International Journal of Nephrology最新文献

{"title":"Growth Differentiation Factor 15 and Risk of Death in Haemodialysis Patients.","authors":"Christelle Calen,&nbsp;Seraina Von Moos,&nbsp;Pietro Cippà,&nbsp;Alexandre Mebazaa,&nbsp;Mattia Arrigo","doi":"10.1155/2023/5163548","DOIUrl":"https://doi.org/10.1155/2023/5163548","url":null,"abstract":"<p><strong>Aim: </strong>Noninvasive identification of haemodialysis patients at high risk of cardiovascular events and death might improve their outcome. Growth differentiation factor 15 is a prognostic biomarker in multiple disease entities, including cardiovascular disease. The aim of this study was to assess the association between plasma GDF-15 and mortality in a cohort of haemodialysis patients.</p><p><strong>Methods: </strong>Circulating GDF-15 was measured in 30 patients after a regular haemodialysis session, followed by a clinical follow-up for all-cause death. Measurements were performed using the Proseek Multiplex Cardiovascular disease panels (Olink Proteomics AB) and validated using the Elecsys GDF-15 electrochemiluminescence immunoassay on a Cobas E801 analyzer (Roche Diagnostics).</p><p><strong>Results: </strong>During a median of 38 months, 9 patients (30%) died. Seven deaths occurred in the group of patients with a circulating GDF-15 above the median and two in the group with lower GDF-15. Mortality was significantly higher in patients with circulating GDF-15 levels above the median, log-rank<i>P</i> = 0.044. The performance of circulating GDF-15 to predict long-term mortality has an area under the ROC curve of 0.76, <i>P</i> = 0.028. Prevalence of most relevant comorbidities and the Charlson comorbidity index were similar across the two groups. A high agreement with a correlation among both diagnostic methods was observed (Spearman's rho = 0.83, <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>Plasma GDF-15 displays promising prognostic properties for the prediction of long-term survival beyond clinical parameters in patients on maintenance haemodialysis.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2023 ","pages":"5163548"},"PeriodicalIF":2.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10063357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9611062","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":"Blind Spot in the Radar of MEST-C Score: Type and Severity of Tubulointerstitial Nephritis in IgA Nephropathy.","authors":"Iram Asrar,&nbsp;Mudassar Hussain,&nbsp;Aurangzeb Afzal,&nbsp;Usman Hassan,&nbsp;Sheeba Ishtiaq","doi":"10.1155/2023/1060526","DOIUrl":"https://doi.org/10.1155/2023/1060526","url":null,"abstract":"<p><strong>Background: </strong>The updated version of predictive classification for immunoglobulin A nephropathy (IgAN) prognosis \"The Oxford Classification\" identifies five histopathological features including mesangial hypercellularity (M), endocapillary proliferation (E), segmental glomerulosclerosis (S), tubular atrophy/interstitial fibrosis (T) and crescents (C), the MEST-C. However, few studies suggest that tubulointerstitial inflammation, which is not included in the MEST-C, is also linked to disease progression and is, consequently, a neglected determinant of prognosis among others. Therefore, there is a need to evaluate this histopathological parameter in patients with IgA nephropathy.</p><p><strong>Materials and methods: </strong>This cross-sectional descriptive study was conducted at Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan. Data of histopathological and immunofluorescence proven renal biopsies (300) of IgA nephropathy patients from January 2016 through May 2022 were extracted using a convenient sampling technique. Biopsies were histologically reviewed for type and severity of tubulointerstitial inflammation, in addition to the MEST-C score. Renal biopsies of patients who had a history of transplant, autolyzed tissue, no glomeruli on histological examination, and/or a tubular atrophy/interstitial fibrosis score of 2 (T2) in MEST-C scoring were excluded. Data were analyzed using SPSS 20. An association between the variables was analyzed using the chi-square and Fischer exact tests. A <i>p</i> value less than 0.05 was considered statistically significant.</p><p><strong>Results: </strong>A total of 247/300 biopsies were eligible for inclusion. The mean age at the time of biopsy was 31.90 ± 12.48 with 63.6% in the age group between 21 and 40 years, and 69.6% were male. Tubulointerstitial inflammation was observed in 90.2% cases with 49.4% showing moderate while 4.5% showing severe degree of inflammation. A strong association of both the type and severity of tubulointerstitial inflammation was found with M, E, T, and C scores (<i>p</i> value < 0.05).