International Urology and Nephrology最新文献

{"title":"Comparison of the prognoses after two different surgical procedures plus radiotherapy in the treatment of patients with prostate cancer: survival analysis based on propensity score matching.","authors":"Yushui Chen, Gen Fan, Yinyu Wu, Yu Wang, Songzhi Cai, Yang Li, Tielong Tang","doi":"10.1007/s11255-025-04489-z","DOIUrl":"https://doi.org/10.1007/s11255-025-04489-z","url":null,"abstract":"<p><strong>Purpose: </strong>The association between different surgical methods combined with radiotherapy and the prognosis of patients with prostate cancer is still unclear. We retrospectively analyzed and compared the prognosis of TURP combined with radiotherapy and RP combined with radiotherapy for prostate cancer based on the SEER database.</p><p><strong>Methods: </strong>We reviewed the SEER database for patients diagnosed with prostate cancer from 2010 to 2015. After propensity score matching, we performed IPTW on the data and performed a survival analysis on the data. KM curve and Cox survival analysis were used to report the association between different surgical methods combined with chemotherapy and the prognosis of prostate cancer patients. Subgroup analysis was used to report the consistency and stability of the results between different patient characteristics.</p><p><strong>Results: </strong>A total of 11,782 patients with prostate cancer were included in this study, Among them, there were 1758 cases (6.52%) in the TURP group and 10,024 cases (92.97%) in the RP group. A total of 928 patients were included in the study after PSM. Cox regression after PSM and IPTW showed that the prognosis of patients in the TURP group combined with radiotherapy was worse. Compared with the RP group combined with radiotherapy group, the TURP group combined with radiotherapy group had a 253% higher risk of death (HR = 3.53, 95%CI2.37-4.59, P < 0.001), and the prognosis of patients in the Gleason ≥ 8 subgroup was even worse. Compared with the Gleason ≤ 7 subgroup, the Gleason ≥ 8 subgroup had a 58% higher risk of death (HR = 158, 95% CI 1.43-1.59, P < 0.001). In addition, subgroup analysis and forest plots after PSM and IPTW showed that there was no significant difference between RP combined with radiotherapy and TURP combined with radiotherapy in the high-, medium-, and low-risk groups, the T staging subgroup without lymph node and distant metastasis, and the Gleason subgroup. It benefited more in patients aged 45-74 years.</p><p><strong>Conclusion: </strong>RP combined with radiotherapy is associated with a better prognosis than TURP combined with radiotherapy, Patients in the Gleason ≤ 7 subgroup had a better prognosis than those in the Gleason ≥ 8 subgroup, and both surgical approaches combined with radiotherapy benefited more patients aged 45-74 years.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803282","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":"Enhanced recovery after surgery in laparoscopic kidney donor nephrectomy: the role of quadratus lumborum and transversus abdominis plane block.","authors":"Cristian A Hernandez-Gaytán, Jorge Alcacio-Mendoza, Jose de Jesus Cendejas-Gomez, Javier Gonzalez-Chavira, Yoztinn Bernal-Benitez, Humberto Zavaleta-Guraieb, Cassandra Dominguez-Hernández, Diana García-Campos, Rafael P Leal-Villalpando, Gerardo Tena-González Méndez, Bernardo Gabilondo-Pliego, Francisco Rodríguez-Covarrubias","doi":"10.1007/s11255-025-04468-4","DOIUrl":"https://doi.org/10.1007/s11255-025-04468-4","url":null,"abstract":"<p><strong>Purpose: </strong>Living donor kidney transplants (LDKTs) represent nearly 35% of all kidney transplants, with laparoscopic living donor nephrectomy (LLDN) being the standard surgical approach. Enhanced Recovery After Surgery (ERAS) protocols have demonstrated better perioperative outcomes in LLDN. This study evaluates the impact of an ERAS protocol on postoperative opioid consumption and length of stay (LOS) compared to standard of care (SC).</p><p><strong>Methods: </strong>This experimental, prospective study included patients undergoing LLDN at a tertiary care center. The ERAS protocol included preoperative nutritional optimization, ultrasound-guided transversus abdominis plane (TAP) and quadratus lumborum (QL) block for multimodal analgesia, opioid restriction and early oral intake, and mobilization. The SC group followed traditional perioperative care.</p><p><strong>Results: </strong>A total of 286 patients, 86 patients in ERAS group and 172 in SC group were analyzed. ERAS group significantly reduced LOS (1.59 ± 0.7 days vs 3.39 ± 1.85 days in the SC group, p < 0.001) and opioid consumption on postoperative day (POD) 1 and 2. The pain scores on POD 1 were lower in the ERAS group, with no differences by POD 2 or 3. There were no differences in operative time, complication rates, or renal function at 6 months between groups.