Clinical and Experimental Nephrology最新文献

{"title":"Water and electrolyte abnormalities in novel pharmacological agents for kidney disease and cancer.","authors":"Maho Terashita, Masahiko Yazawa, Naoka Murakami, Akira Nishiyama","doi":"10.1007/s10157-025-02635-6","DOIUrl":"https://doi.org/10.1007/s10157-025-02635-6","url":null,"abstract":"<p><p>This review article series on water and electrolyte disorders is based on the 'Electrolyte Winter Seminar' held annually for young nephrologists in Japan. This is the third article in this series that focuses on water and electrolyte disturbances caused by novel pharmacological agents for kidney disease and cancer. The advent of novel pharmacological agents in cardiorenal medicine and oncology has introduced both therapeutic benefits and challenges in managing medication-induced water and electrolyte disturbances. These medications, including sodium-glucose cotransporter-2 (SGLT2) inhibitors, non-steroidal mineralocorticoid receptor antagonists (ns-MRAs), and immune checkpoint inhibitors (ICIs), significantly impact water and electrolyte homeostasis. SGLT2 inhibitors used widely in diabetes mellitus, heart failure, and chronic kidney disease mitigate hyperkalemia and hypomagnesemia but increase the risk of hypernatremia in patients on fluid restriction. Conversely, they are beneficial for managing hyponatremia in the syndrome of inappropriate antidiuresis (SIAD). ns-MRAs, prescribed for diabetic kidney disease, exhibit a high risk of hyperkalemia, particularly when combined with renin-angiotensin system inhibitors. ICIs, a breakthrough in oncology, frequently induce hyponatremia through immune-related adverse events, such as hypophysitis and non-immune-related adverse events like SIAD. Understanding the pathophysiology of these disturbances and implementing timely interventions, including hormone replacement and water and electrolyte management, is critical for optimizing treatment outcomes.</p>","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398431","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":"Association between hemoglobin level and mortality in patients undergoing maintenance hemodialysis: a nationwide dialysis registry in Japan.","authors":"Takaaki Kosugi, Takeshi Hasegawa, Takahiro Imaizumi, Hiroki Nishiwaki, Hirokazu Honda, Yasuhiko Ito, Kazuhiko Tsuruya, Masanori Abe, Norio Hanafusa, Takahiro Kuragano","doi":"10.1007/s10157-025-02632-9","DOIUrl":"https://doi.org/10.1007/s10157-025-02632-9","url":null,"abstract":"<p><strong>Background: </strong>The optimal hemoglobin (Hb) range in patients undergoing hemodialysis remains controversial. We aimed to investigate the association between Hb levels and mortality in patients undergoing hemodialysis and explore the potential factors modifying this association.</p><p><strong>Methods: </strong>This observational study utilized a nationwide database from the Japanese Renal Data Registry spanning from 2019 to 2021. This study included 265,779 patients undergoing hemodialysis thrice a week. The association between Hb levels and all-cause and cause-specific mortality was investigated using Cox regression analysis. The nonlinear relationship between Hb levels and outcomes was investigated using restricted cubic spline analysis.</p><p><strong>Results: </strong>During a median follow-up period of 24 months, 45,734 patients died. Compared to the reference Hb category of 10-10.9 g/dL, the risk of all-cause mortality was higher in the Hb categories of < 9.0, 9.0-9.9, and ≥ 13 g/dL with adjusted hazard ratios (95% confidence intervals) of 1.24 (1.20-1.29), 1.09 (1.06-1.12), and 1.19 (1.14-1.25), respectively. Restricted cubic spline analysis also showed a U-shaped relationship between Hb level and mortality. The subgroup analysis indicated that the Hb category of 12.0-12.9 g/dL was associated with increased mortality risk in patients with a dialysis vintage of ≥ 10 years and those with a history of cerebral infarction.</p><p><strong>Conclusion: </strong>Hb levels of < 10.0 and ≥ 13.0 g/dL were significantly associated with an increased mortality risk compared to an Hb level of 10.0-10.9 g/dL in patients undergoing hemodialysis.