International Urology and Nephrology最新文献

{"title":"\"Advancing prognostic tools in IgA nephropathy: implications for risk stratification and targeted therapy\".","authors":"Muhammad Faisal Saleem, Hamza Mahmood Rana, Maaz Ahmad, Maryam Imran Sheikh","doi":"10.1007/s11255-025-04617-9","DOIUrl":"10.1007/s11255-025-04617-9","url":null,"abstract":"","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"3921-3922"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144309891","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 serum spexin levels and diabetic nephropathy in patients with type 2 diabetes: a cross-sectional study.","authors":"Robab Aboutorabi, Golrokh Hariri, Aida Bakhshi, Majid Alizadeh, Hassan Mehrad-Majd","doi":"10.1007/s11255-025-04556-5","DOIUrl":"10.1007/s11255-025-04556-5","url":null,"abstract":"<p><strong>Background: </strong>Diabetic nephropathy (DN) is a serious complication of diabetes, with a high prevalence ranging from 21.8% in China, 35.3% in African countries, and an overall prevalence of 20-40% worldwide. This study investigated serum spexin levels in patients with type 2 diabetes, comparing those with and without DN, and explored its association with metabolic parameters.</p><p><strong>Methods: </strong>This cross-sectional study was conducted among patients with type-2 diabetes according to ADA guidelines. After obtaining informed consent, urine albumin-to-creatinine-ratio (ACR) was determined and patients were categorized into two groups: with-nephropathy (ACR ≥ 30) and without-nephropathy (ACR < 30). The correlation between spexin and demographic, anthropometric, and biochemical variables was further determined. Logistic regression analysis was used to assess the relationship between spexin and the likelihood of DN. Receiver Operating Characteristic (ROC) curve analysis determined the optimal serum spexin cutoff for distinguishing between groups.</p><p><strong>Results: </strong>A total of 97 diabetic individuals (33 with DN, 64 without) participated in the study. Serum spexin was significantly lower in patients with DN compared to those without DN (p < 0.001). Spexin concentrations showed an inverse correlation with LDL and ACR levels. Lower spexin levels were associated with a reduced likelihood of DN (OR 0.46, 95% CI 0.31-0.69; p < 0.001). ROC curve analysis identified a cutoff value of 81.10 ng/ml, with an area under the curve of 0.986, demonstrating 95.3% sensitivity and 94.1% specificity for diagnosing DN.</p><p><strong>Conclusion: </strong>Lower serum spexin levels are associated with impaired kidney function, indicating its potential as a predictive biomarker for diabetic nephropathy. However, further validation in larger and more diverse cohorts is needed to address limitations such as sample size and unmeasured confounders.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"3751-3759"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063777","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 cognitive magnetic resonance-ultrasonography fusion prostate biopsy outcomes in left lateral decubitus vs lithotomy positions: a prospective randomized study cognitive magnetic resonance-ultrasonography fusion prostate biopsy.","authors":"Zeki Bayraktar, Emre Burak Sahinler, Salih Yildirim, Nuri Oguzhan Saglam, Sedat Can Birinci, Orhun Sinanoglu, Cahit Sahin","doi":"10.1007/s11255-025-04544-9","DOIUrl":"10.1007/s11255-025-04544-9","url":null,"abstract":"<p><strong>Introduction: </strong>The study compares the results of cognitive MRI-ultrasonography fusion prostate biopsy in two positions: left lateral decubitus (LLD) and lithotomy.</p><p><strong>Methods: </strong>From June 2023 to December 2024, 200 patients were randomly assigned to two groups (100 in LLD and 100 in lithotomy). Age, BMI, prostate volume, comorbidities, PSA levels, DRE (+) status, and PI-RADS ≥ 3 lesions were recorded. Pain was measured using the visual analog scale (VAS), and complications were monitored. Histopathological results were collected and analyzed.</p><p><strong>Results: </strong>No significant differences were found between the groups in terms of age, BMI, PSA, DRE status, prostate volume, comorbidities, or PI-RADS ≥ 3 lesions. Cancer detection rates were 38% in the LLD group and 32% in the lithotomy group (p = 0.550). The average VAS score was lower in the LLD group (2.41 ± 2.30) compared to the lithotomy group (3.22 ± 2.88) (p = 0.030). The mean Gleason score was similar between groups (LLD: 7.05 ± 1.11, Lithotomy: 7.29 ± 1.04; p = 0.247). No major complications occurred, but hematuria was more frequent in the lithotomy group (p = 0.006).