Clinical Kidney Journal最新文献

{"title":"SUrvey of renal Biopsy registry database and Anticancer dRUg therapy in Japan (SUBARU-J study).","authors":"Takashige Kuwabara, Yoshikazu Miyasato, Tomoko Kanki, Teruhiko Mizumoto, Takeshi Matsubara, Naoki Sawa, Hitoshi Sugiyama, Shoichi Maruyama, Hiroshi Sato, Tatsuo Tsukamoto, Tomohiro Murata, Mariko Miyazaki, Toshiyuki Imasawa, Masashi Mukoyama, Naoka Murakami, Kenar D Jhaveri, Motoko Yanagita","doi":"10.1093/ckj/sfae327","DOIUrl":"10.1093/ckj/sfae327","url":null,"abstract":"<p><strong>Background: </strong>Kidney complications associated with anticancer drug therapy have greatly increased recently. We aimed to investigate the real-world clinical outcomes of anticancer drug therapy-associated renal complications in Japan using the national kidney biopsy database, Japan Renal Biopsy Registry (J-RBR).</p><p><strong>Methods: </strong>From 2018 to 2021, 449 cases from 49 facilities identified as 'drug-induced' histopathology in the J-RBR were screened, of which a total of 135 were confirmed as anticancer drug-related cases and included in the analysis. Overall survival rates were estimated using the Kaplan-Meier method and compared by logrank test. The Cox regression model was used to evaluate the association between variables and deaths.</p><p><strong>Results: </strong>The most common primary sites of malignancies were the lung (33.3%), followed by gastrointestinal (16.3%) and gynaecological (11.1%) cancers. Tubulointerstitial nephritis (TIN; 47.4%) and thrombotic microangiopathy (TMA; 35.6%) were the most frequent diagnoses. All immunoglobulin A nephropathy, minimal change disease and crescentic glomerulonephritis (CrGN) cases were immune checkpoint inhibitor related. All CrGN cases were anti-neutrophil cytoplasmic antibody negative. Antibiotics were most frequently used concomitantly with anticancer drugs in TMA cases among subgroups (TMA versus others: 62.5 versus 27.5%; <i>P</i> < .001). Among TMA cases, the serum lactate dehydrogenase level tended to be higher in cytotoxic agent-associated TMA (CTx-TMA) than in other TMAs, but was not significant between groups (415.5 versus 219.0 U/l; <i>P</i> = .06). Overall survival was worse in CTx-TMA than in other TMAs (<i>P</i> = .007). The Cox model demonstrated proton pump inhibitor (PPI) use (hazard ratio 2.49, <i>P</i> = .001) as a significant prognostic factor, as well as the presence of metastasis and serum albumin level.</p><p><strong>Conclusions: </strong>Our registry analysis highlighted various presentations of biopsy-proven kidney complications associated with anticancer drug therapy. Clinicians should be aware of worse outcomes associated with CTx-TMA and the prognostic role of PPI use.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"17 12","pages":"sfae327"},"PeriodicalIF":3.9,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11630032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812215","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":"ERA Registry Figure of the month Heterogeneity of kidney replacement therapy incidence across Europe.","authors":"Vianda S Stel, Alberto Ortiz, Anneke Kramer","doi":"10.1093/ckj/sfae306","DOIUrl":"https://doi.org/10.1093/ckj/sfae306","url":null,"abstract":"","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"17 11","pages":"sfae306"},"PeriodicalIF":3.9,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11600136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142738594","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":"ERA Registry Figure of the month The prevalence of kidney replacement therapy in Europe and the United States.","authors":"Vianda S Stel, Alberto Ortiz, Anneke Kramer","doi":"10.1093/ckj/sfae372","DOIUrl":"https://doi.org/10.1093/ckj/sfae372","url":null,"abstract":"","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"17 12","pages":"sfae372"},"PeriodicalIF":3.9,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11665634/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142881410","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":"Abnormal neurovascular coupling exists in patients with peritoneal dialysis and hemodialysis: evidence from a multi-mode MRI study.","authors":"Xiayan Yin, Wenbo Yang, Lijun Song, Jiamin Liu, Mingan Li, Zhenghan Yang, Wenhu Liu, Zhenchang Wang, Hao Wang, Weikang Guo","doi":"10.1093/ckj/sfae353","DOIUrl":"10.1093/ckj/sfae353","url":null,"abstract":"<p><strong>Background: </strong>Neurovascular coupling (NVC), as indicated by a comprehensive analysis of the amplitude of low-frequency fluctuation (ALFF) and cerebral blood flow (CBF), provides mechanistic insights into neurological disorders. Patients undergoing peritoneal dialysis (PD) and hemodialysis (HD) often face cognitive impairment, the causes of which are not fully understood.</p><p><strong>Methods: </strong>ALFF was derived from functional magnetic resonance imaging, and CBF was quantified using arterial spin labeling in a cohort comprising 58 patients with PD, 60 patients with HD and 62 healthy controls. Voxel-based global analysis for both ALFF and CBF, alongside region-based analyses of ALFF-CBF coupling coefficients, were conducted. Additionally, the study explored the correlation between clinical laboratory indices and imaging metrics.