Clinical nephrology最新文献

{"title":"The relationship between proteinuria and left ventricular hypertrophy in non-diabetic chronic glomerulonephritis patients.","authors":"Musa Ilker Durak, Beyza Algul Durak, Melahat Coban, Mine Sebnem Karakan","doi":"10.5414/CN111637","DOIUrl":"10.5414/CN111637","url":null,"abstract":"<p><strong>Aim: </strong>Chronic glomerulonephritis (GN) encompasses various disorders that lead to glomerular inflammation and damage through the interaction of environmental triggers such as immune-mediated mechanisms and infections. The aim of the study was to investigate the relationship between proteinuria and left ventricular hypertrophy (LVH) in non-diabetic chronic GN patients.</p><p><strong>Materials and methods: </strong>This study was conducted with 103 (62.4%) male and 62 (37.6%) female chronic GN patients with a mean age of 55.65 ± 15.81 years. Patients were compared with 90 healthy individuals of similar age and gender. Proteinuria levels were measured using 24-hour proteinuria quantification (24h QP). Left ventricular (LV) ejection fraction (LVEF), LV end-diastolic diameter (LVEDD), LV end-systolic diameter (LVESD), and LV mass index (LVMI) were calculated using echocardiography.</p><p><strong>Results: </strong>Proteinuria was determined to be ≥ 3.5 g/day in 54 (32.7%) of the patients. In patients, creatinine, LVMI, and LVH were significantly higher compared to healthy individuals. Patients with nephrotic proteinuria had higher LVMI and LVH compared to those with non-nephrotic proteinuria. A significant relationship was found between LVMI and LVH in patients with nephrotic proteinuria. In the univariate logistic regression analysis, an increase in LVH and LVMI values was found to be associated with an increase in nephrotic proteinuria levels.</p><p><strong>Conclusion: </strong>Increased development of LVH was observed in patients compared to healthy individuals. Significantly higher development of LVH was observed in those with nephrotic proteinuria compared to those without. A significant relationship was observed between nephrotic proteinuria and LVH as well as LVMI in patients with chronic GN.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":"170-177"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976588","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":"Malnutrition and short-term mortality in hospitalized general medical patients with acute kidney injury: A prospective observational study.","authors":"Vishal Choudhary, Surendran Deepanjali","doi":"10.5414/CN111715","DOIUrl":"10.5414/CN111715","url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury (AKI) is a common condition present at admission to hospital in a proportion of general medical patients and it contributes to mortality. Presence of associated malnutrition could worsen the prognosis. We aimed to study the prevalence of malnutrition in patients with community-acquired AKI requiring hospitalization and its association with short-term (in-hospital and 1-month post-discharge) mortality, admission to the intensive care unit (ICU) and length of hospitalization (LOH).</p><p><strong>Materials and methods: </strong>We did a prospective observational study including adult general medical patients who had AKI at admission; patients with chronic kidney disease were excluded. We calculated the Charlson Comorbidity Index (CCI) and Sequential Organ Failure Assessment Score (SOFA). Nutritional assessment was done using Subjective Global Assessment (SGA) and also Prognostic Nutritional Index (PNI). Clinical course and vital status at 1 month after discharge was noted. Predictors of mortality were identified using logistic regression.</p><p><strong>Results: </strong>We recruited 230 patients. The median (interquartile range (IQR)) age was 51 (40 - 64) years; 171 (74.3%) were males. Based on admission creatinine, 60 (26%) were in Kidney Disease Improving Global Outcomes (KDIGO) stage 1, 82 (35.6%) in stage 2, and 88 (38.3%) in stage 3. We found that 132 (57.4%) belonged to SGA category A, 77 (33.5%) to SGA B, and 21 (9.1%) to SGA C. The median (IQR) PNI was 36.3 (30 - 46.6). The short-term mortality was 59 (25.6%). Multivariable analysis showed that male sex (adjusted OR (aOR) (2.75 (1.08 - 6.98); p = 0.033), higher CCI (aOR 1.43 (1.18 - 1.74); p < 0.001), higher SOFA scores (aOR 1.36 (1.19 - 1.55); p < 0.001), and SGA C category (aOR 4.4 (1.39 - 14.03); p = 0.012) to be associated with mortality, while AKI due to underlying infections was associated with survival (aOR 0.38 (0.18 - 0.78); p = 0.008). There was no association of malnutrition with ICU admission or LOH. PNI did not predict mortality.