Clinical Kidney Journal最新文献

{"title":"Chronic kidney disease is associated with incident depression requiring treatment: a retrospective cohort study.","authors":"Andreas Kommer, Paul Christoph Claßen, Eva Maria Schleicher, Julia Weinmann-Menke, Karel Kostev, Christian Labenz","doi":"10.1093/ckj/sfaf186","DOIUrl":"10.1093/ckj/sfaf186","url":null,"abstract":"<p><strong>Background: </strong>Depression is one of the most common psychiatric condition in patients with chronic kidney disease (CKD). It is associated with decreased adherence and quality of life as well as increased risk for dialysis, hospitalization, and mortality. Large population-based analysis evaluating the effect of CKD on the incidence of depression are missing.</p><p><strong>Methods: </strong>We performed a retrospective cohort study investigating the incidence of depression after CKD diagnosis in a large cohort derived from the IQVIA^TM Disease Analyzer database. Patients with CKD were matched to individuals without CKD using the nearest neighbor propensity score matching method. The 10-year cumulative incidence of depression was compared between the cohorts using Kaplan-Meier curves and an univariable conditional Cox regression analysis was performed to assess the association between CKD and depression, as well as antidepressant prescription.</p><p><strong>Results: </strong>Both cohorts included 165 787 individuals each, either with or without CKD. The 10-year incidence of depression was 24.2% in patients with CKD and 22.2% in patients without CKD (<i>P</i> < .001). The incidence of depression followed by an antidepressant prescription was 9.0% in the CKD cohort and 3.5% in the non-CKD cohort (<i>P</i> < .001), resulting in a hazard ratio (HR) of 2.63 (95% confidence intervals (CI) 2.51-2.75). This association was strongest in younger patients below 60 years of age (HR 6.03, 95% CI 5.17-7.01).</p><p><strong>Conclusion: </strong>In this large cohort, CKD is associated with a slightly higher incidence of depression requiring drug treatment. Clinicians caring for patients with CKD, especially younger patients, should be aware of the increased risk.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 7","pages":"sfaf186"},"PeriodicalIF":3.9,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559413","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: Associations of calcium, phosphate and intact parathyroid hormone levels with mortality, residual kidney function and technical failure among patients on peritoneal dialysis.","authors":"","doi":"10.1093/ckj/sfaf179","DOIUrl":"https://doi.org/10.1093/ckj/sfaf179","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1093/ckj/sfad223.].</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 6","pages":"sfaf179"},"PeriodicalIF":3.9,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12160797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282691","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: The benefit of reduced serum phosphate levels depends on patient characteristics: a nationwide cohort study.","authors":"","doi":"10.1093/ckj/sfaf176","DOIUrl":"https://doi.org/10.1093/ckj/sfaf176","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1093/ckj/sfae263.].</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 6","pages":"sfaf176"},"PeriodicalIF":3.9,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265504","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":"Hyponatremia and the risk of sepsis in the setting of chronic kidney disease not on dialysis.","authors":"Steven G Achinger, Ambuj Kumar, Athanasios Tsalatsanis","doi":"10.1093/ckj/sfaf133","DOIUrl":"10.1093/ckj/sfaf133","url":null,"abstract":"<p><strong>Background: </strong>Hyponatremia occurring in the presence of chronic kidney disease (CKD) is associated with increased mortality. Hyponatremia is also associated with sepsis in hypertensive patients without CKD taking thiazide diuretics. It is not known whether hyponatremia in CKD is associated with sepsis.</p><p><strong>Methods: </strong>This retrospective cohort study addressed the hypothesis that hyponatremia in the setting of CKD is associated with sepsis. This study utilized the TriNetX federated health research network that contains medical records of approximately 93 million patients. Inclusion criteria: 40-90 years old, CKD stage 3, 4 or 5 occurring between 1 January 2010 and 31 December 2021. Hyponatremia cohort serum sodium is defined as ≤135 mmol/L. Comparison cohort has a serum sodium 136-144 mmol/L. Primary outcome is diagnosis with sepsis. Secondary outcomes are diagnosis with pneumonia, urinary tract infection, bacteremia, coronavirus disease 2019 (COVID-19), influenza, herpes zoster, meningitis, osteomyelitis and cellulitis.