Clinical Kidney Journal最新文献

{"title":"The association of vascular access flow with sacubitril/valsartan and left ventricular ejection fraction in hemodialysis patients with heart failure with reduced ejection fraction.","authors":"Fan-Yu Chen, Ann Charis Tan, Chyong-Mei Chen, Chih-Yu Yang, Kuo-Hua Lee, Shuo-Ming Ou, Ming-Tsun Tsai, Szu-Yuan Li, Tong-Jia Lin, Zih-Kai Kao, Chin-Te Tseng, Ya-Han Fu, Chih-Ching Lin","doi":"10.1093/ckj/sfaf078","DOIUrl":"https://doi.org/10.1093/ckj/sfaf078","url":null,"abstract":"<p><strong>Background: </strong>Sacubitril/valsartan improves heart function in maintenance hemodialysis (HD) patients with heart failure with a reduced ejection fraction of <40% (HFrEF). However, the effect of sacubitril/valsartan on vascular access flow (Qa) in this population is still unclear.</p><p><strong>Methods: </strong>Hemodialysis patients with HFrEF were enrolled and divided into sacubitril/valsartan and non-sacubitril/valsartan treatment groups and received echocardiographic and Qa measurements at baseline and after 12 months. We compared the changes in Qa (△Qa) and echocardiographic parameters after 12 months. Correlations between △Qa and echocardiographic parameters were also examined. Multiple linear regression analysis was performed to predict △Qa.</p><p><strong>Results: </strong>Thirty-three HD patients with HFrEF were enrolled. Sixteen patients received sacubitril/valsartan treatment. Their mean Qa significantly increased from 633.8 to 948.8 mL/min (<i>P </i>< .001). There was no significant change in Qa for the non-sacubitril/valsartan treatment group (from 637.7 to 621.8 mL/min; <i>P </i>= .436). The change in left ventricular ejection fraction (△LVEF) differed significantly between the sacubitril/valsartan and conventional treatment groups (13.63 ± 11.35% and 1.59 ± 6.99%, respectively; <i>P </i>= .001). The △Qa was significantly correlated with △LVEF (<i>r</i> _s = 0.929; <i>P </i>< .001) and with the change in interventricular septum thickness in diastole (△IVSd, <i>r</i> _s = -0.736; <i>P </i>= .001) in the sacubitril/valsartan group. The △Qa was predicted as -44.034 + 15.868 × △LVEF-25.072 × △IVSd + 145.964 × <i>A</i> (<i>A</i> = 1 for sacubitril/valsartan use and <i>A</i> = 0 for non-sacubitril/valsartan treatment) mL/min (<i>R</i> ²= 0.909).</p><p><strong>Conclusion: </strong>In HD patients with HFrEF, treatment with sacubitril/valsartan is associated with improvement in LVEF and Qa over 12 months.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 4","pages":"sfaf078"},"PeriodicalIF":3.9,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11986818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971784","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":"Quality of life and kidney function in CKD patients: a longitudinal study.","authors":"Graziella D'Arrigo, Carmela Marino, Patrizia Pizzini, Graziella Caridi, Francesco Marino, Giovanna Parlongo, Annalisa Pitino, Mercedes Gori, Giovanni Tripepi, Francesca Mallamaci, Carmine Zoccali","doi":"10.1093/ckj/sfae429","DOIUrl":"https://doi.org/10.1093/ckj/sfae429","url":null,"abstract":"<p><strong>Background: </strong>In chronic kidney disease (CKD), a declining glomerular filtration rate (GFR) leads to physiological and psychosocial burdens that impair quality of life (QoL). However, this relationship has been mainly investigated in cross-sectional studies and a limited number of longitudinal studies that reported contrasting results.</p><p><strong>Objective and methods: </strong>This longitudinal study included 582 patients with Stages 2-5 CKD. QoL was assessed using the Kidney Disease Quality of Life (KDQOL™) instrument at baseline and annually for 3 years. GFR was estimated using the MDRD equation, the equation recommended by guidelines that were contemporary to the study cohort. We analysed the relationship between repeated measures of QoL and GFR using unadjusted and adjusted mixed linear models (MLMs).</p><p><strong>Results: </strong>The cohort had a mean age of 61 ± 12 years, with 60% males and 33% diabetics. Baseline eGFR was 36±13 ml/min/1.73 m². Physical and mental component summary scores of QoL were 43.5 and 45.1, respectively. In MLM analyses adjusted for potential confounders, a 10 ml/min/1.73 m² decrease in eGFR was significantly associated with reductions in physical (<i>β </i>=<i> </i>-0.60, <i>P </i>= .016) and mental (<i>β </i>=<i> </i>-0.52, <i>P </i>= .045) component summary scores over the follow-up period. The physical functioning and role limitation physical health subcomponents of QoL were primarily responsible for these associations.