Clinical Kidney Journal最新文献

{"title":"The Association of Sleep Duration with the Risk of Chronic Kidney Disease: a Systematic Review and Meta-Analysis","authors":"Jin Hean Koh, Brian Sheng Yep Yeo, Timothy Wei En Tan, Mark Yong Siang See, Adele Chin Wei Ng, Shaun Ray Han Loh, Joshua Gooley, Chieh Suai Tan, Song Tar Toh","doi":"10.1093/ckj/sfae177","DOIUrl":"https://doi.org/10.1093/ckj/sfae177","url":null,"abstract":"Background and hypothesis Published literature suggests that sleep duration and quality may be affected in adults with chronic kidney disease. However, the relationship between these two entities remains a matter of debate. The objective of this systematic review and meta-analysis is to assess the effect of sleep duration and quality on chronic kidney disease. Methods A systematic review of the Medline/PubMed, Embase, Cochrane Library and CINAHL databases was conducted for articles pertaining to the association between sleep duration and quality on chronic kidney disease. The main outcome was the hazard/risk ratio of chronic kidney disease in patients of varying sleep durations and quality. Results 42 studies (2 613 971 patients) with a mean age of 43.55 ± 14.01 years were included in the meta-analysis. Compared with a reference range of 7 to 8 hours of sleep, short sleep duration of ≤ 4 hours (RR 1.41, 95% CI: 1.16 to 1.71, p < 0.01), ≤5 hours (RR 1.46, 95% CI: 1.22 to 1.76, p < 0.01), ≤6 hours (RR 1.18, 95% CI: 1.09 to 1.29, p < 0.01) and ≤ 7 hours (RR 1.19, 95% CI: 1.12 to 1.28, p < 0.01) were significantly associated with an increased risk of incident chronic kidney disease. Long sleep duration of ≥ 8 hours (RR 1.15, 95% CI: 1.03 to 1.28, p < 0.01) and ≥ 9 hours (RR 1.46, 95% CI: 1.28 to 1.68, p < 0.01) were also significantly associated with an increased risk of incident chronic kidney disease. Meta-regression did not find any significant effect of age, gender, geographical region and BMI and the association of sleep duration and risk of incident chronic kidney disease. Conclusion Both short and long sleep duration were significantly associated with a higher risk of chronic kidney disease. Interventions targeted towards achieving an optimal duration of sleep may reduce the risk of incident chronic kidney disease.","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141609458","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":"Transfers from home to facility-based dialysis: comparisons of HHD, assisted PD and autonomous PD.","authors":"Antoine Lanot, Clémence Bechade, Cécile Couchoud, Mathilde Lassalle, François Chantrel, Ayman Sarraj, Maxence Ficheux, Annabel Boyer, Thierry Lobbedez","doi":"10.1093/ckj/sfae094","DOIUrl":"10.1093/ckj/sfae094","url":null,"abstract":"<p><strong>Background: </strong>Home dialysis therapies such as peritoneal dialysis (PD) and home hemodialysis (HHD) are beneficial for quality of life and patient empowerment. The short technique survival time partly explains their low prevalence. We aimed to assess the risk of transfer to facility-based hemodialysis in patients treated with autonomous PD, assisted PD and HHD.</p><p><strong>Methods: </strong>This was a retrospective study using data from the REIN registry of patients starting home dialysis in France from 2002 to 2019. The risks of transfer to facility-based hemodialysis (HD) were compared between three modalities of home dialysis (HHD, nurse-assisted PD, autonomous PD) using survival models with a propensity score (PS)-matched and unmatched cohort of patients.</p><p><strong>Results: </strong>The study included 17 909 patients: 628 in the HHD group, 10 214 in the autonomous PD group, and 7067 in the assisted PD group. During the follow-up period, there were 5347 transfers to facility-based HD. The observed number of transfers was 2458 (13.7%) at 1 year and 5069 (28.3) at 5 years after the start of home dialysis, including 3272 (32%) on autonomous PD, 1648 (23.3%) on assisted PD, and 149 (23.7) on HHD. Owing to clinical characteristics differences, only 38% of HHD patients could be matched to patients from the others group. In the PS-matched cohort, the adjusted Cox model showed no difference in the risk of transfer for assisted PD (cs-HR 1.04, 95% CI 0.75-1.44) or HHD (cs-HR 1.07, 95% CI 0.77-1.48) compared with autonomous PD.