International Urology and Nephrology最新文献

{"title":"Impact of ureteral access sheath size on intrarenal pressure evaluated by LithoVue^™ elite single use ureteroscope.","authors":"Sotaro Kayano, Takafumi Yanagisawa, Naoya Tomomasa, Yuji Yata, Eriko Nishi, Shota Kawano, Keiichiro Miyajima, Steffi Kar Kei Yuen, Takahiro Kimura","doi":"10.1007/s11255-025-04430-4","DOIUrl":"10.1007/s11255-025-04430-4","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to assess the impact of ureteral access sheath (UAS) size on intrarenal pressure (IRP) using LithoVue^™ Elite (LVE) ureteroscope (Boston Scientific) during lithotripsy and to identify factors contributing to increased IRP.</p><p><strong>Methods: </strong>A single-arm prospective study was conducted on 21 consecutive patients who underwent ureteroscopic lithotripsy using the LVE at a single center between April 2023 and April 2024. 11/13 Fr or 13/15 Fr UAS was placed in all cases based on the physician's discretion. We analyzed baseline, median, and maximum IRPs and factors associated with increased IRP (≥ 30 mmHg).</p><p><strong>Results: </strong>Median age was 61 (IQR: 48-66) years. Baseline, median, and maximum IRPs were 11 (IQR: 5-16), 32 (IQR: 18-67), and 159 (IQR: 111-222) mmHg, respectively. 11/13Fr and 13/15Fr UAS were utilized in 10 and 11 patients, respectively, with no significant difference in patient demographics between the two groups. The baseline, median, and maximum IRPs were significantly lower in the 13/15Fr UAS group: 5 vs. 18.5 mmHg (p = 0.001), 21 vs. 57 mmHg (p = 0.02), and 111 vs 177.5 mmHg (p = 0.01). The use of 11/13 UAS was the factor associated with an increased median IRP (≥ 30 mmHg). Sex, comorbidities, the presence of hydronephrosis, stone location, the shape of the renal pelvis, and laser size were not.</p><p><strong>Conclusions: </strong>Measurement and monitoring of IRPs using LVE during lithotripsy are technically feasible. Our study confirmed that the use of larger UAS can decrease IRP. Further investigation is needed to clarify the clinical impact of IRP during URS.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"2481-2486"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and location of positioning-related injuries in lateral positioning during laparoscopic kidney surgery.","authors":"Charlotte H Larsen, Samar M Christensen, Elnaz Parwaei, Thordis Thomsen, Frederik F Thomsen","doi":"10.1007/s11255-025-04415-3","DOIUrl":"10.1007/s11255-025-04415-3","url":null,"abstract":"","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"2475-2480"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the quality of life and biochemical characteristics of patients undergoing hemodialysis and peritoneal dialysis: a systematic review and meta-analysis.","authors":"Al-Amin Jamain, Jackson Tan, Hanif Abdul Rahman","doi":"10.1007/s11255-025-04470-w","DOIUrl":"10.1007/s11255-025-04470-w","url":null,"abstract":"<p><strong>Background: </strong>End-stage kidney failure (ESKF) requires kidney replacement therapy (KRT), which has a significant effect on the quality of life (QoL) of patients. Globally, well-established treatment options for ESKF include HD, PD, and kidney transplantation. Each has a unique effect on a patient's QoL in terms of their physical, mental, and social health. The objective of this study was to evaluate and compare the QoL of patients undergoing PD and HD by utilizing the 36-item Short Form Health Survey (SF-36), EuroQoL-5-dimension (EQ-5D), and WHOQOL-BREF questionnaires.</p><p><strong>Methods: </strong>We performed a comprehensive review and meta-analysis by identifying relevant research through the use of ScienceDirect, CINAHL, MEDLINE, and Google Scholar. These studies examined patients with ESKF who were undergoing either HD or PD and reported changes in QoL and biochemical characteristics. If heterogeneity was present, we calculated and pooled the standardized mean differences (SMDs) in QoL among modalities via a random effects model.</p><p><strong>Results: </strong>This analysis included twenty-five (25) studies that examined the QoL and biochemical characteristics of a total of 5,440 participants. Among these participants, 3465 (63.75%) were receiving HD, and 1975 (36.25%) were receiving PD. The QoL instruments assess a variety of effects. However, these studies demonstrate that PD consistently performs better than HD in multiple assessment components, including for burdens of kidney disease, general health, mental health, and emotional. Nevertheless, there was no significant difference in the QoL scores regarding cognitive ability, energy levels, physical health, patient satisfaction, psychology, social interaction, emotional well-being, sexual functioning, or sleeping patterns between these modalities.