</p><p><strong>Conclusions: </strong>This longitudinal study shows that declining kidney function is associated with deteriorating QoL in CKD patients independently of other factors. These findings support the current KDIGO recommendation that regular monitoring of QoL should be incorporated into clinical practice to improve patient outcomes.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 4","pages":"sfae429"},"PeriodicalIF":3.9,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11976526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143955649","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 Trends in kidney transplantation rate across countries.","authors":"Vianda S Stel, Alberto Ortiz, Anneke Kramer","doi":"10.1093/ckj/sfaf055","DOIUrl":"https://doi.org/10.1093/ckj/sfaf055","url":null,"abstract":"","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 3","pages":"sfaf055"},"PeriodicalIF":3.9,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11928784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691291","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":"Newer B-cell and plasma-cell targeted treatments for rituximab-resistant patients with membranous nephropathy.","authors":"Marc Buse, Evangelia Dounousi, Rafael Kramann, Jürgen Floege, Eleni Stamellou","doi":"10.1093/ckj/sfaf088","DOIUrl":"https://doi.org/10.1093/ckj/sfaf088","url":null,"abstract":"<p><p>Membranous nephropathy is the most common cause of nephrotic syndrome in adults. While spontaneous remission occurs in approximately one-third of cases, another one-third of patients receiving immunosuppressive therapy demonstrate treatment resistance. This resistance, coupled with persistent proteinuria, significantly increases the risk of kidney failure. Alternative therapies, including B-cell and plasma-cell targeted treatments have been explored in isolated cases and case series. In this review, we examine the available evidence on the treatment of resistant and relapsing membranous nephropathy with a particular focus on B- and plasma-cell directed therapies.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 5","pages":"sfaf088"},"PeriodicalIF":3.9,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970056","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":"Prophylactic proton pump inhibitor usage and new-onset acute kidney injury in critically ill patients: a retrospective analysis.","authors":"Jing Xu, Zhoucang Zhang, Yujing Pan, Xue Li, Jiaxiang Ding, Mei Wang","doi":"10.1093/ckj/sfaf037","DOIUrl":"10.1093/ckj/sfaf037","url":null,"abstract":"<p><strong>Background: </strong>Proton pump inhibitors (PPIs) are widely prescribed for stress ulcer prophylaxis (SUP) in intensive care unit (ICU) patients. However, the potential association between prophylactic PPIs and the development of new-onset acute kidney injury (AKI) remains unclear.</p><p><strong>Methods: </strong>Patients without AKI or end-stage renal disease and not undergoing renal replacement therapy upon admission to the ICU were identified from the Medical Information Mart for Intensive Care (MIMIC-IV) database. The exposure factor for the study was the initiation of prophylactic PPIs within 48 h of admission, with the primary outcome being the occurrence of new-onset AKI after 48 h. Multivariable regression models were employed to investigate the association between prophylactic PPIs and the risk of new-onset AKI. Various propensity score analyses, along with stratified and subgroup analyses and E-value calculations, were conducted to further evaluate the reliability of the results.</p><p><strong>Results: </strong>A total of 7498 ICU patients were analyzed. The multivariable analysis showed a higher incidence of new-onset AKI in the PPI group (30.7%) compared with the control group (24.1%), yielding an adjusted odds ratio (OR) of 1.43 (95% confidence interval 1.22-1.67). Propensity score analyses confirmed these results, with ORs ranging from 1.34 to 1.49 (<i>P</i> ≤ .005). Results from multiple sensitivity analyses further supported these findings, with an E-value of 2.34 indicating robustness against unmeasured confounders.