</p><p><strong>Conclusions: </strong>There were no significant differences in cancer detection rates or grades between the two groups. The lithotomy position had slightly higher pain scores but no major complications. Hematuria occurred more often in the lithotomy position. Cognitive MRI-US fusion biopsy is safe in both positions.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"3625-3632"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978926","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":"Relationship between male infertility and hematological parameters in patients with thalassemia minor.","authors":"Gumus Kemal, Toksoz Serdar, Guven Acik Gökce, Koseoglu Burak, Yikilmaz Numan, Ozdogan Ilturk","doi":"10.1007/s11255-025-04524-z","DOIUrl":"10.1007/s11255-025-04524-z","url":null,"abstract":"<p><strong>Background: </strong>There is no research explaining the relationship between thalassemia minor and male infertility.</p><p><strong>Objective: </strong>The aim of this study was to investigate the relationship between male infertility and hematological parameters in patients with thalassemia minor.</p><p><strong>Materials and methods: </strong>The patients who were identified as thalassemia carriers during premarital thalassemia screening tests performed at the Public Health Laboratory between 2021 and 2023 were evaluated. The patients with normal semen parameters were assigned to the first group, while those with abnormal semen parameters (oligozoospermia, asthenozoospermia, teratozoospermia, and azoospermia) comprised the second group. The hematologic parameters and hormonal parameters values were examined.</p><p><strong>Results: </strong>The mean age of the patients was 31 (21-43) years. A total of 49 patients with thalassemia minor were included in the study. Of these, 39 had abnormal semen parameters and 10 had normal semen parameters. Among the patients, 8 (16%) had azoospermia, 6 (12%) had oligozoospermia, 9 (18%) had teratozoospermia, and 16 (32%) had asthenozoospermia. The Mean Corpuscular Hemoglobin Concentration (MCHC) values were significantly lower in patients with abnormal semen parameters (p = 0.01). According to the regression analysis, Mean Corpuscular Volume (MCV) increased the likelihood of deteriorating semen parameters by 0.88-fold, while MCHC increased it by 2.64-fold.</p><p><strong>Conclusion: </strong>Deterioration in sperm parameters was observed in men with thalassemia minor, and hematological parameters-particularly MCHC and MCV-were identified as potential risk factors for infertility. These findings underscore the importance of considering hematological parameters when evaluating fertility in men with thalassemia minor. Infertility is multifactorial and other mechanisms such as oxidative stress and inflammation should also be evaluated.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"3577-3582"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143965489","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":"Correlation between parathyroid volume and calcium and phosphorus metabolism in maintenance hemodialysis patients based on Doppler ultrasound technology.","authors":"Shengjie Guo, Liping Liu, Chao Zou, Pingping Liang, Yurou Wang, Chengcheng Sun, Xiaosu Gan, Xiaofang Tian, Liying Yuan","doi":"10.1007/s11255-025-04561-8","DOIUrl":"10.1007/s11255-025-04561-8","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the correlation between parathyroid glands (PTGs) volume and calcium and phosphorus metabolism in maintenance hemodialysis (MHD) patients with Doppler ultrasound.</p><p><strong>Methods: </strong>MHD patients at the Hemodialysis Center of the Third Affiliated Hospital of Zunyi Medical University from January 1, 2024, to January 31, 2024, were selected as study subjects. To investigate the correlation between the number and size of PTGs detected by bedside ultrasound and indicators of calcium and phosphorus metabolism.</p><p><strong>Results: </strong>A total of 135 patients were included, of whom 90 had explored hyperplastic PTGs and 45 did not. Correlation analysis showed a negative correlation between ultrasound total PTGs volume and with age (r = -0.222, P = 0.035), large platelet ratio (r = -0.262, P = 0.013), and mean platelet volume (r = -0.232, P = 0.028), and a positive correlation with parathyroid hormone (iPTH) (r = 0.268, P = 0.011), corrected serum calcium (r = 0.233, P = 0.027), taking cinacalcet (r = 0.252, P = 0.0.017), sevelamer carbonate (r = 0.352, P = 0.002) and compound α-ketoacid tablets (r = 0.478, P < 0.001). Multifactorial linear regression analysis showed a positive correlation between ultrasound total PTGs volume and the correlation with age (t = -3.071, 95% CI: -0.030 ~ -0.007), albumin (t = -2.242, 95% CI: -0.115 ~ -0.008), iPTH (t = 2.748, 95% CI: 0.001 ~ 0.002), corrected serum calcium (t = 2.484, 95% CI: 0.184 ~ 1.563) showed significant linear relationships.