</p>","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390240","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":"Outcomes of kidney transplantation in recipients with SARS-cov-2 infection: a 282-case single-center experience in Japan.","authors":"Eri Sekido, Kohei Unagami, Kazuya Omoto, Ken Arimura, Ikumi Moriyama, Taro Banno, Ayaka Saitoh, Rikako Oki, Daigo Okada, Takafumi Yagisawa, Taichi Kanzawa, Kumiko Kitajima, Toshihito Hirai, Tomokazu Shimizu, Shigeyoshi Yamanaga, Hiroto Egawa, Masashi Inui, Junichi Hoshino, Hideki Ishida, Toshio Takagi","doi":"10.1007/s10157-024-02560-0","DOIUrl":"10.1007/s10157-024-02560-0","url":null,"abstract":"<p><strong>Background: </strong>The coronavirus disease 2019, caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), has become a global epidemic. There are concerns regarding the severity of SARS-CoV-2 infections in kidney transplant (KTx) recipients. However, there is limited data on how the epidemic has affected the treatment and prognosis of these patients. Therefore, we aimed to report the changes in the treatment and outcomes of KTx recipients infected with SARS-CoV-2 during each wave at our institution.</p><p><strong>Methods: </strong>A total of 282 KTx recipients who were infected with SARS-CoV-2 during the study period were followed up at Tokyo Women's Medical University between March 2020 and August 2022. We investigated the outcomes and treatments of infected KTx recipients.</p><p><strong>Results: </strong>Nineteen (6.7%) patients showed severe outcomes, including eight SARS-CoV-2 infection-related deaths. Risk factors associated with severe outcomes included underlying conditions, such as diabetes mellitus, heart disease, and liver disease (odds ratios, 2.09, 2.88, and 5.52, respectively). Treatment strategies changed throughout the epidemic in response to changes in the SARS-CoV-2 variants. Antiviral drugs were gradually administered as soon as they were approved for use.</p><p><strong>Conclusions: </strong>Treatment strategies for KTx recipients were gradually established over the course of the epidemic. Although the proportion of infected KTx recipients decreased compared to that of the general population throughout the epidemic, many patients still followed a severe course.</p>","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":"182-191"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364656","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":"Guidelines for administering gadolinium-based contrast agents to patients with renal dysfunction (Version 3: Revised May 20th, 2024).","authors":"","doi":"10.1007/s10157-024-02607-2","DOIUrl":"10.1007/s10157-024-02607-2","url":null,"abstract":"","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":"131-133"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11828755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142920844","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":"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":"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":"236-247"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11828842/pdf/","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":"OA","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":"221-226"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","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":"Annual change in eGFR in renal hypouricemia: a retrospective pilot study.","authors":"Shinobu Sugihara, Yasutaka Yamamoto, Kei Teramoto, Toshiro Hamada, Satoshi Miyazaki, Kazuhide Ogino, Masanari Kuwabara, Akira Ohtahara, Einosuke Mizuta, Kimiyoshi Ichida, Yusuke Endo, Hiroyuki Minato, Haruaki Ninomiya, Masahiko Kato, Kazuhiro Yamamoto, Ichiro Hisatome","doi":"10.1007/s10157-024-02558-8","DOIUrl":"10.1007/s10157-024-02558-8","url":null,"abstract":"<p><strong>Background: </strong>Extremely low uric acid (UA) levels or increased urinary UA (Uua) excretion might be risk factors for kidney disease in renal hypouricemia (RHU) patients, but their relationship with kidney dysfunction is unclear. This study investigated time-dependent changes in eGFR in RHU patients.</p><p><strong>Methods: </strong>This multicenter retrospective study assessed UA metabolism and changes in eGFR (median 5.5 years) in 13 RHU patients. We then compared eGFR change in 7 of 13 RHU patients whose eGFR could be measured for 4 years with those in normouricemic group (n = 31). In addition, 7 RHU patients were divided into two groups based on URAT1 gene mutations: homozygote and compound heterozygote mutations (Homo/Com group, n = 3), and wild-type and heterogeneous mutations (WT/Hetero group, n = 4).