Clinical nephrology最新文献

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Preoperative dapagliflozin use and cardiac surgery-associated acute kidney injury: A single-center retrospective cohort study. 术前使用达格列净和心脏手术相关急性肾损伤:一项单中心回顾性队列研究
IF 1.1 4区 医学
Clinical nephrology Pub Date : 2025-01-22 DOI: 10.5414/CN111514
Zitong Chen, Kang Liu, Xiaohua Liu, Buyun Wu, Zhimin Huang, Changying Xing, Huijuan Mao
{"title":"Preoperative dapagliflozin use and cardiac surgery-associated acute kidney injury: A single-center retrospective cohort study.","authors":"Zitong Chen, Kang Liu, Xiaohua Liu, Buyun Wu, Zhimin Huang, Changying Xing, Huijuan Mao","doi":"10.5414/CN111514","DOIUrl":"10.5414/CN111514","url":null,"abstract":"<p><strong>Background: </strong>No drug has been shown to be effective in preventing cardiac surgery-associated acute kidney injury (CSA-AKI). In different clinical settings, sodium-glucose transporter 2 (SGLT2) inhibitors confer renal protection and may be promising drug candidates. We examined the association between preoperative dapagliflozin use and the incidence and prognosis of CSA-AKI.</p><p><strong>Materials and methods: </strong>Data were obtained for consecutive patients undergoing cardiac surgery with cardiopulmonary bypass between December 2020 and November 2022 at a large teaching hospital in Eastern China. The exposure was preoperative dapagliflozin use, and the primary outcome was the incidence of AKI within seven days following cardiac surgery. The secondary outcomes included dialysis, death, AKI recovery, and length of hospitalization. The association between the exposures and outcomes was determined by various logistic regression models with propensity scores.</p><p><strong>Results: </strong>A total of 1,424 patients were included, of which 201 (14.1%) received dapagliflozin preoperatively, and 321 (22.5%) developed CSA-AKI. Patients with dapagliflozin use developed CSA-AKI more frequently than those without (32.3 vs. 20.9%, unadjusted odds ratio 1.81; 95% CI, 1.30 - 2.50). However, the association became non-significant in the multivariate model (adjusted odds ratio, 1.11; 95% CI, 0.73 - 1.68), in the adjusted model with inverse probability weighting (odds ratio, 1.21; 95% CI, 0.76 - 1.93), or in the propensity-score-matched model (odds ratio, 1.09, 95% CI, 0.68 - 1.73). Furthermore, there was no significant association between preoperative dapagliflozin use and secondary outcomes.</p><p><strong>Conclusion: </strong>Results from this study suggest that preoperative dapagliflozin use was not associated with a lower risk of CSA-AKI.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001229","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
The nonlinear correlation between total bilirubin and lumbar spine bone mineral density in patients receiving maintenance hemodialysis. 维持性血液透析患者总胆红素与腰椎骨密度的非线性关系。
IF 1.1 4区 医学
Clinical nephrology Pub Date : 2025-01-15 DOI: 10.5414/CN111473
Na Zhao, Song-Tao Yang, Xiao-Fang Shen, Yue-Fei Xiao
{"title":"The nonlinear correlation between total bilirubin and lumbar spine bone mineral density in patients receiving maintenance hemodialysis.","authors":"Na Zhao, Song-Tao Yang, Xiao-Fang Shen, Yue-Fei Xiao","doi":"10.5414/CN111473","DOIUrl":"10.5414/CN111473","url":null,"abstract":"<p><strong>Background: </strong>Patients receiving maintenance hemodialysis (MHD) are at increased risk of osteoporosis. The effects of bilirubin on bone metabolism vary among different disease populations. However, the relationship between total bilirubin (TBIL) and bone metabolism in MHD has not been investigated yet.</p><p><strong>Materials and methods: </strong>This cross-sectional study included 122 MHD patients aged ≥ 18 years who underwent regular hemodialysis at the Blood Purification Center of Aerospace Central Hospital from April 2021 to April 2023. Blood sampling and bone mineral density (BMD) examinations were conducted. Multivariate linear regression, restricted cubic spline and subgroup analyses were performed to evaluate the association between TBIL and BMD.</p><p><strong>Results: </strong>TBIL (correlation coefficient: 1.7 (0.17, 3.25); p = 0.04) was independently associated with BMD in the multivariate linear regression analysis. The results showed that BMD was nonlinearly related to TBIL in MHD patients, exhibiting a J shaped curve (p = 0.035). When plasma TBIL level < 0.64 mg/dL, there is an average increase of 5.3 (95% CI: 2.0 - 8.7; p = 0.002) g/cm<sup>2</sup> in BMD for every 1-unit increase in plasma TBIL level. The association between TBIL and BMD was not significant when the plasma TBIL level was ≥ 0.64 mg/dL.</p><p><strong>Conclusion: </strong>The relationship between TBIL and BMD in MHD patients is J-shaped, with an inflection point of 0.64 mg/dL.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142982633","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
