Clinical and Experimental Nephrology最新文献_第6页

Recovery time is associated with the onset of cardiovascular disease in Japanese patients undergoing maintenance hemodialysis. 在接受维持性血液透析的日本患者中，恢复时间与心血管疾病的发病有关。

IF 2.2 4区医学

Clinical and Experimental Nephrology Pub Date : 2025-03-01 Epub Date: 2024-10-31 DOI: 10.1007/s10157-024-02579-3

Takaaki Nawano, Kazunobu Ichikawa, Tsuneo Konta, Ikuto Masakane, Masafumi Watanabe

{"title":"Recovery time is associated with the onset of cardiovascular disease in Japanese patients undergoing maintenance hemodialysis.","authors":"Takaaki Nawano, Kazunobu Ichikawa, Tsuneo Konta, Ikuto Masakane, Masafumi Watanabe","doi":"10.1007/s10157-024-02579-3","DOIUrl":"10.1007/s10157-024-02579-3","url":null,"abstract":"Introduction: Cardiovascular disease (CVD) is the leading cause of mortality in patients undergoing maintenance hemodialysis (HD), with various reported risk factors. Recovery time (RT) is a valuable indicator of post-dialysis fatigue. However, the association between RT and the onset of CVD remains unexplored. As such, this study aimed to determine the effect of RT on the onset of CVD.Methods: Data from 620 patients undergoing maintenance HD at Yabuki Hospital and 3 related facilities (Yamagata Prefecture, Japan) as of December 31, 2020, were retrospectively analyzed. Patients were asked to respond to the question \"How long does it take you to recover from a dialysis session?\"; the response was defined as RT. The analysis was performed by categorizing patients into 2 groups according to RT: short RT (< 2 h); and long RT (≥ 2 h). The primary outcome was major adverse cardiovascular events (MACE). Secondary outcomes included all-cause death and hospitalization.Results: During the 24-month follow-up, 70 (11.3%) patients developed MACE. The long RT group exhibited a higher incidence of MACE; multivariate analysis revealed that age and long RT were associated with the onset of MACE. All-cause death was observed in 45 (7.3%) patients, with no significant difference between the 2 groups. Hospitalization occurred in 252 (40.6%) patients and was more frequent in the long RT group. Multivariate analysis revealed that age, sex, duration of HD, intact parathyroid hormone level, and long RT were associated with hospitalization.Conclusion: Long RT was an independent risk factor for the onset of CVD.","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":"342-349"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544106","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}

引用次数: 0

Risk factors for chronic kidney disease in Japanese infants with solitary functioning kidney. 日本孤立肾功能婴儿慢性肾脏疾病的危险因素

IF 2.2 4区医学

Clinical and Experimental Nephrology Pub Date : 2025-03-01 Epub Date: 2025-01-04 DOI: 10.1007/s10157-024-02622-3

Toshimasa Morishita, Shuichiro Fujinaga

引用次数: 0

Chloride removal and bicarbonate replacement by isotonic sodium bicarbonate-based continuous hemodiafiltration: a novel method to correct severe metabolic acidosis. 以等渗碳酸氢钠为基础的持续血液渗滤法去除氯化物并补充碳酸氢盐：纠正严重代谢性酸中毒的新方法。

IF 2.2 4区医学

Clinical and Experimental Nephrology Pub Date : 2025-03-01 Epub Date: 2024-11-27 DOI: 10.1007/s10157-024-02555-x

Yoshihiro Inoue, Yayoi Tsuchihashi, Hassu Kin, Masaaki Nakayama, Yasuhiro Komatsu

