Clinical Kidney Journal最新文献

{"title":"Associations between acute kidney injury and bone fractures: a retrospective cohort study","authors":"Hicham I Cheikh Hassan, Bridie S Mulholland, Brendan McAlister, Kelly Lambert, Karumathil M Murali, Stephen Moules, Judy Mullan","doi":"10.1093/ckj/sfae282","DOIUrl":"https://doi.org/10.1093/ckj/sfae282","url":null,"abstract":"Background Acute kidney injury (AKI) is common. An AKI episode may disrupt the normal mineral bone balance maintained by normal kidney function, thereby modifying the risk of developing bone fractures. However, it remains unclear if an AKI episode is associated with the risk of bone fractures. Methods Using retrospective cohort study from an Australian Local Health District, we examined the association between an AKI episode and bone fractures using patient data between 2008 and 2017. Time-varying Cox proportional hazards and propensity-matched analysis were used to examine the association. Sensitivity analyses were undertaken to capture the impact of confirmed AKI status and AKI severity. Results Of 123 426 included patients, 14 549 (12%) had an AKI episode and 12 505 (10%) had a bone fracture. In the unadjusted analysis, AKI was associated with bone fractures [hazard ratio (HR) 1.99, 95% confidence interval (CI) 1.88- 2.11]. This association persisted in the adjusted analysis (HR 1.50, 95%CI 1.41- 1.59) and propensity matched dataset (HR 1.71, 95%CI 1.59- 1.83). The sensitivity analysis yielded similar results with the AKI patients having a higher risk of fractures compared to no AKI patients in the adjusted analysis (HR 1.34, 95%CI 1.25- 1.43) and in the propensity matched dataset (HR 1.44, 95%CI 1.33- 1.55). Similar results were seen in the subsidiary sensitivity analysis excluding patients without baseline creatinine. We did not find an increased risk of bone fractures with increasing AKI severity (P = 0.7). Interaction tests demonstrated a significant association between sex and age category with AKI status and fractures, but not CKD stage or osteoporosis. Conclusions AKI is associated with a greater risk of bone fractures. This could have implications for managing and screening for bone disease in patients post AKI episode. This association should be examined in other cohorts and populations for verification.","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142196379","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}

{"title":"Chronic kidney disease-associated pruritus: a comparison of instruments and associations with patient-reported outcomes using an electronic patient reported outcome survey in Europe","authors":"Murilo Guedes, Charlotte Tu, Nidhi Sukul, Elham Asgari, Fitsum Guebre-Egziabher, Despina Ruessmann, Thilo Schaufler, Hugh Rayner, Michel Jadoul, Laura Labriola, Roberto Pecoits-Filho, Ronald L Pisoni, Angelo Karaboyas","doi":"10.1093/ckj/sfae276","DOIUrl":"https://doi.org/10.1093/ckj/sfae276","url":null,"abstract":"Background and Hypothesis The associations between self-reported chronic kidney disease-associated pruritus (CKD-aP) and patient-reported outcomes (PROs) have been reported using various instruments to assess itch. Data collection via multiple CKD-aP instruments allows the evaluation of different domains and measurements of CKD-aP burden and may help tailor data capture for future research or clinical care. Methods An electronic PRO (ePRO) survey was distributed to European hemodialysis (HD) patients enrolled in the Dialysis Outcomes and Practice Patterns Study (DOPPS) in 2021–2023. The DOPPS is an international cohort study that aims to investigate practice patterns and outcomes in HD patients. The ePRO survey included multiple CKD-aP instruments: average and worst itching intensity numerical rating scales (AI-NRS, WI-NRS) and a KDQOL-36 single question. Linear and logistic regression were used to estimate adjusted associations between CKD-aP instruments and various PROs. Results This analysis included 769 patients who completed the WI-NRS from HD facilities in France, Germany, Italy, Spain, Sweden, and the UK. The correlation between WI-NRS and the KDQOL-36 itch question was 0.88 overall and 0.46 among patients at least somewhat bothered by itch. Mean WI-NRS scores stratified by response to the KDQOL-36 itch question were 8.1, 6.4, 4.1, and 3.1 for extremely, very much, moderately, and somewhat bothered, respectively. Patients with worse WI-NRS scores reported worse sleep quality, greater fatigue, more depressive symptoms, and lower mental and physical quality of life; these associations were similar to those observed for the KDQOL-36 itch question. Discussion Correlation between CKD-aP instruments was high overall, but moderate among the subgroup of patients bothered by itch; differences can be partially attributed to the recall period for the KDQOL-36 (4 weeks) vs. the AI- and WI-NRS (24 hours). The consistent associations of these instruments with poor outcomes underscores the importance to identify and effectively treat HD patients suffering from pruritus.","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142196382","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}

