Journal of Nephrology最新文献

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Maternal and fetal risk factors for congenital anomalies of the kidney and urinary tract: a birth cohort study in urban China. 先天性肾脏和泌尿道畸形的母体和胎儿风险因素:中国城市出生队列研究》(Maternal and fetal risk factors for congenital anomalies of kidney and urinary tracts: a birth cohort study in urban China)。
IF 2.7 4区 医学
Journal of Nephrology Pub Date : 2024-09-20 DOI: 10.1007/s40620-024-02066-8
Wei Zhang, Xiaochun Zhou, Weikai Wang, Li Wang, Chuan Zhang, Jianqin Wang
{"title":"Maternal and fetal risk factors for congenital anomalies of the kidney and urinary tract: a birth cohort study in urban China.","authors":"Wei Zhang, Xiaochun Zhou, Weikai Wang, Li Wang, Chuan Zhang, Jianqin Wang","doi":"10.1007/s40620-024-02066-8","DOIUrl":"https://doi.org/10.1007/s40620-024-02066-8","url":null,"abstract":"<p><strong>Background: </strong>Congenital anomalies of the kidney and urinary tract (CAKUT) are among the most common causes of kidney diseases in children. Previous studies on CAKUT etiologies have been predominantly focused on non-modifiable genetic risk factors. The existing nongenetic studies are limited by lack of comprehensive investigation of potentially modifiable risk factors and the inability to distinguish among various phenotypes of CAKUT. Therefore, this study aimed to comprehensively evaluate both maternal and fetal risk factors of CAKUT, sorted by disease phenotype.</p><p><strong>Methods: </strong>A prospective birth cohort study was conducted among 10,179 women who delivered a singleton live newborn in Lanzhou, China, between 2010 and 2012. Face-to-face interviews were conducted among the participants within 1-3 days after delivery using standard questionnaires to collect information on maternal demographics and characteristics. All newborns underwent postnatal renal ultrasonographic screening during their routine 1-month checkup. Clinical data, including birth outcomes and maternal complications, were confirmed by reviewing their medical records. Maternal and fetal risk factors were compared in children with and without CAKUT. Multivariable logistic regression analysis was performed to identify independent risk factors of CAKUT and their phenotypes, respectively.</p><p><strong>Results: </strong>A total of 489 (4.8%) cases of CAKUT were identified. Logistic regression revealed that maternal overweight (pre-pregnancy), gestational diabetes, preterm birth, and low birth weight were independent risk factors for CAKUT. Maternal overweight increased the risk of vesicoureteral reflux (VUR, odds ratio (OR) = 1.441, 95% confidence interval (CI) 1.010-2.057) and posterior urethral valves (PUV, OR = 1.868, 95% CI 1.074-3.249). Gestational diabetes increased the risk of ureteropelvic junction obstruction (UPJO, OR = 1.269; 95% CI 1.044-1.543) and posterior urethral valves (OR = 1.794; 95% CI 1.302-2.474). Preterm birth increased the risk of ureteropelvic junction obstruction (OR = 1.056; 95% CI 1.004-1.111).</p><p><strong>Conclusions: </strong>Our study identified various risk factors associated with different CAKUT phenotypes, stressing the importance of separate analyses for each phenotype. Our findings may provide helpful guidance on developing targeted and effective CAKUT prevention programs in the future.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289477","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}
引用次数: 0
You don't have to give up anything. Between Čechov and Rita Charon, we can all gather in the clearing where medical humanities lay. 你不必放弃任何东西。在切乔夫和丽塔-卡戎之间,我们可以聚集在医学人文的空地上。
IF 2.7 4区 医学
Journal of Nephrology Pub Date : 2024-09-20 DOI: 10.1007/s40620-024-02092-6
Federica Neve Vigotti
{"title":"You don't have to give up anything. Between Čechov and Rita Charon, we can all gather in the clearing where medical humanities lay.","authors":"Federica Neve Vigotti","doi":"10.1007/s40620-024-02092-6","DOIUrl":"https://doi.org/10.1007/s40620-024-02092-6","url":null,"abstract":"","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289479","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}
引用次数: 0
Persistent mild hypercalcaemia in an infant with pseudohypoaldosteronism and the diagnostic challenges faced 假性醛固酮增多症婴儿的持续性轻度高钙血症及面临的诊断挑战
IF 3.4 4区 医学
Journal of Nephrology Pub Date : 2024-09-19 DOI: 10.1007/s40620-024-02082-8
Martha Spiteri, Sarah Camilleri, Nancy Formosa, Daniela Grima, Edith Said, Valerie Said Conti
