Clinical nephrology最新文献

{"title":"Associations of base excess and alactic base excess with KDIGO stage 2 - 3 acute kidney injury in patients with acute ischemic stroke.","authors":"Jieli Wang, Zhenhua Xi, Weiliang Shi","doi":"10.5414/CN112097","DOIUrl":"https://doi.org/10.5414/CN112097","url":null,"abstract":"<p><strong>Purpose: </strong>To identify the associations of base excess (BE) and alactic base excess (aBE) with KDIGO stage 2 - 3 acute kidney injury (AKI) in patients with acute ischemic stroke (AIS).</p><p><strong>Materials and methods: </strong>In this cohort study, 1,377 adult patients with AIS were identified from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. A univariable logistic regression model was used to explore the associations of all variables with KDIGO stage 2 - 3 AKI during the ICU stay of patients. Confounding factors were screened using bidirectional stepwise regression. Subgroup analysis was stratified based on age, Glasgow Coma Scale (GCS), Sequential Organ Failure Assessment (SOFA), and comorbidities. Forest plot was plotted to identify the associations of BE and aBE with KDIGO stage 2 - 3 AKI in AIS patients in different subgroups. Restricted cubic spline (RCS) was plotted.</p><p><strong>Results: </strong>A total of 1,377 participants were included, of whom 680 developed KDIGO stage 2 - 3 AKI during their ICU stay. After adjusting for covariates including SOFA, sodium, anticoagulants, furosemide, and aspirin, we found that the association between BE < -5.124 mmol/L and KDIGO stage 2 - 3 AKI was significant (OR = 1.51, 95% CI: 1.05 - 2.16). As for aBE, we observed that aBE < -3.444 mmol/L might be related to KDIGO stage 2 - 3 AKI (OR = 1.57, 95% CI: 1.12 - 2.20). In the adjusted model, aBE < -3.444 mmol/L was associated with elevated OR of KDIGO stage 2 - 3 AKI in AIS patients (OR = 1.43, 95% CI: 1.00 - 2.04). RCS revealed the non-liner associations of BE and aBE with KDIGO stage 2 - 3 AKI in AIS patients.</p><p><strong>Conclusion: </strong>Low BE or aBE were associated with an increased risk of KDIGO stage 2 - 3 AKI in patients with AIS.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179652","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 of IL-8 rs4073 -251T>A gene polymorphism with diabetic nephropathy in patients with type 2 diabetes mellitus.","authors":"Idris Kurt, Arzu Ay, Ayten Ustundag, İlhan Kurultak, Sedat Üstündağ","doi":"10.5414/CN112095","DOIUrl":"https://doi.org/10.5414/CN112095","url":null,"abstract":"<p><strong>Background: </strong>Diabetic nephropathy (DN) is one of the most common microvascular complications of type 2 diabetes mellitus (T2DM) and a leading cause of chronic kidney disease worldwide. Inflammatory pathways play a key role in the pathogenesis and progression of DN. Interleukin-8 (IL-8), a pro-inflammatory cytokine involved in leukocyte recruitment and activation, has been associated with renal inflammation and albuminuria. However, the contribution of IL-8 gene polymorphisms to susceptibility and progression of DN remains unclear.</p><p><strong>Materials and methods: </strong>This cross-sectional case-control study included 138 patients with T2DM and 138 age- and sex-matched healthy controls. Diabetic patients were stratified according to the presence of DN based on urinary albumin excretion and diabetic retinopathy. Genomic DNA was isolated from peripheral blood samples, and the IL-8 rs4073 -251T>A polymorphism was determined using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis. Genotype and allele frequencies were compared between groups, and clinical and laboratory parameters were evaluated according to genotype status.</p><p><strong>Results: </strong>Genotype distributions of the IL-8 rs4073 -251T>A polymorphism were similar between T2DM patients and controls, suggesting no association with the development of T2DM. Among diabetic patients, however, the AA genotype was detected only in individuals without nephropathy and was absent in both latent and overt DN groups. Patients lacking the AA genotype demonstrated higher urinary albumin excretion and a greater frequency of nephropathy progression. DN patients also exhibited longer diabetes duration, poorer glycemic control, impaired renal function, and elevated inflammatory markers compared with patients without nephropathy. Additionally, an inverse relationship between the presence of the A allele and leukocyte and neutrophil counts was observed.