{"title":"The impact of severe nephrotic syndrome on thyroid function, nutrition and coagulation","authors":"Anna Matyjek, Stanisław Niemczyk, Sławomir Literacki, Wojciech Fendler, Tomasz Rozmysłowicz, Andreas Kronbichler","doi":"10.1093/ckj/sfae280","DOIUrl":"https://doi.org/10.1093/ckj/sfae280","url":null,"abstract":"Background Nephrotic syndrome (NS) is characterized by urinary loss of proteins, including hormones and their carrier proteins, potentially resulting in endocrine disorders. This study aimed to assess thyroid dysfunction frequency and potential implications in NS. Methods In this case-control study, patients with severe NS (serum albumin ≤ 2.5 g/dL) and controls without proteinuria were evaluated for thyroid, hemostatic, and nutritional parameters, including body composition. Results Forty-two nephrotic and 40 non-proteinuric patients were enrolled. The NS group showed higher thyroid-stimulating hormone and lower free hormones, corresponding to a higher frequency of both euthyroid sick syndrome (ESS; 36% vs 5%; OR = 10.6, 95%CI: 2.2–50.0), and hypothyroidism (31% vs 5%; OR = 8.5, 95%CI: 1.8–40.7) compared to the control group. Levothyroxine supplementation was required for 11 NS patients (26% of the NS group). In addition, in comparison to the control individuals, NS patients exhibited lower lean tissue mass and a trend towards hypercoagulability, which was evidenced by higher levels of most coagulation factors and fibrinolysis inhibitors, and reduced endogenous anticoagulants activities. Furthermore, NS patients with ESS presented with a 10.4 kg (95% CI: −18.68 to −2.12) lower lean tissue mass. Those with hypothyroidism had a significantly reduced activity of coagulation factor X (by −30%, 95%CI: −47 to −13) and protein S (by −27%, 95%CI: −41 to −13) compared to euthyroid NS individuals. Conclusions Thyroid dysfunction is common in severe NS, often necessitating levothyroxine supplementation, which supports routine thyroid workup. A potential link between thyroid, nutritional, and coagulation disorders in NS requires further investigation.","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142196381","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}

{"title":"Kidney re-transplantation in the ipsilateral iliac fossa: a surgeon's perspective on perioperative outcome","authors":"Philipp Tessmer, Clara A Weigle, Anna Meyer, Bengt A Wiemann, Wilfried Gwinner, Gunilla Einecke, Jürgen Klempnauer, Florian W R Vondran, Nicolas Richter, Felix Oldhafer, Oliver Beetz","doi":"10.1093/ckj/sfae271","DOIUrl":"https://doi.org/10.1093/ckj/sfae271","url":null,"abstract":"Background Compared to primary transplantation, ipsilateral renal re-transplantation is associated with an increased risk of surgical complications and inferior graft outcomes. This study investigates whether an ipsilateral re-transplantation approach per se is an independent risk factor for surgical complications and early graft loss. Methods In this retrospective, single-centre analysis, surgical complications and early graft outcomes of ipsilateral kidney re-transplantations from January 2007 to December 2017 were compared with primary transplantations and contralateral re-transplantations. Univariate and multivariate binary logistic regression analyses were performed to identify risk factors for surgical complications requiring surgical revision and graft loss within the first year after transplantation. Results Of the 1.489 kidney transplantations, 51 were ipsilateral, 159 were contralateral re-transplantations, and 1.279 were primary transplantations. Baseline characteristics did not differ between the ipsilateral and contralateral re-transplant recipients except for current and highest PRA levels. Major complications requiring surgical revision were significantly more frequent in ipsilateral re-transplantations (P = 0.010) than in primary transplantations but did not differ between ipsilateral and contralateral re-transplantations (P = 0.217). Graft loss within the first year after transplant was 15.7% in the ipsilateral versus 8.8% in the contralateral re-transplant group (P = 0.163) versus 6.4% in the primary transplantation group (P = 0.009). In a multivariate regression model, ipsilateral re-transplantation was not identified as an independent risk factor for complications requiring surgical revision or first-year graft loss. Conclusions Ipsilateral renal re-transplantation is no risk factor for inferior outcomes. Graft implantation into a pre-transplanted iliac fossa is a feasible and valid therapeutic option.","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142196383","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}