{"title":"Persistent mild hypercalcaemia in an infant with pseudohypoaldosteronism and the diagnostic challenges faced","authors":"Martha Spiteri, Sarah Camilleri, Nancy Formosa, Daniela Grima, Edith Said, Valerie Said Conti","doi":"10.1007/s40620-024-02082-8","DOIUrl":"https://doi.org/10.1007/s40620-024-02082-8","url":null,"abstract":"","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142269447","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}
引用次数: 0
Reducing the carbon footprint for a 30-bed haemodialysis unit by changing the delivery of acid concentrate supplied by individual 5 L containers to a central delivery system 通过将单个 5 升容器供应的浓缩酸输送改为中央输送系统,减少拥有 30 张床位的血液透析单位的碳足迹
IF 3.4 4区 医学
Journal of Nephrology Pub Date : 2024-09-18 DOI: 10.1007/s40620-024-02073-9
Gareth Murcutt, Rosie Hillson, Cate Goodlad, Andrew Davenport
{"title":"Reducing the carbon footprint for a 30-bed haemodialysis unit by changing the delivery of acid concentrate supplied by individual 5 L containers to a central delivery system","authors":"Gareth Murcutt, Rosie Hillson, Cate Goodlad, Andrew Davenport","doi":"10.1007/s40620-024-02073-9","DOIUrl":"https://doi.org/10.1007/s40620-024-02073-9","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Haemodialysis treatments generate greenhouse gas (GHG) emissions mainly as a result of the equipment, consumables and pharmaceuticals required. An internal audit demonstrated a 33% wastage of acid concentrate when using individual 5.0 L containers at a 1:44 dilution ratio. We therefore investigated whether changing the delivery system for acid concentrate would reduce wastage and any associated greenhouse gas emissions.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>We calculated the difference for a 30-bed dialysis unit between receiving acid concentrate in single-use 5.0 L plastic containers versus bulk delivery for a central acid delivery system connected to the dialysis machines. Estimates of carbon dioxide equivalent (CO<sub>2</sub>e) emissions were made using the United Kingdom government database and other sources.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>A 30-station dialysis unit functioning at maximum capacity (3 shifts and 6 days/week), switching to bulk delivery and central acid delivery could realise an approximate total reduction of 33,841 kgCO<sub>2</sub>e/year; in reduced product wastage, saving 6192 kgCO<sub>2</sub>e, 5205 kgCO<sub>2</sub>e from fewer deliveries, and 22,444 kgCO<sub>2</sub>e saving from a reduction in packaging and waste generated, which equates approximately to a one tonne reduction in CO<sub>2</sub>e emissions per dialysis station/year.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>Switching from delivering acid concentrate in individual 5.0 L containers to a central acid delivery system can result in substantial reductions in CO<sub>2</sub>e emissions within a dialysis clinic. The emission savings from reducing the single-use plastic packaging greatly outweigh any gains from eliminating wastage of acid concentrate. Dialysis companies and clinicians should consider reviewing the design of current and future dialysis facilities and policies to determine whether reductions in CO<sub>2</sub>e emissions can be made.</p><h3 data-test=\"abstract-sub-heading\">Graphical Abstract</h3>\u0000","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142257074","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}
引用次数: 0
Gut mucosa alterations after kidney transplantation: a cross sectional study 肾移植后肠道粘膜的改变:一项横断面研究
IF 3.4 4区 医学
Journal of Nephrology Pub Date : 2024-09-18 DOI: 10.1007/s40620-024-02067-7
Rashmi Joshi, Carmine Secondulfo, Alessandro Caputo, Pio Zeppa, Candida Iacuzzo, Luca Apicella, Margherita Borriello, Giancarlo Bilancio, Davide Viggiano
{"title":"Gut mucosa alterations after kidney transplantation: a cross sectional study","authors":"Rashmi Joshi, Carmine Secondulfo, Alessandro Caputo, Pio Zeppa, Candida Iacuzzo, Luca Apicella, Margherita Borriello, Giancarlo Bilancio, Davide Viggiano","doi":"10.1007/s40620-024-02067-7","DOIUrl":"https://doi.org/10.1007/s40620-024-02067-7","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Kidney transplant recipients (KTRs) rely on immunosuppressants like mycophenolate to prevent organ rejection. However, mycophenolate often causes intestinal symptoms and inflammation in various organs, including the skin and the colon. While KTRs have an increased risk for skin cancer, the risk of colorectal cancer is not increased.</p><p>Elucidating the histological alterations in the colon of KTRs and comparing these changes with known skin alterations would help understand how immunosuppressants influence cancer development and progression.