Kidney Research and Clinical Practice最新文献

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Clinical outcomes of bortezomib-based desensitization in highly sensitized living and deceased donor kidney transplantation. 硼替佐米脱敏在高度致敏的活体和已故供体肾移植中的临床效果。
IF 2.9 3区 医学
Kidney Research and Clinical Practice Pub Date : 2025-02-19 DOI: 10.23876/j.krcp.24.077
Hyeran Park, Hanbi Lee, Sang Hun Eum, Ji-Won Min, Hye Eun Yoon, Eun-Jee Oh, Chul Woo Yang, Byung Ha Chung
{"title":"Clinical outcomes of bortezomib-based desensitization in highly sensitized living and deceased donor kidney transplantation.","authors":"Hyeran Park, Hanbi Lee, Sang Hun Eum, Ji-Won Min, Hye Eun Yoon, Eun-Jee Oh, Chul Woo Yang, Byung Ha Chung","doi":"10.23876/j.krcp.24.077","DOIUrl":"https://doi.org/10.23876/j.krcp.24.077","url":null,"abstract":"<p><strong>Background: </strong>Sensitization acts as an immunological barrier to successful kidney transplantation (KT). We aim to investigate the efficacy and safety of bortezomib-based desensitization (BOZ-DSZ) in both highly sensitized living donor KT (LDKT) and deceased donor KT (DDKT).</p><p><strong>Methods: </strong>We applied BOZ-DSZ to 20 highly sensitized patients-14 LDKT and six DDKT candidates-and analyzed the change in anti-human leukocyte antigen (HLA) antibody, the success rate of transplantation, and posttransplant outcomes including biopsy-proven allograft rejection (BPAR) rate, infectious complication, and allograft survival.</p><p><strong>Results: </strong>Among 14 LDKT candidates, the peak mean fluorescence intensity (MFI) level of donor-specific anti-HLA antibody (HLA-DSA) decreased in 10 patients (p < 0.05), and the success rate of KT was 92.9% (13 of 14). Incidence of BPAR within the first posttransplant year was 53.8% (7 of 13), and all such cases were rescued by antirejection treatment. One case resulted in mortality due to pneumonia, and there was one allograft failure during the follow-up of 34 months (range, 6-129 months). Among the six DDKT candidates, the peak MFI level of HLA-DSA showed a significant decrease after DSZ in five patients (p = 0.098), and the success rate of KT was 50.0% (3 of 6). One BPAR case (33.3%) occurred within the first posttransplant year and was successfully treated. There was one case of Cytomegalovirus viremia, and there was no allograft failure during the 36-month follow-up (range, 17-42 months). Conclusion BOZ-DSZ is effective and safe in terms of successful DSZ, infectious complications, and allograft outcomes for both highly sensitized LDKT and DDKT candidates.</p>","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458521","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}
引用次数: 0
Novel insights and practical strategies for health professionals to improve the uptake of plant-based diets in people with chronic kidney disease. 为卫生专业人员提供新的见解和实用策略,以改善慢性肾脏疾病患者对植物性饮食的吸收。
IF 2.9 3区 医学
Kidney Research and Clinical Practice Pub Date : 2025-02-18 DOI: 10.23876/j.krcp.24.272
Kelly Lambert, Vanessa Cullen, Brian Jones, Amy McAlpine, Brad Rossiter
{"title":"Novel insights and practical strategies for health professionals to improve the uptake of plant-based diets in people with chronic kidney disease.","authors":"Kelly Lambert, Vanessa Cullen, Brian Jones, Amy McAlpine, Brad Rossiter","doi":"10.23876/j.krcp.24.272","DOIUrl":"https://doi.org/10.23876/j.krcp.24.272","url":null,"abstract":"<p><p>There has been a significant shift in dietary guidance in the past 5 years for people with chronic kidney disease. Multiple best practice guidelines in nephrology now include nutritional guidance that recommends the adoption of healthy dietary patterns with an emphasis on whole foods and diets with adequate fruit, vegetables, legumes, nuts, wholegrain bread and cereals, with minimal amounts of processed foods high in salt, sugar, and fat. While there is shortage of enthusiasm, from health professionals to adopt this new approach, there is a clear knowledge gap on how to get people to adopt plant-based diets. This is particularly apparent in settings where renal dietetic services are lacking. This manuscript, cowritten