International Journal of Nephrology最新文献

{"title":"Biomarkers Detecting the Activity of ANCA-Associated Vasculitis: A Systematic Literature Review.","authors":"L Baas, R M Krol, E C Hagen, J Spierings, Y K O Teng, C A Koelman, H H F Remmelts","doi":"10.1155/ijne/3133057","DOIUrl":"10.1155/ijne/3133057","url":null,"abstract":"<p><strong>Introduction: </strong>Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) encompasses a group of rare systemic autoimmune diseases characterized by inflammation of small- and medium-sized blood vessels. Despite the efficacy of immunosuppressive therapy in achieving disease remission, a significant proportion of patients experience relapses, underscoring the need for reliable biomarkers to monitor disease activity. This systematic literature review evaluates the potential of urinary and serum biomarkers (CD163, CD206, CD25, and MCP-1) to detect active AAV in adult patients.</p><p><strong>Method: </strong>A comprehensive search on PubMed, Embase, and Cochrane databases identified relevant studies, which were screened and assessed for inclusion based on predefined criteria. Data extraction and quality appraisal were independently conducted using the Quality Assessment Tool for Diagnostic Accuracy Studies (QUADAS-2).</p><p><strong>Results: </strong>A total of 20 studies evaluated biomarkers for their diagnostic accuracy in detecting AAV activity. Most articles were scored as moderate risk of bias, with low concerns regarding applicability. Urinary soluble CD163 shows promising diagnostic accuracy for active renal vasculitis, with sensitivity and specificity values ranging from 0.72 to 1 and 0.67 to 0.98, respectively. Serum soluble CD163 and CD206 demonstrated variable accuracy. Serum MCP-1 did not differ between patients in remission and patients with active disease, while urinary MCP-1 showed potential but with inconsistent results across studies. Serum soluble CD25 was significantly elevated in active disease. Some combinations of biomarkers improved diagnostic performance (usCD163 + usCD25 + ssCD25 and usCD163 + serum Calprotectin + hematuria).</p><p><strong>Conclusion: </strong>In conclusion, while usCD163 individually appears to be the most reliable single biomarker for detecting active renal vasculitis in these studies, the heterogeneity of study designs and cutoff values across studies precludes definitive conclusions. Further research is necessary to standardize biomarker use, evaluate promising biomarker combinations, and improve the accuracy of activity monitoring both in renal and extrarenal AAV.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2025 ","pages":"3133057"},"PeriodicalIF":1.9,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12752823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145878401","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":"Psychological Indices and Health-Related Quality of Life in Renal Replacement Therapy: A Three Groups Cross-Sectional Study.","authors":"Maryam Emadzadeh, Negar Morovatdar, Mohammad Javad Mojahedi, Majid Reza Erfanian Taghvaei, Fatemeh Moharreri, Fatemeh Nazemian, Ali Emadzadeh, Mohammad Khajedaluee","doi":"10.1155/ijne/5976864","DOIUrl":"10.1155/ijne/5976864","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease (CKD) is a significant global health concern. Patients in the last stage of CKD, also known as end stage kidney disease (ESKD), need to use one of the methods of renal replacement therapy including hemodialysis (HD), peritoneal dialysis (PD), and kidney transplantation (KT). ESKD adversely affects physical and mental health, as well as overall quality of life. However, limited research has explored the association between these health burdens and treatment modalities in Iran.</p><p><strong>Methods and materials: </strong>This cross-sectional study included 215 patients with ESKD undergoing HD (<i>n</i> = 66), PD (<i>n</i> = 70), and KT (<i>n</i> = 79) at treatment centers in Mashhad, Iran. A checklist of demographic information, quality of life questionnaire specific for kidney disease patients (Kidney Disease Quality of Life Short Form [KDQOL-SF], version 1.3), Hamilton depression and anxiety inventories, and the Cassidy inventory for problem-solving and social support were distributed among patients. A regression model was employed to adjust for potential confounders, and statistical analysis was conducted using SPSS 11.5.</p><p><strong>Results: </strong>Kidney transplant recipients were younger than patients in the HD and PD groups and exhibited significantly higher mean scores in most domains of the KDQOL, both in general and specific domains. After adjusting for confounding variables such as age, transplant patients were found to have the highest quality of life scores in specific domains. Depression prevalence was high, ranging from 60% to 65% across all groups, with no significant intergroup differences. Anxiety prevalence ranged from 21% to 26%, also without significant differences. Social support was reported as high among ESKD patients (70%-82%) with no variation between treatment modalities.