</p><p><strong>Results: </strong>Compared with HC, NVC was reduced in the bilateral medial superior frontal gyrus (SFGmed), insula, posterior cingulate cortex (PCC) and caudate (CAU) among dialysis patients. Furthermore, the PD group exhibited lower NVC in the bilateral SFGmed, bilateral PCC and left CAU compared with the HD group. Within the PD group, sodium level was negatively correlated with the ALFF-CBF coupling coefficient in the right insula. Additionally, a positive correlation emerged between the ALFF-CBF coupling coefficient in bilateral SFGmed and the dialysis adequacy.</p><p><strong>Conclusion: </strong>While Montreal Cognitive Assessment scores did not significantly differ between patients with PD and HD, PD group demonstrated poorer NVC in the bilateral SFGmed, bilateral PCC and left CAU. Sodium level and dialysis adequacy may affect NVC in patients with PD.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 1","pages":"sfae353"},"PeriodicalIF":3.9,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11756302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028089","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":"Outcomes of kidney transplantation in patients with lysinuric protein intolerance.","authors":"Tomi Rautanen, Kaisa Ahopelto, Harri Niinikoski, Sinikka Karppinen, Marko Lempinen, Fernanda Ortiz, Ilkka Helanterä","doi":"10.1093/ckj/sfae373","DOIUrl":"10.1093/ckj/sfae373","url":null,"abstract":"<p><strong>Background: </strong>Lysinuric protein intolerance (LPI) is a metabolic disorder that leads to dysfunctional intestinal absorption and kidney clearance of cationic amino acids. Chronic kidney disease develops in many LPI patients and leads to end-stage kidney disease in at least 10% of patients. Since data on kidney transplants in LPI patients are limited, we analysed the outcomes of LPI patients after transplantation in Finland.</p><p><strong>Methods: </strong>This retrospective cohort study includes all Finnish LPI patients who have received a kidney transplant. The data were collected from the Finnish Transplant Registry and electronic medical records from 2005 through May 2023 or patient death. The plasma amino acid profile was analysed before and after transplantation.</p><p><strong>Results: </strong>Eight LPI patients (75% female, mean age at transplant 41.9 years) received a kidney allograft and two of the patients received a second transplant. Nine transplants were from deceased donors and one was from a living donor. Acute rejection occurred after four transplantations (two T-cell mediated and two antibody mediated). One patient died 6 months after transplantation due to alveolar proteinosis. Apart from lower citrulline and higher lysine concentrations, plasma amino acid levels showed no changes after transplantation. The 1-, 5- and 10-year graft survivals were 80%, 68.6% and 51.4%, and patient survivals were 88%, 86% and 50%, respectively.</p><p><strong>Conclusions: </strong>Kidney transplantation is feasible in patients with LPI, although the acute rejection rate seems high and severe complications such as pulmonary alveolar proteinosis may occur. Transplantation led to changes in plasma citrulline and lysine concentrations.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 1","pages":"sfae373"},"PeriodicalIF":3.9,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11724718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969904","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":"The utility of brief instruments for depression screening in dialysis patients.","authors":"Isabel Vázquez, Adolfo Figueiras, Ángel Salgado-Barreira","doi":"10.1093/ckj/sfae369","DOIUrl":"10.1093/ckj/sfae369","url":null,"abstract":"<p><strong>Background: </strong>Depression is a frequent but often underdiagnosed comorbid disorder in dialysis patients. The Beck Depression Inventory-Second Edition (BDI-II) is a reliable and valid instrument for depression screening but is relatively long for repeated use in clinical practice. The aim of this study was to compare the BDI-II with the shorter questionnaires Beck Depression Inventory-FastScreen (BDI-FS), the depression subscale of the Hospital Anxiety Depression Scale (HADS-D), the Mental Health (MH) scale of the 36-item Short Form Health Survey (SF-36) and two items of the MH ('So down in the dumps that nothing could cheer you up' and 'Downhearted and blue') to determine the most efficient instruments for screening depressive symptoms in dialysis patients.</p><p><strong>Methods: </strong>A cross-sectional study was conducted involving patients from 14 health centres undergoing in-centre haemodialysis or peritoneal dialysis. All patients completed the BDI-II, HADS-D and MH scale. The sensitivity, specificity and positive and negative predictive values for each brief instrument were assessed relative to BDI-II ≥16.