with consumers with lived experience of chronic kidney disease, outlines seven strategies to facilitate the adoption of plant-based diets and draws on evidence from the fields of marketing, implementation science, and behavior change. These strategies include paying attention to language, starting gradually and increasing variety, then transitioning to increasing vegetable portion size, focusing on adequacy, giving explicit guidance on how to reduce meat, remembering neophobia, and emphasizing the importance of individualized advice. Additional strategies from consumers include the need to address consumer fears about the adequacy of nutrient intake, focus on foods to enjoy not nutrients to restrict; provide advice on how to sensibly include favorite foods and make meals flavorsome and finally consider the adoption of plant-based diets as a spectrum to strive towards-with animal foods included at varying levels depending on food preferences, budget, cultural preferences.</p>","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458524","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}
引用次数: 0
Disaster emergency meal plans for Korean patients who require hemodialysis. 需要血液透析的韩国患者的灾难紧急膳食计划。
IF 2.9 3区 医学
Kidney Research and Clinical Practice Pub Date : 2025-01-24 DOI: 10.23876/j.krcp.24.242
Yumi Jang, Seong Geun Kim, Sua Lee, Hyun Ho Oh, Nara Shin, Young-Ki Lee, Kyung Don Yoo
{"title":"Disaster emergency meal plans for Korean patients who require hemodialysis.","authors":"Yumi Jang, Seong Geun Kim, Sua Lee, Hyun Ho Oh, Nara Shin, Young-Ki Lee, Kyung Don Yoo","doi":"10.23876/j.krcp.24.242","DOIUrl":"https://doi.org/10.23876/j.krcp.24.242","url":null,"abstract":"<p><p>Proactive planning and preparation are critical to the safety of patients on dialysis during emergencies, such as natural disasters, and pandemics, such as coronavirus disease 2019. Patients with end-stage kidney disease are particularly vulnerable to disruptions such as power outages, water shortages, transportation issues, and dialysis center closures because they can result in missed dialysis sessions and severe health deterioration. This study aimed to develop tailored dietary guidelines for Korean patients on hemodialysis by applying the U.S. Centers for Disease Control and Prevention guidelines and considering the dietary limitations of these patients. The proposed guidelines impose strict potassium, phosphorus, sodium, and fluid restrictions and include two 3-day emergency meal plans: one for scenarios involving disruptions of electricity and water supply and another for situations in which these utilities are available. The use of a food exchange list enhances the dietary flexibility of these patients. Although these guidelines cannot replace dialysis, they could mitigate the impact of emergencies on patient health by providing essential support during critical periods.</p>","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029038","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}
引用次数: 0
Sarcopenia, sarcopenic obesity, and frailty in individuals with chronic kidney disease: a comprehensive review. 慢性肾脏疾病患者的肌肉减少症、肌肉减少性肥胖和虚弱:一项全面的综述
IF 2.9 3区 医学
Kidney Research and Clinical Practice Pub Date : 2025-01-21 DOI: 10.23876/j.krcp.24.207
Chia-Ter Chao, Csaba P Kovesdy, Reshma Aziz Merchant
{"title":"Sarcopenia, sarcopenic obesity, and frailty in individuals with chronic kidney disease: a comprehensive review.","authors":"Chia-Ter Chao, Csaba P Kovesdy, Reshma Aziz Merchant","doi":"10.23876/j.krcp.24.207","DOIUrl":"https://doi.org/10.23876/j.krcp.24.207","url":null,"abstract":"<p><p>Population aging is a global challenge that increases the burden of chronic kidney disease (CKD) and geriatric syndromes such as sarcopenia, sarcopenic obesity, and frailty. These conditions affect almost half of older CKD individuals and are associated with poor outcomes, including CKD progression, cardiometabolic complications, increased health and social care costs, and mortality. They can be both the cause and consequent of CKD and lead to a vicious downward spiral if not addressed early. Frailty is