Journal of Nephrology最新文献

{"title":"Assessment and management of emergencies during haemodialysis.","authors":"Julian Yaxley, Alexander Lesser, Victoria Campbell","doi":"10.1007/s40620-024-02124-1","DOIUrl":"10.1007/s40620-024-02124-1","url":null,"abstract":"<p><p>The haemodialysis unit is a complex clinical environment. Medical emergencies complicating haemodialysis treatment are relatively infrequent but are associated with high morbidity and mortality. The management of intradialytic emergencies is challenging and relevant to the practice of all nephrology and critical care clinicians. There are no dedicated resuscitation guidelines for this unique patient population. This review article provides an outline of the assessment and treatment of important intradialytic emergencies (hypotension, hypertension, haemorrhage, hypoxia, neurologic disturbances, cardiac arrest) based on the best available evidence.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":"423-433"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546009","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":"Generalizability of kidney and cardiovascular protection by finerenone to the real world in Italy: insights from Fidelio and Figaro studies.","authors":"Salvatore De Cosmo, Roberto Pontremoli, Annalisa Giandalia, Valeria Manicardi, Alberto Rocca, Antonio Nicolucci, Maria Chiara Rossi, Giuseppe Lucisano, Giusi Graziano, Paolo Di Bartolo, Graziano Di Cianni, Riccardo Candido, Giuseppina T Russo","doi":"10.1007/s40620-024-02171-8","DOIUrl":"10.1007/s40620-024-02171-8","url":null,"abstract":"<p><strong>Background: </strong>We evaluated the proportion of Type 2 diabetes (T2D) patients with chronic kidney disease (CKD) participating in the AMD (Association of Medical Diabetologists) Annals initiative who met the eligibility criteria for phase III-studies on finerenone, showing its renal and cardiovascular benefits.</p><p><strong>Methods: </strong>This analysis involved all T2D patients seen in 2019 in 282 diabetes centers in Italy, for whom data on kidney function (estimated glomerular filtration rate and albuminuria) were available. Data are presented separately for different scenarios, covering the population with main eligibility criteria for inclusion in the FIDELIO-DKD and FIGARO-DKD trials.</p><p><strong>Results: </strong>Among 343,037 T2D patients involved in the analysis, 5.4% met the eligibility criteria of the FIDELIO-DKD study (13.3% if we consider the population with fundus data) and 22.3% met those of the FIGARO-DKD trial. Overall, 110,000 (33%) patients were eligible for treatment with finerenone, with a male prevalence, an average age of 71 years, and good control of the main risk factors (HbA1c 7.3%; BP 138/76 mmHg; LDL-c 87 mg/dl), albeit with large percentages of not well controlled patients (50% with SBP > 140 mmHg; > 30% with LDL-c > 100 mg/dl). Over 12% were on sodium/glucose cotransporter 2 inhibitors or glucagon-like peptide 1 receptor agonists. Based on the event rate from the FIDELITY pooled analysis, the number of potentially avoidable events was 21.7 per 1000 eligible patients for the cardiovascular composite outcome and 16.7 for the renal outcome.</p><p><strong>Conclusions: </strong>This analysis showed that approximately 33% of patients with T2D present the main eligibility criteria for treatment with finerenone and could therefore benefit from it in the near future.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":"589-596"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142828671","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":"Development and evaluation of a kidney health questionnaire and estimates of chronic kidney disease prevalence in the Cooperative Health Research in South Tyrol (CHRIS) study.","authors":"Giulia Barbieri, Lucia Cazzoletti, Roberto Melotti, Essi Hantikainen, Rebecca Lundin, Laura Barin, Martin Gögele, Peter Riegler, Pietro Manuel Ferraro, Peter Paul Pramstaller, Giovanni Gambaro, Maria Elisabetta Zanolin, Cristian Pattaro","doi":"10.1007/s40620-024-02157-6","DOIUrl":"10.1007/s40620-024-02157-6","url":null,"abstract":"<p><strong>Background: </strong>Kidney diseases are a public health burden but are poorly investigated in the general population. In light of inadequate survey tools, we developed a novel questionnaire for use in population-based studies, to retrospectively assess kidney diseases.</p><p><strong>Methods: </strong>The questionnaire covered general kidney diseases, reduced kidney function, and renal surgeries. It was administered between 2011 and 2018 to 11,684 participants (median age = 45 years) of the Cooperative Health Research in South Tyrol (CHRIS) study. Fasting estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (UACR) were measured. By factor analysis we contextualized the questionnaire content with respect to the biochemical measurements. We estimated overall and sex-stratified prevalence of kidney diseases, including possible CKD, calibrating them to the general target population via relative sampling weights.