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>Whole slide images from gut biopsies (Non-transplanted subjects <i>n</i> = 35, KTRs <i>n</i> = 49) were analyzed using the ImageJ and R programming environment. A total of 22,035 epithelial cells, 38,870 interstitial cells, 3465 epithelial cell mitoses, and 7477 endothelial cells, each characterized by multiple microscopy parameters, from a total of 1788 glands were analyzed. The large database was subsequently analyzed to verify the changes of inflammatory milieu in KTRs and in cancer.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>KTRs without colon-cancer showed a significantly higher density of interstitial cells in the colon compared to non-transplanted patients. Moreover, the increase in interstitial cell number was accompanied by subtle modifications in the architecture of the colon glands, without altering the epithelial cell density. We could not identify significant structural modifications in cancer samples between KTRs and non-transplanted patients.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>Our findings demonstrate an increased number of resident interstitial cells in the colon of KTRs, as in other patients treated with mycophenolate. These changes are associated with subtle alterations in the architecture of colon glands.</p><h3 data-test=\"abstract-sub-heading\">Graphical abstract</h3>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142257073","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}
引用次数: 0
Lessons for the clinical nephrologist: legacy effects of bevacizumab and ramucirumab lead to nephrotic syndrome due to renal-limited thrombotic microangiopathy with podocytopathy 给临床肾病学家的启示:贝伐珠单抗和雷莫芦单抗的遗留效应导致肾局限性血栓性微血管病并发荚膜细胞病引起肾病综合征
IF 3.4 4区 医学
Journal of Nephrology Pub Date : 2024-09-17 DOI: 10.1007/s40620-024-02087-3
Takahide Iwasaki, Akihiro Kuma, Makoto Yoshida, Masataka Ikeda, Takahiro Kuragano
{"title":"Lessons for the clinical nephrologist: legacy effects of bevacizumab and ramucirumab lead to nephrotic syndrome due to renal-limited thrombotic microangiopathy with podocytopathy","authors":"Takahide Iwasaki, Akihiro Kuma, Makoto Yoshida, Masataka Ikeda, Takahiro Kuragano","doi":"10.1007/s40620-024-02087-3","DOIUrl":"https://doi.org/10.1007/s40620-024-02087-3","url":null,"abstract":"","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142257072","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}
引用次数: 0
Factors affecting intraperitoneal pressure (IPP) and its prognostic value in predicting leak risk and gastrointestinal symptoms in adult peritoneal dialysis patients: a systematic review and meta-analysis 影响腹膜内压力 (IPP) 的因素及其在预测成人腹膜透析患者渗漏风险和胃肠道症状方面的预后价值:系统综述和荟萃分析
IF 3.4 4区 医学
Journal of Nephrology Pub Date : 2024-09-16 DOI: 10.1007/s40620-024-02091-7
Ka Chun Leung, Stephen Mahony, Edwina A. Brown, Richard W. Corbett
{"title":"Factors affecting intraperitoneal pressure (IPP) and its prognostic value in predicting leak risk and gastrointestinal symptoms in adult peritoneal dialysis patients: a systematic review and meta-analysis","authors":"Ka Chun Leung, Stephen Mahony, Edwina A. Brown, Richard W. Corbett","doi":"10.1007/s40620-024-02091-7","DOIUrl":"https://doi.org/10.1007/s40620-024-02091-7","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Intraperitoneal pressure measurement offers therapeutic and prognostic benefits in predicting leak risks and gastrointestinal symptoms in Peritoneal Dialysis (PD) patients. This systematic review aims to evaluate the prognostic utility of intraperitoneal pressure measurements and different estimated intraperitoneal pressure equations in predicting the risk of non-infectious complications in PD patients.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>Databases including MEDLINE, EMBASE and Cochrane were searched up to July 2023. Randomised and non-randomised trials were included, focusing on End-Stage Kidney Disease (ESKD) patients undergoing PD. Primary outcomes were variables associated with intraperitoneal pressure, while secondary outcomes included PD-related non-infectious complications and gastrointestinal symptoms. Data synthesis combined meta-analysis with narrative synthesis. This review has been registered on PROSPERO (CRD42023475138).