a multidimensional syndrome characterized by reduced physiological reserve and increased vulnerability to stressors. Sarcopenia refers to the progressive and generalized loss of skeletal muscle mass, strength, and/or physical performance with aging. Sarcopenic obesity denotes the combination of sarcopenia and obesity that synergistically leads to poor outcomes. They share common pathogenic mechanisms, such as multimorbidity, inflammation, oxidative stress, uremic milieu, insulin resistance, endocrine disturbances, CKD complications, and psychosocial factors that may limit access to proper nutrition and resources. Management requires a multidisciplinary and patient-centered approach, taking into consideration their baseline physical function and endurance, CKD stage, nutrition status, comorbidities, symptoms, treatment goals, cost, and accessibility. Interventions include exercise, nutrition, comorbidity optimization, geriatric assessment, sensory training, and kidney-oriented care. This review summarizes the current knowledge on the diagnosis and treatment of sarcopenia, sarcopenic obesity, and frailty in individuals with CKD, followed by up-to-date summaries of how best to manage affected individuals.</p>","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458565","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}
引用次数: 0
Microstructural and functional connectivity changes of decision-related brain networks in end-stage kidney disease patients undergoing peritoneal dialysis. 腹膜透析终末期肾病患者决策相关脑网络的微观结构和功能连通性变化
IF 2.9 3区 医学
Kidney Research and Clinical Practice Pub Date : 2025-01-17 DOI: 10.23876/j.krcp.24.146
Jingjing Yin, Dongxue Luo, Shuhua Ma, Chudan Cai, Xiaoyan Shi, Yanqiang Peng, Jianwei Peng, Lingyu Chen, Yanmin Zheng, Ruiwei Guo, Zelin Zhuang, Zhirong Lin, Lei Xie
{"title":"Microstructural and functional connectivity changes of decision-related brain networks in end-stage kidney disease patients undergoing peritoneal dialysis.","authors":"Jingjing Yin, Dongxue Luo, Shuhua Ma, Chudan Cai, Xiaoyan Shi, Yanqiang Peng, Jianwei Peng, Lingyu Chen, Yanmin Zheng, Ruiwei Guo, Zelin Zhuang, Zhirong Lin, Lei Xie","doi":"10.23876/j.krcp.24.146","DOIUrl":"https://doi.org/10.23876/j.krcp.24.146","url":null,"abstract":"<p><strong>Background: </strong>We aimed to explore changes in decision-related brain microstructure, brain functional activities, and functional connectivity, and their correlations with cognitive function in end-stage kidney disease (ESKD) patients undergoing peritoneal dialysis (PD). Furthermore, the impact of dialysis on these changes was examined.</p><p><strong>Methods: </strong>Thirty ESKD patients undergoing PD, 20 chronic kidney disease (CKD) stage 5 patients without dialysis (predialysis CKD stage 5), and 30 healthy controls (HC) were recruited for the study. Various assessments have been conducted, including neuropsychological scale testing, decision-related behavioral tests, voxel-based morphometry, and functional magnetic resonance imaging.</p><p><strong>Results: </strong>Compared to the HC group, PD patients showed decreased functional activation and gray matter volume in multiple decision-related brain areas, including the ventromedial prefrontal cortex (vmPFC), orbitofrontal cortex (OFC), and anterior cingulate cortex (ACC) (p < 0.05, false discovery rate-corrected). The default mode network (DMN) and salience network (SAN) were the primary brain regions that showed decreased functional connectivity to the vmPFC and ACC. Additionally, compared to the predialysis group, the PD group showed enhanced brain activation in decision-related brain regions such as the ACC, vmPFC, and insula. Though PD and predialysis CKD stage 5 patients performed poorly in the neuropsychological and Iowa Gambling Task (IGT), there was no significant difference between the two groups. The structure and function variabilities of the vmPFC were correlated with IGT and Montreal Cognitive Assessment score, and the activation of OFC was negatively associated with blood creatinine, cystatin, and parathyroid hormone levels.