Kidney Research and Clinical Practice最新文献_第4页

Clinical consequence of hypophosphatemia during antiviral therapy for chronic hepatitis B. 慢性乙型肝炎抗病毒治疗期间低磷血症的临床后果。

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.22.197

Mee Yeon Park, Hojin Jeon, Kyungho Park, Junseok Jeon, Minsu Park, Sang Ah Chi, Kyunga Kim, Dong Hyun Sinn, Jung Eun Lee, Geum-Youn Gwak, Wooseong Huh, Yoon-Goo Kim, Hye Ryoun Jang

{"title":"Clinical consequence of hypophosphatemia during antiviral therapy for chronic hepatitis B.","authors":"Mee Yeon Park, Hojin Jeon, Kyungho Park, Junseok Jeon, Minsu Park, Sang Ah Chi, Kyunga Kim, Dong Hyun Sinn, Jung Eun Lee, Geum-Youn Gwak, Wooseong Huh, Yoon-Goo Kim, Hye Ryoun Jang","doi":"10.23876/j.krcp.22.197","DOIUrl":"10.23876/j.krcp.22.197","url":null,"abstract":"Background: Antiviral therapy is an essential treatment for chronic hepatitis B (CHB) infection. Although hypophosphatemia is an important adverse effect of antiviral agents, its clinical significance remains unclear. We investigated the incidence and clinical consequences of hypophosphatemia in a large cohort of CHB patients.Methods: This retrospective cohort study included CHB patients who started antiviral therapy between 2005 and 2015 and continued it for at least 1 year. Patients with decompensated liver cirrhosis, diabetes mellitus, hypertension, concomitant diuretic administration, and end-stage renal disease were excluded. The primary outcome was a change in renal function. Secondary outcomes included the incidence of infection and changes in serum potassium, uric acid, and total carbon dioxide (tCO2).Results: Among the 4,335 patients, hypophosphatemia developed in 75 (1.7%). During the median 2-year follow-up period, patients with hypophosphatemia showed a lower estimated glomerular filtration rate than those in the control group. The incidence of infection and changes in serum potassium, uric acid, and tCO2 were similar between groups.Conclusion: Hypophosphatemia was associated with a renal function decline in patients with CHB receiving antiviral therapy.","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":"123-131"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11877809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029036","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

Clinical guidelines for the diagnosis, evaluation, and management of hypertension for Korean children and adolescents: the Korean Working Group of Pediatric Hypertension. 韩国儿童和青少年高血压的诊断、评估和管理临床指南：韩国儿童高血压工作组。

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.24.096

Se Jin Park, Hyo Soon An, Sung Hye Kim, Seong Heon Kim, Hee Yeon Cho, Jae Hyun Kim, Anna Cho, Ji Hee Kwak, Jae Il Shin, Keum Hwa Lee, Jin-Hee Oh, Jung Won Lee, Hae Soon Kim, Hye-Jung Shin, Mi Young Han, Myung Chul Hyun, Tae Sun Ha, Young Hwan Song

{"title":"Clinical guidelines for the diagnosis, evaluation, and management of hypertension for Korean children and adolescents: the Korean Working Group of Pediatric Hypertension.","authors":"Se Jin Park, Hyo Soon An, Sung Hye Kim, Seong Heon Kim, Hee Yeon Cho, Jae Hyun Kim, Anna Cho, Ji Hee Kwak, Jae Il Shin, Keum Hwa Lee, Jin-Hee Oh, Jung Won Lee, Hae Soon Kim, Hye-Jung Shin, Mi Young Han, Myung Chul Hyun, Tae Sun Ha, Young Hwan Song","doi":"10.23876/j.krcp.24.096","DOIUrl":"10.23876/j.krcp.24.096","url":null,"abstract":"Pediatric hypertension (HTN) is a significant, growing health concern worldwide and also in Korea. Diagnosis, evaluation, and treatment of HTN in Korean children and adolescents are uncertain due to limitations in using the current international guidelines, since the recommendations by the American Academy of Pediatrics (AAP) and European Society of Hypertension (ESH) guidelines differ. Furthermore, these are guidelines for Western youth, who are racially and ethnically different from Koreans. In addition, reference blood pressure values for all pediatric age groups, which are essential for the diagnosis of HTN according to these two guidelines, are absent in Korea. Therefore, HTN guidelines for Korean children and adolescents should be established. The Korean Working Group of Pediatric Hypertension established clinical guidelines for the diagnosis, evaluation, and management of HTN in Korean children and adolescents. These guidelines were based on reported clinical evidence, expert recommendations, and AAP and ESH guidelines. The characteristics of Korean youth and the Korean medical and insurance system were considered during the establishment of the guidelines. By providing recommendations suitable for Korean youth, these guidelines will help in the prevention and management of childhood HTN, thus relieving the burden of cardiovascular disease in adulthood in Korea.","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":"44 1","pages":"20-48"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11864819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382395","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