Effect of persistent hypercalcemia on hemoglobin levels after kidney transplantation. 肾移植术后持续性高钙血症对血红蛋白水平的影响。
IF 1.1 4区 医学
Clinical nephrology Pub Date : 2025-01-10 DOI: 10.5414/CN111553
Gabriel Cojuc-Konigsberg, Alfonso Gindl-Bracho, Cielo Estefanny Linares-Pérez, Sophia Albarrán-Muñoz, Estefania Reul-Linares, Nathalie Desire Pichardo-Cabrera, Lluvia A Marino-Vazquez, Luis Eduardo Morales-Buenrostro, Juan C Ramírez-Sandoval
{"title":"Effect of persistent hypercalcemia on hemoglobin levels after kidney transplantation.","authors":"Gabriel Cojuc-Konigsberg, Alfonso Gindl-Bracho, Cielo Estefanny Linares-Pérez, Sophia Albarrán-Muñoz, Estefania Reul-Linares, Nathalie Desire Pichardo-Cabrera, Lluvia A Marino-Vazquez, Luis Eduardo Morales-Buenrostro, Juan C Ramírez-Sandoval","doi":"10.5414/CN111553","DOIUrl":"10.5414/CN111553","url":null,"abstract":"<p><strong>Introduction: </strong>After kidney transplantation, persistent hyperparathyroidism commonly occurs, often alongside increased serum calcium levels. It is reasonable to infer that kidney transplant recipients (KTRs) with hypercalcemia related to persistent hyperparathyroidism are more susceptible to developing anemia. However, reports suggest that hypercalcemia could be a contributing factor to erythrocytosis. Our aim was to assess the effect of persistent hypercalcemia on the trajectory of hemoglobin levels after transplantation.</p><p><strong>Materials and methods: </strong>We conducted a retrospective cohort study investigating the trajectory of hemoglobin in 385 KTRs with and without persistent hypercalcemia (free Ca > 5.2 mg/dL). We performed mixed-model analyses adjusting for potential confounders.</p><p><strong>Results: </strong>Persistent hypercalcemia was present in 62% KTRs (56% male, median age 36 (IQR 28 - 48) years, median follow-up 4.1 (IQR 1 - 8.2) years). Compared to KTRs without hypercalcemia, KTRs with persistent hypercalcemia had a mean positive difference in hemoglobin levels of +0.76 g/dL/year (95% CI +0.45 - +1.08, p < 0.001) throughout the follow-up period. Specifically, the change slope was +0.80 (95% CI +0.32 - +1.27, p < 0.001) g/dL/year for males and +0.36 (95% CI +0.16 - +1.08, p < 0.001) g/dL/year for females. Persistent hypercalcemia was significantly associated with post-transplant erythrocytosis according to the WHO (47 vs. 24%, OR 2.8, 95% CI 1.8 - 4.4) and altitude-adjusted criteria (22 vs. 10%, OR 2.5, 95% CI 1.2 - 4.5). The effect of hypercalcemia on hemoglobin levels was consistent after adjusting for confounders, except in KTRs who developed an estimated glomerular filtration rate < 45 mL/min/1.73m2 after transplantation.</p><p><strong>Conclusion: </strong>Persistent hypercalcemia after kidney transplantation was significantly associated with higher hemoglobin levels and an increased risk of developing post-transplant erythrocytosis.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945763","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
Comparison of adverse drug reactions of heparin and its derivates in the European Economic Area based on data from EudraVigilance between 2017 and 2021. 基于2017年至2021年EudraVigilance数据的欧洲经济区肝素及其衍生物药物不良反应比较
IF 1.1 4区 医学
Clinical nephrology Pub Date : 2025-01-10 DOI: 10.5414/CN111448
Yan Wang, Liang-Ying Gan, Zhun Sui, Mi Wang, Li Zuo
