Half of Lupus Patients Develop Chronic Kidney Disease, Even Without Nephritis: Study Suggests

Israel: An 18-year follow-up of adults living with systemic lupus erythematosus (SLE) has revealed that more than half develop chronic kidney disease (CKD) over time, including a substantial proportion without a history of lupus nephritis (LN).

The findings, published in The Journal of Rheumatology, highlight the serious burden of CKD in SLE and its link to cardiovascular complications, higher hospitalization rates, and increased mortality.
The research, conducted by Dr. Keren Cohen-Hagai from the Department of Nephrology and Hypertension, Meir Medical Center, Kfar Saba, and the Faculty of Medical and Health Sciences, Tel Aviv University, Israel, and colleagues, examined long-term outcomes in 175 adults diagnosed with SLE. Patients were followed for a mean of over 18 years, making this one of the more extensive assessments of kidney involvement in lupus.
The study revealed the following notable findings: 
  • During the study period, chronic kidney disease was diagnosed in 54.6% of patients, with nearly one in three demonstrating both reduced kidney function and albuminuria.
  • Importantly, 46.1% of patients with CKD had no prior history of lupus nephritis, underscoring that renal complications in lupus are not limited to those with overt nephritis.
  • Of the 175 patients included in the study, 12 eventually required kidney replacement therapy.
  • Statistical analyses revealed that lupus nephritis was the strongest predictor of CKD, with a hazard ratio of 5.4.
  • Other significant predictors of CKD included advancing age and lower estimated glomerular filtration rate (eGFR) at diagnosis.
  • These findings suggest that while lupus nephritis is a powerful driver of kidney damage, clinicians should also remain vigilant in monitoring lupus patients without nephritis for potential signs of renal decline.
  • The study further established that CKD in systemic lupus erythematosus carries broad systemic consequences, with patients who had CKD experiencing higher rates of cardiovascular morbidity.
  • Patients with CKD were also more frequently hospitalized for lupus flare-ups and infections, highlighting the broader health burden associated with renal impairment in lupus.
  • Mortality risk was markedly higher, with 19.1% of patients with CKD dying during follow-up compared to only 1.4% of those without CKD.
“Our findings highlight the critical need for early identification and close monitoring of kidney health in all lupus patients, not just those with lupus nephritis,” the authors noted. They emphasized that CKD in SLE should be considered a major determinant of long-term outcomes, requiring proactive management strategies to mitigate associated risks.
By revealing that nearly half of lupus patients with CKD had no nephritis history, the study challenges assumptions about renal involvement in SLE and broadens the scope of patients who may require closer nephrological evaluation. Given the rising recognition of CKD’s impact on quality of life and survival, the results stress the importance of timely diagnosis, routine kidney assessments, and targeted preventive measures in this high-risk population.
“The long-term investigation highlights CKD as a prevalent and clinically significant complication in lupus, with implications beyond renal health. Addressing kidney involvement early in the disease course may improve cardiovascular outcomes, reduce hospitalizations, and enhance survival in patients with SLE,” the authors concluded.
Reference:
Prevalence, Risk Factors, and Outcomes of Chronic Kidney Disease in Patients With Systemic Lupus Erythematosus With and Without Lupus Nephritis. Keren Cohen-Hagai, Mor Saban, Sydney Benchetrit, Dorin Bar-Ziv, Naomi Nacasch, Moshe Shashar, Yael Pri-Paz Basson, Ori Wand, Ayelet Grupper, Shaye Kivity, Oshrat E. Tayer-Shifman. The Journal of Rheumatology Jul 2025, jrheum.2024-1087; DOI: 10.3899/jrheum.2024-1087

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Elevated serum vitamin D levels are linked with higher skin cancer risk, finds study

Skin cancer, the most common global malignancy, is linked to ultraviolet (UV)-driven serum 25-hydroxyvitamin D (25(OH)D)synthesis, with its controversial role possibly reflecting cumulative UV exposure. This study aimed to assess the association and causality between 25(OH)D levels and skin cancer risk using the National Health and Nutrition Examination Survey (1999–2018) data and Mendelian randomization (MR) analyses, evaluating 25(OH)D as a screening biomarker.

