Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia最新文献

{"title":"The Brazilian registry of kidney biopsies: results from the 2022 national prospective registry.","authors":"Irene L Noronha, Rodrigo José Ramalho, Claudia Maria Costa de Oliveira, Marilia Bahiense-Oliveira, Fabricio Augusto Marques Barbosa, Jose de Resende Barros Neto, Ronny Mitsuoka, Osvaldo Merege Vieira-Neto, Precil Diego Miranda de Menezes Neves","doi":"10.1590/2175-8239-JBN-2026-0096en","DOIUrl":"10.1590/2175-8239-JBN-2026-0096en","url":null,"abstract":"<p><strong>Introduction: </strong>Kidney biopsy plays a central role in the etiological diagnosis and management of kidney diseases. The Brazilian Registry of Kidney Biopsies (BRKB) was established by the Brazilian Society of Nephrology to characterize biopsy-proven kidney diseases nationwide. The aim of this manuscript is to present the BRKB data for 2022.</p><p><strong>Methods: </strong>We analyzed data from adult patients who underwent native kidney biopsy and were prospectively included in the BRKB between January and December 2022. Demographic, clinical, laboratory, and histopathological variables were evaluated.</p><p><strong>Results: </strong>A total of 1,142 kidney biopsies from centers across all Brazilian regions were included. Female patients accounted for 54.8% of cases, and the mean age was 44.8 ± 16.4 years. The main indications for biopsy were kidney dysfunction (51.8%) and nephrotic syndrome (39.4%). Hypertension and diabetes mellitus were present in 47.8% and 15.1% of patients, respectively. At the time of biopsy, 67.1% had an estimated glomerular filtration rate < 60 mL/min/1.73 m2. Glomerular diseases were the most frequent histological diagnoses (72.5%), with lupus nephritis (23.1%), IgA nephropathy (15.0%), and focal segmental glomerulosclerosis (11.2%) being the most common.</p><p><strong>Conclusion: </strong>The 2022 BRKB data provide a contemporary overview of biopsy-proven kidney diseases in Brazil and highlight the predominance of glomerular disorders. Among diabetic patients undergoing biopsy, only half showed histological evidence of diabetic nephropathy, emphasizing the value of kidney biopsy in selected cases.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"48 4","pages":"e20260096"},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645486/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recommendations of the Brazilian Society of Nephrology for the management of chronic kidney disease in primary health care.","authors":"Farid Samaan, Viviane Calice-Silva, Felipe Costa Neves, Pablo Rodrigues Costa Alves, Geraldo Bezerra da Silva Junior, Lilian Pires de Freitas do Carmo, Verônica de Jesus Rodrigues Cardozo Costa, Máira de Faria Polcheira, René Scalet Dos Santos Neto, Patrícia Ferreira Abreu, Gianna Mastroianni Kirsztajn, José A Moura-Neto","doi":"10.1590/2175-8239-JBN-2026-0093en","DOIUrl":"10.1590/2175-8239-JBN-2026-0093en","url":null,"abstract":"<p><p>Brazil has been undergoing rapid epidemiological and demographic transition and faces major challenges in addressing chronic noncommunicable diseases. Among these, chronic kidney disease (CKD) stands out, given its growing prevalence and contribution to 3-7% of healthcare spending in many countries. CKD is considered one of the diseases with the greatest potential for the application of preventive measures, as it has common risk factors, low-cost and widely available diagnostic tests, a known natural history, feasible treatment, and proven cost-effectiveness of interventions. Despite many difficulties, Brazil is internationally recognized for having one of the most robust and inclusive public health systems in the world (the Unified Health System-SUS, in Portuguese). One of the reasons for this recognition is the comprehensiveness and multidisciplinary nature of its primary health care (PHC). Although Brazilian and international guidelines have been published and updated for more than two decades, recent studies continue to show gaps in the implementation of the care pathway for people with CKD in Brazil. The objective of this document was to develop practical recommendations to help PHC managers include CKD in their work routine, considering current guidelines, Brazilian laws, financial and structural resources, and the characteristics of the SUS.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"48 4","pages":"e20260093"},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13638185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of muscle strength training with blood flow restriction on glomerular function in people with stage 3 chronic kidney disease.","authors":"Antonio Filipe Pereira Caetano, Janyeliton Alencar de Oliveira, Amaro Wellington da Silva, Cyro Rego Cabral Junior, Michelle Jacintha Oliveira Cavalcante, Maria do Socorro Cirilo-Sousa","doi":"10.1590/2175-8239-JBN-2026-0061en","DOIUrl":"10.1590/2175-8239-JBN-2026-0061en","url":null,"abstract":"<p><strong>Introduction: </strong>Stage 3 chronic kidney disease (CKD) represents a critical juncture in clinical management. However, muscle strength training (MST) combined with blood flow restriction (BFR) has shown benefits as an adjunctive treatment, but its renal effects remain unclear.