</p><p><strong>Results: </strong>Population-representative prevalence of glomerulonephritis, pyelonephritis, and congenital kidney diseases was 1.0%, 3.0%, and 0.2%, respectively, with corresponding odds ratios for females versus males of 1.4 (95% confidence interval: 1.0, 2.0), 8.7 (6.2, 12.3), and 0.7 (0.3, 1.6), respectively. Prevalence of kidney dysfunction (eGFR < 60 mL/min/1.73 m² or UACR > 30 mg/g) was 8.59%, while prevalence of self-reported CKD was 0.69%, indicating 95.3% of lack of disease awareness, with a similar figure in people with diabetes or hypertension. Overall, 15.76% of the population was affected by a kidney disease of any kind.</p><p><strong>Conclusion: </strong>In the Val Venosta/Vinschgau alpine district, CKD prevalence aligned with Western European estimates. Kidney health questionnaire implementation in population studies is feasible and valuable to assess CKD awareness, which we found to be dramatically low.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":"521-530"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142729445","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":"Epidemiology and early predictors of Fabry nephropathy: evaluation of long-term outcomes from a national Fabry centre.","authors":"Fahmida Mannan, Rajkumar Chinnadurai, Ryan Wiltshire, Jan Hansel, Karolina M Stepien, Reena Sharma, Gisela Wilcox, Eamon McCarron, Philip A Kalra, Ana Jovanovic","doi":"10.1007/s40620-024-02170-9","DOIUrl":"10.1007/s40620-024-02170-9","url":null,"abstract":"<p><strong>Background: </strong>Fabry disease is a rare genetic lysosomal storage disorder, whereby the accumulation of sphingolipids consequently leads to kidney structural damage and dysfunction. We explored the epidemiology of chronic kidney disease (CKD) among patients with Fabry disease at a major UK referral centre in Greater Manchester serving over 7 million people, to inform early predictors of kidney disease and possible treatment planning.</p><p><strong>Methods: </strong>Data were sourced from the electronic records of registered participants from November 2020 to February 2022 of adults diagnosed with Fabry disease, with at least 1 year of follow-up. Four hundred and five participants (female = 223, male = 182) met the initial eligibility criteria. Our study focused on identifying factors linked to incident CKD, with 395 evaluable individuals undergoing outcome analysis over a median of 6.4 years.</p><p><strong>Results: </strong>Findings concluded that 60.5% of participants received disease-modifying treatments, 29.7% experienced non-fatal cardiovascular events, 3.3% developed end-stage kidney disease (ESKD), and 7.3% died. Men had higher use of disease modifying therapy, progression to ESKD requiring kidney replacement therapy, cardiovascular events, and mortality compared to women. Subgroup analysis over 9 years revealed that older age, cardiovascular history, renin-angiotensin-aldosterone system inhibitor use, and higher urine albumin-to-creatinine ratio (uACR) were predictors of faster estimated glomerular filtration rate (eGFR) decline and increased mortality. At baseline, 47.8% of 249 patients with uACR data had CKD, and 25.4% of the remaining individuals developed CKD during follow-up, associated with higher uACR and lower, albeit normal eGFR levels.</p><p><strong>Conclusion: </strong>Over 60% of Fabry disease patients are at lifetime risk of developing CKD, with a substantial risk of mortality, even with initially normal uACR and eGFR values.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":"579-587"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854599","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":"Predictors of renal outcomes and mortality in patients with renal vein thrombosis: a retrospective multicenter study.","authors":"Osama Nady Mohamed, Sharehan Abdelrahman Ibrahim, Shereen Mohammed Mohammed Elsaghir, Marwa Ibrahim Mohamed, Basma Fathy, Ahmed M Dardeer, Sayed Shehata, Hassan M H Mohammed, Amr Setouhi, Ayat Mostafa Mohamed Ahmed, Asmaa Khalf Kamel, Doaa Elzaeem Ismail, Nehal I Abbas, Ahmed Fathy Kamel Ziady, Tamer El Zaeem Esmaeel, Ahmed S Issa, Ahmed M Yassin, Mostafa Mahmoud Hussein, Mostafa M Abdelghany, Momen Mostafa Nagy, Michael Samuel Ayad, Shaimaa F Kamel","doi":"10.1007/s40620-024-02166-5","DOIUrl":"10.1007/s40620-024-02166-5","url":null,"abstract":"<p><strong>Background: </strong>Studies on renal vein thrombosis have been conducted as case reports or case series. The renal outcomes and mortality risk of renal vein thrombosis have not been fully established. We aimed to investigate the clinical characteristics, treatment modalities, and predictors of renal outcomes and mortality in patients with renal vein thrombosis in a large multicenter cohort.</p><p><strong>Methods: </strong>We retrospectively assessed 182 patients with renal vein thrombosis diagnosed between January 2011 and May 2023 using either Doppler ultrasonography or computed tomography venography. The main outcomes analyzed were all-cause mortality, and worsening kidney function.