Journal of Nephrology最新文献

{"title":"Trust in physicians as a mediator of the relationship between person-centered care and medication adherence in patients undergoing hemodialysis: a cross-sectional study.","authors":"Yusuke Kanakubo, Ryohei Inanaga, Tatsunori Toida, Tetsuro Aita, Mamiko Ukai, Atsuro Kawaji, Takumi Toishi, Masatoshi Matsunami, Yu Munakata, Tomo Suzuki, Tadao Okada, Noriaki Kurita","doi":"10.1007/s40620-025-02387-2","DOIUrl":"10.1007/s40620-025-02387-2","url":null,"abstract":"<p><strong>Background: </strong>Person-centered care and trust in physicians influence medication adherence among dialysis patients. However, the mechanisms linking person-centered care to medication adherence, particularly the mediating effect of trust in physicians, remain unclear. This study investigated the interrelationships between person-centered care, trust in physicians, and medication adherence.</p><p><strong>Methods: </strong>Using a multicenter cross-sectional study of Japanese adults receiving outpatient hemodialysis at six dialysis centers, person-centered care was assessed using the 13-item Japanese Primary Care Assessment Tool-Short Form (JPCAT-SF), which included longitudinality and care coordination. Trust in physicians was measured using the five-item Wake Forest Physician Trust Scale. Medication adherence was measured using the 12-item Adherence Starts Knowledge (ASK-12) scale. General linear models examined person-centered care, physician trust, and medication adherence relationships. Mediation analysis determined how much trust in physicians mediated the person-centered care-medication adherence relationship.</p><p><strong>Results: </strong>A total of 483 patients, with median age and dialysis vintage of 71.9 and 5.7 years, respectively, were included in the analysis. High-quality person-centered care was associated with lower barriers to medication adherence in a dose-response manner across JPCAT-SF quartiles compared to no usual source of care. Trust in physicians partially mediated this relationship in a dose-response pattern, with the proportion of the indirect effect increasing from 16.1% (95% CI 4.5-33.8%) in Q2 to 33.3% (95% CI 17.4-65.5%) in Q4. Similar findings were observed for person-centered care subdomains.</p><p><strong>Conclusions: </strong>High-quality person-centered care was associated with medication adherence, with trust in physicians playing a key mediating role. Strategies to enhance medication adherence in hemodialysis patients should incorporate multidimensional person-centered care approaches, building trust and strengthening continuity and care coordination.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873659","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":"Correction: The impact of frailty and malnutrition on hospitalisation and survival in people with kidney failure.","authors":"Jessica Dawson, Brendan Smyth, Michele Ryan, Ann-Maree Randall, Katharine Clifford, Max Thomsett, Chenlei-Kelly Li, Mark A Brown","doi":"10.1007/s40620-025-02407-1","DOIUrl":"10.1007/s40620-025-02407-1","url":null,"abstract":"","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144821614","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":"Nutritional considerations for designing ketogenic dietary interventions for people with Autosomal Dominant Polycystic Kidney Disease.","authors":"Jessica Dawson, Anna Rangan, Gopi K Rangan","doi":"10.1007/s40620-025-02378-3","DOIUrl":"https://doi.org/10.1007/s40620-025-02378-3","url":null,"abstract":"<p><p>Autosomal Dominant Polycystic Kidney Disease (ADPKD) is a progressive genetic disease with few effective treatments available to slow the decline in kidney function. In ADPKD, there has been increasing interest in ketogenic diets, largely based on experimental data showing favorable effects on cyst growth and kidney function. High-quality clinical trials of sufficient duration using clinically relevant endpoints (estimated glomerular filtration rate [eGFR], kidney volume) are crucial to establish efficacy and safety in ADPKD. Although extensive reviews have been published about potential mechanisms of ketogenic diets to slow ADPKD progression, there is no guidance on how these diets should be designed to align with the unique clinical and nutritional needs of people with ADPKD. Potential safety and feasibility concerns for ketogenic diets (risk for nephrolithiasis and cardiovascular disease) should be evaluated in clinical trials to determine whether adherence to a complex diet can be sustained over years. Prior to embarking on a clinical trial, careful development of an ADPKD-appropriate ketogenic diet is required to mitigate against these risks. Thus, the aim of this narrative review is to provide a framework for the specific nutritional factors that should be considered when developing and designing a ketogenic dietary intervention in future clinical trials involving ADPKD patients.