</p><p><strong>Conclusion: </strong>About 10% of patients with community-acquired AKI had severe malnutrition, and it independently predicts mortality. Male sex, higher CCI, and higher SOFA scores were also associated with mortality. AKI associated with infections has a better prognosis.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":"191-199"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967980","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":"Prevalence, associated factors, and prognosis of acute kidney injury in critically ill patients with COVID-19 in sub-Saharan Africa: A retrospective single-center study.","authors":"Mansour Mbengue, Abdelhakh Achafi, Ibrahima Gaye, Jatt Tshabayembi, Fatou Ndiaye, Cheikh M F Kitane, Abdou Niang","doi":"10.5414/CN111607","DOIUrl":"10.5414/CN111607","url":null,"abstract":"<p><strong>Introduction: </strong>Acute kidney injury (AKI) constitutes a complication frequently encountered in patients with severe forms of COVID-19. The aim of this study was to evaluate the prevalence of acute kidney injury and to describe its associated factors.</p><p><strong>Materials and methods: </strong>This was a retrospective, descriptive, analytical study over a period of 18 months at Dalal Jamm Hospital in Dakar. We included all patients admitted to the intensive care unit for the treatment of COVID-19. AKI was defined according to KDIGO 2012.</p><p><strong>Results: </strong>During the study period, we collected 170 files. The mean age was 59.38 ± 14.81 years, and 40.6% were women. Hypertension and diabetes mellitus were the most frequently found comorbidities, respectively, in 37.65% and 31.18% of cases. AKI was present in 50 (29.4%) patients. Acute tubular injury was found in 44% of cases. Hemodialysis was performed in 10% of cases, and the indications were hyperkalemia (100%), and uremic encephalopathy (40%). Death occurred in 62.36% of cases. Recovery of renal function during hospitalization was noted in 16% of patients. In multivariable analysis, the factors associated with AKI were obesity (p = 0.020; adjusted odds ratio (aOR) = 7.406; 95% CI = 2.25 - 37.11) and non-renal Sequential Organ Failure Assessment (SOFA) (p = 0.001; aOR = 5.851; 95% CI = 3.04 - 11.2). AKI was an independently associated factor with death (p = 0.002; aOR = 4.510; 95% CI = 2.51 - 9.52).</p><p><strong>Conclusion: </strong>AKI is common during COVID-19. AKI is correlated with the severity of the disease and the presence of comorbidities. AKI is independently associated with increased risk of death in COVID-19.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":"200-206"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144539243","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 manifestations and prognosis of immune-mediated membranous nephropathy concurrent with other glomerulonephritides: A retrospective Chinese cohort analysis.","authors":"Zhe Li, Shuhua Zhu, Ke Zuo, Dacheng Chen, Weibo Le, Feng Xu, Xia Wang","doi":"10.5414/CN111627","DOIUrl":"10.5414/CN111627","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to analyze the clinical and prognostic differences in immune-mediated membranous nephropathy (MN) concurrent with other forms of glomerulonephritis.</p><p><strong>Materials and methods: </strong>A retrospective cohort study at Jinling Hospital from 2015 to 2023 included patients with PLA2R antibody levels ≥ 14RU/mL who underwent renal biopsy. Those with immune-mediated MN and concurrent glomerulonephritides were compared to a control group with isolated MN diagnosed in 2015.</p><p><strong>Results: </strong>Concurrent glomerulonephritis was found in 5.53% of the MN cohort, including 61 patients with IgA nephropathy (IgAN-MN), 49 with diabetic nephropathy (DN-MN), and 131 with focal segmental glomerulosclerosis (FSGS-MN). Compared to the control group, those with IgAN-MN showed increased severity of glomerular injury yet had a reduced degree of interstitial fibrosis. The DN-MN group exhibited intensified glomerular damage; however, no significant difference was observed in the extent of tubulointerstitial damage. Additionally, the FSGS-MN group displayed more severe damage to both glomerular and tubulointerstitial structures. Both the DN-MN group and the FSGS-MN group exhibited a significantly lower complete remission rate compared to the control group. The renal endpoint event rates were 29.51% for IgAN-MN, 46.94% for DN-MN, and 33.59% for FSGS-MN, which were all significantly higher than the 18.99% rate in the control group.</p><p><strong>Conclusion: </strong>Patients with MN who test positive for serum Anti-PLA2R antibodies may present with other forms of glomerulonephritis. The prognostic outcomes of MN in the presence of concurrent IgAN, DN, or FSGS are notably poorer than those of isolated MN. Renal biopsy is valuable for definitive diagnosis and prognostic evaluation.