Purpose: Although bladder cancer occurs three to 4 times more frequently in men than in women, the relative number of deaths compared to incidence is higher in women, suggesting that women have a worse prognosis than men. Emerging evidence indicates that the activity of the sex steroid hormone pathway may play a role in bladder cancer development, with demonstrations that both androgens and estrogens have biological effects on bladder cancer in vitro and in vivo. This study investigates the influence of sex and menopausal status on recurrence and cancer-specific death (CSD) in bladder cancer patients undergoing radical cystectomy (RC). Materials and Methods: This retrospective analysis included 3,913 patients from the Korean Bladder Cancer Study Group Database who underwent RC between 2010 and 2019. Patients were categorized based on gender and menopausal status (≤50 years: premenopausal; >50 years: postmenopausal). Pathological factors, neoadjuvant chemotherapy, recurrence, and CSD rates were analyzed using chi-square and Fisher exact tests. Results: Among the 3,913 patients, 400 (10.2%) were female. Premenopausal females exhibited significantly lower recurrence rates (28.6%) compared to postmenopausal females (45.7%). CSD rates were similarly reduced in premenopausal females (12.0% vs. 22.2% in postmenopausal females). No significant sex differences in recurrence or CSD were observed among premenopausal patients. Pathological T stage, nodal status, and lymphovascular invasion were significantly associated with recurrence in males, while nodal status alone was significant in females. Neoadjuvant chemotherapy was significantly more frequently administered to male patients under the age of 50, while no difference was observed in the administration of neoadjuvant chemotherapy among female patients based on menopausal status. Conclusion Hormonal changes associated with menopause significantly influence bladder cancer outcomes in women. Premenopausal hormonal environments seem protective, underscoring the need for further research into hormone-driven mechanisms in bladder cancer.

Purpose: To evaluate whether extended pelvic lymph node dissection (PLND) improves survival outcomes compared with standard PLND in patients with bladder cancer (BCa) undergoing radical cystectomy (RC), and to assess its potential benefits in patients with prior or concurrent radical nephroureterectomy (p/cRNU). Materials and Methods: A multicenter analysis included 2202 patients with BCa undergoing RC with standard or extended PLND at 11 tertiary centers from 2003 to 2023. Following propensity score matching, 659 pairs (n=1,318), including 128 patients with p/cRNU, were analyzed. Recurrence-free survival (RFS) was the primary outcome, while overall survival (OS), cancer-specific survival (CSS), and readmission rates were secondary outcomes. Survival analyses performed using Kaplan-Meier methods and clustered Cox models. Results: Extended PLND yielded significantly more lymph nodes than standard PLND (median: 27.0 vs. 17.0, p<0.001) but did not improve RFS, CSS, or OS in the overall cohort (all p>0.05). Extended PLND increased readmission rates (28.4% vs. 20.2%, p=0.001) and readmission risk (odds ratio, 1.57; 95% confidence interval [CI], 1.15–2.16, p=0.005). However, subgroup analysis revealed extended PLND significantly improved RFS in patients with p/cRNU (hazard ratio, 0.54; 95% CI, 0.38–0.77; p<0.001). Conclusion Extended PLND does not provide survival benefits for overall patient population and increases readmission risk but significantly improves RFS in patients with p/cRNU. Tailoring PLND extent based on upper tract disease status is recommended.

Background: Calcineurin inhibitor (CNI) toxicity is a significant cause of graft dysfunction in kidney transplant recipients, yet distinguishing it from acute rejection (AR) and acute tubular necrosis (ATN) remains challenging. This study investigated the use of urinary mRNA biomarkers as a noninvasive tool for identifying CNI toxicity. Methods: We retrospectively enrolled 110 kidney transplant recipients and classified them into four groups based on pathological findings: stable graft function (n=35), CNI toxicity (n=25), AR (n=30), and ATN (n=20). Candidate biomarkers were selected using the GEO database. Urinary mRNA was extracted from cell pellets, reverse-transcribed, and quantified by real-time polymerase chain reaction. Results: Estimated glomerular filtration rates were comparable among the CNI toxicity, AR, and ATN groups. Four transcripts (LTF, NNMT, WFDC2, and HIF1A) were identified as candidate biomarkers. Urinary mRNA levels of LTF, NNMT, and HIF1A were significantly lower in the CNI toxicity group than the AR group. NNMT and HIF1A levels were also significantly lower than those observed in the ATN group. In contrast, WFDC2 levels did not differ significantly across groups. A three-gene signature (LTF, NNMT, and HIF1A) effectively differentiated CNI toxicity from AR and ATN (area under the curve [AUC], 0.867;95% confidence interval [CI], 0.787–0.947) and significantly enhanced the diagnostic performance of the clinical variable-based model (AUC increased from 0.776; 95% CI, 0.660–0.892, to 0.934; 95% CI, 0.881–0.986). Conclusions Urinary mRNA levels of LTF, NNMT, and HIF1A may serve as useful biomarkers for identifying CNI toxicity in kidney transplant recipients with graft dysfunction.