</p><p><strong>Conclusion: </strong>In summary, PD can change the structure and function of decision-related brain circuits (vmPFC-OFC-ACC) and reduce integration within DMN and SAN, which is correlated with cognitive function and clinical features. Moreover, our findings may suggest the comparable capability of PD in preserving one's cognitive function and disease progression. Multimodal neuroimaging based on structure and function can provide more objective information for the early diagnosis and intervention of cognitive impairment in ESKD patients.</p>","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029061","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}
引用次数: 0
Diffuse subcutaneous oxalosis masquerading as lower limb cellulitis. 弥漫性皮下草化病伪装成下肢蜂窝织炎。
IF 2.9 3区 医学
Kidney Research and Clinical Practice Pub Date : 2025-01-17 DOI: 10.23876/j.krcp.24.282
Gerry George Mathew, Anand Alwan
{"title":"Diffuse subcutaneous oxalosis masquerading as lower limb cellulitis.","authors":"Gerry George Mathew, Anand Alwan","doi":"10.23876/j.krcp.24.282","DOIUrl":"https://doi.org/10.23876/j.krcp.24.282","url":null,"abstract":"","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029037","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}
引用次数: 0
Emergency department visits for patients with end-stage kidney disease in Korea: registry data from the National Emergency Department Information System 2019-2021. 韩国终末期肾病患者急诊科就诊:2019-2021年国家急诊科信息系统的登记数据
IF 2.9 3区 医学
Kidney Research and Clinical Practice Pub Date : 2025-01-17 DOI: 10.23876/j.krcp.24.170
AJin Cho, Seon A Jeong, Hayne Cho Park, Hye Eun Yoon, Jungeon Kim, Young-Ki Lee, Kyung Don Yoo
{"title":"Emergency department visits for patients with end-stage kidney disease in Korea: registry data from the National Emergency Department Information System 2019-2021.","authors":"AJin Cho, Seon A Jeong, Hayne Cho Park, Hye Eun Yoon, Jungeon Kim, Young-Ki Lee, Kyung Don Yoo","doi":"10.23876/j.krcp.24.170","DOIUrl":"https://doi.org/10.23876/j.krcp.24.170","url":null,"abstract":"<p><strong>Background: </strong>Patients with end-stage kidney disease (ESKD) frequently visit the emergency department (ED) due to complications from comorbidities and dialysis. This study aimed to investigate the clinical outcomes and patterns of ED visits, hospitalizations, and in-hospital mortality among ED visits by ESKD patients in South Korea.</p><p><strong>Methods: </strong>This study utilized data from the National Emergency Department Information System from 2019 to 2021. ED visits were analyzed for ESKD patients and compared with non-chronic kidney disease (non-CKD) patients. Logistic regression analyses were conducted to assess factors associated with hospitalization and mortality, adjusting for demographics, insurance, and clinical characteristics, including the Korean Triage and Acuity Scale (KTAS).</p><p><strong>Results: </strong>The study included 125,392 ED visits from ESKD patients and 19,287,972 from non-CKD patients. ED visits by ESKD patients had significantly higher hospitalization (66.7%) and in-hospital mortality (9.4%) rates compared to those by non-CKD patients (21.0% and 5.1%, respectively). ESKD patients were older, more frequently female, and more likely to receive medical aid. Factors strongly associated with higher hospitalization and mortality rates included advanced age, male sex, transfer from another facility, higher KTAS scores, and prolonged ED stays. Common causes of ED visits in ESKD patients included vascular device complications, digestive system disorders, pneumonia, pulmonary edema, and fluid or electrolyte imbalances.</p><p><strong>Conclusion: </strong>ED visits by patients with ESKD were characterized by high severity, hospitalization rates, and in-hospital mortality. Further research on factors affecting clinical outcomes may improve mortality and morbidity in this population.</p>","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029060","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}
引用次数: 0
The impact of body mass index on mortality according to age in hemodialysis patients: an analysis of the Korean Renal Data System. 血液透析患者体重指数对年龄死亡率的影响:韩国肾脏数据系统的分析。
