN-directed therapies in the transplant setting.

submission trends to the ERA Congress provide a valuable lens through which to observe the evolution of nephrology research and education. Analysing submissions from 2020 to 2026, we document a marked recovery following the COVID-19 disruption, culminating in a record number of abstracts for the 2026 Congress in Glasgow. Beyond volume, notable shifts have occurred in subject mix, geographic participation and reviewer scoring patterns. Chronic kidney disease and glomerular disorders now dominate submissions, reflecting major scientific advances and changing clinical priorities, while international engagement has broadened substantially. These trends suggest that the ERA Congress has entered a new phase characterised by sustained high activity rather than transient post-pandemic rebound. We discuss the implications for congress programme design, peer review, inclusiveness and future strategic planning, highlighting how abstract data can inform the direction of large scientific meetings and the nephrology community at large.

Since its discovery as an antirachitic agent, vitamin D has been recognized for its importance to health, most namely bone health, prompting food fortification practices that are still in place today. The two forms of vitamin D, ergocalciferol (D2) and cholecalciferol (D3), are obtained through the diet or synthesized in the skin via ultraviolet-B radiation. Vitamin D is activated by enzymes mainly found in hepatic and renal tissues, to exert downstream effects via the nuclear vitamin D receptor (VDR). VDR is expressed nearly in all tissues, allowing activated vitamin D to have pleiotropic functions. This review focuses on the gastrointestinal tract, with high VDR content and known associations between vitamin D deficiency and disease states. For example, VDR expression within esophageal submucosal glands may influence fibrosis in eosinophilic esophagitis, while in the stomach VDR is associated with malignancy and Heliocobacter pylori infection. Intestinal diseases like inflammatory bowel disease, intestinal failure, and irritable bowel syndrome have also been linked to vitamin D deficiency and VDR expression. Although there are studies focused on the impact of genetic polymorphisms in VDR and vitamin D supplementation on intestinal diseases, they remain largely inconclusive at this time. Interest in the gut-lung axis has further prompted the investigation of vitamin D in respiratory conditions like chronic pulmonary obstructive disease, asthma, and Mycobacterium tuberculosis infection. While it is clear that vitamin D is important to both the gut and the lungs, there is still a need for further research on the overall role of this important vitamin.

This retrospective study analyzed 10,934 hyperkalemia episodes to compare outcomes between the hyperkalemia routine group and the hyperkalemia standardized group, the latter managed with a strategy supported by the 'Serum Potassium Management Center System' in a real-world implementation setting. The study compared process and outcome metrics between this system-level intervention cohort and the routine care cohort. The hyperkalemia standardized group exhibited significantly higher rates of diagnosis (19.00% vs. 15.43%), treatment (85.23% vs. 58.29%), and review (89.41% vs. 60.86%) (all p < 0.05). With respect to disease burden, the hyperkalemia standardized group was associated with lower hospitalization costs in the chronic kidney disease-heart failure (CKD-HF) and chronic kidney disease-diabtes mellitus-heart failure comorbid subgroups, as well as shorter hospital stays in the CKD-HF comorbid subgroup (all p < 0.05). A non-significant trend toward reduced hospitalization costs and shorter hospital stays was also observed in the CKD subgroup. In conclusion, implementation of the 'Serum Potassium Management Center System' was associated with improved quality of hyperkalemia care, as reflected by more favorable process indicators and disease burden-related outcomes.