Kidney Research and Clinical Practice最新文献

{"title":"Exercise as an adjunctive therapy for patients on maintenance hemodiafiltration.","authors":"Jessica L F Andrade, Ayden T Heitmann, Miguel K Rodrigues, Dave K Marchand, Adelson M Rodrigues, Bruno P Biluca, Rene Freitas, Thiago Reis, Miguel A Goes, Mayron F Oliveira","doi":"10.23876/j.krcp.24.243","DOIUrl":"https://doi.org/10.23876/j.krcp.24.243","url":null,"abstract":"<p><strong>Background: </strong>Fatigue and sedentarism are common in kidney disease and dialysis treatment. Although hemodiafiltration effectively removes solutes and improves mortality, the influence of exercise as an adjunct therapy on maintenance hemodiafiltration programs remains understudied.</p><p><strong>Methods: </strong>A multicenter 6-month study was assessed comparing individuals with chronic kidney disease enrolled in exercise training (exercise group) during dialysis (intradialytic vs. interdialytic) compared to usual care (control group). Physical tests included a YMCA step test for endurance, handgrip, and one-repetition maximum for muscle strength. Single-pool, standard, and equilibrated Kt/Vurea were surrogates for hemodiafiltration adequacy.</p><p><strong>Results: </strong>Eighty-nine patients (54 ± 15 years) and 33 control patients (60 ± 17 years) underwent the exercise protocol. The mean disease vintage was 108 ± 84 and 132 ± 108 months, respectively, while the dialysis vintage was 60 ± 42 and 60 ± 36 months. Control-group Kt/Vurea showed improvement from baseline to month 6 (single-pool, 1.18 ± 0.03 to 1.30 ± 0.04; standard, 1.94 ± 0.04 to 2.09 ± 0.04; equilibrated, 1.09 ± 0.03 to 1.21 ± 0.02; p < 0.001). However, exercise-group Kt/Vurea showed a comparatively greater improvement between the baseline and month 6 (single pool, 1.19 ± 0.05 to 1.47 ± 0.04; standard, 1.99 ± 0.03 to 2.15 ± 0.03; equilibrated, 1.08 ± 0.03 to 1.24 ± 0.03; p < 0.001). The exercise group had a statistically significant increase in the handgrip test (279.5 ± 78.5 N to 295.2 ± 76.5 N, p < 0.01) and fat-free mass (13.9 ± 2.8 kg/m2 to 14.4 ± 2.7 kg/m2, p < 0.01). There were no statistically significant differences between the interdialytic and intradialytic groups in dialysis adequacy and exercise variables.</p><p><strong>Conclusion: </strong>Supervised exercise for maintenance hemodiafiltration patients was associated with improvements in dialysis efficiency/performance outcomes. The results support exercise as an adjunct therapy for hemodiafiltration patients whether conducted during the intradialytic or interdialytic period.</p>","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026817","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":"Longitudinal association between kidney and lung function in the Korean general population.","authors":"Sinyoung Kwon, Hyung Woo Kim, Hye Jung Shin, Myeongjee Lee, Ah Young Leem, Ji Ye Jung, Young Sam Kim, Youngmok Park","doi":"10.23876/j.krcp.24.253","DOIUrl":"https://doi.org/10.23876/j.krcp.24.253","url":null,"abstract":"<p><strong>Background: </strong>The longitudinal relationship between kidney and lung function remains poorly understood. We examined the longitudinal association between estimated glomerular filtration rate (eGFR) and lung function in a Korean population with normal kidney and lung function from 2005 to 2014.</p><p><strong>Methods: </strong>We recruited participants from the Ansan and Ansung cohorts of the Korean Genome and Epidemiology Study. Linear mixed-effects models were employed to analyze the relationship between eGFR and lung function parameters such as forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and FEV1/FVC ratio. The models were adjusted for confounding factors, including age, height (or body mass index), residential area, smoking status, and baseline lung function (or eGFR).</p><p><strong>Results: </strong>A total of 4,388 participants were followed for up to 8 years, revealing a significant bidirectional relationship between decreases in eGFR and declines in lung function in both males and females. The results remained consistent after adjusting for potential confounders, including physical activity, socioeconomic status, alcohol consumption, systolic blood pressure, hypertension, diabetes mellitus, total cholesterol levels, hemoglobin levels, and proteinuria.</p><p><strong>Conclusion: </strong>Our findings suggest a bidirectional long-term relationship between kidney and lung function in the Korean general population, although the direction of causality remains unclear. This study highlights the importance of monitoring both kidney and lung health, particularly in an aging population.