</p><p><strong>Conclusions: </strong>A significant linear correlation was observed between PTGs volume, assessed via Doppler ultrasound, and the variables of age, albumin, iPTH, and corrected serum calcium in MHD patients. Therefore, it is essential for MHD patients to be closely monitored and have these serological indices controlled.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"3799-3809"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076969","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":"Pfannenstiel incision versus iliac fossa incision for retrieval of resected specimen after laparoscopic radical nephrectomy: a prospective randomised parallel arm study.","authors":"Prasant Nayak, Dheeraj Dheeroo, Vivek Tarigopula, Swarnendu Mandal, Kirti Singh, Manoj Das, Sambit Tripathy","doi":"10.1007/s11255-025-04528-9","DOIUrl":"10.1007/s11255-025-04528-9","url":null,"abstract":"<p><strong>Purpose: </strong>Although laparoscopic radical nephrectomy (LRN) is the standard of care for large and complex malignant renal masses, the location of the incision for kidney retrieval remains a point of debate, and no clear-cut guidelines exist. This study aimed to compare the outcomes of kidney specimen retrieval after LRN using either a Pfannenstiel incision (PFN) or an iliac fossa incision (IFN).</p><p><strong>Methods: </strong>This was an open-labelled, parallel-group, randomised trial. The calculated sample was 52 [26 = each arm]. The primary endpoint was the surgical site pain in the immediate postoperative period measured by the Universal Pain Assessment Tool, every fourth hour till 48 h. Secondary endpoints were total operative time, incision length, blood loss during specimen retrieval, length of postoperative hospital stay, wound site cosmesis [Manchester scar scale] at 3 months postoperatively, and wound complications between the groups in the early postoperative period.</p><p><strong>Results: </strong>Demographic characteristics were comparable in both groups. Pain scores demonstrated a significant difference in favour of the Pfannenstiel incision group, particularly at 12, 16, 20, 24, 36 and 40 h postoperatively. There were no significant differences between groups on the other parameters.</p><p><strong>Conclusion: </strong>The PFN has significantly less operative site pain than IFN following LRN.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"3553-3558"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019827","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":"Comparative efficacy of expanded hemodialysis and online hemodiafiltration: a systematic review and meta-analysis.","authors":"Ozgur Aktas, Ruslan Akhmedullin, Anara Abbay, Arif E Narin, Muharrem S Yanilmaz, Candan Genc, Abduzhappar Gaipov, Adrian Covic, Mehmet Kanbay","doi":"10.1007/s11255-025-04559-2","DOIUrl":"10.1007/s11255-025-04559-2","url":null,"abstract":"<p><strong>Background and aim: </strong>The comparison between online hemodiafiltration (online HDF) and expanded hemodialysis (HDx) remains undetermined. This systematic review and meta-analysis were conducted to provide comparative evidence on the molecule clearance, efficacy, and all-cause mortality of HDx versus online HDF in patients with end-stage kidney disease (ESKD).</p><p><strong>Materials and methods: </strong>A comprehensive search was conducted up to September 10, 2024, using various electronic databases PubMed, Cochrane Library, Scopus, Web of Science, and Ovid MEDLINE with adherence to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Risk ratios (RR) for binary outcomes and standardized mean differences (Hedge's g) were used for continuous outcomes.</p><p><strong>Results: </strong>The meta-analysis included eight studies, consisting of 614 patients in total. No statistical difference in all-cause mortality was found between HDx and online HDF (RR 0.97; 95% Cl 0.62-1.53, p = 0.91, I² = 0%). Online HDF revealed a decrease in β2-microglobulin clearance (Hedges's g = - 0.61, 95% CI - 1.04 to - 0.18, p = 0.01), with no differences in creatinine, phosphate, and urea clearance. Prolactin clearance favored online HDF (Hedge's g = - 1.49, 95% Cl - 3.36 to 0.37, p = 0.12) but the pooled estimate remained insignificant, with high heterogeneity (I² = 90.87%).