Kidney Research and Clinical Practice最新文献

{"title":"Role of tocilizumab in the treatment of chronic active antibody-mediated rejection: an unmet medical need in kidney transplantation.","authors":"Jin Hyeog Lee, Jaeseok Yang","doi":"10.23876/j.krcp.26.382","DOIUrl":"https://doi.org/10.23876/j.krcp.26.382","url":null,"abstract":"","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169767","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":"Kidney function-dependent plasma proteomic architecture of incident myocardial infarction: a proteome-wide association study of UK Biobank participants.","authors":"Yongwoo Lee, Young Rok Ham, Ki Ryang Na, Dae Eun Choi","doi":"10.23876/j.krcp.26.191","DOIUrl":"https://doi.org/10.23876/j.krcp.26.191","url":null,"abstract":"<p><strong>Background: </strong>Individuals across the spectrum of kidney function experience excess risk of acute myocardial infarction (AMI), but whether the plasma proteome's association with this risk is itself modified by the estimated glomerular filtration rate (eGFR) remains uncharacterized.</p><p><strong>Methods: </strong>Cox proteome-wide association studies of 2,923 Olink proteins in 33,446 UK Biobank participants (fully adjusted model 2: 29,417 complete cases, 1,584 incident AMI events; the full eligible cohort comprised 1,848 events, the complete-case reduction reflecting full covariate adjustment). After fully adjusted screening, protein × eGFR interaction models tested whether each protein association was modified by eGFR (continuous). Incremental prediction was evaluated with a leakage-free elastic-net Cox model.</p><p><strong>Results: </strong>Over a median 13.9-year follow-up, 1,848 AMI events occurred. After multivariable adjustment, 975 proteins were linked to AMI (false discovery rate [FDR]-adjusted p < 0.05). For 176 of these, the AMI association was modified by kidney function (interaction FDR < 0.05)-strengthening as eGFR declined for 154 proteins and at higher eGFR for a smaller set of 22. Exploratory GSEA identified FDR-significant innate immune enrichment in the higher-eGFR direction, whereas lower-eGFR cardiac and matrix signals were nominal. Adding plasma proteins to clinical predictors modestly improved 10-year AMI prediction (Harrell C, 0.748 → 0.780; ΔC = 0.032, 95% confidence interval = 0.021-0.043).</p><p><strong>Conclusion: </strong>Kidney function modifies the plasma proteomic signature of incident AMI: most protein-AMI associations intensify as eGFR declines, while a smaller subset strengthens at preserved filtration. This supports kidney function-aware proteomic cardiovascular risk interpretation.</p>","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149111607","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":"Machine learning predicts major adverse kidney and cardiovascular events in heart failure with reduced ejection fraction.","authors":"Cheng-Chien Lai, Shao-Sung Huang, Ya-Wen Lu, Chung-Kuan Wu, Yi-Hong Wu, Shang-Ju Wu, Jin-Long Huang, Yao-Ping Lin, Wei-Cheng Tseng","doi":"10.23876/j.krcp.26.020","DOIUrl":"https://doi.org/10.23876/j.krcp.26.020","url":null,"abstract":"<p><strong>Background: </strong>Heart failure with reduced ejection fraction (HFrEF) links to adverse kidney and cardiovascular events. However, current machine learning (ML)-based algorithms do not include comprehensive echocardiographic features or predict adverse kidney outcomes.</p><p><strong>Methods: </strong>We built ML models to predict 3-year all-cause mortality, major adverse cardiovascular events (MACE), and major adverse kidney events (MAKE) in retrospective HFrEF cohorts. Models were developed from 1,486 patients at Taipei Veterans General Hospital during 2011-2018 and externally validated in 246 patients from the heart-failure-post-acute-care program at Taichung Veterans General Hospital during 2020-2023. Model performance was compared to the traditional Meta-Analysis Global Group in Chronic Heart Failure score (MAGGIC), Logistic Regression (LR), and Kidney-Failure-Risk-Equation (KFRE).</p><p><strong>Results: </strong>For mortality, Ensemble had the highest area under receiver-operating-characteristic curve (AUROC, 0.863; 95% confidence interval [CI], 0.814-0.913; p < 0.001), outperforming MAGGIC (AUROC, 0.741; 95% CI, 0.673-0.810) with net reclassification index (NRI) of 0.294 (95% CI, 0.147-0.440; p = 0.001). For MACE, Ensemble (AUROC, 0.816; 95% CI, 0.769-0.864; p < 0.001) surpassed LR (AUROC, 0.734; 95% CI, 0.677-0.791). For MAKE, Ensemble (AUROC, 0.858; 95% CI, 0.806-0.910; p < 0.001) exceeded KFRE (AUROC, 0.647; 95% CI, 0.560-0.735) with NRI of 0.267 (95% CI, 0.133-0.396; p < 0.001). External validation confirmed good Ensemble discrimination (AUROCs of 0.803, 0.808, and 0.859 for mortality, MACE, and MAKE, respectively). An online tool (https://vghhfrefai.com/) was created for application.