International Journal of Nephrology最新文献

{"title":"Impact of Iron Deficiency and Erythropoiesis-Stimulating Agents on Anemia in CKD Progression.","authors":"Collince Odiwuor Ogolla, Lucy W Karani, Stanslaus Musyoki, Phidelis Maruti","doi":"10.1155/ijne/2567637","DOIUrl":"10.1155/ijne/2567637","url":null,"abstract":"<p><p><b>Background:</b> Anemia is a frequent complication in patients with chronic kidney disease (CKD), with the incidence rising in stages 3-5. Iron deficiency and defective erythropoiesis are the major causes. Still, the role of iron status and the stimulating capability of ESAs on the progression of CKD have hardly been evaluated. <b>Objective:</b> To assess the effect of iron deficiency and ESA therapy with respect to the correction of anemia and preservation of kidney function in patients with CKD stages 3-5. <b>Methods:</b> A follow-up observational study was carried out in 120 CKD patients at nephrology department in a tertiary institution, from January 2023 to December 2024. The patients were classified into three groups: Group 1 and Group 3 considered iron-deficient, with no ESA and ESA therapy, respectively, while Group 2 was non-iron-deficient with no ESA. The parameters tested were hemoglobin levels, serum ferritin, transferrin saturation (TSAT), and estimated glomerular filtration rate (eGFR) at baseline and at 6 months after treatment. The ESA treatment given consisted of epoetin alfa or darbepoetin alfa, with iron supplementation given according to iron-deficiency status. <b>Results:</b> Baseline hemoglobin levels were significantly lower in Group 1 (9.5 ± 1.2 g/dL), and these subjects were associated with a faster decline of eGFR by value per year (annual decline in eGFR: 3.5 ± 2.3 mL/min/1.73 m²) compared to Groups 2 and 3 (<i>p</i> < 0.01). The ESA-treated group (Group 3) exhibited relatively the greatest improvement in hemoglobin level (to 12.3 ± 1.5 g/dL) and the slowest decline in kidney function (1.7 ± 1.2 mL/min/1.73 m²). Iron supplementation produced greater changes in ferritin and TSAT. <b>Conclusion:</b> Iron deficiency is a paramount modifiable driver of anemia and CKD progression. ESA treatment improves anemia and retards renal deterioration, especially when coupled with iron supplementation. Early detection and correction of anemia might merit interplay in pursuit of optimized CKD outcomes.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2025 ","pages":"2567637"},"PeriodicalIF":1.4,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12488314/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Prognosis of Maintenance Hemodialysis Patients With Various Types of Vascular Access in Hemodialysis Centers in Wuhan: A Retrospective Cohort Study.","authors":"Li Cheng, Yonglong Min, Can Tu, Sheng Wan, Qianshen Zhu, Jing Chen, Wenhui Qiu, Nan Jiang, Hongbo Li","doi":"10.1155/ijne/5865205","DOIUrl":"10.1155/ijne/5865205","url":null,"abstract":"<p><p><b>Objective:</b> The relationship between different types of vascular access in maintenance hemodialysis (MHD) patients and patient prognosis is controversial. The vascular access of patients from various dialysis centers in Wuhan was summarized, and its relationship with prognosis was analyzed. <b>Methods:</b> The characteristics of MHD patients treated at 70 dialysis centers in the Wuhan Hemodialysis Quality Control System from 2017 to 2023 were collected. The demographic characteristics, laboratory indicators, compliance rates with laboratory indicators, annual mortality changes, survival time, and risk of death were compared in patients with various types of vascular access. <b>Results:</b> A total of 45,830 MHD patients were included in the study. Overall, arteriovenous fistulas (AVFs) and tunneled and cuffed catheters (TCCs) remain the most common types of vascular access. Non-tunneled and cuffed catheters (NCC) use decreases annually, whereas arteriovenous graft (AVG) use increases annually. Male patients mostly had AVFs. The vascular access types of patients with diabetic nephropathy were mainly TCCs (28.6%) and AVGs (29.4%). AVG patients had the highest average hemoglobin level. NCC patients had the lowest average hemoglobin, albumin, and potassium levels. AVF patients had the highest average albumin, potassium, calcium, phosphorus, and parathyroid hormone levels. TCC patients had the lowest calcium and phosphorus levels. From 2017 to 2023, the mortality rates of AVF, TCC, and AVG patients were significantly higher in 2022 (11%, 19.9%, and 11.7%, respectively). The median survival time of AVF patients was 4.92 (2.75, 7.75) years, which was significantly longer than that of TCC patients (2.83 [1.42, 4.92]) and NCC patients (1.00 [0.25, 2.25]). After multivariate adjustment, the risk of death in patients with internal fistulas was 50.6% lower than that in patients with catheters, according to the Cox regression analysis model (hazard ratio = 0.494, 95% CI: 0.439-0.556, <i>p</i> < 0.001). <b>Conclusions:</b> Among MHD patients with different vascular access types who were treated in Wuhan from 2017 to 2023, the numbers of AVF, AVG, and TCC patients increased with increasing overall number of MHD patients, whereas the number of NCC patients decreased. The overall condition and survival time of AVF patients were significantly better than those of MHD patients with other vascular access types, and the risk of death was lower.