</p><p><strong>Conclusion: </strong>KT was associated with better quality-of-life outcomes compared to HD and PD, highlighting the potential benefits of organ donation programs. Given the substantial burden of mental health issues among ESKD patients, early detection and intervention for depression and anxiety should be prioritized in both dialysis and transplant populations.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2025 ","pages":"5976864"},"PeriodicalIF":1.9,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12752859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145878371","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":"Diuretic Use Among Hemodialysis Patients in Lebanon: A Multicenter Observational Retrospective Study.","authors":"Iqbal Fahs, Faten Ezzeddine, Mariam Dabbous, Jihan Safwan, Fouad Sakr, Mohamad Rahal","doi":"10.1155/ijne/4348593","DOIUrl":"10.1155/ijne/4348593","url":null,"abstract":"<p><strong>Background: </strong>Despite their fundamental role in managing volume overload, diuretic use in hemodialysis patients is inconsistent. This study aims to examine diuretic use, compare clinical outcomes between diuretic users and nonusers, and identify predictive factors among hemodialysis patients in Lebanon.</p><p><strong>Method: </strong>This was a multicenter retrospective observational study. Patients' data were retrieved from eight large dialysis centers in Lebanon. Descriptive and bivariate analyses were performed, followed by multivariable logistic regression to examine the association of diuretic use with the sociodemographic, hemodialysis parameters, and clinical outcomes of patients.</p><p><strong>Results: </strong>A total of 250 patients were included in the study. Diuretics were utilized among 38.4% of the patients, all of whom were on loop diuretics, primarily furosemide (71.3%). The mean furosemide equivalent dose was 153.56 ± 122.57 mg per day (range 20-500 mg). Only 28.7% and 16.1% were on furosemide equivalent doses of at least 250 mg and 320 mg per day, respectively. Diuretic users were more likely to have a residual kidney function (ORa = 23.189, 95% CI: 5.129-104.831, <i>p</i> < 0.001), a shorter dialysis vintage (ORa = 0.892, 95% CI: 0.472-0.958, <i>p</i> = 0.046), and a higher postdialysis systolic blood pressure (ORa = 13.760, 95% CI: 10.381-18.232, <i>p</i> = 0.026) compared to nonusers. Other hemodialysis parameters and clinical outcomes did not differ between diuretic users and nonusers. Furosemide equivalent doses of at least 250 mg per day were significantly associated with lower predialysis systolic blood pressure and dry weight, while doses of 320 mg and more per day were significantly associated with fewer intradialytic hypotension episodes, lower predialysis systolic blood pressure, dry weight, and interdialytic weight gain (all <i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>This study reveals suboptimal dosing despite a relatively high prevalence of utilization of diuretics among hemodialysis patients. Most hemodialysis parameters and clinical outcomes do not differ between diuretic users and nonusers. Higher diuretic doses are associated with improved clinical outcomes, emphasizing the need for further research to optimize dosing practices in this population.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2025 ","pages":"4348593"},"PeriodicalIF":1.9,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12752862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145878357","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":"Genetic Determinants of Chronic Kidney Disease (CKD) in India: A Comprehensive Genomewide Association Study (GWAS) Analysis.","authors":"Mythri Shankar, Sairam Bashyam, Gireesh Reddy, Kishan A, Sreedhara C G","doi":"10.1155/ijne/5578625","DOIUrl":"10.1155/ijne/5578625","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic kidney disease (CKD) poses a major health burden globally and affects nearly 17% of the Indian population. Despite established risk factors such as diabetes and hypertension, significant interindividual variability suggests a genetic contribution to CKD susceptibility. This study explores genetic variants predisposing to CKD in the Indian population using a genomewide association approach.</p><p><strong>Methods: </strong>A total of 90 patients with CKD and 90 healthy controls were genotyped using the Illumina Infinium Global Screening Array (640,000 markers). After stringent quality control, 5.7 million genetic markers were retained for analysis. Single-nucleotide polymorphisms (SNPs) were assessed using logistic regression including age, sex, and ten principal components as covariates. Variants meeting standard genomewide significance thresholds (<i>p</i> ≤ 5 × 10^-8) were considered significant.