Kidney Research and Clinical Practice最新文献

{"title":"Association of metformin with cardiovascular and graft outcomes in kidney transplant recipients with posttransplantation diabetes mellitus.","authors":"Dongyeon Lee, Jiyun Jung, Sichan Kim, Jaeyun Lee, Jangwook Lee, Chung Hee Baek, Hyunwook Kwon, Sung Shin, Younghoon Kim, Sung Joon Shin, Su-Kil Park, Jae Yoon Park, Hyosang Kim","doi":"10.23876/j.krcp.23.085","DOIUrl":"10.23876/j.krcp.23.085","url":null,"abstract":"<p><strong>Background: </strong>Posttransplantation diabetes mellitus (PTDM) is a crucial problem after kidney transplantation. We aimed to determine whether metformin affects cardiovascular and graft outcomes in patients with PTDM.</p><p><strong>Methods: </strong>This retrospective cohort study included 1,663 kidney transplant recipients without preexisting diabetes mellitus. The patients were divided into metformin and non-metformin groups, with matched propensity scores. We also estimated metformin's effect on percutaneous coronary intervention (PCI), major adverse cardiovascular events (MACEs), acute rejection, and graft failure.</p><p><strong>Results: </strong>Of 634 recipients with PTDM, 406 recipients were treated with metformin. The incidence of PCI was 2.4% and 7.1% in the metformin and non-metformin groups, respectively (p = 0.04). The metformin group exhibited a lower risk of PCI in Cox regression analyses (hazard ratio [HR], 0.27; 95% confidence interval [CI], 0.10-0.77; p = 0.014), especially in subgroups with male sex, age over 49 years (median), long-term metformin use (mean of ≥1,729 days), and simultaneous tacrolimus administration. Long-term metformin use was also associated with lower incidence of MACEs (HR, 0.09; 95% CI, 0.01-0.67; p = 0.02). Incidence of graft failure was 9.9% and 17.0% in the metformin and non-metformin groups, respectively (p = 0.046). Both long-term use and higher dose of metformin, as well as tacrolimus administration with metformin, were associated with a lower risk of graft failure (HR, 0.29; 95% CI, 0.11-0.75; p = 0.01; HR, 0.39; 95% CI, 0.18-0.85; p = 0.02; and HR, 0.39; 95% CI, 0.19-0.79; p = 0.009, respectively).</p><p><strong>Conclusion: </strong>Metformin use is associated with a decreased risk of developing coronary artery disease and better graft outcomes in PTDM.</p>","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":"86-98"},"PeriodicalIF":3.8,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12824509/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139425049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypocalcemia as a nontraditional risk factor for cardiovascular events and all-cause din patients with chronic kidney disease: insights from the Korean Cohort Study for Outcomes in Patients With Chronic Kidney Disease (KNOW-CKD).","authors":"Sang Heon Suh, Hong Sang Choi, Chang Seong Kim, Eun Hui Bae, Kook-Hwan Oh, Jayoun Kim, Suah Sung, Young Youl Hyun, Jong Cheol Jeong, Sangjun Lee, Sue K Park, Seong Kwon Ma, Soo Wan Kim","doi":"10.23876/j.krcp.25.266","DOIUrl":"https://doi.org/10.23876/j.krcp.25.266","url":null,"abstract":"<p><strong>Background: </strong>The clinical implication of hypocalcemia is elusive in patients with chronic kidney disease (CKD). The present study aimed to investigate whether low serum calcium levels increase the risk of major adverse cardiovascular events (MACEs) and cardiovascular mortality in patients with non-dialysis CKD.</p><p><strong>Methods: </strong>A total of 2,188 patients with CKD at stages 1 to 5 (pre-dialysis) were categorized by corrected calcium levels into low (<8.5 mg/dL), normal, and high (≥9.5 mg/dL) groups, and were prospectively observed for a median duration of 9.2 years. The study outcomes were MACE and all-cause death.