Kidney Research and Clinical Practice最新文献_第3页

Safety of direct oral anticoagulants in hemodialysis patients with venous thromboembolism: an analysis using the Korean National Health Insurance Service database. 静脉血栓栓塞的血液透析患者直接口服抗凝剂的安全性：使用韩国国民健康保险服务数据库的分析

IF 2.9 3区医学

Kidney Research and Clinical Practice Pub Date : 2025-01-09 DOI: 10.23876/j.krcp.24.093

Hyejin Mo, Hyangkyoung Kim, Seung Boo Yang, Young Joo Kwon

{"title":"Safety of direct oral anticoagulants in hemodialysis patients with venous thromboembolism: an analysis using the Korean National Health Insurance Service database.","authors":"Hyejin Mo, Hyangkyoung Kim, Seung Boo Yang, Young Joo Kwon","doi":"10.23876/j.krcp.24.093","DOIUrl":"https://doi.org/10.23876/j.krcp.24.093","url":null,"abstract":"Background: Limited data exist regarding the safety of direct oral anticoagulants in hemodialysis patients with venous thromboembolic disease. This study aims to investigate the safety of direct oral anticoagulants in hemodialysis patients using national data.Methods: The National Health Insurance Service database was retrospectively queried to identify chronic kidney disease patients who took direct oral anticoagulants for venous thromboembolism from 2008 to 2019. Bleeding complications and all-cause mortality were compared between 118 hemodialysis patients (HD group) and 227 matched chronic kidney disease patients not undergoing hemodialysis (CKD group).Results: The use of direct oral anticoagulants among chronic kidney disease patients, with or without dialysis, increased over time. The incidence rate of all-cause mortality per 100 person-years was 38.1 in the HD group and 10.5 in the CKD group (adjusted hazard ratio [HR], 3.28; 95% confidence interval [CI], 2.27-4.75; p < 0.001). When considering death as a competing risk, there was no significant difference in gastrointestinal bleeding (adjusted HR, 1.61; 95% CI, 0.91-2.88; p = 0.115) and intracranial bleeding (adjusted HR, 1.86; 95% CI, 0.73-4.74; p = 0.193) between the HD and CKD groups.Conclusion: In comparison to chronic kidney disease patients not on hemodialysis, the major bleeding risk, including gastrointestinal and intracranial bleeding, was comparable in hemodialysis patients using direct oral anticoagulants for venous thromboembolism.","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":"143007334","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

Predictive models for posttransplant diabetes mellitus in kidney transplant recipients using machine learning and deep learning approach: a nationwide cohort study from South Korea. 使用机器学习和深度学习方法的肾移植受者移植后糖尿病预测模型：来自韩国的一项全国性队列研究

IF 2.9 3区医学

Kidney Research and Clinical Practice Pub Date : 2025-01-09 DOI: 10.23876/j.krcp.24.113

Seoyoung Choi, Mi Ryung Pyo, Sangwoong Kim, Jong Cheol Jeong, Yu Ho Lee, Hyejin Mo, Jeong-Hoon Lee, Jaeseok Yang, Myoung Soo Kim, Hye Eun Yoon, Sejoong Kim