{"title":"Chloride removal and bicarbonate replacement by isotonic sodium bicarbonate-based continuous hemodiafiltration: a novel method to correct severe metabolic acidosis.","authors":"Yoshihiro Inoue, Yayoi Tsuchihashi, Hassu Kin, Masaaki Nakayama, Yasuhiro Komatsu","doi":"10.1007/s10157-024-02555-x","DOIUrl":"10.1007/s10157-024-02555-x","url":null,"abstract":"Background: Previous reports highlighted the efficacy of hemofiltration utilizing isotonic sodium bicarbonate solution as replacement fluid for severe metabolic acidosis. This approach corrects metabolic acidosis by eliminating chloride and supplementing bicarbonate. Here, we present the results of an in vitro study aimed at determining the effect of Isotonic sodium bicarbonate-based Continuous HemoDiafiltration (IBB-CHDF).Methods: Conventional Continuous HemoDiaFiltration (CHDF) and IBB-CHDF utilized aqueous solutions mimicking blood's electrolyte composition. To assess the efficacy and safety, we compared serial changes in pH, HCO3-, Na+, and K+ concentrations. Blood flow rate was 100 mL/min, and the dialysis fluid flow rate maintained 1.0 L/h for both CHDF and IBB-CHDF. Replacement flow rates ranged from 0.5 to 1.5 L/h for CHDF and 0.1 to 1.5 L/h for IBB-CHDF.Results: At a replacement flow rate of 0.5 L/h with IBB-CHDF, bicarbonate increased from 14.7 mEq/L to within the physiological range (25.9 mEq/L), whereas in conventional CHDF, the post-treatment bicarbonate concentration did not increase (16.5 mEq/L). The maximum bicarbonate concentration achieved was 22.0 mEq/L at a replacement flow rate of 1.5 L/h in conventional CHDF. Notably, in IBB-CHDF, the sodium concentration remained constant at 150 mEq/L, 10 mEq/L higher than conventional CHDF, and did not escalate despite increasing the replacement flow rate.Conclusion: IBB-CHDF effectively corrects metabolic acidosis without inducing sodium and water overload by eliminating excess chloride while providing bicarbonate.","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":"316-321"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142726571","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}

引用次数: 0

Phase angle variability on bleeding risks in hemodialysis patients. 相角变化对血液透析患者出血风险的影响。

IF 2.2 4区医学

Clinical and Experimental Nephrology Pub Date : 2025-03-01 Epub Date: 2024-10-15 DOI: 10.1007/s10157-024-02577-5

Masayuki Ohta, Toshiro Kan, Yuichi Yoshida, Hiroki Sato, Takuma Hoshino, Tadanao Sato, Yutaka Hoshino

{"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":"10.1007/s10157-024-02577-5","url":null,"abstract":"Background: 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.Methods: 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.Results: 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).Conclusion: PhA is a predictive marker for bleeding risk in hemodialysis patients. Routine PhA monitoring could help stratify bleeding risk and optimize clinical management.","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":"332-341"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","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}

引用次数: 0

Risk factors for septic shock in older patients with urinary tract infection. 老年尿路感染患者出现脓毒性休克的风险因素。

IF 2.2 4区医学

Clinical and Experimental Nephrology Pub Date : 2025-03-01 Epub Date: 2024-11-25 DOI: 10.1007/s10157-024-02563-x

Takaaki Tsuchiya, Kenta Taito, Yui Ota, Shiho Matsuno, Noriko Yamanaka, Masatoshi Oka, Noriyuki Suzuki, Mitsuyo Itabashi, Takashi Takei