</p>","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028868","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":"Clinical significance of the time-average systemic immunoinflammatory index in primary immunoglobulin A nephropathy: a bicentric retrospective cohort study.","authors":"Ya Hu, Ziyuan Huang, Wanwan Zhao, Hong Zhang, Ganxiu Li, Sishi Lin, Fangfang Feng, Chaosheng Chen, Zewen Liu","doi":"10.23876/j.krcp.24.260","DOIUrl":"https://doi.org/10.23876/j.krcp.24.260","url":null,"abstract":"<p><strong>Background: </strong>Systemic immune inflammation index (SII) is a potential marker that can reflect the systemic inflammatory response. However, the clinical significance of SII for immunoglobulin A nephropathy (IgAN) has yet to be determined.</p><p><strong>Methods: </strong>This was a retrospective analysis, covering January 2011 to December 2023, involving 1,399 IgAN patients confirmed through renal biopsy. The low TASII (L-TASII) group comprised patients with a time-average SII (TASII) below the top third of the cohort, whereas the high TASII (H-TASII) group included all remaining patients. All patients were matched 1:1 according to age, sex, follow-up time, and baseline estimated glomerular filtration rate (eGFR). Clinical pathology and prognosis were assessed and compared between the two groups.</p><p><strong>Results: </strong>After matching, the L-TASII and H-TASII groups each feature 556 cases. Patients in the H-TASII group had lower albumin levels (36.88 ± 6.24 g/L vs. 37.93 ± 5.45 g/L, p = 0.01) and higher proteinuria levels (2.19 ± 2.25 g/day vs. 1.75 ± 2.07 g/day, p = 0.003). With an eGFR ≥30% when compared with the baseline or end-stage renal disease as the composite endpoint events, Kaplan-Meier curve analysis revealed that after an average follow-up of 59.91 ± 32.42 months, the survival rate was markedly lower in the H-TASII group than in L-TASII group (log-rank p < 0.01). Analysis revealed that TASII levels are independent predictors for the occurrence of endpoint events (hazard ratio, 1.02; 95% confidence interval, 1.01-1.04; p = 0.001).</p><p><strong>Conclusion: </strong>IgAN patients with a high TASII have more serious clinical manifestations such as creatinine, urinary protein, and inflammatory markers, while there is a worse prognosis for patients with low TASII. Thus, the TASII score represents a significant risk factor for adverse renal outcomes in IgAN patients and serves as a reliable predictor of renal survival.</p>","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020305","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":"Prediction model for 6-month mortality in incident older hemodialysis patients in South Korea.","authors":"Woo Yeong Park, Eunjin Bae, Hui-Seung Lee, Chi-Yeon Lim, Jang-Hee Cho, Byung Chul Yu, Miyeun Han, Sang Heon Song, Gang-Jee Ko, Jae Won Yang, Sungjin Chung, Yu Ah Hong, Young Youl Hyun, In O Sun, Hyunsuk Kim, Won Min Hwang, Sung Joon Shin, Soon Hyo Kwon, Kyung Don Yoo","doi":"10.23876/j.krcp.23.224","DOIUrl":"https://doi.org/10.23876/j.krcp.23.224","url":null,"abstract":"<p><strong>Background: </strong>Early mortality following hemodialysis initiation hinders survival improvement in older patients. This study aimed to develop a clinical risk model for predicting 6-month mortality after dialysis initiation in older Korean hemodialysis patients.</p><p><strong>Methods: </strong>We analyzed data from incident hemodialysis patients aged >70 years from the Korean Society of Geriatric Nephrology (KSGN) database. A prediction model was developed using multivariate logistic regression analysis and externally validated with independent datasets.</p><p><strong>Results: </strong>Among 1,751 incident hemodialysis patients, the 6-month mortality rate was 15.5%. Using multivariate logistic analysis, we constructed the KSGN score as an independent risk factor for 6-month mortality, and its components and score are as follows: old age at dialysis initiation (≥85 years, score 2); hypertension and renovascular disease as a primary etiology of end-stage kidney disease (ESKD) (score 1); malignancy history (yes, score 1); low serum albumin (<3.5 g/dL, score 1); hypertension treatment (yes, score -1); prepared vascular access on maintenance dialysis (arteriovenous fistula/ arteriovenous graft, score -3). In the development cohort, the area under the curve (AUC) for the KSGN score was significantly higher than the Alberta Wick's score (0.707 vs. 0.683, p = 0.001). In the validation cohort, the KSGN score's performance was comparable to existing models.