{"title":"Predictive models for posttransplant diabetes mellitus in kidney transplant recipients using machine learning and deep learning approach: a nationwide cohort study from South Korea.","authors":"Seoyoung Choi, Mi Ryung Pyo, Sangwoong Kim, Jong Cheol Jeong, Yu Ho Lee, Hyejin Mo, Jeong-Hoon Lee, Jaeseok Yang, Myoung Soo Kim, Hye Eun Yoon, Sejoong Kim","doi":"10.23876/j.krcp.24.113","DOIUrl":"10.23876/j.krcp.24.113","url":null,"abstract":"Background: Posttransplant diabetes mellitus (PTDM) complicates kidney transplant recipients (KTRs) in morbidity and mortality. This study aimed to predict PTDM risk in KTRs using machine learning and deep learning models.Methods: Data were obtained from the Korea Organ Transplantation Registry, a nationwide cohort study of KTRs. Four machine learning algorithms, including eXtreme Gradient Boosting (XGBoost), CatBoost, light gradient boosting machine and logistic regression, and deep learning were implemented on 41 pretransplant and 31 posttransplant variables to predict PTDM. Model performance was assessed using the area under the curve (AUC) of the receiver operating characteristic curve, accuracy, precision, recall, and F1 score.Results: Among 3,213 KTRs, 497 patients (15.5%) developed PTDM within 1 year. The PTDM group had higher age, body mass index (BMI), triglyceride level, and prevalence of hypertension and cardiovascular disease, and lower total cholesterol level at baseline than the No-PTDM group. The XGBoost model showed the highest AUC (0.738) and F1 score (0.42), and modest accuracy (0.86), while the CatBoost model exhibited the highest accuracy (0.87) and precision (0.79). Feature importance in XGBoost was highest for recipient age, followed by baseline BMI, triglyceride level at posttransplant 6 months, baseline glycated hemoglobin and high-density lipoprotein cholesterol level, white blood cell (WBC) count and serum uric acid level at 6 months, baseline WBC count, and tacrolimus trough level at discharge.Conclusion: The XGBoost model demonstrated the best performance for predicting PTDM within 1 year, offering an accurate tool for early identification and personalized care of high-risk KTRs for PTDM.","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":"143772506","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

Immunoglobulin M nephropathy: requiring more attention. 免疫球蛋白 M 肾病：需要更多关注。

IF 2.9 3区医学

Kidney Research and Clinical Practice Pub Date : 2025-01-01 Epub Date: 2024-07-24 DOI: 10.23876/j.krcp.24.104

Kyung Chul Moon

引用次数: 0

Mind the gap in kidney care: translating what we know into what we do. 注意肾脏护理的差距：将我们所知道的转化为我们所做的。

IF 2.9 3区医学

Kidney Research and Clinical Practice Pub Date : 2025-01-01 Epub Date: 2025-01-15 DOI: 10.23876/j.krcp.24.100

Valerie A Luyckx, Katherine R Tuttle, Dina Abdellatif, Ricardo Correa-Rotter, Winston W S Fung, Agnès Haris, Li-Li Hsiao, Makram Khalife, Latha A Kumaraswami, Fiona Loud, Vasundhara Raghavan, Stefanos Roumeliotis, Marianella Sierra, Ifeoma Ulasi, Bill Wang, Siu-Fai Lui, Vassilios Liakopoulos, Alessandro Balducci

{"title":"Mind the gap in kidney care: translating what we know into what we do.","authors":"Valerie A Luyckx, Katherine R Tuttle, Dina Abdellatif, Ricardo Correa-Rotter, Winston W S Fung, Agnès Haris, Li-Li Hsiao, Makram Khalife, Latha A Kumaraswami, Fiona Loud, Vasundhara Raghavan, Stefanos Roumeliotis, Marianella Sierra, Ifeoma Ulasi, Bill Wang, Siu-Fai Lui, Vassilios Liakopoulos, Alessandro Balducci","doi":"10.23876/j.krcp.24.100","DOIUrl":"10.23876/j.krcp.24.100","url":null,"abstract":"Historically, it takes an average of 17 years to move new treatments from clinical evidence to daily practice. Given the highly effective treatments now available to prevent or delay kidney disease onset and progression, this is far too long. The time is now to narrow the gap between what we know and what we do. Clear guidelines exist for the prevention and management of common risk factors for kidney disease, such as hypertension and diabetes, but only a fraction of people with these conditions worldwide are diagnosed, and even fewer are treated to target. Similarly, the vast majority of people living with kidney disease are unaware of their condition, because in the early stages it is often silent. Even among patients who have been diagnosed, many do not receive appropriate treatment for kidney disease. Considering the serious consequences of kidney disease progression, kidney failure, or death, it is imperative that treatments are initiated early and appropriately. Opportunities to diagnose and treat kidney disease early must be maximized beginning at the primary care level. Many systematic barriers exist, ranging from patient to clinician to health systems to societal factors. To preserve and improve kidney health for everyone everywhere, each of these barriers must be acknowledged so that sustainable solutions are developed and implemented without further delay.","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":"6-19"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11838860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007333","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}