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812122","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":"Effective management of lupus nephritis using a novel combination therapy with low-dose steroids: a case report.","authors":"Niloufar Ebrahimi, Duvuru Geetha, Joselyn Reyes-Bahamonde, Craig W Zuppan, Amir Abdipour, Sayna Norouzi","doi":"10.1007/s40620-025-02361-y","DOIUrl":"10.1007/s40620-025-02361-y","url":null,"abstract":"<p><p>Lupus nephritis (LN) is the predominant severe manifestation of systemic lupus erythematosus (SLE). The approach to managing LN is highly heterogeneous due to the clinical heterogeneity of the disease. Here, we report a 28-year-old Caucasian female with refractory biopsy-proven active LN class III and V, diagnosed  approximately six years prior to presentation who was successfully managed with both belimumab and voclosporin. Her laboratory findings were significant for high-titer anti-dsDNA antibodies (> 300), low complements, and increasing proteinuria despite ongoing treatment with MMF and low-dose prednisone. The patient fulfilled the EULAR/ACR classification criteria for SLE, achieving a score of 28, reflecting significant systemic disease involvement. The patient tolerated the combination of volcosporin and belimumab well for nine months. She did not report any specific side effects during this time and was in clinical remission with no signs of systemic flare-up based on the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K). This case highlights the potential of combining belimumab, voclosporin, mycophenolate mofetil (MMF), and low-dose steroids in selected patients.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799445","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":"Social vulnerability and chronic kidney disease-associated mortality in the United States: 1999-2020.","authors":"Benjamin Grobman, Arian Mansur, Christine Y Lu","doi":"10.1007/s40620-025-02369-4","DOIUrl":"https://doi.org/10.1007/s40620-025-02369-4","url":null,"abstract":"<p><strong>Background: </strong>While significant sociodemographic disparities in the burden of chronic kidney disease (CKD) are well established, less is known about how area-level socioeconomic status interacts with these disparities.</p><p><strong>Methods: </strong>This study used data from the Centers for Disease Control and Prevention Wide-Ranging Online Database for Epidemiologic Research (CDC WONDER) Underlying Cause of Death Database to identify deaths from CKD among people aged 45 and older in the United States from 1999-2020. We used county-level Social Vulnerability Index data to examine the relationship between Social Vulnerability Index and CKD-associated mortality for the overall population and for sociodemographic subgroups.</p><p><strong>Results: </strong>The age-adjusted mortality rate for the overall population was 73.56 (95% CI 67.74-79.39). Mortality from CKD was significantly higher in the 4th quartile of Social Vulnerability Index, representing the most vulnerable areas (age-adjusted mortality rate = 81.39, 95% CI 75.77-87.00), compared to the 1st quartile, representing the least vulnerable areas (age-adjusted mortality rate = 66.07, 95% CI 59.02-73.12). For both the overall population and all sociodemographic subgroups, higher Social Vulnerability Index was associated with a higher risk of CKD-associated mortality. Within each Social Vulnerability Index quartile, Black Americans and males had higher CKD-associated mortality than White Americans and females, respectively.