Clinical nephrology最新文献

筛选
英文 中文
Bidirectional two-sample Mendelian randomization analysis reveals a causal effect of chronic pain on chronic kidney diseases and renal function. 双向双样本孟德尔随机分析揭示了慢性疼痛对慢性肾脏疾病和肾功能的因果影响。
IF 1 4区 医学
Clinical nephrology Pub Date : 2025-10-01 DOI: 10.5414/CN111662
Chengwei Wu, Qiankun Zhang, Zhenhua Wu
{"title":"Bidirectional two-sample Mendelian randomization analysis reveals a causal effect of chronic pain on chronic kidney diseases and renal function.","authors":"Chengwei Wu, Qiankun Zhang, Zhenhua Wu","doi":"10.5414/CN111662","DOIUrl":"10.5414/CN111662","url":null,"abstract":"<p><strong>Objective: </strong>A growing body of research has shown a connection between chronic pain and chronic kidney disease (CKD). However, it is unclear if these correlations point to a cause-and-effect link. Our goal is to investigate the causal link between renal function or CKD and chronic pain.</p><p><strong>Materials and methods: </strong>Using genome-wide association study (GWAS) datasets on these traits, we performed bidirectional two-sample Mendelian randomization (MR) analyses in this work to evaluate genetic linkages and possible causal links between chronic pain and CKD or renal function. The CKD Genetics Consortium provided the GWAS data for CKD symptoms, estimated creatinine-based glomerular filtration rate (eGFRcrea) and cystatin C-based GFR (eGFRcys). A sizable biomedical database of GWAS provided summary statistics for both chronic widespread musculoskeletal pain (CWP) and multisite chronic pain (MCP).</p><p><strong>Results: </strong>MR analysis revealed that MCP was significantly associated with an increased risk of CKD (OR = 1.52; 95% CI: 0.97 - 2.40; p = 0.037) and eGFRcys decline (OR = 0.97; 95% CI: 0.95 - 0.99; p = 0.014). The reliability of the MR analysis was demonstrated by sensitivity analysis. However, MR analysis did not find a significant association between CWP and CKD or renal function decline. Additionally, this study did not discover a link between renal function decline or CKD and chronic pain.</p><p><strong>Conclusion: </strong>Our research revealed a substantial correlation between MCP and a higher risk of CKD and renal function deterioration.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":"266-272"},"PeriodicalIF":1.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607709","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
Diet quality, unprocessed plant-based foods, and vascular function in adults with CKD: Secondary analysis of a pilot randomized clinical trial. 饮食质量、未加工的植物性食物和成人CKD的血管功能:一项试点随机临床试验的二次分析
IF 1 4区 医学
Clinical nephrology Pub Date : 2025-10-01 DOI: 10.5414/CN111683
Luis Perez, Taylor Struemph, Sridharan Raghavan, Zhiying You, Gregory G Schwartz, Kristen L Nowak, Michel Chonchol, Anna Jovanovich
{"title":"Diet quality, unprocessed plant-based foods, and vascular function in adults with CKD: Secondary analysis of a pilot randomized clinical trial.","authors":"Luis Perez, Taylor Struemph, Sridharan Raghavan, Zhiying You, Gregory G Schwartz, Kristen L Nowak, Michel Chonchol, Anna Jovanovich","doi":"10.5414/CN111683","DOIUrl":"10.5414/CN111683","url":null,"abstract":"<p><strong>Objective: </strong>Chronic kidney disease (CKD) is prevalent among Veterans and is strongly associated with cardiovascular disease (CVD) and mortality. Fruit and vegetable intake may help manage CKD and CVD. However, the relationships of dietary intake of kidney-impacting nutrients from plant-based foods with vascular function, oxidation, and inflammation in CKD is uncertain.</p><p><strong>Materials and methods: </strong>We conducted a post-hoc analysis of the Phosphate Lowering in CKD Trial evaluating the association of unprocessed, plant-based energy and nutrient intake with pulse wave velocity (PWV), flow meditated dilation (FMD), and markers of oxidative stress and inflammation. Participants had stage 3b - 4 CKD and serum phosphorus of 2.8 - 5.5 mg/dL. Linear regression models were adjusted for age, sex, body mass index, blood pressure, diabetes, CVD, and kidney function.</p><p><strong>Results: </strong>Participants (n = 42) were aged 66 ± 7 years with estimated glomerular filtration rate 36.2 ± 10.1 mL/min/1.73m<sup>2</sup>; 88% were male. Diets comprised large proportions of animal and processed foods. Higher daily intake of unprocessed plant-based energy, potassium, phosphorus, and protein were each significantly associated with lower PWV in fully adjusted models: -1.11 cm/s (95% CI: -1.98, -0.25 cm/s), -0.49 cm/s (95% CI: -0.86, -0.12 cm/s), -312.4 cm/s (95% CI: -514.5, -110.3 cm/s), and -280.3 cm/s (95% CI: -484.4, -76.2 cm/s), respectively. However, unprocessed, plant-based nutrient intakes were not associated with FMD or markers of oxidation or inflammation.