Clinical Kidney Journal最新文献

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Apical tubular complement activation and the loss of kidney function in proteinuric kidney diseases. 蛋白尿肾病中肾小管补体激活和肾功能丧失。
IF 3.9 2区 医学
Clinical Kidney Journal Pub Date : 2024-07-10 eCollection Date: 2024-08-01 DOI: 10.1093/ckj/sfae215
Firas F Alkaff, Rosa G M Lammerts, Mohamed R Daha, Stefan P Berger, Jacob van den Born
{"title":"Apical tubular complement activation and the loss of kidney function in proteinuric kidney diseases.","authors":"Firas F Alkaff, Rosa G M Lammerts, Mohamed R Daha, Stefan P Berger, Jacob van den Born","doi":"10.1093/ckj/sfae215","DOIUrl":"10.1093/ckj/sfae215","url":null,"abstract":"<p><p>Many kidney diseases are associated with proteinuria. Since proteinuria is independently associated with kidney function loss, anti-proteinuric medication, often in combination with dietary salt restriction, comprises a major cornerstone in the prevention of progressive kidney failure. Nevertheless, complete remission of proteinuria is very difficult to achieve, and most patients with persistent proteinuria slowly progress toward kidney failure. It is well-recognized that proteinuria leads to kidney inflammation and fibrosis via various mechanisms. Among others, complement activation at the apical side of the proximal tubular epithelial cells is suggested to play a crucial role as a cause of progressive loss of kidney function. However, hitherto limited attention is given to the pathophysiological role of tubular complement activation relative to glomerular complement activation. This review aims to summarize the evidence for tubular epithelial complement activation in proteinuric kidney diseases in relation to loss of kidney function.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"17 8","pages":"sfae215"},"PeriodicalIF":3.9,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11318052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141970803","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}
引用次数: 0
Correlation between retinal vascular geometric parameters and pathologically diagnosed type 2 diabetic nephropathy 视网膜血管几何参数与病理诊断的 2 型糖尿病肾病之间的相关性
IF 4.6 2区 医学
Clinical Kidney Journal Pub Date : 2024-07-10 DOI: 10.1093/ckj/sfae204
Fang Liu, Xiaoniao Chen, Qian Wang, Wenwen Lin, Ying Li, Ruimin Zhang, Hui Huang, Shuangshuang Jiang, Yue Niu, Weicen Liu, Liqiang Wang, Weiguang Zhang, Ying Zheng, Xueying Cao, Yong Wang, Jie Wu, Li Zhang, Li Tang, Jianhui Zhou, Zheyi Dong
{"title":"Correlation between retinal vascular geometric parameters and pathologically diagnosed type 2 diabetic nephropathy","authors":"Fang Liu, Xiaoniao Chen, Qian Wang, Wenwen Lin, Ying Li, Ruimin Zhang, Hui Huang, Shuangshuang Jiang, Yue Niu, Weicen Liu, Liqiang Wang, Weiguang Zhang, Ying Zheng, Xueying Cao, Yong Wang, Jie Wu, Li Zhang, Li Tang, Jianhui Zhou, Zheyi Dong","doi":"10.1093/ckj/sfae204","DOIUrl":"https://doi.org/10.1093/ckj/sfae204","url":null,"abstract":"Background Diabetic nephropathy (DN) and diabetic retinopathy (DR) are common microvascular complications of diabetes. The purpose of this study was to investigate the correlation between retinal vascular geometric parameters and pathologically diagnosed type 2 DN, and to determine the capacity of retinal vascular geometric parameters in differentiating DN from non-diabetic nephropathy (NDRD). Methods The study participants were adult patients with type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD) who underwent a renal biopsy. Univariate and multivariable regression analyses were performed to evaluate associations between retinal vessel geometry parameters and pathologically diagnosed DN. Multivariate binary logistic regression analyses were performed to establish a differential diagnostic model for DN. Results In total, 403 patients were examined in this cross-sectional study, including 152 (37.7%) with DN, 157 (39.0%) with NDRD, and 94 (23.3%) with DN combined with NDRD. After univariate logistic regression, Total vessel fractal dimension, arteriolar fractal dimension, venular fractal dimension were all found to be associated with DN. In multivariate analyses adjusting for age, sex, blood pressure, diabetes, DR, and other factors, smaller