</p><p><strong>Conclusion: </strong>Ensemble ML models with detailed clinical and echocardiographic features surpassed conventional risk scores, enabling early detection of major adverse cardiorenal events among HFrEF.</p>","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149111653","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":"Developmental PM2.5 exposure and stage-dependent kidney senescence.","authors":"Hyojin Ha, Seoyeong Ahn, Whanhee Lee","doi":"10.23876/j.krcp.26.414","DOIUrl":"https://doi.org/10.23876/j.krcp.26.414","url":null,"abstract":"","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149111516","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":"The effect of the interplay between PGC-1α and HIF-1α on preserving mitochondrial metabolism in diabetic kidney disease.","authors":"Jee Young Lee, Bo Young Nam, Jaejin Ryu, Gyuri Kim, Ye Eun Ko, Hyung Woo Kim, Jung Tak Park, Tae-Hyun Yoo, Shin-Wook Kang, Seung Hyeok Han","doi":"10.23876/j.krcp.25.412","DOIUrl":"https://doi.org/10.23876/j.krcp.25.412","url":null,"abstract":"<p><strong>Background: </strong>Hypoxia-inducible factor-1 alpha (HIF-1α) plays a multifaceted role in energy metabolism by promoting glycolysis and inhibiting pyruvate kinase M2 (PKM2) activity. This study aimed to investigate the role of peroxisome proliferator-activated receptor- gamma coactivator-1 alpha (PGC-1α) in modulating HIF-1α-mediated regulation of mitochondrial metabolism in renal tubular epithelial cells (RTECs) under diabetic conditions.</p><p><strong>Methods: </strong>Primary RTECs from the C57BL/6 mice were high glucose (HG)-stimulated, with or without transfection using the Ppargc1a plasmid (pPGC1α) or Ppargc1a small interfering RNA (siPGC1α). To evaluate whether PGC-1α regulates HIF-1α, chromatin immunoprecipitation (ChIP) and luciferase reporter assays were performed. In vivo, db/db mice received daily oral gavage of metformin or resveratrol for 12 weeks. This study examined tricarboxylic acid (TCA) cycle intermediates, PGC-1α, HIF-1α, PKM2, glycolysis, fatty acid oxidation (FAO), mitochondrial function, and morphology.</p><p><strong>Results: </strong>HG-treated RTECs exhibited decreased Ppargc1a and Pkm2, increased Hif1a expression, a shift toward aberrant glycolysis, and impaired FAO. Ppargc1a overexpression reversed these changes, while silencing Ppargc1a exacerbated them. These changes were mitigated by silencing Hif1a. ChIP assay results indicated the binding of PGC-1α at the Hif1a promoter regulatory region. In an animal model of diabetic kidney disease, Ppargc1a activation with metformin and resveratrol partially recapitulated the in vitro findings, showing favorable metabolic effects.</p><p><strong>Conclusion: </strong>PGC-1α deficiency under diabetic conditions led to TCA cycle intermediate accumulation, which enhanced HIF-1α activity and disrupted mitochondrial metabolism. PGC-1α negatively regulated HIF-1α expression, in part via promoter association, elucidating its regulatory role in mitochondrial metabolism.</p>","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149111634","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":"Soluble urokinase-type plasminogen activator receptor in glomerular disease: a marker of activity or renal vulnerability?","authors":"Jong Hyun Jhee","doi":"10.23876/j.krcp.26.350","DOIUrl":"https://doi.org/10.23876/j.krcp.26.350","url":null,"abstract":"","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149012748","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":"Recurrent 2,8-dihydroxyadenine crystalline nephropathy after kidney transplantation due to adenine phosphoribosyltransferase deficiency.","authors":"Bioh Kim, Hanbi Lee, Hye Eun Yoon, Seok Joon Shin, Hoon Seok Kim, Yeong Jin Choi, Byung Ha Chung, Sang Hun Eum","doi":"10.23876/j.krcp.26.166","DOIUrl":"https://doi.org/10.23876/j.krcp.26.166","url":null,"abstract":"","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149012711","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":"Association between the number of pregnancies and chronic kidney disease in Korean women: a population-based cross-sectional study from the Korean Genome and Epidemiology Study-Health Examinee (KoGES-HEXA) cohort.","authors":"Seung Hee Jeong, Ji Hyun Kim, Ju Hwan Oh, A Young Cho, In O Sun, Ha-Eun Lee","doi":"10.23876/j.krcp.25.411","DOIUrl":"https://doi.org/10.23876/j.krcp.25.411","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease (CKD) is a growing public health burden. Repeated pregnancies exert anatomical and physiological stress on the kidneys; however, the association between number of pregnancies and CKD is unclear.