</p><p><strong>Conclusion: </strong>The high-frequency and strong statistical association of tubulointerstitial inflammation with the M, E, T, and C scores in our study elucidate its prognostic role in the progression and management of IgA nephropathy.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2023 ","pages":"1060526"},"PeriodicalIF":2.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10027444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9167022","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":"Primary Hyperoxaluria Type 1: Clinical, Paraclinical, and Evolutionary Aspects in Adults from One Nephrology Center.","authors":"Hajji Meriam,&nbsp;Asma Bettaieb,&nbsp;Hayet Kaaroud,&nbsp;Fethi Ben Hamida,&nbsp;Taher Gargeh,&nbsp;Ridha Mrad,&nbsp;Kahena Bouzid,&nbsp;Ezzeddine Abderrahim","doi":"10.1155/2023/2874414","DOIUrl":"https://doi.org/10.1155/2023/2874414","url":null,"abstract":"<p><strong>Introduction: </strong>Primary hyperoxaluria type 1 (PH1) is a rare and inherited condition of urolithiasis. The aim of our study was to analyze clinical, paraclinical, and evolutionary aspects of PH1 in adult patients in our Nephrology department.</p><p><strong>Methods: </strong>We conducted a retrospective single-center study between 1990 and 2021. We collected patients followed for PH1 confirmed by genetic study and/or histopathological features of renal biopsy and morphoconstitutional analysis of the calculi.</p><p><strong>Results: </strong>There were 25 patients with a gender ratio of 1.78. The median age at onset of symptoms was 18 years. A delay in diagnosis more than 10 years was noted in 13 cases. The genetic study found the I244T mutation in 17 cases and 33-34 InsC in 4 cases. A kidney biopsy was performed in 5 cases, on a native kidney in 4 cases and on a graft biopsy in one case. The analysis of calculi was done in 10 cases showing type Ic in 2 cases. After a median follow-up of 13 years (1 year-42 years), 14 patients progressed to end-stage chronic renal failure (ESRD). The univariate study demonstrated a remarkable association with progression to ESRD in our population (44% vs. 56%) RR = 13.32 (adjusted ORs (95% CI): 2.82-62.79) (<i>p</i> < 0.01).</p><p><strong>Conclusion: </strong>Progression to ESRD was frequent in our series. Early diagnosis and adequate management can delay such an evolution.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2023 ","pages":"2874414"},"PeriodicalIF":2.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10372328/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9900994","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":"Somatic Symptoms of Depression Lose Association with Mortality upon Adjustment for Frailty: Analysis from the Fitness Haemodialysis Cohort.","authors":"Benjamin M Anderson,&nbsp;Muhammad Qasim,&nbsp;Gonzalo Correa,&nbsp;Felicity Evison,&nbsp;Suzy Gallier,&nbsp;Charles J Ferro,&nbsp;Thomas A Jackson,&nbsp;Adnan Sharif","doi":"10.1155/2023/4518843","DOIUrl":"https://doi.org/10.1155/2023/4518843","url":null,"abstract":"<p><strong>Introduction: </strong>The somatic symptom component of depression is associated with increased hospitalisation and mortality and poorer health-related quality of life (HRQOL). However, the relationship of subsets of depression symptoms with frailty and outcomes is not known. This study aimed to (1) explore the relationship between the Clinical Frailty Scale (CFS) and components of depression and (2) their association with mortality, hospitalisation, and HRQOL in haemodialysis recipients.</p><p><strong>Methods: </strong>We conducted a prospective cohort study of prevalent haemodialysis recipients, with deep bio-clinical phenotyping including CFS and PHQ-9 somatic (fatigue, poor appetite, and poor sleep) and cognitive component scores. EuroQol EQ-5D summary index assessed HRQOL at the baseline. Electronic linkage to English national administration datasets ensured robust follow-up data for hospitalisation and mortality events. <i>Findings</i>. Somatic (<i>β</i> = 0.067; 95% C.I. 0.029 to 0.104; <i>P</i> < 0.001) and cognitive (<i>β</i> = 0.062; 95% C.I. 0.034 to 0.089; <i>P</i><0.001) components were associated with increased CFS scores. Both somatic (<i>β</i> = -0.062; 95% C.I. -0.104 to -0.021; <i>P</i><0.001) and cognitive (<i>β</i> = 0.052; 95% C.I. -0.081 to -0.024; <i>P</i> < 0.001) scores were associated with lower HRQOL. Somatic scores lost mortality association on addition of CFS to the multivariable model (HR1.06; 95% C.I. 0.977 to 1.14; <i>P</i>=0.173). Cognitive symptoms were not associated with mortality. Neither the component score was associated with hospitalisation on multivariable analyses.