</p><p><strong>Conclusion: </strong>The study's findings show that patients with PD have a higher QoL in comparison to those with HD. Despite reports of enhanced QoL among PD patients, their global prevalence remains relatively low. Therefore, healthcare professionals should prioritize the development and implementation of strategies for ESKF patients, considering PD as the primary treatment. The results suggest a trend favoring PD over HD in various aspects of QOL. However, the significant heterogeneity and the lower number of PD patients require careful interpretation of these findings.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"2681-2696"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparative analysis of robotic prostatectomy techniques post TURP/HOLEP: retzius-sparing vs. non-retzius approaches: evaluation of perioperative, functional, and oncological outcomes.","authors":"Atanu Kumar Pal, Jeni Mathew, Sandeep Prabhakaran, T A Kishore","doi":"10.1007/s11255-025-04423-3","DOIUrl":"10.1007/s11255-025-04423-3","url":null,"abstract":"<p><strong>Purpose: </strong>We evaluated the perioperative, functional, and oncological outcomes of Retzius-sparing and conventional non-Retzius-sparing robotic radical prostatectomy (RS-RARP and NRS-RARP) in the patients with a prior history of transurethral resection and enucleation of prostate (Post TURP/HOLEP).</p><p><strong>Methods: </strong>A total of 47 patients who had at least completed one year of follow-up after robotic radical prostatectomy and had a prior TURP/HOLEP were included in this retrospective analysis. The clinico-demographic data, perioperative parameters such as mean operating time, blood loss, mean hospital stay, complications as per Clavien-Dindo grading, and readmission were evaluated. Continence, potency, and biochemical recurrence were assessed to check the functional and oncological outcomes.</p><p><strong>Results: </strong>There was no significant difference in mean age, body mass index (BMI), co-morbidities, D-Amico risk stratification, preoperative PSA level and positive cores in TRUS-guided biopsy. The console time and blood loss were significantly less in the RS-RARP group (91.6 ± 24.2 vs. 128.9 ± 38.7 min vs. 110.3 ± 57.5 vs. 152.9 ± 64.9 ml, p = 0.0002 and p = 0.02, respectively). The complication rate, mean postoperative catheter duration, lymph nodes, readmission rates, final histopathology, and invasion status were similar in both groups. Continence achieved at 1,3,6,9 and 12-month follow-up was significantly more in the RS-RARP group (90% vs. 64.7% at 12-month; p = 0.01). The potency rates in nerve-sparing cases at 6-month and 1-year follow-ups were similar. Margin positivity rates and Biochemical recurrence were comparable and statistically insignificant in both groups.</p><p><strong>Conclusion: </strong>Retzius-sparing RARP had less console time, less intraoperative blood loss and better continence recovery in both immediate and at 12-month follow-up. The potency, biochemical recurrence and margin status in both approaches were similar.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"2435-2443"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143447632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preliminary experience with minimally invasive transvaginal single-port laparoscopic vesicovaginal fistula repair: report of 10 cases.","authors":"Qi Zeng, Xin Chang Zou, Bin Wang, Hai Chao Chao, Jian Biao Huang","doi":"10.1007/s11255-025-04410-8","DOIUrl":"10.1007/s11255-025-04410-8","url":null,"abstract":"<p><strong>Background and purpose: </strong>As a common complication following genitourinary trauma, the methods and approaches for repairing vesicovaginal fistulas (VVF) remain controversial. Minimally invasive techniques, such as laparoscopy, are gaining widespread attention. This study summarizes our surgical experiences and postoperative management regarding transvaginal single-port laparoscopic repair of vesicovaginal fistulas.