</p><p><strong>Conclusion: </strong>The IL-8 rs4073 -251T>A polymorphism does not appear to influence susceptibility to T2DM; however, the presence of the A allele may exert a protective effect against the development of diabetic nephropathy. This protective effect may be mediated through modulation of inflammatory pathways, as suggested by the inverse association between the A allele and inflammatory cell counts. Larger multicenter studies are required to confirm these findings.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179680","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":"Comprehensive look at emergency admissions in renal care (CLEAR): A study from a tertiary care hospital in South India.","authors":"Manjusha Yadla, Meliath Babu Nayana","doi":"10.5414/CN111937","DOIUrl":"10.5414/CN111937","url":null,"abstract":"<p><p>With the increasing number of chronic kidney disease (CKD) patients, emergency renal care admissions are on the rise. Non-availability of structured emergency dialysis services at primary/secondary health care levels is the reason why a majority of patients seek emergency care in tertiary care settings. In addition, acute kidney injury (AKI) due to sepsis, poisoning, and obstruction still remains one of the major causes of emergency kidney care services.</p><p><strong>Aim: </strong>Our aim was to analyze the patterns and outcomes of emergency kidney care admissions in a tertiary care setting.</p><p><strong>Materials and methods: </strong>A case record study of patients admitted over a duration of 3 years to the emergency kidney care department was done at our setting, a tertiary care public sector teaching hospital.</p><p><strong>Results: </strong>Of 4,700 admissions, 3,700 case records were analyzed. The majority (> 50%) were dialysis patients with fluid overload (pulmonary edema), sepsis, and catheter-related infections. In dialysis CKD patients, the predominant cause of seeking emergency care was fluid overload (40%) and sepsis (21%), whereas in AKI it was sepsis (25%) and obstructive uropathy (11%).</p><p><strong>Conclusion: </strong>Half the admissions to emergency kidney care comprised dialysis patients. Important causes for seeking emergency care were pulmonary edema and sepsis. A high mortality rate was observed in those with high Sequential Organ Failure Assessment (SOFA) scores upon admission.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104968","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":"An observational study of patients receiving delayed-release budesonide (Nefecon) for immunoglobulin A nephropathy in the United States: A case series of Asian-American patients.","authors":"Wei Sun, Terri Madison, Li Yang, Elizabeth Liang, Giancarlo Pesce, Sarah Zaidi, Vishnudas Sarda, Ramin Tolouian, Christopher Ngai","doi":"10.5414/CN112036","DOIUrl":"10.5414/CN112036","url":null,"abstract":"<p><strong>Introduction: </strong>IgA nephropathy (IgAN) is a leading cause of glomerulonephritis worldwide with variability by race and ethnicity. This study aimed to provide insights on the treatment journey and clinical outcomes in Asian-American patients with IgAN treated with delayed-release budesonide (Nefecon) in a real-world setting.</p><p><strong>Materials and methods: </strong>In this observational cohort study, a total of 45 consecutive patients with IgAN treated with Nefecon at Chinatown Kidney Care (CKC) (New York, NY, USA) were included. Study outcomes included treatment patterns and clinical outcomes (time to kidney failure, estimated glomerular filtration rate (eGFR), and urine protein-to-creatinine ratio (UPCR)). All variables were summarized descriptively. Subgroup analyses were performed among patients who were treated for ≥ 9 months vs. those treated for < 9 months.</p><p><strong>Results: </strong>Overall, after 9 months of treatment, eGFR remained stable and UPCR decreased by an average of 19%. Improved clinical outcomes were reported among those who were treated for ≥ 9 months (preservation of eGFR and 26% reduction in UPCR) compared with those treated for < 9 months (decline in eGFR and ~ 3% reduction in UPCR). Nefecon was well tolerated with no severe or unexpected adverse events reported.</p><p><strong>Conclusion: </strong>Real-world IgA nephropathy treatment-associated outcomes with Nefecon in Asian-American patients for proteinuria and kidney function were consistent with those observed in the NefIgArd clinical trial. The reduction in proteinuria and improvement in kidney function was greater in patients who completed the 9-month course of therapy. These findings reveal an opportunity for further education among nephrologists regarding the recommended duration of treatment with Nefecon.