</p><p><strong>Conclusion: </strong>The ERAS protocol demonstrated significant advantages over SC, including shorter LOS and reduced opioid use, without compromising safety or long-term renal outcomes. These findings support the routine adoption of ERAS protocols in LLDN as a safe and feasible approach.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795377","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 impact of end-stage kidney disease on hospitalization outcomes in patients with complete heart block: insights from united states population data.","authors":"Nadhem Abdallah, Abdilahi Mohamoud, Mahmoud Ismayl, Ammar Aladaileh, Charles A Herzog","doi":"10.1007/s11255-025-04474-6","DOIUrl":"https://doi.org/10.1007/s11255-025-04474-6","url":null,"abstract":"<p><strong>Introduction: </strong>Patients with end stage kidney disease (ESKD) suffer higher rates of mortality, partly because of cardiac conduction abnormalities. Despite this, data on complete heart block (CHB) cases in patients with ESKD remain limited.</p><p><strong>Methods: </strong>Admissions for CHB were identified in the 2016-2019 National Inpatient Sample. In-hospital outcomes were compared between patients with and without ESKD. The primary outcome was mortality. Secondary outcomes included, Permanent Pacemaker (PPM) and Temporary Pacemaker (TPM) use, palliative care, vasopressor use, mechanical ventilation use, length of stay (LOS), and total charges. Multivariable regression models were used to adjust for confounders.</p><p><strong>Results: </strong>Among 150,265 hospitalizations with a primary diagnosis of CHB, 5,109 (3.4%) had a diagnosis of ESKD. ESKD was associated with higher odds of mortality (adjusted Odds Ration [aOR] 1.54, 95% CI 1.15-2.07), vasopressors use (aOR 1.9, 95% CI 1.25-2.88), mechanical ventilation (aOR 1.26, 95% CI 1.03-1.56), palliative care (aOR 1.41, 95% CI 1.03-1.94), TPM use (aOR 1.26, 95% CI 1.09-1.47), lower odds of PPM use (aOR 0.54, 95% CI 0.47-0.62), longer LOS (+ 1.29 days, p < 0.001) and higher charges ($123,110 vs. $87,235, p < 0.001).</p><p><strong>Conclusion: </strong>Patients with ESKD admitted for CHB had higher fatal and non-fatal adverse outcomes compared to patients without ESKD.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788153","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 relationship between serum salusins levels and atherosclerosis, endothelial dysfunction and cardiac morphology in autosomal dominant polycystic kidney disease.","authors":"Sumeyye Elif Akti, Ibrahim Dogan, Baris Eser, Mucahit Yetim, Hüseyin Kayadibi","doi":"10.1007/s11255-025-04494-2","DOIUrl":"https://doi.org/10.1007/s11255-025-04494-2","url":null,"abstract":"<p><strong>Purpose: </strong>We aimed to assess the associations between serum salusins levels and atherosclerosis, endothelial dysfunction and cardiac morphology in autosomal dominant polycystic kidney disease (ADPKD).</p><p><strong>Methods: </strong>This study comprised 83 patients with ADPKD, and 53 healthy individuals. Salusin α and β levels were measured by ELISA. Echocardiography, flow-mediated vasodilatation, and carotid artery intima-media thickness measurements were conducted.</p><p><strong>Results: </strong>Serum salusin α levels were significantly lower and the salusin β/α ratio was significantly higher in the patient group compared to Controls [2.64 (1.83-3.30) pg/mL vs. 3.20 (2.55-7.87) pg/mL, P = 0.002 and 2.81 (2.30-3.54) vs. 2.64 (2.02-3.18), P = 0.041, respectively]. Patients were further categorized into two groups: Group 1 (eGFR ≥ 60 mL/min/1.73 m²) and Group 2 (eGFR = 59-15 mL/min/1.73 m²). The salusin α level was 2.31 (1.73-3.24) pg/mL in Group 2 and 2.72 (1.94-3.32) pg/mL in Group 1. In the correlation analysis performed in Group 2, there was a statistically significant negative correlation between salusin α and left ventricular mass (LVM) and LVM index (P = 0.019, P = 0.015, respectively), as well as a statistically significant positive correlation between salusin β/α ratio and LVM (P = 0.004) and LVM index (P = 0.025). In Group 1, a statistically significant positive correlation was detected between proteinuria and salusin β (P = 0.036).</p><p><strong>Conclusion: </strong>In patients with ADPKD, salusin α was found to be significantly lower, while salusin β/α ratio was found to be significantly higher compared to healthy individuals. Low salusin α levels and high salusin β/α ratio were associated with LVM in advanced stages of ADPKD and salusin β was associated with proteinuria in early stage of ADPKD patients.