Objective: Hyperuricemia has been described commonly in preeclamptic pregnancies, often prece ding the diagnosis of preeclampsia and historically was used as a diagnostic marker of preeclampsia.The aim of this study was to determine the usefulness of gestation corrected hyperuricemia (GCH) to predict the recurrence of preeclampsia on subsequent pregnancy. Methods: The retrospective study of 64 women who had previous preeclampsia and checked serum uric acid was analyzed. GCH was defined as being one standard deviation above the gestation-specific mean. And we used uric acid z-scores ([serum uric acid value-gestation specific mean]/standard deviation of the population) to account for gestation-specific alterations in uric acid and tested this as a continuous variable. The relationship between GCH and recurrence of preeclampsia on subsequent pregnancy was analyzed. Obstetric outcomes were reviewed according to absence or presence of GCH. P<0.05 was considered as significant. Results: Of 64 women, seventeen had the development of recurrent preeclampsia (26.6%). The absence or presence of GCH was not associated with the recurrence of preeclampsia on subsequent pregnancy (P=0.267). And gestation-specific uric acid z-score as a continuous variable did not show any association with the prediction of preeclampsia on subsequent pregnancy (P=0.427). GCH was associated with the small for gestational age (P=0.010). Conclusion GCH does not predict the recurrence of preeclampsia on subsequent pregnancy.

Objective: Hyperuricemia has been described commonly in preeclamptic pregnancies, often prece ding the diagnosis of preeclampsia and historically was used as a diagnostic marker of preeclampsia.The aim of this study was to determine the usefulness of gestation corrected hyperuricemia (GCH) to predict the recurrence of preeclampsia on subsequent pregnancy. Methods: The retrospective study of 64 women who had previous preeclampsia and checked serum uric acid was analyzed. GCH was defined as being one standard deviation above the gestation-specific mean. And we used uric acid z-scores ([serum uric acid value-gestation specific mean]/standard deviation of the population) to account for gestation-specific alterations in uric acid and tested this as a continuous variable. The relationship between GCH and recurrence of preeclampsia on subsequent pregnancy was analyzed. Obstetric outcomes were reviewed according to absence or presence of GCH. P<0.05 was considered as significant. Results: Of 64 women, seventeen had the development of recurrent preeclampsia (26.6%). The absence or presence of GCH was not associated with the recurrence of preeclampsia on subsequent pregnancy (P=0.267). And gestation-specific uric acid z-score as a continuous variable did not show any association with the prediction of preeclampsia on subsequent pregnancy (P=0.427). GCH was associated with the small for gestational age (P=0.010). Conclusion GCH does not predict the recurrence of preeclampsia on subsequent pregnancy.

Objective: Hyperuricemia has been described commonly in preeclamptic pregnancies, often prece ding the diagnosis of preeclampsia and historically was used as a diagnostic marker of preeclampsia.The aim of this study was to determine the usefulness of gestation corrected hyperuricemia (GCH) to predict the recurrence of preeclampsia on subsequent pregnancy. Methods: The retrospective study of 64 women who had previous preeclampsia and checked serum uric acid was analyzed. GCH was defined as being one standard deviation above the gestation-specific mean. And we used uric acid z-scores ([serum uric acid value-gestation specific mean]/standard deviation of the population) to account for gestation-specific alterations in uric acid and tested this as a continuous variable. The relationship between GCH and recurrence of preeclampsia on subsequent pregnancy was analyzed. Obstetric outcomes were reviewed according to absence or presence of GCH. P<0.05 was considered as significant. Results: Of 64 women, seventeen had the development of recurrent preeclampsia (26.6%). The absence or presence of GCH was not associated with the recurrence of preeclampsia on subsequent pregnancy (P=0.267). And gestation-specific uric acid z-score as a continuous variable did not show any association with the prediction of preeclampsia on subsequent pregnancy (P=0.427). GCH was associated with the small for gestational age (P=0.010). Conclusion GCH does not predict the recurrence of preeclampsia on subsequent pregnancy.

Objective: Hyperuricemia has been described commonly in preeclamptic pregnancies, often prece ding the diagnosis of preeclampsia and historically was used as a diagnostic marker of preeclampsia.The aim of this study was to determine the usefulness of gestation corrected hyperuricemia (GCH) to predict the recurrence of preeclampsia on subsequent pregnancy. Methods: The retrospective study of 64 women who had previous preeclampsia and checked serum uric acid was analyzed. GCH was defined as being one standard deviation above the gestation-specific mean. And we used uric acid z-scores ([serum uric acid value-gestation specific mean]/standard deviation of the population) to account for gestation-specific alterations in uric acid and tested this as a continuous variable. The relationship between GCH and recurrence of preeclampsia on subsequent pregnancy was analyzed. Obstetric outcomes were reviewed according to absence or presence of GCH. P<0.05 was considered as significant. Results: Of 64 women, seventeen had the development of recurrent preeclampsia (26.6%). The absence or presence of GCH was not associated with the recurrence of preeclampsia on subsequent pregnancy (P=0.267). And gestation-specific uric acid z-score as a continuous variable did not show any association with the prediction of preeclampsia on subsequent pregnancy (P=0.427). GCH was associated with the small for gestational age (P=0.010). Conclusion GCH does not predict the recurrence of preeclampsia on subsequent pregnancy.