{"title":"Comparison of adverse drug reactions of heparin and its derivates in the European Economic Area based on data from EudraVigilance between 2017 and 2021.","authors":"Yan Wang, Liang-Ying Gan, Zhun Sui, Mi Wang, Li Zuo","doi":"10.5414/CN111448","DOIUrl":"10.5414/CN111448","url":null,"abstract":"<p><strong>Introduction: </strong>Hemodialysis patients need long-term frequent use of parenteral anticoagulants, and the side effects need to be taken seriously. This study aimed to assess the reporting of adverse drug reactions (ADRs) following administration of unfractionated heparin (UFH), low molecular weight heparins (LMWHs), fondaparinux, and danaparoid, in relation to their usage in European Economic Area (EEA).</p><p><strong>Materials and methods: </strong>The total number of ADRs of each anticoagulant between 2017 to 2021 was collected using data from the EudraVigilance database. The number of hemorrhages, thrombocytopenia, injection-site reaction, liver injury, hypersensitivity and bone disorder were collected, respectively. Usage of these anticoagulants was estimated using sales data from the IQVIA MIDAS database. The reporting rates of ADRs were calculated and compared using χ<sup>2</sup>-test.</p><p><strong>Results: </strong>Between 2017 and 2021 in the EEA, the overall ADRs reporting rates per 10,000,000 standard units (SU) of UFH, enoxaparin, nadroparin, dalteparin, fondaparinux, and danaparoid were 12.3, 40.8, 23.6, 36.5, 91.4, and 430.0, respectively. There were significant differences among these drugs (χ<sup>2</sup> = 7,239.26, p < 0.001). Specifically, hemorrhage and thrombocytopenia were reported at higher rates, ranging from 2.8 to 140.1, and 2.0 to 115.9 per 10,000,000 SU among different anticoagulants. Injection-site reactions and hypersensitivity came in second, between 0.2 - 29.0 and 0.1 - 53.1 per 10,000,000 SU, respectively. The reporting rates for liver injury and bone disorder were reported at low rates.</p><p><strong>Conclusion: </strong>The reporting rates of ADRs for heparin and its derivates were all very low. In comparison, the reporting rate of ADRs for danaparoid and fondaparinux was relatively high. The most commonly reported ADRs were hemorrhage, thrombocytopenia, followed by injection-site reactions and hypersensitivity.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945762","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
Evaluation of kidney disease knowledge and its determinants among patients with chronic kidney disease. 慢性肾病患者肾病知识及其决定因素的评估。
IF 1.1 4区 医学
Clinical nephrology Pub Date : 2025-01-09 DOI: 10.5414/CN111543
Sibel Gulcicek, Zeynep Atli, Ertugrul Erol, Talat Alp Ikizler, Nurhan Seyahi
{"title":"Evaluation of kidney disease knowledge and its determinants among patients with chronic kidney disease.","authors":"Sibel Gulcicek, Zeynep Atli, Ertugrul Erol, Talat Alp Ikizler, Nurhan Seyahi","doi":"10.5414/CN111543","DOIUrl":"10.5414/CN111543","url":null,"abstract":"<p><strong>Purpose: </strong>Patient self-care and knowledge of chronic kidney disease (CKD) play a crucial role in treatment effectiveness at slowing disease progression and reducing complications. There is need for tools that can quantitatively assess patients' knowledge of CKD. We aimed to translate the Kidney Disease Knowledge Survey (KiKS) to Turkish, validate the questionnaire among CKD patients, and identify the determinants of CKD knowledge.</p><p><strong>Materials and methods: </strong>The 28-item KiKS was translated into Turkish and administered to 271 CKD patients not on dialysis. Reliability of survey questions was assessed using Cronbach's α coefficient. Hotelling's T-squared test was used to measure effectiveness and homogeneity of the scale. Univariate and multivariate regression analyses were performed to identify the determinants of CKD knowledge.</p><p><strong>Results: </strong>The mean age of participants was 56.7 ± 13.0 years; 54.2% were male, and 68.3% had CKD stages 3 - 5. Cronbach's α value of scale for the 28-item KiKS was 0.804, confirming its reliability (p < 0.001). Multivariate linear regression analysis showed that CKD stage 3 patients were associated with lower KiKS scores compared to stage 1. Participants who were aware of their CKD diagnosis and used the internet to obtain information about kidney disease had higher scores.</p><p><strong>Conclusion: </strong>The Turkish version of KiKS is reliable and valid to assess the knowledge level of Turkish CKD patients. Advanced stages of CKD were associated with less knowledge about kidney disease in this population. Targeted educational interventions or longitudinal studies are needed to assess the impact of improved CKD knowledge on clinical outcomes.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945764","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
