Clinical and Experimental Nephrology最新文献

{"title":"Kidney injury associated with fosravuconazole L-lysine ethanolate.","authors":"Takahiro Shinzato, Kojiro Nagai, Yuuki Hoshino, Yuuichi Fujiwara, Yoshihiro Yamamoto, Kikuno Ogura, Azusa Morishita, Takao Okawa, Kenta Ito, Masaaki Murakami, Ken Matsuo, Satoshi Tanaka","doi":"10.1007/s10157-024-02582-8","DOIUrl":"10.1007/s10157-024-02582-8","url":null,"abstract":"<p><strong>Background: </strong>Fosravuconazole L-lysine ethanolate (F-RVCZ) is a prodrug of ravuconazole and a triazole antifungal drug used for the treatment of onychomycosis. It has been reported in previous studies that the kidney injury caused by F-RVCZ is 1% or less.</p><p><strong>Methods: </strong>Serum creatinine levels were compared, and glomerular filtration rate and urine protein were estimated before and after starting the administration of F-RVCZ, as well as after the end of the administration period. The cause of kidney injury was investigated using renal pathology, and risk factors were also investigated.</p><p><strong>Results: </strong>F-RVCZ was administered to 46 patients. Ten of these patients were excluded because three were maintenance dialysis patients and seven were not measured for serum creatinine. Remaining 36 patients were included in the analyses. Kidney injury occurred in 27.8% of patients treated with F-RVCZ; this condition persisted in 10% of patients after the end of the administration period. No changes were observed in the urinalysis after the administration of F-RVCZ. A kidney biopsy was performed in one patient, but no lesions were found that could be the cause of kidney injury. Patients who developed kidney injury were significantly more likely to be receiving angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers (odds ratio 18.9, 95% confidential interval: 1.69-210, p = 0.0169).</p><p><strong>Conclusion: </strong>Kidney injury is caused by F-RVCZ more frequently than previously reported, but the mechanism remains unclear.</p>","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":"427-432"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564022","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":"SGLT2 inhibitors increase low serum magnesium levels in patients with chronic kidney disease immediately after treatment.","authors":"Kosuke Osawa, Masaki Ohya, Shuto Yamamoto, Yuri Nakashima, Yusuke Tanaka, Yukiko Yamano, Taisuke Takatsuka, Shin-Ichi Araki","doi":"10.1007/s10157-024-02590-8","DOIUrl":"10.1007/s10157-024-02590-8","url":null,"abstract":"<p><strong>Background: </strong>Sodium-glucose cotransporter 2 (SGLT2) inhibitors have been shown in clinical trials to increase serum Mg²⁺ levels in patients with type 2 diabetes mellitus. However, it is unclear whether this effect is similarly observed in patients with chronic kidney disease (CKD) and whether such an increase is observed immediately after treatment.</p><p><strong>Methods: </strong>Our retrospective observational study included the 62 patients with CKD who started SGLT2 inhibitor therapy at our institution between 2017 and 2022 and who had complete data on serum Mg²⁺ measurements at baseline and at 1, 3, and 6 months after treatment. Patients were divided into three subgroups, stratified by serum Mg²⁺ levels at baseline. We evaluated the changes in serum Mg²⁺ levels from baseline to 6 months after treatment and the factors associated with these changes.</p><p><strong>Results: </strong>Median eGFR and mean serum Mg²⁺ at baseline were 33.5 mL/min/1.73 m² and 2.03 mg/dL, respectively. Treatment with SGLT2 inhibitors significantly increased serum Mg²⁺ levels immediately from 1 month after treatment compared with those at baseline and persisted over 6 months, with an overall mean change of 0.13 mg/dL from baseline to 6 months. This increased effect was observed in the low and middle tertile subgroups, but not in the high tertile subgroup. Multivariate linear regression analysis revealed that baseline serum Mg²⁺ levels and sodium-chloride differences, as a parameter of acid-base status, were independently associated with these changes.</p><p><strong>Conclusions: </strong>SGLT2 inhibitors increased serum Mg²⁺ levels in patients with CKD, particularly those with lower baseline Mg²⁺ levels, potentially improving their prognosis.