</p><p><strong>Results: </strong>The analysis of the baseline characteristics revealed the correlation between low corrected calcium levels and clinically unfavorable features. The cumulative incidence of MACE and cardiovascular and all-cause death, but not nonfatal myocardial infarction and nonfatal stroke, significantly differed by corrected calcium levels. Cox regression analyses demonstrated that low corrected calcium levels were independently and significantly associated with the risk of MACE (adjusted hazard ratio [HR], 2.854; 95% confidence interval [CI], 1.439-5.659), cardiovascular death (adjusted HR, 5.256; 95% CI, 1.993-13.861), and all-cause death (adjusted HR, 1.902; 95% CI, 1.185-3.054), but not with the risk of nonfatal MI or nonfatal stroke.</p><p><strong>Conclusion: </strong>Hypocalcemia is significantly associated with the risk of adverse cardiovascular outcomes in patients with non-dialysis CKD. As a nontraditional risk factor for cardiovascular events and all-cause death in this population, the presence of hypocalcemia should urge more intense monitoring for the development of cardiovascular events.</p>","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147690849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expert opinion on the optimal use of sevelamer in clinical practice in Southeast Asia.","authors":"Bancha Satirapoj, Chong Men Leong, Christopher Thiam Seong Lim, Dung Huu Nguyen, Fariz Safhan Mohamad Nor, Kajohnsak Noppakun, Minh Tuan Nguyen, Mohamad Zaimi Abdul Wahab, Paweena Susantitaphong, Thao Ngoc Phuong Huynh, The Cuong Nguyen, Mansij Biswas","doi":"10.23876/j.krcp.25.253","DOIUrl":"https://doi.org/10.23876/j.krcp.25.253","url":null,"abstract":"<p><p>Chronic kidney disease (CKD)-mineral bone disorder (MBD) is a prevalent and serious complication in patients with advanced CKD, particularly in Southeast Asia where the disease burden is high. This condition significantly increases the risk of cardiovascular events and mortality. This review synthesizes mechanistic insights, clinical trial evidence, guideline recommendations, and expert perspectives to evaluate the role of sevelamer, a non-calcium-based phosphate binder, in the management of CKD-MBD. Regional epidemiological and clinical practice data from Southeast Asia were also examined. Sevelamer effectively controls hyperphosphatemia without exacerbating hypercalcemia or vascular calcification. Beyond phosphate binding, it offers pleiotropic benefits including improvements in lipid profile, reductions in vascular inflammation, and potential survival advantages. Despite challenges such as higher cost and pill burden, long-term safety and efficacy have been consistently demonstrated, particularly in high-risk CKD populations. Sevelamer represents a preferred therapeutic option in the management of CKD-MBD due to its efficacy and favorable safety profile. Insights from Southeast Asia highlight the need for improved accessibility, physician education, and supportive health policies to optimize its use in real-world practice.</p>","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147674590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Targeting intestinal zinc transporters: a novel therapeutic approach for zinc deficiency in chronic kidney disease.","authors":"Itsuro Kazama","doi":"10.23876/j.krcp.25.468","DOIUrl":"https://doi.org/10.23876/j.krcp.25.468","url":null,"abstract":"","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147639294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic significance of soluble urokinase-type plasminogen activator receptor in patients with glomerulonephritis: association with renal outcomes.","authors":"Ji-Young Choi, Se-Hyun Oh, Ju-Min Yook, Mingyu Kim, Jieun Yoo, You Hyun Jeon, Jeong-Hoon Lim, Hee-Yeon Jung, Jang-Hee Cho, Chan-Duck Kim, Yong-Lim Kim, Sun-Hee Park","doi":"10.23876/j.krcp.25.294","DOIUrl":"https://doi.org/10.23876/j.krcp.25.294","url":null,"abstract":"<p><strong>Background: </strong>We investigated the association of longitudinally assessed soluble urokinase-type plasminogen activator receptor (suPAR) levels and renal outcomes in patients with glomerulonephritis (GN).