IF 2.9 3区 医学
Kidney Research and Clinical Practice Pub Date : 2025-01-16 DOI: 10.23876/j.krcp.24.160
Hyunglae Kim, Seon A Jeong, Yoonjung Cho, Kyeong Min Kim, Sun Deuk Hwang, Sun Ryoung Choi, Hajeong Lee, Ji Hyun Kim, Su Hyun Kim, Tae Hee Kim, Ho-Seok Koo, Chang-Yun Yoon, Kiwon Kim, Seon Ho Ahn, Hye Eun Yoon, Tae Hyun Ban, Yu Ah Hong, Yong Kyun Kim
{"title":"The impact of body mass index on mortality according to age in hemodialysis patients: an analysis of the Korean Renal Data System.","authors":"Hyunglae Kim, Seon A Jeong, Yoonjung Cho, Kyeong Min Kim, Sun Deuk Hwang, Sun Ryoung Choi, Hajeong Lee, Ji Hyun Kim, Su Hyun Kim, Tae Hee Kim, Ho-Seok Koo, Chang-Yun Yoon, Kiwon Kim, Seon Ho Ahn, Hye Eun Yoon, Tae Hyun Ban, Yu Ah Hong, Yong Kyun Kim","doi":"10.23876/j.krcp.24.160","DOIUrl":"https://doi.org/10.23876/j.krcp.24.160","url":null,"abstract":"<p><p>The impact of age on the relationship between body mass index (BMI) and all-cause mortality in hemodialysis (HD) patients is not clearly understood. We analyzed the association between BMI and all-cause mortality, stratified by age, in patients undergoing HD using data from the Korean Renal Data System (KORDS). We analyzed 66,129 HD patients from the 2023 KORDS database, with data collected between 2001 and 2022. Patients were grouped by age: <65 years (\"young\" group, n = 24,589), 65-74 years (\"younger-old\" group, n = 17,732), and ≥75 years (\"older-old\" group, n = 23,808). Patients were further stratified into BMI quartiles. Kaplan-Meier curves and event time ratio for the relative change in the survival time were calculated. During the follow-up period, 14,360 (21.7%) of the patients died, with a median follow-up of 3.4 years. Kaplan-Meier curves revealed poorer outcomes in lower BMI quartiles across all age groups. The lowest BMI quartile was significantly associated with a shorter survival time compared to the highest BMI quartile, with a 15% reduction in the young group (p = 0.001) and a 12% reduction in the older-old group (p = 0.002). Predicted survival time increases with rising BMI in the young group, but the rate of increase slows in the younger-old group and plateaus in the older-old group after around a BMI of 25 kg/m2. The decline in survival time with age was more pronounced in the 7-year survival than the 2-year survival. Lower BMI is associated with higher all-cause mortality in HD patients, with a more pronounced impact in younger patients.</p>","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007339","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}
引用次数: 0
Validation of an acute kidney injury prediction model as a clinical decision support system. 急性肾损伤预测模型作为临床决策支持系统的验证。
IF 2.9 3区 医学
Kidney Research and Clinical Practice Pub Date : 2025-01-09 DOI: 10.23876/j.krcp.24.163
Giae Yun, Jinyeong Yi, Sangyub Han, Jihyeon Seong, Enver Menadjiev, Hyunkyung Han, Jaesik Choi, Ji Hyun Kim, Sejoong Kim
{"title":"Validation of an acute kidney injury prediction model as a clinical decision support system.","authors":"Giae Yun, Jinyeong Yi, Sangyub Han, Jihyeon Seong, Enver Menadjiev, Hyunkyung Han, Jaesik Choi, Ji Hyun Kim, Sejoong Kim","doi":"10.23876/j.krcp.24.163","DOIUrl":"https://doi.org/10.23876/j.krcp.24.163","url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury (AKI) is a critical clinical condition that requires immediate intervention. We developed an artificial intelligence (AI) model called PRIME Solution to predict AKI and evaluated its ability to enhance clinicians' predictions.</p><p><strong>Methods: </strong>The PRIME Solution was developed using convolutional neural networks with residual blocks on 183,221 inpatient admissions from a tertiary hospital (2013-2017) and externally validated with 4,501 admissions at another tertiary hospital (2020-2021). To assess its application, we conducted a prospective evaluation using retrospectively collected data from 100 patients at the latter hospital, including 15 AKI cases. AKI prediction performance was compared among specialists, physicians, and medical students, both with and without AI assistance.