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2025 ","pages":"5865205"},"PeriodicalIF":1.4,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12352979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Exploratory Single-Arm Clinical Trial on Eucommia Ulmoides Leaf Extract Effects on Blood Pressure, Oxidative Stress, and Atrial Natriuretic Peptide (ANP) in Individuals With and Without Chronic Kidney Disease.","authors":"Hiroshi Satonaka, Shohei Yokoyama, Akira Ishimitsu, Chisato Takahashi, Tatemitsu Rai, Daisuke Nagata, Toshihiko Ishimitsu, Akihiro Tojo","doi":"10.1155/ijne/5598055","DOIUrl":"10.1155/ijne/5598055","url":null,"abstract":"<p><p>Eucommia ulmoides (Tochu) has been shown to possess a variety of beneficial effects on profiles affecting the onset of lifestyle- or aging-related diseases, such as hypertension, diabetes, dyslipidemia, or obesity. This exploratory single-arm clinical study was conducted on a total of 17 participants including those with mild chronic kidney disease (CKD) (<i>n</i> = 9), who were administered a tablet product containing Tochu leaf extract for a short period (median: 33 days), to investigate its effects on blood pressure or related clinical markers. Mean systolic blood pressure (SBP) of all the participants significantly decreased from 128.3 ± 12.3 mmHg at the start to 123.8 ± 10.2 mmHg at the end of the administration (<i>p</i> < 0.05). Analysis of CKD patients alone, however, revealed that SBP, to a greater extent, decreased from 130.7 ± 12.9 mmHg to 121.2 ± 10.7 mmHg (<i>p</i> < 0.01), while the change in non-CKD patients was not significant. Furthermore, SBP decrease in CKD patients with hypertension (<i>n</i> = 7) alone was also significant and comparable. Mean blood oxidative stress index of all participants was decreased from 300.2 ± 76.7 U.CARR to 285.9 ± 63.0 U.CARR (<i>p</i> < 0.05), while median atrial natriuretic peptide (ANP) of all the participants was increased from 8.1 (5.0-9.6) pg/mL to 8.8 (5.8-12.1) pg/mL (<i>p</i> < 0.05). Our findings suggested that Tochu-derived components may have potential therapeutic benefit at earlier stages in CKD, which could fill the gaps in currently underserved opportunities for prevention or intervention. <b>Trial Registration:</b> UMIN Clinical Trials Registry: UMIN000050727.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2025 ","pages":"5598055"},"PeriodicalIF":1.7,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Glucocorticoid Use in Patients With Biopsy-Proven Acute Interstitial Nephritis: Insights From a Colombian Cohort.","authors":"Joaquín Rodelo-Ceballos, Camilo García-Prada, Mauricio Restrepo-Escobar, Laura Lopera-Restrepo, Angie Pinto-Diaz, Luis Fernando Arias-Restrepo","doi":"10.1155/ijne/9980649","DOIUrl":"https://doi.org/10.1155/ijne/9980649","url":null,"abstract":"<p><p><b>Introduction:</b> Acute interstitial nephritis (AIN) is a major cause of acute kidney injury, commonly triggered by medications or infections. Although glucocorticoid (GC) therapy is recommended for patients who do not improve after removing the suspected cause, the evidence supporting its use remains limited. <b>Materials and Methods:</b> This retrospective cohort study was conducted at the Pathology Unit of the University of Antioquia-San Vicente Fundación Hospital in Medellín, Colombia, reviewing patients aged 14 and older with biopsy-proven AIN over an 11-year period. Two groups were formed based on whether or not they received GC treatment. Key outcomes included changes in delta creatinine (serum creatinine change from peak to 6-month follow-up) and the need for permanent kidney replacement therapy. Linear regression analyses assessed factors influencing delta creatinine at 6 months, adjusting for age, clinical severity, time to GC initiation, and histological findings. <b>Results:</b> Of 139 eligible patients, 101 received GC therapy. The GC-treated group showed a significantly greater reduction in delta creatinine compared to the nontreated group (-2.3 mg/dL; 95% CI, -3.6 to -1.1, <i>p</i> < 0.001). Multivariate analysis identified GC therapy as an independent predictor of improved kidney function (delta creatinine reduction: -1.47 mg/dL; 95% CI, -2.68 to -0.27, <i>p</i>=0.017), particularly when initiated within 7 days of diagnosis. The GC-treated group also had a lower incidence of permanent dialysis dependence (54% at admission vs. 11% at 6 months). Adverse events occurred in 20.1% of the cohort, with a higher frequency in the GC group (<i>p</i>=0.076). <b>Conclusion:</b> GC therapy may improve kidney outcomes in patients with biopsy-proven AIN, especially when initiated early. These results support the need for prospective studies to further evaluate its efficacy in AIN management.