Clinical Kidney Journal最新文献

{"title":"Efficacy and safety of low-dose telitacicept in IgA nephropathy: a real-world study.","authors":"Chenxi Liu, Juanyong Zhao, Ming Xia, Xinyan Fan, Xunzi Tang, Xiaomiao Hao, Lili Wan, Bin Len, Di Liu, Haiyang Liu, Linshan Zhou, Xia Tan, Hong Liu","doi":"10.1093/ckj/sfag312","DOIUrl":"10.1093/ckj/sfag312","url":null,"abstract":"<p><strong>Background: </strong>Immunoglobulin A nephropathy (IgAN) represents one of the most common causes of primary glomerulonephritis with unmet clinical needs. This study evaluates the efficacy and safety of telitacicept in patients with IgAN.</p><p><strong>Methods: </strong>This real-world study included 38 biopsy-proven IgAN patients with baseline estimated glomerular filtration rate (eGFR) >10 mL/min/1.73 m² and urine protein-to-creatinine ratio (UPCR) >440 mg/g. Nineteen patients received weekly telitacicept 80 mg (telitacicept group), divided into early-start (telitacicept treatment initiated within 6 months after diagnosis) and late-start (>6 months) subgroups. The other 19, diagnosed during the same period but not receiving telitacicept, served as controls. Clinical data were collected over 12 months. Safety was evaluated.</p><p><strong>Results: </strong>Baseline characteristics were comparable between groups. In the telitacicept group, median UPCR was 1715.98 mg/g (interquartile range 1281.63-2892.11) and median eGFR was 45.45 mL/min/1.73 m² (interquartile range 33.86-93.14). Over 12 months, telitacicept 80 mg weekly was associated with a trend toward greater proteinuria reduction (-51.52% versus -33.31%, <i>P</i> = .081) and a favorable change in renal function (+1.77 versus -4.06 mL/min/1.73 m², <i>P</i> = .008). The early-start subgroup showed greater benefits than the late-start subgroup. In an exploratory analysis of patients with eGFR <35 mL/min/1.73 m² (<i>n</i> = 7 each), telitacicept treatment yielded a sustained reduction in UPCR (-48.83% versus +9.68%) and a stable mean annualized eGFR slope (+0.77 versus -8.88 mL/min/1.73 m²) over 12 months. No severe adverse events occurred with telitacicept, versus one in controls.</p><p><strong>Conclusions: </strong>Our study supports the potential efficacy of low-dose telitacicept in reducing proteinuria and stabilizing eGFR in IgAN. Its clinical benefits were more pronounced when initiated early after diagnosis. Furthermore, in IgAN patients with severe renal impairment, telitacicept may yield better outcomes for proteinuria reduction and eGFR preservation than conventional treatment. These advantages position low-dose telitacicept as a potentially effective treatment strategy, though larger prospective studies are warranted.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"19 10","pages":"sfag312"},"PeriodicalIF":5.3,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13678823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A critical appraisal of guidelines and recommendations for the management of ANCA-associated vasculitis.","authors":"Vanja Ivković, Sejin Park, Lauren Floyd, Yoon Seo Kwon, Annette Bruchfeld, Andreas Kronbichler, Jae Il Shin","doi":"10.1093/ckj/sfag317","DOIUrl":"10.1093/ckj/sfag317","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to appraise 11 currently available guidelines for ANCA-associated vasculitis (AAV), identify potential gaps, and provide recommendations for improvement.</p><p><strong>Methods: </strong>The guidelines were appraised using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument consisting of 23 appraisal criteria/items across six domains (D). Four reviewers independently appraised guidelines and scaled domain scores were calculated.</p><p><strong>Results: </strong>The average score of all guidelines was 4.5 ± 0.8 out of 7.0. Agreement between the reviewers was excellent. British Society for Rheumatology 2025 guidelines scored highest (5.8/7.0), being the only guideline unanimously recommended for use. In 'D1/Scope and purpose', all guidelines achieved high scores. In 'D2/Stakeholder involvement', major gaps were identified in the inclusion of the views and preferences of the target population (2c), with few guidelines including patient representatives, addressing patient participation, or considering patient views. In 'D3/Rigour of development', all but two guidelines received high scores. Implementation of the procedure for updating the guidelines (3 h) and for external review (3 g) was addressed poorly. In 'D4/Clarity of presentation', all guidelines except one received a high score. 'D5/Applicability' had the lowest scores due to gaps in the criteria for monitoring/auditing guideline implementation (5d), resource/cost implications (5c), lack of advice/tools for implementation (5a), and inadequate addressing of facilitators/barriers in guideline application (5a). 'D6/Editorial independence' was addressed well.