</p><p><strong>Results: </strong>Without assistance, specialists demonstrated the highest accuracy (0.797), followed by medical students (0.619) and the PRIME Solution (0.568). AI assistance improved overall recall (61.0% to 74.0%) and F1 scores (38.7% to 42.0%), while reducing average review time (73.8 to 65.4 seconds, p < 0.001). However, the impact varied across expertise levels. Specialists showed the greatest improvement (recall, 32.1% to 64.3%; F1, 36.4% to 48.6%), whereas medical students' performance improved but aligned more closely with the AI model. Additionally, the effect of AI assistance varied by prediction outcome, showing greater improvement in recall for cases predicted as AKI, and better precision, F1 score, and review time reduction (73.4 to 62.1 seconds, p < 0.001) for cases predicted as non-AKI.</p><p><strong>Conclusion: </strong>AKI predictions were enhanced by AI assistance, but the improvements varied according to the expertise of the user.</p>","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007489","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}
引用次数: 0
Methylcrotonyl-CoA carboxylase 2 supports leucine catabolism to promote mitochondrial biogenesis and alleviate cisplatin-induced acute kidney injury. 甲基巴豆酰辅酶a羧化酶2支持亮氨酸分解代谢,促进线粒体生物发生,减轻顺铂诱导的急性肾损伤。
IF 2.9 3区 医学
Kidney Research and Clinical Practice Pub Date : 2025-01-09 DOI: 10.23876/j.krcp.24.169
Hu Li, Kangqiang Weng, Hao Qi, Huiyue Qi, Linlu She, Junliang Qiu, Yingbo Dai
{"title":"Methylcrotonyl-CoA carboxylase 2 supports leucine catabolism to promote mitochondrial biogenesis and alleviate cisplatin-induced acute kidney injury.","authors":"Hu Li, Kangqiang Weng, Hao Qi, Huiyue Qi, Linlu She, Junliang Qiu, Yingbo Dai","doi":"10.23876/j.krcp.24.169","DOIUrl":"https://doi.org/10.23876/j.krcp.24.169","url":null,"abstract":"<p><strong>Background: </strong>Cisplatin is widely used in clinical practice, but its nephrotoxicity severely limits its use. Previous studies have shown that cisplatin-induced acute kidney injury (AKI) is closely related to mitochondrial damage and that alleviating mitochondrial dysfunction can alleviate cisplatin-induced AKI. Methylcrotonyl‑CoA carboxylase 2 (MCCC2) is mainly located in mitochondria, where it catalyzes the catabolism of leucine and maintains mitochondrial function; however, the role of MCCC2 in cisplatin-induced renal injury has not yet been studied.</p><p><strong>Methods: </strong>In vitro, the expression of MCCC2 was manipulated by transfecting HK-2 cells with lentiviruses, and changes in the acetoacetate content, cell viability, apoptosis, oxidative stress, mitochondrial function, and mitochondrial biogenesis were evaluated. In vivo, MCCC2 overexpression was manipulated by adeno-associated viruses, and serum and kidneys were collected for subsequent experiments to detect changes in renal function, tissue damage, apoptosis, oxidative stress, mitochondrial damage, and mitochondrial biogenesis.</p><p><strong>Results: </strong>We found that MCCC2 was downregulated in cisplatin-induced AKI models. In vitro, leucine catabolism was inhibited by cisplatin, while overexpression of MCCC2 supported leucine catabolism, upregulated peroxisome proliferator-activated receptor gamma coactivator 1-alpha expression, promoted mitochondrial biogenesis, improved mitochondrial function, and alleviated cisplatin-induced apoptosis and oxidative stress in HK-2 cells. In contrast, the knockdown of MCCC2 exacerbated these effects, while leucine deprivation reversed the effects of MCCC2 overexpression on mitochondrial function and biogenesis. In vivo, the overexpression of MCCC2 promoted mitochondrial biogenesis, maintained the integrity of the mitochondrial structure and function, and alleviated cisplatin-induced AKI.</p><p><strong>Conclusion: </strong>MCCC2 supported leucine catabolism and promoted mitochondrial biogenesis, providing a new therapeutic strategy for cisplatin-induced AKI.</p>","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007237","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}
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