International Urology and Nephrology最新文献

{"title":"Harnessing ARNI in advanced CKD - a new frontier for cardiac and renal protection.","authors":"Umair Maaz, Fatima Hussain, Muskan Asghar, Saman Adnan","doi":"10.1007/s11255-024-04279-z","DOIUrl":"10.1007/s11255-024-04279-z","url":null,"abstract":"","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"1353-1354"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604285","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":"Optimal stone density for ablation lithotripsy with vapor tunnel Ho:YAG pulse modality.","authors":"Luis Rico, Leandro Blas, Lorena Banda Ramos, Javier Pizzarello, Carlos Ameri, Pablo Contreras","doi":"10.1007/s11255-024-04289-x","DOIUrl":"10.1007/s11255-024-04289-x","url":null,"abstract":"<p><strong>Introduction: </strong>Vapor-Tunnel™ (VT) consists of a very long pulse that uses the minimum peak power, causing the energy to pass through a previously created vapor channel or tunnel. There are studies that have shown acceptable ablation lithotripsy efficiency. Nevertheless, there are no in-vivo studies that have compared the VT performance according to the stone density.</p><p><strong>Methods: </strong>A retrospective study of 152 patients who underwent RIRS using VT Ho:YAG laser was performed. We divided the patients according to the stone density (Group 1: < 1000UH vs. Group 2: > 1000UH). We assessed the lithotripsy efficiency (mm³/JJ) and the laser-energy consumption (JJ/mm³). The stone-free rate (SFR) was defined as the absence of stone fragments in a non-contrast abdominal computed tomography 4 weeks after the procedure.</p><p><strong>Results: </strong>Ninety three patients were included in Group 1 and 59 in Group 2. Body mass index was higher in Group 1 and the median stone volume was higher in Group 2 (846 vs. 672 mm³, p = 0.03). Total energy used (11.9 vs. 24 kj, p < 0.001), the laser emission time (19 vs. 30 min, p < 0.001), and the total operative time (60 vs. 85 min, p < 0.001) were lower in the Group 1. SFR was higher in Group 1 (96.7% vs. 57.6%, p < 0.001) with a global SFR of 81.6%. The ablation lithotripsy efficiency was higher in Group 1 (0.053 mm³/JJ vs. 0.035 mm³/JJ, p < 0.001).</p><p><strong>Conclusions: </strong>VT Ho:YAG was associated with decreased laser time, operative time and laser-energy consumption in Group 1 than Group 2. Similarly, VT Ho:YAG increased lithotripsy efficiency and the SFR compared to hard stones with the same laser settings and pulse modality.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"1091-1096"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142668023","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":"Vancomycin-associated acute kidney injury in underweight patients: a propensity score matching analysis.","authors":"Tatsuya Okuwaki, Masahiro Kobayashi, Rino Kikuchi, Yoshinori Tomoda, Moeka Ogawa, Kumi Kasugai, Yoshinori Seto, Atsushi Tomizawa, Katsuya Otori","doi":"10.1007/s11255-024-04306-z","DOIUrl":"10.1007/s11255-024-04306-z","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the effect of being underweight on the incidence of vancomycin-associated acute kidney injury (AKI) using propensity score matching analysis.</p><p><strong>Methods: </strong>This study is a retrospective analysis of patients who received vancomycin and had their serum concentration measured at Kitasato University Hospital between January 1, 2016 and December 31, 2020. Patients were divided into underweight and non-underweight groups based on body mass index (BMI), and propensity score matching analysis was used to evaluate whether underweight affected the incidence of acute kidney injury.</p><p><strong>Results: </strong>480 patients met the selection criteria, and 111 patients from each group (BMI < 18.5 and BMI ≥ 18.5) were successfully matched using propensity score matching. After matching, there were no differences in non-physical characteristics between the two groups. The incidence of AKI was 23.4% (26 of 111) in the BMI < 18.5 group and 37.8% (42 of 111) in the BMI ≥ 18.5 group, with the BMI < 18.5 group having a significantly lower incidence. The odds ratio was 0.503 [95% CI 0.281-0.900].</p><p><strong>Conclusion: </strong>This study showed that underweight patients (BMI < 18.5) had a significantly lower incidence of vancomycin-associated AKI compared to those with BMI ≥ 18.5. As there have been no previous reports on the association between underweight and vancomycin-associated AKI, this study provides novel insights.