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2025 ","pages":"9980649"},"PeriodicalIF":1.7,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12031597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lack of Association Between Intraoperative Hypotension and Postoperative Acute Kidney Injury in Patients Undergoing Pancreaticoduodenectomy: A Retrospective Cohort Study.","authors":"Yue Gu, Wenwen Zhang, Jing Zhou, Xiaoge Niu, Yanliang Wang, Limeng Wang, Lei Yan, Yang Xu, Fengmin Shao","doi":"10.1155/ijne/5568151","DOIUrl":"https://doi.org/10.1155/ijne/5568151","url":null,"abstract":"<p><p><b>Background:</b> Acute kidney injury (AKI) is a common postoperative event. Previous research suggests that intraoperative hypotension (IOH) is associated with postoperative AKI. This connection, however, has not been studied in patients undergoing pancreaticoduodenectomy. <b>Methods:</b> Based on a retrospective cohort study, we analyzed 844 adult patients who had pancreaticoduodenectomy between December 2016 and June 2020 in Henan Provincial People's Hospital. We graphically modeled the associations between the lowest intraoperative systolic and diastolic pressure and AKI using a restricted cubic spline with all covariates adjusted. The association between time under the above-specified systolic blood pressure (SPB) and diastolic blood pressure (DBP) thresholds and AKI, respectively, was investigated using logistic regression models. We further tested the robustness of our findings with a sensitivity analysis. <b>Results:</b> AKI occurred in 98 (11.6%) of the 844 patients in this cohort. Blood pressure components below the thresholds of 100 mmHg for systolic and 60 mmHg for diastolic were visual change points associated with increasing odds of AKI. The median (IQR) time under SBP < 100 mmHg was 15.0 (0, 40) min and 65.0 (18.8, 105.4) min for DBP < 60 mmHg. Time spent under the threshold of SBP less than 100 mmHg and DBP less than 60 mmHg was not significantly associated with AKI. <b>Conclusions:</b> We found no relationship between IOH and postoperative AKI after pancreaticoduodenectomy. More research is needed to investigate the complex aspects influencing intraoperative blood management in order to lessen the occurrence of AKI.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2025 ","pages":"5568151"},"PeriodicalIF":1.7,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11999749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterisation of IgA Nephropathy in an Australian Cohort.","authors":"Shriram Swaminathan, Nithya Neelakantan, Henry Bryant, Pimvara Rattanamastip, Gagandeep Sandhu, Bobby Chacko","doi":"10.1155/ijne/9976879","DOIUrl":"10.1155/ijne/9976879","url":null,"abstract":"<p><p><b>Aim:</b> This retrospective cohort study aims to evaluate the prognostic factors for progression of immunoglobulin A nephropathy (IgAN) to kidney failure (defined as the initiation of kidney replacement therapy or death) and all-cause mortality in an Australian population. <b>Methods:</b> We conducted a retrospective analysis of 363 individual patients with biopsy-proven IgAN over a 21-year period (2000-2020) in the Hunter Region of New South Wales. Demographic data, comorbidities, biopsy features and biochemical markers were collected for a minimum of 12 months following biopsy diagnosis. A multivariable analysis using Cox regression was performed to examine their association with renal progression. <b>Results:</b> A total of 104 patients met the inclusion criteria and were followed for a median of 72 months. The cohort had a mean age at presentation of 45 years, with a predominantly male population. Most patients presented with haematuria and non-nephrotic range proteinuria. We stratified patients into three risk categories: low risk, intermediate risk, and high risk. Twenty-eight patients (26.92%) developed kidney failure and 15 patients (14.4%) experienced a > 20 mL/min eGFR decline within the first 12 months. The multivariable analysis revealed the following key factors associated with kidney failure: additional renal pathology on biopsy (HR 3.90, 95% CI 1.63-9.29), proteinuria (HR 1.15, 95% CI 1.02-1.29) and moderate-severe interstitial fibrosis/tubular atrophy (T2) (HR 7.00, 95% CI 2.32-21.05). There were 17 deaths (16.3%) in the cohort, with a mean survival time of 167.8 months (95% CI 152.6-183.1). <b>Conclusion:</b> In contrast to earlier reports from Australia, our findings emphasise that the progression to kidney failure is not uncommon in IgAN. We identified several predictors of the renal progression that are consistent with the previous studies. This highlights the need for a change in clinical management, as IgAN should no longer be considered a benign condition.