Clinical Kidney Journal最新文献

{"title":"Novel therapies improve prognosis of IgAN and limit the applicability of the International IgA Nephropathy Prediction Tool.","authors":"Xue Shen, Pei Chen, Lijun Liu, Sufang Shi, Xujie Zhou, Sean J Barbour, Jicheng Lv, Hong Zhang","doi":"10.1093/ckj/sfaf251","DOIUrl":"10.1093/ckj/sfaf251","url":null,"abstract":"<p><strong>Background: </strong>The International IgA Nephropathy Prediction Tools using clinical variables and the Oxford MEST scores were developed in outdated cohorts. External validation is required to assess the tool's applicability in predicting progression risk for patients on novel therapies.</p><p><strong>Methods: </strong>We included 677 immunoglobulin A nephropathy (IgAN) patients (Peking University First Hospital, 2003-23) treated with endothelin receptor antagonists, Nefecon, sodium-glucose cotransporter 2 inhibitors, hydroxychloroquine or telitacicept, a BAFF/APRIL inhibitor. The primary outcome was defined as a 50% decline in estimated glomerular filtration rate or end-stage kidney disease. Discrimination (C-statistic), calibration [calibration slope, Integrated Calibration Index (ICI)], model fit (R² _D) and risk stratification (Kaplan-Meier curves) were assessed.</p><p><strong>Results: </strong>The median follow-up was 4.8 years (interquartile range 2.2, 8.1), and 190 (28.1%) patients experienced the primary outcome, with a 5-year risk of 9.8%. Compared with the median biopsy year of reported cohorts of original model, our cohort is more contemporary (2017). We validated both original and updated models (and for full model with and without race version). All versions showed adequate discrimination, poor calibration and model fit: C-statistic ∼0.74, calibration slope ∼0.50, R² _D <20%, ICI >0.10, and poor separation of Kaplan-Meier curves, except for the highest-risk group. The tools consistently overestimated risk in patients receiving novel therapies. These findings further demonstrated that novel therapies can improved clinical outcomes for IgAN patients.</p><p><strong>Conclusions: </strong>In this study, both versions of both models demonstrated limited performance and overestimated risks. Given the prognostic improvement with novel IgAN therapies, these prediction tools may need updating for use in currently treated patients.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 9","pages":"sfaf251"},"PeriodicalIF":4.6,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12445651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145112089","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":"Walking autonomy in chronic dialysis patients: insights from a nationwide registry and focus group analysis.","authors":"Marine Naudin, Cécile Couchoud, Mathilde Lassalle, Nicolas Goin, Maud François, Marina Serru, Roxana Virdol, Alexandre Ganea, Delphine Dedenis, Ana Ferreira, Marion Delaporte, Matthias Buchler, Jean-Michel Halimi, Bénédicte Sautenet","doi":"10.1093/ckj/sfaf213","DOIUrl":"10.1093/ckj/sfaf213","url":null,"abstract":"<p><strong>Background: </strong>Patients with chronic kidney disease (CKD) requiring kidney replacement therapy experience a loss in walking autonomy. This study used data from the French Renal Epidemiology and Information Network in Nephrology (REIN) registry and those from the National Health Data System [Système national des Données de Santé (SNDS)] to assess associations between walking inabilities and patient characteristics.</p><p><strong>Methods: </strong>We extracted data on all patients receiving kidney replacement therapy in France as of 31 December 2020. We used logistic regression to evaluate data associated with walking autonomy. We also created four focus groups to explore the perspectives of dialysis patients with respect to walking autonomy, and conducted a thematic analysis of qualitative data.</p><p><strong>Results: </strong>Data were available for 50 629 adults undergoing dialysis. Among the remaining 48 243 patients without missing data, 6834 (14%) were identified as having a walking disability, defined as walking with assistance or being totally unable to walk. Walking disabilities were associated with numerous comorbidities after adjustment for age. Despite their limitations, 2117 (46%) patients requiring assistance and 730 (43%) with total inability to walk had not been reimbursed for a mobility aid through the National Health Data System (SNDS). Thematic analysis identified four major themes from the focus groups: difficulties carrying out daily tasks, impact on social life, impact on connection to the body and psychological impact.