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"1329-1336"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142800705","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":"Totally Retroperitoneal One-Position Approach for Laparoscopic Radical Surgery in Upper Urinary Tract Urothelial Carcinoma: A Clinical Trial Evaluation.","authors":"Yan Xuechuan, Zhao Kai, Zhang Zongliang, Yin Xinbao, Zhu Guanqun, Yang Han, Wang Ke","doi":"10.1007/s11255-024-04293-1","DOIUrl":"10.1007/s11255-024-04293-1","url":null,"abstract":"<p><strong>Background: </strong>The standard of care for upper tract urothelial carcinoma (UTUC) traditionally involved open nephroureterectomy with bladder cuff excision. Despite the adoption of transabdominal laparoscopic one-stage nephroureterectomy to mitigate this, the persistently high rate of postoperative intestinal obstruction remains a clinical challenge. This study introduces an innovative approach: a single-position, completely retroperitoneal laparoscopic nephroureterectomy coupled with a 75-45-degree positional change for bladder cuff resection in the treatment of UTUC. The study further evaluates the clinical efficacy of this novel surgical technique.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 125 patients diagnosed with UTUC who underwent radical nephroureterectomy at our institution between May 2018 and December 2023. The experimental cohort comprised 65 individuals who received total retroperitoneal one-position laparoscopic nephroureterectomy (TROLN), complete with total intracorporeal bladder cuffing and distal ureterectomy. In contrast, the control cohort included 60 patients who had laparoscopic nephrectomy with a lower abdominal oblique incision for bladder sleeve resection. The study evaluated various perioperative metrics, such as operative duration, blood loss during surgery, incision size, resumption of oral intake postoperatively, drainage tube removal timeline, hospital stay duration, Visual Analogue Scale (VAS) for pain assessment, and complication incidence. In addition, pathological and oncological outcomes were scrutinized.</p><p><strong>Results: </strong>The TROLN group exhibited pronounced benefits across various surgical outcomes, including reduced operative duration, minimized intraoperative blood loss, shorter incision lengths, lower postoperative pain assessments, expedited return to oral nutrition, swifter drain extraction, and a condensed overall hospitalization period (all P < 0. 05). However, the oncological outcomes showed no significant differences between the TROLN group and the control group.</p><p><strong>Conclusion: </strong>Drawing from our clinical insights, TROLN is a safe and effective modified technique that offers advantages over traditional laparoscopic combined with open surgery for treating UTUC, including reduced invasiveness, less bleeding, fewer complications, and shorter hospital stays. However, additional prospective studies are imperative to validate these observations.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"1135-1141"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11903564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716209","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":"Effects of urination process on heart rate variability.","authors":"Faruk Dişli, Sedat Yıldız","doi":"10.1007/s11255-024-04282-4","DOIUrl":"10.1007/s11255-024-04282-4","url":null,"abstract":"<p><strong>Purpose: </strong>Heart rate variability (HRV) is used for the assessment of activity of the autonomic nervous system (ANS). As urination is also under the control of the ANS, this study aimed to investigate the usefulness of HRV in the assessment of ANS during the peri-urination period. The psychological effects of sitting on a chair or on the toilet during pre- and post-urination periods were also assessed.</p><p><strong>Methods: </strong>Electrocardiogram was used to measure HRV in male participants (n = 40, aged 18-30). They were allowed to drink water to ease urination. At the stage close to voiding, six measurements (each for 90 s) were taken sequentially in sitting position (pre-urination chair, pre-urination toilet, urination, post-urination toilet, post-urination chair, and basal post-urination chair). HRV indices included standard deviation of R-R intervals (SDNN), root mean square of successive differences in R-R intervals (RMSSD), percentage of successive R-R intervals differing more than 50 ms (pNN50), total power (TP), very-low-frequency (VLF), low-frequency (LF), and high-frequency (HF) bands together with the ratio of LF/HF.