Clinical Kidney Journal最新文献_第9页

The time is now: CKJ adopts new policies for patient representation and for more sex-inclusive research. 时不我待：CKJ 通过了关于患者代表和更多性别包容性研究的新政策。

IF 3.9 2区医学

Clinical Kidney Journal Pub Date : 2024-06-27 eCollection Date: 2024-07-01 DOI: 10.1093/ckj/sfae192

Kate I Stevens, Alexander Woywodt, Jürgen Floege

引用次数: 0

Measures of wave intensity as non-invasive surrogate for cardiac function predicts mortality in hemodialysis patients 作为心脏功能无创替代指标的波强度测量可预测血液透析患者的死亡率

IF 4.6 2区医学

Clinical Kidney Journal Pub Date : 2024-06-27 DOI: 10.1093/ckj/sfae172

Christopher C Mayer, Pantelis A Sarafidis, Julia Matschkal, Marieta Theodorakopoulou, Georg Lorenz, Artemios Karagiannidis, Susanne Angermann, Fotini Iatridi, Matthias C Braunisch, Antonios Karpetas, Marcus Baumann, Eva Pella, Uwe Heemann, Siegfried Wassertheurer, Christoph Schmaderer

{"title":"Measures of wave intensity as non-invasive surrogate for cardiac function predicts mortality in hemodialysis patients","authors":"Christopher C Mayer, Pantelis A Sarafidis, Julia Matschkal, Marieta Theodorakopoulou, Georg Lorenz, Artemios Karagiannidis, Susanne Angermann, Fotini Iatridi, Matthias C Braunisch, Antonios Karpetas, Marcus Baumann, Eva Pella, Uwe Heemann, Siegfried Wassertheurer, Christoph Schmaderer","doi":"10.1093/ckj/sfae172","DOIUrl":"https://doi.org/10.1093/ckj/sfae172","url":null,"abstract":"Background and hypothesis Risk prediction in hemodialysis patients is challenging due to the impact of the dialysis regime on patient's volume status and the complex interplay with cardiac function, comorbidities, and hypertension status. Cardiac function as a key predictor of cardiovascular mortality in hemodialysis patients is challenging to assess in daily routine. Thus, the aim of this study was to investigate the association of a novel, non-invasive relative index of systolic function with mortality and to assess its interplay with volume removal. Methods In total, 558 (373 male/185 female) hemodialysis patients with a median age of 66 years were included in this analysis. They underwent 24-hour ambulatory blood pressure monitoring including wave intensity analysis (i.e. S to D ratio (SDR)). All-cause and cardiovascular mortality served as endpoints, and multivariate, proportional hazards models were used for risk prediction. Intra-dialytic changes were analyzed in tertiles according to ultrafiltration volume. During a follow-up of 37.8 months, 193 patients died (92 due to cardiovascular reasons). Results SDR was significantly associated with all-cause (univariate HR = 1.36 [1.20–1.54]; p &lt; 0.001) and cardiovascular (univariate HR = 1.41 [1.20–1.67]; p &lt; 0.001) mortality. The associations remained significant in multivariate analysis accounting for possible confounders. Changes in SDR from pre-/early- to post-dialytic averages were significantly different for the three ultrafiltration volume groups. Conclusion This study provides well-powered evidence for the independent association of a novel index of systolic function with mortality. Furthermore, it revealed a significant association between intradialytic changes of the measure and intradialytic volume removal.","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141531736","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}

引用次数: 0

Prevalence, awareness, treatment, and control of hypertension in community dwelling older adults with chronic kidney disease: the irish longitudinal study on ageing 患有慢性肾病的社区老年人的高血压患病率、认识、治疗和控制情况：爱尔兰老龄问题纵向研究

IF 4.6 2区医学

Clinical Kidney Journal Pub Date : 2024-06-26 DOI: 10.1093/ckj/sfae184

Leonard D Browne, Mohammed Y Alamin, Hamid H Miri, Robert Hall, Meera Tandan, Donal Sexton, Austin G Stack