We integrated data from the National Health and Nutrition Examination Survey (1999–2018; n = 21,357 U.S. adults, including 631 skin cancer cases) with MR analyses using genome-wide association study-derived genetic variants to assess the causal relationship between serum 25(OH)D levels and skin cancer risk.

Higher 25(OH)D levels were associated with increased risks of nonmelanoma skin cancer [odds ratio (OR) (95% confidence interval (CI)) = 2.94 (2.10, 4.20)], melanoma [OR (95% CI) = 2.94 (1.73, 5.28)], and other skin cancers [OR (95% CI) = 2.10 (1.36, 3.36)]. MR analyses supported a causal relationship for nonmelanoma skin cancer [OR (95% CI) = 1.01 (1.00, 1.02)] and melanoma [OR (95% CI) = 1.00 (1.00, 1.01)]. Risks were highest in males, older adults, and individuals with obesity.

People with higher vitamin D levels had nearly 3× the odds of getting skin cancer compared to those with lower levels. Genetic analysis supports a modest causal link—meaning vitamin D might contribute to risk, but the effect is small.Vitamin D is produced in your skin when you’re exposed to UV rays—the primary risk factor for skin cancer. Therefore, high vitamin D probably indicates more sun exposure, which drives the increased risk.

Higher serum 25(OH)D levels are associated with increased skin cancer risk, likely reflecting cumulative UV exposure. Routine monitoring of 25(OH)D, combined with UV exposure management, is recommended for risk stratification in skin cancer screening, particularly among high-risk groups. Validation in multiethnic cohorts is needed to confirm these findings.

Reference:

Meng J, Du R, Li P, Lyu J. Association between Serum 25-Hydroxyvitamin D Levels and Skin Cancer Risk: An Observational Study Based on NHANES and Mendelian Randomization Analysis. Cancer Screen Prev. 2025;4(2):89-97. doi: 10.14218/CSP.2025.00010.

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Study Finds Periodontitis Significantly Increases Glaucoma Risk

Researchers have found in a new study that periodontitis, a common inflammatory disease of the gums and tooth support structures, is strongly associated with open angle glaucoma (OAG), particularly in individuals aged over 40 years, men, and diabetics. The study was conducted by Jeong H. N. and colleagues published in the Journal of Glaucoma.

This cross-sectional population-based questionnaire utilized the Korean National Health and Nutrition Examination Survey (KNHANES) data for 2010–2011 to determine whether periodontitis subjects are at greater risk of OAG, a chronic ocular condition that causes irreversible vision impairment if not treated. The finding of this study highlights that oral health could be implicated in ocular disease prevention or attenuation, especially among susceptible populations.

The research started with the assessment of 17,478 participants from the KNHANES database and narrowed the sample to 3,681 adults aged ≥19 years who had complete and valid data from dental and ophthalmologic examinations. Exclusion factors were thorough, excluding participants with a history of ocular surgeries (e.g., cataract, retina, or refractive surgery), with age-related macular degeneration, pregnant women undergoing orthodontic therapy, or with missing clinic data. The final population was stringently evaluated for periodontitis and glaucoma according to standardized definitions.

Periodontal health was determined by the World Health Organization’s (WHO) Community Periodontal Index (CPI), and glaucoma was diagnosed according to International Society of Geographical and Epidemiological Ophthalmology (ISGEO) criteria.

Key Findings

  • 197 out of 3,681 participants (4.59%) were found to have glaucoma, while 3,484 (95.41%) did not have it.

  • Among the patients with glaucoma, 80 (39.48%) also had periodontitis.

  • However, among the individuals without glaucoma, 892 (22.20%) had periodontitis.

The presence of periodontitis was strongly related to glaucoma:

  • Odds Ratio (OR): 1.53

  • 95% Confidence Interval (CI): 1.06–2.22

  • P < 0.001 after age, sex, diabetes (DM), hypertension (HTN), smoking, and alcohol consumption adjustment.

Subgroup analyses indicated even greater associations in specific groups:

  • For those ≥40 years old, the OR was 1.75 (95% CI: 1.18–2.61).

  • In men, the OR was 1.65 (95% CI: 1.01–2.70).