</p><p><strong>Conclusion: </strong>The burden of CKD-associated mortality in the United States is rising, with people living in more socially vulnerable counties facing a higher risk of CKD death. Racial disparities in CKD-associated mortality persist even within counties of similar social vulnerability, indicating the urgent need to address these health disparities.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144784484","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":"Efficacy and safety of antithrombotics in patients with atrial fibrillation undergoing hemodialysis: a nationwide cohort study in Korea.","authors":"Se-Jun Park, Yu-Na Kim, Byeong Kil Oh, Hoon Yu, Suhyeon Moon, Mi Yeon Lee, Sang-Jin Ha, Jeonggyu Kang","doi":"10.1007/s40620-025-02340-3","DOIUrl":"https://doi.org/10.1007/s40620-025-02340-3","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation and chronic kidney disease mutually interact, presenting distinct clinical dilemmas where the optimal risk-benefit profile of antithrombotic therapy remains undefined.</p><p><strong>Methods: </strong>This study was conducted using the Korean Health Insurance Review and Assessment Service database in patients with atrial fibrillation undergoing hemodialysis. The primary outcomes included thromboembolism and intracranial hemorrhage rates, while major bleeding and all-cause death were secondary outcomes. Selecting patients not taking antithrombotics as a reference, Kaplan-Meier and Cox proportional hazard analyses were performed for those taking antiplatelets, direct oral anticoagulants (DOACs), and warfarin. The net clinical benefit was obtained by balancing the efficacy and safety of each antithrombotic therapy.</p><p><strong>Results: </strong>There were 13,311 patients on hemodialysis recorded as with atrial fibrillation, the mean age was 63.1 ± 12.8 years, with the mean CHA₂DS₂-VASc score of 3.3 ± 1.6. One-fifth of the patients received antithrombotic therapy, with 67.1% using antiplatelet drugs. Warfarin was associated with an increased thromboembolic risk (HR 1.25; 95% CI, 1.01-1.56), while findings for DOACs remain inconclusive. In net clinical benefit analysis, with warfarin demonstrated the most unfavorable profile, and DOACs exhibited comparable net clinical benefit to antiplatelet agents (0.57; 95% CI, - 0.56-1.70).</p><p><strong>Conclusion: </strong>This study provides real-world evidence on the use of antithrombotic therapy in atrial fibrillation patients undergoing hemodialysis. The findings highlight the profound complexity and uncertainty in managing this high-risk population, underscoring the importance for comprehensive assessment, individualized treatment approaches, and further dedicated research to establish optimal prevention and treatment strategies.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144760370","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":"Quantifying ultrasound echogenicity difference for accurate chronic kidney disease diagnosis.","authors":"Lixia Zhao, Jun Shang, Yaying Shi, Yonghong Yan, Ping Li, Weidong Niu, Guijun Zhang, Zhaoyan Ding, Xu Chu, Tao Wang, Shuguang Zheng","doi":"10.1007/s40620-025-02352-z","DOIUrl":"https://doi.org/10.1007/s40620-025-02352-z","url":null,"abstract":"<p><strong>Background: </strong>This study aims to evaluate the diagnostic ability of quantitative renal echogenicity for chronic kidney disease (CKD) using ultrasounds.</p><p><strong>Methods: </strong>Between September 2018 and December 2019, patients with kidney disease at our hospital underwent ultrasound imaging and serum creatinine tests. Five radiologists assessed patient ultrasound image echogenic characteristics for CKD diagnosis. Novel quantitative imaging measurements were also collected. Estimated glomerular filtration rate (eGFR) was used to classify patients into CKD or non-CKD groups. The diagnostic accuracy of the radiologists' assessment and quantitative measurements was analyzed using Receiver Operating Characteristic (ROC) curves.</p><p><strong>Results: </strong>In our study, 339 patients participated. Radiologists' visual analysis showed low accuracy (42.5-46.9%) for CKD diagnosis. Conversely, bilateral mid-renal cortex echogenicity and echogenicity difference value showed a strong correlation with eGFR. We identified two effective CKD indicators: the Echogenicity Difference Value between Right Renal Sinus and Right Renal Cortex, which achieved 0.838 AUC (area under the curve), 77.90% accuracy, 68.45% sensitivity, and 87.13% specificity; and the Echogenicity Difference Value between Left Renal Sinus and Left Renal Cortex, which showed 0.805 AUC, 75.22% accuracy, 70.24% sensitivity, and 80.12% specificity.