</p><p><strong>Results: </strong>We evaluated 182 patients comprising 76 males (41.8%) and 106 females (58.2%). Nephrotic syndrome was the most common cause (51.6%) followed by malignancy (33%) and post-trauma or surgery (11%). Kidney function worsened in 126 patients (69.2%). Acute kidney injury (AKI) was identified in 72 patients (39.6%), whereas 54 patients (29.7%) developed chronic kidney disease (CKD). Multivariate logistic regression showed that declining kidney function was reliably predicted by nephrotic syndrome (Odds ratio (OR): 6.41, P = 0.004), serum albumin (OR: 0.31, P = 0.003), and diabetes mellitus (OR: 14.04, P < 0.001). Eighty-two patients (45.1%) died while being monitored. Sepsis accounted for the majority of deaths (25.3%). Bilateral renal vein thrombosis (Hazard Ratio (HR): 5.61, P < 0.001), malignancy (HR: 6.15, P = 0.004), serum albumin (HR: 0.12, P < 0.001), hemoglobin (Hb) level (HR: 0.102, P < 0.001) and diabetes mellitus (HR: 2.42, P = 0.007) were all reliable predictors of all-cause mortality using multivariate Cox regression.</p><p><strong>Conclusion: </strong>Renal vein thrombosis is associated with a higher risk of mortality and worsening kidney function. It is essential to promptly identify high risk patients and start early treatment to prevent unfavorable outcomes.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":"551-561"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909769","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":"Exploring new gene-disease associations in polycystic kidney disease: a case report highlighting the importance of a precise genomic diagnosis.","authors":"Gemma Scholes, Yael Prawer, Jessica Ryan, Kunal Verma, Kushani Jayasinghe","doi":"10.1007/s40620-024-02113-4","DOIUrl":"10.1007/s40620-024-02113-4","url":null,"abstract":"","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":"765-769"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391214","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":"Rifampicin-induced acute kidney injury due to pigment nephropathy: a lesson for the clinical nephrologist.","authors":"Pankaj Jawandhiya, Gayatri Dhote, Ankur Gupta, Vandana Admane, Jitesh Atram","doi":"10.1007/s40620-024-02129-w","DOIUrl":"10.1007/s40620-024-02129-w","url":null,"abstract":"","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":"771-775"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142801112","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":"Clinical presentation, outcomes and risk of relapses of lupus podocytopathy in a multicentre Italian cohort.","authors":"Grazia Dea Bonelli, Savino Sciascia, Marta Calatroni, Vincenzo L'imperio, Roberta Fenoglio, Lorenza Maria Argolini, Camillo Carrara, Nicola Lepori, Francesco Reggiani, Alessandra Bortoluzzi, Fausta Catapano, Mariele Gatto, Chiara Tani, Elisa Longhitano, Maurizio Garozzo, Barbara Trezzi, Emanuele Conte, Domenico Santoro, Maria Gerosa, Marta Mosca, Dario Roccatello, Renato Alberto Sinico, Gabriella Moroni","doi":"10.1007/s40620-024-02178-1","DOIUrl":"10.1007/s40620-024-02178-1","url":null,"abstract":"<p><strong>Background: </strong>In an Italian cohort of lupus podocytopathy patients, we aimed to characterize the presenting features, therapy, and outcomes, and explore differences between relapsing and non-relapsing patients.</p><p><strong>Methods: </strong>We identified 29 patients with lupus podocytopathy from 1994 to 2023 in 11 Italian Nephrology/Rheumatology Units, and divided them into two groups: relapsing and non-relapsing. Given the limited sample size, a p-value ≤ 0.2 was considered as significant.</p><p><strong>Results: </strong>The median age of the patients was 43 (25-52) years, 89.7% were females, 89.6% presented with nephrotic syndrome, 34.4% with acute kidney dysfunction, and 44% with arterial hypertension. After corticosteroids and/or immunosuppressive therapy, complete (25 patients) or partial remission (4 patients) occurred within a median of 4 (1-9) months. Nine patients (31%) relapsed. After a further course of therapy, remission was achieved within 5 (2-11) months. Relapsing patients had higher serum creatinine (0.94 [0.73-2.65] vs 0.8 [0.6-1.1] mg/dl; p = 0.12), lower estimated glomerular filtration rate (76 [32.5-107.5] vs 93 [59.3-109.7] ml/min/1.73m²; p = 0.23) and higher proteinuria (7.7 [5.9-11.7] vs 6.5 g/day [3.2-10.1]; p = 0.14) at lupus podocytopathy diagnosis than non-relapsing subjects. Activity indexes at biopsy were higher [(1 (0-2) vs 0 (0-1); p = 0.08] and cutaneous systemic lupus erythematosus manifestations were more prevalent (44.4% vs 10.5%; p = 0.06) in relapsing patients. After an observation of 49 (18-23) months, 86.2% of patients were in complete remission while 13.8% remained in partial remission. One patient developed mild chronic kidney function impairment.