</p>","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":"452-459"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142643883","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":"MicroRNAs in idiopathic childhood nephrotic syndrome.","authors":"Aditi Sinha, Manraj Sra, Aijaz Ahmed, Saumyaranjan Mallick, Himanshi Saini, Kshetrimayum Ghanapriya Devi, Pankaj Hari, Arvind Bagga","doi":"10.1007/s10157-024-02595-3","DOIUrl":"10.1007/s10157-024-02595-3","url":null,"abstract":"<p><strong>Background: </strong>miRNAs are non-coding RNA that are recognized as biomarkers of kidney disorders. There is limited information on the differential expression of miRNA and their target genes in idiopathic nephrotic syndrome of childhood.</p><p><strong>Methods: </strong>We enrolled patients, 2-18 years old, with steroid-sensitive nephrotic syndrome, either at onset or during relapse, and steroid-resistant disease, at diagnosis of steroid-resistance. Patients with steroid-sensitive disease were off immunosuppressive medications, while those with steroid-resistance were on therapy with prednisolone at enrollment. Controls were healthy children attending the hospital for vaccinations or for minor non-infectious, non-kidney ailments. Following RNA extraction from whole blood, differential expression of 2549 miRNAs was examined to identify differentially expressed miRNA, defined as those with absolute log₂ fold change > 2 and adjusted P < 0.05. Target genes, predicted using miRNet, were compared against the genes for nephrotic syndrome in the NCBI database, and the ontology of selected genes was examined using DAVID.</p><p><strong>Results: </strong>Comparison of miRNA expression in 36 patients and 12 controls led to the identification of 62 and 12 differentially expressed miRNA in patients with steroid-sensitive and steroid-resistant disease, respectively. Of 76 miRNAs that were differentially regulated between the two disease categories, 26 were unique to steroid-sensitive disease and 11 to steroid-resistance. Of 5955 and 2813 genes targeted by the miRNAs specific to steroid-sensitive and steroid-resistant nephrotic syndrome, respectively, 79 were relevant in context of the disease.</p><p><strong>Conclusion: </strong>Steroid-sensitive and steroid-resistant nephrotic syndrome have distinct miRNA expression profiles, which can be examined as biomarkers and in pathogenetic pathways.</p>","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":"477-484"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766861","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":"Survival benefit of CPAP therapy among dialysis patients with obstructive sleep apnea.","authors":"Kunitoshi Iseki, Takuhiro Moromizato, Chiho Iseki, Kei Nakamura, Hiroshi Nakamura","doi":"10.1007/s10157-024-02604-5","DOIUrl":"10.1007/s10157-024-02604-5","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>We observed lower risk of all-cause mortally among continuous positive airway pressure (CPAP) users compared to those non-users using a large polysomnography (PSG) registry. However, the effect of CPAP on mortality risk has not been examined in dialysis patents.</p><p><strong>Methods: </strong>We studied 9841 patients with PSG performed from September 1990 to 2010 in Nakamura clinic, Okinawa. Among them, we found 195 dialysis patients: 16 (1.0%) dialysis patients with apnea hypopnea index (AHI) < 5/hour in 1665 subjects and 179 (2.2%) in 8176 obstructive sleep apnea (OSA) patients. CPAP users were defined as patients who had been on CPAP for more than one month. Patients qualified and eligible for CPAP but refused were assigned as CPAP non-users. The median observation was 6.6 years. Mortality rates were compared between CPAP users and non-users using multivariate logistic analysis adjusted for age, sex, body mass index (BMI), AHI and medical history.</p><p><strong>Results: </strong>Among OSA dialysis patients (men 127, women 37), 116 (2.6%) were CPAP users and 48 (2.3%) were CPAP non-users. The number of deaths was 52 (29 CPAP users and 23 (CPAP non-users) during follow-up. The death rate was 25.0% for CPAP users and 47.9% for non-users. CPAP users showed better survival; hazard ratio (HR) 0.47 and 95% confidence interval (CI) of 0.27-0.81 (P = 0.007).