retinal vascular fractal dimensions were significantly associated with DN (P &amp;lt; .05). We developed a differential diagnostic model for DN combining traditional clinical indicators and retinal vascular geometric parameters, the area under the curve of the model for equation established by multivariate logistic regression was 0.930. Conclusions Retinal vessel fractal dimension is of great significance for the rapid and noninvasive differentiation of DN. Incorporating retinal vessel fractal dimension into the diagnostic model for DN and NDRD can improve the diagnostic efficiency.","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"4 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141587372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Transfers from home to facility-based dialysis: comparisons of HHD, assisted PD and autonomous PD. 从居家透析到设施内透析:居家透析、辅助透析和自主透析的比较。
IF 3.9 2区 医学
Clinical Kidney Journal Pub Date : 2024-07-10 eCollection Date: 2024-07-01 DOI: 10.1093/ckj/sfae094
Antoine Lanot, Clémence Bechade, Cécile Couchoud, Mathilde Lassalle, François Chantrel, Ayman Sarraj, Maxence Ficheux, Annabel Boyer, Thierry Lobbedez
{"title":"Transfers from home to facility-based dialysis: comparisons of HHD, assisted PD and autonomous PD.","authors":"Antoine Lanot, Clémence Bechade, Cécile Couchoud, Mathilde Lassalle, François Chantrel, Ayman Sarraj, Maxence Ficheux, Annabel Boyer, Thierry Lobbedez","doi":"10.1093/ckj/sfae094","DOIUrl":"10.1093/ckj/sfae094","url":null,"abstract":"<p><strong>Background: </strong>Home dialysis therapies such as peritoneal dialysis (PD) and home hemodialysis (HHD) are beneficial for quality of life and patient empowerment. The short technique survival time partly explains their low prevalence. We aimed to assess the risk of transfer to facility-based hemodialysis in patients treated with autonomous PD, assisted PD and HHD.</p><p><strong>Methods: </strong>This was a retrospective study using data from the REIN registry of patients starting home dialysis in France from 2002 to 2019. The risks of transfer to facility-based hemodialysis (HD) were compared between three modalities of home dialysis (HHD, nurse-assisted PD, autonomous PD) using survival models with a propensity score (PS)-matched and unmatched cohort of patients.</p><p><strong>Results: </strong>The study included 17 909 patients: 628 in the HHD group, 10 214 in the autonomous PD group, and 7067 in the assisted PD group. During the follow-up period, there were 5347 transfers to facility-based HD. The observed number of transfers was 2458 (13.7%) at 1 year and 5069 (28.3) at 5 years after the start of home dialysis, including 3272 (32%) on autonomous PD, 1648 (23.3%) on assisted PD, and 149 (23.7) on HHD. Owing to clinical characteristics differences, only 38% of HHD patients could be matched to patients from the others group. In the PS-matched cohort, the adjusted Cox model showed no difference in the risk of transfer for assisted PD (cs-HR 1.04, 95% CI 0.75-1.44) or HHD (cs-HR 1.07, 95% CI 0.77-1.48) compared with autonomous PD.</p><p><strong>Conclusions: </strong>Unlike results from other countries, where nurse assistance is not fully available for PD-associated care, there was no difference in technique survival between autonomous PD, nurse-assisted PD, and HHD in France. This discrepancy may be attributed to our inclusion of a broader spectrum of patients who derive significant benefits from assisted PD.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"17 7","pages":"sfae094"},"PeriodicalIF":3.9,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11270015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141757531","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}
引用次数: 0
The Association of Sleep Duration with the Risk of Chronic Kidney Disease: a Systematic Review and Meta-Analysis 睡眠时间与慢性肾病风险的关系:系统回顾与元分析
IF 4.6 2区 医学
Clinical Kidney Journal Pub Date : 2024-07-10 DOI: 10.1093/ckj/sfae177
Jin Hean Koh, Brian Sheng Yep Yeo, Timothy Wei En Tan, Mark Yong Siang See, Adele Chin Wei Ng, Shaun Ray Han Loh, Joshua Gooley, Chieh Suai Tan, Song Tar Toh