</p><p><strong>Conclusions: </strong>Prophylactic PPI use is associated with an increased risk of new-onset AKI in ICU patients. Indiscriminate use of PPIs should be avoided.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 3","pages":"sfaf037"},"PeriodicalIF":3.9,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11932333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699516","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":"Cancer risks in people on dialysis and kidney transplant recipients: a Catalan cohort study, 2003-21.","authors":"Laia Oliveras, Laura Pareja, Josepa Ribes, Jordi Comas, Carlos Couceiro, Àlex Favà, Sergi Codina, Ana Coloma, Anna Manonelles, Nuria Lloberas, Edoardo Melilli, Elisenda Martinez-Carbonell, Jordi Gálvez, Sonia Mosteiro, Jaume Tort, Josep M Borràs, Josep M Cruzado, Nuria Montero","doi":"10.1093/ckj/sfaf077","DOIUrl":"https://doi.org/10.1093/ckj/sfaf077","url":null,"abstract":"<p><strong>Background: </strong>People with kidney failure have a higher risk of cancer compared with age- and sex-matched individuals in the general population, yet data from southern Europe are limited. This study explores cancer incidence in the kidney failure population in Catalonia.</p><p><strong>Methods: </strong>We identified cancer cases through linkage of the Catalan Kidney Registry with Catalan cancer databases. Standardized incidence ratios (SIRs) were calculated for all-site and site-specific cancers in people on dialysis and kidney transplant recipients.</p><p><strong>Results: </strong>We described the epidemiology of cancer in 21 595 people on dialysis and 8037 kidney transplant recipients in Catalonia (2003-21). Cancer risk was more than two times higher in people on dialysis (SIR 2.11, 95% CI 2.02-2.19) and nearly four times higher in kidney transplant recipients (SIR 3.82, 95% CI 3.65-3.99) compared with the general population. Risks varied by cancer site, with a significantly higher incidence of kidney and thyroid cancers in the dialysis cohort, and skin cancer in the transplant cohort. The highest cancer risks were observed in the youngest, those with glomerular diseases, and those with the longest time since transplantation.</p><p><strong>Conclusions: </strong>People with kidney failure face a high burden of cancer, particularly after kidney transplantation. Understanding the epidemiology of cancer in the kidney failure population is crucial for shaping health policies.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 4","pages":"sfaf077"},"PeriodicalIF":3.9,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11986820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981380","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":"Subcutaneous ofatumumab in recurrent focal segmental glomerulosclerosis after kidney transplantation.","authors":"Shirley Pollack, Moran Plonsky-Toder, Rami Tibi, Irina Libinson-Zebegret, Renata Yakobov, Daniella Magen","doi":"10.1093/ckj/sfaf083","DOIUrl":"https://doi.org/10.1093/ckj/sfaf083","url":null,"abstract":"<p><strong>Background: </strong>Recurrent focal segmental glomerulosclerosis (rFSGS) is a severe condition occurring after kidney transplantation (KT) and has a high graft loss rate. Its incidence is reported as up to 55% of KTs, typically diagnosed within 1.5 months post-transplant. Treatment typically involves plasmapheresis, with adjunctive rituximab therapy, achieving partial or complete remission in up to 57% of patients. We report the case of a paediatric patient who experienced two episodes of rFSGS post-KT, presenting with acute kidney injury (AKI). The second episode was treated with subcutaneous ofatumumab with complete remission.</p><p><strong>Methods: </strong>The treatment protocol included four weekly plasmapheresis treatments, with Kesimpta administered subcutaneously at a dose of 20 mg twice weekly, given at the end of the plasmapheresis session. Plasmapheresis was then discontinued for 48-72 h following Kesimpta administration. CD20 levels were followed.