</p><p><strong>Conclusion: </strong>The KSGN score may be a valuable tool for predicting early mortality after dialysis initiation in older patients with ESKD, aiding in decision-making and management regarding dialysis initiation.</p>","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017382","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":"Clinical and dietary risk factors of hyperuricemia in Korean children and adolescents: the 8th Korea National Health and Nutrition Examination Survey.","authors":"Sang Youn You, Sung-Il Cho, Jin-Soon Suh","doi":"10.23876/j.krcp.24.219","DOIUrl":"https://doi.org/10.23876/j.krcp.24.219","url":null,"abstract":"<p><strong>Background: </strong>The global prevalence of hyperuricemia is steadily increasing, and reports indicate an upward trend in children and adolescents. Using data from the Korean National Health and Nutrition Examination Survey (KNHANES), this study aimed to examine the association of dietary factors with hyperuricemia among Korean children and adolescents in addition to known other risk factors.</p><p><strong>Methods: </strong>This cross-sectional study included 1,268 participants aged 10 to 18 years from the eighth KNHANES 2019-2021. Dietary information was collected using a single 24-hour recall method. The associations among serum uric acid and intake of total energy, protein, fat, sodium, and sugar were analyzed using multiple regression analysis adjusting for confounding variables (age, sex, blood pressure, estimated glomerular filtration rate [eGFR], body mass index, and hemoglobin A1c [HbA1c]).</p><p><strong>Results: </strong>From the 1,268 participants (median age, 13 years; male, 56%), 150 (11.8%) had hyperuricemia. In multiple regression analysis, higher sugar intake was independently associated with hyperuricemia (odds ratio [OR], 1.79; p = 0.01) in addition to obesity (OR, 5.5; p < 0.001), age of 13 to 15 years (OR, 2.02; p = 0.002), higher HbA1c (OR, 1.6; p = 0.04), and lower eGFR (eGFR ≥75 and <90 mL/min/1.73 m2: OR, 1.63 [p = 0.01]; eGFR <75 mL/min/1.73 m2: OR, 3.42 [p = 0.002]).</p><p><strong>Conclusion: </strong>The results revealed that the increasing prevalence of hyperuricemia in Korean children and adolescents, and pubertal age, obesity, decreased kidney function, prediabetic state, and high sugar intake are associated with the risk of hyperuricemia in Korean children and adolescents.</p>","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033280","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":"Clinical features and outcomes of immunoglobulin G4-related kidney disease and immunoglobulin G4-related retroperitoneal fibrosis in Korea.","authors":"Sua Lee, Chul Woo Yang","doi":"10.23876/j.krcp.24.056","DOIUrl":"https://doi.org/10.23876/j.krcp.24.056","url":null,"abstract":"<p><strong>Background: </strong>Immunoglobulin G4 (IgG4)-related disease (RD) is a newly recognized disease, and a few epidemiologic studies about this disorder have been published. This research aimed to demonstrate the clinical features and outcomes of IgG4-related kidney disease (RKD) and IgG4-related retroperitoneal fibrosis (RPF) compared to other organs' involvement.</p><p><strong>Methods: </strong>Patients who were diagnosed with IgG4-RD from January 2009 to July 2019 at three medical institutions in South Korea were included. They were classified into three groups: RKD, RPF, and Others groups. The differences in symptoms, laboratory, histological and radiological findings, treatment, and outcomes among the three groups were evaluated.</p><p><strong>Results: </strong>Of 94 patients, 13 (13.8%) and 22 patients (23.4%) were classified into the RKD and RPF groups, respectively. There were older (p = 0.004) and more asymptomatic patients (p = 0.02) in the RKD and RPF groups. In the RKD group, hypocomplementemia (p = 0.003) and eosinophilia (p = 0.001) were more frequently identified. In logistic regression analysis, hypocomplementemia (odds ratio [OR], 14.04; 95% confidence interval [CI], 1.38-142.95) and decreased renal function at the time of diagnosis (OR, 0.95; 95% CI, 0.91-0.98) were associated with renal involvement. Older age (OR, 1.05; 95% CI, 1.00-1.11), male (OR, 6.11; 95% CI, 1.41-26.61), and higher serum IgG4 levels (OR, 1.00; 95% CI, 1.00-1.00) were associated with retroperitoneal involvement. The treatment duration was longer in the RKD and RPF groups (p = 0.01) with glucocorticoids.