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2025 ","pages":"9976879"},"PeriodicalIF":1.7,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11968155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radial Expansion of the Nephrogenic Zone in the Fetal Human Kidney During Advanced Pregnancy: A Microanatomical Look at a Little Noticed Process.","authors":"Will W Minuth","doi":"10.1155/ijne/7571982","DOIUrl":"10.1155/ijne/7571982","url":null,"abstract":"<p><p><b>Introduction:</b> The experiences with preterm and low birth weight babies indicate a special vulnerability of their kidneys, since different kinds of noxae can evoke the termination of nephron formation. This leads to oligonephropathy, which is associated with serious consequences for health in the later stages of life. While the clinical aspects have been intensely investigated, only few pathological data point to the initial traces left by the noxae. Up to this date, only the reduction in the width of the nephrogenic zone (NZ) and the lack of here occurring basophilic S-shaped bodies were reported. <b>Methods and Materials:</b> The relationship between the arising nephron and its structural neighbors changes throughout the developmental progress. Locally, this determines the vertical width of the NZ reflected by the radial expansion of both the parenchyma and the interstitium. Since information about the origin, the site, and the involved structures is not available, the related microanatomical features were recorded. <b>Results:</b> The data reveal that the renal vesicles, comma-shaped bodies, and S-shaped bodies are unequally distributed in the NZ. Due to their progressive sizes, it has an influence on the local vertical width of the NZ. This parameter is registered as the distance between the inner side of the renal capsule and the proximal pole of the respective stage of the nephron anlage. The vertical width can be further subdivided: the constant height of the district of progenitor cell recruitment and the variable height of the area of nephron shaping. Exclusively here, the radial expansion of the shaping nephron stages can be noticed. It starts at the section border between the head and the conus of the related collecting duct ampulla by positioning the primitive renal vesicle. While the respective proximal pole stays mounted next to the connecting tubule of a previously developed nephron, the distal pole sticks between the head and the conus at the CD ampulla for linking the future connecting tubule. This causes that henceforth the medial aspect of the extending renal vesicle, comma-shaped body, or S-shaped body stages radially expands in close proximity to the elongating conus of the CD ampulla. <b>Conclusion:</b> Between the arising nephron stages and the elongating conus of the CD ampulla, a linked radial expansion occurs. This new finding is essential to identify the extent of targeting of noxae that subsequently leads to a reduction in the width of the NZ.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2025 ","pages":"7571982"},"PeriodicalIF":1.7,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11949609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Calcimimetic R568 Reduces Vascular Smooth Muscle Cell Calcification in Vitro Via ERK 1/2 Phosphorylation.","authors":"Jonas Engeßer, Philipp Gregor Albert, Matthias Scheuch, Norina Loth, Sylvia Stracke","doi":"10.1155/ijne/2492846","DOIUrl":"10.1155/ijne/2492846","url":null,"abstract":"<p><p><b>Background:</b> Vascular calcification (VC) is a common complication of chronic kidney disease, ultimately leading to high morbidity and cardiovascular mortality. In this study, we investigated the effects of the calcimimetic R568 in an in vitro model of human vascular smooth muscle cell (VSMC) calcification. <b>Methods:</b> Human VSMCs were cultured under elevated calcium (2.4 mmol/L) and phosphate (2.7 mmol/L) concentrations. Calcification was analyzed using von Kossa staining and colorimetric calcium measurement. Intracellular signaling was examined via Western blot, and apoptosis was assessed by the TUNEL assay. <b>Results:</b> Treatment with R568 significantly reduced VC over the 9-day treatment period. R568 treatment led to increased phosphorylation of extracellular signal-regulated kinase (ERK 1/2) compared to the control group. Calcimimetic treatment was also associated with a reduction in apoptosis. Blocking ERK 1/2 phosphorylation completely abolished the inhibitory effects of R568 on VC. <b>Conclusion:</b> Our study provides new insights into the mechanism of action of calcimimetics during VC and highlights the importance of ERK 1/2 signaling in this process.