{"title":"The weighing process in patients on hemodialysis: an opportunity to improve volume management","authors":"Janosch Niknam, Sebastian Mussnig, Christoph Matthias, Maximilian Waller, Nikolaus Keil, Simon Krenn, Joachim Beige, Daniel Schneditz, Manfred Hecking","doi":"10.1093/ckj/sfae275","DOIUrl":"https://doi.org/10.1093/ckj/sfae275","url":null,"abstract":"Introduction Hemodialysis relies on accurate body mass (BM) assessment to determine ultrafiltration volumes, but we have not identified published practice patterns, disclosing how to handle clothing mass. Here we investigated the potential impact of clothing mass on predialysis BM determination, hypothesizing that a standardized template for clothing mass estimation enhances accuracy, compared to conventional practice. Methods Measurements included dressed and undressed BM predialysis. A pre-established template for average clothing mass was used to approximate undressed BM from clothed measurements. Differences to undressed BM were compared using Bland-Altman plots and tested for statistical significance using Wilcoxon signed rank tests. Results After excluding erroneous results, data from 48 patients were analyzed. Thirty-six patients (75%) did not habitually estimate clothing mass, but used their dressed BM as the predialysis BM, while the other 12 patients (25%) reported deducting a self-estimated clothing mass from their clothed predialysis BM. The differences to undressed BM were 0.819 ± 0.462 kg and 0.342 ± 0.321 kg in these two groups, respectively, indicating that patients underestimated clothing mass. Using the template to deduct clothing mass from clothed predialysis BM, these differences could be reduced to 0.197 ± 0.220 kg and 0.133 ± 0.135 kg, respectively. The average differences using the patient-reported BM and the template-based BM made up 39.4% and 8.6% of the average, subsequent ultrafiltration volume, respectively, suggesting that potential overestimation of the actual ultrafiltration volume could be reduced. Conclusion A standardized template for clothing mass may be useful to derive representative predialysis BM, leading to more precise ultrafiltration calculation. Exact BM determination might improve volume management in hemodialysis.","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142196394","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}

{"title":"Machine learning for identification of short-term all-cause and cardiovascular deaths among patients undergoing peritoneal dialysis patients","authors":"Xiao Xu, Zhiyuan Xu, Tiantian Ma, Shaomei Li, Huayi Pei, Jinghong Zhao, Ying Zhang, Zibo Xiong, Yumei Liao, Ying Li, Qiongzhen Lin, Wenbo Hu, Yulin Li, Zhaoxia Zheng, Liping Duan, Gang Fu, Shanshan Guo, Beiru Zhang, Rui Yu, Fuyun Sun, Xiaoying Ma, Li Hao, Guiling Liu, Zhanzheng Zhao, Jing Xiao, Yulan Shen, Yong Zhang, Xuanyi Du, Tianrong Ji, Caili Wang, Lirong Deng, Yingli Yue, Shanshan Chen, Zhigang Ma, Yingping Li, Li Zuo, Huiping Zhao, Xianchao Zhang, Xuejian Wang, Yirong Liu, Xinying Gao, Xiaoli Chen, Hongyi Li, Shutong Du, Cui Zhao, Zhonggao Xu, Li Zhang, Hongyu Chen, Li Li, Lihua Wang, Yan Yan, Yingchun Ma, Yuanyuan Wei, Jingwei Zhou, Yan Li, Jie Dong, Kai Niu, Zhiqiang He","doi":"10.1093/ckj/sfae242","DOIUrl":"https://doi.org/10.1093/ckj/sfae242","url":null,"abstract":"Although more and more cardiovascular risk factors have been verified in peritoneal dialysis (PD) populations in different countries and regions, it is still difficult for clinicians to accurately and individually predict death in the near future. We aimed to develop and validate machine learning-based models to predict near-term all-cause and cardiovascular death. Machine learning models were developed among 7539 PD patients, which were randomly divided into a training set and an internal test set by 5 random shuffles of 5-fold cross-validation, to predict the cardiovascular death and all-cause death in 3 months. We chose objectively-collected markers such as patient demographics, clinical characteristics, laboratory data and dialysis-related variables to inform the models and assessed the predictive performance using a range of common performance metrics, such as sensitivity, positive predictive values (PPV), the area under the receiver operating curve (AUROC) and the area under the precision recall curve (AUPRC). In the test set, the CVDformer models had a AUROC of 0.8767 (0.8129, 0.9045) and 0.9026 (0.8404, 0.9352) and AUPRC of 0.9338 (0.8134,0.9453) and 0.9073 (0.8412,0.9164) in predicting near-term all-cause death and cardiovascular death, respectively. The CVDformer models had high sensitivity and PPV for predicting all-cause and cardiovascular deaths in 3 months in our PD population. Further calibration is warranted in the future.","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142196396","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}

