Clinical Kidney Journal最新文献

{"title":"Obinutuzumab is effective for the treatment of rituximab-refractory PLA2R-associated membranous nephropathy.","authors":"Wenyan Su, Jianyi Li, Jinzhao Men, Shuo Zhong, Yunzhao Wang, Yao Zhang, Liang Xu, Jie Gao, Dan Liu, Rong Wang, Jing Sun, Haiping Wang","doi":"10.1093/ckj/sfaf026","DOIUrl":"https://doi.org/10.1093/ckj/sfaf026","url":null,"abstract":"<p><strong>Background: </strong>Clinical experience with obinutuzumab in patients with rituximab-refractory phospholipase A2 receptor (PLA2R)-associated membranous nephropathy remains limited. This study aimed to evaluate the efficacy and safety of obinutuzumab in treating patients with rituximab-refractory PLA2R-associated membranous nephropathy.</p><p><strong>Methods: </strong>A single-center retrospective study was conducted on 20 patients with rituximab-refractory PLA2R-associated membranous nephropathy who received two doses of 1 g obinutuzumab, administered 2 weeks apart. At 6 months, patients with urinary protein levels exceeding 3.5 g/d received an additional dose of 1-2 g obinutuzumab. The primary clinical outcome was a composite measure of complete or partial remission during follow-up. Continuous secondary outcomes included 24-hour urinary protein, serum albumin, serum creatinine, serum anti-PLA2R levels, and CD19 B-cell counts at the time of obinutuzumab infusion, at 3 months, and at the last visit.</p><p><strong>Results: </strong>A total of 20 patients with clinical manifestations of nephrotic syndrome were included in this study, with a median follow-up period of 9 months. The mean age of the patients was 46.25 ± 13.05 years. At a median follow-up of 4.50 months (3.00-8.25 months) after obinutuzumab therapy, remission was achieved in 16 patients. Two patients (10%) achieved complete remission, while 14 (70%) attained partial remission. At baseline, 16 out of 20 patients tested positive for serum anti-PLA2R antibodies, and immunological remission was observed in 11 of these 16 patients during follow-up. All patients experienced B-lymphocyte depletion within 1 month after receiving obinutuzumab infusion and maintained this depletion at 3 months. B-lymphocyte reconstitution was noted in 4 out of 20 patients (20%) at 6 months. No patients experienced fatal adverse events.</p><p><strong>Conclusion: </strong>Obinutuzumab mainly induces short-term partial remissions in patients with rituximab-refractory primary membranous nephropathy, which may be related to the short follow-up period. However, this study demonstrates that obinutuzumab is an effective and safe treatment for rituximab-refractory PLA2R-associated membranous nephropathy.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 5","pages":"sfaf026"},"PeriodicalIF":3.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12056547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971787","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":"Extracorporeal myoglobin elimination using the adsorber CytoSorb or the high-flux HF80 dialyzer for patients with severe rhabdomyolysis: a comparative study.","authors":"Justa Friebus-Kardash, Jasmin Omar, Michael Jahn, Christina Scharf, Kristina Schönfelder, Anja Gaeckler, Kristina Boss, Bartosz Tyczynski, Andreas Kribben","doi":"10.1093/ckj/sfaf071","DOIUrl":"https://doi.org/10.1093/ckj/sfaf071","url":null,"abstract":"<p><strong>Background: </strong>Critically ill patients are frequently affected by severe rhabdomyolysis, consequently requiring renal replacement therapy (RRT). We asked whether CytoSorb is more potent than continuous veno-venous hemodiafiltration (CVVHDF) with the high-flux HF80 dialyzer in removing myoglobin and improving outcome for patients with rhabdomyolysis accompanied by acute kidney injury (AKI).</p><p><strong>Methods: </strong>The historical HF80 cohort consisted of 97 patients who underwent CVVHDF with the HF80 dialyzer between 2010 and 2016. The CytoSorb cohort consisted of 102 patients who underwent treatment with CytoSorb in combination with CVVHDF with the standard high-flux F60S dialyzer between 2018 and 2023.</p><p><strong>Results: </strong>Patients treated with the HF80 dialyzer achieved a median relative reduction of myoglobin of 39% after 24 h of treatment and of 69% after 3 days of treatment; this reduction was similar to the median relative myoglobin elimination achieved for the CytoSorb group (40% after 24 h and 60% after 3 days). The proportions of patients in whom return of diuresis occurred were comparable between the two extracorporeal treatments. The groups did not differ significantly in in-hospital mortality rates. The decrease in the Sequential Organ Failure Assessment (SOFA) and Simplified Acute Physiology Score II (SAPS II) scores at the end of therapy was more pronounced in the CytoSorb group (SOFA <i>P</i> <i> </i>< .0001; SAPS II <i>P</i> <i> </i>< .0001) than in the HF80 group (SOFA <i>P</i> <i> </i>= .004; SAPS II <i>P</i> <i> </i>= .03). The frequency of new-onset end-stage kidney disease among survivors was similar in both groups.</p><p><strong>Conclusions: </strong>Our analysis showed that using CytoSorb resulted in myoglobin reduction rates and clinical outcomes similar to those achieved with CVVHDF with the high-flux HF80 dialyzer for patients with rhabdomyolysis and AKI.