</p><p><strong>Conclusion: </strong>Dialysis patients with OSA showed better survival rates with the use of CPAP. Screening for OSA is recommended if patients complain of sleep problems, such as insomnia, daytime sleepiness, headache, and fatigue.</p>","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":"485-491"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827596","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":"Predictive values of four nutritional indices for adverse outcomes in patients with hypertension.","authors":"Hiroki Ejiri, Kenichi Tanaka, Hiroshi Kimura, Hirotaka Saito, Michio Shimabukuro, Koichi Asahi, Tsuyoshi Watanabe, Junichiro James Kazama","doi":"10.1007/s10157-024-02586-4","DOIUrl":"10.1007/s10157-024-02586-4","url":null,"abstract":"<p><strong>Background: </strong>Malnutrition, evaluated by nutritional indices, is reportedly related to a poor prognosis in patients with hypertension. However, clinical evidence on which index is more suitable for predicting a kidney prognosis is limited, and it has not been evaluated in hypertension. The aim of the present study was to investigate and compare the predictive values of four nutritional indices: Geriatric Nutritional Risk Index (GNRI); Prognostic Nutrition Index (PNI); Triglycerides × Total cholesterol × Body weight Index (TCBI); and the controlling nutritional status (CONUT) score.</p><p><strong>Methods: </strong>A retrospective, cohort study of 1255 hypertensive patients under care in the Fukushima Cohort Study was conducted. The primary outcome was kidney events, defined as a combination of a 50% decline in eGFR from baseline and renal failure requiring dialysis therapy or kidney transplantation. Kaplan-Meier analyses and multivariate Cox regression analyses were conducted to examine associations between the four nutritional indices and kidney events. The area under the curve (AUC) values of the receiver-operating characteristic curves were also examined to compare the predictive values of these nutritional indices.</p><p><strong>Results: </strong>Lower GNRI, lower PNI, and higher CONUT score were significantly related to a higher risk of kidney events. GNRI (AUC = 0.729, 95% confidence interval 0.681-0.777) and PNI (AUC = 0.710, 95% confidence interval 0.665-0.756) had significantly higher AUCs for kidney events than the TCBI and CONUT score.</p><p><strong>Conclusions: </strong>GNRI and PNI showed greater predictive values for kidney events than other nutritional indices in patients with hypertension.</p>","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":"433-443"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582307","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":"Renal tubular damage as an independent risk factor for all-cause and cardiovascular mortality in a community-based population: the Takahata study.","authors":"Takaya Suzuki, Kazunobu Ichikawa, Natsuko Suzuki, Masafumi Watanabe, Tsuneo Konta","doi":"10.1007/s10157-024-02592-6","DOIUrl":"10.1007/s10157-024-02592-6","url":null,"abstract":"<p><strong>Background: </strong>Renal tubular damage plays a crucial role in the development of end-stage kidney disease, a risk factor for cardiovascular events and mortality. However, the relationship between renal tubular damage and all-cause and cardiovascular mortality rates in the general population remains unclear. To address this gap, we conducted a cohort study in the general population using the urinary β2-microglobulin-creatinine ratio (UBCR) as a marker of renal tubular damage.</p><p><strong>Methods: </strong>This study included 3427 residents aged ≥ 40 years in Takahata, Japan. We examined the association between the UBCR values in single-spot urine samples at enrollment and all-cause and cardiovascular mortality rates within a median follow-up of 9.2 years.</p><p><strong>Results: </strong>The participants were divided into two groups based on their UBCR levels (< 300 μg/g and ≥ 300 μg/g groups). Kaplan-Meier analysis showed a significantly higher incidence of all-cause and cardiovascular mortality rates in the high UBCR group (log-rank P < 0.01). Multivariable Cox proportional hazards model adjusted for age, sex, estimated glomerular filtration rate (eGFR), urine albumin level, smoking, and comorbidities showed a significantly higher hazard ratio of 1.49 (95% confidence interval (CI) 1.10-2.03, P = 0.01) for all-cause mortality and a hazard ratio of 1.73 (95% CI 1.00-2.98, P = 0.048) for cardiovascular mortality in the high-UBCR group. The net reclassification index was significantly improved by adding a high UBCR to the conventional risk factors.