{"title":"Cystatin C vs Creatinine eGFR in Advanced CKD: an analysis of the STOP-ACEi Trial","authors":"Sebastian Spencer, Robert Desborough, Samir Mehta, Natalie Ives, Sunil Bhandari","doi":"10.1093/ckj/sfae268","DOIUrl":"https://doi.org/10.1093/ckj/sfae268","url":null,"abstract":"Background and hypothesis In this secondary analysis of the STOP-ACEi trial, we explored the impact of discontinuing or continuing renin angiotensin system inhibitor therapy in people with advanced chronic kidney disease on cystatin C estimated glomerular filtration rate. Methods Cystatin C eGFR were calculated at baseline, 12-, 24- and 36-months using CKD-EPI Cystatin 2012, EKFC and CKD-EPI Combined 2021 equations. We excluded samples obtained after the initiation of kidney-replacement therapy. Primary analysis used complete case analysis and mixed-effects linear regression model, adjusting for minimization variables, baseline value, time-point, and treatment by time interaction. Sensitivity analysis was conducted using a pattern mixture model to account for missing data that was not at random. To model the longitudinal cystatin C data with time-to-event data, a joint model was utilized which incorporated the cystatin C measurements at various time points and accounted for the occurrence of kidney replacement therapy. Results The mean cystatin C eGFR (CKD-EPI 2012) at baseline were 17.8 mg/L [SD: 6.3] and 17.9 ml/min/1.73m2 [SD: 6.3] in the STOP and CONTINUE arms respectively. The estimated least squares mean difference at 12 months between STOP and CONTINUE arm was -1.46 (95% CI: -2.39 to -0.52, p=0.002). The estimated least squares mean difference at 24 months was -2.27 (95% CI: -3.48 to -1.06, p<0.001). The estimated least squares mean difference at 36 months was -1.72 (95% CI: -3.48 to 0.03, p=0.05). Conclusion Our results are consistent with the primary study's analysis and sensitivity analyses support these findings and provide additional insights. Our findings demonstrate the similarity of creatinine and cystatin eGFR results and therefore support the use of cystatin C as an alternative marker of eGFR in advanced CKD, particularly in those whom creatinine is likely to be less accurate.","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142196395","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}