</p><p><strong>Results: </strong>Of the 145 patients included in the study (mean age 62 years; 66% male), 24.8% had depressive symptoms (BDI ≥16). The cut-off points with the highest sensitivity and negative predictive value for BDI-FS were ≥3 (91.7% and 96.1%, respectively) and ≥4 (80.6% and 92.4%, respectively) and for the HADS-D these were ≥4 (91.7% and 95.8%, respectively) and ≥5 (83.3% and 92.6%, respectively). The cut-off points for the total MH and the two items (considered separately or together) resulted in lower sensitivity (<80%) and lower negative predictive values (<90%).</p><p><strong>Conclusions: </strong>Both the BDI-FS and HADS-D are adequate screening tools for depression in the dialysis population. As the BDI-FS is easier to complete and score and enables identification of patients at risk of suicide, it may be the best alternative to the BDI-II for depression screening in dialysis patients in clinical settings.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 1","pages":"sfae369"},"PeriodicalIF":3.9,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11704791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945851","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":"Remote management of anaemia in patients with end-stage kidney disease using a wearable, non-invasive sensor.","authors":"Amy Steig, Forrest Miller, Samir Shreim, Jake Wilcox, Carole Sykes, David Whittaker, Rajesh Sivaprakasam, Samit Gupta, David Kuraguntla","doi":"10.1093/ckj/sfae375","DOIUrl":"10.1093/ckj/sfae375","url":null,"abstract":"<p><p>Anaemia is a prevalent complication in patients with end-stage kidney disease (ESKD) undergoing haemodialysis. This study evaluates the accuracy of the Alio SmartPatch™, a non-invasive remote monitoring device, in measuring haemoglobin (Hb) and haematocrit (Hct) levels in haemodialysis patients by comparing its results with standard blood-based laboratory methods. The results from 116 patients across multiple sites in the USA and the Kingdom of Jordan show that SmartPatch measurements align closely with standard blood-based laboratory methods, meeting clinically acceptable limits of agreement. The current standard methods of Hb and Hct measurements are invasive and require visits to clinical sites, whereas the FDA-cleared SmartPatch offers non-invasive measurement of these parameters up to 240 times per month, thereby enhancing personalized care and patient engagement. This study demonstrates the potential of remote monitoring technologies, such as the SmartPatch, to improve the management of ESKD-associated anaemia. Further research is warranted to evaluate the device's long-term outcomes and its impact across diverse patient populations.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 1","pages":"sfae375"},"PeriodicalIF":3.9,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11761439/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045728","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":"Ten tips in lupus nephritis management.","authors":"Selene T Y Teoh, Desmond Y H Yap, Tak Mao Chan","doi":"10.1093/ckj/sfae376","DOIUrl":"https://doi.org/10.1093/ckj/sfae376","url":null,"abstract":"<p><p>Lupus nephritis is an important cause of severe glomerulonephritis, and a leading cause of kidney failure in young adults. While the disease can lead to rapid destruction of nephrons if untreated, there are effective therapies to reverse the severe acute kidney injury and prevent the lifetime risk of kidney failure. Early diagnosis and timely intervention are therefore of critical importance. Clinical management of lupus nephritis has improved considerably over the past two decades. The advent of mycophenolate as standard immunosuppressive therapy was a major paradigm shift that improved the safety and convenience of treatment and also patients' quality of life. Effective therapeutic options continue to increase, such as belimumab (a monoclonal antibody that inhibits B-cell activating factor, BAFF) and voclosporin (a calcineurin inhibitor) which have obtained regulatory approval in U.S.A. and Europe. There is also accumulating experience on tacrolimus, which has regulatory approval for lupus nephritis treatment in Japan and commonly used off-label in many countries. Ironically, the increasing therapeutic options have resulted in uncertainties in deciding which medication, and which treatment regimen, is best for a patient. In this context, one needs to take into consideration the distinct characteristics and the risk profile of each patient, and adopt a holistic and long-term perspective, so that treatment can be personalized to achieve favourable clinical outcomes.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 1","pages":"sfae376"},"PeriodicalIF":3.9,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11770280/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051831","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":"Isolated microhematuria in potential kidney donors: evaluating kidney biopsy findings with dipstick urinalysis and urine microscopy results.","authors":"Ehab A Hammad, Dalia A Obeid, Dieter C Broering, Yaser Z Shah, Jens G Brockmann, Kris A Marquez, Ahmed M Nazmi, Hassan A Aleid, Hadeel M AlManea, Amira M AlAbassi, Melba A Solomon, Nancy Jacob, Tariq Z Ali","doi":"10.1093/ckj/sfae371","DOIUrl":"10.1093/ckj/sfae371","url":null,"abstract":"<p><strong>Background: </strong>Isolated microhematuria (IMH) can signal hidden glomerular disease, necessitating detailed evaluations for potential kidney donors, including kidney biopsies. The optimal strategy for deciding on kidney biopsies remains unclear. While the British Transplant Society supports dipstick analysis, KDIGO focuses solely on urine microscopy. This study explored the correlation between kidney biopsy outcomes and results from dipstick urinalysis and urine microscopy in potential kidney donors.