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788155","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":"Treatment outcomes and comparative survival analysis of intraductal carcinoma of the prostate.","authors":"Taylor Stamey, Kristen Armel, Andrew W Ju, Shoujun Chen, Musharraf Navaid, Arjun Bhatt, Michael C Larkins","doi":"10.1007/s11255-025-04485-3","DOIUrl":"https://doi.org/10.1007/s11255-025-04485-3","url":null,"abstract":"<p><strong>Purpose: </strong>Intraductal carcinoma of the prostate is a rare subset of prostate cancer, for which no consensus treatment guidelines exist. We seek to investigate treatment and survival outcomes for IDC-P in the context of current NCCN guidelines.</p><p><strong>Methods: </strong>The Surveillance, Epidemiology, and End Results (SEER) database was queried to identify patients with intraductal carcinoma of the prostate diagnosed between 2000 and 2020. Cox regression analysis and log-rank comparisons of both overall and cause-specific survival over 5- and 10-year timeframes were conducted.</p><p><strong>Results: </strong>945 patients were identified. Cox regression analysis demonstrated treatment with unimodal surgery (hazard ratio (HR) = 3.70, p = 0.005) was associated with decreased 10-year cause-specific survival, while unimodal treatment with radiotherapy was associated with decreased 5- and 10-year overall survival (HR = 2.14, p = 0.025; HR = 2.16, p = 0.005, respectively). Univariate survival subanalysis of treatment regimens demonstrated decreased 5-year cause-specific (p = 0.004) and overall (p = 0.019) survival among patients that received only radiotherapy as treatment. Radical prostatectomy alone was non-inferior to radical prostatectomy with adjuvant radiotherapy in the context of 10-year overall survival (90% vs 80%; p = 0.58).</p><p><strong>Conclusion: </strong>Differences in both 5- and 10-year overall survival and cause-specific survival were present among patients diagnosed with IDC-P. Treatment with unimodal radiotherapy among patients with IDC-P was associated with decreased survival compared to treatment with radical prostatectomy ± adjuvant radiotherapy, while radical prostatectomy alone was non-inferior to radical prostatectomy with adjuvant radiotherapy. Further research into the risk stratification and optimal treatment of these patients is warranted.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788157","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":"Unveiling trends in urinary tract cancer mortality among older adults in the United States (1999-2022): a CDC WONDER perspective.","authors":"Laksh Kumar, Talha Ali, Faiqa Iqbal, Muhammad Ahmed, Bazil Azeem","doi":"10.1007/s11255-025-04490-6","DOIUrl":"https://doi.org/10.1007/s11255-025-04490-6","url":null,"abstract":"<p><strong>Background: </strong>Urinary tract cancers (UTCs), including bladder cancer, remain a significant public health challenge, particularly among individuals aged 75 and older. Despite declining bladder cancer-specific mortality rates between 2015 and 2020, the broader trends in UTC mortality and associated demographic disparities remain underexplored.</p><p><strong>Methods: </strong>We analyzed mortality data from 1999 to 2022 using the CDC WONDER database. UTC deaths were identified using ICD- 10 codes C64 to C68. Age-adjusted mortality rates (AAMRs) per 100,000 population were calculated, stratified by sex, race/ethnicity, and census regions. Joinpoint regression identified annual percent changes (APCs) to assess temporal trends.</p><p><strong>Results: </strong>From 1999 to 2022, 477,157 UTC deaths were recorded, 66% of which occurred among individuals aged 75 and older. The AAMR increased from 97.1 in 1999 to 103.5 in 2022, with a rise between 1999 and 2007 (APC: 0.63%), a decline from 2007 to 2019 (APC: - 0.33%), and a resurgence from 2019 to 2022 (APC: 2.42%). Older males exhibited higher AAMRs than females (178.7 vs. 53.6 in 2022), and Whites had the highest AAMR (108.5) among racial groups. The Western region recorded the highest AAMR (84.3) during the study period.</p><p><strong>Conclusion: </strong>The resurgence in UTC mortality post- 2019 highlights emerging challenges, particularly among older males, Whites, and residents of the Western region. Targeted interventions, including improved screening and equitable healthcare access, are essential to mitigate these disparities and improve outcomes.