</p><p><strong>Conclusion: </strong>Walking disability is strongly associated with patient comorbidities. It impairs quality of life, particularly through psychological and social consequences. Dedicated interventions and improved access to assistive devices are needed to help patients with walking disabilities.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 8","pages":"sfaf213"},"PeriodicalIF":4.6,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12358797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144882347","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 Swedish Renal Registry: a nationwide registry for chronic kidney disease of all stages.","authors":"Anne-Laure Faucon, Helena Rydell, Maria Stendahl, Gunilla Welander, Torbjörn Lundgren, Karl-Göran Prûtz, Staffan Schön, Ursa Bonnevier, Aline Kåveryd Hult, Håkan Hedman, Frida Fondelius, Mårten Segelmark, Marie Evans","doi":"10.1093/ckj/sfaf238","DOIUrl":"10.1093/ckj/sfaf238","url":null,"abstract":"<p><strong>Background: </strong>National registries that capture patients with chronic kidney disease (CKD) across all stages are scarce. We present here the Swedish Renal Registry (SRR), a nationwide prospective register covering the whole spectrum of CKD.</p><p><strong>Methods: </strong>Created in 1991, SRR enrolls CKD patients referred to adult nephrologist care (non-dialysis CKD [ND-CKD], kidney transplantation, maintenance dialysis), with an overall coverage of nearly all nephrology clinics in Sweden. SRR encompasses several interconnected databases in which longitudinal clinical, biological, kidney-related, patient-reported data, as well as provider-level information are collected. This report presents the design of the registry, as well as patients characteristics and temporal trends between 2008 and 2021.</p><p><strong>Results: </strong>A total of 45 590 new ND-CKD patients [72 years, 16 656 (36%) women, eGFR 26 ml/min per 1.73 m²], and 8829 incident kidney transplant recipients (51 years, 35% women) were enrolled in SRR between 2008 and 2021. SRR also included 16 034 new patients [68 years, 5420 (34%) women] on maintenance dialysis [70% hemodialysis (HD), 30% peritoneal dialysis (PD)]. Between 2015 and 2021, 4753 patients [59 years, 1884 (40%) women, eGFR 37 ml/min per 1.73 m²] had a registered kidney biopsy. We observed a decrease in HD incidence (69% to 60%, <i>P</i> for trend <.01) and an increase in PD incidence (26% to 32%, <i>P</i> < .01) and pre-emptive transplantation (4.7% to 7.5%, <i>P</i> < .01). The prevalence of comorbidities is high in all CKD stages and increase as eGFR declines. While nephroangiosclerosis and diabetic kidney disease are the most common etiologies, glomerulonephritis are the most frequent diagnoses in biopsied and transplanted patients.</p><p><strong>Conclusion: </strong>The SRR is a nationwide register which aims to contribute to address gaps in our understanding of CKD, to identify important challenges and health priorities, evaluate real-life clinical management and analyze international variations, improve health outcomes, improve quality of life, and reduce the burden of CKD.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 9","pages":"sfaf238"},"PeriodicalIF":4.6,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12421726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039233","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":"Effect of spironolactone on cardiovascular and renal outcomes in patients with chronic kidney disease.","authors":"Tz-Heng Chen, Shuo-Ming Ou, Kuan-Hsun Lin, Yang Ho, Wei-Cheng Tseng, Yuan-Chia Chu, Der-Cherng Tarng","doi":"10.1093/ckj/sfaf247","DOIUrl":"10.1093/ckj/sfaf247","url":null,"abstract":"<p><strong>Background: </strong>Steroidal mineralocorticoid receptor antagonists (MRAs), including spironolactone, effectively treat resistant hypertension, reduce proteinuria and lower mortality in heart failure with reduced ejection fraction. However, their long-term effects in chronic kidney disease (CKD) remain unclear. This study investigated spironolactone's impact on end-stage renal disease (ESRD), major adverse cardiovascular events (MACE), hyperkalemia and mortality in CKD patients.