Clinical and Experimental Nephrology最新文献

{"title":"Efficacy of valganciclovir prophylaxis in kidney transplant recipients following low-dose rituximab induction therapy: a multicenter retrospective study.","authors":"Tomohiro Takehara, Hayato Nishida, Kazunobu Ichikawa, Takaaki Nawano, Satoshi Takai, Hiroki Fukuhara, Tomohiko Matsuura, Shinya Maita, Mitsuru Saito, Reiichi Murakami, Shingo Hatakeyama, Wataru Obara, Hisao Saitoh, Chikara Ohyama, Tomonori Habuchi, Masafumi Watanabe, Norihiko Tsuchiya","doi":"10.1007/s10157-024-02578-4","DOIUrl":"https://doi.org/10.1007/s10157-024-02578-4","url":null,"abstract":"<p><strong>Background: </strong>Rituximab (RIT) induction therapy is widely used for desensitization against ABO-incompatible living-donor kidney transplants (KT). However, the efficacy of valganciclovir (VGCV) prophylaxis against cytomegalovirus (CMV) disease and infection in KT recipients (KTRs) following RIT induction remains unclear.</p><p><strong>Methods: </strong>The current multicenter retrospective study included 213 KTRs who received low-dose RIT induction between 1998 and 2021, across 6 facilities included in the Michinoku Renal Transplant Network (MRTN). VGCV dosage varied from 450 mg/day (twice weekly) to 900 mg/day (daily), with treatment durations of 3-12 months. The primary and secondary endpoints were the incidence of CMV disease and infection, respectively.</p><p><strong>Results: </strong>The incidence of CMV disease was significantly higher in the VGCV group (23.5%; 16 patients) than in the non-VGCV group (5.5%; 8 patients) (p < 0.01). The incidence of CMV infection was 54.5% (79 patients) in the non-VGCV group and 48.5% (33 patients) in the VGCV group, with no significant difference (p = 0.42). In the subgroup of CMV-seronegative KTRs receiving allografts from CMV-seropositive donors (CMV IgG (D + /R-)), 18 out of 24 KTRs received VGCV prophylaxis, of whom 10 (55.6%) developed CMV disease. Within this subgroup, only 4 KTRs received VGCV with the standard protocol (900 mg daily for 6 months), and none developed CMV disease.</p><p><strong>Conclusion: </strong>Insufficient VGCV prophylaxis does not reduce the incidence of CMV disease in KTRs following low-dose RIT induction. Despite concerns about leukopenia due to RIT and VGCV, in KTRs with CMV IgG (D + /R-) serostatus, VGCV prophylaxis with a standard protocol may be advisable.</p>","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The risk of chronic kidney disease or proteinuria with long or short sleep duration: a systematic review and meta-analysis of cohort studies.","authors":"Meng Hu, Yongchong Wang, Wen Zhu, Xiaozhen Chen","doi":"10.1007/s10157-024-02575-7","DOIUrl":"https://doi.org/10.1007/s10157-024-02575-7","url":null,"abstract":"<p><strong>Objective: </strong>Irregular sleep duration has been linked with systemic diseases as well as chronic kidney disease (CKD). However, most of the evidence is low-quality and from cross-sectional data. We hereby present a meta-analysis of cohort studies examining the longitudinal association between short and long sleep with the risk of CKD or proteinuria.</p><p><strong>Methods: </strong>Databases of Embase, PubMed, CENTRAL, Web of Science, and Scopus were searched up to 5th April 2024. The risk of CKD/proteinuria was assessed with short or long sleep duration.</p><p><strong>Results: </strong>Nine studies were included. Both short and long sleep duration were associated with a mild increase in the risk of CKD/proteinuria. Based on different cutoffs for short sleep, we noted that sleep of ≤ 7 h was not associated with a significantly increased risk of CKD/proteinuria. A mild significant risk was noted in the subgroup of ≤ 6 h while a significant association was noted for sleep ≤ 5 h. For longer sleep duration, individuals with ≥ 8 h of sleep had an increased risk of CKD/proteinuria. However, the results were non-significant for individuals with ≥ 9 h of sleep. Non-significant results were noted for separate analyses on male, female, high body mass index, and elderly (≥ 60 years) individuals.</p><p><strong>Conclusion: </strong>Both short and long sleep durations are associated with a significant increase in the risk of CKD/proteinuria in the adult population.