</p><p><strong>Conclusion: </strong>Despite overall low diet quality, higher consumption of unprocessed, plant-based energy and nutrients was associated with lower arterial stiffness. Future studies are needed to explore these associations in larger cohorts with CKD and the effects of diet quality interventions.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":"273-284"},"PeriodicalIF":1.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316039","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
Longitudinal trajectory of metabolic components and outcomes in chronic kidney disease: The National Health Insurance Service-National Health Screening Cohort. 慢性肾脏疾病代谢成分和结果的纵向轨迹:国民健康保险服务-国民健康筛查队列。
IF 1 4区 医学
Clinical nephrology Pub Date : 2025-10-01 DOI: 10.5414/CN111519
Hyuk Huh, Jae Sung Lee, Eun Hee Park, Minji Noh, Hoseok Koo, Kyung Don Yoo
{"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":"237-248"},"PeriodicalIF":1.0,"publicationDate":"2025-10-01","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}
引用次数: 0
Rituximab for double-positive anti-GBM antibody and ANCA-associated glomerulonephritis: The first reported case in Asia and literature review. 利妥昔单抗治疗双阳性抗gbm抗体和anca相关性肾小球肾炎:亚洲首例报道病例和文献综述。
IF 1 4区 医学
Clinical nephrology Pub Date : 2025-09-18 DOI: 10.5414/CN111588
Chang-Ying Chen, Ying-Ren Chen, Wei-Ren Lin, Wei-Hung Lin
{"title":"Rituximab for double-positive anti-GBM antibody and ANCA-associated glomerulonephritis: The first reported case in Asia and literature review.","authors":"Chang-Ying Chen, Ying-Ren Chen, Wei-Ren Lin, Wei-Hung Lin","doi":"10.5414/CN111588","DOIUrl":"10.5414/CN111588","url":null,"abstract":"<p><strong>Background: </strong>Double-positive patients exhibit both anti-glomerular basement membrane antibody and anti-neutrophil cytoplasmic antibody. Its initial treatment includes induction cyclophosphamide, glucocorticoids, and plasmapheresis, followed by maintenance therapy similar to that for anti-neutrophil cytoplasmic antibody-associated vasculitis. However, some patients suffer from refractoriness and intolerance to cyclophosphamide, creating an unmet need for second-line therapy. Moreover, no guidance has been provided on the choice of immunosuppressant agents for maintenance therapy.</p><p><strong>Case presentation: </strong>A 55-year-old Asian woman presented with post-prandial vomiting and a persistent high fever for 1 month. She was diagnosed as a double-positive patient after developing rapidly progressive glomerulonephritis, with a creatinine level of 332 μmol/L. She received induction therapy with cyclophosphamide, glucocorticoids, and plasmapheresis soon after diagnosis. However, worsening renal function and severe nausea and vomiting occurred after 3 monthly doses of cyclophosphamide. Four weekly doses of re-induction rituximab at 375 mg/m<sup>2</sup>, followed by maintenance rituximab 500 mg every 6 months, were administered. The patient had a stable creatinine level of 208 μmol/L 17 months after diagnosis.</p><p><strong>Conclusion: </strong>Rituximab may be a viable alternative as an induction therapy for double-positive patients when first-line cyclophosphamide is not effective or is not tolerated. Moreover, rituximab may be an effective maintenance therapy for double-positive patients. This case study demonstrates not only the efficacy of rituximab in double-positive patients but also reports the first Asian case of the disorder treated successfully with rituximab.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079686","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
A case of lipoprotein glomerulopathy complicated with IgA nephropathy. 脂蛋白肾小球病合并IgA肾病1例。
IF 1 4区 医学
Clinical nephrology Pub Date : 2025-09-04 DOI: 10.5414/CN111795
Jiajun Wu, Xian Sun
{"title":"A case of lipoprotein glomerulopathy complicated with IgA nephropathy.","authors":"Jiajun Wu, Xian Sun","doi":"10.5414/CN111795","DOIUrl":"10.5414/CN111795","url":null,"abstract":"","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991651","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
Efficacy and safety of repositioning malfunctioning peritoneal dialysis catheters with fluoroscopically guided guidewire manipulation. 透视引导导丝复位腹膜透析管的有效性和安全性。