</p><p><strong>Results: </strong>In 13 RHU patients, the median and mean serum UA (SUA) were 0.8 (0.4-2.5) and 1.1 ± 0.7 mg/dL. The median and mean Uua were 44.3 (12.7-141.1) and 49.7 ± 36.2 mg/dL. The median and mean urinary urate clearance (Cua/Ccr) were 46.8 (11.3-73.6) and 43.3 ± 19.7%. Over 4 years, eGFR did not change in the RHU group but declined in the normouricemic group. Annual mean eGFR decline and change rate in the RHU group were the same as those in the normouricemic group (- 1.09 ± 1.11 vs. - 1.09 ± 1.92 mL/min/1.73 m²/year, p = 0.996) (- 1.74 ± 1.96 vs. - 1.36 ± 2.10%, p = 0.664). And no significant difference was found in eGFR decline or change rate between Homo/Com and WT/Hetero groups (- 0.33 ± 1.03 vs. - 1.67 ± 0.85 mL/min/1.73 m²/year, p = 0.116) (- 0.61 ± 1.62 vs. - 2.59 ± 1.91%, p = 0.210).</p><p><strong>Conclusion: </strong>RHU from URAT1 genetic mutation may not show eGFR decline over 4 consecutive years.</p>","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":"173-181"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11828821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364646","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":"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":"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":"192-211"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","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":"Retraction Note: Circ_0000064 knockdown attenuates high glucose-induced proliferation, inflammation and extracellular matrix deposition of mesangial cells through miR-424-5p-mediated WNT2B inhibition in cell models of diabetic nephropathy.","authors":"Jianfei Li, Yan Min, Qin Zhao","doi":"10.1007/s10157-024-02619-y","DOIUrl":"10.1007/s10157-024-02619-y","url":null,"abstract":"","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":"248"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142920848","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 impact of chronic kidney disease on prognosis in acute stroke: unraveling the pathophysiology and clinical complexity for optimal management.","authors":"Kruthajn Rajesh, Kevin J Spring, Ivica Smokovski, Vedant Upmanyue, Man Mohan Mehndiratta, Giovanni F M Strippoli, Roy G Beran, Sonu M M Bhaskar","doi":"10.1007/s10157-024-02556-w","DOIUrl":"10.1007/s10157-024-02556-w","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease (CKD) significantly increases stroke risk and severity, posing challenges in both acute management and long-term outcomes. CKD contributes to cerebrovascular pathology through systemic inflammation, oxidative stress, endothelial dysfunction, vascular calcification, impaired cerebral autoregulation, and a prothrombotic state, all of which exacerbate stroke risk and outcomes.</p><p><strong>Methods: </strong>This review synthesizes evidence from peer-reviewed literature to elucidate the pathophysiological mechanisms linking CKD and stroke. It evaluates the efficacy and safety of acute reperfusion therapies-intravenous thrombolysis and endovascular thrombectomy-in CKD patients with acute ischemic stroke. Considerations, such as renal function, drug dosage adjustments, and the risk of contrast-induced nephropathy, are critically analyzed. Evidence-based recommendations and research priorities are drawn from an analysis of current practices and existing knowledge gaps.</p><p><strong>Results: </strong>CKD influences stroke outcomes through systemic and local pathophysiological changes, necessitating tailored therapeutic approaches. Reperfusion therapies are effective in CKD patients but require careful monitoring of renal function to mitigate risks, such as contrast-induced nephropathy and thrombolytic complications. The bidirectional relationship between stroke and CKD highlights the need for integrated management strategies to address both conditions. Early detection and optimized management of CKD significantly reduce stroke-related morbidity and mortality.</p><p><strong>Conclusion: </strong>Optimizing stroke care in CKD patients requires a comprehensive understanding of their pathophysiology and clinical management challenges. This article provides evidence-based recommendations, emphasizing individualized treatment decisions and coordinated care. It underscores the importance of integrating renal considerations into stroke treatment protocols and highlights the need for future research to refine therapeutic strategies, address knowledge gaps, and consider tailored interventions to improve outcomes and quality of life for this high-risk population.</p>","PeriodicalId":10349,"journal":{"name":"Clinical and Experimental Nephrology","volume":" ","pages":"149-172"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766870","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}