</p><p><strong>Methods: </strong>This retrospective hospital-based cohort study enrolled patients with CKD stage 3-5 between 1 January 2011 and 30 June 2023. The patients were classified as spironolactone users or nonusers, with each user matched to two nonusers by propensity scores. The outcomes of interest included ESRD, MACE, all-cause mortality and severe hyperkalemia. MACE include nonfatal stroke, nonfatal myocardial infarction and cardiovascular death.</p><p><strong>Results: </strong>After propensity score matching, 2711 spironolactone users and 5422 nonusers were included in this analysis. Spironolactone users exhibited higher risks of all-cause mortality [adjusted hazard ratio (aHR) 1.23; 95% confidence interval (CI) 1.11-1.37] and severe hyperkalemia (aHR 1.44; 95% CI 1.24-1.68) than nonusers. However, there was a lower risk of MACE (aHR 0.90; 95% CI 0.82-0.99), primarily due to a significant reduction in stroke risk (aHR 0.79; 95% CI 0.71-0.88). The risk of ESRD was similar between the two groups (aHR 1.09; 95% CI 0.85-1.38).</p><p><strong>Conclusions: </strong>In patients with CKD, spironolactone use was associated with a decreased risk of stroke but increased risks of severe hyperkalemia and all-cause mortality, while the risk of ESRD remained unchanged. Individualized clinical decision-making and appropriate dose adjustment are important to balance the potential benefits and risks associated with spironolactone therapy.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 9","pages":"sfaf247"},"PeriodicalIF":4.6,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12409270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145013988","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":"Living and deceased donor kidney transplant rates across Europe: ERA Registry Figure of the month.","authors":"Vianda S Stel, Alberto Ortiz, Anneke Kramer","doi":"10.1093/ckj/sfaf236","DOIUrl":"https://doi.org/10.1093/ckj/sfaf236","url":null,"abstract":"","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 7","pages":"sfaf236"},"PeriodicalIF":4.6,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12341905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144834343","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":"Citrate and calcium kidney stones.","authors":"Alireza Zomorodian, Orson W Moe","doi":"10.1093/ckj/sfaf244","DOIUrl":"10.1093/ckj/sfaf244","url":null,"abstract":"<p><p>Citrate, a tricarboxylic acid cycle intermediate, plays a central role in renal physiology by acting as both a urinary base equivalent and a potent inhibitor of calcium stone formation. Hypocitraturia, a common metabolic abnormality in calcium nephrolithiasis, is not a binary disorder but a continuum shaped by acid-base status, diet, potassium balance, proximal tubular handling, and systemic citrate status. We provide an update on the biology of citrate, renal regulation of its excretion, clinical pathophysiology, and treatment of hypocitraturia. Identical urinary citrate levels may have different implications depending on systemic acid-base status and urinary calcium excretion. Hypocitraturia prevalence is increasing, paralleling rises in metabolic syndrome, obesity, and dietary habit changes. Experimental models confirm that systemic or intracellular acidosis, potassium deficiency, and upregulation of renal transport and metabolism of citrate reduce urinary citrate, enhancing stone risk. Potassium citrate remains the cornerstone of therapy, increasing both urinary citrate and pH. However, its use requires caution in calcium phosphate stone formers and patients with chronic kidney disease. Citrate resistance, defined as inadequate urinary citrate response despite good potassium delivery, is a therapeutic challenge. Novel interventions including sodium-dicarboxylate cotransporter-1 (NaDC-1) inhibitors and citrate analogs such as hydroxycitrate may offer future alternatives. In conclusion, urinary citrate must be interpreted within physiological and clinical contexts. Recognizing hypocitraturia as a modifiable, non-binary risk factor allows for more precise risk stratification and individualized therapy in stone prevention, particularly when lithogenicity overlaps with acid-base and renal abnormalities.