</p><p><strong>Objective: </strong>To analyze the effects of MST+BFR on markers of glomerular function in individuals with CKD-3.</p><p><strong>Method: </strong>A randomized, longitudinal clinical trial with 40 participants divided into 4 groups: control (G1); low-load MST (G2); high-load MST (G3); and low-load MST combined with BFR (G4). Serum creatinine, cystatin C, microalbuminuria, and estimated eGFR were used as dependent variables. The MST protocol was conducted over 12 weeks, 3 times per week, for 30-40 minutes, with 3 exercises (single- and multi-joint) per day at progressive intensities. Data analysis (intention-to-treat) was performed using the Shapiro-Wilk test (normality), paired t-test/Wilcoxon test (within-group comparisons), ANOVA/Kruskal-Wallis tests (between-group comparisons), Bonferroni test (post hoc corrections), and Cohen's d (effect size) with a p-value ≤ 0.05.</p><p><strong>Results: </strong>The participants were predominantly male (52.5%) with low levels of physical activity (60%), hypertension (87.5%), and some with diabetes (37.5%). Group 4 showed a significant increase in albuminuria levels (p = 0.048), as well as significant differences compared with Group 1 (creatinine, p = 0.032) and Group 2 (creatinine, p = 0.036; and eGFR-Cr, p = 0.032).</p><p><strong>Conclusion: </strong>MST+BFR was not associated with severe adverse effects on serum creatinine/cystatin C levels, eGFR estimates, or urinary creatinine and microalbuminuria levels, but it may significantly increase albuminuria levels.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"48 4","pages":"e20260061"},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13680052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kidney health for all: caring for people, protecting the planet.","authors":"Raymond Vanholder, Dina Abdellatif, Augusto Cesar Soares Dos Santos, Ricardo Correa-Rotter, Natarajan Gopalakrishnan, Bill Wang, Stefanos Roumeliotis, Alessandro Balducci, Ágnes Haris, Manjusha Yadla, Li-Li Hsiao","doi":"10.1590/2175-8239-JBN-2026-0162en","DOIUrl":"10.1590/2175-8239-JBN-2026-0162en","url":null,"abstract":"<p><p>The current kidney care model - focused on late-stage disease and in-center hemodialysis - is unsustainable due to costs, environmental burden, poor outcomes, and reduced quality of life. The 78th World Health Assembly's recognition of kidney disease as a serious health threat presents a critical opportunity to reshape kidney care. In alignment with this, the 2026 World Kidney Day theme, \"Kidney Health for All: Caring for People, Protecting the Planet\" calls for a systematic change. A sustainable model must prioritize early detection and prevention, reducing the need for kidney replacement therapy. Transplantation and home dialysis benefit people with kidney failure, as well as the environment and society. Dialysis itself must become more eco-friendly without compromising quality of care, recognizing that planetary perturbations in turn affect kidney health. Conservative care should also be considered, particularly for elderly and frail patients, when the quality-of-life benefits outweigh those offered by dialysis. Achieving this shift requires coordinated action across all stakeholders; education and engagement of the public, policymakers, and health professionals to raise awareness about the threat of kidney disease; and an urgent move toward patient-centered care.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"48 4","pages":"e20260162"},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13682596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The lactate gap as a diagnostic clue in ethylene glycol poisoning and a tool for differentiating methanol intoxication.","authors":"Koody André Hassemi Kitawara, Carlos Alberto Balda, Érika Bevilaqua Rangel","doi":"10.1590/2175-8239-JBN-2026-0062en","DOIUrl":"https://doi.org/10.1590/2175-8239-JBN-2026-0062en","url":null,"abstract":"","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"48 4","pages":"e20260062"},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13638184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recommendations of the Brazilian Society of Nephrology for hemodiafiltration in maintenance dialysis therapy.","authors":"Fernanda Salomão Gorayeb-Polacchini, Rosilene Motta Elias, Ana Lydia Lédo de Castro Ribeiro Cabeça, Dirceu Reis da Silva, Elizabeth Machado, Farid Samaan, Isadora Cartaxo de Sousa Calvo, José