</p>","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of communication environment and health literacy of patients on chronic hemodialysis: a multicenter observational study (SMEL-HD study).","authors":"Chieko Hamada, Junko Kuwamura, Mitsumine Fukui, Isao Ohsawa, Yuuya Nakamura, Shigenobu Suzuki, Fukuji Takeda, Reo Kanda, Atsuko Urita, Yasuhiko Tomino","doi":"10.1007/s10157-024-02572-w","DOIUrl":"https://doi.org/10.1007/s10157-024-02572-w","url":null,"abstract":"<p><strong>Background: </strong>The ability to access health and medical information have implications for prognosis and quality of life. This study investigated the current communication environment and health literacy in chronic hemodialysis (HD) patients and their associations with patients' physical condition and clinical findings.</p><p><strong>Methods: </strong>This was a cross-sectional, single-arm, multicenter exploratory study. Data were collected from 211 patients (64 males) undergoing chronic HD at five facilities. This included a survey of communication environments, health literacy, dialysis management information, and clinical findings.</p><p><strong>Results: </strong>Among the participants, 145 (68.7%) reported using the Internet. They primarily collected health-related as well as everyday life information through the Internet. Health literacy fell within the problematic range. In terms of e-Health literacy, \"understanding\" and \"easy\" showed a positive trend, while \"accessing,\" \"appraising,\" and \"applying\" were perceived as \"difficult.\" Three groups were identified based on Internet usage: good communication environment (CE) group (134 participants), poor-CE group (56 participants), and a group that did not respond (21 participants). Grip strength, serum albumin level, and \"information acquisition\" were significantly lower in the poor-CE group. Health literacy increases as the duration of dialysis extends, and decreases with advancing age.</p><p><strong>Conclusions: </strong>Patients who used the Internet gained a wide range of information, including health-related information, for their daily lives. The use of ICT is lower among patients with decreased physical activity, and further investigation is desired into how actively encouraging these patients to collect health information via the Internet can enhance their health literacy.</p>","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phase angle variability on bleeding risks in hemodialysis patients.","authors":"Masayuki Ohta, Toshiro Kan, Yuichi Yoshida, Hiroki Sato, Takuma Hoshino, Tadanao Sato, Yutaka Hoshino","doi":"10.1007/s10157-024-02577-5","DOIUrl":"https://doi.org/10.1007/s10157-024-02577-5","url":null,"abstract":"<p><strong>Background: </strong>This study investigated the association between Phase Angle (PhA), measured by bioelectrical impedance analysis, and bleeding risk in hemodialysis patients to evaluate PhA as a predictive marker for bleeding events.</p><p><strong>Methods: </strong>This retrospective cohort study included 102 hemodialysis patients who underwent PhA measurements between July 2019 and April 2024. Demographic data, medical histories, dialysis parameters, and bleeding events were collected. Patients were stratified by PhA values and followed for a median of 832 days (IQR: 516-1304 days). Multivariate Cox proportional hazards regression and Kaplan-Meier analysis were performed.</p><p><strong>Results: </strong>The cohort had an average age of 74.0 years and a median dialysis vintage of 6.7 years. During follow-up, 19 patients (18.6%) experienced major bleeding events. Lower PhA was an independent risk factor for bleeding (HR: 0.24, 95% CI 0.11-0.52, p < 0.001). Kaplan-Meier analysis showed that patients with PhA ≥ 4.00 had a higher probability of remaining free from major bleeding at 2 years (94.3%) compared to those with PhA < 4.00 (75.0%) (p < 0.001). In 82 patients with repeat PhA measurements, bleeding event-free rates at 2 years were 97.5%, 75%, 100%, and 78.3% for the High to High, High to Low, Low to High, and Low to Low groups, respectively (p < 0.001).</p><p><strong>Conclusion: </strong>PhA is a predictive marker for bleeding risk in hemodialysis patients. Routine PhA monitoring could help stratify bleeding risk and optimize clinical management.