</p><p><strong>Results: </strong>The study identified 87 SNP loci associated with CKD, of which two genes, MPP7 and MAD1L1, reached genomewide significance. Variants with extremely high odds ratios (e.g., MAD1L1 OR > 1000) were interpreted as possible methodological artifacts. SNPs in PDZK1IP1, ANO3, C3AR1, FTO, and CD70 demonstrated suggestive biomarker potential (OR < 10, <i>p</i> < 10^-4), warranting replication in larger cohorts. These findings provide new insights into genes involved in tubular integrity, immune activation, and metabolic regulation in CKD.</p><p><strong>Conclusion: </strong>This genomewide analysis represents one of the first studies on CKD genetics in the Indian population. While the MPP7 variant emerges as a credible susceptibility locus, several other SNPs show promising biomarker potential. Larger, multiethnic studies and functional validation are needed to confirm their roles in CKD pathogenesis and therapeutic targeting.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2025 ","pages":"5578625"},"PeriodicalIF":1.4,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12660636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145648456","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":"Work and Dialysis: Navigating Employment Challenges Among Young Adults on Maintenance Hemodialysis in Tanzania.","authors":"Daniel Msilanga, Upendo Nkwera, Priyank Punatar, Jonathan Mngumi, Elizabeth Msangi, Gudila Valentine, Happiness Mushi, Jacqueline Shoo","doi":"10.1155/ijne/9980961","DOIUrl":"10.1155/ijne/9980961","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic kidney disease (CKD) increasingly affects young adults in low-and middle-income countries, with significant social and economic consequences. In Tanzania, many patients begin dialysis during their most productive years, often disrupting employment and financial stability. This study aimed to examine employment patterns and dialysis-related work challenges among young adults on maintenance hemodialysis at Muhimbili National Hospital.</p><p><strong>Methods: </strong>We conducted a hospital-based cross-sectional study at Muhimbili National Hospital from October to December 2024, involving adults aged 18-49 years on maintenance hemodialysis for at least three months. Data were collected using a structured questionnaire and supplemented with clinical records to assess sociodemographic, dialysis-related, employment, and transplant-related factors. Descriptive statistics were used to summarize the findings.</p><p><strong>Results: </strong>We included 134 patients aged between 18 and 49 years, with a mean age of 35.8 years (SD: 8.9). A total of 58.3% were either employed or self-employed, with 44.9% reporting that they did not work on dialysis days. Among those working, 65.4% experienced changes in their work patterns due to treatment demands, and 42.4% worked fewer than 4 days per week. Among the unemployed participants (24.6%), more than half (57.6%) reported resigning from work due to dialysis-related challenges. Out-of-pocket payment for dialysis was common, reported by 52.3% of participants. Although awareness of kidney transplantation was high (92.5%), only 27.6% had previously pursued or were actively pursuing it, primarily hindered by the absence of a donor (48.3%), high cost (23.0%), or both (28.7%).</p><p><strong>Conclusion: </strong>Young adults on maintenance hemodialysis in Tanzania face significant employment disruptions and limited access to kidney transplantation, highlighting the need for integrated interventions to support their social and economic well-being.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2025 ","pages":"9980961"},"PeriodicalIF":1.4,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12602022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145495357","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":"Calcification of the Thoracic Aorta and Its Segments and Chronic Kidney Disease in Participants of the ELSA-Brasil Cohort.","authors":"Júlia Sosa Antunes Cândido, Luisa Campos Brant, Lidyane Valle Camelo, Jesiana Ferreira Pedrosa, Luana Giatti, José Geraldo Mill, Antonio Luiz Pinho Ribeiro, Sandhi Maria Barreto","doi":"10.1155/ijne/9818803","DOIUrl":"10.1155/ijne/9818803","url":null,"abstract":"<p><strong>Introduction: </strong>Aortic calcification may be a vascular marker of health risk. Loss of elastic recoil due to arterial calcification results in hemodynamic changes that, in turn, can lead to damage to target organs, such as the kidneys. There are few studies analyzing the association between the presence of calcification in the thoracic aorta and chronic kidney disease (CKD).</p><p><strong>Objective: </strong>To investigate the association between calcification of transthoracic aortic (TAC) and its segments and CKD in individuals living in the community without established cardiovascular disease and to verify whether arterial stiffness is a confounder of this relationship.