</p><p><strong>Patients and methods: </strong>We retrospectively analyzed the clinical data of 10 transvaginal single-port laparoscopic vesicovaginal fistula repairs performed in the Department of Urology at the Second Affiliated Hospital of Nanchang University from September 2022 to August 2023. All patients had complex vesicovaginal fistulas that had been treated poorly by multiple surgeries. This analysis included the causes of the fistulas, perioperative care, and efficacy. We recorded the operation time, intraoperative blood loss, and length of hospital stay, and we analyzed and summarized the surgical methods and treatment outcomes. Patients were followed up for 12 months post-surgery to assess urinary leakage and changes in their quality of life.</p><p><strong>Results: </strong>Among the 10 patients, the average age was 58 ± 4.10 years. All surgeries were successfully completed. The average operation time was 96 ± 15 min, with an average postoperative hospital stay of 5.70 ± 0.64 days. The urethral catheter was removed after 2 weeks of follow-up, and no patients experienced complications such as bleeding, urinary leakage, or infection. One month post-operation, both the cystomelan infusion test and cystography indicated no presence of a fistula or residual fistula tract. Follow-up cystoscopy conducted 3 months after the surgery showed that the fistula had completely healed, demonstrating remarkable surgical outcomes. One year after the surgery, the patients were asymptomatic and showed no signs of recurrence.</p><p><strong>Conclusion: </strong>Transvaginal single-port laparoscopic vesicovaginal fistula repair is safe and effective in treating complex vesicovaginal fistula, while retaining bladder function to the greatest extent, and is worthy of clinical promotion and application.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"2395-2400"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143407977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A meta-analysis of perioperative, oncological, and functional outcomes of robot-assisted partial nephrectomy for completely endophytic and hilar lesions.","authors":"Li Huang, Jian-Qin Wang","doi":"10.1007/s11255-025-04431-3","DOIUrl":"10.1007/s11255-025-04431-3","url":null,"abstract":"<p><strong>Background: </strong>This study aims to compare the perioperative, functional, and oncological outcomes of robot-assisted partial nephrectomy in complex renal masses (CRM) with non-CRM tumors.</p><p><strong>Methods: </strong>A systematic literature review was conducted in PubMed, Embase, Web of Science, and Cochrane Library databases, following the PRISMA guidelines. The studies comparing RAPN outcomes between complex renal masses (CRM), specifically completely endophytic and hilar renal tumors, versus non-complex renal masses (non-CRM), which include non-endophytic, and non-hilar renal tumors.</p><p><strong>Results: </strong>Twelve studies involving 8126 patients were analyzed. The results revealed CRM group increased operative time (Mean Difference [MD]: 14.35 min; 95% CI: 5.14-23.55; p = 0.002), higher blood loss (MD: 20.42 mL; 95% CI: 0.83-40.02; p = 0.041), and greater decline in estimated glomerular filtration rate (eGFR) (MD: 2.19 mL/min/1.73 m²; 95% CI: 0.59-3.78; p = 0.007). Major complications were significantly more frequent in the CRM group (OR: 1.57; 95% CI: 1.15-2.13; p = 0.004). However, no significant differences were observed in length of hospital stay, positive surgical margins (PSM), or local recurrence rates.</p><p><strong>Conclusions: </strong>RAPN for CRM is associated with longer operative times, increased blood loss, greater decline in eGFR, and higher rates of major complications. However, oncological outcomes (PSM and local recurrence rates) are comparable to those for non-CRM. These findings suggest that RAPN remains a feasible option for treating CRM in experienced centers, provided that careful patient selection and preoperative planning are followed.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"2359-2370"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The global burden of chronic kidney disease due to glomerulonephritis: trends and predictions.","authors":"Xiaotong Wang, Zhaoyi Liu, Na Yi, Liguo Li, Li Ma, Linyue Yuan, Xuejiao Wang","doi":"10.1007/s11255-025-04440-2","DOIUrl":"10.1007/s11255-025-04440-2","url":null,"abstract":"<p><strong>Background: </strong>Glomerulonephritis (GN), one of the primary causes of chronic kidney disease (CKD), is gaining recognition as a major public health issue. This research sought to evaluate the worldwide impact of chronic kidney disease due to glomerulonephritis (GN-CKD) between 1990 and 2021 and to forecast trends up to 2036, leveraging data from the Global Burden of Disease (GBD) study.