</p>","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world fracture risk, osteoporosis treatment status, and mortality of Japanese non-dialysis patients with chronic kidney disease stages G3-5.","authors":"Yasuo Imanishi, Satsuki Taniuchi, Sho Kodama, Hisako Yoshida, Tetsuo Ito, Ryota Kawai, Naoki Okubo, Ayumi Shintani","doi":"10.1007/s10157-024-02562-y","DOIUrl":"https://doi.org/10.1007/s10157-024-02562-y","url":null,"abstract":"<p><strong>Background: </strong>Few studies have investigated fracture risk and mortality in a Japanese chronic kidney disease (CKD) stages G3-5 population using a large-scale clinical database.</p><p><strong>Methods: </strong>This retrospective cohort study extracted data from 1 April 2008 to 30 April 2023. A single age-sex-matched control without CKD was matched with each non-dialysis CKD (estimated glomerular filtration rate < 60 mL/min/1.73 m²) patient. The incidences of all and hip fractures and all-cause mortality after the index date were calculated.</p><p><strong>Results: </strong>Among 76,598 (38,299 per group) individuals matched, the incidence of all fractures did not differ between the CKD and control groups (5.7% vs 5.8%; hazard ratio [HR] 1.022 [95% confidence interval CI 0.952-1.098], P = 0.542). The CKD group had higher risk of hip fracture than the control group (incidence of hip fracture, 1.7% vs 1.3%; HR 1.415 [95% CI 1.234-1.622], P < 0.001). Multivariable regression analysis showed an increased risk for hip fracture in the CKD vs control groups, and a greater difference in this risk was observed with younger age. Osteoporosis treatment and bone mineral density (BMD) measurements were 10.0% and 5.3% in the CKD group and 4.4% and 4.4% in the control group, respectively. Mortality was also higher in the CKD group (HR 1.413 [95% CI 1.330-1.501], P < 0.001).</p><p><strong>Conclusions: </strong>Japanese patients with CKD had higher risk of hip fracture than those without. Treatment and BMD measurement for fracture are insufficient in Japanese patients with CKD, and more adequate management of fracture risk is needed.</p>","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Causality between diabetes and membranous nephropathy: Mendelian randomization.","authors":"Zhihang Su, Ziqi Luo, Di Wu, Wen Liu, Wangyang Li, Zheng Yin, Rui Xue, Liling Wu, Yuan Cheng, Qijun Wan","doi":"10.1007/s10157-024-02566-8","DOIUrl":"https://doi.org/10.1007/s10157-024-02566-8","url":null,"abstract":"<p><strong>Background: </strong>Membranous nephropathy (MN) has not yet been fully elucidated regarding its relationship with Type I and II Diabetes. This study aims to evaluate the causal effect of multiple types of diabetes and MN by summarizing the evidence from the Mendelian randomization (MR) study.</p><p><strong>Methods: </strong>The statistical data for MN was obtained from a GWAS study encompassing 7979 individuals. Regarding diabetes, fasting glucose, fasting insulin, and HbA1C data, we accessed the UK-Biobank, within family GWAS consortium, MAGIC, FinnGen database, MRC-IEU, and Neale Lab, which provided sample sizes ranging from 17,724 to 298,957. As a primary method in this MR analysis, we employed the Inverse Variance Weighted (IVW), Weighted Median, Weighted mode, MR-Egger, Mendelian randomization pleiotropy residual sum, and outlier (MR-PRESSO) and Leave-one-out sensitivity test. Reverse MR analysis was utilized to investigate whether MN affects Diabetes. Meta-analysis was applied to combine study-specific estimates.</p><p><strong>Results: </strong>It has been determined that type 2 diabetes, gestational diabetes, type 1 diabetes with or without complications, maternal diabetes, and insulin use pose a risk to MN. Based on the genetic prediction, fasting insulin, fasting blood glucose, and HbA1c levels were not associated with the risk of MN. No heterogeneity, horizontal pleiotropy, or reverse causal relationships were found. The meta-analysis results further validated the accuracy.</p><p><strong>Conclusions: </strong>The MR analysis revealed the association between MN and various subtypes of diabetes. This study has provided a deeper understanding of the pathogenic mechanisms connecting MN and diabetes.</p>","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142388531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimating the prevalence of chronic kidney disease in the older population using health screening data in Japan.","authors":"Arisa Kobayashi, Keita Hirano, Tadahisa Okuda, Tatsuyoshi Ikenoue, Takashi Yokoo, Shingo Fukuma","doi":"10.1007/s10157-024-02570-y","DOIUrl":"https://doi.org/10.1007/s10157-024-02570-y","url":null,"abstract":"<p><strong>Background: </strong>In aging societies, the prevalence of chronic kidney disease (CKD) is expected to increase but may be underestimated because many asymptomatic patients remain undiagnosed. This study aimed to estimate the CKD prevalence among the general older population in Japan.