</p><p><strong>Methods: </strong>Cross-sectional study with 2427 participants from visit 2 of ELSA-Brasil, in Minas Gerais (2012-2015). TAC and its ascending (ATAC), aortic arch (AAC), and descending (DTAC) segments were categorized by the degree of calcification (0; greater than 0 and less than 100 HU; and greater than 100 HU). The presence of CKD was verified by glomerular filtration rate (eGFR CKDEPI) < 60 mL/min/1.73 m² and/or albumin/creatinine ratio ≥ 30 mg/g. The adjustment covariates were age, sex, race/color, schooling, smoking, cholesterol/HDL ratio, BMI, diabetes, hypertension, and pulse wave velocity (PWV). Logistic regression models were performed to analyze the associations. Statistical significance was defined as <i>p</i> < 0.05.</p><p><strong>Results: </strong>After all adjustments, there was an association between DTAC and CKD in the group with the highest degree of calcification (OR: 2.66-1.05; 6.71). The inclusion of PWV in the final model slightly increased the magnitude of the association with DTAC (OR: 2.75; 1.07-7.05). No statistical association was found for TAC, ATAC, and AAC.</p><p><strong>Conclusion: </strong>Greater degree of DTAC is positively associated with CKD, regardless of the level of arterial stiffening.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2025 ","pages":"9818803"},"PeriodicalIF":1.4,"publicationDate":"2025-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12597233/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145488669","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":"Ameliorative Effects of <i>Tribulus Terrestris</i> (Qutayb) Extracts Against Gentamicin-Induced Nephrotoxicity in Wistar Rats.","authors":"Ahmed Al-Mohamadi, Imadeldin M Taj Eldin, Doa'a Ibrahim, Rowaida Albadani","doi":"10.1155/ijne/7620700","DOIUrl":"10.1155/ijne/7620700","url":null,"abstract":"<p><p><i>Tribulus terrestris</i> has a long-standing historical legacy, having been used for centuries in the treatment of various kidney disorders and other health issues. This research aimed to evaluate the kidney-protective and antioxidant effects of different <i>Tribulus terrestris</i> extracts in ameliorating gentamicin-induced nephrotoxicity in Wistar albino rats. The study included nine rat groups of Wistar rats (<i>n</i> = 6 per group) treated for 14 days. The control group was given intraperitoneal injections of normal saline and dimethyl sulfoxide (DMSO). Group 2 received subcutaneous gentamicin injections at a dose of 100 mg/kg for eight days. Groups 3-5 were given an intraperitoneal ethanol extract of <i>Tribulus terrestris</i> (EETT) at 150, 300, and 450 mg/kg, respectively. Groups 6-8 received an intraperitoneal acetonitrile extract of <i>Tribulus terrestris</i> (AETT) at 150, 300, and 450 mg/kg, respectively. Group 9 was administered 200 mg/kg of intraperitoneal N-acetylcysteine. The results revealed that the EETT exhibited a protective effect against gentamicin-induced renal damage in Wistar albino rats. This protection was shown by reduced kidney tissue damage, lower MDA levels, and increased antioxidant enzyme levels, CAT, and GSH. Moreover, EETT administration dose-dependently improved renal histology, with full recovery observed at 450 mg/kg, whereas AETT showed no protective effect suggesting a potential dose-dependent effect. Additional studies are necessary to investigate how EETT's dose-response curve affects its ability to treat kidney damage induced by gentamicin in rats. Conversely, various doses of AETT failed to show a protective effect against gentamicin-induced nephrotoxicity.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2025 ","pages":"7620700"},"PeriodicalIF":1.4,"publicationDate":"2025-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12588765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145458580","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":"Desidustat for the Treatment of Anaemia in Adult End-Stage Kidney Disease Patients on Maintenance Haemodialysis: A Prospective Observational Study.","authors":"Ankit Tiwari, Niranjan M, Karthik Kalidindi, Siddharth Herur, Anshul Dudani, Vijay Chander Bukka, Gangadhar Taduri, Swarnalatha Guditi","doi":"10.1155/ijne/5375585","DOIUrl":"10.1155/ijne/5375585","url":null,"abstract":"<p><strong>Aim: </strong>Anaemia is a prevalent complication in patients with end-stage kidney disease (ESKD), significantly impacting morbidity and mortality. Desidustat, a hypoxia-inducible factor prolyl hydroxylase inhibitor, offers an alternative to erythropoiesis-stimulating agents for managing anaemia. This study aims to assess the response of haemoglobin and safety and efficacy of desidustat in ESKD patients.</p><p><strong>Methods: </strong>This prospective observational study evaluated the efficacy and safety of desidustat in 50 ESKD patients on maintenance haemodialysis. Patients received 100 mg oral desidustat thrice weekly for 6 months, with regular monitoring of haemoglobin, iron profiles, lipid profiles, and adverse effects.