</p><p><strong>Conclusions: </strong>Unlike results from other countries, where nurse assistance is not fully available for PD-associated care, there was no difference in technique survival between autonomous PD, nurse-assisted PD, and HHD in France. This discrepancy may be attributed to our inclusion of a broader spectrum of patients who derive significant benefits from assisted PD.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11270015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141757531","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":"Pathogenic heterozygous TRPM7 variants and hypomagnesemia with developmental delay","authors":"Willem Bosman, Kameryn M Butler, Caitlin A Chang, Mythily Ganapathi, Edwin Guzman, Femke Latta, Wendy K Chung, Felix Claverie-Martin, Jessica M Davis, Joost G J Hoenderop, Jeroen H F de Baaij","doi":"10.1093/ckj/sfae211","DOIUrl":"https://doi.org/10.1093/ckj/sfae211","url":null,"abstract":"Background Heterozygous variants in TRPM7, encoding an essential and ubiquitously expressed cation channel, may cause hypomagnesemia, but current evidence is insufficient to draw definite conclusions and it is unclear whether any other phenotypes can occur. Methods Individuals with unexplained hypomagnesemia underwent whole exome sequencing which identified TRPM7 variants. Pathogenicity of the identified variants was assessed by combining phenotypic, functional and in silico analyses. Results We report three new heterozygous missense variants in TRPM7 (p.Met1000Thr, p.Gly1046Arg, p.Leu1081Arg) in individuals with hypomagnesemia. Strikingly, autism spectrum disorder and developmental delay, mainly affecting speech and motor skills, was observed in all three individuals, while two out of three also presented with seizures. The three variants are predicted to be severely damaging by in silico prediction tools and structural modeling. Furthermore, these variants result in a clear loss-of-function of TRPM7-mediated magnesium uptake in vitro, while not affecting TRPM7 expression or insertion into the plasma membrane. Conclusions This study provides additional evidence for the association between heterozygous TRPM7 variants and hypomagnesemia and adds developmental delay to the phenotypic spectrum of TRPM7-related disorders. Considering the TRPM7 gene is relatively tolerant to loss-of-function variants, future research should aim to unravel by which mechanisms specific heterozygous TRPM7 variants can cause disease.","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141575491","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":"Hypoaldosteronism due to a novel SEC61A1 variant successfully treated with fludrocortisone","authors":"Diana Karpman, Martin L Lindström, Mattias Möller, Sofie Ivarsson, Ann-Charlotte Kristoffersson, Zivile Bekassy, Agnes B Fogo, Maria Elfving","doi":"10.1093/ckj/sfae213","DOIUrl":"https://doi.org/10.1093/ckj/sfae213","url":null,"abstract":"Genetic variants in SEC61A1 are associated with autosomal dominant tubulointerstitial kidney disease. SEC61A1 is a translocon in the endoplasmic reticulum membrane and variants affect biosynthesis of renin and uromodulin. We describe a patient with a novel de novo heterozygous SEC61A1 variant, Phe458Val, detected by whole genome sequencing. The patient presented at 1 year of age with failure-to-thrive, kidney failure (glomerular filtration rate, GFR, 18 ml/min/1.73m2), hyperkalemia and acidosis. Plasma renin was low or normal, aldosterone was low or undetectable and uromodulin was low. Kidney biopsy at 2 years exhibited subtle changes suggestive of tubular dysgenesis without tubulocystic or glomerulocystic lesions and with renin staining of the juxtaglomerular cells. The patient experienced extreme fatigue due to severe hypotension attributed to hypoaldosteronism and at 8 years of age fludrocortisone treatment was initiated with marked improvement in her well-being. Blood pressure normalized as did potassium. Biopsy at 9 years showed extensive glomerulosclerosis and mild tubulointerstitial fibrosis, as well as tubular mitochondrial abnormalities, but without specific diagnostic changes. Her GFR improved to 54 ml/min/1.73m2. As the