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 9","pages":"sfaf244"},"PeriodicalIF":4.6,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12445640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145112127","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":"Management and treatment of chronic kidney disease in the Danish Lolland-Falster Health Study: focus on renoprotection and cardiovascular disease prevention.","authors":"Ebba Mannheimer, Morten Buus Jørgensen, Kristine Hommel, Anne-Lise Kamper, Randi Jepsen, Bo Feldt-Rasmussen, Mads Hornum","doi":"10.1093/ckj/sfaf242","DOIUrl":"10.1093/ckj/sfaf242","url":null,"abstract":"<p><strong>Background: </strong>In the Danish population-based Lolland-Falster Health Study (LOFUS), we recently identified a chronic kidney disease (CKD) prevalence of 18%. Importantly, overall disease recognition was only 7.1%, and awareness was as low as 4.4%. This reveals a significant gap in identifying CKD, consequently delaying initiation of guideline-directed renoprotective treatments, cardiovascular disease prevention, and referrals to specialized nephrology care.</p><p><strong>Methods: </strong>Cross-sectional study including adult participants with CKD identified in LOFUS. Data were obtained from biochemical analyses, clinical examinations, and questionnaires. Redeemed prescriptions and nephrology referrals were assessed using national medical registers. Blood pressure control, treatment with renin-angiotensin-system inhibitors and statins, as well as lifestyle factors were examined, and their association with CKD stage analyzed.</p><p><strong>Results: </strong>Among 2881 individuals with CKD, 57.6% were women, median age was 67.8 years, 71.3% were in CKD stages 1-2 and 21% had cardiovascular disease. Less than half of individuals had blood pressure control (47.5%). Treatment with renin-angiotensin-system inhibitors and statins, when indicated, were 72.8% and 32.2%, respectively, and more frequent in individuals with diabetes. In multivariable analyses, the odds ratios for blood pressure control (1.68; 95% CI,1.12-2.52), treatment with renin-angiotensin-system inhibitors (7.91; 95% CI,2.14-29.18), and statins (1.77; 95% CI,1.06-2.96) were significantly higher in stages 3b-5 compared to stage 1. Less than one-third had a BMI <25 kg/m² and >80% self-reported non-smoking. Of those meeting nephrology referral criteria (<i>n </i>= 99), one-third had been referred.</p><p><strong>Conclusion: </strong>Our findings highlight gaps between guideline-recommended CKD management and practice, particularly in early stages and in non-diabetic individuals, emphasizing the need for early detection and improved guideline adherence.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 9","pages":"sfaf242"},"PeriodicalIF":4.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12399973/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991763","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":"Detection of haematuria and proteinuria reflects injury to significantly different glomerular surface areas: a quantitative hypothesis.","authors":"Osamu Uemura","doi":"10.1093/ckj/sfaf245","DOIUrl":"10.1093/ckj/sfaf245","url":null,"abstract":"","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 8","pages":"sfaf245"},"PeriodicalIF":4.6,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12375914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945148","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":"CRISPR and gene editing for kidney diseases: where are we?","authors":"Viola D'Ambrosio, Chen Huimei, Nicole Vo, Keith Siew, Rhys D R Evans, Benjamin Freedman, Francesco Pesce","doi":"10.1093/ckj/sfaf246","DOIUrl":"10.1093/ckj/sfaf246","url":null,"abstract":"<p><p>Genome editing technologies, particularly clustered regularly interspaced short palindromic repeats (CRISPR)-Cas9, have transformed biomedical research by enabling precise genetic modifications. Due to its efficiency, cost-effectiveness and versatility, CRISPR has been widely applied across various stages of research, from fundamental biological investigations in preclinical models to potential therapeutic interventions. In nephrology, CRISPR represents a groundbreaking