</p><p><strong>Results: </strong>A KT patient experienced a second rFSGS, presenting with massive proteinuria of 13 g/day, 3 years post-transplant. Due to severe allergic reaction to rituximab during the first recurrence, she was treated with a combination of plasmapheresis and Kesimpta during the second episode. CD20 levels were undetected within two doses of Kesimpta treatment. Full remission and AKI resolved 1 month after initiation of this treatment. There were no severe adverse effects of the combined protocol.</p><p><strong>Conclusions: </strong>We propose a combination treatment of subcutaneous ofatumumab and intensive plasmapheresis, with CD19 and CD20 levels monitored regularly, might be safe and effective in rFSGS in KT patients.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 4","pages":"sfaf083"},"PeriodicalIF":3.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11982811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988951","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":"Cardiometabolic protein expression levels and pathways associated with kidney function decline in older European adults with advanced kidney disease.","authors":"Ryan E Aylward, Samantha Hayward, Nicholas C Chesnaye, Roemer J Janse, P Andreas Jonsson, Claudia Torino, Antonio Demetrio, Maciej Szymczak, Christiane Drechsler, Friedo W Dekker, Marie Evans, Kitty J Jager, Christoph Wanner, Brian Rayner, Yoav Ben-Shlomo, Nicki Tiffin, Fergus J Caskey, Kate Birnie","doi":"10.1093/ckj/sfaf079","DOIUrl":"https://doi.org/10.1093/ckj/sfaf079","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular disease and chronic kidney disease (CKD) progression pathophysiology are similar. We investigated associations of cardiometabolic protein expression and pathways with kidney function decline in older adults with advanced CKD referred for nephrology assessment.</p><p><strong>Methods: </strong>Two plasma proteomic panels analysed at baseline (Olink^® cardiometabolic T96 and cardiovascular II T96, Uppsala, Sweden) and longitudinal estimated glomerular filtration rate (eGFR) data from European adults aged >65 years with a single eGFR of <20 mL/min/1.73 m² [European Quality (EQUAL) Study] were used to explore mechanisms of CKD progression. Protein-slope associations were estimated using generalized linear mixed-effects models and with a false-discovery rate <i>P</i> < .05 taken to validation to verify the effect size of the association. Proteins were further modularized into biological pathways using pathway enrichment analysis.</p><p><strong>Results: </strong>A discovery sub-cohort of 238 complete-case participants from Germany, the UK and Poland (median age 76 years, 41% female sex, median baseline eGFR 17.8 mL/min/1.73 m²) were included and 246 participants from Sweden formed the validation sub-cohort (median age 75 years, 28% female, median baseline eGFR 17.5 mL/min/1.73 m²). Of the 175 analysed proteins, higher expression levels of Receptor-type tyrosine-protein phosphatase S [-15.4% change in eGFR per year per doubling of protein expression; 95% confidence interval (CI) -23.5%, -7.6%], Insulin-like growth factor binding protein 6 (-7.9%; 95% CI -12.3%, -3.5%) and Ficolin 2 (-7.4%; 95% CI -12.0%, -2.8%) showed a validated association with eGFR decline.</p><p><strong>Conclusions: </strong>Higher expression levels of proteins and biological pathways involving fibrogenesis and the complement cascade were found to be associated with kidney function loss. However, study limitations and unavailability of concurrent kidney cellular proteomic signatures necessitate further study.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 4","pages":"sfaf079"},"PeriodicalIF":3.9,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968341","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":"Long-term evaluation of the timing of corticosteroid therapy in an IgA nephropathy cohort.","authors":"Wanyin Hou, Haiyan Yang, Pei Chen, Chen Tang, Xujie Zhou, Lijun Liu, Li Zhu, Sufang Shi, Jicheng Lv, Hong Zhang","doi":"10.1093/ckj/sfaf076","DOIUrl":"https://doi.org/10.1093/ckj/sfaf076","url":null,"abstract":"<p><strong>Background: </strong>Current proposed KDIGO guidelines suggest systemic corticosteroid therapy to reduce glomerular inflammation in immunoglobulin A nephropathy (IgAN), however the optimal timing for initiating steroid treatment remains a topic of debate. This study evaluates the impact of early versus delayed steroid initiation on long-term outcomes in IgAN patients.