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":"276-285"},"PeriodicalIF":0.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13621273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148758105","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":"Isolated primary glucosuria without SGLT2 mutation: A case report.","authors":"Mercedes Galloway, Tarek Zaho, Charles W Heilig","doi":"10.5414/CN111921","DOIUrl":"10.5414/CN111921","url":null,"abstract":"<p><strong>Background: </strong>Primary renal glucosuria typically results from SLC5A2 mutations affecting SGLT2 and manifests as isolated urinary glucose excretion with normoglycemia. Rarely, sustained glucosuria occurs in the absence of known genetic mutations or systemic disease.</p><p><strong>Case presentation: </strong>A 63-year-old male with well-controlled stage 3 chronic kidney disease displayed lifelong glucosuria (urine glucose +50 to +100 mg/dL), beginning at age 18, with persistently normal HbA1c and no history of diabetes or systemic symptoms. Investigations showed isolated glucosuria on repeated urinalyses, minimal nonspecific amino acid changes, and negative targeted genetic testing for <i>SLC5A2</i>. He was diagnosed presumptively as primary renal glucosuria of unknown genetic etiology. The patient remains asymptomatic under conservative follow-up.</p><p><strong>Conclusion: </strong>This uncommon presentation of long-standing isolated glucosuria without SLC5A2 mutations highlights the need for broader genetic assessment, potentially whole-exome sequencing and enriched understanding of alternative renal glucose transport mechanisms.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149036784","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":"Analytical validation of an ELISA-based test kit for polymeric IgA immune complexes in IgA nephropathy.","authors":"Wei Wang, Qi Bian, Qing Zhong, Shasha Chen, Lisha Ma, Zhiyong Guo, Aibing Rao, Jicheng Lv, Hong Zhang, Xingfang Xie, Jing Jin, Guisen Li","doi":"10.5414/CN111934","DOIUrl":"10.5414/CN111934","url":null,"abstract":"<p><strong>Background and objectives: </strong>Circulating polymeric IgA immune complexes (Poly-IgA) have been proposed as potential biomarkers for IgA nephropathy (IgAN); however, standardized clinical assays for their detection are not yet available. We developed and analytically validated an ELISA-based test kit for Poly-IgA and evaluated its diagnostic performance in a retrospective, two-center cohort.</p><p><strong>Materials and methods: </strong>Analytical validation of the ELISA kit was performed using samples collected from two independent centers. The validation included evaluation of the linear range, precision, and limit of detection (LOD). Clinical samples comprised healthy controls, patients with IgA nephropathy (IgAN), and patients with non-IgAN kidney diseases (nKD), including membranous nephropathy (MN), focal segmental glomerulosclerosis (FSGS), and other biopsy-confirmed glomerular diseases. Diagnostic sensitivity, specificity, and correlations with routine clinical parameters were evaluated.</p><p><strong>Results: </strong>The test kit demonstrated robust analytical performance, with a limit of blank (LOB) of 10 U/mL, recovery ranging from 85 to 105%, and a linear range of 15.63 - 500 U/mL. Receiver operating characteristic (ROC) curve analysis of retrospective clinical samples yielded an area under the curve (AUC) of 0.87. At an optimal cutoff value of 75.6 U/mL, the assay demonstrated a sensitivity of 82.7%, specificity of 76.0%, and overall diagnostic accuracy of 78.0%. These findings suggest that the assay may serve as a promising diagnostic tool for differentiating IgAN from non-IgAN kidney diseases; however, further validation in larger, multicenter, and more diverse cohorts is warranted.</p><p><strong>Conclusion: </strong>The ELISA-based Poly-IgA test kit was analytically validated and demonstrated good diagnostic performance in differentiating IgAN from nKD in a two-center cohort. Although its specificity of 76% is insufficient to replace kidney biopsy as the diagnostic gold standard, the assay may serve as a promising non-invasive adjunctive tool to support clinical decision-making, particularly for screening and disease monitoring. In light of these limitations, including the relatively small sample size, prospective multicenter studies in larger and more diverse populations are warranted to further establish its clinical utility.