  • In diabetic patients, the OR was 2.70 (95% CI: 1.46–5.02), indicating they were almost three times more likely to have glaucoma if also diagnosed with periodontitis.

These results reinforce the developing understanding of the mouth–eye relationship and necessitate more longitudinal studies investigating causal pathways and mechanisms. Incorporation of monitoring for oral health into general health evaluations has the potential to enhance the early detection and prevention of glaucoma and perhaps other systemic conditions.

Reference:

Noh, J. H., Lee, M. Y., Yoo, C., Sung, K. R., & Kim, J. M. (2025). Relationship Between Periodontitis and Open Angle Glaucoma: The Korea National Health and Nutrition Examination Survey. Journal of glaucoma, 34(8), 565–574. https://doi.org/10.1097/IJG.0000000000002584

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Hysterectomy with bilateral oophorectomy may increase risk of stroke, reveals research

Given the seriousness and increased frequency of strokes, many studies have been conducted to assess the relationship between hysterectomy and/or bilateral oophorectomy and the risk of stroke with varying results. A new study suggests women having a hysterectomy and/or bilateral oophorectomy have higher risks of stroke compared with those who did not have surgery. Results of the study are published online today in Menopause, the journal of The Menopause Society.

Stroke is the third dominant cause of death and the fourth dominant cause of disability around the world, representing a significant public health challenge. Therefore, ongoing prevention efforts that address modifiable risk factors are essential to reduce the burden of this disease.

Estrogen levels play a major role. Women of reproductive age have a lower stroke risk, whereas postmenopausal women are roughly two times more likely to have a stroke within a decade of menopause. Both hysterectomy and oophorectomy significantly affect estrogen levels. Hysterectomy may result in lower ovarian sex steroid levels, resulting in earlier menopause. An oophorectomy can reduce premenopausal serum estradiol by up to 80% and androgen levels by about 50% in both premenopausal and postmenopausal women.

Although multiple studies have previously been conducted around the relationship between surgery and stroke risk, results have been mixed. This latest study using data from the National Health and Nutrition Examination Survey (NHANES) included more than 21,000 women, with an average of 8.3 follow-up years, documenting 193 stroke-related deaths. The analysis of these results found an increased risk for hysterectomy with bilateral oophorectomy but not for hysterectomy alone or hysterectomy with unliteral oophorectomy. A pooling analysis of this study’s results with other cohorts, however, revealed an 18% higher risk of stroke for hysterectomy with bilateral oophorectomy, and a 5% higher risk of stroke for hysterectomy alone.

Although the new study lacked surgical indication data, meta-analysis studies show that there is no connection between a benign or malignant diagnosis when determining the associated risk of surgery. Similarly, current evidence does not differentiate the amount of risk based on specific indications (ie, endometriosis, adenomyosis, fibroids, abnormal uterine bleeding, prolapse, or other rare conditions).

Additional studies with a large sample size and longer follow-up period are needed to address the disparities of type of stroke, age at surgery, surgical techniques, and menopause status on the association between stroke risk and hysterectomy and/or bilateral oophorectomy.

Survey results are published in the article “Stroke risk in women with or without hysterectomy and/or bilateral oophorectomy: evidence from the NHANES 1999-2018 and meta-analysis.”

“The results of this study demonstrate increased stroke risk related to hysterectomy and/or bilateral oophorectomy, highlighting that these common procedures carry longer-term risks. They also call attention to an opportunity for more careful assessment of cardiovascular risk and implementation of risk reduction strategies in women who undergo these surgeries,” says Dr. Stephanie Faubion, medical director for The Menopause Society.

Reference:

Shao, C., et al. (2025) Stroke risk in women with or without hysterectomy and/or bilateral oophorectomy: evidence from the NHANES 1999-2018 and meta-analysis. Menopause. doi.org/10.1097/GME.0000000000002616

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Dehydration in elderly may increase risk of intracerebral hemorrhage and stroke: Study

A new study published in the Journal of Stroke and Cardiovascular Diseases showed that dehydration was associated with an increased risk of stroke in a large sample of persons aged 80 and over.