</p><p><strong>Conclusion: </strong>Renal and retroperitoneal involvement in IgG4-RD presented clinical features that distinguish it from other organs' involvement, such as incidental diagnosis, hypocomplementemia, eosinophilia, and the need for a longer duration of maintenance treatment.</p>","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064010","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":"Home care program with telemonitoring for patients undergoing peritoneal dialysis in South Korea: a cost-utility analysis.","authors":"KyungYi Kim, Tae Hyun Kim, Jaeyong Shin, Suk-Yong Jang, Hyung Woo Kim, Beom Seok Kim, Sang Gyu Lee","doi":"10.23876/j.krcp.24.246","DOIUrl":"https://doi.org/10.23876/j.krcp.24.246","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic accelerated the use of digital health technologies to improve care access and quality of life. The Korean Ministry of Health and Welfare introduced a home care program for end-stage renal disease patients on peritoneal dialysis (PD), incorporating educational consultations and remote monitoring. This study evaluates the long-term economic effectiveness of this digital health-based home care program.</p><p><strong>Methods: </strong>A Markov model was developed to assess the lifetime cost-effectiveness of the PD home care program. Simulations involved 1,000 patients aged 50 in a PD health state, transitioning annually. Effectiveness was measured in quality-adjusted life years (QALYs), and a cost-utility analysis was performed from a limited societal perspective. The willingness-to-pay (WTP) threshold was US$ 32,255 (gross domestic product per capita) per QALY, with a 4.5% discount rate for both QALYs and costs. Outcomes included the incremental cost-effectiveness ratio (ICER) and incremental net monetary benefit, with scenario, sensitivity, and expected value of perfect information (EVPI) analyses addressing uncertainty.</p><p><strong>Results: </strong>The base case analysis yielded an ICER of $4,895 per QALY, well within the WTP threshold. Sensitivity analysis highlighted PD-associated costs as the most critical parameters. Monte Carlo simulations (10,000 iterations) indicated a 79.0% probability of the home care program being optimal. EVPI analysis suggested an additional $2,963 per patient with perfect parameter information.</p><p><strong>Conclusion: </strong>The PD home care program in Korea appears to be a cost-effective strategy, potentially reducing peritonitis incidence and enhancing healthcare efficiency.</p>","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027373","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 prolonged elevated heart rate on sepsis-associated acute kidney injury patients: a causal inference and prediction study.","authors":"Fuxing Deng, Chunlin Zhu, Yaoyuan Cao, Shuangping Zhao","doi":"10.23876/j.krcp.24.206","DOIUrl":"https://doi.org/10.23876/j.krcp.24.206","url":null,"abstract":"<p><strong>Background: </strong>This study investigates the relationship between prolonged elevated heart rate (pe-HR) and mortality among patients with sepsis-associated acute kidney injury (S-AKI) using causal inference and machine learning.</p><p><strong>Methods: </strong>Pe-HR was defined as a heart rate exceeding 100 beats/min for 11 hours within a 12-hour interval. The average treatment effect (ATE) was a measure of the therapeutic effect of β-blockers. The primary outcome measure of the study was the 90-day survival and hospitalization survival as the secondary endpoint. Four machine learning algorithms were employed to assess whether an increase in pe-HR enhanced the performance of predictions.</p><p><strong>Results: </strong>The study included a total of 14,388 patients with S-AKI from MIMIC (Medical Information Mart for Intensive Care)-IV. The results revealed that both 90-day and in-hospital survival were lower in patients with pe-HR than in those without (hazard ratio: 1.62 for 90-day survival and 1.22 for in-hospital survival). The ATE of development pe-HR was 56.3 days survival higher than without pe-HR. The ATE of β-blocker use was 40.2 days survival higher than no use. Four machine learning algorithms showed that the inclusion of pe-HR improved the accuracy of 90-day survival predictions (p < 0.05), with the best area under the receiver operating characteristic curve reaching 0.76.</p><p><strong>Conclusion: </strong>In S-AKI patients, pe-HR was significantly associated with lower survival rates. Including pe-HR in prediction models improved their accuracy for 90-day survival. Our results suggest a causal relationship, highlighting the potential therapeutic benefit of β-blockers in managing S-AKI patients.