{"title":"The Association of Sleep Duration with the Risk of Chronic Kidney Disease: a Systematic Review and Meta-Analysis","authors":"Jin Hean Koh, Brian Sheng Yep Yeo, Timothy Wei En Tan, Mark Yong Siang See, Adele Chin Wei Ng, Shaun Ray Han Loh, Joshua Gooley, Chieh Suai Tan, Song Tar Toh","doi":"10.1093/ckj/sfae177","DOIUrl":"https://doi.org/10.1093/ckj/sfae177","url":null,"abstract":"Background and hypothesis Published literature suggests that sleep duration and quality may be affected in adults with chronic kidney disease. However, the relationship between these two entities remains a matter of debate. The objective of this systematic review and meta-analysis is to assess the effect of sleep duration and quality on chronic kidney disease. Methods A systematic review of the Medline/PubMed, Embase, Cochrane Library and CINAHL databases was conducted for articles pertaining to the association between sleep duration and quality on chronic kidney disease. The main outcome was the hazard/risk ratio of chronic kidney disease in patients of varying sleep durations and quality. Results 42 studies (2 613 971 patients) with a mean age of 43.55 ± 14.01 years were included in the meta-analysis. Compared with a reference range of 7 to 8 hours of sleep, short sleep duration of ≤ 4 hours (RR 1.41, 95% CI: 1.16 to 1.71, p &amp;lt; 0.01), ≤5 hours (RR 1.46, 95% CI: 1.22 to 1.76, p &amp;lt; 0.01), ≤6 hours (RR 1.18, 95% CI: 1.09 to 1.29, p &amp;lt; 0.01) and ≤ 7 hours (RR 1.19, 95% CI: 1.12 to 1.28, p &amp;lt; 0.01) were significantly associated with an increased risk of incident chronic kidney disease. Long sleep duration of ≥ 8 hours (RR 1.15, 95% CI: 1.03 to 1.28, p &amp;lt; 0.01) and ≥ 9 hours (RR 1.46, 95% CI: 1.28 to 1.68, p &amp;lt; 0.01) were also significantly associated with an increased risk of incident chronic kidney disease. Meta-regression did not find any significant effect of age, gender, geographical region and BMI and the association of sleep duration and risk of incident chronic kidney disease. Conclusion Both short and long sleep duration were significantly associated with a higher risk of chronic kidney disease. Interventions targeted towards achieving an optimal duration of sleep may reduce the risk of incident chronic kidney disease.","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"108 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141609458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Pathogenic heterozygous TRPM7 variants and hypomagnesemia with developmental delay 致病性杂合子TRPM7变体和伴有发育迟缓的低镁血症
IF 4.6 2区 医学
Clinical Kidney Journal Pub Date : 2024-07-06 DOI: 10.1093/ckj/sfae211
Willem Bosman, Kameryn M Butler, Caitlin A Chang, Mythily Ganapathi, Edwin Guzman, Femke Latta, Wendy K Chung, Felix Claverie-Martin, Jessica M Davis, Joost G J Hoenderop, Jeroen H F de Baaij
{"title":"Pathogenic heterozygous TRPM7 variants and hypomagnesemia with developmental delay","authors":"Willem Bosman, Kameryn M Butler, Caitlin A Chang, Mythily Ganapathi, Edwin Guzman, Femke Latta, Wendy K Chung, Felix Claverie-Martin, Jessica M Davis, Joost G J Hoenderop, Jeroen H F de Baaij","doi":"10.1093/ckj/sfae211","DOIUrl":"https://doi.org/10.1093/ckj/sfae211","url":null,"abstract":"Background Heterozygous variants in TRPM7, encoding an essential and ubiquitously expressed cation channel, may cause hypomagnesemia, but current evidence is insufficient to draw definite conclusions and it is unclear whether any other phenotypes can occur. Methods Individuals with unexplained hypomagnesemia underwent whole exome sequencing which identified TRPM7 variants. Pathogenicity of the identified variants was assessed by combining phenotypic, functional and in silico analyses. Results We report three new heterozygous missense variants in TRPM7 (p.Met1000Thr, p.Gly1046Arg, p.Leu1081Arg) in individuals with hypomagnesemia. Strikingly, autism spectrum disorder and developmental delay, mainly affecting speech and motor skills, was observed in all three individuals, while two out of three also presented with seizures. The three variants are predicted to be severely damaging by in silico prediction tools and structural modeling. Furthermore, these variants result in a clear loss-of-function of TRPM7-mediated magnesium uptake in vitro, while not affecting TRPM7 expression or insertion into the plasma