</p><p><strong>Results: </strong>HR, SDNN, TP, LF, and LF/HF increased during urination process (P < 0.05), whereas RMSSD, pNN50, and HF increased before urination on toilet (P < 0.05) compared to sitting on a chair before and after urination.</p><p><strong>Conclusion: </strong>HRV indices dynamically reflected the physiological stages of urination. Parasympathetic activity (revealed by pNN50, RMSSD, and HF) increased before urination, whereas sympathovagal balance (revealed by LF/HF) increased during urination. Thus, HRV appears to be a suitable technique for studying physiological and pathological aspects of urination.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"1069-1076"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620750","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":"Sulforaphane alleviates renal fibrosis through dual regulation on mTOR-mediated autophagy pathway.","authors":"Di Zhang, Han Zhang, Shiqi Lv, Cheng Zhu, Shaomin Gong, Xixi Yu, Yulin Wang, Xinhui Huang, ShuangXin Yuan, Xiaoqiang Ding, Xiaoyan Zhang","doi":"10.1007/s11255-024-04295-z","DOIUrl":"10.1007/s11255-024-04295-z","url":null,"abstract":"<p><p>Renal fibrosis is a common pathological process of progressive chronic kidney disease (CKD). However, effective therapy is constrained currently. Autophagy is an important mechanism in kidney injury and repairment but its exact role in renal fibrosis was discrepant according to previous studies. Sulforaphane (SFN), a natural plant compound, has been explored as a promising nutritional therapy for a variety of diseases. But the salutary effect and underlying mechanism of SFN on CKD have not been fully elucidated. In this study, we investigated the effect of SFN on renal fibrosis in unilateral ureteral obstruction (UUO) mice. Then we examined the regulatory effect of SFN on autophagy-related proteins in renal fibroblasts and renal tubular epithelial cells. Our results showed that sulforaphane could significantly alleviate renal fibrosis in UUO mice. In vitro, the expression levels of autophagy-related protein showed that SFN could upregulate the autophagy activity of renal interstitial fibroblasts and downregulate the autophagy activity of renal tubular epithelial cells. Furthermore, we found that phosphorylated mTOR protein levels was reduced in renal fibroblasts and increased in renal tubular epithelial cells after SFN treatment. Our results strongly suggested that SFN could alleviate renal fibrosis through dual regulation of mTOR-mediated autophagy pathway. This finding may provide a new perspective on the renal salutary effect of SFN and provide a preclinical rationale for exploring the therapeutic potential of SFN to slow down renal fibrosis.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"1277-1287"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142728736","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":"Comparing post-treatment urinary and colorectal procedures in prostate cancer patients using population-based linked data.","authors":"Tenaw Tiruye, Alex Jay, Braden Higgs, Michael O'Callaghan, Liesel M FitzGerald, Kim Moretti, David Roder, Kerri Beckmann","doi":"10.1007/s11255-024-04304-1","DOIUrl":"10.1007/s11255-024-04304-1","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate urinary and colorectal procedures among men who underwent radical prostatectomy (RP) and external beam radiotherapy (EBRT).</p><p><strong>Methods: </strong>We studied 16,271 (RP = 8516 and EBRT = 7755) South Australian men diagnosed with prostate cancer between 2001 and 2021. Colorectal and urinary procedures were extracted from hospital admission procedure codes and Medical Benefits Schedule item codes. Rates were estimated at 30-days, 90-days, 6-months, 1-year, 2-years and 5-years post-treatment. We estimated the average treatment effect of RP (compared with EBRT) by applying propensity-matched analyses, accounting for sociodemographic and clinical characteristics. Subgroup analyses were undertaken for different treatment periods (2001-2010 vs. 2011-2021).