{"title":"Prevalence, awareness, treatment, and control of hypertension in community dwelling older adults with chronic kidney disease: the irish longitudinal study on ageing","authors":"Leonard D Browne, Mohammed Y Alamin, Hamid H Miri, Robert Hall, Meera Tandan, Donal Sexton, Austin G Stack","doi":"10.1093/ckj/sfae184","DOIUrl":"https://doi.org/10.1093/ckj/sfae184","url":null,"abstract":"Background Hypertension is highly prevalent in chronic kidney disease (CKD), posing a significant but modifiable risk for adverse clinical outcomes. This study explored the prevalence, awareness, treatment, and control of hypertension in older Irish adults with CKD. Methods Data were analysed from participants in Wave 1 of The Irish Longitudinal Study on Ageing (TILDA) who were aged 50 years and older. CKD was defined as eGFR &lt; 60 ml/min/1.72m2, hypertension defined as systolic blood pressure (SBP) ≥140 mmHg and/or diastolic blood pressure (DBP) ≥90 mmHg and/or self-reported use of antihypertensive medication. Participant awareness and treatment of hypertension was based on self-report and SBP/DBP &lt; 140/90 mmHg. Multivariable logistic regression examined relationships with awareness, treatment, and control of hypertension expressed as adjusted odds ratios. Results Prevalence of hypertension was significantly higher in participants with CKD than without (81.9% vs 59.7%, P &lt; 0.001). Among hypertensive individuals, 70.1% (95% CI: 65.8–74.1) were aware, 83.5% (95% CI 80.0–86.6) were on treatment, yet blood pressure control &lt; 140/90 mmHg and &lt; SBP 120 mmHg was achieved in only 49.3% (CI 44.0–54.7%), and 17.9% (CI 14.4–22.1) respectively. In multivariable analysis, advancing age 1.05 (CI 1.01–1.10), obesity 6.23 (CI 2.51–15.5), diabetes 5.78 (CI 1.55–21.5), cardiovascular disease 9.89 (CI 3.27–29.9) were associated with higher odds of treatment, while cardiovascular disease 2.35 (CI 1.39–3.99) and combination antihypertensive therapy 1.76 (CI 1.03–3.01) was associated with blood pressure control. Conclusion The prevalence of hypertension is substantial in older Irish adults with CKD; however, control is poor. Approximately, one third of participants were unaware of their hypertensive status and approximately one fifth were untreated.","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141522658","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}

引用次数: 0

Further improvement of circuit survival in citrate based continuous renal replacement therapy. 进一步提高以枸橼酸盐为基础的持续肾脏替代疗法的回路存活率。

IF 3.9 2区医学

Clinical Kidney Journal Pub Date : 2024-06-26 eCollection Date: 2024-08-01 DOI: 10.1093/ckj/sfae187

Alena Post, Èmese R H Heijkoop, Lotte L M Diebels, Adrian Post, Matijs van Meurs, Peter H J van der Voort, Casper F M Franssen, Meint Volbeda

{"title":"Further improvement of circuit survival in citrate based continuous renal replacement therapy.","authors":"Alena Post, Èmese R H Heijkoop, Lotte L M Diebels, Adrian Post, Matijs van Meurs, Peter H J van der Voort, Casper F M Franssen, Meint Volbeda","doi":"10.1093/ckj/sfae187","DOIUrl":"10.1093/ckj/sfae187","url":null,"abstract":"Background: Continuous renal replacement therapy (CRRT) is the most frequently used modality of renal replacement therapy (RRT) in critical care patients with acute kidney injury (AKI). Adequate CRRT delivery can be challenging, due to problems with circuit patency. To improve circuit patency, we developed a new CRRT protocol using continuous veno-venous hemodiafiltration (CVVHDF) with 3.0 mmol/l regional citrate anticoagulation (CVVHDF/RCA3.0) as our first choice RRT modality.Methods: Retrospective comparison of efficacy and safety of a CVVHDF/RCA3.0 protocol with our former continuous veno-venous hemofiltration protocol with 2.2 regional citrate anticoagulation (CVVH/RCA2.2) in adult critically ill patients with AKI requiring CRRT between 25 April 2020 and 24 October 2021.Results: In total, 56 patients (257 circuits) and 66 patients (290 circuits) were included in the CVVH/RCA2.2 and CVVHDF/RCA3.0 groups, respectively. Median circuit survival was significantly higher in patients treated with CVVHDF/RCA3.0 (39.6 (IQR 19.5-67.3) hours) compared to patients treated with CVVH/RCA2.2 (22.9 (IQR 11.3-48.6) hours) (P < .001). Higher body weight and higher convective flow were associated with a lower circuit survival. Metabolic control was similar, except for metabolic alkalosis that occurred less frequently during CVVHDF/RCA3.0 (19% of patients) compared to CVVH/RCA2.2 (46% of patients) (P = .006).Conclusions: CRRT circuit survival was longer with CVVHDF/RCA3.0 compared to CVVH/RCA2.2. CRRT circuit survival was negatively associated with higher body weight and higher convective flow.","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11292220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141888608","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}

引用次数: 0

Common mistakes in biostatistics. 生物统计学中的常见错误。

IF 3.9 2区医学

Clinical Kidney Journal Pub Date : 2024-06-26 eCollection Date: 2024-07-01 DOI: 10.1093/ckj/sfae197

Graziella D'Arrigo, Samar Abd El Hafeez, Sabrina Mezzatesta, Domenico Abelardo, Fabio Pasquale Provenzano, Antonio Vilasi, Claudia Torino, Giovanni Tripepi