membrane. Conclusions This study provides additional evidence for the association between heterozygous TRPM7 variants and hypomagnesemia and adds developmental delay to the phenotypic spectrum of TRPM7-related disorders. Considering the TRPM7 gene is relatively tolerant to loss-of-function variants, future research should aim to unravel by which mechanisms specific heterozygous TRPM7 variants can cause disease.","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"8 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141575491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Hypoaldosteronism due to a novel SEC61A1 variant successfully treated with fludrocortisone 氟氢可的松成功治疗新型 SEC61A1 变异引起的醛固酮过多症
IF 4.6 2区 医学
Clinical Kidney Journal Pub Date : 2024-07-06 DOI: 10.1093/ckj/sfae213
Diana Karpman, Martin L Lindström, Mattias Möller, Sofie Ivarsson, Ann-Charlotte Kristoffersson, Zivile Bekassy, Agnes B Fogo, Maria Elfving
{"title":"Hypoaldosteronism due to a novel SEC61A1 variant successfully treated with fludrocortisone","authors":"Diana Karpman, Martin L Lindström, Mattias Möller, Sofie Ivarsson, Ann-Charlotte Kristoffersson, Zivile Bekassy, Agnes B Fogo, Maria Elfving","doi":"10.1093/ckj/sfae213","DOIUrl":"https://doi.org/10.1093/ckj/sfae213","url":null,"abstract":"Genetic variants in SEC61A1 are associated with autosomal dominant tubulointerstitial kidney disease. SEC61A1 is a translocon in the endoplasmic reticulum membrane and variants affect biosynthesis of renin and uromodulin. We describe a patient with a novel de novo heterozygous SEC61A1 variant, Phe458Val, detected by whole genome sequencing. The patient presented at 1 year of age with failure-to-thrive, kidney failure (glomerular filtration rate, GFR, 18 ml/min/1.73m2), hyperkalemia and acidosis. Plasma renin was low or normal, aldosterone was low or undetectable and uromodulin was low. Kidney biopsy at 2 years exhibited subtle changes suggestive of tubular dysgenesis without tubulocystic or glomerulocystic lesions and with renin staining of the juxtaglomerular cells. The patient experienced extreme fatigue due to severe hypotension attributed to hypoaldosteronism and at 8 years of age fludrocortisone treatment was initiated with marked improvement in her well-being. Blood pressure normalized as did potassium. Biopsy at 9 years showed extensive glomerulosclerosis and mild tubulointerstitial fibrosis, as well as tubular mitochondrial abnormalities, but without specific diagnostic changes. Her GFR improved to 54 ml/min/1.73m2. As the renin-angiotensin system promotes aldosterone release, and the patient had repeatedly undetectable aldosterone levels, the SEC61A1 variant presumably contributed to severe hypotension. Treatment with a mineralocorticoid had a beneficial effect and corrected the electrolyte and acid-base disorder. We suggest that the increased blood pressure hemodynamically improved the patient's kidney function.","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"41 1 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141575490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Risk factors for major bleeding in patients with atrial fibrillation and CKD G3-G5D on oral anticoagulants 服用口服抗凝剂的心房颤动和慢性肾功能衰竭 G3-G5D 患者大出血的风险因素
IF 4.6 2区 医学
Clinical Kidney Journal Pub Date : 2024-07-06 DOI: 10.1093/ckj/sfae206
Frida Welander, Henrik Renlund, Anders Själander
{"title":"Risk factors for major bleeding in patients with atrial fibrillation and CKD G3-G5D on oral anticoagulants","authors":"Frida Welander, Henrik Renlund, Anders Själander","doi":"10.1093/ckj/sfae206","DOIUrl":"https://doi.org/10.1093/ckj/sfae206","url":null,"abstract":"Background Patients with chronic kidney disease (CKD) and atrial fibrillation (AF) on oral anticoagulants (OAC) are at high risk of bleeding. Determinants of major bleeding risk in OAC-users with AF and CKD are not well established and available bleeding score systems do not perform well in CKD. This study aims to present risk factors associated with major bleeding in a Swedish cohort of OAC- treated patients with CKD GFR category 3–5D (G3-G5D). Methods A Swedish register-based cohort study including patients with AF and G3-G5D on warfarin or DOAC between 2009–2018. Data collected from