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2025 ","pages":"2492846"},"PeriodicalIF":1.7,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continuous Renal Replacement Therapy Versus Intermittent Hemodialysis for Renal Prognosis in Elderly Patients With Acute Kidney Injury.","authors":"Enhui Li, Linlin Zhang, Yikai He, Huipeng Ge, Rong Tang, Jinbiao Chen, Yong Zhong, Xiangning Yuan, Weiwei Zhang, Yizi Gong, Xiangcheng Xiao","doi":"10.1155/ijne/8899604","DOIUrl":"https://doi.org/10.1155/ijne/8899604","url":null,"abstract":"<p><p><b>Background:</b> Continuous renal replacement therapy (CRRT) and intermittent hemodialysis (IHD) represent two common modes of renal replacement therapy (RRT) for elderly patients with acute kidney injury (AKI), but their clinical effectiveness is debated. This study aimed to compare the impact of CRRT and IHD on renal prognosis in elderly patients with AKI by analyzing their clinical data. <b>Methods:</b> The retrospective study population included elderly patients admitted to Xiangya Hospital between 2018 and 2022, who required RRT for AKI. Patients were separated into two cohorts based on the original RRT modes (CRRT or IHD). In our study, the primary outcome was recovery of renal function at discharge and the secondary outcome was RRT dependency rate at 90 days. A multivariate logistic regression model was constructed for the purpose of comparing the impact of CRRT and IHD on renal prognosis. <b>Results:</b> The mortality rate at the time of patient discharge was significantly elevated in the CRRT cohort relative to the IHD cohort (49.6% vs. 2.1%, <i>p</i> < 0.001). However, for the 155 patients who survived at discharge, the analysis revealed no statistically significant discrepancy in renal recovery across the two groups (40.3% vs. 59.7%, <i>p</i> = 0.694). Multivariate logistic regression analysis showed no statistically meaningful distinction among the CRRT and IHD groups concerning renal function recovery at discharge. Nevertheless, in comparison with IHD, CRRT reduced the risk of RRT dependence at 90 days. <b>Conclusions:</b> Our study indicated that CRRT and IHD have comparable effects on renal recovery at discharge in elderly patients with AKI who require RRT. However, in comparison with IHD, CRRT was linked to a diminished likelihood of requiring RRT at 90 days.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2025 ","pages":"8899604"},"PeriodicalIF":1.7,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11991802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Utility of the MEST-C Score Combined With Clinical Parameters in Hispanic Patients With IgA Nephropathy.","authors":"Lyzinhawer Alza-Arcila, Esteban Echeverri-Fernández, Mauricio Restrepo-Escobar, Ligia Lorena Calderón, José Manuel Ustáriz, Luis Fernando Arias-Restrepo, Joaquín Roberto Rodelo-Ceballos","doi":"10.1155/ijne/6974280","DOIUrl":"https://doi.org/10.1155/ijne/6974280","url":null,"abstract":"<p><p><b>Introduction:</b> The Oxford/MEST-C classification is a histopathological scoring system for patients with IgA nephropathy (IgAN) that has demonstrated prognostic utility. The aim of this study was to evaluate the prognostic utility of the combination of clinical characteristics and MEST-C in Hispanic ethnicity patients. <b>Methods:</b> Retrospective cohort study. Clinical, laboratory, and kidney biopsy information with MEST-C classification was obtained. The primary outcome was the development of end-stage kidney disease (ESKD). Cox regression analysis was performed for factors associated with ESKD, and Kaplan-Meier survival analysis for kidney survival. <b>Results:</b> A total of 397 patients were included, 51% were male, median age was 38 years with an interquartile range (IQR) of 28-53. The main comorbidity was hypertension present in 60.5%. At the time of biopsy, estimated glomerular filtration rate (eGFR) was 54 mL/min (IQR 33-94) and 24 h proteinuria was 1680 mg (IQR 594-3500). 30.7% of patients developed ESKD over a median follow-up of 1702 days (IQR 808-2858). Multivariate analysis of M, E, S, T, and C lesions showed that only S and T lesions correlated with the development of ESKD. The combination of S and T items of the MEST-C score with variables such as age, eGFR, proteinuria, and hypertension were significantly associated with the outcome. Explored prognostic models showed a high Harrel's C concordance index of 0.89. <b>Conclusion:</b> Performing the MEST score, especially the presence of sclerosing (S) and tubular fibrosis/atrophy (T) lesions combined with clinical variables are prognostic variables in the Hispanic population.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2025 ","pages":"6974280"},"PeriodicalIF":1.7,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11991785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}