</p><p><strong>Conclusions: </strong>The radiologists' visual analysis of renal echogenic characteristics is insufficient for CKD diagnosis. Quantitative echogenicity analysis using the proposed echogenicity difference values is more objective and effective for diagnosing CKD.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144753628","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":"Type 2 diabetes mellitus modifies the relationship between coronary artery calcification and adverse kidney outcome in patients with chronic kidney disease: the findings from KNOW-CKD.","authors":"Hae-Ryong Yun, Young Su Joo, Hyung Woo Kim, Jung Tak Park, Nak-Hoon Son, Tae-Hyun Yoo, Shin-Wook Kang, Yaeni Kim, Soo Wan Kim, Yeong Hoon Kim, Kook-Hwan Oh, Seung Hyeok Han","doi":"10.1007/s40620-025-02364-9","DOIUrl":"https://doi.org/10.1007/s40620-025-02364-9","url":null,"abstract":"<p><strong>Background: </strong>Kidney function declines faster in patients with type 2 diabetes mellitus (T2DM) than in those without, and coronary artery calcification is a risk factor for adverse kidney outcomes. Thus, we examined whether T2DM modified the relationship between coronary artery calcification and chronic kidney disease (CKD) progression.</p><p><strong>Methods: </strong>Among 2067 participants from the KoreaN Cohort Study for Outcome in Patients With CKD, the main exposures analyzed were T2DM and coronary artery calcification. The primary outcome was CKD progression, which was a composite of > 50% decline in estimated glomerular filtration rate (eGFR) or kidney failure requiring kidney replacement therapy. A multivariable cause-specific hazard model was used to determine the association between the main exposures and the primary outcome.</p><p><strong>Results: </strong>During 8633 person-years of follow-up, the primary outcome occurred in 565 (27.3%) participants. After adjusting for confounding factors, T2DM and coronary artery calcification score > 0 were associated with 2.03- and 1.51-fold increased risks of CKD progression, respectively. T2DM and coronary artery calcification showed a significant interaction in terms of the primary outcome. In patients with T2DM, coronary artery calcification score > 0 was associated with a significantly higher risk of CKD progression compared with coronary artery calcification score = 0. However, the significant association of coronary artery calcification score > 0 versus coronary artery calcification score = 0 was lost in patients without T2DM. The slope of eGFR decline was steeper in patients with T2DM and coronary artery calcification score > 0 than in those with T2DM or coronary artery calcification score > 0 alone.</p><p><strong>Conclusions: </strong>Coronary artery calcification is more strongly associated with the risk of CKD progression in patients with T2DM than in those without. Therefore, the clinical implications of coronary artery calcification vary depending on the presence of T2DM.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144742355","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":"Patency and maturation rates after forearm arteriovenous fistulas: systematic review with meta-analysis.","authors":"Diogo Cristino, João Rocha Neves, Ryan Melo, Mario D'Oria, José Oliveira-Pinto","doi":"10.1007/s40620-025-02346-x","DOIUrl":"https://doi.org/10.1007/s40620-025-02346-x","url":null,"abstract":"<p><strong>Background: </strong>The growing burden of chronic kidney disease has significantly increased the demand for hemodialysis, with reliable vascular access being vital for treatment success. Although the radiocephalic arteriovenous fistula (AVF) remains the first option as a long term hemodialysis access, challenges related to aging patient population and prevalence of comorbidities may compromise maturation and durability. Therefore, this systematic review with meta-analysis aims to determine the patency and maturation rates of radiocephalic AVF, focusing on how different patient characteristics and surgical methodologies impact these rates.