</p><p><strong>Conclusion: </strong>Overall, both modalities are found to be effective, but online HDF revealed superior efficacy with potential advantages in middle-molecule clearance. Further standardized, randomized, and high-quality trials are required not only to confirm these findings but also to address the substantial heterogeneity found in the clearance of prolactin, myoglobulin, and albumin loss.</p><p><strong>Registration: </strong>PROSPERO registration number: CRD42024622632.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"3761-3772"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004804","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":"Anti-sarcopenic effect of leucine-enriched branched-chain amino acid supplementation among elderly chronic kidney disease patients: a double-blinded randomized controlled trial.","authors":"Neti Sunsandee, Paramat Thimachai, Bancha Satirapoj, Ouppatham Supasyndh","doi":"10.1007/s11255-025-04560-9","DOIUrl":"10.1007/s11255-025-04560-9","url":null,"abstract":"<p><strong>Background: </strong>Leucine, a branched-chain amino acid (BCAA), is an effective nutritional strategy to enhance skeletal muscle mass in aging populations. This study aimed to evaluate the effects of oral leucine-enriched BCAA supplementation on muscle mass, muscle synthesis biomarkers, and physical performance in elderly patients with chronic kidney disease (CKD).</p><p><strong>Methods: </strong>A randomized controlled trial was conducted among CKD patients aged over 65 years. The participants were randomly assigned to receive either oral mixed BCAA supplementation (60% leucine, 4.5 g/day; 20% valine, 1.5 g/day; 20% isoleucine, 1.5 g/day) (N = 29) or a placebo (N = 26) for 12 weeks. Muscle mass, serum insulin-like growth factor 1 (IGF-1), and myostatin levels were measured at baseline and after 12 weeks. A 3-day food record was reviewed by a dietitian, and functional capacity was assessed using handgrip and 6-min walk tests.</p><p><strong>Results: </strong>Fifty-five patients (mean age 75.4 ± 5.2 years) were enrolled. Daily protein and calorie intake were comparable between groups. At study conclusion, lean muscle mass significantly increased in the leucine group compared to placebo (0.4 kg [95% CI 0.1-0.7] vs. - 0.2 kg [95% CI - 0.6-0.2], P = 0.010). A significant difference in the percentage change in muscle mass was also observed (1.0 ± 1.8% vs. - 0.5 ± 2.6%, P = 0.014). No significant differences were found in muscle strength, serum myostatin, IGF-1, or adverse events.</p><p><strong>Conclusions: </strong>Leucine-enriched BCAA supplementation for 12 weeks significantly increased muscle mass but did not impact biomarkers of muscle activity or functional capacity in elderly CKD patients.</p><p><strong>Clinical trial registration: </strong>TCTR20200314003.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"3811-3819"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086213","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":"Perioperative effects of dexmedetomidine on renal function in allogeneic kidney transplant patients: a meta-analysis.","authors":"Yong Guo, Gongbin Lan, Shanbiao Hu","doi":"10.1007/s11255-025-04576-1","DOIUrl":"10.1007/s11255-025-04576-1","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Allogeneic kidney transplantation represents a cornerstone therapeutic strategy for patients diagnosed with end-stage renal disease. The perioperative management of these patients plays a crucial role in ensuring both optimal graft viability and favorable postoperative outcomes. Dexmedetomidine, a highly selective α2-adrenergic agonist, has attracted considerable attention for its potential renoprotective properties, which are attributed to its anti-inflammatory effects, suppression of sympathetic nervous activity, and ability to stabilize hemodynamics. This meta-analysis was undertaken to systematically integrate the current body of evidence regarding the impact of dexmedetomidine on perioperative renal function in recipients of allogeneic kidney transplants.