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 5","pages":"sfaf071"},"PeriodicalIF":3.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12056548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981026","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":"Role of intrarenal complement production in kidney transplantation.","authors":"Paolo Molinari, Shivani Wadnerkar, Katja L Ferrari, Giuseppe Castellano, Nicholas Chun, Paolo Cravedi","doi":"10.1093/ckj/sfaf135","DOIUrl":"10.1093/ckj/sfaf135","url":null,"abstract":"<p><p>Systemic complement is a major contributor to the onset and progression of kidney graft injury. However, the kidney itself is an important site of complement production. Renal-derived complement plays a key role in graft dysfunction, unlike in some other solid organ transplants. Complement factors are generated by multiple renal cell types under both physiological and pathological conditions. Renal complement production mediates ischemia/reperfusion injury and acute cellular and humoral rejection but protective effects of the complement cascade have been reported as well. More recently, intracellular complement production and activation (complosome) has also been shown to be an important regulator of key metabolic and cellular functions in renal cells and in immune kidney infiltrates, adding complexity to the field. Herein, we review current knowledge on the role of renal-derived complement in the pathophysiology of kidney graft damage and the current landscape of complement targeted therapeutics in kidney transplantation.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 5","pages":"sfaf135"},"PeriodicalIF":3.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12104811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ten tips on how to manage kidney health in migrants and refugees.","authors":"Ewa Pawłowicz-Szlarska, Valerie Luyckx, Mehmet Sukru Sever, Serhan Tuglular, Andrzej Więcek","doi":"10.1093/ckj/sfaf132","DOIUrl":"10.1093/ckj/sfaf132","url":null,"abstract":"<p><p>The number of forcibly displaced people worldwide continues to rise each year due to armed conflicts, human rights violations and natural disasters. Many others migrate in search of better living conditions. People with chronic kidney disease, particularly those requiring kidney replacement therapy, are especially vulnerable during displacement. Preparedness is crucial to minimize risks for these patients. Education and training provided in the pre-disaster period may raise patients' resilience and improve outcomes. Local or national kidney disaster relief task forces could help coordinate evacuation efforts and care for migrant patients, ensuring collaboration among stakeholders. While providing high-quality kidney care is essential, challenges such as healthcare costs, reimbursement issues, and social or cultural barriers may limit access in host countries. It is also critical to address the psychological needs of displaced people. Caring for displaced patients raises ethical concerns, leading to moral distress and burnout among healthcare providers. Collaborative efforts to address these challenges are essential to ensure the best outcomes for both displaced individuals and host countries.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 5","pages":"sfaf132"},"PeriodicalIF":3.9,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12086542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101415","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":"Kidney transplant in patients with C3 glomerulopathy.","authors":"Rose Mary Attieh, Joyita Bharati, Purva Sharma, Gayatri Nair, Gashu Ayehu, Kenar D Jhaveri","doi":"10.1093/ckj/sfaf134","DOIUrl":"10.1093/ckj/sfaf134","url":null,"abstract":"<p><p>Complement protein 3 (C3) glomerulopathy (C3G) is a rare and progressive kidney disease primarily affecting young individuals and frequently advancing to end-stage kidney disease (ESKD). For ESKD, kidney transplantation remains the optimal treatment option; however, C3G has a high recurrence rate post-transplantation, affecting over two-thirds of transplanted patients. Despite advances in our understanding of C3G, significant gaps persist regarding the optimal timing for transplantation and the best strategies for peri-transplant management. Currently, no clear evidence links functional complement levels to the risk of post-transplant recurrence. Genetic counseling is also complex, due to variable gene penetrance and weak genotype-phenotype correlations, which limit predictive accuracy. Transplant-related factors are believed to significantly influence C3G recurrence, yet there are no established methods for preventing recurrence after transplantation. Eculizumab has shown inconsistent efficacy in managing recurrent C3G. However, new proximal complement inhibitors, such as factor B and C3 inhibitors, are under investigation in clinical trials and show promise. Some of these trials include kidney transplant patients with C3G, and their outcomes could potentially shape future treatment protocols.