</p><p><strong>Results: </strong>Patients in the hyponatremia cohort had a higher hazard of sepsis than comparison cohort [hazard ratio 1.683 (95% confidence interval 1.526, 1.857), <i>P</i> < .001]. Patients in the hyponatremia cohort also had a higher hazard of bacteremia, pneumonia, COVID-19, osteomyelitis, urinary tract infection and cellulitis.</p><p><strong>Discussion: </strong>Chronic hyponatremia in CKD is associated with higher hazard of sepsis and a variety of infectious illnesses. These findings may help inform future efforts to prospectively identify patients at risk for sepsis and possibly allow earlier intervention. Further study is needed to determine whether the risk of sepsis in the hyponatremia population is due to hyponatremia or due to unmeasured covariates.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 6","pages":"sfaf133"},"PeriodicalIF":3.9,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12146840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257418","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":"Renal denervation is effective in reducing blood pressure in patients with CKD.","authors":"Agnes Bosch, Dennis Kannenkeril, Roland E Schmieder","doi":"10.1093/ckj/sfaf126","DOIUrl":"10.1093/ckj/sfaf126","url":null,"abstract":"<p><p>Hypertension is a major cause and the predominant accelerator of progressive loss of renal function in patients with chronic kidney disease (CKD). Despite advances in pharmacological intervention in recent years, a significant proportion of patients with CKD have uncontrolled, often treatment-resistant hypertension, necessitating alternative therapeutic approaches to control hypertension and slow the progression of renal function decline. Renal denervation modifies efferent and afferent renal sympathetic nerve activity and thus addresses an important modifier of both, blood pressure and renal function that has not been adequately addressed by pharmacologic therapies. This article reviews the current evidence on renal denervation in hypertensive patients with CKD. Safety and efficacy data from clinical trials and observational studies are reassuring that renal denervation is emerging as a promising additional treatment option for patients with uncontrolled hypertension and CKD. However, further randomized controlled data are needed to support these findings, particularly in patients with advanced CKD.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 6","pages":"sfaf126"},"PeriodicalIF":3.9,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12146849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257419","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":"Efficacy and safety of finerenone in obesity-related glomerulopathy.","authors":"Dan-Dan Qiu, Jing Liu, Rui-Han Chen, Feng Zhang, Yu An, Song Jiang","doi":"10.1093/ckj/sfaf157","DOIUrl":"10.1093/ckj/sfaf157","url":null,"abstract":"<p><strong>Background: </strong>This study aims to evaluate the efficacy and safety of finerenone in the treatment of obesity-related glomerulopathy (ORG).</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 69 patients diagnosed with ORG between January 2022 and July 2023, of whom 30 received finerenone (10-20 mg/day).</p><p><strong>Results: </strong>The cohort had a mean age of 44.30 ± 11.43 years, comprising 54 males. The median body mass index (BMI) was 31.18 (28.89, 33.68) kg/m², the median 24-hour proteinuria level was 1.35 (1.2, 1.86) g/24 h, the mean estimated glomerular filtration rate (eGFR) was 87.39 ± 28.41 ml/min/1.73 m², and the mean serum potassium level was 4.01 ± 0.33 mmol/l. All patients were followed for over 1 year. Compared to the control group, the finerenone group had a lower baseline BMI [29.86 (28.66, 32.91) vs. 31.67 (30.18, 34.56) kg/m², <i>P</i> = .019] and higher baseline proteinuria [1.72 (1.23, 2.63) vs. 1.32 (1.12, 1.66) g/24 h, <i>P</i> = .007]. The utilization of renin-angiotensin system (RAS) inhibitors, sodium-glucose cotransporter-2 (SGLT2) inhibitors, glucagon-like peptide-1 (GLP-1) receptor agonists, and statins showed no significant differences between the groups. At 1-year follow-up, the finerenone group demonstrated significantly greater reduction in 24-hour proteinuria (-35.03% vs. -11.20%, <i>P</i> = .010) and systolic blood pressure (-10.07 vs. -4.44 mmHg, <i>P</i> = .045), along with a more stable eGFR (2.85% vs. -8.20%, <i>P</i> = .009) compared with the control group. Additionally, serum potassium levels increased more in the finerenone group (8.09% vs. 1.73%, <i>P</i> = .005). No significant difference in adverse events were observed between the groups.