Neonicotinoids (NEOs) continuously exert chronic effects on human health, yet their impacts on renal function remain understudied. This study investigates the association between NEOs and renal function utilizing an integrated epidemiological and toxicological approach. Urinary NEOs and their characteristic metabolites were quantified using ultra-performance liquid chromatography-tandem mass spectrometry in 847 individuals from a Yinchuan community-dwelling elderly cohort. Multiple epidemiological models were employed to systematically evaluate both single and mixed exposure associations with renal parameters. Concurrently, a long-term imidacloprid (IMI) exposure mouse model (based on human equivalent exposure, 103 μg/kg/day) was established to validate the epidemiological findings. The population study revealed significant positive associations between all measured NEOs and serum uric acid (UA) levels (P < 0.05). In mixture analyses, IMI-olefin was identified as the predominant contributor to elevated UA and the primary driver of decreased estimated glomerular filtration rate among all NEOs. In animal models, environmentally relevant IMI exposure functionally validated these findings by significantly elevating UA and blood urea nitrogen levels (P < 0.05). Collectively, low-dose NEOs exposure is positively associated with renal dysfunction in elderly adults, a risk corroborated by murine models at population-relevant exposure levels.

Herbal medicines, including traditional Japanese Kampo formulations, are widely used for various conditions. Although generally considered safe, they may cause unexpected adverse events, which are often underrecognized. We report a case of cystitis potentially associated with a traditional Japanese multicomponent herbal formulation. A 77-year-old man presented with dysuria, urinary frequency, and gross hematuria. The patient had been taking a Kampo formulation for 35 days. Laboratory studies showed hematuria without evidence of a urinary tract infection. Computed tomography and cystoscopy revealed bladder wall thickening with erythematous and edematous changes. Given the temporal relationship between initiation of the herbal formulation and symptom onset, drug-induced cystitis was suspected. Discontinuation of the formulation led to marked improvement in symptoms, urinalysis findings, and imaging results without additional specific treatment. Bladder malignancy and interstitial cystitis were considered unlikely based on cystoscopic findings, imaging studies, urine cytology, and spontaneous resolution of the lesions, although eosinophilic and viral cystitis could not be completely excluded.

Introduction Kidney transplantation remains the treatment of choice for end-stage kidney disease (ESKD) because of its excellent outcomes in terms of both graft and recipient survival. However, preserving the long-term health of living kidney donors represents a major challenge in nephrology. Rigorous post-donation follow-up is essential for the early detection of potential renal and cardiovascular complications and for ensuring donor safety. Methods We conducted a retrospective, descriptive, and analytical study over a 26-year period (1998-2024) at the Ibn Sina University Hospital Center in Rabat, Morocco. The study included all living-related kidney donors (LRKD) who underwent nephrectomy for kidney donation according to the Kidney Disease: Improving Global Outcomes (KDIGO) eligibility criteria. The primary objective was to evaluate the incidence of chronic kidney disease (CKD) after donation. Secondary objectives included the assessment of cardiovascular complications, particularly hypertension, and the identification of associated risk factors. Estimated glomerular filtration rate (eGFR) was used to monitor renal function over time. Quantitative variables were expressed as mean±standard deviation, while qualitative variables were presented as frequencies and percentages. Univariate and multivariate analyses were performed, with statistical significance set at p<0.05. Results A total of 154 LRKD were included, with a mean age of 43±12 years and a predominance of female donors (male-to-female ratio: 0.45). During follow-up, infectious complications were the most frequently observed adverse events, affecting 38 donors (24.6%), with recurrent urinary tract infections being the predominant manifestation, reported in 17 donors (11%). In addition, hypertension was diagnosed in 17 donors (11%), while CKD developed in eight donors (5.2%) A decline in eGFR below 60 mL/min/1.73 m² was observed in eight donors (5.2%), with no progression to ESKD. The mean serum creatinine at 20 years of follow-up was 82.3±18.56 µmol/L. Multivariate analysis identified advanced age, male sex, and baseline eGFR as significant predictors of post-donation CKD (p<0.001), whereas no factor was significantly associated with the occurrence of hypertension. In addition, six full-term pregnancies were reported among female donors, without maternal or fetal complications. Conclusion Our findings highlight the importance of rigorous and long-term medical follow-up in LRKD in order to anticipate late complications. Particular attention should be paid to male donors, who appear to be at higher risk of developing renal impairment. Post-donation follow-up should be individualized to ensure optimal management and preserve donor health over time.

Urinary Tract Infections are an emerging public health concern among individuals with diabetes mellitus, particularly in South Asia where high disease burden, genetic diversity and increasing drug resistance contribute to the progressive increase in burden. While metabolic and clinical risk factors are well studied, the role of host innate immune genetic variations in shaping UTI susceptibility among diabetics remains poorly understood. This case-control study evaluated functional polymorphisms in key innate immunity genes, TLR4 (rs4986790, rs4986791), MBL2 (rs1800450) and LTA (rs909253), in 70 T2D patients with UTI and 70 T2D patients without UTI. Genotyping was performed using 5'-hydrolysis probe assay. Across all the four SNPs, the risk allele consistently showed a higher frequency among T2D patients with UTI, indicating a directional trend suggestive of cumulative susceptibility. Also, a strong and significant protective association was observed for the LTA rs909253 'G' allele, which was less frequent in cases than controls. This low-inflammatory 'AA' genotype was also markedly enriched among rUTI cases compared to controls. Clinically, 34.3% of cases experienced rUTIs. This observed directional increase of risk alleles across all four innate immunity SNPs, along with the protective role of LTA rs909253 'G' allele, highlights cumulative host genetic modulation of UTI risk in T2D and supports translational use of genetic profiling in infection risk prediction.