Carolino Divino Filho, Kalyanne Cabral de Paula do Ó, Maria Gabriela Motta Guimarães, Maria Goretti Moreira Guimarães Penido, Patrícia Ferreira Abreu, Stenio Barbosa de Freitas, Vera Hermina Kalika Koch, José A Moura-Neto","doi":"10.1590/2175-8239-JBN-2026-0161en","DOIUrl":"10.1590/2175-8239-JBN-2026-0161en","url":null,"abstract":"<p><p>Hemodiafiltration (HDF) combines diffusive and convective clearance, enhancing the removal of uremic toxins, particularly middle molecules, compared with conventional hemodialysis (HD). Recent evidence, including meta-analyses and the CONVINCE trial, suggests that high-volume HDF is associated with improved clinical outcomes, particularly when adequate convective volumes are achieved. In Brazil, the expansion of this modality has been accompanied by studies demonstrating its feasibility, safety, and applicability across different clinical settings. This position statement from the Brazilian Society of Nephrology (SBN), educational rather than normative in nature, provides recommendations based on the best available evidence and expert consensus regarding the use of HDF in maintenance dialysis in Brazil. The document addresses patient selection, minimum prescription parameters, operational targets, technical and safety requirements, as well as ethical, regulatory, and economic aspects, with the aim of supporting clinical and managerial decision-making, reducing practice variability, and promoting safer, higher-quality dialysis care.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"48 4","pages":"e20260161"},"PeriodicalIF":1.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Renal expression of Bach1 and oxidative stress in chronic kidney disease: evidence from a preclinical model.","authors":"Beatriz Oliveira Da Cruz, Patricia Pereira Almeida, Nathalia Silva-Costa, Michele Lima Brito, D'Angelo Carlo Magliano, Milena Barcza Stockler-Pinto","doi":"10.1590/2175-8239-JBN-2025-0333en","DOIUrl":"10.1590/2175-8239-JBN-2025-0333en","url":null,"abstract":"<p><strong>Introduction: </strong>The transcription factor BTB and CNC homology 1 (Bach1) represses the nuclear factor erythroid 2-related factor 2 (Nrf2), which controls antioxidant gene expression, and its role in chronic kidney disease (CKD) remains unclear.</p><p><strong>Methods: </strong>CKD was induced by 5/6 nephrectomy in rats. Kidney fibrosis and oxidative stress markers were measured. The gene expression of Nrf2, Bach1, and nuclear factor kappa B (NF-κB) was assessed.</p><p><strong>Results: </strong>CKD increased oxidative stress markers in plasma, kidney, and heart, as well as promoted kidney fibrosis. Moreover, CKD reduced cardiac Nrf2 expression. However, Bach1, Nrf2, and NF-κB remained unchanged in the kidney.</p><p><strong>Conclusion: </strong>CKD did not modulate Bach1 mRNA levels in the kidneys of 5/6 nephrectomized rats.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"48 3","pages":"e20250333"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13282137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148258159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methanol intoxication and acute kidney injury: pathophysiological mechanisms and therapeutic approaches.","authors":"Guilherme Nobre Nogueira, Camilla Beatriz Marinho Teles, Marcos Vinicius Sousa Varão, Anderson Carneiro Costa, Gabriel Moreira de Lima Ramos, Elizabeth De Francesco Daher","doi":"10.1590/2175-8239-JBN-2025-0344en","DOIUrl":"10.1590/2175-8239-JBN-2025-0344en","url":null,"abstract":"<p><p>Methanol intoxication is a potentially lethal condition that primarily affects the central nervous system, but it can also induce significant renal damage. Acute kidney injury (AKI) in this context is often underestimated, despite being an important prognostic marker associated with increased mortality and morbidity. This review aims to elucidate the pathophysiological mechanisms linking methanol intoxication to AKI, describe the cellular and metabolic pathways involved, and discuss current therapeutic approaches for renal protection and recovery. A descriptive and analytical review was conducted through searches in the PubMed, Embase, and Cochrane Library databases, including studies published between 2000 and 2025. Eligible articles addressed methanol-related nephrotoxicity, AKI mechanisms, or treatment strategies involving fomepizole, hemodialysis, and renal support. The nephrotoxic effects of methanol are mediated by the accumulation of formic acid, which inhibits mitochondrial cytochrome oxidase, leading to tissue hypoxia, oxidative stress, and cellular apoptosis. The main renal alterations include osmotic nephrosis and acute tubular necrosis, frequently associated with metabolic acidosis, rhabdomyolysis, or hemolysis. Risk factors such as anemia, sepsis, volume depletion, and acute pancreatitis exacerbate renal injury. AKI is linked to higher rates of multiple organ failure and in-hospital mortality. Methanol-induced AKI results from multifactorial mechanisms involving mitochondrial dysfunction, oxidative stress, and hemodynamic instability.