</p><p><strong>Conclusions: </strong>Both somatic and cognitive depression symptoms are associated with frailty and poorer HRQOL in haemodialysis recipients but were not associated with mortality or hospitalisation when adjusted for frailty. The risk profile of depression somatic scores may be related to overlap with symptoms of frailty.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2023 ","pages":"4518843"},"PeriodicalIF":2.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10307017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9794119","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":"Effects of Oral Sodium Bicarbonate Supplementation on Protein Metabolism and Inflammation in Iraqi Hemodialysis Patients: An Open-Label Randomized Controlled Trial.","authors":"Zina A Rasheed,&nbsp;Ban A Al-Hashemi,&nbsp;Ala A Ali","doi":"10.1155/2023/6657188","DOIUrl":"https://doi.org/10.1155/2023/6657188","url":null,"abstract":"<p><strong>Background: </strong>The effect of correcting metabolic acidosis on protein metabolism in hemodialysis patients is controversial.</p><p><strong>Objectives: </strong>To study the effects of oral sodium bicarbonate on protein metabolism and markers of inflammation in acidotic hemodialysis patients. <i>Patients and Methods</i>. An open-label randomized controlled trial was conducted at a single center. Sixty-six clinically stable adult hemodialysis patients were recruited with an average predialysis serum bicarbonate level of <22 mmol/l and a dialysate bicarbonate concentration of 35 mmol/l. Forty-nine participants have completed the study. Oral sodium bicarbonate tablets of 500 mg were given daily in the intervention group (<i>n</i> = 25) for 12 weeks versus the standard of care in the control group (<i>n</i> = 24). Outcomes compared intervention versus nonintervention in both groups at equivalent time points (0 and 3 months). The clinical data, anthropometry, dialysis adequacy, albumin, normalized protein catabolism rate, blood gas analysis, and bicarbonate were recorded at 0 and 3 months. In addition, muscle mass and handgrip strength were measured. Finally, IL-6 as a marker of inflammation was measured at randomization and three months.</p><p><strong>Results: </strong>Serum bicarbonate and pH increased significantly from 17.57 ± 3.34 mmol/L to 20.69 ± 2.54 mmol/L and from 7.26 ± 0.06 to 7.34 ± 0.04, respectively (<i>p</i> < 0.0001). Serum albumin was significantly higher in the intervention group at three months than in the control group, 4.11 ± 0.45 vs. 3.79 ± 0.47 (<i>p</i> value 0.011). Serum potassium significantly decreased in the intervention group at three months compared to the control group, 5.00 ± 0.43 mEq/l vs. 5.33 ± 0.63 mEq/l (<i>p</i> value 0.03). Muscle strength expressed as handgrip has improved significantly in the intervention group at three months compared to the control group, 45.01 ± 19.19 vs. 33.93 ± 15.06 (<i>p</i> value 0.03). The IL-6 values were less in the intervention group at 3 months with a <i>p</i> value of 0.01. The interdialytic weight of the intervention group at three months was 2.42 ± 0.64 compared to the 2.20 ± 1.14 control group, but this did not reach statistical significance (<i>p</i> value of 0.4). The composite of (albumin + nPCR) at three months was achieved in 59.18% of the intervention group compared to 14.28% with a <i>p</i> value of 0.01.</p><p><strong>Conclusions: </strong>Correcting metabolic acidosis in hemodialysis patients improved serum albumin and nPCR without hypokalemia or significant interdialytic weight gain. This was particularly evident in patients with minimal inflammation with low IL-6 values.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2023 ","pages":"6657188"},"PeriodicalIF":2.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10403331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9943351","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 Effect of <i>Olea europaea</i> Leaf Extract on Cisplatin-Induced Nephrotoxicity in the Rat Model.","authors":"Doa'a Ibrahim,&nbsp;Abdulsalam Halboup,&nbsp;Mohammed Al Ashwal,&nbsp;Amani Shamsher","doi":"10.1155/2023/2074498","DOIUrl":"https://doi.org/10.1155/2023/2074498","url":null,"abstract":"<p><strong>Background: </strong><i>Olea europaea</i> leaf extract (OELE) has potential health benefits and protects against cytotoxicity. This study investigated the possible ameliorative effect of OELE on cisplatin-induced nephrotoxicity in rats.