</p><p><strong>Methods: </strong>This cross-sectional study used health screening data from the Japan Health Insurance Association collected between April 2014 and March 2023. Data from older people aged 65-90 years who underwent renal function screening for estimated glomerular filtration rate (eGFR) and urine protein tests were analyzed. CKD was defined as eGFR < 60 mL/min/1.73 m² or proteinuria ≥ 1 + . Inverse probability weighting was used to account for the selection bias. The variables used for weighting were age, sex, insurance status, and the number of previous screenings.</p><p><strong>Results: </strong>Among 2.98 million older individuals, 588,809 (19.7%) had undergone screening (median [IQR] age, 69.9 [67.9-76.2] years, 337,862 women [57.4%]). Regarding the weighted CKD prevalence, 25.3% of the individuals aged 65-90 years had CKD; 11.8% of those aged 65-75 years and 34.6% of those aged 75 years and over showed an increase in prevalence with age. Among the patients with CKD, over half exhibited mild renal dysfunction without proteinuria. Hypertension and diabetes were common comorbidities in older patients with CKD.</p><p><strong>Conclusions: </strong>This cross-sectional study revealed that the weighted prevalence of CKD in the older population aged 65-90 years was high (one in four individuals), indicating that it increases with age. Further studies are required to examine the clinical significance of these findings.</p>","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142379172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcomes in peritoneal dialysis with refractory peritonitis: significance of the day 5 cell count.","authors":"Ilay Berke, Dilek Barutcu Atas, Murat Tugcu, Hakki Arikan, Arzu Velioglu, Ebru Asicioglu","doi":"10.1007/s10157-024-02564-w","DOIUrl":"10.1007/s10157-024-02564-w","url":null,"abstract":"<p><strong>Background: </strong>Peritoneal dialysis-associated peritonitis is a common and severe complication of peritoneal dialysis, associated with high morbidity and mortality. However, there's a lack of research on refractory peritonitis, which is difficult to manage and has a poor prognosis. Our study aimed to investigate factors affecting clinical outcomes in peritoneal dialysis patients with refractory peritonitis over a 12-year period at a medical faculty hospital in Turkey.</p><p><strong>Methods: </strong>We conducted a retrospective study at a single center from January 2009 to December 2020, involving 135 patients with 236 episodes of refractory peritonitis. The average age of the patient cohort was 53.0 ± 15.9 years, and 72 (53.4%) of the patients were male. The leading identified causes of end-stage kidney disease were glomerulonephritis, hypertensive glomerulosclerosis, and diabetic nephropathy. Data on microbiological etiology, dialysate white blood cell counts, and patient demographics were analyzed to identify catheter removal risk factors. Statistical significance was set at p ≤ 0.05.</p><p><strong>Results: </strong>Comparative analysis between patients with and without catheter loss revealed no significant differences in gender, age, presence of diabetes, prior hemodialysis, or duration of peritoneal dialysis. However, multivariate logistic regression analysis showed that a dialysate white blood cell count exceeding 1000/mm³ on day 5 and hospitalization had a positive association with catheter loss, while the presence of gram-positive bacterial growth had an inverse correlation.</p><p><strong>Conclusion: </strong>Our study shows that fifth-day dialysate white blood cell count predicts refractory peritonitis outcomes. Future research should focus on developing tools to manage catheter removal proactively and enhance patient prognosis.