引用次数: 0

In silico medicine and -omics strategies in nephrology: contributions and relevance to the diagnosis and prevention of chronic kidney disease. 肾脏病学中的硅医学和组学策略：对诊断和预防慢性肾脏病的贡献和意义。

IF 2.9 3区医学

Kidney Research and Clinical Practice Pub Date : 2025-01-01 Epub Date: 2024-07-05 DOI: 10.23876/j.krcp.23.334

Ana Checa-Ros, Antonella Locascio, Nelia Steib, Owahabanun-Joshua Okojie, Totte Malte-Weier, Valmore Bermúdez, Luis D'Marco

{"title":"In silico medicine and -omics strategies in nephrology: contributions and relevance to the diagnosis and prevention of chronic kidney disease.","authors":"Ana Checa-Ros, Antonella Locascio, Nelia Steib, Owahabanun-Joshua Okojie, Totte Malte-Weier, Valmore Bermúdez, Luis D'Marco","doi":"10.23876/j.krcp.23.334","DOIUrl":"10.23876/j.krcp.23.334","url":null,"abstract":"Chronic kidney disease (CKD) has been increasing over the last years, with a rate between 0.49% to 0.87% new cases per year. Currently, the number of affected people is around 850 million worldwide. CKD is a slowly progressive disease that leads to irreversible loss of kidney function, end-stage kidney disease, and premature death. Therefore, CKD is considered a global health problem, and this sets the alarm for necessary efficient prediction, management, and disease prevention. At present, modern computer analysis, such as in silico medicine (ISM), denotes an emergent data science that offers interesting promise in the nephrology field. ISM offers reliable computer predictions to suggest optimal treatments in a case-specific manner. In addition, ISM offers the potential to gain a better understanding of the kidney physiology and/or pathophysiology of many complex diseases, together with a multiscale disease modeling. Similarly, -omics platforms (including genomics, transcriptomics, metabolomics, and proteomics), can generate biological data to obtain information on gene expression and regulation, protein turnover, and biological pathway connections in renal diseases. In this sense, the novel patient-centered approach in CKD research is built upon the combination of ISM analysis of human data, the use of in vitro models, and in vivo validation. Thus, one of the main objectives of CKD research is to manage the disease by the identification of new disease drivers, which could be prevented and monitored. This review explores the wide-ranging application of computational medicine and the application of -omics strategies in evaluating and managing kidney diseases.","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":"49-57"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11838848/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141734499","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}

引用次数: 0

Unveiling the podocyte-protective effect of sodium-glucose cotransporter-2 inhibitors. 揭示钠-葡萄糖共转运蛋白-2抑制剂对足细胞的保护作用。

IF 2.9 3区医学

Kidney Research and Clinical Practice Pub Date : 2025-01-01 Epub Date: 2024-12-05 DOI: 10.23876/j.krcp.24.144

Buchun Jiang, Zhiwen Cheng, Dongjie Wang, Fei Liu, Jingjing Wang, Haidong Fu, Jianhua Mao

引用次数: 0

Management of high-flow arteriovenous access. 高流量动静脉通路的管理。

IF 2.9 3区医学

Kidney Research and Clinical Practice Pub Date : 2025-01-01 Epub Date: 2025-01-31 DOI: 10.23876/j.krcp.23.196