</p><p><strong>Conclusion: </strong>UBCR is an independent risk factor for all-cause and cardiovascular mortality in the general population, independent of eGFR and urinary albumin levels.</p>","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":"444-451"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11937237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142616062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pleuroperitoneal communication through the retroperitoneum.","authors":"Akira Nakamura, Kohkichi Morimoto, Tadashi Yoshida","doi":"10.1007/s10157-024-02613-4","DOIUrl":"10.1007/s10157-024-02613-4","url":null,"abstract":"","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":"505-506"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885236","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":"Comparative study of the protective effects of coenzyme Q10 and cinnamon extract on possible kidney damage and dysfunction of amiodarone in rats.","authors":"Ozgur Ekici, Abdullah Gul, Ercument Keskin, Seval Bulut, Bahadir Suleyman, Renad Mammadov, Betul Cicek, Ozlem Demir, Murat Gunay, Halis Suleyman","doi":"10.1007/s10157-024-02584-6","DOIUrl":"10.1007/s10157-024-02584-6","url":null,"abstract":"<p><strong>Background: </strong>An increase in free oxygen radicals and proinflammatory cytokines and decrease in intracellular adenosine triphosphate account for the nephrotoxic effect of amiodarone. This study investigated the protective effects of Coenzyme Q10 (CoQ10), cinnamon extract (CE) and the combination of the two (CoCE) on possible amiodarone-induced renal injury in rats.</p><p><strong>Methods: </strong>Thirty male albino Wistar rats were cetegorized into healthy (HG), amiodarone (ADG), CoQ10 + amiodarone (CoQA), CE + amiodarone (CEA), and CoCE + amiodarone (CoCEA) groups. First, CoQ10 (10 mg/kg) and CE (100 mg/kg) were orally given. After 1 h, 50 mg/kg amiodarone was orally given to all groups except for HG. Amiodarone, CoQ10, and CE administration was continued orally at the indicated doses once daily for 10 days.Then, blood samples were collected from all groups to determine creatinine, blood urea nitrogen (BUN), and kidney injury molecule (KIM-1) levels, followed by euthanasia and removal of kidney tissues. Oxidative stress and inflammatory parameters were analysed in the tissue samples. Histopathological examination was also performed on the tissues.</p><p><strong>Results: </strong>Amiodarone increased malondialdehyde levels and decreased total glutathione, superoxide dismutase, and catalase levels (p < 0.001). Amiodarone increased the expression and tissue levels of tissue nuclear factor kappa B, tumor necrosis factor-alpha, interleukin-1β and interleukin-6, and led to increases in serum creatinine and BUN and KIM-1 levels (p < 0.001). Amiodarone also caused histopathological damage (p < 0.001).CoQ10, CE and especially CoCE inhibited biochemical changes and tissue damage (p < 0.001).</p><p><strong>Conclusion: </strong>Although CoQ10, CE, and CoCE effectively prevent amiodarone-induced oxidative and inflammatory nephrotoxicity, CoCE appears to be superior.</p>","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":"414-426"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544105","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 role of C-reactive protein-to-albumin ratio as a prognostic biomarker in patients hospitalized for cardiorenal syndrome.","authors":"Panagiotis Theofilis, Aikaterini Vordoni, Paschalis Karakasis, Nikolaos Volis, Aikaterini Kampourelli, Georgia Doumani, Eleni Xanthopoulou, Rigas G Kalaitzidis","doi":"10.1007/s10157-024-02596-2","DOIUrl":"10.1007/s10157-024-02596-2","url":null,"abstract":"<p><strong>Background: </strong>Cardio-renal syndrome, characterized by simultaneous cardiac and renal impairment, presents significant challenges in patient prognostication and management. This study aimed to investigate the C-reactive protein-to-albumin ratio (CRP/Albumin ratio) as a prognostic marker in patients with cardiorenal syndrome.