</p><p><strong>Methods: </strong>This cross-sectional study used data from the Korean Genome and Epidemiology Study-Health Examinee (KoGES-HEXA; 2004-2013). The number of pregnancies was categorized as 0, 1, 2, 3, 4, or ≥5. The primary outcome was CKD, defined as an estimated glomerular filtration rate <60 mL/min/1.73 m2, using the CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) formula, or dipstick proteinuria ≥1+. We evaluated the association between number of pregnancies and CKD and whether it varied by adverse pregnancy outcomes (APOs).</p><p><strong>Results: </strong>We included 100,433 women (age, 52.7 ± 8.0 years [mean ± standard deviation]). Of the parous women (n = 99,654), 3.8% (n = 3,795) had CKD. In the fully adjusted model, women with ≥5 pregnancies had modestly higher CKD odds than women with one pregnancy (odds ratio, 1.20; 95% confidence interval, 1.01-1.43). The association differed by age (p for interaction <0.001), with a significant trend among women aged ≥60 years (p for trend = 0.009). In subgroup analyses, ≥5 pregnancies remained associated with CKD among women without preeclampsia or gestational diabetes mellitus, with no clear evidence of interactions.</p><p><strong>Conclusion: </strong>A higher number of pregnancies was modestly associated with a higher prevalence of CKD in Korean women, including those without APO history. Although residual confounding by age and birth cohort cannot be excluded, the number of pregnancies may be relevant to women's long-term kidney health.</p>","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149012746","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":"Association of isolated systolic and diastolic hypertension with moderately increased albuminuria: the Korea National Health and Nutrition Examination Survey.","authors":"Hansol Choi, Jenny Moon, Minsung Cho, Jong Hyun Jhee, Chan Joo Lee, Hyeon Chang Kim, Hokyou Lee","doi":"10.23876/j.krcp.26.188","DOIUrl":"https://doi.org/10.23876/j.krcp.26.188","url":null,"abstract":"<p><strong>Background: </strong>Studies show variable results on health outcomes of isolated diastolic hypertension (IDH); however, data are scarce on its association with early kidney injury.</p><p><strong>Methods: </strong>We analyzed the Korea National Health and Nutrition Examination Survey data (2011-2014 and 2019-2024) in adults ≥19 years. After excluding those taking antihypertensive medication or with established kidney disease, participants were categorized into normal blood pressure (BP [mmHg]; systolic BP [SBP] <120 and diastolic BP [DBP] <80), elevated BP (SBP 120 to <130 and DBP <80), stage 1 hypertension (SBP 130 to <140 or DBP 80 to <90 but not stage 2 hypertension), and stage 2 hypertension (SBP ≥140 or DBP ≥90) according to the 2025 American Heart Association/American College of Cardiology guidelines. Stage 1 and 2 hypertension was further classified as IDH, isolated systolic hypertension (ISH), or systolic-diastolic hypertension (SDH). Moderately increased albuminuria was defined as urine albumin-to-creatinine ratio of 30-<300 mg/g.</p><p><strong>Results: </strong>Among 33,638 participants (mean age, 43.2 years; 47.9% female), multivariable-adjusted ORs (95% CIs) for moderately increased albuminuria were 1.45 (1.18-1.78) for stage 1 IDH, 1.66 (1.21-2.28) for stage 1 ISH, 2.09 (1.60-2.74) for stage 1 SDH, and 3.38 (2.85-4.01) for stage 2 hypertension. In age-stratified analysis, stage 1 IDH showed 1.37- and 1.58-fold higher odds of moderately increased albuminuria in participants aged <50 and ≥50 years, respectively.</p><p><strong>Conclusion: </strong>IDH, even at stage 1, was associated with moderately increased albuminuria, suggesting it may not be benign. Longitudinal studies are needed to determine whether IDH predicts subsequent kidney injury and whether early attention to elevated DBP modifies kidney and cardiovascular outcomes.</p>","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149012716","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":"Beyond procedure counts: reconsidering physician involvement in maintenance hemodialysis.","authors":"Sungjin Chung, Jeonghwan Lee, Yu Ah Hong, Gang-Jee Ko, Sehoon Park, Jungho Shin, Young-Ki Lee, Won Min Hwang, Donghyung Lee, Jae Won Yang, Jae-Won Lee, Jae Young Kim, Hyeanji Kim, Ji Young You, Jung Pyo Lee","doi":"10.23876/j.krcp.26.416","DOIUrl":"https://doi.org/10.23876/j.krcp.26.416","url":null,"abstract":"","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149012734","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}