{"title":"Common mistakes in biostatistics.","authors":"Graziella D'Arrigo, Samar Abd El Hafeez, Sabrina Mezzatesta, Domenico Abelardo, Fabio Pasquale Provenzano, Antonio Vilasi, Claudia Torino, Giovanni Tripepi","doi":"10.1093/ckj/sfae197","DOIUrl":"10.1093/ckj/sfae197","url":null,"abstract":"Biostatistics plays a pivotal role in developing, interpreting and drawing conclusions from clinical, biological and epidemiological data. However, the improper application of statistical methods can lead to erroneous conclusions and misinterpretations. This paper provides a comprehensive examination of the most frequent mistakes encountered in the biostatistical analysis process. We identified and elucidated 10 common errors in biostatistical analysis. These include using the wrong metric to describe data, misinterpreting P-values, misinterpreting the 95% confidence interval, misinterpreting the hazard ratio as an index of prognostic accuracy, ignoring the sample size calculation, misinterpreting analysis by strata in randomized clinical trials, confusing correlation and causation, misunderstanding confounders and mediators, inadequately codifying variables during the data collection, and bias arising when group membership is attributed on the basis of future exposure in retrospective studies. We discuss the implications of these errors and propose some practical strategies to mitigate their impact. By raising awareness of these pitfalls, this paper aims to enhance the rigor and reproducibility of biostatistical analyses, thereby fostering more robust and reliable biomedical research findings.","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11333961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142008402","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}

引用次数: 0

Proximal Tubule Hypertrophy and Hyperfunction: A Novel Pathophysiological Feature in Disease States 近端肾小管肥大和功能亢进：疾病状态下的一种新的病理生理学特征

IF 4.6 2区医学

Clinical Kidney Journal Pub Date : 2024-06-25 DOI: 10.1093/ckj/sfae195

Mehmet Kanbay, Sidar Copur, Mustafa Guldan, Lasin Ozbek, Alper Hatipoglu, Adrian Covic, Francesca Mallamaci, Carmine Zoccali

{"title":"Proximal Tubule Hypertrophy and Hyperfunction: A Novel Pathophysiological Feature in Disease States","authors":"Mehmet Kanbay, Sidar Copur, Mustafa Guldan, Lasin Ozbek, Alper Hatipoglu, Adrian Covic, Francesca Mallamaci, Carmine Zoccali","doi":"10.1093/ckj/sfae195","DOIUrl":"https://doi.org/10.1093/ckj/sfae195","url":null,"abstract":"The role of proximal tubules, a major component of the renal tubular structure located at the renal cortex, in healthy and diseased states has been examined extensively. Along with its physiological role in the reabsorption of various molecules, including electrolytes, amino acids and monosaccharides, transcellular transport of different hormones and regulation of homeostasis, pathological events affecting proximal tubules may underlie multiple disease states. Proximal tubular hypertrophy or hyper-functioning state, despite being a compensatory mechanism at first in response to various stimuli or alterations at tubular transport proteins, have shown to be critical pathophysiological events leading to multiple disorders, including diabetes mellitus, obesity, metabolic syndrome, congestive heart failure. Moreover, pharmacotherapeutic agents have primarily targeted proximal tubules, including sodium-glucose cotransporter-2, urate transporters and carbonic anhydrase enzyme. In this narrative review, we focus on the physiological role of proximal tubules in healthy states and the current understanding of the proximal tubular pathologies leading to disease states and potential therapeutic targets.","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141553104","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}

引用次数: 0

The potential of ChatGPT in medicine: an example analysis of nephrology specialty exams in Poland ChatGPT 在医学中的潜力：波兰肾脏病专业考试实例分析