IF 1 4区 医学
Clinical nephrology Pub Date : 2025-09-01 DOI: 10.5414/CN111605
Ron Cheuk Lau Wong, Eric Wai Pan Cheung, Agnes Wong, Brian Kar Ho Lee, Ka King Cheng, Danny Hing Yan Cho
{"title":"Efficacy and safety of repositioning malfunctioning peritoneal dialysis catheters with fluoroscopically guided guidewire manipulation.","authors":"Ron Cheuk Lau Wong, Eric Wai Pan Cheung, Agnes Wong, Brian Kar Ho Lee, Ka King Cheng, Danny Hing Yan Cho","doi":"10.5414/CN111605","DOIUrl":"10.5414/CN111605","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the efficacy and safety of fluoroscopic-guided repositioning of peritoneal dialysis (PD) catheter using guidewire manipulation in our center in Hong Kong.</p><p><strong>Materials and methods: </strong>All patients underwent fluoroscopic-guided PD catheter repositioning in our institution between November 1, 2017 to December 31, 2022 were reviewed. Patients fulfilling the selection criteria were identified, with their clinical notes, relevant radiological reports, interventional images, and operative records retrospectively reviewed. The success rate was evaluated, with the technical success defined as improved free contrast flow or return of continuous steady stream after test injection of normal saline immediately after repositioning; clinical success defined as functional peritoneal dialysis catheter at 30 days post-repositioning. Logistic regression models were applied to evaluate the variables associated with successful manipulation. Post-manipulation complications and the PD time gained after successful manipulation were also reviewed.</p><p><strong>Results: </strong>46 patients were identified and 54 procedures were performed over the study period. 35 of the interventions (64.8%) resulted in technical success, and 25 cases (46.3%) resulted in clinical success. The median extra PD time gained after successful manipulation was 619 days (IQR, 313.5 - 1,007; range, 110 - 1,872). The median for number of days of hospital stay after the procedure was 2.5 days (IQR, 2 - 5; range, 1 - 65). Seven cases (13.0%) developed immediate complications, with most cases being peritonitis (n = 5), and all were successfully treated with intraperitoneal antibiotics. There was no associated mortality.</p><p><strong>Conclusion: </strong>Fluoroscopic-guided repositioning of the PD catheter was found to be a useful and safe treatment option for malfunctioning PD catheter and could potentially spare patients from the conventional operative intervention.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":"159-169"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143980290","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
Development of autoimmune antibodies against human phospholipase A2 receptor and the application as diagnostic criteria for primary membranous nephropathy. 人磷脂酶A2受体自身免疫抗体的研制及其作为原发性膜性肾病诊断标准的应用
IF 1 4区 医学
Clinical nephrology Pub Date : 2025-09-01 DOI: 10.5414/CN111747
Shukun Wu, Yixing Zhai, Na Yang, Zhou Zhou, Yingchun Huang, Li Yang, Bing Lai, Guisen Li
{"title":"Development of autoimmune antibodies against human phospholipase A2 receptor and the application as diagnostic criteria for primary membranous nephropathy.","authors":"Shukun Wu, Yixing Zhai, Na Yang, Zhou Zhou, Yingchun Huang, Li Yang, Bing Lai, Guisen Li","doi":"10.5414/CN111747","DOIUrl":"https://doi.org/10.5414/CN111747","url":null,"abstract":"<p><strong>Introduction: </strong>Membranous nephropathy (MN) is a severe chronic kidney disease (CKD) with ~ 30% of patients progressing to end-stage renal disease within 10 years. Phospholipase A2 receptor (PLA2R) is one of the major target antigens of MN. Despite the importance of PLA2R antibodies in the pathogenesis, diagnosis, and prognosis of MN, anti-human PLA2R monoclonal antibodies have not been obtained. This lack hinders the measurement of chemical PLA2R antibody titers, which are critical for drug development.</p><p><strong>Purpose: </strong>The purpose of this study is to obtain standard anti-human PLA2R monoclonal antibodies by creating a phage antibody library to screen for antibodies.</p><p><strong>Materials and methods: </strong>Our study used CHO cells expressing the human PLA2R CysR-FnII-CTLD1 structural domain (CC1h) and obtained candidate antibodies by screening a human phage display library. These candidate antibodies were expressed in CHO cells, and their binding affinity for CC1h was determined by enzyme-linked immunosorbent assay (ELISA) and biological layer interferometry (BLI). In addition, we calibrated the representative antibody names of A13 and A13SP to obtain transforming factors using a commercial PLA2R antibody ELISA kit.