{"title":"Risk factors for septic shock in older patients with urinary tract infection.","authors":"Takaaki Tsuchiya, Kenta Taito, Yui Ota, Shiho Matsuno, Noriko Yamanaka, Masatoshi Oka, Noriyuki Suzuki, Mitsuyo Itabashi, Takashi Takei","doi":"10.1007/s10157-024-02563-x","DOIUrl":"10.1007/s10157-024-02563-x","url":null,"abstract":"Backgrounds: Few studies have addressed the risk factors for the development of septic shock in older patients with urinary tract infections. We decided to investigate whether a similar risk exists in in older patients.Methods: A total of 1478 older patients (492 men, 986 women) aged 65 years or older (mean age 85.1 years) who were hospitalized and treated for urinary tract infections were included in this study, and factors contributing to the development of septic shock in these patients, including in terms of the causative pathogens and treatments employed, were investigated through a retrospective review of the patients' medical charts.Results: Underlying urinary tract infection with urolithiasis was found as the most significant risk factor for the development of septic shock (p < 0.01). Patients with urolithiasis were more frail, had higher urinary pH and calcium levels, and showed a higher frequency of infections caused by antimicrobial-resistant and rare bacteria. Cluster analysis revealed a higher incidence of death, septic shock, urolithiasis, and frailty in the patient group treated with carbapenem and/or MRSA agents.Conclusion: Septic shock was associated with a high risk of death in older patients with urinary tract infections, and urolithiasis was identified as an independent risk factor for the development of septic shock. Urolithiasis was also associated with frailty, suggesting that prevention of frailty may indirectly improve the prognosis of patients with septic shock secondary to urinary tract infections.","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":"368-375"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709762","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}

引用次数: 0

Treatment of hyponatremia: comprehension and best clinical practice. 低钠血症的治疗：理解与最佳临床实践。

IF 2.2 4区医学

Clinical and Experimental Nephrology Pub Date : 2025-03-01 Epub Date: 2025-01-23 DOI: 10.1007/s10157-024-02606-3

Hirofumi Sumi, Naoto Tominaga, Yoshiro Fujita, Joseph G Verbalis

引用次数: 0

The estimation of healthcare cost of kidney transplantation in Japan using large-scale administrative databases. 利用大规模行政数据库估算日本肾移植的医疗成本。

IF 2.2 4区医学

Clinical and Experimental Nephrology Pub Date : 2025-03-01 Epub Date: 2024-11-20 DOI: 10.1007/s10157-024-02551-1

Masataka Hasegawa, Hirotaka Kato, Takashi Yoshioka, Rei Goto

{"title":"The estimation of healthcare cost of kidney transplantation in Japan using large-scale administrative databases.","authors":"Masataka Hasegawa, Hirotaka Kato, Takashi Yoshioka, Rei Goto","doi":"10.1007/s10157-024-02551-1","DOIUrl":"10.1007/s10157-024-02551-1","url":null,"abstract":"Background: The financial burden of kidney replacement therapy (KRT) is considerable, and detailed information on KRT costs is essential for managing these huge healthcare costs. However, cost analyses for kidney transplantation (KTx) are limited in Japan. This study aimed to report the healthcare costs of KTx recipients in Japan based on large medical receipt data.Methods: This cost analysis of KTx recipients using the Japan Medical Data Center Claims Database between January 2005 and August 2020 identified living donor KTx (LDKT) and deceased donor KTx (DKT) recipients. The primary outcome was the total direct healthcare costs of KTx recipients. As an exploratory analysis, we examined the factors that contributed to the increase in the costs of LDKT.Results: In total, 84 LDKT and 17 DKT recipients were included in this study. The total healthcare costs for LDKT and DKT recipients during the first year after KTx were 6,639,982 and 6,840,450 JPY/year, respectively. However, after the second year post-KTx, total healthcare costs decreased to 1,735,931 and 1,348,642 JPY/year for LDKT and DKT recipients, respectively. During the first year, inpatient costs accounted for > 70% of the total healthcare costs, whereas pharmaceutical costs accounted for more than half after the second year post-KTx. The use of everolimus and male sex were associated with higher and lower total healthcare costs in the first and subsequent years after LDKT, respectively.Conclusion: Using large-scale administrative databases, this study revealed the total healthcare costs of KTx in Japan and provided valuable information for the health technology assessment of KTx.","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":"350-358"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11893673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675322","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}

引用次数: 0

The risk of chronic kidney disease or proteinuria with long or short sleep duration: a systematic review and meta-analysis of cohort studies. 睡眠时间长或短导致慢性肾病或蛋白尿的风险：队列研究的系统回顾和荟萃分析。

IF 2.2 4区医学

Clinical and Experimental Nephrology Pub Date : 2025-03-01 Epub Date: 2024-10-23 DOI: 10.1007/s10157-024-02575-7