</p>","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033413","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":"Physical activity and the risk of dementia in end-stage renal disease patients undergoing hemodialysis: a nationwide population-based study.","authors":"Hong Sang Choi, Bongseong Kim, Kyung-Do Han, Sang Heon Suh, Chang Seong Kim, Eun Hui Bae, Seong Kwon Ma, Soo Wan Kim","doi":"10.23876/j.krcp.24.197","DOIUrl":"https://doi.org/10.23876/j.krcp.24.197","url":null,"abstract":"<p><strong>Background: </strong>Several studies have reported that dementia has a high prevalence in end-stage kidney disease (ESKD) patients. However, the relationship between physical activity (PA) and the risk of dementia has not been elucidated for hemodialysis patients.</p><p><strong>Methods: </strong>A total of 11,724 patients aged ≥40 years who started hemodialysis between 2012 and 2017 were identified from the Korean National Health Insurance Service database. Individuals with PA were defined as meeting the following criteria: 1) 1 or more days per week of vigorous activity of at least 20 minutes per day or 2) 1 or more days per week of moderate-intensity activity of at least 30 minutes per day. The occurrence of dementia was monitored until the end of 2018 based on specific codes of International Classification of Diseases, 10th Revision.</p><p><strong>Results: </strong>During the 1.9-year follow-up, 489 hemodialysis patients developed dementia. PA was associated with a lower risk of any dementia (hazard ratio, 0.686; 95% confidence interval, 0.553-0.85) even after adjusting for confounding factors. The risk of dementia was lower in hemodialysis patients with PA when the risk of Alzheimer disease was analyzed separately, but vascular dementia was not. PA was associated with a lower risk of dementia in a dose-dependent manner when stratified by the energy expenditure level. In subgroup analyses stratified by age, sex, income level, smoking, drinking, diabetes mellitus, hypertension, dyslipidemia, and cerebrovascular accident, the risk of dementia tended to be lower in hemodialysis patients with PA than in those without PA.</p><p><strong>Conclusion: </strong>PA was associated with a lower risk of dementia development in ESKD patients undergoing hemodialysis.</p>","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795735","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":"Effect of preparedness of emergency equipment on patient survival in hemodialysis facilities: a Korean nationwide cohort study.","authors":"Se Yeon Park, Yo Seop Cha, Do Hyoung Kim, AJin Cho, Hayne Cho Park, Bo Yeon Kim, Miri Lee, Gui Ok Kim, Jinseog Kim, Young-Ki Lee","doi":"10.23876/j.krcp.24.213","DOIUrl":"https://doi.org/10.23876/j.krcp.24.213","url":null,"abstract":"<p><strong>Background: </strong>Intradialytic cardiac arrest is a serious complication of hemodialysis (HD) in patients with end-stage kidney disease. Therefore, appropriate emergency equipment should be prepared before the initiation of HD. However, little is known about the effects of preparedness of emergency equipment on the outcomes of patients undergoing HD. We aimed to evaluate the effects of preparedness of emergency equipment on mortality in Korean patients undergoing maintenance HD.</p><p><strong>Methods: </strong>Data from HD quality assessment and National Health Service claims between October and December 2015 were used. In total, 34,950 patients were categorized into two groups based on the availability of emergency equipment in the HD facilities. Cox proportional hazards models were used to assess the impact of preparedness of emergency equipment on patient mortality over a mean follow-up period of 53.7 ± 23.0 months.</p><p><strong>Results: </strong>The proportions of patients in the groups with and without emergency equipment were 95.2% (n = 33,267) and 4.8% (n = 1,683), respectively. Serum calcium and phosphorus levels, as well as systolic and diastolic blood pressures, were lower, whereas single-pool Kt/V was higher, in the group with emergency equipment than in the group without. After adjustment for demographic and clinical parameters, preparedness of emergency equipment was observed to be an independent risk factor for patient mortality (hazard ratio, 0.87; 95% confidence interval, 0.79-0.96; p = 0.004).</p><p><strong>Conclusion: </strong>Preparedness of emergency equipment was associated with decreased mortality among patients undergoing HD. A well-equipped HD unit can help increase patient survival.</p>","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795732","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}