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015945","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":"Fracture incidence and mortality in kidney transplant recipients compared with waitlisted dialysis patients: A single-center retrospective analysis.","authors":"Jae Sung Lee, Minji Noh, Eun Hee Park, Kyung Sun Park, Jong Ha Park, Jong Soo Lee, Kyung Don Yoo","doi":"10.5414/CN112007","DOIUrl":"10.5414/CN112007","url":null,"abstract":"<p><strong>Aims: </strong>Kidney transplantation (KT) improves survival in end-stage renal disease (ESRD); however, the post-transplant fracture risk remains uncertain. This study aimed to compare the fracture incidence between kidney transplant recipients (KTRs) and waitlisted dialysis patients and to examine the association between fracture events and all-cause mortality in each group.</p><p><strong>Materials and methods: </strong>This study included a single-center cohort of 504 KTRs and 423 waitlisted dialysis patients treated at a tertiary hospital in South Korea from 1998 to 2019. Fractures were identified through radiological report review, and mortality data were retrieved from medical records. Multivariate Cox regression models were used to evaluate mortality predictors, including fracture events, as covariates.</p><p><strong>Results: </strong>The fracture incidence did not differ significantly between KTRs (9.1%) and dialysis patients (12.5%). Moreover, fractures were not significantly associated with increased mortality in either group (KTRs: hazard ratio (HR), 2.03; 95% confidence interval (CI), 0.62 - 6.67; p = 0.24; dialysis: HR, 0.97; 95% CI, 0.12 - 8.08; p = 0.98). Age was the strongest mortality predictor. Among KTRs, tacrolimus use was associated with lower mortality compared with cyclosporine (HR, 0.18; 95% CI, 0.05 - 0.66; p = 0.009).</p><p><strong>Conclusion: </strong>KTRs have a fracture risk comparable to that of dialysis patients, and fractures were not significantly associated with mortality. The survival benefits of KT are driven by factors other than fracture-related complications. Ongoing, proactive bone health management remains essential in KTRs because transplantation does not eliminate the elevated fracture risk.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical outcomes of peritoneal dialysis in patients with chronic liver and kidney failure: A single-center study.","authors":"Sefia Khan, Oluwatitomi Tedunjaiye, Thomas Kerr, Jigesh Shah, Ramesh Saxena","doi":"10.5414/CN111740","DOIUrl":"10.5414/CN111740","url":null,"abstract":"<p><strong>Background: </strong>Simultaneous liver-kidney (SLK) transplant is the ideal therapeutic option for patients with chronic liver and kidney failure (CLKF), but the shortage of organs leaves many patients dialysis dependent. Hemodialysis is frequently utilized but is poorly tolerated due to exacerbation of preexisting intravascular instability. Peritoneal Dialysis (PD) may pose several advantages: providing hemodynamic stability, and ascites management.</p><p><strong>Materials and methods: </strong>This was a retrospective observational study that included all patients with CLKF who initiated PD from July 2002 to December 2022 at the University of Texas Southwestern Medical Center/DaVita Dialysis Center. Medical charts were reviewed for demographics, clinical outcomes, laboratory values, and censoring events.</p><p><strong>Results: </strong>27 patients with CLKF initiated PD during this period. The mean MELD-3.0 score was 25. A total of 23 patients had clinical ascites requiring frequent large-volume paracentesis prior to PD initiation. Mean follow-up was 42.4 + 39 months. Peritonitis rates were 0.21 episodes per patient-year on PD. Six patients died with an annualized mortality of 63/1,000 patient-years. The hospitalization rate was 0.82 per patient-year. Six patients received an SLK transplant, and 1 received liver transplant followed by a kidney transplant. Six patients remained on the waiting list, and 2 were in the transplant work-up by the study end. Ten patients were deemed ineligible for SLK transplant. It is noteworthy that none of these patients required large-volume paracentesis after PD initiation.</p><p><strong>Discussion: </strong>In this single-center study on PD patients with CLKF, we observed excellent outcomes, with mortality, hospitalizations, and peritonitis rates comparable to those of the general PD population. Furthermore, by providing continuous drainage of ascites, PD alleviated the need for large-volume paracentesis. In addition, PD did not affect the candidacy for SLK transplant. Hence, PD should be considered a viable dialysis modality in patients with CLKF.