</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Out of 1828 identified studies, 12 were included for systematic review and 10 for meta-analysis. Body Mass Index (BMI) and Body Surface Area (BSA) showed a consistent positive correlation with intraperitoneal pressure (BMI: <i>r</i> = 0.49, 95% CI 0.35–0.61, <i>I</i><sup>2</sup> = 67.39%, <i>p</i> = 0.003; BSA: <i>r</i> = 0.2, 95% CI 0.08–0.31, <i>I</i><sup>2</sup> = 14.10%, <i>p</i> = 0.324). Conversely, the association between intraperitoneal pressure and age, intraperitoneal volume, and Charlson Comorbidity Index were less consistent. Subgroup analysis demonstrated an association between higher intraperitoneal pressure in patients with increased BMI and BSA. However, the relationship between intraperitoneal pressure and non-infectious mechanical complications remained inconclusive.</p><h3 data-test=\"abstract-sub-heading\">Discussion</h3><p>This review underscores a significant association between intraperitoneal pressure and anthropometric measures (BMI and BSA). The majority of the studies identified included a small sample and considerable bias. However, the association between intraperitoneal pressure and clinically relevant outcomes was not clear.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>While increasing body mass index and body surface areas are associated with increasing intraperitoneal pressure, the clinical relevance of measuring intraperitoneal pressure in an adult population remains unclear, particularly given the absence of an association with clinically relevant non-infectious outcomes.</p><h3 data-test=\"abstract-sub-heading\">Graphical abstract</h3>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142257075","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}
引用次数: 0
Methods for phenotyping adult patients with acute kidney injury: a systematic review 对急性肾损伤成人患者进行表型分析的方法:系统综述
IF 3.4 4区 医学
Journal of Nephrology Pub Date : 2024-09-16 DOI: 10.1007/s40620-024-02080-w
Anjay P. Shah, William Snead, Anshul Daga, Rayon Uddin, Esra Adiyeke, Tyler J. Loftus, Azra Bihorac, Yuanfang Ren, Tezcan Ozrazgat-Baslanti
{"title":"Methods for phenotyping adult patients with acute kidney injury: a systematic review","authors":"Anjay P. Shah, William Snead, Anshul Daga, Rayon Uddin, Esra Adiyeke, Tyler J. Loftus, Azra Bihorac, Yuanfang Ren, Tezcan Ozrazgat-Baslanti","doi":"10.1007/s40620-024-02080-w","DOIUrl":"https://doi.org/10.1007/s40620-024-02080-w","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Acute kidney injury (AKI) is a multifaceted disease characterized by diverse clinical presentations and mechanisms. Advances in artificial intelligence have propelled the identification of AKI subphenotypes, enhancing our capacity to customize treatments and predict disease trajectories.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>We conducted a systematic review of the literature from 2017 to 2022, focusing on studies that utilized machine learning techniques to identify AKI subphenotypes in adult patients. Data were extracted regarding patient demographics, clustering methodologies, discriminators, and validation efforts from selected studies.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>The review highlights significant variability in subphenotype identification across different populations. All studies utilized clinical data such as comorbidities and laboratory variables to group patients. Two studies incorporated biomarkers of endothelial activation and inflammation into the clinical data to identify subphenotypes. The primary discriminators were comorbidities and laboratory trajectories. The association of AKI subphenotypes with mortality, renal recovery and treatment response was heterogeneous across studies. The use of diverse clustering techniques contributed to variability, complicating the application of findings across different patient populations.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>Identifying AKI subphenotypes enables clinicians to better understand and manage individual patient trajectories. Future research should focus on validating these phenotypes in larger, more diverse cohorts to enhance their clinical applicability and support personalized medicine in AKI management.</p><h3 data-test=\"abstract-sub-heading\">Graphical abstract</h3>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142257109","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}
引用次数: 0
Association between serum potassium, risk and prognosis of peritonitis in peritoneal dialysis patients - results from the Peritoneal Dialysis Telemedicine-assisted Platform Cohort (PDTAP) Study 腹膜透析患者血清钾与腹膜炎风险和预后之间的关系--腹膜透析远程医疗辅助平台队列(PDTAP)研究结果
IF 3.4 4区 医学
Journal of Nephrology Pub Date : 2024-09-15 DOI: 10.1007/s40620-024-02056-w