Exploring the mindset of kidney transplant recipients regarding COVID-19 vaccination: An insightful survey analysis. 探讨肾移植受者对COVID-19疫苗接种的心态:一项有见地的调查分析。
IF 1.1 4区 医学
Clinical nephrology Pub Date : 2025-01-08 DOI: 10.5414/CN111530
Burak Pacacı, Ilay Berke, Dilek Barutcu Atas, Murat Tugcu, Hakki Arikan, Ebru Asicioglu, Serhan Tuglular, Arzu Velioglu
{"title":"Exploring the mindset of kidney transplant recipients regarding COVID-19 vaccination: An insightful survey analysis.","authors":"Burak Pacacı, Ilay Berke, Dilek Barutcu Atas, Murat Tugcu, Hakki Arikan, Ebru Asicioglu, Serhan Tuglular, Arzu Velioglu","doi":"10.5414/CN111530","DOIUrl":"10.5414/CN111530","url":null,"abstract":"<p><strong>Background: </strong>Kidney transplant (KT) recipients are at risk of severe disease and high mortality from COVID-19, and vaccination offers some degree of protection. In this study, KT recipients' and controls' attitudes towards COVID-19 vaccination were examined.</p><p><strong>Materials and methods: </strong>In this cross-sectional survey-based study, the willingness and hesitancy towards COVID-19 vaccines in KT recipients and a control group from the general population were assessed via questionnaire. Vaccine hesitancy was described as either not being fully vaccinated or vaccine refusal.</p><p><strong>Results: </strong>A total of 154 KT recipients and 172 controls completed the questionnaire. The rate of those who had received at least 1 dose of COVID-19 vaccine was similar in the two study groups (92.4 vs. 92.9%, p = 0.88). The proportion of those fully vaccinated against COVID-19 was significantly lower in the KT recipients (58.7 vs. 70.4% p = 0.033). Only 11 (7.1%) of the KT recipients refused the COVID-19 vaccination. There was no significant difference between the groups in terms of vaccine refusal and vaccine hesitancy rates. Concerns about vaccine-related adverse events were common in both groups (63.6 vs. 53.8%; p = 0.488).</p><p><strong>Conclusion: </strong>Although participants showed a high willingness towards COVID-19 vaccination, the number of KT recipients who were fully vaccinated appears to be lower than controls. Concerns about vaccine-related adverse events were the main reason for avoiding vaccination. Healthcare personnel, particularly nephrologists and public health experts, must take a proactive role in addressing vaccine hesitancy and ensuring that patients receive the required protection against COVID-19.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945765","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
Nutritional and psychological sequelae of COVID-19 infection in maintenance hemodialysis patients. 维持性血液透析患者感染 COVID-19 后的营养和心理后遗症。
IF 1.1 4区 医学
Clinical nephrology Pub Date : 2025-01-01 DOI: 10.5414/CN111369
Sara T Ibrahim, Basant M Talaat, Iman E ElGohary, Gihane I Khalil, Dalia A Maharem
{"title":"Nutritional and psychological sequelae of COVID-19 infection in maintenance hemodialysis patients.","authors":"Sara T Ibrahim, Basant M Talaat, Iman E ElGohary, Gihane I Khalil, Dalia A Maharem","doi":"10.5414/CN111369","DOIUrl":"10.5414/CN111369","url":null,"abstract":"<p><strong>Aim: </strong>The risk of infection with COVID-19 in hemodialysis (HD) patients is higher compared to the general population. Additionally, HD patients are at higher risk of developing post-COVID-19 infection sequelae. However, this has not been thoroughly investigated. Therefore, we aimed to study the impact of COVID-19 on nutritional status and psychological health in HD patients 6 months following recovery.</p><p><strong>Materials and methods: </strong>We recruited HD patients who were proven to be infected with COVID-19 and received treatment at two HD units in two institutions between April 2022 and December 2022. Additionally, we enrolled a group of age- and sex-matched HD patients who had not previously been infected with COVID-19 or received vaccination. Nutritional status was assessed using malnutrition inflammation score (MIS), while psychological health was assessed using online questionnaires. The Patient Health Questionnaire 9 (PHQ 9) was employed to assess symptoms of depression, the Generalized Anxiety Disorder 7 (GAD 7) was used to identify anxiety disorders, the Patient Health Questionnaire 15 (PHQ 15) was utilized to measure somatic symptoms, and the Insomnia Severity Index (ISI) was used to measure insomnia.