Meng Hu, Yongchong Wang, Wen Zhu, Xiaozhen Chen

{"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":"10.1007/s10157-024-02575-7","url":null,"abstract":"Objective: 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.Methods: 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.Results: 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.Conclusion: Both short and long sleep durations are associated with a significant increase in the risk of CKD/proteinuria in the adult population.","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":"301-315"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","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}

引用次数: 0

Correction: Kidney lesions and risk of cardiovascular events in biopsy-proven diabetic kidney disease with type 2 diabetes. 修正：活组织检查证实的糖尿病肾病合并2型糖尿病的肾脏病变和心血管事件的风险。

IF 2.2 4区医学

Clinical and Experimental Nephrology Pub Date : 2025-03-01 Epub Date: 2025-01-09 DOI: 10.1007/s10157-024-02611-6

Miho Shimizu, Kengo Furuichi, Tadashi Toyama, Masayuki Yamanouchi, Daiki Hayashi, Akihiko Koshino, Keisuke Sako, Keisuke Horikoshi, Takahiro Yuasa, Akira Tamai, Taichiro Minami, Megumi Oshima, Shiori Nakagawa, Shinji Kitajima, Ichiro Mizushima, Akinori Hara, Norihiko Sakai, Kiyoki Kitagawa, Mitsuhiro Yoshimura, Junichi Hoshino, Yoshifumi Ubara, Yasunori Iwata, Takashi Wada

引用次数: 0

Influence of infection control for COVID-19 on nutrition in relatively healthy Japanese HD patients: a retrospective observational study. COVID-19感染控制对相对健康的日本血液透析患者营养状况的影响：一项回顾性观察研究。

IF 2.2 4区医学

Clinical and Experimental Nephrology Pub Date : 2025-02-28 DOI: 10.1007/s10157-025-02638-3

Yuki Chiba, Ryotaro Takahashi, Rui Makino, Mai Yoshida, Koji Okamoto, Tasuku Nagasawa, Ichiro Kato, Sadatoshi Ito, Tetsuhiro Tanaka, Mariko Miyazaki

{"title":"Influence of infection control for COVID-19 on nutrition in relatively healthy Japanese HD patients: a retrospective observational study.","authors":"Yuki Chiba, Ryotaro Takahashi, Rui Makino, Mai Yoshida, Koji Okamoto, Tasuku Nagasawa, Ichiro Kato, Sadatoshi Ito, Tetsuhiro Tanaka, Mariko Miyazaki","doi":"10.1007/s10157-025-02638-3","DOIUrl":"https://doi.org/10.1007/s10157-025-02638-3","url":null,"abstract":"Background: Infection control for the novel coronavirus disease 2019 (COVID-19) has been linked to decreased physical activity and nutritional deterioration in the general population; however, the influence on hemodialysis (HD) patients is not well discussed.Methods: This multicenter retrospective study utilized the Geriatric Nutritional Risk Index (GNRI), Survival Index, and Nutritional Risk Index for Japanese HD patients (NRI-JH) to assess nutritional status and body composition over five observation periods. The primary endpoint was the body fluid removal rate (%) pre- and post-HD, whereas secondary endpoints included changes in GNRI, SI, body composition, and differences in NRI-JH.Results: We enrolled 139 HD patients in three facilities. The results showed a decrease in GNRI score, which indicates nutritional deterioration, between February 2020 and August 2020 (96.8 (93.2-98.9) vs. 93.8 (90.8-97.6)) (P = 0.0005). Multivariable analysis revealed that nutritional deterioration was associated with higher C-reactive protein and lower hemoglobin levels (P = 0.0004 and P = 0.0010, respectively), which were more noticeable in the urban facility. Furthermore, nutritional deterioration was linked to a decrease in soft lean and somatic cell mass and an increase in body fat mass, suggesting reduced physical activity.Conclusions: Nutritional deterioration was observed shortly after the first COVID-19 outbreak, suggesting an association with decreased physical activity.","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522699","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}

引用次数: 0