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A systematic and comprehensive search of the literature was conducted using multiple databases-PubMed, Embase, Web of Science, Cochrane Library, and the China National Knowledge Infrastructure (CNKI)-up to March 2025. IEligible studies included those involving adult recipients of allogeneic kidney transplants, wherein dexmedetomidine was administered during the perioperative period, and renal function outcomes such as serum creatinine (Cr), blood urea nitrogen (BUN), urine output, or delayed graft function (DGF) were reported. Two reviewers independently extracted data to ensure objectivity and accuracy; disagreements were resolved by discussion. The pooled data were analyzed using a random-effects model. Statistical heterogeneity was quantified using the I&lt;sup&gt;2&lt;/sup&gt; statistic, while potential publication bias was assessed through funnel plot symmetry. Sensitivity analyses were conducted to evaluate the robustness of the synthesized results.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Eleven studies comprising 1417 patients were included. Compared to controls, dexmedetomidine significantly reduced serum creatinine levels (SMD = - 0.75, 95% CI - 1.18 to - 0.32, p &lt; 0.001; I&lt;sup&gt;2&lt;/sup&gt; = 84.1%) and BUN levels (SMD = - 0.87, 95% CI - 1.30 to - 0.44, p = 0.001; I&lt;sup&gt;2&lt;/sup&gt; = 74.5%). Urine output was significantly increased (SMD = 0.98, 95% CI 0.23 to 1.74, p &lt; 0.001; I&lt;sup&gt;2&lt;/sup&gt; = 90.0%). The incidence of delayed graft function was lower in the dexmedetomidine group (OR = 0.71, 95% CI 0.52 to 0.97, p = 0.616; I&lt;sup&gt;2&lt;/sup&gt; = 0.0%). Length of hospital stay was also reduced (SMD = - 0.16, 95% CI - 0.29 to - 0.04, p = 0.364; I&lt;sup&gt;2&lt;/sup&gt; = 5.9%). Sensitivity analyses confirmed the robustness of the results. No significant publication bias was detected.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The results of this meta-analysis support the renoprotective potential of dexmedetomidine when administered during the perioperative phase of allogeneic kidney transplantation. Its use is associated with improvements in key renal function markers, such as reductions in serum creatinine and BUN levels, as well as a decreased incidence of delayed graft funct","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"3821-3838"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093836","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":"Evidence-based practice of exercise during dialysis in maintenance hemodialysis patients.","authors":"Xinjie Xiang, Junfeng Zhang, Hong Lin, Jincan Mai, Taorong Xu","doi":"10.1007/s11255-025-04624-w","DOIUrl":"10.1007/s11255-025-04624-w","url":null,"abstract":"<p><strong>Objective: </strong>To develop a standardized evidence-based practice plan for exercise during dialysis in maintenance hemodialysis patients based on the best evidence.</p><p><strong>Methods: </strong>Based on the Johns Hopkins evidence-based nursing practice model as theoretical guidance, the evidence of exercise during dialysis in maintenance hemodialysis patients was systematically retrieved, evaluated and summarized, and an evidence-based practice plan was formed and applied in clinical practice. 35 patients and 19 nurses were reviewed before and after the application of evidence, and the obstacle factors and improvement measures were discussed and analyzed. The effect and significance of the evidence application were analyzed by comparing the patients' grip strength, 30-s sit-to-stand test, quality of life score, self-efficacy, and dialysis adequacy.</p><p><strong>Results: </strong>Extracted 28 pieces of evidence from 35 best evidence sources and 8 review indicators were formulated. Following the implementation of evidence-based practices, the adherence rates for the eight indicators showed significant improvement (P < 0.05). The analysis identified 12 barriers and 12 facilitators, leading to the development of 16 change strategies. Before and 1 month, 2 months and 3 months after the application of evidence, the patients' grip strength, 30-s sit-to-stand test and quality of life score were compared, and the differences were statistically significant (P < 0.05). There was no significant difference in self-efficacy and dialysis adequacy (P > 0.05).</p><p><strong>Conclusions: </strong>Evidence-based practice of intradialytic exercise in maintenance hemodialysis patients can standardize intradialytic exercise rehabilitation. It can improve the muscle strength of upper and lower limbs and the quality of life of patients. However, its effect on self-efficacy and dialysis adequacy is limited.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"3851-3865"},"PeriodicalIF":1.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484377","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}