</p><p><strong>Results: </strong>A total of 60 subjects (30 patients and 30 controls) were assessed in the study. We found statistically significant differences between patients and controls regarding the MIS (median score (interquartile range (IQR)); 11 (9 - 12) and 5.5 (5 - 7), respectively), PHQ 15 (median score (IQR); 17.5 (15 - 19) and 9 (6 - 11), respectively), PHQ 9 (median score (IQR); 17 (13 - 19) and 5 (7 - 8), respectively), GAD 7 (median score (IQR); 14 (11 - 16) and 6 (4 - 8), respectively), and ISI (median score (IQR); 20 (15 - 22) and 8 (7 - 11), respectively), with p < 0.001 for all scores.</p><p><strong>Conclusion: </strong>COVID-19 has long-term effects on the psychosocial health of HD patients and may lead to a higher incidence of malnutrition 6 months post recovery.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":"44-52"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307252","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
Use of bisphosphonates in chronic kidney disease is associated with cardiovascular death. 慢性肾病患者使用双膦酸盐与心血管死亡有关。
IF 1.1 4区 医学
Clinical nephrology Pub Date : 2025-01-01 DOI: 10.5414/CN111428
Kathleen A Borghoff, Agnes E Ounda, Melissa L Swee, Saket Girotra, Amal A Shibli-Rahhal, Patrick Ten Eyck, Diana I Jalal, Anna J Jovanovich
{"title":"Use of bisphosphonates in chronic kidney disease is associated with cardiovascular death.","authors":"Kathleen A Borghoff, Agnes E Ounda, Melissa L Swee, Saket Girotra, Amal A Shibli-Rahhal, Patrick Ten Eyck, Diana I Jalal, Anna J Jovanovich","doi":"10.5414/CN111428","DOIUrl":"10.5414/CN111428","url":null,"abstract":"<p><strong>Background and objectives: </strong>Chronic kidney disease (CKD) is associated with increased cardiovascular risk, which may be mediated by vascular calcification. Based on evidence that bisphosphonates inhibit vascular calcification, we hypothesized use of bisphosphonates in CKD would be associated with lower incident cardiovascular disease (CVD), CVD-related mortality, and all-cause mortality.</p><p><strong>Materials and methods: </strong>This was a longitudinal observational study including 2,593 Framingham Offspring participants. We used propensity score-adjusted Cox regression models to determine the association between bisphosphonate use and outcomes: time to incident CVD, time to CVD-related mortality, and time to all-cause mortality. The data were stratified by presence or absence of CKD, defined as estimated glomerular filtration rate < 60 mL/min/1.73m<sup>2</sup>. The propensity score included age, sex, hypertension, smoking status, diabetes, total cholesterol, high-density lipoprotein, and self-reported history of fracture.</p><p><strong>Results: </strong>In unadjusted and propensity score-adjusted analyses, those with CKD using bisphosphonates had a trend toward increased incident CVD risk (adjusted hazard ratio (HR) 1.66 (95% CI, 93 - 2.97)) compared to those with CKD not using bisphosphonates. Those with CKD using bisphosphonates also had increased risk of cardiovascular mortality in the propensity score-adjusted model (adjusted HR 2.20 (95% CI, 1.12 - 4.32)). There was no significant association between bisphosphonate use and all-cause mortality in participants with CKD. Among individuals without CKD, bisphosphonate use was significantly associated with an increase in all-cause mortality in the propensity-score adjusted analysis (adjusted HR 1.59 (95% CI, 1.27 - 1.98)). However, there was no significant association between bisphosphonate use and incident CVD events (adjusted HR 0.85 95% CI, 0.63 - 1.16) or CVD-related death (adjusted HR 0.70 (95% CI 0.36 - 1.37) in those without CKD.</p><p><strong>Conclusion: </strong>Contrary to our hypothesis, bisphosphonate use was associated with a trend toward increased incident CVD and a two-fold higher risk of CVD mortality in CKD.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":"5-11"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614747","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
The incidence and prevalence of immunoglobulin A nephropathy in the United States. 美国免疫球蛋白 A 肾病的发病率和流行率。
IF 1.1 4区 医学
Clinical nephrology Pub Date : 2025-01-01 DOI: 10.5414/CN111489