renin-angiotensin system promotes aldosterone release, and the patient had repeatedly undetectable aldosterone levels, the SEC61A1 variant presumably contributed to severe hypotension. Treatment with a mineralocorticoid had a beneficial effect and corrected the electrolyte and acid-base disorder. We suggest that the increased blood pressure hemodynamically improved the patient's kidney function.","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141575490","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":"Risk factors for major bleeding in patients with atrial fibrillation and CKD G3-G5D on oral anticoagulants","authors":"Frida Welander, Henrik Renlund, Anders Själander","doi":"10.1093/ckj/sfae206","DOIUrl":"https://doi.org/10.1093/ckj/sfae206","url":null,"abstract":"Background Patients with chronic kidney disease (CKD) and atrial fibrillation (AF) on oral anticoagulants (OAC) are at high risk of bleeding. Determinants of major bleeding risk in OAC-users with AF and CKD are not well established and available bleeding score systems do not perform well in CKD. This study aims to present risk factors associated with major bleeding in a Swedish cohort of OAC- treated patients with CKD GFR category 3–5D (G3-G5D). Methods A Swedish register-based cohort study including patients with AF and G3-G5D on warfarin or DOAC between 2009–2018. Data collected from high quality registers including Swedish Renal Registry and Auricula, a register for AF and oral anticoagulants. Risk factors for major bleeding were investigated with Cox regression analysis. Results Of 2453 included patients 59% were on warfarin (time in therapeutic range 67%) and 41% on DOAC. Major bleeding rates were 8.9/100 patient-years. Factors associated with increased bleeding risk were GFR category, G5/5D versus G3, hazard ratio 1.92 (95% confidence interval 1.43–2.56), previous gastrointestinal bleeding, 1.77 (1.39–2.25), previous other bleeding 1.33 (1.09–1.62), congestive heart failure 1.36 (1.11–1.68), male sex 1.28 (1.03–1.60) and vascular disease, 1.35 (1.01–1.79). Conclusion Patients with AF and G3-G5D on OAC are at high risk of bleeding. Previous major bleeding and kidney failure are strongly associated with major bleeding. The present study also shows an association between OAC-associated bleeding and male sex, congestive heart failure and vascular disease. Knowledge about determinants of bleeding in advanced CKD is essential when deciding on when to anticoagulate or not.","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141575489","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":"Vertebral fractures in patients with CKD and the general population: a call for diagnosis and action","authors":"Laia Gifre, Elisabeth Massó, Maria Fusaro, Mathias Haarhaus, Pablo Ureña, Mario Cozzolino, Sandro Mazzaferro, Jordi Calabia, Pilar Peris, Jordi Bover","doi":"10.1093/ckj/sfae191","DOIUrl":"https://doi.org/10.1093/ckj/sfae191","url":null,"abstract":"Vertebral fractures (VFs) are the most common osteoporotic fractures in the general population, and they have been associated with high mortality, decreased quality of life and high risk of subsequent fractures, especially when recent, multiple or severe. Currently, VF diagnosis and classification determine fracture risk and the most appropriate anti-osteoporotic treatment. However, VFs are clearly underdiagnosed, especially in patients with chronic kidney disease (CKD), and CKD-associated osteoporosis has been disregarded until recently. VFs are associated with higher morbidity and mortality, and their prevalence and incidence differ depending on the grade of renal dysfunction (CKD G1–G5) and/or the type of renal replacement therapy (dialysis or transplantation). In addition to classical risk factors [such as higher age, female sex, reduced bone mineral density (BMD), diabetes and steroid use], various other factors have been associated with an increased risk of VFs in CKD, including CKD grade, haemodialysis vintage, time since renal transplantation, low or high intact parathyroid hormone and phosphate levels, and/or vitamin D and K1 deficiencies. Importantly, several clinical societies have recently modified their algorithms according to the fracture risk