</p><p><strong>Conclusions: </strong>Several aspects of AAV guidelines could be improved, including the inclusion of patient views and preferences, the processes for translating guidelines into clinical practice, and clearer criteria for monitoring guideline implementation and uptake.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"19 10","pages":"sfag317"},"PeriodicalIF":5.3,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13684405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149236931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Creatinine increases have consistent and differential prognostic impact across kidney function.","authors":"Philip Vestergaard Munch, Simon Sawhney, Uffe Heide-Jørgensen, Simon Kok Jensen, Samira Bell, David Yeung, Zhi Tan, Tim Scale, Matthew Thomas James, Christian Fynbo Christiansen","doi":"10.1093/ckj/sfag319","DOIUrl":"https://doi.org/10.1093/ckj/sfag319","url":null,"abstract":"<p><strong>Background: </strong>Within the current criteria for acute kidney injury (AKI), it remains debated whether small absolute creatinine increases are associated with higher mortality in patients with low baseline estimated glomerular filtration rates (eGFRs), and whether these changes carry prognostic value comparable to relative increases. We therefore examined the prognostic impact of rapid creatinine increases across baseline eGFRs in patients undergoing major elective surgery.</p><p><strong>Methods: </strong>We pooled data on patients undergoing major elective surgery from Canada, Denmark, Scotland, and Wales. This clinical setting was chosen because creatinine levels in this group are routinely monitored both before and after an acute stress event, regardless of clinical status. We ascertained the highest relative creatinine increase within 7 days and the highest absolute creatinine increase within 2 days during the first 7 days after surgery. We used logistic regressions with splines and interaction terms to construct heatmaps depicting age-, sex-, year-, and surgery type-standardized 90-day mortality according to creatinine increases across baseline eGFRs.</p><p><strong>Results: </strong>There were 311 975 surgical procedures performed in 279 554 patients, with 11 568 deaths. Compared to no change in creatinine, a 0.3 mg/dl (26.5 µmol/l) absolute increase was associated with a consistent 2.2-3.3 percentage point increase in mortality for eGFR between 15 and 90 ml/min/1.73 m². However, while the excess mortality associated with a 0.3 mg/dl and a 50% creatinine increase was similar at baseline eGFR of 90 ml/min/1.73 m², the excess mortality of a 50% creatinine increase was substantially greater among those with baseline eGFRs <30 ml/min/1.73 m².</p><p><strong>Conclusions: </strong>A small absolute creatinine increase of 0.3 mg/dl is associated with a consistent increase in mortality across baseline eGFRs, indicating its relevance as a component of the AKI criteria. However, the higher excess mortality associated with a 50% increase at low eGFRs should be emphasized in future guidelines to improve clinical discussions.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"19 10","pages":"sfag319"},"PeriodicalIF":5.3,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New potassium binders: we need them-we do not need them.","authors":"Luca De Nicola, Marie Evans, Juergen Floege, Carmine Zoccali","doi":"10.1093/ckj/sfag360","DOIUrl":"10.1093/ckj/sfag360","url":null,"abstract":"<p><p>New potassium binders may facilitate contemporary chronic kidney disease care by controlling hyperkalemia and thereby facilitating the continued use of kidney- and cardioprotective therapies, particularly renin-angiotensin-aldosterone system inhibitors. The opposing view is that sodium polystyrene sulfonate remains effective, familiar, inexpensive, and often well tolerated, while direct comparative evidence has not yet shown clinically meaningful superiority of newer binders. This debate weighs clinical utility, comparative efficacy, safety, and cost, concluding that new binders are valuable options but that their routine replacement of established low-dose sodium polystyrene sulfonate and the need for potassium binders beyond optimized diuretic therapy, acidosis control, diet, etc. requires stronger comparative evidence.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"19 10","pages":"sfag360"},"PeriodicalIF":5.3,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13672991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149215056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood pressure variability associates with mortality risk of patients with ANCA-associated vasculitis.","authors":"Elisabetta Bussalino, Elisa Russo, Lucia Maccio, Marta Donati, Federica Mescia, Marta Calatroni, Martina Tedesco, Gabriella Moroni, Federico Alberici, Francesca Viazzi, Pasquale Esposito","doi":"10.1093/ckj/sfag356","DOIUrl":"10.1093/ckj/sfag356","url":null,"abstract":"<p><strong>Objectives: </strong>Antineutrophil cytoplasmic antibody-associated vasculitis (AAV) is associated with increased cardiovascular risk, related to persistent inflammation and endothelial dysfunction. Long-term systolic blood pressure variability (SBPV), reflecting vascular damage, may predict outcomes better than mean blood pressure (BP). We investigated the impact of BP control and visit-to-visit BP variability (VVV), on all-cause mortality in AAV patients during maintenance therapy.