Iranian journal of kidney diseases最新文献

{"title":"Predictive Factors for Successful Discontinuation of Continuous Renal Replacement Therapy: A Retrospective Single-Center Observational Study.","authors":"Mete Erdemir, Özlem Gürbüz, Hakan Sapmaz, Mahmut Yilmaz, Sercan Yilmaz, Gürhan Taşkin, H Levent Yamanel","doi":"10.61882/ijkd.3.03.8885","DOIUrl":"10.61882/ijkd.3.03.8885","url":null,"abstract":"<p><strong>Introduction: </strong>Determining the optimal timing for discontinuing continuous renal replacement therapy (CRRT) in intensive care units (ICUs) remains a significant clinical challenge. This study aimed to identify the clinical and laboratory determinants of successful CRRT discontinuation in critically ill patients with acute kidney injury (AKI).</p><p><strong>Methods: </strong>This retrospective, single-center observational study was conducted in Gülhane Training and Research Hospital, Ankara, Türkiye. A total of 396 patients who received CRRT between January 2019 and March 2023 were screened. After excluding patients with prior renal replacement therapy (RRT) (n = 66) and end-stage kidney disease (n = 250), 80 patients were included in the final analysis. Successful discontinuation was defined as independence from any RRT for at least seven consecutive days following CRRT cessation. Clinical variables were compared between the successful and unsuccessful groups.  Results. The mean age of the patients was 71.16 ± 14.96 years. In univariate analysis, successful discontinuation was significantly associated with higher 24-h urine output during CRRT [385 (0-3880) mL vs. 100 (0-1850) mL; P = .010], a stable or decreasing lactate trend in the first four hours (69% vs. 40%; P = .033), and a lower requirement for invasive mechanical ventilation (36.4% vs. 58.3%; P = .050). Receiver operating characteristic (ROC) curve analysis identified 24-h urine output as a significant predictor of success (Area under the curve (AUC) = 0.666; 95% Confidence interval (CI): 0.546-0.786; P = .011) with a threshold of 365 cc/24h (sensitivity: 52.3%, specificity: 80.6%). In the final logistic regression model, urine output in the last 24 hours remained an independent predictor of weaning success (Odds ratio (OR) = 1.001; 95% CI: 1.000-1.002; P = .009).</p><p><strong>Conclusion: </strong>The 24-h urine output preceding CRRT termination and the trend of lactate levels during the 4-hour period post-initiation are important predictive values for the success of CRRT discontinuation.</p>","PeriodicalId":14610,"journal":{"name":"Iranian journal of kidney diseases","volume":"20 3","pages":"149-156"},"PeriodicalIF":0.9,"publicationDate":"2026-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156591","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":"Distribution of CYP3A4*1/*1B (rs2740574) and CYP3A5*1/*3 (rs776746) Genetic Variants in Renal Transplant Recipients Treated with Sirolimus in Urmia (Iran).","authors":"Khadijeh Makhdoomi, Azam Mivefroshan, Lale Jafari, Zahra Ghelich Khan, Isa Abdi Rad, Morteza Bagheri","doi":"10.61882/ijkd.3.03.9130","DOIUrl":"10.61882/ijkd.3.03.9130","url":null,"abstract":"<p><p> Introduction. Rapamycin, also referred to as Sirolimus, is an immunosuppressive medication used in kidney transplantation to prevent organ rejection. Sirolimus is metabolized predominantly by the enzymes CYP3A4 and CYP3A5. The objective of this study was to evaluate the distribution of CYP3A4*1/*1B (rs2740574, -392A > G) and CYP3A5*1/*3 (rs776746, 6986A > G) genetic variants in renal transplant recipients treated with Sirolimus in Urmia (Iran). Methods. This assessment involved thirty-nine renal transplant recipients in Urmia Imam Khomeini University Hospital, Urmia (Iran) who were treated with a daily dose of 1mg/day Sirolimus. The CYP3A4*1/*1B and CYP3A5*1/*3 allelic variants were identified using the Restriction Fragment Length Polymorphism-Polymerase Chain Reaction (RFLP-PCR) technique.  Results. The frequencies of CYP3A4 *1/*1 (-392AA), CYP3A4 *1/*1B (-392AG), and CYP3A4 *1B/*1B (-392GG) genotypes and CYP3A4 *1 (-392A) and CYP3A4 *1B (-392G) alleles were 37(94.87%), 2(5.13%), 0(0%), 76(97%), and 2(3%), respectively. The genotypic distribution for CYP3A5 was 0(0%) for CYP3A5*1/*1 (6986AA), 6(15.38%) for CYP3A5*1/*3 (6986AG), and 33(84.62%) for CYP3A5*3/*3 (6986GG). The allelic frequencies were 6(8%) for CYP3A5*1 (6986A) and 72(92%) for CYP3A5*3 (6986G). Only one patient with CYP3A4.