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 5","pages":"sfaf134"},"PeriodicalIF":3.9,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12082085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144092609","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 burden of hyperkalaemia in chronic kidney disease: a systematic literature review.","authors":"Jürgen Floege, Andrew H Frankel, Kevin F Erickson, Ketevan Rtveladze, Yogesh Punekar, Jahangir Nabi Mir, Jessica Walters, Alexandra Ehm, James Fotheringham","doi":"10.1093/ckj/sfaf127","DOIUrl":"10.1093/ckj/sfaf127","url":null,"abstract":"<p><strong>Background: </strong>The global epidemiology and burden of hyperkalaemia in patients with chronic kidney disease (CKD) are unclear due to the inconsistent definitions of hyperkalaemia. The combination of adverse effects and interaction between comorbidity and pharmacotherapies, such as renin-angiotensin-aldosterone system inhibitors (RAASi), justify a systematic understanding of this common complication of CKD.</p><p><strong>Methods: </strong>This systematic literature review aimed to identify and descriptively summarize the evidence on hyperkalaemia risk factors and associated characteristics in adult CKD patients, including the effects of sub-optimal RAASi. Medline^® and Embase^® databases were searched from January 2000 to April 2024, with additional hand searching. Publications were screened by two independent reviewers. Data were extracted by one reviewer and verified by another reviewer; study quality assessment was also conducted.</p><p><strong>Results: </strong>A total of 138 studies described in 145 publications met the eligibility criteria. The published literature revealed varying prevalence of hyperkalaemia amongst inconsistent definitions and a significant increase in the prevalence and incidence of hyperkalaemia among patients with CKD, regardless of RAASi treatment. Hyperkalaemia was associated with adverse outcomes and increased hospital resource use. Additionally, studies pointed to negative health and economic outcomes due to sub-optimal RAASi dosing in CKD patients with hyperkalaemia, as well as in those with CKD and comorbid heart failure.</p><p><strong>Conclusions: </strong>This review expands on current research, offering a new perspective specifically focused on CKD patients and wider clinical and economic outcomes. Identification of wider clinical and economic consequences of hyperkalaemia in CKD patients, and the interplay between these risks and the risks of sub-optimal RAASi dosing, justify the need for future research. Clinicians should exercise caution when managing this condition in this complex patient group.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 5","pages":"sfaf127"},"PeriodicalIF":3.9,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12082095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144092674","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":"CD9 expression in minimal change disease and focal segmental glomerulosclerosis.","authors":"Daniel Christiadi, Hana Angelia Kawatu, Giles Walters, Mitali Fadia, Simon Jiang","doi":"10.1093/ckj/sfaf130","DOIUrl":"https://doi.org/10.1093/ckj/sfaf130","url":null,"abstract":"","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 5","pages":"sfaf130"},"PeriodicalIF":3.9,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970054","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":"Efficacy and safety of finerenone in IgA nephropathy: an observational multicentre study.","authors":"Qiao-Rui Wang, Longlong Wu, Jian Huang, Hong Pan, Xin-Fei Wang, Li Li, Fei Han, Yong-Fei Wang, Miao-Lian Wu, Yi Yang","doi":"10.1093/ckj/sfaf125","DOIUrl":"https://doi.org/10.1093/ckj/sfaf125","url":null,"abstract":"<p><strong>Background: </strong>Finerenone, a non-steroidal mineralocorticoid receptor antagonist, reduces renal risks in type 2 diabetic nephropathy, but its use in immunoglobulin nephropathy (IgAN) lacks evidence. This study assessed the safety and efficacy of 6-month finerenone treatment in IgAN patients.</p><p><strong>Methods: </strong>This retrospective cohort study was mainly conducted in three Grade 3A hospitals. Patients diagnosed with IgAN and receiving standard supportive care were included. Participants were divided into the renin-angiotensin system inhibitor (RASI) and RASI + finerenone groups. The primary outcome was the percentage decrease in protein-to-creatinine ratio (PCR) over 6 months following the index study visit.</p><p><strong>Results: </strong>In total, 178 patients were included in the analysis. PCR was reduced by 45.1% in the RASI + finerenone group and 32.5% in the RASI group (<i>P</i> = .013). Compared with 18 patients (20.2%) in the control group, 33 (37.1%) had residual PCR reduced to <0.3 g/g. After 6 months, serum potassium increased by 0.17 mmol/L from baseline, with no uncontrollable hyperkalemia (persistent serum potassium >5.5 mmol/L despite treatment). In addition, one patient presented with a blood pressure <90/60 mmHg without significant clinical symptoms in the RASI + finerenone group. And eGFR decreased by 1.94 ± 6.73 mL/min/1.73 m² from baseline, but not statistically significant. There were no differences in the incidence of adverse events between the two groups.</p><p><strong>Conclusions: </strong>Finerenone added to optimized RAS blocker therapy significantly reduced PCR in IgAN patients, and its safety profile was consistent with previous reports, suggesting the need for long-term renal outcome studies.