</p><p><strong>Methods: </strong>We retrospectively studied 95 AAV patients followed at three Italian nephrology centers. SBPV was defined as the standard deviation of ≥4 systolic BP measurements within 12 months from the first SBPV assessment. Patients were stratified by SBPV tertiles. The primary outcome was all-cause mortality.</p><p><strong>Results: </strong>Over a median follow-up of 78 months, 14 patients (14.7%) died. Deceased patients were older and had higher pulse pressure (PP) and VVV. Hypertension prevalence increased across SBPV tertiles (35%, 62%, 69%; <i>P</i> = .02). Mortality rose from 6% in the lowest to 34.5% in the highest SBPV tertile (Fisher's exact, <i>P</i> = .001). Time-averaged systolic BP was not associated with mortality. Conversely, each 5-mmHg increase in SBPV was associated with a two-fold higher risk of death [hazard ratio (HR) 2.03, 95% confidence interval (CI) 1.29-3.20; <i>P</i> = .002]. SBPV remained significantly associated with outcome after full multi-variable adjustment, including age, sex, myeloperoxidase positivity, estimated glomerular filtration rate, PP, and proteinuria (adjusted HR 8.06 per 1 mmHg, 95% CI 1.42-45.54; <i>P</i> = .02).</p><p><strong>Conclusion: </strong>In AAV patients, increased VVV was associated with all-cause mortality outperforming mean systolic BP. Further research is needed to confirm the impact of variable blood pressure on patient outcomes in AAV.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"19 10","pages":"sfag356"},"PeriodicalIF":5.3,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13678739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anti-PLA2R positivity does not exclude malignancy in membranous nephropathy: lessons from the course after tumor treatment.","authors":"Saide Elif Güllülü Boz, Abdülmecit Yıldız","doi":"10.1093/ckj/sfag357","DOIUrl":"10.1093/ckj/sfag357","url":null,"abstract":"","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"19 10","pages":"sfag357"},"PeriodicalIF":5.3,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13678737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corticosteroids, serum proteins, and the next phase of precision medicine in IgA nephropathy.","authors":"Carmine Zoccali, Jürgen Floege","doi":"10.1093/ckj/sfag345","DOIUrl":"10.1093/ckj/sfag345","url":null,"abstract":"<p><p>Systemic glucocorticoids remain an important but problematic treatment option in high-risk IgA nephropathy, offering kidney protection at the cost of clinically relevant toxicity. Recent serum proteomic analyses embedded within the randomized TESTING trial provide a new framework for identifying patients most likely to benefit from methylprednisolone. In 241 Chinese participants with IgA nephropathy, longitudinal profiling of 479 serum samples showed that methylprednisolone significantly modulated 302 proteins involved in cytoskeletal regulation, extracellular matrix interactions, immunometabolism, coagulation, protein turnover, and related pathways. Importantly, complement- and endothelial injury-associated pathways were incompletely modified and remained linked to adverse kidney outcomes, suggesting residual disease mechanisms that may require complementary targeted therapies. Among baseline proteins, leptin and C1QTNF5 emerged as practical candidate biomarkers of glucocorticoid responsiveness, improving prediction of treatment efficacy beyond conventional clinical variables. These findings support a shift from purely prognostic risk stratification toward treatment-informed precision medicine in IgA nephropathy. However, the biomarker model requires prospective validation across diverse populations, steroid regimens, and background therapies, and future tools must integrate both predicted kidney benefit and treatment-related harm. If confirmed, serum proteomics could help clinicians move beyond population-average steroid decisions toward biologically guided selection of patients most likely to benefit while avoiding unnecessary toxicity.