</p><p><strong>Results: </strong>At 1-year post-treatment, the crude rates of colorectal procedures were 43 and 70/1000 person-years among RP and EBRT patients, respectively, while crude rates for urinary procedures were 258 and 74/1000 person-years, respectively. Propensity matched analyses indicated that patients undergoing RP underwent more post-treatment urinary procedures, being 21.2% higher at 6-months and 16.3% higher at 5-years than men who received EBRT. Colorectal procedures were slightly more frequent among RP than EBRT patients during the first 90-days but less frequent from 1-year onwards (5.9% lower at 5-years among RP group). Between 2011 and 2021, there were considerably fewer urinary procedures for men who underwent RP than those treated between 2001 and 2010.</p><p><strong>Conclusion: </strong>There is a statistically significant difference in the frequency of post-treatment procedures between patients who underwent RP and those who had EBRT, which likely indicates a difference in adverse treatment effects. These findings may lead to more informed treatment decision-making.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"1189-1198"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806924","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":"Machine learning approaches for predicting and diagnosing chronic kidney disease: current trends, challenges, solutions, and future directions.","authors":"Prokash Gogoi, J Arul Valan","doi":"10.1007/s11255-024-04281-5","DOIUrl":"10.1007/s11255-024-04281-5","url":null,"abstract":"<p><p>Chronic Kidney Disease (CKD) represents a significant global health challenge, contributing to increased morbidity and mortality rates. This review paper explores the current landscape of machine learning (ML) techniques employed in CKD prediction and diagnosis, highlighting recent trends, inherent challenges, innovative solutions, and future directions. Through an extensive literature survey, we identified key limitations and challenges, including the use of small datasets, the absence of stage-specific predictions, insufficient focus on model interpretability, and a lack of discussions on safeguarding patient privacy in managing sensitive CKD data. We considered these limitations and challenges as research gaps, and this review paper aims to address them. We emphasize the potential of Generative AI to augment dataset sizes, thereby enhancing model performance and reliability. To address the lack of stage-specific predictions, we highlight the need for effective multi-class models to accurately predict CKD stages, enabling tailored treatments and improved patient outcomes. Furthermore, we discuss the critical importance of model interpretability, utilizing methods such as SHAP (SHapley Additive exPlanations) and LIME (Local Interpretable Model-agnostic Explanations) to ensure transparency and trust among healthcare professionals. Privacy concerns surrounding sensitive patient data are also addressed. We present innovative privacy-preserving solutions using technologies, such as homomorphic encryption, federated learning, and blockchain. These solutions facilitate collaboration across institutions while maintaining patient confidentiality and addressing challenges related to limited generalizability and reproducibility in CKD prediction. This review informs healthcare professionals and researchers about advancements in ML for CKD prediction, to improve patient outcomes and address research gaps.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"1245-1268"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142668009","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 evaluation of different specimen extraction techniques in laparoscopic simple nephrectomy in female patients.","authors":"Jeena Kudunthail, Mahendra Singh, Deepak Bhirud, Gautam Ram Choudhary, Shiv Charan Navriya, Arjun S Sandhu","doi":"10.1007/s11255-024-04294-0","DOIUrl":"10.1007/s11255-024-04294-0","url":null,"abstract":"<p><strong>Objective: </strong>To compare different specimen extraction techniques in laparoscopic simple nephrectomy among female patients, focusing on perioperative outcomes, complications, and postoperative recovery.