</p><p><strong>Methods: </strong>Rats were assigned into six groups; two groups received 150 mg/kg or 300 mg/kg of OELE, one group received a single dose of cisplatin (6 mg/kg) IP on the first day of the experiment, two groups received a single dose of cisplatin 150 mg/kg or 300 mg/kg of OELE on the first day then starting from the fifth day for 10 consecutive days, and one group acted as a control. <i>Results and Conclusion</i>. The findings showed that cisplatin-induced nephrotoxicity was evidenced by a significant increase in serum creatinine blood urea nitrogen (BUN) and a significant decrease in estimated creatinine clearance and potassium level, which corresponded with the alterations in the histopathology of the renal tissue. OELE significantly ameliorated the nephrotoxic effects of cisplatin as dose-dependent.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2023 ","pages":"2074498"},"PeriodicalIF":2.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10368505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10241464","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 Growing Challenge of Chronic Kidney Disease: An Overview of Current Knowledge.","authors":"Rikke Borg,&nbsp;Nicholas Carlson,&nbsp;Jens Søndergaard,&nbsp;Frederik Persson","doi":"10.1155/2023/9609266","DOIUrl":"https://doi.org/10.1155/2023/9609266","url":null,"abstract":"<p><p>Chronic kidney disease (CKD) is becoming one of the world's most prevalent noncommunicable chronic diseases. The World Health Organization projects CKD to become the 5th most common chronic disease in 2040. Causes of CKD are multifactorial and diverse, but early-stage symptoms are often few and silent. Progression rates are highly variable, but patients encounter both an increased risk for end-stage kidney disease (ESKD) as well as increased cardiovascular risk. End-stage kidney disease incidence is generally low, but every single case carries a significant burden of illness and healthcare costs, making prevention by early intervention both desirable and worthwhile. This review focuses on the prevalence, diagnosis, and causes of CKD. In addition, we discuss the developments in the general treatment of CKD, with particular attention to what can be initiated in general practice. With the addition of recent landmark findings and the expansion of the indication for using sodium-glucose cotransporter 2 inhibitors, there are now new effective treatments to add to standard therapy. This will also be relevant for primary care physicians as many patients with CKD have their family physician as their primary health care professional handling kidney function preservation. In the future, more precise and less invasive diagnostic methods may not only improve the determination of the underlying cause of CKD but may also carry information regarding which treatment to use (i.e. personalized medicine). This could lead to a reduced number of preventive treatments per individual, while at the same time improving the prognosis. This review summarizes ongoing efforts in this area.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2023 ","pages":"9609266"},"PeriodicalIF":2.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9995188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9469526","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 Impact of Anaemia on Outcomes, Admissions, and Costs in Patients with Chronic Kidney Disease in Two Public Nephrology Practices in Queensland: A CKD.QLD Registry Study.","authors":"Jianzhen Zhang,&nbsp;Vishal Diwan,&nbsp;Zaimin Wang,&nbsp;Helen G Healy,&nbsp;Sree Krishna Venuthurupalli,&nbsp;Rajitha Abeysekera,&nbsp;Wendy E Hoy","doi":"10.1155/2023/8720293","DOIUrl":"https://doi.org/10.1155/2023/8720293","url":null,"abstract":"<p><strong>Aim: </strong>Anaemia among patients with chronic kidney disease (CKD) leads to poor overall outcomes. This study explores anaemia and its impact on nondialysis CKD (NDD-CKD) patients.</p><p><strong>Methods: </strong>2,303 adults with CKD from two CKD.QLD Registry sites were characterised at consent and followed until start of kidney replacement therapy (KRT), death, or censor date. Mean follow-up was 3.9 (SD 2.1) years. Analysis explored the impact of anaemia on death, KRT start, cardiovascular events (CVE), admissions, and costs in these NDD-CKD patients.</p><p><strong>Results: </strong>At consent, 45.6% patients were anaemic. Males were more often anaemic (53.6%) than females, and anaemia was significantly more common over the age of 65 years. The prevalence of anaemia was highest among CKD patients with diabetic nephropathy (27.4%) and renovascular disease (29.2%) and lowest in patients with genetic renal disease (3.3%). Patients with admissions for gastrointestinal bleeding had more severe anaemia, but accounted for only the minority of cases overall. Administration of ESAs, iron infusions, and blood transfusions were all correlated with more severe degrees of anaemia. The number of hospital admissions, length of stay, and hospital costs were all strikingly higher with more severe degrees of anaemia. Adjusted hazard ratios (CI 95%) of patients with moderate and severe anaemia vs. no anaemia for subsequent CVE, KRT, and death without KRT were 1.7 (1.4-2.0), 2.0 (1.4-2.9), and 1.8 (1.5-2.3), respectively.