</p>","PeriodicalId":14610,"journal":{"name":"Iranian journal of kidney diseases","volume":"20 3","pages":"163-167"},"PeriodicalIF":0.9,"publicationDate":"2026-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156572","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":"Eculizumab in Systemic Lupus Erythematosus Complicated with Thrombotic Microangiopathy.","authors":"Azar Nickavar, Nafiseh Mortazavi, Shima Salehi","doi":"10.61882/ijkd.3.03.9466","DOIUrl":"10.61882/ijkd.3.03.9466","url":null,"abstract":"<p><p>Thrombotic microangiopathy (TMA) is a rare but serious complication of systemic lupus erythematosus (SLE) in children, which is often resistant to different medical treatments. This is the report of a 13 years old female with a newly diagnosed SLE, complicated with a refractory course of SLE-TMA. Eculizumab had an effective therapeutic impact with clinical and laboratory improvement of TMA.</p>","PeriodicalId":14610,"journal":{"name":"Iranian journal of kidney diseases","volume":"20 3","pages":"175-179"},"PeriodicalIF":0.9,"publicationDate":"2026-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156533","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":"Joint Modeling of Multivariate Longitudinal Measurements and Survival Data: Application to Hemodialysis Data.","authors":"Asma Pourhoseingholi, Shahrzad Ossareh, Erfan Ghasemi, Ali Akbar Jafari, Bijan Moghimi-Dehkordi, Mohsen Vahedi","doi":"10.61882/ijkd.3.03.9536","DOIUrl":"10.61882/ijkd.3.03.9536","url":null,"abstract":"<p><strong>Introduction: </strong>In studies involving hemodialysis patients, repeated laboratory measurements (longitudinal data) and survival outcomes are often analyzed separately, which can lead to biased results due to ignoring measurement errors and the intrinsic dependency between the two analyses. Joint modeling has emerged as a powerful approach to handle such data. This study aims to investigate the impact of six time-varying biochemical markers, along with baseline covariates, on the survival of hemodialysis patients using a multivariate joint model.</p><p><strong>Methods: </strong>A longitudinal cohort of 894 maintenance hemodialysis (MHD) patients, who had started dialysis between 2004 and 2023, were included. Baseline and follow-up clinical information and monthly laboratory measurements were analyzed. A multivariate linear mixed-effects model was jointly fitted with a Cox proportional hazards model to simultaneously assess the longitudinal biomarkers and time-to-event data. Analyses were performed using R software.</p><p><strong>Results: </strong>The model indicated that older age (Hazard Ratio, HR = 1.02, P < .001), male gender (HR = 1.72, P < .001), diabetes mellitus (HR = 1.61, P < .001), walking disability at admission (HR = 1.78, P < .001), and catheter-based vascular access (HR = 1.71, P < .001) were significantly associated with an increased risk of mortality. Higher square root of phosphate levels (HR = 13.97, P < .001) were linked to increased, and higher square root of creatinine (HR = 0.32, P < .001), hemoglobin (HR = 0.75, P = .009) and albumin (HR = 0.31, P < .001) levels were associated with decreased mortality.</p><p><strong>Conclusion: </strong>Findings of the joint model confirm the importance of baseline clinical risk factors and modifiable biochemical markers on the survival outcomes of hemodialysis patients.</p>","PeriodicalId":14610,"journal":{"name":"Iranian journal of kidney diseases","volume":"20 3","pages":"138-148"},"PeriodicalIF":0.9,"publicationDate":"2026-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156524","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":"Stepwise Interpretation of Albumin Fraction Abnormalities on Serum Protein Capillary Electrophoresis in Nephrotic Syndrome: A Case Series.","authors":"Emine Feyza Yurt, Medine Alpdemir, Mehmet Şeneş","doi":"10.61882/ijkd.20.02.9386","DOIUrl":"10.61882/ijkd.20.02.9386","url":null,"abstract":"<p><p>Serum protein electrophoresis (SPEP) is commonly used in the diagnostic evaluation of nephrotic syndrome (NS) to rule out monoclonal gammopathies. However, NS itself and various other factors may cause transient bisalbuminemia, resulting in albumin fraction irregularities in capillary SPEP and complicating interpretation. This study proposes a stepwise approach for interpreting albumin fraction irregularities, illustrated through three representative cases of NS. Case 1: a 44-year-old woman with isolated proteinuria, Case 2: a 36-year-old woman with diabetic foot infection, and Case 3: a 58-year-old