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"48 3","pages":"e20250344"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13205139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148015495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex-specific differences in serum phosphate persist in patients with CKD.","authors":"Martina Schatz, Rafael Tavares, Luciene M Dos Reis, Rosilene M Elias, Rosa M A Moyses","doi":"10.1590/2175-8239-JBN-2025-0345en","DOIUrl":"10.1590/2175-8239-JBN-2025-0345en","url":null,"abstract":"<p><strong>Introduction: </strong>Phosphate plays a critical role in numerous metabolic processes, and sex-specific differences have been identified in its concentrations in the general population. However, such differences have not been investigated in the context of CKD, in which additional factors may exert a more pronounced impact on these levels.</p><p><strong>Methods: </strong>This retrospective study was conducted in an outpatient nephrology clinic and included data from 632 patients with CKD stages 1-5.</p><p><strong>Results: </strong>Serum phosphate was negatively associated with age (r = -0.08; p = 0.04) and estimated glomerular filtration rate (eGFR) (r = -0.23; p < 0.001). Women had significantly higher serum phosphate levels than men (3.6 mg/dL vs. 3.3 mg/dL; p = 0.01), an association confirmed in multivariate analysis. No significant sex differences were observed in serum calcium, parathyroid hormone (PTH), 25-hydroxyvitamin D, or the use of vitamin D supplements, calcium salts, or calcitriol.</p><p><strong>Conclusion: </strong>Even in the presence of CKD, women have higher serum phosphate (P) levels than men. This sex difference should be considered in the management of CKD-mineral and bone disorder (CKD-MBD).</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"48 3","pages":"e20250345"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13160562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147874187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between inflammatory markers and mortality in hemodialysis patients.","authors":"Cigdem Cindoglu, Burcu Beyazgül, Derya Abuşka, Ufuk Acar","doi":"10.1590/2175-8239-JBN-2025-0312en","DOIUrl":"10.1590/2175-8239-JBN-2025-0312en","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to evaluate the association between mortality and biomarkers reflecting inflammatory and nutritional status in hemodialysis (HD) patients, including the systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), C-reactive protein-to-albumin ratio (CAR), hemoglobin, albumin, lymphocyte and platelet (HALP) score, and prognostic nutritional index (PNI).</p><p><strong>Methods: </strong>This retrospective cohort study included 135 patients on routine HD. Baseline sociodemographic data, complete blood count, and biochemical parameters were recorded. Patients were followed for one year and classified as survivors or non-survivors. Predictors of mortality were analyzed using logistic regression (Enter method), with multicollinearity assessed by the variance inflation factor (VIF) and tolerance statistics.</p><p><strong>Results: </strong>The mean age of the patients included in the study was 55.2 ± 16.6 years, and 47.4% were male. In univariate analyses, age, albumin, calcium, CRP, white blood cell count, neutrophil count, hematocrit, hemoglobin, SII, NLR, CAR, and PNI were found to be significantly associated with survival (all p < 0.05). In the multivariate logistic regression analysis, only CAR (aOR = 1.374; 95% CI 1.011-1.869), PNI (aOR = 0.861; 95% CI 0.775-0.956), and hemoglobin (aOR = 0.725; 95% CI 0.532-0.988) were identified as independent predictors. The model's accuracy rate was 82%, and the AUC value was calculated as 0.87.</p><p><strong>Conclusion: </strong>Our study demonstrated that easily accessible and low-cost parameters, particularly CAR and PNI, are clinically valuable in predicting survival. The identification of hemoglobin levels as an independent predictor further supports the prognostic significance of hematological parameters. This study may serve as a basis for future research on the prognostic use of these biomarkers, emphasizing the need for large-scale and prospective studies.</p>","PeriodicalId":14724,"journal":{"name":"Jornal brasileiro de nefrologia : 'orgao oficial de Sociedades Brasileira e Latino-Americana de Nefrologia","volume":"48 3","pages":"e20250312"},"PeriodicalIF":1.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13166101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147874198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}