</p><p><strong>Materials and methods: </strong>Pubmed, Web of Science and Cochrane were systematically searched for studies assessing patency and maturation rates of radiocephalic AVF. Primary and secondary endpoints were pooled by random-effects meta-analysis, with sources of heterogeneity being explored by meta-regression.</p><p><strong>Results: </strong>Thirty-six cohort studies were selected, 15 of which were prospective. The meta analytical incidence of primary patency rates at 30 days, and at 1, 2, and 3 years after fistula creation was 84.18%, 68.43%, 59.86% and 55.10%, respectively. Additionally, the meta-analytical incidence of maturation failure, infection, aneurysm degeneration, early-thrombosis and reintervention rates was 24.7%, 3.9%, 3.6%, 6.3% and 29.4%, respectively. All the variables previously referred had high levels of heterogeneity associated. Furthermore, meta-regression analysis identified previous vascular access construction and latero-lateral anastomosis as factors associated with higher maturation failure rates.</p><p><strong>Conclusion: </strong>The significant heterogeneity observed in the endpoints evaluated highlight the complexity of radiocephalic AVF management. These findings underline the need for standardized clinical practices and further large-scale studies to identify factors influencing radiocephalic AVF outcomes.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731816","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 of accelerometer-measured physical activity with adverse cardiovascular outcomes in individuals with or without chronic kidney diseases: the UK biobank study.","authors":"Byounghwi Ko, Ye Eun Ko, Chan-Young Jung, Dong Hoon Kang, Cheol Ho Park, Hee Byung Koh, Ga Young Heo, Hyung Woo Kim, Jung Tak Park, Tae-Hyun Yoo, Shin-Wook Kang, Sue Kyung Park, Soo Wan Kim, Yeong Hoon Kim, Suah Sung, Kook Hwan Oh, Seung Hyeok Han","doi":"10.1007/s40620-025-02345-y","DOIUrl":"https://doi.org/10.1007/s40620-025-02345-y","url":null,"abstract":"<p><strong>Background: </strong>Physical activity is important for health and longevity, but little is known on patients living with chronic kidney disease (CKD). In fact, most studies in patients with CKD have relied on self-reported data, highlighting an unmet need for studies using objective measurements. We investigated the association between device-measured physical activity and adverse outcomes by CKD status.</p><p><strong>Methods: </strong>This study included 65,088 participants without CKD and 1170 with CKD, from the UK Biobank, who completed a one-week accelerometer assessment. CKD was defined as either baseline estimated glomerualr filtration rate (eGFR) < 60 mL/min/1.73 m² or two consecutive eGFR measurements < 60 mL/min/1.73 m² from primary care data recorded prior to the accelerometer study. The main predictor was device-measured physical activity, categorized into quartiles. The primary outcome was all-cause mortality; secondary outcomes included three-point major adverse cardiovascular events and non-cardiovascular death. We used cause-specific competing risk models adjusting for multiple covariates.</p><p><strong>Results: </strong>Over a median follow-up period of 8.04 years, all-cause mortality occurred in 2028 (3.06%) participants, with an incidence of 3.84/1000 person-years. Compared with the 1st quartile, the adjusted hazard ratios (95% confidence intervals) for all-cause mortality for the 2nd, 3rd, and 4th quartiles were 0.72 (0.64-0.80), 0.65 (0.57-0.72), and 0.57 (0.49-0.66) in non-CKD, and 0.56 (0.33-0.96), 0.42 (0.23-0.79), and 0.33 (0.16-0.68) in CKD participants. This pattern was consistent for non-cardiovascular deaths. However, device-measured physical activity was not significantly associated with three-point major adverse cardiovascular events in CKD, while a significant association was observed in the non-CKD group.</p><p><strong>Conclusion: </strong>Device-measured physical activity showed differential associations with outcomes by CKD status. The null association between physical activity and three-point major adverse cardiovascular events in CKD suggests a complex cardiovascular pathophysiology in this population.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731813","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}