classification (including the presence of VFs) and determined the most appropriate anti-osteoporotic treatment for the general population. However, there are no specific guidelines addressing this topic in patients with CKD despite an important paradigm shift regarding the prognostic value of BMD in 2017 after the publication of the CKD-Mineral and Bone Disorder (CKD-MBD) KDIGO guidelines. A proactive attitude towards diagnosis, treatment and research is proposed to avoid therapeutic nihilism.","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141587373","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":"Integrating multiple kidney function markers to predict all-cause and cardiovascular disease mortality: prospective analysis of 366,758 UK Biobank participants","authors":"Ryosuke Fujii, Roberto Melotti, Anna Köttgen, Alexander Teumer, Daniele Giardiello, Cristian Pattaro","doi":"10.1093/ckj/sfae207","DOIUrl":"https://doi.org/10.1093/ckj/sfae207","url":null,"abstract":"Background &amp; Hypothesis Reduced kidney function is a risk factor of cardiovascular and all-cause mortality. This association was demonstrated for several kidney function markers, but it is unclear whether integrating multiple measured markers may improve mortality risk prediction. Methods We conducted an exploratory factor analysis (EFA) of serum creatinine- and cystatin C-based estimated glomerular filtration rate (eGFRcre and eGFRcys, derived by Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) and European Kidney Function Consortium (EKFC) equations), blood urea nitrogen (BUN), uric acid, and serum albumin among 366 758 participants of the UK Biobank without history of kidney failure. Fitting Cox-proportional hazard models, we compared ability of the identified latent factors to predict overall mortality and mortality by cardiovascular disease (CVD), also considering CVD-specific causes like coronary heart disease and cerebrovascular disease. Results During 12.5 years of follow-up, 26 327 deceased from any cause, 5 376 died from CVD, 2 908 from CHD, and 1 116 from cerebrovascular disease. We identified two latent factors, EFA1 and EFA2 both representing kidney function variations. When using the CKD-EPI equations, EFA1 performed like eGFRcys, with EFA1 showing slightly larger hazard ratios for overall and CVD-related mortality. At 10-years of follow-up, EFA1 and eGFRcys showed moderate discrimination performance for CVD-related mortality, outperforming all other kidney indices. eGFRcre was the least predictive marker across all outcomes. When using the EKFC equations, eGFRcys performed better than EFA1, all other results remaining similar. Conclusions While EFA is an attractive approach to capture the complex effects of kidney function, eGFRcys remains the most practical and effective measurement for all-cause and CVD mortality risk prediction.","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141575496","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":"Calcium Polystyrene Sulfonate Induced Colitis: Advanced characterization of crystal nature with infrared spectroscopy","authors":"Helena Vidal, Vilma Salgado, Patrícia Alves, Nuno Moreira Fonseca1, Vincent Frochot, Aníbal Ferreira","doi":"10.1093/ckj/sfae210","DOIUrl":"https://doi.org/10.1093/ckj/sfae210","url":null,"abstract":"Classical potassium binders are used in the treatment of hyperkalemia and are widely associated with gastrointestinal side effects, with crystal colonic injury being rare but potentially fatal. In this report, we describe the case of an 82-year-old male with hyperkalemia and calcium polystyrene sulfonate crystal associated colonic necrosis. Traditionally, this diagnosis has relied on the examination of crystal morphology and polarization through microscopy. Our study enhances crystal identification by incorporating an analysis of the physical characteristics of the crystals using infrared spectroscopy. This is the first description, to our knowledge, of calcium polystyrene sulfonate infrared spectrum.","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141575492","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":"High premature atrial complex burden and risk of renal function decline","authors":"Chao-Yu