</p><p><strong>Methods: </strong>We conducted a retrospective study of 268 IgAN patients treated with corticosteroids for >3 months within 3 years of kidney biopsy. Patients were categorized into early therapy (steroids within 30 days) and delayed therapy (after 30 days). Propensity score matching created matched cohorts. Kaplan-Meier curves and Cox regression assessed outcomes. The primary endpoint was a composite renal outcome [estimated glomerular filtration rate (eGFR) >50% reduction, end-stage kidney disease or renal death]. Secondary endpoints included eGFR decline >30% or >40% and an eGFR slope and time-average proteinuria.</p><p><strong>Results: </strong>Propensity score matching identified 191 individuals for analysis. The primary outcome was significantly better in the early therapy group, with a hazard ratio (HR) of 0.41 [95% confidence interval (CI) 0.17-0.96, <i>P</i> = .041]. Significant benefits were also observed for secondary outcomes, including a lower frequency of >30% and >40% eGFR decline in the early therapy group, with HRs of 0.48 (95% CI 0.24-0.98, <i>P</i> = .04) and 0.34 (95% CI 0.14-0.81, <i>P</i> = .01), respectively. Cox regression confirmed that the timing of steroid initiation (early vs delayed) was a significant factor associated with kidney progression [HR = 0.33 (95% CI 0.14-0.77), <i>P</i> = .01]. The average eGFR slope over 10 years was more favorable in the early therapy group (-1.0 ± 6.0 vs -2.9 ± 6.8 mL/min/1.73 m² per year, <i>P</i> = .039). No significant differences in baseline characteristics were found to influence the timing of steroid use in progressive IgAN.</p><p><strong>Conclusions: </strong>Early corticosteroid therapy may help reduce renal decline and preserve long-term kidney function in IgAN patients requiring steroid treatment.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 5","pages":"sfaf076"},"PeriodicalIF":3.9,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12044332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967978","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":"From bytes to bites: application of large language models to enhance nutritional recommendations.","authors":"Karin Bergling, Lin-Chun Wang, Oshini Shivakumar, Andrea Nandorine Ban, Linda W Moore, Nancy Ginsberg, Jeroen Kooman, Neill Duncan, Peter Kotanko, Hanjie Zhang","doi":"10.1093/ckj/sfaf082","DOIUrl":"https://doi.org/10.1093/ckj/sfaf082","url":null,"abstract":"<p><p>Large language models (LLMs) such as ChatGPT are increasingly positioned to be integrated into various aspects of daily life, with promising applications in healthcare, including personalized nutritional guidance for patients with chronic kidney disease (CKD). However, for LLM-powered nutrition support tools to reach their full potential, active collaboration of healthcare professionals, patients, caregivers and LLM experts is crucial. We conducted a comprehensive review of the literature on the use of LLMs as tools to enhance nutrition recommendations for patients with CKD, curated by our expertise in the field. Additionally, we considered relevant findings from adjacent fields, including diabetes and obesity management. Currently, the application of LLMs for CKD-specific nutrition support remains limited and has room for improvement. Although LLMs can generate recipe ideas, their nutritional analyses often underestimate critical food components such as electrolytes and calories. Anticipated advancements in LLMs and other generative artificial intelligence (AI) technologies are expected to enhance these capabilities, potentially enabling accurate nutritional analysis, the generation of visual aids for cooking and identification of kidney-healthy options in restaurants. While LLM-based nutritional support for patients with CKD is still in its early stages, rapid advancements are expected in the near future. Engagement from the CKD community, including healthcare professionals, patients and caregivers, will be essential to harness AI-driven improvements in nutritional care with a balanced perspective that is both critical and optimistic.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 4","pages":"sfaf082"},"PeriodicalIF":3.9,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11992566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977453","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}