Hoon Suk Park, Seok Joon Shin

{"title":"Management of high-flow arteriovenous access.","authors":"Hoon Suk Park, Seok Joon Shin","doi":"10.23876/j.krcp.23.196","DOIUrl":"10.23876/j.krcp.23.196","url":null,"abstract":"An arteriovenous fistula or graft is essential for hemodialysis (HD). It involves connecting a high-resistance artery to a low-resistance vein, which increases cardiac output (CO). In the early days of HD, patients with end-stage kidney disease (ESKD) were typically younger, and their HD access was located in the distal forearm. However, in the modern era, ESKD patients are often the elderly, with many being the very elderly (over 80 years old). These elderly patients often have poor vessel quality, making distal forearm access unsuitable. As a result, upper arm access, which is more prone to high-flow access, is commonly used. The cardiac status of these modern elderly ESKD patients is vulnerable to high-flow access. High-flow HD access can lead to high-output cardiac failure in ESKD patients. Initial evaluation for high-flow access involves measuring the flow volume using Doppler ultrasound. If the HD access flow volume exceeds 2,000 mL/min, further assessments, including CO and cardiopulmonary recirculation ratio caused by the HD access, should be strongly considered. Treatment for high-flow access involves reducing the flow. There are several surgical and endovascular methods for flow reduction, such as aneurysmorrhaphy, short segment small-diameter graft interposition at the inflow area of the HD access, and banding. Patients with high-flow access are generally asymptomatic. Therefore, nephrologists as primary care physicians for HD patients should provide detailed explanations to patients with high-flow access and high-output cardiac failure and ensure that they understand the prognosis of these conditions. Nephrologists need increased attention to high-flow HD access.","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":"44 1","pages":"58-68"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11838845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382428","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}

引用次数: 0

Bowman capsule rupture in children with myeloperoxidase-antineutrophil cytoplasmic antibody-associated glomerulonephritis predicts poor renal survival. 患有髓过氧化物酶-抗中性粒细胞胞浆抗体相关肾小球肾炎的儿童Bowman囊破裂预示着肾存活率低。

IF 2.9 3区医学

Kidney Research and Clinical Practice Pub Date : 2025-01-01 Epub Date: 2023-11-01 DOI: 10.23876/j.krcp.23.051

Pei Zhang, Li-Li Jia, Meng-Zhen Fu, Kai-Li Shi, Chun-Lin Gao, Zheng-Kun Xia

{"title":"Bowman capsule rupture in children with myeloperoxidase-antineutrophil cytoplasmic antibody-associated glomerulonephritis predicts poor renal survival.","authors":"Pei Zhang, Li-Li Jia, Meng-Zhen Fu, Kai-Li Shi, Chun-Lin Gao, Zheng-Kun Xia","doi":"10.23876/j.krcp.23.051","DOIUrl":"10.23876/j.krcp.23.051","url":null,"abstract":"Background: Recent developments indicated that Bowman capsule rupture (BCR) is observed in antineutrophil cytoplasmic antibody (ANCA)-associated glomerulonephritis (AAGN). We aimed to explore the relationship between BCR and clinical manifestations, pathological changes, and prognosis in children with myeloperoxidase (MPO)-AAGN.Methods: A total of 56 children with MPO-AAGN were divided into BCR (+) and BCR (-) groups according to the status of Bowman's capsule.Results: After retrospective analysis of the data, 24 children (42.9%) were found to have BCR. The results showed that BCR positively correlated with intrarenal immune cell infiltrates, obsolescence and crescents in glomeruli, tubulointerstitial inflammation, tubulitis, and tubular atrophy negatively correlated with normal glomeruli and immunoglobulin G deposition in the kidney. The clinical features and kidney pathological changes were more severe in the BCR (+) group than BCR (-) group, and the renal survival rate was significantly poorer in the BCR (+) group than BCR (-) group (χ2 = 5.45, p = 0.02). Moreover, estimated glomerular filtration rate (≤15 mL/ min/1.73 m2), BCR and ANCA renal risk score (ARRS) were independent risk factors for the development of end-stage kidney disease (ESKD) in children with MPO-AAGN. After combining BCR with the Berden classification and ARRS, our data suggested that the Berden classification + BCR and ARRS + BCR showed better predictive values for ESKD than those of the Berden classification and ARRS, respectively.Conclusion: BCR is an important pathological lesion that correlates with severe clinical manifestations, pathological changes, and poor prognosis in children with MPO-AAGN.","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":"111-122"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11838847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71424669","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}