man with ankylosing spondylitis, all presenting with nephrotic-range proteinuria. On initial SPEP case 1 exhibited a distinct sharp peak, while cases 2 and 3 showed irregular bands between the albumin and α1 regions. A stepwise interpretative approach was applied: First, technical errors were excluded by repeat analysis using alternative capillaries on the same analyzer. Second, potential biochemical interferences were evaluated. Third, SPEP was repeated using freshly collected samples. Fourth, persistent albumin fraction irregularities prompted consideration of biochemical albumin modifications, such as glycosylated or carbamylated forms. Fifth, other causes including drugs, heavy metal toxicity, liver disease, and systemic inflammation were excluded. Finally, additional tests such as immunofixation electrophoresis were performed to rule out monoclonal proteins. In the absence of monoclonal proteins, the condition was interpreted as bisalbuminemia related to NS. Using this approach, transient bisalbuminemia was considered the most likely cause in Cases 1 and 2, whereas the disappearance of the irregular band in Case 3 suggested a preanalytical artifact. Systematic interpretation of albumin fraction irregularities can help distinguish true pathology from benign or artifactual patterns in patients with NS.</p>","PeriodicalId":14610,"journal":{"name":"Iranian journal of kidney diseases","volume":"20 2","pages":"122-129"},"PeriodicalIF":0.9,"publicationDate":"2026-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156488","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":"Analysis of Factors Influencing Vascular Calcification in Chronic Kidney Disease Patients Based on Oxidative Stress Response and Establishment of a Predictive Model.","authors":"Lei Ran, Xiaoxi Wu, Li Guo, Jing Li, Lei Wang, Jianmin Zhang, Xuan Zhou","doi":"10.61882/ijkd.20.02.9108","DOIUrl":"10.61882/ijkd.20.02.9108","url":null,"abstract":"<p><strong>Introduction: </strong>In this study, we compared the oxidative stress responses of patients with chronic kidney disease (CKD) and those with CKD-associated vascular calcification (CKD-VC), and established a risk predictive model for CKD-VC based on this comparison, providing a new approach for the clinical prevention and treatment of CKD-VC.</p><p><strong>Methods: </strong>We conducted several cross-sectional surveys involving 173 patients with chronic kidney disease (CKD) who were admitted between September 2023 and October 2024 admitted to Affiliated Hospital of Hebei University. Sixty-two patients had VC (CKD-VC group), while the 111 patients did not have VC (CKD group). The levels of superoxide dismutase (SOD), malondialdehyde (MDA), glutathione peroxidase (GSH-Px), and catalase (CAT) of the two groups were measured. Additionally, factors influencing CKD-VC were analyzed using Logistic regression, and a risk predictive model was established accordingly.</p><p><strong>Results: </strong>The levels of SOD and GSH-Px were lower in the CKD-VC group than the CKD group, whereas the CAT and MDA level was higher (P < .05). Logistic regression analysis indicated that SOD, GSH-Px, CAT, MDA, serum calcium, serum phosphorus, age, hypersensitive C-reactive protein (hs-CRP), albumin (ALB), and urine acid (UA) were all independent factors affecting CKD-VC (P < .05). The risk predictive model established based on these factors had high diagnostic sensitivity and specificity for CKD-VC, reaching 100.00% and 87.39%, respectively, with an area under the curve (AUC) of 0.980.</p><p><strong>Conclusion: </strong>This study established a risk predictive model for CKD-VC based on oxidative stress response, which has high diagnostic efficacy. This model provides a new approach for the clinical prevention and treatment of CKD-VC in the future, helping to more accurately identify high-risk patients and take corresponding intervention measures to effectively ensure patient safety.</p>","PeriodicalId":14610,"journal":{"name":"Iranian journal of kidney diseases","volume":"20 2","pages":"77-86"},"PeriodicalIF":0.9,"publicationDate":"2026-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156511","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":"Protective Effects of Humulus lupulus L. Extract on CCl₄-Induced Nephrotoxicity in Rats.","authors":"Shiva Rahimi, Lotfollah Rezagholizadeh, Ramin Salimnejad, Reza Alipanah-Moghadam, Masoud Ojarudi Ojarudi, Pouria Sobhi, Aliakbar Fazaeli","doi":"10.61882/ijkd.20.02.8560","DOIUrl":"10.61882/ijkd.20.02.8560","url":null,"abstract":"<p><strong>Introduction: </strong>Oxidative stress is a key contributor to acute kidney injury (AKI), a condition exacerbated by nephrotoxic agents like carbon tetrachloride (CCl₄). Humulus lupulus L. (hops), which is rich in polyphenols, exhibits potent antioxidant properties. This study evaluated the nephroprotective effects of Humulus lupulus L. extract on CCl₄-induced AKI in rats.