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":"207-217"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198407","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":"Effects of chronic kidney disease-associated pruritus on quality of life in hemodialysis and non-dialysis patients: A cross-sectional study.","authors":"Abdullah Ucar, Mevlut Tamer Dincer, Safak Mirioglu, Siddik Keskin, Cebrail Karaca","doi":"10.5414/CN111649","DOIUrl":"10.5414/CN111649","url":null,"abstract":"<p><strong>Aims: </strong>Chronic kidney disease-associated pruritus (CKD-aP) is a common and distressing symptom, particularly in hemodialysis (HD) patients, significantly impacting their quality of life. This study aimed to investigate the effects of CKD-aP frequency and severity on quality of life in both HD and non-HD stage 3 - 5 CKD patients.</p><p><strong>Materials and methods: </strong>This cross-sectional case-control study was conducted from January to May 2024. Pruritus was assessed using the 5-D itch scale, and quality of life was evaluated with the World Health Organization Quality of Life Scale-Short Form (WHOQoL-BREF) questionnaire. Correlations between pruritus severity and patient characteristics were analyzed.</p><p><strong>Results: </strong>The study involved 169 patients, comprising 80 non-HD stage 3 - 5 CKD patients and 89 HD patients, with a mean age of 55.2 ± 16.7 years. Pruritus was significantly more prevalent in the HD group than in the non-HD group (61.8 vs. 41.3%, p = 0.008). HD patients had more pruritic body areas and higher 5-D itch scale scores (0 (0 - 8.5) vs. 0 (0 - 3.75), p = 0.002; 9.3 (8.0 - 14.8) vs. 8.0 (8.0 - 10.3), p = 0.003). In the HD group, pruritus was associated with lower quality of life in the psychological health, social relationships, and environment domains of the WHOQoL-BREF questionnaire (50.0 (35.4 - 58.3)% vs. 54.2 (42.7 - 66.7)%, p = 0.027; 50.0 (33.3 - 58.3)% vs. 50.0 (41.6 - 66.7)%, p = 0.046; 53.1 (40.6 - 65.5)% vs. 56.3 (50.0 - 68.8)%, p = 0.026, respectively). Pruritus also correlated with lower hemoglobin levels, higher serum creatinine levels, and poorer overall quality of life in both groups, with female sex and erythropoiesis-stimulating agent use as significant contributing factors.</p><p><strong>Conclusion: </strong>Pruritus significantly impairs the quality of life in HD patients.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":"178-190"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109977","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 predictive model for olfactory dysfunction in patients undergoing maintenance hemodialysis.","authors":"Ci Sun, Haixia Zhang, Ying Lu, Sheng Feng, Kai Song, Weiwei Li","doi":"10.5414/CN111702","DOIUrl":"https://doi.org/10.5414/CN111702","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the current status and risk factors of olfactory dysfunction in patients undergoing maintenance hemodialysis (MHD), establish a prediction model, and evaluate its effectiveness.</p><p><strong>Materials and methods: </strong>The demographic characteristics and laboratory tests of MHD patients at the Second Affiliated Hospital of Soochow University's hemodialysis center from February to May 2024 were collected. Basic information from individuals with normal renal function at the physical examination center served as a normal control group. Olfactory function was assessed using Sniffin' Sticks, categorizing subjects as having normal, hyposmia, or anosmia based on their scores. Binary and ternary logistic regression analyses were conducted to ascertain risk factors for olfactory dysfunction occurrence and progression in MHD patients, establish predictive models, and assess their performance using receiver operating characteristic curve (ROC curve) and prediction probability graph.</p><p><strong>Results: </strong>Among 53 individuals with normal renal function, 17 cases (32.1%) exhibited hyposmia, while 3 cases (5.7%) demonstrated anosmia. Among 159 MHD patients, 97 cases (61.0%) had hyposmia and 24 cases (15.1%) had anosmia. The prevalence of olfactory dysfunction in the MHD group was significantly higher than that observed in the normal control group (χ² = 26.434, p < 0.001). Logistic regression analysis revealed that advanced age (OR = 2.373, 95% CI: 1.143 - 4.928, p = 0.020), hypoalbuminemia (OR = 1.299, 95% CI: 1.051 - 1.607, p = 0.016), hypocholesterolemia (OR = 2.373, 95% CI: 1.143 - 4.928, p = 0.020), low education level (secondary or higher education/no education, OR = 0.065, 95% CI: 0.007 - 0.601, p = 0.016; primary education/no education: OR = 0.093, 95% CI: 0.019 - 0.457, p = 0.003) were identified as risk factors for anosmia development. Hypocholesterolemia was a risk factor for hyposmia (OR = 2.052, 95% CI: 1.228 - 3.429, p = 0.005). The prediction model of anosmia was In(P/1-P) = 14.97 + 0.997·age (years)/10 - 0.466·albumin (g/L) -1.942·cholesterol (mmol/L) +2.936·education level (P is the probability of anosmia). ROC curve and prediction probability graph indicated good performance of our prediction model.