</p><p><strong>Results: </strong>This study demonstrated a 76% response rate to desidustat, with a mean haemoglobin rise of 0.82 g/dL (9.56% increase) over 6 months. Notably, higher baseline serum iron and ferritin levels predicted greater responses. Additionally, desidustat reduced serum ferritin, TSAT, LDL, and total cholesterol levels without impacting blood pressure.</p><p><strong>Conclusion: </strong>Desidustat demonstrated efficacy and safety in ESKD patients on haemodialysis, offering effective haemoglobin management and a favourable safety profile. These findings support desidustat as a viable treatment option for patients with anaemia, providing a valuable alternative to existing therapies.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2025 ","pages":"5375585"},"PeriodicalIF":1.4,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12549191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145377360","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":"Circulating Muscle Markers for Sarcopenia in Peritoneal Dialysis.","authors":"Lixing Xu, Jack Kit-Chung Ng, Winston Wing-Shing Fung, Gordon Chun-Kau Chan, Kai-Ming Chow, Cheuk-Chun Szeto","doi":"10.1155/ijne/8817404","DOIUrl":"10.1155/ijne/8817404","url":null,"abstract":"<p><p>Sarcopenia, characterized by the progressive decline in muscle mass and function, is an important complication among patients undergoing peritoneal dialysis (PD). Despite its prevalence, there is a notable lack of comprehensive research focused on early diagnosis or treatment target for sarcopenia in PD patients. This review explores the pathophysiology of sarcopenia and examines the potential role of various biomarkers related to muscle mass and function. These markers include myokines (cytokines produced by skeletal muscle) such as myostatin, follistatin, activin A, growth differentiation factor 15 (GDF-15), and irisin, as well as adiponectin, leptin, insulin-like growth factor-1 (IGF-1), vitamin D, myoglobin, and cortisol. These markers hold promise for early diagnosis and as therapeutic targets for managing sarcopenia. By reviewing the current literature in this area, we aim to identify directions for further research on diagnostic strategies and therapeutic options for sarcopenic PD patients.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2025 ","pages":"8817404"},"PeriodicalIF":1.4,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12543519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145354566","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":"Updating Predictive Model for Cisplatin-Induced Acute Kidney Injury: Incorporating Concomitant Medications and the Standard Supportive Care.","authors":"Kazuki Saito, Satoru Nihei, Junichi Asaka, Kenzo Kudo","doi":"10.1155/ijne/6615898","DOIUrl":"10.1155/ijne/6615898","url":null,"abstract":"<p><strong>Background and objective: </strong>Cisplatin-induced acute kidney injury (C-AKI) is detrimental to adequate cancer treatment. While scoring systems to predict C-AKI are available, they do not account for the impact of concomitant medications. This study aimed to enhance the predictive model by incorporating concomitant medications as a new predictor.</p><p><strong>Methods: </strong>We included data from 1785 patients who received cisplatin at Iwate Medical University Hospital between April 2014 and March 2023. Initially, we assessed the performance of the existing model in our cohort. We then explored additional predictors to improve their discriminatory ability guided by the Akaike information criterion. Candidates for new predictors were concomitant anticancer and supportive care medications that were previously unexamined. Finally, we assessed the statistical usefulness of the updated model using the C-statistic and its clinical usefulness using net reclassification improvement (NRI) and decision curve analysis (DCA).</p><p><strong>Results: </strong>The discriminatory power of the existing model was poor, with a C-statistics of 0.621 (95% confidence interval [CI]: 0.582-0.660). Incorporating magnesium supplementation as a novel predictor significantly improved the model's performance, increasing the C-statistic to 0.695 (95% CI: 0.660-0.731). The updated model demonstrated a superior NRI of 0.143 (95% CI: 0.043-0.243). In the DCA, the updated model yielded higher net benefits for most threshold probabilities.</p><p><strong>Conclusion: </strong>The existing model did not demonstrate satisfactory clinical performance in our cohort. While incorporating magnesium supplementation significantly improved model discrimination, its status as standard care limits its utility as a predictive variable. These findings underscore the necessity of developing C-AKI prediction models within cohorts receiving uniform, contemporary supportive care regimens.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2025 ","pages":"6615898"},"PeriodicalIF":1.4,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12539992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145345105","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}