</p><p><strong>Methods: </strong>This study included 96 patients diagnosed with primary GN by renal biopsy during 2013-2020 at two tertiary hospitals. Serum suPAR levels were measured at biopsy and follow-up. The association between serum suPAR levels and renal outcomes was analyzed.</p><p><strong>Results: </strong>Ln(suPAR) levels at the time of biopsy were comparable among GN groups (p = 0.49). Significant reductions in Ln(suPAR) from baseline to follow-up were observed across all GN groups during a median of 2.3 years of follow-up (p < 0.05). The annual proportional change in Ln(suPAR) (%/year) differed significantly among the four GN groups (p < 0.001), with immunoglobulin A nephropathy showing the greatest reduction rate compared to focal segmental glomerulosclerosis (p < 0.001) and membranous nephropathy (p = 0.045). Kaplan-Meier analysis showed that patients in the highest tertile of Ln(suPAR) at biopsy had a significantly higher incidence of kidney function decline (p = 0.03), whereas the incidences of no reduction in proteinuria and achieving a ≥50% reduction in proteinuria did not differ significantly among tertiles (p = 0.72 and p = 0.07, respectively). Higher Ln(suPAR) levels at biopsy were significantly associated with an increased risk of declining estimated glomerular filtration rate (eGFR) in a Cox proportional hazards model (hazard ratio, 1.87; 95% confidence interval, 1.01-3.47; p = 0. 047).</p><p><strong>Conclusion: </strong>In patients with biopsy-proven primary GN, higher suPAR levels at biopsy independently predicted subsequent eGFR decline but not proteinuria change, supporting longitudinal suPAR assessment as a complementary tool for renal risk stratification.</p>","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A journey through veins: discovery to modern therapy.","authors":"Muhammad Nauman Hashmi, Fayez Hejaili, Tushar J Vachharajani, Arif Asif, Omer Siddiqui, Claudio Ronco","doi":"10.23876/j.krcp.25.366","DOIUrl":"https://doi.org/10.23876/j.krcp.25.366","url":null,"abstract":"<p><p>Vascular access is the cornerstone of successful hemodialysis, serving as the lifeline for millions of patients with end-stage kidney disease. Since the inception of maintenance dialysis in the 1960s, the development of reliable vascular access has undergone significant evolution, reflecting advancements in medical technology, surgical techniques, and an improved understanding of access-related complications. This review traces the historical progression of vascular access, beginning with the pioneering Scribner shunt, followed by the emergence of arteriovenous fistulas, arteriovenous grafts, and central venous catheters. Each era of innovation has aimed to improve access longevity, minimize complications such as infection and thrombosis, and enhance patient quality of life. Additionally, this article highlights the global disparities, clinical challenges, and future directions in vascular access management, including the role of endovascular procedures, wearable technologies, and access monitoring. Understanding this evolution not only provides context for current practices but also guides future improvements in hemodialysis care.</p>","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147592935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiological characteristics and treatment patterns of Alport syndrome in Korea.","authors":"Min Ji Park, Ji Hyun Kim, Keum Hwa Lee, Min Hyun Cho, Peong Gang Park","doi":"10.23876/j.krcp.25.348","DOIUrl":"https://doi.org/10.23876/j.krcp.25.348","url":null,"abstract":"<p><strong>Background: </strong>Alport syndrome is the second most common inherited kidney disease, yet many patients remain undiagnosed until advanced kidney failure or receive inappropriate immunosuppressive therapy. Genetic testing indicates it is more common than recognized, but most epidemiological studies have been regional, lacking nationwide assessments.