</p><p><strong>Methods: </strong>This observational cohort study included consecutive patients hospitalized for cardiorenal syndrome. Baseline demographics, medical history, and prior medication use were recorded. Routine laboratory tests, including serum CRP and albumin, were performed on the first hospitalization day, and their ratio was calculated. Patients were divided into two groups based on the median CRP/Albumin ratio. A transthoracic echocardiographic examination was conducted for each subject. The primary endpoint was in-hospital mortality.</p><p><strong>Results: </strong>A total of 135 patients were enrolled (median age: 79 years, median hospitalization: 9 days, 64.5% male). The population was categorized into two groups: Group 1 with CRP/Albumin ratio < 576 and Group 2 with CRP/Albumin ratio ≥ 576. Baseline characteristics and medication use prior to admission were similar, except for a higher prevalence of diabetes and coronary artery disease in Group 2. Co-existing infection and oliguria/anuria were more common in Group 2. There were no significant differences in laboratory parameters and echocardiographic findings. Cox regression analysis revealed that a CRP/Albumin ratio ≥ 576 was an independent predictor of in-hospital mortality (hazard ratio: 3.09, 95% CI 1.22-7.81, p = 0.017), even after adjusting for confounders.</p><p><strong>Conclusion: </strong>An elevated CRP/Albumin ratio was associated with a higher risk of in-hospital mortality in patients with cardiorenal syndrome, highlighting the critical role of inflammation in this population.</p>","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":"469-476"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675328","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":"Estimated glomerular filtration rate versus creatinine clearance to determine anticoagulant dosage after lower-limb orthopedic surgery.","authors":"Kozo Watanabe, Hiroki Hasegawa, Jun Katoh, Yutaka Hayashi, Isaku Saku, Kazunori Ohshima, Akira Hishida, George Seki, Naoki Ikegaya","doi":"10.1007/s10157-024-02580-w","DOIUrl":"10.1007/s10157-024-02580-w","url":null,"abstract":"<p><strong>Background: </strong>Anticoagulation is recommended for thromboprophylaxis after lower-limb orthopedic surgery. The suggested dosage is based on creatinine clearance (CCr) in the labels. However, most facilities only provide estimated glomerular filtration rate (eGFR) as laboratory data. Because the eGFR equation adjusts for a body surface area (BSA) of 1.73 m², it may overestimate renal function in patients with a small BSA. This retrospective study aimed to determine whether different renal function estimation formulas affect the incidences of venous thromboembolism (VTE) and bleeding when determining anticoagulant dosages.</p><p><strong>Methods: </strong>This study included patients who underwent lower-limb orthopedic surgery and received anticoagulants (edoxaban, enoxaparin, and fondaparinux) between 2017 and 2020 at Yaizu City Hospital. Anticoagulant dosing was evaluated using CCr, eGFR, and de-indexed eGFR (without correction for BSA), and the incidences of VTE and bleeding were compared among these formulas.</p><p><strong>Results: </strong>The median values for BSA, CCr, eGFR, and de-indexed eGFR were 1.40 m², 56.0 mL/min, 73.0 mL/min/1.73m², and 60.9 mL/min, respectively. There was no significant difference in the VTE incidence among these formulas. However, when dose reduction or contraindication threshold was determined by eGFR vs. CCr, the bleeding incidence was significantly higher in the group that was overdosed by CCr (6.0% vs. 25.7%, p < 0.05). Similarly, using de-indexed eGFR vs. CCr, the bleeding incidence was significantly higher in the group that was overdosed by CCr (7.5% vs. 28.6%, p < 0.05).</p><p><strong>Conclusions: </strong>In orthopedic surgery, anticoagulant dosages should be based on CCr for patients with a small BSA to avoid bleeding risks.</p>","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":"405-413"},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521190","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}