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":"169-177"},"PeriodicalIF":0.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147484441","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":"A rare case of renal cancer with PLA2R-positive membranous nephropathy and AL amyloidosis: Insights into mechanisms and treatment.","authors":"Jian Zhang, Junyue Huang, Bin Zhou, Limin Tian, Zhigang Ma, Wenhui Huang, Hui Zhao","doi":"10.5414/CN111957","DOIUrl":"10.5414/CN111957","url":null,"abstract":"<p><p>Renal clear cell carcinoma (RCC), the predominant subtype of kidney cancer, is characterized by paraneoplastic syndromes, of which membranous nephropathy (MN) represents the most common paraneoplastic glomerulonephritis. While phospholipase A2 receptor (PLA2R) antibodies indicate primary MN, the concurrent presence of light-chain amyloidosis may further complicate the clinical manifestations in malignancy-associated cases. A rare case of RCC concurrent with phospholipase A2 receptor PLA2R-positive MN and light chain amyloidosis is reported in this paper. An elderly male patient presented with nephrotic syndrome and a right renal mass. The patient underwent a nephrectomy after admission. Pathological examination confirmed the diagnosis of right kidney renal clear cell carcinoma. Renal biopsy revealed PLA2R-positive MN and AL amyloidosis. Interestingly, in this case, glomerular light chain staining showed no monoclonal restriction, but λ light chain deposition was found in the vessels. However, the nephrotic syndrome showed no improvement after tumor resection. The patient achieved remission following sequential treatment with bortezomib, dexamethasone, daratumumab, and rituximab. This case illustrates the complex interplay among RCC, PLA2R-positive MN, and AL amyloidosis, complicating patient management. Future research should focus on the immunological mechanisms of PLA2R antibody production in malignancy and the pathophysiological links among these conditions. Clinicians should remain vigilant for secondary causes of nephrotic syndrome in renal malignancy patients and adopt comprehensive, multidisciplinary approaches to improve outcomes.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":"231-238"},"PeriodicalIF":0.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147510111","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":"Role of platelet-to-lymphocyte ratio in predicting augmented renal clearance following intracerebral hemorrhage surgery.","authors":"Jiaxin Dong, Qian Zhang, Min Huang, Jing Zhou, Suming Zhou, Dongmei Zhu","doi":"10.5414/CN111993","DOIUrl":"https://doi.org/10.5414/CN111993","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the potential of the platelet-to-lymphocyte ratio (PLR) as a predictive biomarker for augmented renal clearance (ARC) in patients undergoing intracerebral hemorrhage (ICH) surgery.</p><p><strong>Materials and methods: </strong>A single-center retrospective cohort study was conducted on 174 patients who underwent ICH surgery. Pearson or Spearman correlation analyses were used to examine the relationship between PLR and baseline characteristics. Restricted cubic spline curves were employed to assess the association between PLR and ARC occurrence. Logistic regression models were applied to identify risk factors for ARC, while the predictive performance of PLR was evaluated using receiver operating characteristic curves. All statistical analyses were performed using IBM SPSS Statistics v.24.0 and R v.4.0.2.</p><p><strong>Results: </strong>Among the 174 patients, 99 (56.9%) developed ARC. The optimal cutoff value for PLR was determined to be 201.31. The AUC of PLR for predicting ARC was 0.69 (95% CI: 0.61 - 0.77), with a sensitivity of 65.3% and specificity of 73.7%. Subgroup analyses revealed that this association was particularly pronounced in patients aged over 55 years, those with a body mass index ≤ 25 kg/m², an APACHE II score of 10 - 20, and a hemorrhage volume ≤ 30 mL. Integrating PLR into a composite model (APACHE II, SOFA, and GCS) increased the AUC from 0.70 (95% CI: 0.62 - 0.78) to 0.73 (95% CI: 0.65 - 0.81). The addition of PLR to the composite scoring system yielded a category net reclassification improvement of 0.12 (95% CI: 0.00 - 0.25).</p><p><strong>Conclusion: </strong>Preoperative low PLR is significantly associated with the early occurrence of ARC and serves as an independent predictor for ARC.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863704","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}