Marc DeCongelio, Sarah N Ali, Martina Furegato, Sandipan Bhattacharjee, Ancilla W Fernandes
{"title":"The incidence and prevalence of immunoglobulin A nephropathy in the United States.","authors":"Marc DeCongelio, Sarah N Ali, Martina Furegato, Sandipan Bhattacharjee, Ancilla W Fernandes","doi":"10.5414/CN111489","DOIUrl":"10.5414/CN111489","url":null,"abstract":"<p><strong>Aims: </strong>Reliable national estimates for the incidence and prevalence of immunoglobulin A nephropathy (IgAN) in the United States (U.S.) are needed. We performed a national survey with pathologists and used insurance claims data to estimate IgAN frequency nationwide.</p><p><strong>Materials and methods: </strong>An online survey with pathologists was conducted between November and December 2021 to obtain data on the number and types of biopsies evaluated and the proportion with IgAN confirmed. Biopsy data were extrapolated to two different claims databases to estimate incidence and prevalence. Results were validated against a separate dataset of electronic health records.</p><p><strong>Results: </strong>A total of 43 pathologists from across U.S. regions reported evaluating a mean of 169 kidney biopsies (standard deviation 179.1) in the past 12 months. Of the 7,267 total biopsies evaluated, 632 (8.7%) were IgAN. Based on the respective claims databases, annual incidence rates of 2.1 and 2.2 per 100,000 and prevalence rates of 59.9 and 62.7 per 100,000 were estimated. Results from the validation dataset were similar, with an incidence of 1.9 per 100,000 and prevalence of 54.2 per 100,000.</p><p><strong>Conclusion: </strong>This study estimated incidence and prevalence of IgAN. Extrapolating the findings to the U.S. population for 2021, total prevalence was 198,887 - 208,184 persons.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":"19-25"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11659967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142667458","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
Acute renal injury induced by ensartinib in a lung adenocarcinoma patient treated with sequential ALK inhibitors: A case report and literature review. 序贯ALK抑制剂治疗肺腺癌患者恩沙替尼引起的急性肾损伤:1例报告和文献复习。
IF 1.1 4区 医学
Clinical nephrology Pub Date : 2024-12-31 DOI: 10.5414/CN111539
Xinmiao Xie, Jing Yang, Fuhua Chen, Xiaoxia Wang
{"title":"Acute renal injury induced by ensartinib in a lung adenocarcinoma patient treated with sequential ALK inhibitors: A case report and literature review.","authors":"Xinmiao Xie, Jing Yang, Fuhua Chen, Xiaoxia Wang","doi":"10.5414/CN111539","DOIUrl":"10.5414/CN111539","url":null,"abstract":"<p><strong>Introduction: </strong>Lung cancer ranks among the foremost causes of mortality associated with cancer. Ensartinib is a highly effective oral anaplastic lymphoma kinase (ALK) inhibitor utilized in the treatment of ALK-positive lung adenocarcinoma. This report presents a case of acute renal failure attributed to the administration of ensartinib. This is the first case report documenting the nephrotoxic effects of ensartinib, specifically manifesting as acute tubulointerstitial nephritis (ATIN) and IgA nephropathy.</p><p><strong>Case presentation: </strong>This report details the case of a 52-year-old man diagnosed with ALK-positive lung adenocarcinoma. The patient was initially treated with crizotinib for a duration exceeding 6 months; however, he was subsequently transitioned to ensartinib due to disease progression characterized by the development of brain metastases. Within 3 months of initiating treatment with ensartinib, the patient experienced acute kidney failure. The renal failure was attributed to ATIN and IgA nephropathy, which were considered manifestations of renal toxicity associated with ensartinib.</p><p><strong>Conclusion: </strong>This case underscores the uncommon adverse effect of ALK-targeting therapy, specifically regarding acute renal failure induced by ensartinib. We recommend conducting a renal biopsy to ascertain the presence of drug-induced nephrotoxicity. An accurate diagnosis and timely intervention can prevent the deterioration of renal function.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142913818","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}
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