</p><p><strong>Methods: </strong>The analysis of GN-CKD from 1990 to 2021 utilized GBD open data as a secondary dataset to examine global prevalence, deaths, disability-adjusted life years (DALYs), and age-standardized rates of GN-CKD, and the changing trends of these indicators were statistically analyzed. To assess the practical difference between each country/region and the frontier, we utilized the 2021 DALYs and Socio-Demographic Index (SDI). To assist healthcare institutions in formulating more effective public health policies, the age-standardized mortality and DALYs rate until 2036 were predicted using Bayesian age-period-cohort (BAPC) modeling techniques.</p><p><strong>Results: </strong>The global prevalence rate of GN-CKD, as indicated by the age-standardized prevalence rate (ASPR), grew 10.81% between 1990 and 2021, with a marginal average annual change of 0.04 (AAPC0.04, 0.03-0.05). Similarly, there was an increase of 15.84% in the age-standardized death rate (ASDR) for GN-CKD during this period, with an average annual trend of 0.50 (AAPC0.50, 0.41-0.59). Moreover, the age-standardized DALYs rate (ASYR) for GN-CKD observed an upward trend of 8.60% from 1990 to 2021, with a modest average annual change of 0.27 (AAPC0.27, 0.17-0.37). Our findings indicate that the impact of GN-CKD differs across gender, geographic areas, and socioeconomic statuses. Elevated fasting plasma glucose levels, high body-mass index (BMI), and elevated systolic blood pressure were the main contributors to deaths and disability-adjusted life years (DALYs). Fortunately, the burden of GN-CKD is expected to diminish by 2036.</p><p><strong>Conclusions: </strong>The worldwide impact of GN-CKD has risen, with variations observed between genders and across SDI regions. Encouraging trends point toward a potential reduction in GN-CKD-related burden in the future.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"2613-2624"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12259738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Varieties of altered TFE3 can occur in MiT-family-related renal cell carcinomas.","authors":"Allison K Kennedy, Hassan D Kanaan, Kanika Arora, Harry Zhang, Jason M Hafron, Shelly L Kaufman, Mark A Micale, Ping L Zhang","doi":"10.1007/s11255-025-04394-5","DOIUrl":"10.1007/s11255-025-04394-5","url":null,"abstract":"<p><strong>Background: </strong>In TFE3 translocation renal cell carcinoma (RCC), rearrangements involving the TFE3 gene can lead to overexpression of the TFE3 transcription factor. This upregulation increases lysosomal activity and autophagy, which in turn contributes to tumor cell proliferation. Although TFE3 translocation RCC is one of the more extensively studied RCC subtypes, other genetic abnormalities, such as gene copy number alterations, may also play a role in disease development. Accordingly, this study aimed to more precisely categorize TFE3-altered RCC variants using fluorescence in situ hybridization (FISH), while also evaluating their histopathological characteristics and clinical behavior.</p><p><strong>Methods: </strong>In this retrospective study spanning the past 9 years, 16 cases of renal cell carcinoma (RCC) were examined for TFE3 gene alterations using FISH. The cohort was divided into two groups: TFE3-altered RCC cases as the positive group (n = 6) and TFE3-negative RCC cases as the negative group (n = 10). TFE3 alterations, tumor pathology, and clinical outcomes were systematically evaluated.</p><p><strong>Results: </strong>The age of patients with TFE3-altered RCC ranged from 6 to 70 years old. There were five female patients and one male patient, which is consistent with the known female predominance of this RCC subtype. The TFE3 alterations observed in this cohort included: TFE3 gene rearrangement (n = 1), TFE3 gene rearrangement with copy number gain (n = 1), copy number gain of intact TFE3 gene (n = 3), and copy number loss of TFE3 gene (n = 1). Clinical outcomes varied, with some patients experiencing poor prognoses, including the development of distant metastases.</p><p><strong>Conclusions: </strong>Our data show that TFE3 alterations in RCC span a range of genetic events, from gene rearrangements to copy number variations, as determined by FISH. These TFE3-altered RCCs in adults may be associated with unfavorable outcomes, underscoring the value of FISH in both diagnosing and refining our understanding of TFE3-altered RCC.