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788159","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":"Mortality trends of renal diseases due to hypertension in adults: an analysis of gender, race, place of death, and geographical disparities in the United States from 1999 to 2020.","authors":"Muhammad Shaheer Bin Faheem, Muhammad Bilal Masood, Aleeza Rehman, Shamikha Cheema, Hafiz Muhammad Kamran Ahmad Mughal, Farhan Ahmed, Muhammad Ahmad Abbasi, Syed Ibrahim Ali, Ibrahim Rashid","doi":"10.1007/s11255-025-04493-3","DOIUrl":"https://doi.org/10.1007/s11255-025-04493-3","url":null,"abstract":"<p><strong>Introduction: </strong>Hypertension-related renal diseases remain a significant healthcare concern, particularly in the United States, owing to the higher mortality rate across different demographic groups. This retrospective study aimed to analyze trends in mortality rates of hypertension-related kidney diseases stratified by age, race, gender, urbanization, state, and place of death.</p><p><strong>Methods: </strong>Database of Center of Disease Control and Prevention (CDC) WONDER was used to extract death certificates among adults in US population from 1999 to 2020 using ICD codes. Gender, race, location of death, urbanization, and geographic location per state were used to determine age-adjusted mortality rates (AAMR) per 1,000,000 at a significant level of p < 0.05. Annual percentage changes (APC) and average annual percentage changes (AAPC) were computed using the Joinpoint Regression Program.</p><p><strong>Results: </strong>From 1999 to 2020, about 590,139 were reported among adults with a variable trend having a spike of AAMR from 49.5 in 1999 to 140.2 in 2000 followed by another sudden rise in AAMR from 177.5 in 2010 to a peak of 257.4 (APC: 4.85) in 2012. Then there is notable decline to 46.8 (APC: 46.89) in 2015 and afterward, a steady rise to 77.1 (APC: 16.69) observed in 2020. Overall, males (144.9) had higher AAMRs than females (109.2) throughout the study period with females having more deaths. Among races, African Americans (246.2) had highest AAMR among all followed by Hispanics (124.8), American Alaskans (118.6), Whites (111.4), and lastly Asians (102.9). About half deaths were reported in medical facilities (49.44%) with least reported in hospice (3.29%). The highest AAMRs were observed in non-metropolitan regions (142.2) compared to the large metropolitan (114.1) having lowest AAMR with small metropolitan (129.9) in between. The state of Utah (66.5) was observed lowest AAMR in contrast with the state of North Dakota (191.2) having highest AAMR among all states.</p><p><strong>Conclusion: </strong>Hypertension-related renal diseases were responsible for 590,139 deaths. Males, African American, non-metropolitan areas, and the state of Dakota demonstrated the highest AAMR. Further research is needed to understand the root cause of these disparities.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779969","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":"Health literacy, illness perception, and their association with medication adherence in end-stage renal disease.","authors":"Muhammad Amir Hamza, Shahan Ullah, Hina Ahsan, Wajeeha Ali, Mariam Masud, Ali Ahmed","doi":"10.1007/s11255-025-04472-8","DOIUrl":"https://doi.org/10.1007/s11255-025-04472-8","url":null,"abstract":"<p><strong>Background: </strong>Medication non-adherence is a prevalent and complicated problem among patients receiving hemodialysis. Strictly following the prescribed medication regimen is crucial for achieving successful dialysis in end-stage renal disease.</p><p><strong>Objective: </strong>This study aimed to investigate how health literacy and illness perception influence medication adherence in hemodialysis patients.</p><p><strong>Methods: </strong>An observational cross-sectional study was conducted from October 2023 to February 2024 at dialysis units of multisite hospitals across Rawalpindi and Islamabad, Pakistan. A pre-validated, reliable, and interview-based questionnaire was utilized, and a convenience sampling technique was employed to collect data from 390 patients. The Statistical Package for the Social Sciences version 23.0 was utilized for statistical analysis.</p><p><strong>Results: </strong>More than half of the dialysis patients were female, 52.8%, 31% were between the ages of 46-60, and 66.6% had minimal or no education. Of the patients studied, 45.1% exhibited inadequate health literacy, 46.7% held negative perceptions of their illness, and 41.8% demonstrated low levels of medication adherence. The study found a weak correlation: a negative correlation between health literacy and illness perception (r = - 0.080), a positive correlation between health literacy and medication adherence (r = 0.024), and a negative correlation between illness perception and medication adherence (r = -0.061), none of which were statistically significant.