</p><p><strong>Methods: </strong>Twenty-four male Wistar rats were divided into four groups (n = 6): normal control, CCl₄ control, and two treatment groups receiving Humulus lupulus extract (100 or 200 mg/kg/day, intraperitoneally) for 14 days. On day 14, all groups except the normal control received CCl₄ (1 mL/kg, 1:1 v/v in olive oil, intraperitoneally). Forty-eight hours post-CCl₄ administration, serum and renal tissue samples were collected to assess biochemical markers (urea, creatinine, uric acid), oxidative stress parameters (malondialdehyde [MDA], total antioxidant capacity [TAC], catalase [CAT], superoxide dismutase [SOD], glutathione peroxidase [GPx]), and histopathological changes.</p><p><strong>Results: </strong>CCl₄ significantly increased serum urea, creatinine, uric acid, and renal MDA levels while decreasing TAC, CAT, SOD, and GPx activities. Pretreatment with Humulus lupulus extract significantly attenuated these alterations, with the 200 mg/kg dose demonstrating superior efficacy. Histopathological analysis revealed reduced tubular and glomerular damage in treated groups.</p><p><strong>Conclusion: </strong>Humulus lupulus extract attenuated CCl4-induced nephrotoxicity in rats by enhancing antioxidant defenses. These preclinical findings suggest that hops extract warrants further investigation as a potential candidate for mitigating oxidative stress in AKI.</p>","PeriodicalId":14610,"journal":{"name":"Iranian journal of kidney diseases","volume":"20 2","pages":"87-96"},"PeriodicalIF":0.9,"publicationDate":"2026-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156474","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":"Evaluation of the Performance of Biomarkers in Predicting Hemodialysis Patients Survival Using Time-Dependent ROC Curve.","authors":"Zahra Shayan, Shahrokh Ezzatzadegan Jahromi, Somayeh Abbasi, Kamran Mehrabani-Zeinabad, Farnaz Niroomand","doi":"10.61882/ijkd.20.02.9299","DOIUrl":"10.61882/ijkd.20.02.9299","url":null,"abstract":"<p><strong>Introduction: </strong>End-stage kidney disease (ESKD) is a growing global public health problem, and patients undergoing hemodialysis (HD) experience a high mortality rate despite advances in medical care. Identifying reliable prognostic biomarkers is therefore essential. Regression-based survival models are widely used in HD studies; however, while they estimate associations, they do not directly quantify the predictive accuracy of biomarkers. This study aimed to evaluate the predictive performance of selected baseline biomarkers for survival in HD patients using the time-dependent receiver operating characteristic (ROC) curve.</p><p><strong>Methods: </strong>This retrospective cohort study included 2,192 ESKD patients undergoing maintenance HD in Fars province, Iran, between 2011 and 2020. Time-dependent area under the ROC curve (AUC) values were calculated to assess the prognostic performance of baseline biomarkers at 3, 12, 24, and 36 months after initiation of dialysis.</p><p><strong>Results: </strong>Age, serum albumin, creatinine, and calcium showed relatively better predictive performance for survival. For age, the AUCs at 3, 12, 24, and 36 months were 64.2, 57.1, 57.1, and 58.8, respectively, while corresponding values for serum albumin were 67.5, 62.3, 61.4, and 59.8. Serum albumin and calcium demonstrated higher discrimination for early survival, whereas serum creatinine showed more stable predictive performance over the follow-up period. The combined risk score outperformed individual biomarkers, with AUCs of 71.2, 63.9, 63.5, and 64.1 at 3, 12, 24, and 36 months, respectively.</p><p><strong>Conclusion: </strong>Time-dependent ROC analysis revealed time-varying prognostic performance of baseline biomarkers in HD patients and demonstrated improved discrimination when biomarkers were combined into a composite risk score.