</p><p><strong>Conclusions: </strong>Finerenone is associated with reduced proteinuria, lower blood pressure, and stabilized eGFR in patients with ORG, without a significant increase in adverse events.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 6","pages":"sfaf157"},"PeriodicalIF":3.9,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12160826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282692","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":"Short- and long-term outcomes in oliguric and non-oliguric acute kidney injury in intensive care: a retrospective, post hoc, bicentric study.","authors":"Sarjit Singh, Mark Andonovic, Jamie P Traynor, Martin F Shaw, Malcolm A B Sim, Patrick B Mark, Kathryn A Puxty","doi":"10.1093/ckj/sfaf170","DOIUrl":"10.1093/ckj/sfaf170","url":null,"abstract":"<p><strong>Background: </strong>Patients admitted to intensive care units (ICUs) frequently develop acute kidney injury (AKI). There is limited research comparing outcomes between oliguric and non-oliguric AKI in this population. This study aimed to investigate the short- and long-term outcomes in oliguric and non-oliguric AKI in intensive care patients; the specific outcomes assessed were mortality and major adverse kidney events. We hypothesised that short- and long-term outcomes would be poorer in oliguric compared with non-oliguric AKI in intensive care patients.</p><p><strong>Methods: </strong>This retrospective observational cohort study utilised prospectively collected data routinely gathered during patients' admission. All adult patients >16 years of age admitted to two large Scottish general adult ICUs were included. Patients with long-term kidney replacement therapy, prior transplantation and ICU readmission were excluded. Oliguria was defined as urine output <0.3 ml/kg/h for 24 h. Outcomes were assessed using Cox proportional hazards analyses; should its assumptions be violated, odds ratios at prespecified time points were undertaken.</p><p><strong>Results: </strong>Of the 2147 patients identified with <i>de novo</i> AKI, 1666 had sufficient urine output data for analysis. A total of 528 (31.7%) subjects had oliguric AKI lasting at least 24 h. The 1-year mortality was higher in oliguric patients [adjusted hazard ratio 1.45 (95% confidence interval 1.02-2.12), <i>E</i>-value 1.93]. Our data violated the proportional hazards assumption for major adverse kidney events; the 1-year odds ratio for major adverse renal events was non-significant at 1.25 (95% confidence interval 0.92-1.69).</p><p><strong>Conclusion: </strong>Our study demonstrated that one-third of patients with AKI in intensive care developed oliguria using a standardised definition of oliguria. Oliguric AKI was found to be significantly associated with higher rates of mortality from in-critical care through 1-year post-discharge.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 6","pages":"sfaf170"},"PeriodicalIF":3.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12203070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526632","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":"Inherited kidney disease and CAKUT are common causes of kidney failure: ERA Registry Figure of the month.","authors":"Vianda S Stel, Alberto Ortiz, Anneke Kramer","doi":"10.1093/ckj/sfaf163","DOIUrl":"https://doi.org/10.1093/ckj/sfaf163","url":null,"abstract":"","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 5","pages":"sfaf163"},"PeriodicalIF":3.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198417","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":"Glucagon-like peptide-1 receptor agonist therapy in patients with type 2 diabetes and advanced CKD: kidney and cardiovascular outcomes in a real-world setting.","authors":"Ching-Chung Hsiao, Mon-Ting Chen, Chieh-Yu Liu, Chih-Yu Chan, Yu-Wei Fang, Hung-Hsiang Liou, Ming-Hsien Tsai","doi":"10.1093/ckj/sfaf172","DOIUrl":"10.1093/ckj/sfaf172","url":null,"abstract":"<p><strong>Background: </strong>The advent of glucagon-like peptide-1 receptor antagonists (GLP-1 RAs) has generated significant interest in their potential cardiovascular benefits for patients with type 2 diabetes mellitus (T2DM). However, they lack comprehensive evaluations of their impact on kidney and cardiovascular outcomes in patients with advanced chronic kidney disease (CKD). This study aimed to evaluate the effects of GLP-1 RAs on kidney and cardiovascular outcomes in patients with T2DM and advanced CKD.