Objective: Hyperuricemia has been described commonly in preeclamptic pregnancies, often prece ding the diagnosis of preeclampsia and historically was used as a diagnostic marker of preeclampsia.The aim of this study was to determine the usefulness of gestation corrected hyperuricemia (GCH) to predict the recurrence of preeclampsia on subsequent pregnancy. Methods: The retrospective study of 64 women who had previous preeclampsia and checked serum uric acid was analyzed. GCH was defined as being one standard deviation above the gestation-specific mean. And we used uric acid z-scores ([serum uric acid value-gestation specific mean]/standard deviation of the population) to account for gestation-specific alterations in uric acid and tested this as a continuous variable. The relationship between GCH and recurrence of preeclampsia on subsequent pregnancy was analyzed. Obstetric outcomes were reviewed according to absence or presence of GCH. P<0.05 was considered as significant. Results: Of 64 women, seventeen had the development of recurrent preeclampsia (26.6%). The absence or presence of GCH was not associated with the recurrence of preeclampsia on subsequent pregnancy (P=0.267). And gestation-specific uric acid z-score as a continuous variable did not show any association with the prediction of preeclampsia on subsequent pregnancy (P=0.427). GCH was associated with the small for gestational age (P=0.010). Conclusion GCH does not predict the recurrence of preeclampsia on subsequent pregnancy.

Purpose: Renal tumors account for approximately 7% of all childhood cancers. These include Wilms tumor (WT), clear cell sarcoma of the kidney (CCSK), malignant rhabdoid tumor of the kidney (MRTK), renal cell carcinoma (RCC), congenital mesoblastic nephroma (CMN) and other rare tumors. We investigated the epidemiology of pediatric renal tumors in Korea. Materials and Methods: From January 2001 to December 2015, data of pediatric patients (0–18 years) newly-diagnosed with renal tumors at 26 hospitals were retrospectively analyzed. Results: Among 439 patients (male, 240), the most common tumor was WT (n=342, 77.9%), followed by RCC (n=36, 8.2%), CCSK (n=24, 5.5%), MRTK (n=16, 3.6%), CMN (n=12, 2.7%), and others (n=9, 2.1%). Median age at diagnosis was 27.1 months (range 0-225.5) and median follow-up duration was 88.5 months (range 0-211.6). Overall, 32 patients died, of whom 17, 11, 1, and 3 died of relapse, progressive disease, second malignant neoplasm, and treatment-related mortality. Five-year overall survival and event free survival were 97.2% and 84.8% in WT, 90.6% and 82.1% in RCC, 81.1% and 63.6% in CCSK, 60.3% and 56.2% in MRTK, and 100% and 91.7% in CMN, respectively (p < 0.001). Conclusion The pediatric renal tumor types in Korea are similar to those previously reported in other countries. WT accounted for a large proportion and survival was excellent. Non-Wilms renal tumors included a variety of tumors and showed inferior outcome, especially MRTK. Further efforts are necessary to optimize the treatment and analyze the genetic characteristics of pediatric renal tumors in Korea.

The Korean Society for Electrolyte and Blood Pressure Research, in collaboration with the Korean Society of Nephrology, has published a clinical practice guideline (CPG) document for hyponatremia treatment. The document is based on an extensive evidence-based review of the diagnosis, evaluation, and treatment of hyponatremia with the multidisciplinary participation of representative experts in hyponatremia with methodologist support for guideline development. This CPG consists of 12 recommendations (two for diagnosis, eight for treatment, and two for special situations) based on eight detailed topics and nine key questions. Each recommendation begins with statements graded by the strength of the recommendations and the quality of the evidence. Each statement is followed by rationale supporting the recommendations. The committee issued conditional recommendations in favor of rapid intermittent bolus administration of hypertonic saline in severe hyponatremia, the use of vasopressin receptor antagonists in heart failure with hypervolemic hyponatremia, and syndrome of inappropriate antidiuresis with moderate to severe hyponatremia, the individualization of desmopressin use, and strong recommendation on the administration of isotonic fluids as maintenance fluid therapy in hospitalized pediatric patients. We hope that this CPG will provide useful recommendations in practice, with the aim of providing clinical support for shared decision-making to improve patient outcomes.