</p><p><strong>Conclusion: </strong>The prevalence rate of olfactory dysfunction in MHD patients was found to be 76.1%. Advanced age, hypoalbuminemia, hypocholesterolemia, and low education level were identified as significant risk factors for anosmia. Advanced age, hypoalbuminemia, and lower education level also posed risks for deterioration of olfactory function.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945150","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 effects of switching from etelcalcetide to upacicalcet in hemodialysis patients with secondary hyperparathyroidism.","authors":"Eiichi Sato, Miyako Urata, Shohei Sato, Takao Ono, Manaka Degawa, Hongmei Lu, Mayumi Nomura, Daisuke Matsumura, Noriaki Moriyama, Mayuko Amaha, Tsukasa Nakamura","doi":"10.5414/CN111695","DOIUrl":"https://doi.org/10.5414/CN111695","url":null,"abstract":"<p><strong>Aims: </strong>No English-language research papers have reported on the clinical use of upacicalcet, a novel intravenous calcimimetic agent for the treatment of secondary hyperparathyroidism (SHPT) in hemodialysis patients. Therefore, this study aimed to investigate the outcomes of switching from etelcalcetide to upacicalcet.</p><p><strong>Materials and methods: </strong>The subjects included 37 hemodialysis patients with SHPT treated with etelcalcetide before switching to upacicalcet. This study was a single-center retrospective study conducted in Japan. Serum levels of corrected calcium (Ca), phosphorus (P), intact parathyroid hormone (iPTH), and the dose of maxacalcitol were assessed at 3 and 6 months after switching to upacicalcet.</p><p><strong>Results: </strong>As a result of the switch from etelcalcetide to upacicalcet, the serum corrected Ca level remained unchanged, from 8.9 ± 0.6 to 9.1 ± 0.7 mg/dL (p = 0.104) at 3 months and to 9.0 ± 0.6 mg/dL (p = 0.197) at 6 months. Meanwhile, the serum P level decreased from 6.3 ± 1.5 to 5.8 ± 1.5 mg/dL (p = 0.069) at 3 months and to 5.9 ± 1.9 mg/dL (p = 0.039) at 6 months. The iPTH level increased slightly, from 153.8 ± 100.3 pg/mL to 176.4 ± 124.6 pg/mL (p = 0.337) at 3 months and to 206.5 ± 168.7 pg/mL (p = 0.017) at 6 months. Multiple regression analysis revealed that the change in iPTH was related to the change in P levels.</p><p><strong>Conclusion: </strong>These findings suggested that upacicalcet may be a useful option for managing serum P levels in hemodialysis patients with SHPT.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945174","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":"Longitudinal trajectory of metabolic components and outcomes in chronic kidney disease: The National Health Insurance Service-National Health Screening Cohort.","authors":"Hyuk Huh, Jae Sung Lee, Eun Hee Park, Minji Noh, Hoseok Koo, Kyung Don Yoo","doi":"10.5414/CN111519","DOIUrl":"10.5414/CN111519","url":null,"abstract":"<p><strong>Aims: </strong>Longitudinal trajectory analysis can provide important insights into the optimal levels of metabolic factors in chronic kidney disease (CKD). This study evaluated the association between longitudinal trajectories of metabolic disturbances and prognosis in CKD.</p><p><strong>Materials and methods: </strong>We used data from the National Health Insurance Service-National Health Screening Cohort, which comprises data from 514,866 subjects randomly selected from the 2002 and 2003 health screening participants, who were aged between 40 and 79 years. Subjects were classified into trajectory groups using K-means clustering - an algorithm that assigns individual data points to groups according to similarity of the data - based on metabolic parameters, including blood pressure (BP), total cholesterol, triglycerides, low-density lipoprotein cholesterol (LDL-C), and body mass index (BMI). Subjects were classified into groups with similar trajectories based on the central value with the minimum distance. The optimal number of clusters was selected using the Calinski-Harabasz index. Outcomes were a decline in renal function and all-cause mortality.</p><p><strong>Results: </strong>A total of 24,094 CKD patients were included in the trajectory analysis. After clustering, BP, triglycerides, and LDL-C were divided into low and high categories, while BMI was classified into 6 categories according to the distribution of participants. Logistic regression analysis showed that a high systolic BP trajectory and underweight trajectory were associated with all-cause mortality, while high systolic BP, low diastolic BP, and high triglyceride trajectories were associated with a decline in renal function.