Chen, Chih-Hen Yu, Po-Tseng Lee, Mu-Shiang Huang, Pin-Hsuan Chiu, Pei-Fang Su, Ping-Yen Liu, Ting-Chun Huang","doi":"10.1093/ckj/sfae208","DOIUrl":"https://doi.org/10.1093/ckj/sfae208","url":null,"abstract":"Background Atrial arrhythmia, particularly atrial fibrillation (AF), is known to be associated with renal function decline and increased risk of end-stage kidney disease. These years, premature atrial complexes (PACs) as subclinical arrhythmia are proposed to be a marker of atrial cardiomyopathy and associated with poor clinical outcomes. However, the relationship between excessive daily PAC burden and renal outcomes remains unexplored. Methods This retrospective, all-comers cohort study analyzed 30 488 consecutive Holter monitoring records obtained from a validated Holter databank at a referral medical center in Taiwan between 2011 and 2018. After exclusion, 10 981 patients were categorized into three groups: high daily PAC burden (≥100 beats per day), low PAC burden (&amp;lt;100 beats per day), and the AF group. We used parallel propensity score matching to balance confounding factors between groups. The primary study interest was major adverse kidney events, including an estimated glomerular filtration rate (eGFR) decline of 40%, eGFR below 15 mL/min/1.73m², or the initiation of hemodialysis. Results After a mean follow-up of 4.07 ± 3.03 years, patients with high PAC burden had a 1.24-fold higher incidence of major adverse kidney events compared to the low PAC burden group (95% CI: 1.03–1.50). The risk of major adverse kidney events was similar between patients with AF and those with high PAC burden (adjusted HR: 1.05, 95% CI: 0.87–1.25), but significantly higher in the AF group than in the low PAC burden group (adjusted HR: 1.29, 95% CI: 1.07–1.56). Conclusion Excessive daily PAC burden is associated with a higher risk of major adverse kidney events and has a comparable impact as AF.","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141551860","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":"Anaemia and quality of life in chronic kidney disease: a consensus document from the European Anaemia of CKD Alliance","authors":"Indranil Dasgupta, Corinne Isnard Bagnis, Matteo Floris, Hans Furuland, Daniel Gallego Zurro, Loreto Gesualdo, Nathalie Heirman, Roberto Minutolo, Antonello Pani, José Portolés, Christian Rosenberger, José Emilio Sánchez Alvarez, Pablo Ureña Torres, Raymond C Vanholder, Christoph Wanner","doi":"10.1093/ckj/sfae205","DOIUrl":"https://doi.org/10.1093/ckj/sfae205","url":null,"abstract":"Anaemia is common in chronic kidney disease (CKD) and has a significant impact on quality of life (QoL), work productivity, and outcomes. Current management includes oral or intravenous iron and erythropoiesis-stimulating agents (ESAs), to which hypoxia inducible factor prolyl hydroxylase inhibitors (HIF-PHIs) have been recently added, increasing the available therapeutic options. In randomised controlled trials, only intravenous iron improved cardiovascular outcome, while some ESAs were associated with increased adverse cardiovascular events. Despite therapeutic advances, several challenges and unmet needs remain in the current management of anaemia of CKD. In particular, clinical practice does not include an assessment of QoL, which prompted a group of European nephrologists and representatives of patient advocacy groups to revisit the current approach. In this consensus document, the authors propose a move towards a more holistic, personalised, and long-term approach, based on existing evidence. The focus of treatment should be on improving QoL without increasing the risk of adverse cardiovascular events, and tailoring management strategies to the needs of the individual. In addition, the authors discuss the suitability of a currently available anaemia of CKD-specific-health-related QoL measure for inclusion in the routine clinical management of anaemia of CKD. The authors also outline the logistics and challenges of incorporating such a measure into electronic health records and how it may be used to improve QoL for people with anaemia of CKD.","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141551857","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}