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study with a new user design that utilized propensity score matching to establish comparable groups of GLP-1 RA users and nonusers. We obtained data from 69 US healthcare organizations within the TriNetX platform from 1 January 2018 to 31 December 2022. We included 632 308 patients with T2DM, aged ≥18 years, and an estimated glomerular filtration rate of ≤45 mL/min/1.73 m², ultimately focusing on 51 910 matched pairs of GLP-1 RA users and nonusers. Cox proportional hazards model was used to evaluate treatment effects on various outcomes.</p><p><strong>Results: </strong>The matched groups had a mean age of approximately 65 years, with men comprising 43% of each cohort. GLP-1 RA users exhibited a significantly lower incidence of dialysis initiation and major adverse cardiovascular events than GLP-1 RA nonusers, with respective hazard ratios (HRs) of 0.89 [95% confidence interval (CI) 0.85-0.93] and 0.92 (95% CI 0.88-0.95). Mortality rates were significantly reduced (HR 0.81; 95% CI 0.78-0.84). Moreover, GLP-1 RA users had significant cardiovascular benefits, which were consistent across subgroup and sensitivity analyses.</p><p><strong>Conclusions: </strong>GLP-1 RAs were significantly associated with the incidence of kidney and cardiovascular events in patients with T2DM and advanced CKD, suggesting the potential importance of incorporating GLP-1 RA treatment to help modify disease progression and improve survival in this high-risk population.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 6","pages":"sfaf172"},"PeriodicalIF":3.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12160804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282726","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":"Trajectories of urea‑to‑creatinine ratio and risk of clinical outcomes in survivors of acute kidney disease: a population-based study.","authors":"Heng-Chih Pan, Jui-Yi Chen, Nai-Chi Teng, Fang-Yu Yeh, Chun Yin See, Chiao-Yin Sun, Vin-Cent Wu, Likwang Chen","doi":"10.1093/ckj/sfaf175","DOIUrl":"10.1093/ckj/sfaf175","url":null,"abstract":"<p><strong>Background: </strong>The urea-to-creatinine ratio (UCR) serves as a common metric for assessing dehydration, catabolism, excessive protein intake and impaired kidney perfusion. However, the performance of UCR in patients with acute kidney disease (AKD) remains unexplored.</p><p><strong>Methods: </strong>In this retrospective cohort study, we enrolled 6703 survivors of AKD from a nationwide population-based database in Taiwan linked with laboratory data from 1 January 2015 to 31 December 2018. Using a group-based trajectory model (GBTM), we identified UCR trajectories and investigated their dynamic changes. We associated these trajectories with major adverse kidney events (MAKEs) as the primary outcome, and mortality and major adverse cardiovascular events (MACEs) as secondary outcomes in AKD survivors.</p><p><strong>Results: </strong>A total of 9717 AKD survivors were enrolled with a mean follow-up of 1.3 ± 0.9 years. The incidence of MAKEs was 43.7%, the incidence of mortality was 26.3% and the incidence of MACEs was 31.1%. After adjusting for known covariates, UCR trajectories independently predicted MAKEs, all-cause mortality and MACEs. Compared with the middle trajectory group, the high UCR trajectory group had a significantly elevated risk of MAKEs [hazard ratio (HR) 1.54, 95% confidence interval (CI) 1.38-1.73], mortality rate (HR 1.59, 95% CI 1.41-1.80) and MACEs (HR 1.57, 95% CI 1.40-1.77). In contrast, the low UCR trajectory group had an increased risk of MAKEs (HR 1.30, 95% CI 1.20-1.41) and a reduced risk of mortality rate (HR 0.84, 95% CI 0.74-0.95).</p><p><strong>Conclusions: </strong>Distinct UCR trajectories predicted MAKEs, all-cause mortality and MACEs in AKD survivors. A high UCR trajectory was associated with the highest risk of adverse events, whereas a low UCR trajectory carried a higher risk of MAKEs but a lower risk of mortality. These findings underscore the clinical relevance of monitoring UCR trajectories for long-term prognosis and risk stratification in AKD patients.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 6","pages":"sfaf175"},"PeriodicalIF":3.9,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526634","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}