{"title":"Post-transplant renal anaemia: a call to action from a national study in routine clinical practice","authors":"Jose Portoles, Marta Crespo, Miguel Martínez Belotto, Eduardo Martínez Morales, Emma Calatayud Aristoy, Paula Mora Lopez, S C González Garcia, Laia Oliveras, Julio Colina, A Singh, Asunción Sancho Calabuig, Emilio Rodrigo Calabia, Nuria Montero, Alex Gutierrez-Dalmau, Auxiliadora Mazuecos, Julio Pascual","doi":"10.1093/ckj/sfae269","DOIUrl":"https://doi.org/10.1093/ckj/sfae269","url":null,"abstract":"Background Post-transplant anaemia is a prevalent yet often overlooked condition that poses significant risks. Current guidelines consider the same treatment recommendations and goals for these patients as for chronic kidney disease patients not on dialysis (CKD-NDD). Previous old reports demonstrated lack of awareness and suboptimal management indicating a pressing need for improvement. We therefore wanted to update this information on post-transplant anemia. Aims To describe the present state of anaemia management, goals, and adherence to guidelines within a representative sample of the kidney transplant (KTx) population. Methods We designed a retrospective nationwide multicentre study including outpatients from 8 KTx hospitals. Nephrologists gathered data from electronic medical records encompassing demographics, comorbidities, KTx characteristics and immunosuppressive therapy and information pertaining to anaemia management (laboratory values, previously prescribed treatments, and subsequent adjustments). The European statement on KDIGO guidelines was the reference for definitions, drug prescriptions and targets. Anemia occurring within the initial six months post-transplantation was classified as early onset. Results We included 297 patients with post-transplant anemia aged 62.8 (SD 13.6) and 60% male. They had received a graft from cardiac-death or brain-death donors (61.6% and 31.1%, respectively) a median of 2.5 years [0.5–8.7] before. Among them 77% (n = 228) were classified as having late post-transplant anemia, characterized by a higher prevalence of microcytic and iron deficiency anemia. A total of 158 patients were on erythropoietic stimulating agents (ESAs) treatment, yet surprising 110 of them lacked iron supplementation. Notably, 44 patients had an indication for iron supplementation and among them, 30 exhibited absolute iron deficiency. Out of the 158 patients receiving ESAs, only 39 surpassed the limit for the ESA resistance index indicating poor response. This resistance was more frequent among patients with early post-transplant anemia (26.1 vs 9.2%). We have identified iron profile, early post-transplant anemia and eGFR as factors associated with the highest risk of resistance Conclusion We found that Hb targets are individualized upwards in post-transplant anemia. In this setting, iron therapy continues to be underutilized, especially intravenous, and iron deficiency and prior events (blood transfusion or hospital admission) explain most of the hyporesponsiveness to ESA. This highlights missed opportunities for precise prescription targeting and adherence to established guidelines, suggesting a need for improved management strategies in post-transplant anemia patients.","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142196397","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}

{"title":"Kidney effects of triple CFTR modulator therapy in people with cystic fibrosis","authors":"Pierre Gabai, Etienne Novel-Catin, Quitterie Reynaud, Raphaële Nove-Josserand, Solenne Pelletier, Denis Fouque, Laetitia Koppe, Isabelle Durieu","doi":"10.1093/ckj/sfae256","DOIUrl":"https://doi.org/10.1093/ckj/sfae256","url":null,"abstract":"Background Elexacaftor/tezacaftor/ivacaftor (ETI) is a new cystic fibrosis transmembrane conductance regulator (CFTR) modulator that has transformed the respiratory prognosis of people with cystic fibrosis (pwCF). However, its impact on other organs such as the kidneys, where CFTR is expressed, remains unclear. Since pwCF are risk of both kidney disease and urolithiasis, we aimed to study the potential effects of ETI on renal function, volume status, and risk factors for urolithiasis. Methods This prospective, observational, single-center, before-after cohort study, involved adult pwCF eligible for ETI. The changes in plasma and urinary profiles were assessed by comparing renal function (using 2021 CKD-EPIcreatinine and 2021 CKD-EPIcreatinine-cystatin C formulas), volume status (using aldosterone/renin ratio and blood pressure), and risk factors for urolithiasis, at the time of ETI introduction (M0) and 7 months after (M7). Results Nineteen pwCF were included. No significant change in renal function was observed between M0 and M7 (2021 CKD-EPIcreatinine: 105.5 mL/min/1.73m² at M0 vs. 103.3 mL/min/1.73m² at M7; p = 0.17). There was a significant reduction in aldosterone level (370.3 pmol/L at M0 vs. 232.4 pmol/L at M7; p = 0.02) and aldosterone/renin ratio (33.6 at M0 vs. 21.8 at M7; p = 0.03). Among the risk factors for urolithiasis, a significant reduction in magnesuria level was found (4.6 mmol/d at M0 vs. 3.8 mmol/d at M7; p = 0.01). Conclusion These findings suggest that ETI seem to have no short-term impact on the renal function of adult pwCF and appears to correct secondary hyperaldosteronism due to excessive sweat losses. Further investigations are needed to determine the potential impact of decreased magnesuria observed under ETI therapy on the risk of urolithiasis.","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142196400","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}

{"title":"A step forward for estimating GFR in young adults.","authors":"Guido Filler,Mara Medeiros","doi":"10.1093/ckj/sfae262","DOIUrl":"https://doi.org/10.1093/ckj/sfae262","url":null,"abstract":"","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142262223","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}