high quality registers including Swedish Renal Registry and Auricula, a register for AF and oral anticoagulants. Risk factors for major bleeding were investigated with Cox regression analysis. Results Of 2453 included patients 59% were on warfarin (time in therapeutic range 67%) and 41% on DOAC. Major bleeding rates were 8.9/100 patient-years. Factors associated with increased bleeding risk were GFR category, G5/5D versus G3, hazard ratio 1.92 (95% confidence interval 1.43–2.56), previous gastrointestinal bleeding, 1.77 (1.39–2.25), previous other bleeding 1.33 (1.09–1.62), congestive heart failure 1.36 (1.11–1.68), male sex 1.28 (1.03–1.60) and vascular disease, 1.35 (1.01–1.79). Conclusion Patients with AF and G3-G5D on OAC are at high risk of bleeding. Previous major bleeding and kidney failure are strongly associated with major bleeding. The present study also shows an association between OAC-associated bleeding and male sex, congestive heart failure and vascular disease. Knowledge about determinants of bleeding in advanced CKD is essential when deciding on when to anticoagulate or not.","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"29 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141575489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Integrating multiple kidney function markers to predict all-cause and cardiovascular disease mortality: prospective analysis of 366,758 UK Biobank participants 综合多种肾功能指标预测全因和心血管疾病死亡率:对 366 758 名英国生物库参与者的前瞻性分析
IF 4.6 2区 医学
Clinical Kidney Journal Pub Date : 2024-07-06 DOI: 10.1093/ckj/sfae207
Ryosuke Fujii, Roberto Melotti, Anna Köttgen, Alexander Teumer, Daniele Giardiello, Cristian Pattaro
{"title":"Integrating multiple kidney function markers to predict all-cause and cardiovascular disease mortality: prospective analysis of 366,758 UK Biobank participants","authors":"Ryosuke Fujii, Roberto Melotti, Anna Köttgen, Alexander Teumer, Daniele Giardiello, Cristian Pattaro","doi":"10.1093/ckj/sfae207","DOIUrl":"https://doi.org/10.1093/ckj/sfae207","url":null,"abstract":"Background &amp; Hypothesis Reduced kidney function is a risk factor of cardiovascular and all-cause mortality. This association was demonstrated for several kidney function markers, but it is unclear whether integrating multiple measured markers may improve mortality risk prediction. Methods We conducted an exploratory factor analysis (EFA) of serum creatinine- and cystatin C-based estimated glomerular filtration rate (eGFRcre and eGFRcys, derived by Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) and European Kidney Function Consortium (EKFC) equations), blood urea nitrogen (BUN), uric acid, and serum albumin among 366 758 participants of the UK Biobank without history of kidney failure. Fitting Cox-proportional hazard models, we compared ability of the identified latent factors to predict overall mortality and mortality by cardiovascular disease (CVD), also considering CVD-specific causes like coronary heart disease and cerebrovascular disease. Results During 12.5 years of follow-up, 26 327 deceased from any cause, 5 376 died from CVD, 2 908 from CHD, and 1 116 from cerebrovascular disease. We identified two latent factors, EFA1 and EFA2 both representing kidney function variations. When using the CKD-EPI equations, EFA1 performed like eGFRcys, with EFA1 showing slightly larger hazard ratios for overall and CVD-related mortality. At 10-years of follow-up, EFA1 and eGFRcys showed moderate discrimination performance for CVD-related mortality, outperforming all other kidney indices. eGFRcre was the least predictive marker across all outcomes. When using the EKFC equations, eGFRcys performed better than EFA1, all other results remaining similar. Conclusions While EFA is an attractive approach to capture the complex effects of kidney function, eGFRcys remains the most practical and effective measurement for all-cause and CVD mortality risk prediction.","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"19 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141575496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Vertebral fractures in patients with CKD and the general population: a call for diagnosis and action 慢性肾脏病患者和普通人群中的椎体骨折:呼吁诊断和行动