</p><p><strong>Conclusion: </strong>Anaemia is associated with higher rates of CVE, progression to KRT and death in NDD- CKD patients, and with greater hospital utilisation and costs. Preventing and treating anaemia should improve clinical and economic outcomes.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2023 ","pages":"8720293"},"PeriodicalIF":2.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10171986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9467654","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":"Critically Ill Patients with Renal Hyperfiltration: Optimizing Antibiotic Dose.","authors":"Jorge Rico-Fontalvo,&nbsp;José Correa-Guerrero,&nbsp;María Cristina Martínez-Ávila,&nbsp;Rodrigo Daza-Arnedo,&nbsp;Tomás Rodriguez-Yanez,&nbsp;Amilkar Almanza-Hurtado,&nbsp;José Cabrales,&nbsp;Carmen Julia Mendoza-Paternina,&nbsp;Alvaro Frías-Salazar,&nbsp;Julio Morales-Fernández","doi":"10.1155/2023/6059079","DOIUrl":"https://doi.org/10.1155/2023/6059079","url":null,"abstract":"<p><p>Renal hyperfiltration (RHF) is a prevalent phenomenon in critically ill patients characterized by augmented renal clearance (ARC) and increased of elimination of renally eliminated medications. Multiple risk factors had been described and potential mechanisms may contribute to the occurrence of this condition. RHF and ARC are associated with the risk of suboptimal exposure to antibiotics increasing the risk of treatment failure and unfavorable patient outcomes. The current review discusses the available evidence related to the RHF phenomenon, including definition, epidemiology, risk factors, pathophysiology, pharmacokinetic variability, and considerations for optimizing the dosage of antibiotics in critically ill patients.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2023 ","pages":"6059079"},"PeriodicalIF":2.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9991472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9086353","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":"Gender Disparity in Expression of Sarcopenia in Haemodialysis Recipients: Analysis from the FITNESS Cohort.","authors":"Benjamin M Anderson,&nbsp;Daisy V Wilson,&nbsp;Muhammad Qasim,&nbsp;Gonzalo Correa,&nbsp;Felicity Evison,&nbsp;Suzy Gallier,&nbsp;Charles J Ferro,&nbsp;Thomas A Jackson,&nbsp;Adnan Sharif","doi":"10.1155/2023/5885059","DOIUrl":"https://doi.org/10.1155/2023/5885059","url":null,"abstract":"<p><strong>Background: </strong>There has been little exploration of the interplay between sarcopenia and frailty in haemodialysis, particularly regarding gender difference. We aimed to (1) assess whether ultrasound-derived low muscle mass (LMM) and sarcopenia are more common in male or female haemodialysis recipients; (2) assess whether age influences any observed gender difference, and (3) explore the interplay between sarcopenia, frailty, and gender in haemodialysis recipients.</p><p><strong>Methods: </strong>This was an exploratory analysis of a subgroup of adult prevalent (≥3 months) haemodialysis with frailty phenotype (FP) scores. Bilateral anterior thigh thickness (BATT) was obtained according to an established ultrasound protocol. Associations with frailty were explored via both linear and logistic regressions for BATT, LMM, and sarcopenia with a priori covariables, stratified by gender.</p><p><strong>Results: </strong>In total of 223 studies, participants had ultrasound measurements. Males showed greater prevalence of LMM. On adjusted analyses, LMM was associated with lower hand grip strength in males (<i>β</i> = -4.17; 95% C.I. -7.57 to -0.77; <i>P</i>=0.02), but not females (<i>β</i> = -1.88; 95% C.I. -5.41 to 1.64; <i>P</i>=0.29). LMM was also associated with slower walking speed in both males (<i>β</i> = -0.115; 95% C.I. -0.258 to -0.013; <i>P</i>=0.03) and females (<i>β</i> = -0.152; 95% C.I. -0.300 to -0.005; <i>P</i>=0.04). Sarcopenia was associated with greater odds of frailty on adjusted models in males (OR = 9.86; 95% C.I. 1.8 to 54.0; <i>P</i>=0.01), but not females (OR = 5.16; 95% C.I. 0.22 to 124; <i>P</i>=0.31).</p><p><strong>Conclusions: </strong>The clinical expression and significance of sarcopenia differ substantially between males and females on haemodialysis. Further work is required to elucidate underlying mechanisms and guide tailored treatment.</p>","PeriodicalId":14177,"journal":{"name":"International Journal of Nephrology","volume":"2023 ","pages":"5885059"},"PeriodicalIF":2.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10290558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10094972","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}