</p><p><strong>Methods: </strong>We analyzed Korean National Health Insurance data, covering the entire population. Patients were identified using the rare disease registration code (V267), requiring laboratory and genetic or histopathological confirmation. We estimated prevalence and incidence, examined therapeutic history before diagnosis, and assessed treatment patterns, particularly renin-angiotensin system (RAS) inhibition.</p><p><strong>Results: </strong>In 2023, 788 prevalent cases (15.5 per million) were identified; fewer than 10% of the estimated 8,800 COL4A5 male carriers are registered. From 2014 to 2023, 529 incident cases were recorded with a steadily rising incidence. At diagnosis, 30% had been labeled with other glomerulonephritis, with 15% receiving immunosuppressants and 58% RAS inhibitors. After diagnosis, RAS inhibitor use increased by 25%, but immunosuppressive therapy persisted.</p><p><strong>Conclusion: </strong>This nationwide analysis of registered Alport syndrome cases suggests potential underdiagnosis in Korea, with delays in appropriate recognition and treatment. Many patients receive unnecessary immunosuppression due to misdiagnosis, underscoring the need for improved diagnostic awareness and broader genetic testing.</p>","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147592899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tegoprazan and the risk of end-stage kidney disease progression: a nationwide Korean study.","authors":"Yu Jeong Lee, Jinmi Kim, Dong Han Yu, Nam Kyung Je, Harin Rhee","doi":"10.23876/j.krcp.25.379","DOIUrl":"https://doi.org/10.23876/j.krcp.25.379","url":null,"abstract":"<p><strong>Background: </strong>Tegoprazan, a potassium-competitive acid blocker used in South Korea since 2018, was examined in this study for its potential association with death or progression to end-stage kidney disease (ESKD) among patients with stage 3 or 4 chronic kidney disease (CKD) prescribed tegoprazan for more than 90 days.</p><p><strong>Methods: </strong>This real-world, retrospective study used national claims data from South Korea recorded between 2013 and 2022. Three independent pairwise analyses were conducted after 1:1 propensity score matching (PSM), comparing the risks of death or ESKD progression between CKD-tegoprazan and CKD-histamine 2 receptor agonists (H2RAs), CKD-tegoprazan and CKD-proton pump inhibitors (PPIs), and CKD-PPIs and CKD-H2RAs. Each outcome was compared using a Cox proportional hazards model, and results were combined in a network meta-analysis.</p><p><strong>Results: </strong>After PSM, 674, 902, and 4,583 pairs of patients' data were available for each analysis, respectively. Nearly 50% of patients were aged 75 or older. More than 85%, 45%, and 28% of the patients had hypertension, diabetes, and ischemic heart disease, respectively, and approximately 70% were prescribed an antithrombotic agent. The risk of death or ESKD was not increased in the CKD-tegoprazan cohort compared to CKD-H2RA (hazard ratio, 0.91 [95% confidence interval, 0.66-1.26]; p = 0.57) or CKD-PPIs (hazard ratio, 0.87 [95% confidence interval, 0.66-1.15]; p = 0.32). Network meta-analysis yielded the same trends.</p><p><strong>Conclusion: </strong>In patients with stage 3 or 4 CKD and multiple risk factors for ESKD progression, using tegoprazan for a minimum of 90 days did not increase the risk of death or ESKD progression.</p>","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147592911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of early vs. late initiation of continuous renal replacement therapy on composite outcomes including acute kidney disease and mortality: a multicenter propensity-matched cohort study (LINKA cohort).","authors":"Sei-Hong Min, Sung Gyun Kim, Jung Nam An, Sejoong Kim","doi":"10.23876/j.krcp.25.421","DOIUrl":"https://doi.org/10.23876/j.krcp.25.421","url":null,"abstract":"<p><strong>Background: </strong>The optimal timing of continuous renal replacement therapy (CRRT) initiation in acute kidney injury (AKI) remains uncertain, particularly regarding long-term kidney outcomes. This study evaluated whether early CRRT initiation improves the risk of acute kidney disease (AKD) or death.