</p><p><strong>Conclusion: </strong>This study demonstrated the association between longitudinal trajectories of metabolic disturbances and the prognosis of CKD. Using trajectories of metabolic parameters could be helpful for predicting renal outcomes and mortality in CKD.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144871782","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 tumor necrosis factor receptors 1 and 2 with kidney volume and function in patients with autosomal dominant polycystic kidney disease.","authors":"Seyda Gul Ozcan, Metin Ergul, Necmi Eren, Sertac Tunc, Durdane Yagmur Ersoy, Mevlut Tamer Dincer, Ibrahim Murat Bolayirli, Nurhan Seyahi","doi":"10.5414/CN111745","DOIUrl":"10.5414/CN111745","url":null,"abstract":"<p><strong>Background: </strong>Autosomal dominant polycystic kidney disease (ADPKD) is a prevalent genetic disorder characterized by renal cyst formation, progressive kidney enlargement, and declining kidney function. The pro-inflammatory effects of tumor necrosis factor through its receptors TNFR1 and TNFR2 may have a role in the growth of cysts and kidney volume in ADPKD cases. This study aimed to assess the association between serum TNFR1 and TNFR2 levels, kidney function (estimated glomerular filtration rate (eGFR)), and height-adjusted total kidney volume (HtTKV) in ADPKD patients.</p><p><strong>Materials and methods: </strong>We recruited 50 ADPKD and 20 non-ADPKD chronic kidney disease (CKD) patients. Serum TNFR1, TNFR2, and cystatin C levels were measured using enzyme-linked immunosorbent assay. Magnetic resonance imaging was performed to measure kidney volumes, and eGFR was calculated using a serum creatinine-cystatin C-based formula. Correlation analyses and multivariate regression models were utilized to evaluate associations between biomarkers and eGFR.</p><p><strong>Results: </strong>TNFR1 levels showed a significant negative correlation with eGFR (r = -0.332, p = 0.019) in ADPKD patients, while no such association was observed in CKD patients. No significant correlations were found between HtTKV and either TNFR1 or TNFR2 concentration. Multivariate regression analysis revealed that TNFR1 was independently associated with lower eGFR values (B = -27.114, p = 0.019).</p><p><strong>Conclusion: </strong>High levels of TNFR1 are correlated with lower kidney function in ADPKD patients but are not associated with kidney volume. The absence of linkages with HtTKV may be influenced by the use of tolvaptan in this cohort. Further longitudinal studies are warranted to explore the causal roles of TNFRs in ADPKD progression.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144871781","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":"Central blood volume and cardiac output index predict all-cause and cardiovascular mortality in chronic hemodialysis patients.","authors":"Chung-Kuan Wu, Li-Juan Lin, Chew-Teng Kor, Chia Lin Wu","doi":"10.5414/CN111484","DOIUrl":"10.5414/CN111484","url":null,"abstract":"<p><strong>Background: </strong>This study investigated the effect of central blood volume (CBV) and cardiac output index (COI) on the all-cause and cardiovascular mortality in chronic hemodialysis (CHD) patients.</p><p><strong>Materials and methods: </strong>Adult CHD patients with functional arteriovenous access at the hemodialysis center of a medical center between January 1, 2003, and December 31, 2014, were recruited in this retrospective observational study. The primary and secondary endpoints were all-cause and cardiovascular mortality. Cumulative incidences of all-cause and cardiovascular mortality during the follow-up period were estimated and compared using the Kaplan-Meier method and log-rank test. Logistic regression and Cox proportional hazards models were used to calculate odds and hazard ratios.</p><p><strong>Results: </strong>A total of 390 CHD patients were enrolled, including 34 patients with early mortality. The early mortality group had a higher CBV than the survival group. CBV and COI were independently associated with all-cause and cardiovascular mortality. Low COI (< 3 L/min/m²) and high CBV (≥ 1.25 L) independently predicted long-term all-cause and cardiovascular mortality. The highest risks of all-cause and cardiovascular mortality were observed in patients with low COI and high CBV, followed by high COI and high CBV and then low COI and low CBV. Mortality was the lowest in those with high COI and low CBV.</p><p><strong>Conclusion: </strong>CBV and COI are important factors for predicting death in CHD patients. Those with low COI and high CBV had the worst outcomes.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":"108-119"},"PeriodicalIF":1.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966788","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}