</p><p><strong>Conclusion: </strong>A considerable proportion of the patients demonstrate low medication adherence, inadequate health literacy, and negative perceptions of their illness, highlighting the urgent need for targeted interventions. Structured educational programs, motivational interviewing, individual or group support, and in-person or remote (web- or telephone-based) counseling can help address these issues. Additionally, healthcare professionals-led interventions by doctors, pharmacists, and nurses play a crucial role in raising awareness, enhancing medication adherence, and optimizing treatment outcomes.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779884","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":"Association between daily coffee intake and diabetic kidney disease: evidence from the 2007 to 2016 NHANES.","authors":"Kuohai Xiong, Tianshu Gao","doi":"10.1007/s11255-025-04480-8","DOIUrl":"https://doi.org/10.1007/s11255-025-04480-8","url":null,"abstract":"<p><strong>Purpose: </strong>Regular coffee intake is recognized as a protective factor against various chronic diseases, particularly diabetes. However, the correlation between coffee intake-both the act of drinking coffee and the amount consumed-and diabetic kidney disease (DKD) remains uncertain. The goal of this study is to measure the correlation between coffee intake and DKD.</p><p><strong>Methods: </strong>This cross-sectional study was based on data from the 2007 to 2016 National Health and Nutrition Examination Survey (NHANES). DKD was characterized by the coexistence of diabetes combined with impaired glomerular filtration rate (eGFR < 60 mL/min/1.73 m²) or ACR ≥ 30 mg/g. Weighted logistic regression and restricted cubic spline (RCS) analyses were adopted to evaluate the correlation between coffee intake and DKD. The subgroup analyses were implemented to assess the reliability of the results.</p><p><strong>Results: </strong>The study included 13,177 participants, representing a weighted population of 125,388,198 individuals. Among them, 8198 (64%) participants consumed coffee and 1430 (7.6%) were classified as having DKD. After controlling for covariates, multivariable logistic regression showed a negative correlation between moderate coffee intake and DKD (OR = 0.68; 95% CI: 0.55-0.83; P < 0.001). The RCS analysis suggested a U-shaped, non-linear correlation between coffee intake and DKD (P overall = 0.013; P nonlinear = 0.047). The subgroup analyses further supported the stability and reliability of these findings.</p><p><strong>Conclusion: </strong>The results indicate a U-shaped correlation between coffee intake and diabetic kidney disease.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763750","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":"Safety and efficacy of L-carnitine supplementation in improving cardiac function of hemodialysis patients: a systematic review and meta-analysis.","authors":"Rayyan Nabi, Hanzala Ahmed Farooqi, Sabahat Ul Ain Munir Abbasi, Najaf Ahmed Rajpar, Aqsa Munir, Hamza Bin Ahmed, Uzair Iqbal, Tabeer Zahid, Zahid Nabi","doi":"10.1007/s11255-025-04478-2","DOIUrl":"https://doi.org/10.1007/s11255-025-04478-2","url":null,"abstract":"<p><strong>Purpose: </strong>Heart failure is a significant complication among patients undergoing hemodialysis, often associated with left ventricular hypertrophy and dysfunction. L-carnitine, crucial for fatty acid metabolism, has shown promise in improving cardiac function. This systematic review and meta-analysis aim to evaluate the safety and efficacy of L-carnitine supplementation in improving cardiac function in hemodialysis patients.</p><p><strong>Methodology: </strong>A comprehensive search of PubMed, Cochrane, and EMBASE was conducted up to October 3, 2024, to identify relevant studies. The trials assessing the effects of L-carnitine on echocardiographic parameters such as left ventricular ejection fraction (LVEF), left ventricular mass index (LVMI), and diastolic function were included. A random-effects model was applied to pool data, and heterogeneity was assessed using the I² statistic.</p><p><strong>Results: </strong>A total of 23 studies were included in the systematic review, with 7 studies involving 426 participants being meta-analyzed. L-carnitine supplementation significantly improved LVEF (MD = 1.64, 95% CI 0.10-3.17, p = 0.04), with low heterogeneity (I² = 37%). However, no significant changes were observed for LVMI (MD = -3.19, p = 0.60) or diastolic markers (E/A ratio MD = -0.13, p = 0.47; E/e ratio MD = -0.35, p = 0.67).</p><p><strong>Conclusion: </strong>L-carnitine supplementation significantly improves cardiac function, particularly systolic function (LVEF) in hemodialysis patients. However, its effects on LVMI and markers of diastolic function are inconclusive. Future large-scale trials are warranted to further elucidate its role in cardiac function among this population.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763872","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}