</p><p><strong>Methods: </strong>This retrospective study encompassed all potential kidney donors who received kidney biopsies following a positive urine dipstick result for IMH, irrespective of whether red blood cells (RBCs) were found on urine microscopy. We performed sensitivity and specificity analyses to assess the effectiveness of microscopy and dipstick urinalysis in identifying histological abnormalities in the kidney biopsies.</p><p><strong>Results: </strong>Approximately 49% of potential donors-133 out of 271-who had kidney biopsies due to positive dipstick tests showed negative results in urine microscopy for RBCs. In total, 168 donor candidates, or 62%, had abnormal findings in their biopsies, with nearly half of those diagnosed with immunoglobulin A nephropathy having negative urine microscopy results. Furthermore, 58% of potential donors with negative urine microscopy results-77 out of 133-also exhibited abnormal biopsy findings. The urine microscopy test displayed a sensitivity of 54.2% (95% confidence interval 46.6-61.5) and a specificity of 54.4% (95% confidence interval 44.8-63.7) for detecting abnormal biopsy results.</p><p><strong>Conclusion: </strong>This study highlighted a significant presence of donors with IMH with underlying glomerular lesions. Using urine microscopy showed limited sensitivity and specificity in identifying abnormal histopathological results. Relying solely on urine microscopy may miss critical pathologies like IgAN in prospective kidney donors. The persistence of IMH during dipstick urinalysis calls for kidney biopsy in potential donors. These findings suggest that our results be incorporated into future global guideline formulations.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 1","pages":"sfae371"},"PeriodicalIF":3.9,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11739450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001300","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":"Clinical implications of mineralocorticoid receptor overactivation.","authors":"Christopher El Mouhayyar, Monika Chhikara, Mengyao Tang, Sagar U Nigwekar","doi":"10.1093/ckj/sfae346","DOIUrl":"10.1093/ckj/sfae346","url":null,"abstract":"<p><p>The mineralocorticoid receptor (MR) is a nuclear transcription factor that plays a critical role in regulating fluid, electrolytes, blood pressure, and hemodynamic stability. In conditions such as chronic kidney disease (CKD) and heart failure (HF), MR overactivation leads to increased salt and water retention, inflammatory and fibrotic gene expression, and organ injury. The MR is essential for transcriptional regulation and is implicated in metabolic, proinflammatory, and pro-fibrotic pathways. It is widely expressed in various cell types throughout the body, including the gastrointestinal tract, heart, brain, kidneys, immune cells, and vasculature. Animal studies suggest that MR activation induces oxidative stress in the kidneys and mediates renal inflammation and fibrosis. Immune cell-specific deletion of MR has shown protection against cardiac fibrosis, indicating the MR's role in pathological remodeling. In vascular smooth muscle cells, the MR regulates vascular tone and vasoconstriction. Mineralocorticoid receptor antagonists (MRAs) can be categorized based on their chemical structure as either steroidal or nonsteroidal. Steroidal MRAs (sMRA), such as spironolactone and eplerenone, have demonstrated cardiovascular benefits but are limited by hyperkalemia, gynecomastia, and sexual dysfunction. Nonsteroidal MRAs (nsMRA) have shown promise in preclinical studies and clinical trials. They offer a promising alternative by effectively blocking MR without hormone-like effects, potentially improving cardiovascular and renal disease management. Further education is necessary regarding the significance of MRA utilization in CKD and HF, balancing benefits with the risk of hyperkalemia. This risk could be mitigated by combining MRAs with potassium-binding agents. Studies are underway to explore the synergistic effects between nsMRAs and other agents, such as SGLT-2i inhibitors and Glucagon-like peptide-1 agonists, to optimize cardiorenal outcomes. Overall, MR overactivation remains a significant therapeutic target, with nsMRAs showing promise as pivotal therapies in CKD and HF management. This review highlights the evolving landscape of MR-targeted therapies, their molecular mechanisms, and clinical implications in cardiorenal diseases.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 1","pages":"sfae346"},"PeriodicalIF":3.9,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11704795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945825","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}