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"19 10","pages":"sfag345"},"PeriodicalIF":5.3,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13678821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum T50 is not independently associated with coronary artery calcification in early chronic kidney disease.","authors":"Guido de La Roij, Kevin Ocran, Marc Vervloet, Andreas Pasch, Rozemarijn Vliegenthart, Gerjan Navis, Martin H de Borst, Joost G J Hoenderop, Jeroen H F de Baaij","doi":"10.1093/ckj/sfag339","DOIUrl":"https://doi.org/10.1093/ckj/sfag339","url":null,"abstract":"<p><strong>Background: </strong>The serum T50 test quantifies calcification propensity, with lower values indicating a higher propensity for calcification. Lower T50 values have been associated with adverse cardiovascular outcomes, particularly in advanced chronic kidney disease. Whether serum T50 is associated with coronary artery calcification (CAC) in individuals with mildly to moderately reduced kidney function remains unclear. We examined this association in a population-based cross-sectional study.</p><p><strong>Methods: </strong>We analysed 1945 participants from the population-based Lifelines ImaLife cohort with mildly to moderately reduced kidney function (estimated glomerular filtration rate, 37.5-87.6 ml/min/1.73 m²). Serum T50 was measured using a standardized nephelometric assay. CAC was assessed by electrocardiographically triggered non-contrast computed tomography and categorized into 0, 1-99, 100-399, and ≥400 Agatston units. Associations between continuous T50 (per 10-min increase) and CAC categories were examined using multinomial logistic regression.</p><p><strong>Results: </strong>Of the 1945 participants, 56.5% had detectable CAC (CAC 1-99: 30.9%, 100-399: 14.4%, ≥400: 11.2%). In crude analyses, higher T50 values were associated with the presence of CAC [odds ratio (OR) 1.02, 95% confidence interval 1.01-1.03] and with CAC categories 1-99, 100-399, and ≥400 versus 0 (ORs 1.01, 1.02, and 1.03, respectively). These associations were no longer significant after adjustment for age, body mass index, and sex. Subgroup analyses did not identify risk groups in which T50 was significantly associated with the presence or severity of CAC.</p><p><strong>Conclusion: </strong>In this cohort with mildly to moderately reduced kidney function, T50 was not independently associated with prevalent CAC after multi-variable adjustment.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"19 10","pages":"sfag339"},"PeriodicalIF":5.3,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: Molecular mechanisms in podocytopathies: finding suitable targets for a new era of glomerular gene therapy.","authors":"","doi":"10.1093/ckj/sfag314","DOIUrl":"https://doi.org/10.1093/ckj/sfag314","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1093/ckj/sfaf332.].</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"19 10","pages":"sfag314"},"PeriodicalIF":5.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combined statin and fenofibrate therapy and cardiorenal outcomes in patients with CKD, dyslipidemia, and ischemic heart disease.","authors":"Yen-Chih Chang, Ming-Hsien Tsai, Yu-Wei Fang, Meng-Ting Chen, Ya-Hui Tseng, Cheng-Chun Wei","doi":"10.1093/ckj/sfag343","DOIUrl":"https://doi.org/10.1093/ckj/sfag343","url":null,"abstract":"<p><strong>Background: </strong>Adults with non-dialysis-dependent chronic kidney disease (CKD), ischemic heart disease (IHD), and hypertriglyceridemia are at high cardiorenal risk; whether starting fenofibrate together with statin therapy is effective and safe in this population is uncertain.</p><p><strong>Methods: </strong>In a multicenter retrospective cohort study emulating a target trial in the TriNetX Global Collaborative Network (2018-2024), 112 003 (28.5%) of 392 969 statin initiators with CKD and hypertriglyceridemia had IHD. Those without dialysis dependence were assigned to statin-fenofibrate combination therapy or statin monotherapy according to fenofibrate initiation within 3 months of the first statin prescription. The main outcomes were expanded major adverse cardiovascular events (MACEs) (acute myocardial infarction, stroke, heart failure, cardiac arrest, or all-cause death) and end-stage kidney disease (ESKD) necessitating dialysis. Propensity score matching yielded 3191 pairs. Cox models estimated hazard ratios (HRs).</p><p><strong>Results: </strong>Median follow-up was 881 days with combination therapy and 925 days with statin monotherapy. Combination therapy was associated with lower risks of MACE [1472 [46.1%] vs 1576 [49.4%] events; HR, 0.93; 95% confidence interval (CI), 0.86-0.99] and ESKD necessitating dialysis (264 [8.3%] vs 335 [10.5%]; HR, 0.79; 95% CI, 0.67-0.92). Risks of all-cause mortality (377 vs. 375), acute myocardial infarction (537 vs. 570), heart failure (1059 vs. 1134), stroke (310 vs. 312), acute kidney injury (825 vs. 840), and coded safety events were not significantly different between groups.</p><p><strong>Conclusions: </strong>Among selected adults with non-dialysis-dependent CKD, hypertriglyceridemia, and IHD, statin-fenofibrate combination therapy was associated with lower risks of MACE and of ESKD necessitating dialysis, without a significant increase in coded safety events.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"19 10","pages":"sfag343"},"PeriodicalIF":5.3,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}