</p><p><strong>Methods: </strong>In this multicenter retrospective cohort, 852 patients with baseline creatinine ≤4 mg/dL who received CRRT at eight tertiary hospitals were screened. Early initiation was defined as starting CRRT before KDIGO stage 3 or before severe oliguria (<0.3 mL/ kg/hr for 24 hours). Propensity score matching (1:1) based on demographic, clinical, and laboratory variables yielded 746 matched patients. The primary outcome was a composite of AKD (≥50% increase in serum creatinine from baseline at 3 months) or death before 3-month follow-up. Multivariable logistic regression and stratified analyses by median baseline creatinine were performed.</p><p><strong>Results: </strong>Early CRRT was associated with a significantly lower incidence of the composite outcome (odds ratio [OR], 0.40; 95% confidence interval [CI], 0.28-0.57; p < 0.001). The protective effect persisted in both the low-creatinine (OR, 0.46; 95% CI, 0.29-0.72) and high-creatinine subgroups (OR, 0.38; 95% CI, 0.21-0.68). A significant interaction between early CRRT and baseline creatinine (p = 0.04) suggested that the magnitude of benefit associated with early CRRT varied according to baseline renal function. Early CRRT was not significantly associated with 90-day mortality alone (adjusted OR, 0.69; p = 0.27).</p><p><strong>Conclusion: </strong>Early CRRT initiation was associated with improved kidney-related outcomes, particularly in patients with lower baseline renal function. These findings support a more individualized approach to CRRT timing based on baseline kidney function.</p>","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147513186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"p-Cresyl sulfate promotes smooth muscle cell proliferation and endothelial dysfunction, leading to development of neointimal hyperplasia.","authors":"Shina Lee, EunYoung Jeon, Seung-Jung Kim","doi":"10.23876/j.krcp.25.194","DOIUrl":"https://doi.org/10.23876/j.krcp.25.194","url":null,"abstract":"<p><strong>Background: </strong>Vascular access failure is a major cause of morbidity in hemodialysis patients, primarily driven by smooth muscle cell (SMC) proliferation-related neointimal hyperplasia. The uremic toxin p-cresyl sulfate (p-CS) has been linked to poor vascular access outcomes, but its pathogenic mechanisms remain unclear. This study investigated whether p-CS promotes SMC proliferation and induces endothelial dysfunction, and contributes to neointimal hyperplasia.</p><p><strong>Methods: </strong>Human aortic SMCs were treated with p-CS to assess proliferation and activation of ERK1/2 and p38 MAPK signaling. In human umbilical vein endothelial cells (HUVECs), oxidative stress and expression of inflammatory mediators (NF-κB, ICAM-1, MCP-1) were measured at mRNA and protein levels, along with eNOS and iNOS expression. A Transwell co-culture system was used to evaluate whether p-CS-induced endothelial alterations affect SMC proliferation. Neointimal formation after p-CS exposure was confirmed using an ex vivo mouse aorta model.</p><p><strong>Results: </strong>p-CS promoted SMC proliferation in a dose-dependent manner and activated ERK1/2 and p38 MAPK. In HUVECs, p-CS induced ROS generation and increased NF-κB, ICAM-1, and MCP-1 expression, while upregulating iNOS and suppressing eNOS. In co-culture, p-CS-stimulated HUVECs enhanced SMC proliferation; this effect was attenuated by NAC, probenecid, or neutralizing antibodies against MCP-1 and ICAM-1. In the ex vivo aorta model, p-CS induced neointimal hyperplasia accompanied by elevated α-SMA, ICAM-1, and MCP-1 expression.</p><p><strong>Conclusion: </strong>These findings suggest that p-CS may promote SMC proliferation both directly and indirectly through endothelial dysfunction, ultimately contributing to neointimal hyperplasia. Further studies are needed to clarify the clinical implications of p-CS in vascular access dysfunction.</p>","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147513208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}