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on data from 45 female patients who underwent laparoscopic nephrectomy between September 2022 and July 2024. Patients were divided into three groups: laparoscopic transperitoneal nephrectomy with transvaginal extraction (LTN-TVS), Pfannenstiel extraction (LTN-PFN), and retroperitoneoscopic nephrectomy (RPN) with flank extraction. Demographic data, operative details, extraction times, postoperative outcomes, and sexual function scores were analyzed.</p><p><strong>Results: </strong>The LTN-PFN group had the shortest operative (106.93 ± 20.89 min) and extraction times (18.00 ± 2.97 min) compared to LTN-TVS (127.80 ± 27.88 min, 30.13 ± 8.05 min) and RPN (130.8 ± 32.62 min, 18.93 ± 16.35 min) groups (P < 0.05). Initially longer extraction times were seen in the transvaginal group which decreased with experience. The LTN-TVS group had significantly lower pain scores at 24 and 48 h and reduced analgesic needs (P < 0.01) as compared to other groups. Scar assessment scores favored the transvaginal group. Incisional hernias occurred in 2 PFN and 1 RPN patient, but none in the TVS group. Hospital stay, pelvic floor, and sexual function scores showed no significant differences among the groups.</p><p><strong>Conclusion: </strong>The transvaginal extraction method offers a promising, minimally invasive alternative with superior postoperative outcomes and minimal complications, making it a preferred approach in female patients undergoing laparoscopic nephrectomy.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"1113-1121"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710123","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 uric acid to high-density lipoprotein cholesterol ratio and chronic kidney disease among Chinese middle-aged and older adults with abnormal glucose metabolism: a nationwide cohort study.","authors":"Qi Liu, Danna Zheng, Xiaobo Shen, Juan Jin, Qiang He","doi":"10.1007/s11255-024-04308-x","DOIUrl":"10.1007/s11255-024-04308-x","url":null,"abstract":"<p><strong>Background: </strong>Previous research has demonstrated a correlation between uric acid to high-density lipoprotein cholesterol ratio (UHR) and chronic kidney disease (CKD), yet the evidence remains unclear in individuals with abnormal glucose metabolism. The objective of this research was to investigate the correlation between UHR and the occurrence of CKD, as well as the rapid kidney function decline among individuals aged over 45 years with abnormal glucose metabolism, using data from the China Health and Retirement Longitudinal Study (CHARLS).</p><p><strong>Methods: </strong>This study employed K-means clustering to categorize individuals based on UHR control levels into four classes. Subsequently, multivariate logistic regression analyses were utilized to explore the relationships between UHR and the occurrence of CKD as well as rapid kidney function decline. To examine the potential nonlinear relationship, restricted cubic spline (RCS) analyses were employed. Subgroup analyses and various sensitivity analyses were applied to validate the reliability of the results.</p><p><strong>Results: </strong>This study encompassed 3902 participants, all of whom had prediabetes or diabetes. In the fully adjusted logistic regression model assessing the risk of CKD development, the odds ratios (ORs) for Class 2, Class 3, and Class 4, versus Class 1, were 1.08 (0.71 to 1.67), 1.71 (1.06 to 2.77), and 2.13 (1.02 to 4.35), respectively. For every 1 standard deviation (SD) increase in cumulative UHR exposure, there was a 32% elevation in the risk of CKD incidence (OR: 1.32, 95% CI 1.12 to 1.56). RCS curves suggested a linear association between cumulative UHR (CumUHR) and CKD occurrence, but a nonlinear association with rapid renal function progression. Subgroup analysis indicated an interaction between age and UHR on the development of CKD. The application of multiple sensitivity analyses yielded consistent outcomes, suggesting the robustness of the findings.</p><p><strong>Conclusion: </strong>In individuals with abnormal glucose metabolism, suboptimal control of UHR signifies an elevated risk of rapid kidney function decline and the incidence of CKD in the future. Therefore, close monitoring of long-term variations in UHR can facilitate early identification of the risk for CKD development.</p>","PeriodicalId":14454,"journal":{"name":"International Urology and Nephrology","volume":" ","pages":"1297-1309"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768887","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}