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT06460987.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 5","pages":"sfaf125"},"PeriodicalIF":3.9,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985833","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":"Association of dietary carbohydrate intake with risk of mortality in maintenance hemodialysis patients: a multicenter prospective cohort study.","authors":"Qiuxia Zhong, Zizhen Lin, Yaya Yang, Yan Huang, Xiaolei Lan, Chaoying Xia, Yaozhong Kong, Qijun Wan, Yumin Li, Sheng Huang, Yan Liu, Aiqun Liu, Fanna Liu, Xianhui Qin, Youbao Li, Min Liang","doi":"10.1093/ckj/sfaf124","DOIUrl":"10.1093/ckj/sfaf124","url":null,"abstract":"<p><strong>Background: </strong>Current evidence on the relationship between dietary carbohydrate intake (DCI) and mortality risk among patients undergoing maintenance hemodialysis (MHD) is limited. Moreover, the joint impact of DCI and dietary energy intake (DEI) on mortality remains unclear. Therefore, we aimed to investigate both the individual and combined associations of DCI and DEI with all-cause and cardiovascular disease (CVD) mortality.</p><p><strong>Methods: </strong>This study included 1044 MHD patients from eight outpatient dialysis centers across China. The DCI, expressed as a percentage of carbohydrate intake in total energy intake, was determined via 24-h dietary recalls over 3 days. The study outcomes included all-cause and CVD mortality. Cox proportional hazard models were utilized to evaluate both the individual and combined associations of DCI and DEI with mortality risk.</p><p><strong>Results: </strong>During a median follow-up of 45.6 months, 352 deaths were recorded, of which 206 (58.5%) were due to CVD. When DCIs were assessed as quartiles, patients in the fourth quartile (≥72.1%) were associated with a greater risk of all-cause mortality [hazard ratio (HR) 2.16; 95% confidence interval (CI) 1.10, 4.25] than patients in the first quartile (<61.5%), whereas patients in the second quartile (61.5%-66.7%; HR 1.27; 95% CI 0.87, 1.87) and the third quartile (66.7%-72.1%; HR 1.40; 95% CI 0.84, 2.31) were not significantly different. A similar trend was found for CVD mortality. When analyzed jointly, patients with high DCIs (≥72.1%) and low DEIs (<25 kcal/kg/day) had the highest risk of all-cause and CVD mortality.</p><p><strong>Conclusions: </strong>A higher DCI was associated with a higher risk of all-cause and CVD mortality in MHD patients. Patients with high DCIs and low DEIs had a worse survival prognosis.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 5","pages":"sfaf124"},"PeriodicalIF":3.9,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12086540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101413","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":"High bicarbonate replacement fluid and time to pH normalization during continuous veno-venous hemofiltration with regional citrate anticoagulation: a retrospective single-center cohort study.","authors":"Timo Mayerhöfer, Paul Köglberger, Fabian Perschinka, Georg F Lehner, Lisa Schilchegger, Romuald Bellmann, Andreas Peer, Birgit Zassler, Sebastian Schauflinger, Michael Joannidis","doi":"10.1093/ckj/sfaf117","DOIUrl":"https://doi.org/10.1093/ckj/sfaf117","url":null,"abstract":"<p><strong>Background: </strong>In critically ill patients, acid-base disorders are common before start of continuous renal replacement therapy. The aim of this study was to determine the influence of a high bicarbonate replacement fluid (30 mmol/L, Phoxilium^®) on underlying acid-base disturbances.</p><p><strong>Methods: </strong>This single-center retrospective study included patients treated with continuous veno-venous hemofiltration (CVVH) at a medical ICU from January 2018 to May 2019. All patients received CVVH with regional citrate anticoagulation (RCA) and a high bicarbonate RF (Phoxilium^®). Patients were categorized based on their initial pH. Acid-base parameters were closely monitored over 72 h at pre-specified intervals.</p><p><strong>Results: </strong>The study included 64 patients with a median age of 68 years. At the start of CVVH, 56.3% (<i>n</i> = 36) had acidemia, 12.5% (<i>n</i> = 8) had alkalemia and 32.3% (<i>n</i> = 20) had a normal pH. The median pH of patients with acidemia [0 h: 7.28 (interquartile range 7.23-7.33)] was corrected quickly to the normal range within 8 h [7.36 (interquartile range 7.29-7.4)]. The median pH of patients with alkalemia took longer (48 h) to reach normal values and patients with a normal pH showed a further pH increase within the normal range over the 72 h. All patients showed an increasing bicarbonate and base excess from 24 to 72 h.</p><p><strong>Conclusions: </strong>The RF in CVVH with RCA appears to be one of several factors influencing acid-base balance. Patients with different pre-existing acid-base disorders showed distinct correction kinetics. Prospective studies are needed to determine the clinical relevance of these findings and to optimize RF composition for better patient outcomes.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 5","pages":"sfaf117"},"PeriodicalIF":3.9,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994429","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}