</p><p><strong>Conclusions: </strong>Lupus podocytopathy typically presents with nephrotic syndrome and kidney dysfunction, it responds favourably to treatment, and generally results in a favourable renal outcome. We observed that more active renal and extrarenal lupus manifestations at the onset of lupus podocytopathy were indicative of higher susceptiblity to disease recurrence.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":"643-653"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066187","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":"A period prevalence study of palliative care need and provision in adult patients attending hospital-based dialysis units.","authors":"Alannah L Cooper, Natalie Panizza, Rebecca Bartlett, Dipna Martin-Robins, Janie A Brown","doi":"10.1007/s40620-024-02193-2","DOIUrl":"10.1007/s40620-024-02193-2","url":null,"abstract":"<p><strong>Background: </strong>Advanced chronic kidney disease is a life-limiting disease that is known to benefit from palliative care. Unmet palliative care need in patients with kidney failure is commonly reported but the level of need among patients receiving haemodialysis is unknown.</p><p><strong>Methods: </strong>A period prevalence study of adult patients attending two hospital-based dialysis units was conducted. Patient medical records were reviewed using the Gold Standards Framework Proactive Indication Guidance to assess for potential palliative care need.</p><p><strong>Results: </strong>A total of 128 patient medical records were reviewed, 45% (n = 58) of patients could have potentially benefitted from palliative care. Of the patients with indicators for palliative care, 72% (n = 42) had no evidence of receiving or awaiting any form of palliative care. High levels of palliative care need were found in patients who identified as Aboriginal or Torres Strait Islander and non-Indigenous patients.</p><p><strong>Conclusions: </strong>This study found high levels of palliative care need among adult patients attending hospital-based dialysis units. The majority of patients with indicators were not receiving any form of palliative care.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":"687-695"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047123","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":"Insights into the real-world practice of vascular access care pathways in Italy: data from a national survey.","authors":"Laura Buzzi, Ivano Baragetti, Michela Maria Barbagallo, Antonio Marciello, Massimo Lodi, Walter Morale, Marcello Napoli, Giacomo Forneris","doi":"10.1007/s40620-024-02013-7","DOIUrl":"10.1007/s40620-024-02013-7","url":null,"abstract":"<p><strong>Background: </strong>International guidelines issued recommendations for vascular access (VA) care for hemodialysis, but there are no registry data regarding this topic in Italy.</p><p><strong>Methods: </strong>A survey consisting of 17 items was sent to all Italian dialysis wards, via the Italian Society of Nephrology (SIN) website, from April to June 2021. The items were defined, discussed and approved by experts in vascular access management within the Italian Society of Nephrology. A total of 124 dialysis units answered, accounting for 14% of all dialysis units. The survey thus encompasses all regions within the country, with some regional variations in terms of adherence.</p><p><strong>Results: </strong>One hundred twenty-four facilities provided data, regarding 12,276 patients: 61% had an arteriovenous fistula (AVF), 34% had a central venous catheter (CVC), and 5% had an arteriovenous graft (AVG). Among them, two-thirds of the facilities reported having a vascular access care pathway, formally standardized in 79% of cases. Forty-six % of centers had a fully equipped vascular access care pathway, encompassing preoperative mapping (80%), vascular access setup (71%), arteriovenous fistula maturation monitoring (76%), first-level (80%) and second-level (78%) monitoring, and surgical and/or endovascular treatment of complications (66%). Vascular access monitoring was computerized in 39% of facilities. First-level monitoring (physical examination) was primarily done by nurses in two-thirds of facilities. Of note, 45% of centers had nurses who were skilled in ultrasound-guided cannulation. Quite surprisingly, facilities with less than 100 patients had a greater prevalence of arteriovenous fistulas than those with more than 100 patients (p = 0.0023). A protocolled vascular access care pathway was associated with a higher likelihood of having an arteriovenous fistula (70% AVF vs 42,1% CVC; p = 0.04). The presence in the facility of interventional nephrologists or nurses with ultrasound-guided cannulation skills significantly reduced the prevalence of central venous catheters.</p><p><strong>Conclusion: </strong>These survey data further strengthen the need for formal and shared vascular access monitoring protocols.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":" ","pages":"481-489"},"PeriodicalIF":2.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141855761","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}