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"2425-2433"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role and application prospective of non-steroidal MRA in the treatment of diabetic kidney disease.","authors":"Yu Sun, Mingzhu Wang","doi":"10.1007/s11255-025-04456-8","DOIUrl":"10.1007/s11255-025-04456-8","url":null,"abstract":"<p><p>Chronic kidney disease (CKD) has diverse etiologies and complex pathogenesis, and is prone to recurrent episodes and prolonged illness. In recent years, the prevalence of CKD has been increasing year by year, and the global prevalence in the general population has reached 14.3%. Diabetic kidney disease (DKD) is a common complication of diabetes mellitus (DM), and about 20-40% of DM patients have combined DKD, which is also the main cause of CKD and end-stage renal disease (ESRD). DM catalyzes CKD in approximately 30-50% of global cases, affecting around 285 million individuals. It primarily triggers diabetic nephropathy (DN), the leading cause of end-stage renal disease worldwide. Research indicates that activation of the mineralocorticoid receptor (MR) plays a role in the onset and progression of DKD. Counteracting MR overactivation offers antioxidative, anti-inflammatory, and anti-fibrotic benefits, thereby ameliorating target organ damage. MR antagonists (MRAs) such as spironolactone and eplerenone have been validated for renal protection. However, their clinical application is hindered by adverse effects including hyperkalemia, gynecomastia in males, erectile dysfunction, and menstrual irregularities in females. Finerenone, a novel non-steroidal MRA, exhibits a unique mechanism of action, binding to MR and inhibiting the recruitment of transcription co-factors involved in gene expression, effectively slowing the progression of diabetic nephropathy (DN). In addition, finerenone demonstrates improved safety and efficacy in treating heart failure and chronic kidney disease. It also plays a significant role in the management of atrial fibrillation and myocardial infarction. This article reviews recent studies on finerenone, summarizing its mechanism of action in treating DN, evidence from clinical trials, adverse reactions, combined use with other inhibitors, and future prospective, aiming to provide insights for the prevention and treatment of DN.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"2567-2577"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lipoprotein(a) levels and cardiovascular mortality risk in Chinese patients undergoing hemodialysis.","authors":"Qiaojing Liang, Guojuan Zhang, Liping Jiang, Binghan Li, Kangkang Song","doi":"10.1007/s11255-025-04459-5","DOIUrl":"10.1007/s11255-025-04459-5","url":null,"abstract":"<p><strong>Purpose: </strong>Lipoprotein(a) (Lp(a)) is recognized as an independent risk factor for cardiovascular disease (CVD) in the general population. However, its impact on CVD mortality among Chinese patients undergoing maintenance hemodialysis (MHD) has not been fully established. This study aimed to evaluate the association between Lp(a) levels and both CVD mortality and all-cause mortality in this population.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted involving 200 MHD patients from Beijing Tongren Hospital, analyzed from January 1, 2013, to July 1, 2024. The mortality outcomes included CVD-related and all-cause mortality. Kaplan-Meier survival curves were utilized to assess the impact of Lp(a), while Cox regression analysis and restrict cubic spline were performed to explore associations.</p><p><strong>Results: </strong>The median follow-up duration was 66.5 months, with 121 deaths recorded (60.5%), of which 66 (54.5%) were due to CVD. Kaplan-Meier analysis indicated that patients in the highest tertile of Lp(a) levels had the lowest survival for both CVD mortality and all-cause mortality. In multivariable Cox regression, higher Lp(a) levels were independently associated with an increased risk of both CVD mortality and all-cause mortality. The restricted cubic splines regression model showed that the risk of CVD mortality and all-cause mortality increased with rising Lp(a) levels.</p><p><strong>Conclusion: </strong>Elevated serum Lp(a) levels are independently associated with increased mortality from both CVD and all causes in Chinese MHD patients. These findings indicate that serum Lp(a) may be a significant risk factor for CVD mortality in this population.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"2669-2679"},"PeriodicalIF":1.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}