Zi Wang, Xiaoying Ma, Shaomei Li, Huaying Pei, Jinghong Zhao, Ying Zhang, Zibo Xiong, Yumei Liao, Ying Li, Qiongzhen Lin, Wenbo Hu, Yulin Li, Zhaoxia Zheng, Liping Duan, Gang Fu, Shanshan Guo, Beiru Zhang, Rui Yu, Li Hao, Guiling Liu, Zhanzheng Zhao, Jing Xiao, Yulan Shen, Yong Zhang, Xuanyi Du, Tianrong Ji, Caili Wang, Lirong Deng, Yingli Yue, Shanshan Chen, Zhigang Ma, Yingping Li, Li Zuo, Huiping Zhao, Xianchao Zhang, Xuejian Wang, Yirong Liu, Xinying Gao, Xiaoli Chen, Hongyi Li, Shutong Du, Cui Zhao, Zhonggao Xu, Li Zhang, Hongyu Chen, Li Li, Lihua Wang, Yan Yan, Yingchun Ma, Yuanyuan Wei, Jingwei Zhou, Yan Li, Fuyun Sun, Jie Dong
{"title":"Association between serum potassium, risk and prognosis of peritonitis in peritoneal dialysis patients - results from the Peritoneal Dialysis Telemedicine-assisted Platform Cohort (PDTAP) Study","authors":"Zi Wang, Xiaoying Ma, Shaomei Li, Huaying Pei, Jinghong Zhao, Ying Zhang, Zibo Xiong, Yumei Liao, Ying Li, Qiongzhen Lin, Wenbo Hu, Yulin Li, Zhaoxia Zheng, Liping Duan, Gang Fu, Shanshan Guo, Beiru Zhang, Rui Yu, Li Hao, Guiling Liu, Zhanzheng Zhao, Jing Xiao, Yulan Shen, Yong Zhang, Xuanyi Du, Tianrong Ji, Caili Wang, Lirong Deng, Yingli Yue, Shanshan Chen, Zhigang Ma, Yingping Li, Li Zuo, Huiping Zhao, Xianchao Zhang, Xuejian Wang, Yirong Liu, Xinying Gao, Xiaoli Chen, Hongyi Li, Shutong Du, Cui Zhao, Zhonggao Xu, Li Zhang, Hongyu Chen, Li Li, Lihua Wang, Yan Yan, Yingchun Ma, Yuanyuan Wei, Jingwei Zhou, Yan Li, Fuyun Sun, Jie Dong","doi":"10.1007/s40620-024-02056-w","DOIUrl":"https://doi.org/10.1007/s40620-024-02056-w","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Hypokalemia has been associated with an increased risk of peritoneal dialysis (PD)-associated peritonitis. However, hypokalemia is commonly associated with malnutrition, inflammation, and severe coexisting comorbidities, which thus are suspected of being potential confounders. This study was aimed at testing whether hypokalemia was independently associated with the occurrence and prognosis of PD-associated peritonitis.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>A national-level dataset from the Peritoneal Dialysis Telemedicine-assisted Platform Cohort (PDTAP) Study was used to explore the independent association of serum potassium with PD-associated peritonitis. Unmatched and propensity score-adjusted multivariate competing risk models, as well as univariate competing risk models following 1:1 propensity score matching, were conducted to balance potential biases between patients with and without hypokalemia. The association between potassium levels prior to peritonitis and treatment failure due to peritonitis was also investigated.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>During a median follow-up of 25.7 months in 7220 PD patients, there was a higher incidence of peritonitis in patients with serum potassium below 4.0 mmol/L compared to those with higher serum levels (677 [0.114/patient-year] vs. 914 [0.096/patient-year], <i>P</i> = 0.001). After adjusting for demographics, laboratory tests, residual renal function, and medication use, baseline potassium levels below 4.0 mmol/L were not linked to an increased risk of peritonitis, with a hazard ratio of 0.983 (95% CI 0.855–1.130, <i>P</i> = 0.810). This result remained consistent in both the propensity score adjusted multivariate competing risk regression (HR = 0.974, 95% CI 0.829–1.145, <i>P</i> = 0.750) and the univariate competing risk regression after 1:1 propensity score matching (Fine-Gray test, <i>P</i> = 0.218). The results were similar when analyzing patients with serum potassium level above or below 3.5 mmol/L. Lastly, hypokalemia before the occurrence of peritonitis was not independently associated with treatment failure.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Hypokalemia was not found to be an independent risk factor for PD-associated peritonitis or treatment failure of peritonitis in China.</p><h3 data-test=\"abstract-sub-heading\">Graphical abstract</h3>\u0000","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142257076","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}
引用次数: 0
Coping model, personality traits, social support and clinical outcomes in patients undergoing continuous ambulatory peritoneal dialysis: a post-hoc analysis of a randomized trial 持续非卧床腹膜透析患者的应对模式、人格特质、社会支持和临床结果:随机试验的事后分析
IF 3.4 4区 医学
Journal of Nephrology Pub Date : 2024-09-14 DOI: 10.1007/s40620-024-02090-8
Yifei Wu, Xiao Xu, Quan Wenxiang, Jie Dong
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