IF 4.6 2区 医学
Clinical Kidney Journal Pub Date : 2024-07-06 DOI: 10.1093/ckj/sfae191
Laia Gifre, Elisabeth Massó, Maria Fusaro, Mathias Haarhaus, Pablo Ureña, Mario Cozzolino, Sandro Mazzaferro, Jordi Calabia, Pilar Peris, Jordi Bover
{"title":"Vertebral fractures in patients with CKD and the general population: a call for diagnosis and action","authors":"Laia Gifre, Elisabeth Massó, Maria Fusaro, Mathias Haarhaus, Pablo Ureña, Mario Cozzolino, Sandro Mazzaferro, Jordi Calabia, Pilar Peris, Jordi Bover","doi":"10.1093/ckj/sfae191","DOIUrl":"https://doi.org/10.1093/ckj/sfae191","url":null,"abstract":"Vertebral fractures (VFs) are the most common osteoporotic fractures in the general population, and they have been associated with high mortality, decreased quality of life and high risk of subsequent fractures, especially when recent, multiple or severe. Currently, VF diagnosis and classification determine fracture risk and the most appropriate anti-osteoporotic treatment. However, VFs are clearly underdiagnosed, especially in patients with chronic kidney disease (CKD), and CKD-associated osteoporosis has been disregarded until recently. VFs are associated with higher morbidity and mortality, and their prevalence and incidence differ depending on the grade of renal dysfunction (CKD G1–G5) and/or the type of renal replacement therapy (dialysis or transplantation). In addition to classical risk factors [such as higher age, female sex, reduced bone mineral density (BMD), diabetes and steroid use], various other factors have been associated with an increased risk of VFs in CKD, including CKD grade, haemodialysis vintage, time since renal transplantation, low or high intact parathyroid hormone and phosphate levels, and/or vitamin D and K1 deficiencies. Importantly, several clinical societies have recently modified their algorithms according to the fracture risk classification (including the presence of VFs) and determined the most appropriate anti-osteoporotic treatment for the general population. However, there are no specific guidelines addressing this topic in patients with CKD despite an important paradigm shift regarding the prognostic value of BMD in 2017 after the publication of the CKD-Mineral and Bone Disorder (CKD-MBD) KDIGO guidelines. A proactive attitude towards diagnosis, treatment and research is proposed to avoid therapeutic nihilism.","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"24 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141587373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
Calcium Polystyrene Sulfonate Induced Colitis: Advanced characterization of crystal nature with infrared spectroscopy 聚苯乙烯磺酸钙诱发的结肠炎:利用红外光谱对晶体性质进行高级表征
IF 4.6 2区 医学
Clinical Kidney Journal Pub Date : 2024-07-05 DOI: 10.1093/ckj/sfae210
Helena Vidal, Vilma Salgado, Patrícia Alves, Nuno Moreira Fonseca1, Vincent Frochot, Aníbal Ferreira
{"title":"Calcium Polystyrene Sulfonate Induced Colitis: Advanced characterization of crystal nature with infrared spectroscopy","authors":"Helena Vidal, Vilma Salgado, Patrícia Alves, Nuno Moreira Fonseca1, Vincent Frochot, Aníbal Ferreira","doi":"10.1093/ckj/sfae210","DOIUrl":"https://doi.org/10.1093/ckj/sfae210","url":null,"abstract":"Classical potassium binders are used in the treatment of hyperkalemia and are widely associated with gastrointestinal side effects, with crystal colonic injury being rare but potentially fatal. In this report, we describe the case of an 82-year-old male with hyperkalemia and calcium polystyrene sulfonate crystal associated colonic necrosis. Traditionally, this diagnosis has relied on the examination of crystal morphology and polarization through microscopy. Our study enhances crystal identification by incorporating an analysis of the physical characteristics of the crystals using infrared spectroscopy. This is the first description, to our knowledge, of calcium polystyrene sulfonate infrared spectrum.","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"45 1","pages":""},"PeriodicalIF":4.6,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141575492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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
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