引用次数: 0

Loss of Cutibacterium is responsible for chronic kidney disease-associated pruritus in patients on dialysis. Cutibacterium的缺失是透析患者慢性肾脏疾病相关瘙痒的原因。

IF 2.9 3区医学

Kidney Research and Clinical Practice Pub Date : 2025-01-01 Epub Date: 2023-09-06 DOI: 10.23876/j.krcp.23.057

Jeong Geon Lee, Hoonhee Seo, Seung Seob Son, Hee Seul Jeong, Kyung Mi Lee, Nam-Jun Cho, Samel Park, Hyo-Wook Gil, Hyun-A Park, Sukyung Kim, Eun Young Lee

{"title":"Loss of Cutibacterium is responsible for chronic kidney disease-associated pruritus in patients on dialysis.","authors":"Jeong Geon Lee, Hoonhee Seo, Seung Seob Son, Hee Seul Jeong, Kyung Mi Lee, Nam-Jun Cho, Samel Park, Hyo-Wook Gil, Hyun-A Park, Sukyung Kim, Eun Young Lee","doi":"10.23876/j.krcp.23.057","DOIUrl":"10.23876/j.krcp.23.057","url":null,"abstract":"Background: Chronic kidney disease (CKD)-associated pruritus is a severe distressing condition that frequently occurs in patients undergoing dialysis. In this study, the profile of the skin microbiome was analyzed to understand the underlying etiology and potential treatments.Methods: Seventy-six end-stage kidney disease (ESKD) patients (hemodialysis, 40; peritoneal dialysis, 36) and 15 healthy controls were enrolled and swabbed at three sites: back, antecubital fossa, and shin. The pruritus severity of the enrolled subjects was validated by the Worst Itch Numeric Rating Scale (WI-NRS), 5-D itch scale, and Uremic Pruritus in Dialysis Patients (UP-Dial). The 16S genebased metagenomics method was applied to skin microbiome analysis.Results: In the comparison of bacterial communities of ESKD patients and the control group, there was a significant difference on back. Specifically, the average composition ratio of the Cutibacterium in the back samples was significantly lower in ESKD patients than in healthy controls (p < 0.01). In further analysis of ESKD patients, Cutibacterium was significantly lower in the high pruritus group than in the low pruritus group (p < 0.05), even though other clinical parameters such as age, calcium-phosphorus product, and intact parathyroid hormone showed no significance difference between the groups.Conclusion: In ESKD patients, the skin microbiome of the back was significantly altered, and the severity of itching was related to the reduction of Cutibacterium. This research reveals the relationship between skin microbiota and CKD-associated pruritus in multiple skin sites for the first time. The results of this study suggest a potential data basis for the diagnosis and treatment of CKD-associated pruritus.","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":"176-188"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11838852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41125732","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}

引用次数: 0

Zebra bodies in lupus nephritis without Fabry disease or hydroxychloroquine therapy. 无法布里病或羟氯喹治疗的狼疮性肾炎斑马体。

IF 2.9 3区医学

Kidney Research and Clinical Practice Pub Date : 2025-01-01 Epub Date: 2025-01-17 DOI: 10.23876/j.krcp.24.283

Yaning Wang, Rongdan Cai, Yunqi Liu, Ning Yu, Mingfeng Zhao

引用次数: 0