</p>","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142379171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of ultrasound in measuring quadriceps muscle thickness in patients receiving maintenance hemodialysis: comprehensive systematic review and meta-analysis.","authors":"Anas Elgenidy, Shady Sapoor, Hasnaa Abdelrhem, Ahmed Said Ali, Saif Sulliman, Sohieb Hedawy, Ayman Elgharori, Hassaan Mady, Wisam Abraheem Hasan, Mohamed Nasser, Esraa Abd Elaal Atta, Mohamed Ghita, Mostafa G Aly, Jana Zschüntzsch","doi":"10.1007/s10157-024-02557-9","DOIUrl":"https://doi.org/10.1007/s10157-024-02557-9","url":null,"abstract":"<p><strong>Background: </strong>Muscle wasting, a prevalent issue in hemodialysis patients, is effectively assessed by measuring quadriceps muscle thickness, a crucial health indicator. This meta-analysis integrates findings from various studies on the application of ultrasonography (US) for measuring the thickness of quadriceps muscles in patients undergoing maintenance hemodialysis.</p><p><strong>Design and methods: </strong>We conducted a thorough literature search across PubMed, Scopus, EMBASE, Cochrane Central Register of Controlled Trials, and Web of Science up to April 2023. The R software's Meta package was used for mean difference analysis of quadriceps rectus femoris thickness (QRFT) and quadriceps vastus intermedius thickness (QVIT) between hemodialysis patients and healthy controls. All of the patients entered the meta-analysis are Caucasians. Sub-group analyses based on measurement sites and pre- and post-dialysis comparisons were performed.</p><p><strong>Results: </strong>Among 15 studies with 1584 patients, a significant decrease in QRFT and QVIT was observed in hemodialysis patients compared to healthy controls (mean difference = 0.40 cm, 95% CI: -0.49 to -0.31 and 0.46 cm, respectively). Right and left QRFT were notably thinner in hemodialysis patients (RT: mean difference = 0.39 cm; LT: mean difference = 0.42 cm). Similarly, right and left QVIT were notably thinner in hemodialysis patients (RT: mean difference = 0.45 cm; LT: mean difference = 0.47 cm). No significant pre- and post-dialysis QRFT differences were found.</p><p><strong>Conclusion: </strong>Ultrasonography is a reliable, accessible tool for assessing quadriceps muscle thickness in hemodialysis patients, revealing consistent muscle thickness reduction. These findings emphasize the need for routine muscle health monitoring in this population and support ultrasound use for regular assessments.</p>","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of encapsulated peritoneal sclerosis in patients undergoing peritoneal dialysis using neutral-pH dialysate.","authors":"Toshiaki Nakano, Hiromasa Kitamura, Shoji Tsuneyoshi, Akihiro Tsuchimoto, Kumiko Torisu, Hiroaki Tsujikawa, Hideki Kawanishi, Kazuhiko Tsuruya, Takanari Kitazono","doi":"10.1007/s10157-024-02565-9","DOIUrl":"https://doi.org/10.1007/s10157-024-02565-9","url":null,"abstract":"<p><strong>Background: </strong>Encapsulated peritoneal sclerosis (EPS) is a serious complication in patients undergoing peritoneal dialysis (PD). Neutral-pH dialysate is associated with less peritoneal damage and a lower incidence of EPS than conventional PD solution. However, monitoring for peritoneal damage and predicting EPS remain important during PD therapy.</p><p><strong>Methods: </strong>We measured the mesothelial cell area, dialysate-to-plasma ratio of creatinine after 4 h, and concentrations of the potential biological markers effluent fibrin degradation products (eFDPs), cancer antigen-125, and interleukin-6 in the effluent dialysate from patients who had been undergoing PD therapy for > 5 years in our hospital. These biomarkers were obtained from the drainage fluid of the final measurement of peritoneal equilibration testing before withdrawal from PD therapy. The concentrations of these potential biomarkers were measured in 39 patients who withdrew from PD therapy and were enrolled in the study.</p><p><strong>Results: </strong>Three participants developed EPS after withdrawing PD. The dialysate-to-plasma ratio of creatinine, area of mesothelial cells, and interleukin-6 appearance rate in participants who developed EPS tended to be higher than those in patients who did not, but there were no significant differences. Significantly more eFDPs were in participants who developed EPS than in those who did not (138.5 ± 15.1 vs. 32.9 ± 7.4 µg/mL, P = 0.002). There was no difference in the cancer antigen-125 appearance rate between the groups. A cut-off value of eFDPs ≥ 119.1 µg/mL was optimal for predicting EPS (P = 0.006, specificity = 0.972, sensitivity = 1.000).</p><p><strong>Conclusion: </strong>This study shows that eFDPs may be a useful biological marker for predicting EPS in patients undergoing PD using neutral-pH dialysate.</p>","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}