</p><p><strong>Results: </strong>43 high-affinity candidate antibodies were obtained by screening human phage display libraries, and 9 groups of IgG antibodies and their IgG4SP subtype antibodies showed high affinity by CHO cell expression, ELISA, and BLI experiments, and we screened 1 group of antibodies with high protein expression levels and high affinity names of A13 and A13SP subtypes from these 9 antibodies. A few of the remaining 8 groups of antibodies and subtypes also showed high protein expression levels and high affinity, and these antibodies can also be used as alternative antibodies. In addition, we calibrated the representative antibody A13 using a commercial PLA2R antibody ELISA kit and obtained an average conversion factor of 1 RU = 70 ng, and we found that the standard curves of the A13 and A13SP subtype antibody groups exhibited a high concordance with that of the commercial PLA2R antibody ELISA kit, which was higher than that of the other alternative antibodies, and therefore this also indicates that the A13 and A13SP subtype antibodies are the most preferred antibody groups in our antibody library.</p><p><strong>Conclusion: </strong>The A13 and A13SP subtype antibodies showed high protein expression levels and high antibody affinity, and the standard curves showed high concordance with the commercial kits, and this conclusion suggests that the A13 and A13SP subtype antibodies can be used as standard antibodies in the ELISA kits for the quantitative detection of human PLA2R antibodies.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945115","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
Angiotensin receptor-neprilysin inhibitor in the management of heart failure in patients with an episode of malignant hypertension and advanced kidney dysfunction: A case series and literature review. 血管紧张素受体-奈普利素抑制剂在恶性高血压和晚期肾功能不全患者心力衰竭治疗中的应用:一个病例系列和文献综述
IF 1 4区 医学
Clinical nephrology Pub Date : 2025-09-01 DOI: 10.5414/CN111487
Tomohiro Saito, Masahide Mizobuchi, Mitsuru Kawanishi, Kazuki Abe, Yuki Kajio, Risa Samejima, Yuuki Mima, Hirokazu Honda
{"title":"Angiotensin receptor-neprilysin inhibitor in the management of heart failure in patients with an episode of malignant hypertension and advanced kidney dysfunction: A case series and literature review.","authors":"Tomohiro Saito, Masahide Mizobuchi, Mitsuru Kawanishi, Kazuki Abe, Yuki Kajio, Risa Samejima, Yuuki Mima, Hirokazu Honda","doi":"10.5414/CN111487","DOIUrl":"10.5414/CN111487","url":null,"abstract":"<p><p>Although malignant hypertension (MH) treatment has significantly advanced with the introduction of modern antihypertensive agents, progression to end-stage renal disease remains a significant cause of morbidity and mortality. Additionally, the efficacy of sacubitril/valsartan, which is an angiotensin receptor-neprilysin inhibitor (ARNI), for patients with advanced kidney dysfunction and MH remains unknown. We report the cases of two patients with severe kidney and cardiac dysfunction who received uninterrupted antihypertensive treatment, including sacubitril/valsartan and experienced significant clinical improvement in proteinuria and renal function as well as left ventricular reverse remodeling. This report highlights the benefits of ARNI therapy for MH and its renoprotective effects.</p>","PeriodicalId":10396,"journal":{"name":"Clinical nephrology","volume":" ","pages":"218-225"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198404","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 relationship between proteinuria and left ventricular hypertrophy in non-diabetic chronic glomerulonephritis patients. 非糖尿病性慢性肾小球肾炎患者蛋白尿与左心室肥厚的关系。
IF 1 4区 医学
Clinical nephrology Pub Date : 2025-09-01 DOI: 10.5414/CN111637
Musa Ilker Durak, Beyza Algul Durak, Melahat Coban, Mine Sebnem Karakan
{"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}
引用次数: 0
Malnutrition and short-term mortality in hospitalized general medical patients with acute kidney injury: A prospective observational study. 急性肾损伤住院普通医疗患者营养不良与短期死亡率:一项前瞻性观察研究
IF 1 4区 医学
Clinical nephrology Pub Date : 2025-09-01 DOI: 10.5414/CN111715
Vishal Choudhary, Surendran Deepanjali
{"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}
引用次数: 0
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
相关产品
×
本文献相关产品
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信