Stroke is still a major cause of morbidity and death globally, and early clinical status and modifiable risk factors have a significant impact on outcomes. It is becoming more widely acknowledged that dehydration, a prevalent but sometimes disregarded ailment in hospitalized and elderly patients, may have a role in the severity and recovery of stroke.

Dehydration can exacerbate ischemia damage by increasing blood viscosity, promoting thrombus formation, and impairing brain perfusion. This study looked through a sizable database to see whether dehydration and stroke are related. Adults 80 years of age and older who had medical visits prior to the pandemic, from January 1, 2018, to December 31, 2019, made up the research population.

Laboratory test data and ICD-10 diagnostic codes were used to identify the dehydration cohort. Based on ICD-10 codes, outcome measurements included one of 3 stroke types: transient ischemic attack, ischemic stroke, or intracerebral hemorrhage. A subanalysis was conducted on people with diabetes.

This study found a total of 563,476 of the 3,125,610 people aged 80 and above were dehydrated. There were 443,450 diabetics and 101,661 dehydrated people. In both groups, the dehydration cohorts were somewhat older (82.7 vs. 82.4, p <0.001), slightly more female, and non-Hispanic white.

Dehydrated people had 1.98–3.99 times the risk of stroke after adjusting for common covariates in propensity score matching: ischemic stroke (OR=1.98, 95% CI=1.9-2.07), TIA (OR=2.88, 95% CI=2.74-3.28), and intracerebral hemorrhage (OR=3.99, 95% CI=3.41-4.67). The diabetic group experienced ischemic stroke (OR=1.97, 95% CI=1.81-2.16), TIA (OR=2.81, 95% CI=2.33-3.39), and intracerebral hemorrhage (OR=6.76, 95% CI=4-11.42).

Overall, in this sizable sample of 3 million people, as well as in a subset with diabetes, a substantial correlation between dehydration and stroke was discovered. The risk of dehydration in older persons is increased by both the physiological changes associated with natural aging and drugs used to address cardiovascular stroke risk factors. Blood viscosity may account for the link between ischemic stroke and TIA, but the intracerebral hemorrhage correlation is unexpected. Future research ought to assess if better hydration results in fewer strokes.

Source:

Hamrick, I., Tuan, W.-J., Harker, P., Adogwa, O., & Hyacinth, H. I. (2025). Association between dehydration and stroke, a retrospective cohort study of a large database. Journal of Stroke and Cerebrovascular Diseases: The Official Journal of National Stroke Association, 108430, 108430. https://doi.org/10.1016/j.jstrokecerebrovasdis.2025.108430

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Dual antiplatelet therapy is not more effective than aspirin alone after CABG: ESC Study

Dual antiplatelet therapy (DAPT) was not more effective than aspirin alone for the prevention of major adverse cardiovascular events and increased major bleeding in patients with acute coronary syndrome (ACS) who underwent coronary artery bypass grafting (CABG), according to late-breaking research presented in a Hot Line session today at ESC Congress 20251 and simultaneously published in New England Journal Medical.

ESC Guidelines recommend DAPT with aspirin plus a P2Y12 inhibitor over single antiplatelet therapy for patients with ACS (heart attacks or unstable angina) who have undergone CABG.2 “These recommendations are mainly based on extrapolation of data from non-CABG studies, sub-studies of ACS trials and smaller randomised studies with surrogate endpoints. Data from larger randomised trials with clinically relevant endpoints are lacking. We conducted the TACSI trial to investigate whether 12 months of DAPT with ticagrelor and aspirin would reduce the risk of all-cause death and cardiovascular events compared with aspirin alone in ACS patients after CABG,” explained Principal Investigator, Professor Anders Jeppsson from Sahlgrenska University Hospital, Gothenburg, Sweden.

The TACSI trial was an investigator-initiated pragmatic, open-label, registry-based randomised trial conducted in all 22 cardiothoracic surgery centres in Sweden, Denmark, Norway, Finland and Iceland. Patients undergoing their first isolated CABG were randomised 1:1 within 3–14 days to either DAPT (ticagrelor 90 mg twice daily plus aspirin 75 mg once daily) or aspirin only (75–160 mg daily according to local protocols) for 12 months. The primary efficacy endpoint of major adverse cardiovascular events (MACE) was a composite of all-cause death, myocardial infarction, stroke or new coronary revascularisation within 12 months. The primary safety endpoint was major bleeding.