IF 4.6 2区医学

Clinical Kidney Journal Pub Date : 2024-06-22 DOI: 10.1093/ckj/sfae193

Jan Nicikowski, Mikołaj Szczepański, Miłosz Miedziaszczyk, Bartosz Kudliński

{"title":"The potential of ChatGPT in medicine: an example analysis of nephrology specialty exams in Poland","authors":"Jan Nicikowski, Mikołaj Szczepański, Miłosz Miedziaszczyk, Bartosz Kudliński","doi":"10.1093/ckj/sfae193","DOIUrl":"https://doi.org/10.1093/ckj/sfae193","url":null,"abstract":"Background and hypothesis In November 2022, OpenAI released a chatbot named ChatGPT, a product capable of processing natural language to create human-like conversational dialogue. It has generated a lot of interest, including from the scientific community as well as the medical science community. Recent publications have shown that ChatGPT can correctly answer questions from medical exams such as the United States Medical Licensing Examination (USMLE) and other specialty exams. To date, there have been no studies in which ChatGPT has been tested on specialty questions in the field of nephrology anywhere in the world. Methods Using the ChatGPT-3.5 and 4.0 algorithm in this comparative cross-sectional study, we analyzed 1560 single-answer questions from the national specialty exam in nephrology from 2017 to 2023 that were available in the Polish Medical Examination Center's question database along with answer keys. Results Of the 1556 questions posed to ChatGPT-4.0, correct answers were obtained with an accuracy of 69.84%, compared to ChatGPT-3.5 (45.70%, P = .0001) and to the top results of medical doctors (85.73%, P = .0001). Of the 13 tests, ChatGPT-4.0 exceeded the required ≥60% pass rate in 11 tests passed, and scored higher than the average of the human exam results. Conclusion ChatGPT-3.5 was not spectacularly successful in nephrology exams. The ChatGPT-4.0 algorithm was able to pass most of the analyzed nephrology specialty exams. New generations of ChatGPT achieve similar results to humans. The best results of humans are better than ChatGPT-4.0.","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141551862","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}

引用次数: 0

Association between wet-bulb globe temperature with kidney function in different geographic region in a large Taiwanese population study 台湾人口大型研究中不同地理区域湿球温度与肾功能的关系

IF 4.6 2区医学

Clinical Kidney Journal Pub Date : 2024-06-21 DOI: 10.1093/ckj/sfae173

Wei-Yu Su, Ping-Hsun Wu, Ming-Yen Lin, Pei-Yu Wu, Yi-Chun Tsai, Yi-Wen Chiu, Jer-Ming Chang, Chih-Hsing Hung, Chih-Da Wu, Chao-Hung Kuo, Szu-Chia Chen

{"title":"Association between wet-bulb globe temperature with kidney function in different geographic region in a large Taiwanese population study","authors":"Wei-Yu Su, Ping-Hsun Wu, Ming-Yen Lin, Pei-Yu Wu, Yi-Chun Tsai, Yi-Wen Chiu, Jer-Ming Chang, Chih-Hsing Hung, Chih-Da Wu, Chao-Hung Kuo, Szu-Chia Chen","doi":"10.1093/ckj/sfae173","DOIUrl":"https://doi.org/10.1093/ckj/sfae173","url":null,"abstract":"The worldwide prevalence and incidence rates of end-stage renal disease have been increasing, and the trend is pronounced in Taiwan. This is especially evident in southern Taiwan, where the wet-bulb globe temperature (WBGT) is consistently higher than other regions. The association between kidney function and WBGT has not been fully investigated. Therefore, the aim of this study was to evaluate the association between estimated glomerular filtration rate (eGFR) and WBGT, and variations in this association across different geographic regions in Taiwan. We used the Taiwan Biobank (TWB) to obtain data on community-dwelling individuals, and linked these data with WBGT data obtained from the Central Weather Bureau, and then processed the data using a machine learning model. WBGT data were recorded during the working period of the day from 8:00 AM to 5:00 PM. These data were then compiled as 1-year, 3-year, and 5-year averages, recorded prior to the survey year of the TWB of each participant. We identified 114 483 participants who had WBGT data during 2012–2020. Multivariable analysis showed that, in northern Taiwan, increases in 1-year and 3-year averages of WBGT during the working period (β = −0.092, p = 0.043; and β = −0.193, p &lt; 0.001, respectively) were significantly associated with low eGFR. In southern Taiwan, increases in 1-year, 3-year and 5-year averages of WBGT during the working period (β = −0.518, p &lt; 0.001; β = −0.690, p &lt; 0.001; and β = −0.386, p = 0.001, respectively) were significantly associated with low eGFR. These findings highlight the importance of heat protection for people working outdoors or in high-temperature environments, as a measure to prevent negative impacts on kidney function. Moreover, we observed that in southern Taiwan, every 1°C increase in WBGT had a greater impact on the decrease in eGFR compared to other regions in Taiwan.","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141522605","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}

引用次数: 0

Unexpected seronegative response in relapsed PLA2R-associated membranous nephropathy. PLA2R 相关膜性肾病复发的意外血清阴性反应

IF 3.9 2区医学

Clinical Kidney Journal Pub Date : 2024-06-21 eCollection Date: 2024-07-01 DOI: 10.1093/ckj/sfae189

Wing Yin Leung, Henry H L Wu, Beena Nair, Alexander Woywodt, Arvind Ponnusamy

引用次数: 0

To the lighthouse: navigating nephrology through the world of social media. 前往灯塔：在社交媒体世界中领航肾脏病学。

IF 3.9 2区医学

Clinical Kidney Journal Pub Date : 2024-06-20 eCollection Date: 2024-07-01 DOI: 10.1093/ckj/sfae170

Lauren Floyd, Jasmine Sethi, Madelena Stauss, Alexander Woywodt

引用次数: 0