</p>","PeriodicalId":14610,"journal":{"name":"Iranian journal of kidney diseases","volume":"20 2","pages":"97-104"},"PeriodicalIF":0.9,"publicationDate":"2026-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156518","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 Occult Kidney Disease and COVID-19 Mortality: Evidence from a Retrospective Study.","authors":"Fernando Guerrero-Romero, Gerardo Martínez-Aguilar, Mayela Ríos-Mier, Julia B Garay-Sierra, Abraham S Mercado-Sosa, Paulina Flores-Galindo, Luis E Simental-Mendía","doi":"10.61882/ijkd.20.02.9439","DOIUrl":"10.61882/ijkd.20.02.9439","url":null,"abstract":"<p><strong>Introduction: </strong>Occult kidney disease (OKD), a term that describes the initial phase of renal failure, is usually overlooked in routine clinical evaluations. Therefore, the goal of this study was to determine whether OKD is associated with the disease severity and mortality in COVID-19 patients.</p><p><strong>Methods: </strong>A retrospective study was conducted in patients with COVID-19. COVID-19 was considered based on a positive reverse transcriptase-polymerase chain reaction test for SARS-CoV-2. OKD was defined with an estimated glomerular filtration rate < 60 ml/min/1.73 m2 and creatinine concentrations ≤1.3 mg/dl.</p><p><strong>Results: </strong>A total of 809 patients with COVID-19 were selected for the study. The frequency of OKD, acute kidney injury, and chronic kidney disease was 7.7%, 15.0%, and 12.4%, respectively. The logistic regression analysis adjusted showed that OKD (OR = 1.86; CI 95%: 1.05-3.32), acute kidney injury (OR = 2.03; CI 95%: 1.42-2.89), and chronic kidney disease (OR = 3.07; CI 95%: 1.90-4.97) were associated with mortality by COVID-19.</p><p><strong>Conclusion: </strong>Our results indicate that OKD is associated with increased mortality in patients with COVID-19.</p>","PeriodicalId":14610,"journal":{"name":"Iranian journal of kidney diseases","volume":"20 2","pages":"116-121"},"PeriodicalIF":0.9,"publicationDate":"2026-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156495","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":"Muscle Mass Deficit Indexed to Body Surface Area Predicts Poor Physical Health and Quality of Life in Hemodialysis Patients.","authors":"Turkan Yagmur Ozel, Feyza Nur Sarısık, Murat Sahin, Esra Tasgetiren, Ertugrul Erken, Ozkan Gungor, Orcun Altunoren","doi":"10.61882/ijkd.20.02.9451","DOIUrl":"10.61882/ijkd.20.02.9451","url":null,"abstract":"<p><strong>Introduction: </strong>Hemodialysis patients experience significantly lower quality of life compared to the healthy individuals, largely due to symptoms such as bone pain, fatigue, pruritus, anorexia, inflammation, malnutrition, and anemia. This study aimed to investigate the effects of sarcopenia and low muscle mass on quality of life, with a particular focus on physical health indices.</p><p><strong>Methods: </strong>The study included 62 patients on maintenance hemodialysis. Sarcopenia was diagnosed using the fat-free mass index (FFMI), defined as skeletal muscle mass divided by height squared (kg/m²). Additionally, skeletal muscle mass was normalized to body surface area (BSA); values below the sample mean of 46.12 kg/m² were classified as low muscle mass. Quality of life was assessed with the Kidney Disease Quality of Life (KDQOL) Version 1.3 questionnaire and scored using the KDQOL-SF™ Version 1.3 Scoring Program.</p><p><strong>Results: </strong>Sarcopenia was present in 18 patients (29%) according to FFMI. Patients scored lowest in general health (35.6), energy/fatigue (40.9), and both SF-12 physical (37.5) and mental health (37.2) domains. Sarcopenic patients reported significantly higher pain scores (60.97 ± 29.54 vs. 46.19 ± 27.37; P = .046), but other domains did not differ. Patients with low muscle mass/BSA (kg/m2) had lower sleep (51.5 ± 11.7 vs. 59.6 ± 13.0; P = .01), energy/fatigue (35.6 ± 20.1 vs. 52.8 ± 20.7; P = .005), and SF-12 physical health scores (35.7 ± 9.0 vs. 40.6 ± 8.3; P = .03). Muscle mass indexed to BSA was an independent predictor of the SF-12 physical health composite score.</p><p><strong>Conclusion: </strong>Low muscle mass, particularly when indexed to BSA, is associated with reduced physical health in hemodialysis patients and poorer quality of life across multiple domains. BSA-indexed muscle mass showed stronger and more consistent associations than FFMI-based definitions.</p>","PeriodicalId":14610,"journal":{"name":"Iranian journal of kidney diseases","volume":"20 2","pages":"105-115"},"PeriodicalIF":0.9,"publicationDate":"2026-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156567","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}