tool for elucidating the molecular mechanisms underlying kidney diseases and developing innovative therapeutic approaches. This review synthesizes the latest advancements in CRISPR-based gene editing within nephrology, highlighting its applications in genetic kidney disorders, polygenic nephropathies and functional genomic studies. Preclinical studies utilizing CRISPR-engineered kidney organoids and animal models have provided crucial insights into disease pathophysiology, offering platforms for drug discovery and precision medicine. Additionally, CRISPR-based functional screens have identified novel disease-associated pathways, particularly in diabetic nephropathy and glomerular disorders. Beyond experimental research, the therapeutic potential of CRISPR in nephrology is emerging, with recent advances in base editing and prime editing demonstrating the feasibility of correcting pathogenic mutations in conditions such as Alport syndrome and autosomal dominant polycystic kidney disease. Moreover, CRISPR plays a pivotal role in xenotransplantation, with gene-edited porcine kidneys addressing key immunological and virological barriers. Despite its promise, clinical translation faces challenges, including delivery efficiency, off-target effects and ethical considerations. This review provides an overview of the current state and future directions of CRISPR-based gene editing in nephrology, underscoring its transformative potential in advancing kidney disease research and therapeutics.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 9","pages":"sfaf246"},"PeriodicalIF":4.6,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12415518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029085","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 impact of hemoadsorption in patients with chronic kidney disease undergoing coronary artery bypass grafting.","authors":"Erdal Simsek, Serdar Gunaydin","doi":"10.1093/ckj/sfaf241","DOIUrl":"10.1093/ckj/sfaf241","url":null,"abstract":"<p><strong>Background: </strong>With an annual incidence of up to 30%, cardiac surgery-associated acute kidney injury (CSA-AKI) may be one of the most underestimated yet common complications, hence reno-protective interventions are critical. We evaluated the impact of hemoadsorption (HA) on clinical outcomes in KDIGO (Kidney Disease: Improving Global Outcomes) G2/A2 patients (GFR 60-89 ml/min/1.73 m² and 30-300 mg/g albuminuria) undergoing coronary artery bypass grafting (CABG).</p><p><strong>Method: </strong>Forty patients with chronic kidney disease (KDIGO G2/A2) were treated with intraoperative HA therapy during CABG surgery (HA group) and were compared with 40 propensity-score matched control CABG patients without intraoperative HA (control group). Primary endpoints were the need for renal replacement therapy (RRT) and/or worsening of the KDIGO stage during the perioperative period. Secondary endpoints included changes in inflammatory biomarkers, vasopressor use, and ICU/hospital stay.</p><p><strong>Results: </strong>No significant differences were observed in demographics between groups. Worsened KDIGO stages were more frequent in the control group (<i>P</i> = .04), and the HA group had less RRT use and shorter ICU stays (<i>P</i> = .02 and <i>P</i> = .03). On the first postoperative day, levels of serum creatinine (1.85 ± 0.6 vs 2.75 ± 0.6 mg/dl; <i>P</i> = .035), myoglobin (210±75 vs 310 ± 80 μg/l; <i>P</i> = .04), NT-proBNP (130 ± 30 vs 180 ± 40 pg/ml; <i>P</i> = .04), IL-6 (8.2±4 vs 22.2 ± 4 pg/ml; <i>P</i> = .012), procalcitonin (1.4 ± 0.1 vs 1.76 ± 0.2 μg/l, <i>P</i> = .02), C-reactive protein (7.6 ± 2 vs 14.2 ± 4 mg/l, <i>P</i> = .01), and D-dimer (0.76 ± 0.04 vs 2.2 ± 0.07 mg/l, <i>P</i> = .002) were significantly lower in the HA group.</p><p><strong>Conclusion: </strong>This pioneering study highlights the potential benefits of HA in mitigating kidney function and inflammation in CABG patients with borderline chronic kidney disease. These findings require validation in large, multicenter trials.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 9","pages":"sfaf241"},"PeriodicalIF":4.6,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12404029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144991772","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}