The 2,201 patients included had a mean age of 66 years and 14.4% were women. The primary endpoint of MACE occurred in a similar proportion of patients in each group: 4.8% of patients in the DAPT group and 4.6% in the aspirin only group (hazard ratio [HR] 1.09; 95% confidence interval [CI] 0.74 to 1.60; log rank p=0.77). Major bleeding was more frequent in the DAPT group (4.9% vs. 2.0%; HR 2.50; 95% CI 1.52 to 4.11).

A key secondary endpoint of net adverse clinical events (the primary endpoint plus major bleeding) was higher in the DAPT group than in the aspirin group (9.1% vs. 6.4%; HR 1.45; 95% CI 1.07 to 1.97). A total of 0.7% of patients with DAPT and 0.2% with aspirin only died during the first year after randomisation (HR 4.01; 95% CI 0.85 to 18.9).

Concluding, Professor Jeppsson said: “Our 12-month data do not support the use of DAPT over aspirin alone in ACS patients after CABG, given the lack of improvement in MACE and the increased risk of major bleeding. However, further long-term follow-up is needed.” 

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Gout Significantly Impairs Hand Function, Comparable to Rheumatoid Arthritis, suggests study

Researchers have found in a new study that gout severely affects hand function, reducing grip strength, endurance, and dexterity due to joint and tissue changes. The level of manual impairment is nearly as significant as that seen in rheumatoid arthritis.

The aim of the study was to compare the hand function (grip strength and grip endurance, manual dexterity, and perceived hand functional disability) of participants with gout, rheumatoid arthritis, and healthy control. Grip strength and grip endurance were assessed using a hand dynamometer, while manual dexterity was evaluated through the Nine-Hole Peg Test. Perceived hand functional disability was measured using the Duruöz Hand Index. Results: The grip strength was similar between gout and healthy control (p>0.05). Dominant and non-dominant grip endurance in gout were lower than healthy control (p=0.008, p=0.001). The dominant placing, removing, and total Nine-Hole Peg Test time of gout compared to healthy control were higher (p=0.001, p<0.001, and p<0.001). The non-dominant placing, removing, and total Nine-Hole Peg Test time of gout were higher than healthy control (p=0.002, p=0.004, and p=0.002). The Duruöz Hand Index in gout was higher than healthy control (p=0.002), but lower than rheumatoid arthritis (p=0.008). The findings indicate that individuals with gout experience impairments in grip strength, manual dexterity, and perceived hand function. Assessing hand function during clinical examinations of patients with gout should be considered.

Reference:

Mete O, Apaydin H, Varol F, Gülöksüz EGA, Pamukcu M. Hand function in gout: a comparative study with rheumatoid arthritis and healthy. Rev Assoc Med Bras (1992). 2025 Jul 7;71(6):e20250054. doi: 10.1590/1806-9282.20250054. PMID: 40638474; PMCID: PMC12245048.

Keywords:

Hand, function, gout, comparative, study, rheumatoid arthritis, healthy, Mete O, Apaydin H, Varol F, Gülöksüz EGA, Pamukcu M, Revista da Associação Médica Brasileira

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Happy music could help you recover from motion sickness

Scientists studying ways of improving motion sickness have found that playing different types of music may help people recover more effectively. Using a specially calibrated driving simulator, they induced car sickness in participants and then played different types of music while they tried to recover. Soft and joyful music produced the best recovery effects, while sad music was less effective than doing nothing at all.

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Dad’s childhood passive smoking may confer lifelong poor lung health onto his kids

A father’s exposure to passive smoking as a child may impair the lifelong lung function of his children, putting them at risk of COPD—a risk that is heightened further if they are childhood passive smokers themselves—finds research published online in the respiratory journal Thorax.

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People with learning disabilities seem to progress faster to severe type 2 diabetes

People with learning disabilities progress faster to severe type 2 diabetes and are at greater risk of dying from their condition than people without these disabilities, suggests research published in the journal BMJ Open Diabetes Research & Control.

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