Safety of the reduced fixed dose of mycophenolate mofetil confirmed via therapeutic drug monitoring in de novo kidney transplant recipients. 通过治疗药物监测，确认在新肾移植受者中减少固定剂量的霉酚酸酯的安全性。

IF 2.9 3区医学

Kidney Research and Clinical Practice Pub Date : 2025-01-01 Epub Date: 2024-10-24 DOI: 10.23876/j.krcp.23.274

Hee-Yeon Jung, Yu Jin Seo, Deokbi Hwang, Woo-Sung Yun, Hyung-Kee Kim, Seung Huh, Eun Sang Yoo, Jeong-Hoon Lim, Ji-Young Choi, Sun-Hee Park, Yong-Lim Kim, Dong Il Won, Jang-Hee Cho, Chan-Duck Kim

{"title":"Safety of the reduced fixed dose of mycophenolate mofetil confirmed via therapeutic drug monitoring in de novo kidney transplant recipients.","authors":"Hee-Yeon Jung, Yu Jin Seo, Deokbi Hwang, Woo-Sung Yun, Hyung-Kee Kim, Seung Huh, Eun Sang Yoo, Jeong-Hoon Lim, Ji-Young Choi, Sun-Hee Park, Yong-Lim Kim, Dong Il Won, Jang-Hee Cho, Chan-Duck Kim","doi":"10.23876/j.krcp.23.274","DOIUrl":"10.23876/j.krcp.23.274","url":null,"abstract":"Background: Mycophenolate mofetil (MMF) is usually prescribed with a reduced fixed dose in Asian kidney transplant recipients (KTRs). However, the clinical efficacy and safety of the fixed dose have not yet been investigated via therapeutic drug monitoring. We evaluated whether reduced fixed-dose MMF is an optimal dosing strategy to achieve the therapeutic target of mycophenolic acid (MPA) exposure in Korean KTRs.Methods: This open-label, prospective study enrolled 50 de novo KTRs prescribed with tacrolimus, corticosteroid, and fixed-dose MMF (1.0-1.5 g/day). The trough level (C0) and area under the curve (AUC0-12 hr) of MPA were measured at 1 and 24 weeks after kidney transplantation (KT). The relationship of body weight (BW)-adjusted MMF dose with MPA C0 and MPA AUC0-12 hr was assessed using linear regression analysis.Results: The initial fixed dose of MMF of 1.44 ± 0.16 g/day was adjusted in 24 patients (48.0%) and then reduced to a mean dose of 1.19 ± 0.31 g/day at 24 weeks after KT. Most patients (≥84.0%) attained the minimum required MPA C0 of 1.0 μg/mL and MPA AUC0-12 hr of 30 μg × hr/mL at 1 and 24 weeks. The BW-adjusted MMF dose demonstrated significant positive correlations with MPA C0 and MPA AUC0- 12 hr at 1 and 24 weeks after KT. Moreover, 14 patients (28.0%) reported MPA-related adverse events that were predictable based on MPA AUC0-12 hr (cutoff level, 46.4 μg × hr/mL).Conclusion: The current reduced fixed-dose MMF strategy can help achieve the therapeutic target of MPA exposure in tacrolimus- treated Korean KTRs during the early posttransplant period.","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":"200-209"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11838851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142503036","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

Nephrology consultation improves the clinical outcomes of patients with acute kidney injury. 肾病咨询可改善急性肾损伤患者的临床结果。

IF 2.9 3区医学

Kidney Research and Clinical Practice Pub Date : 2025-01-01 Epub Date: 2023-09-08 DOI: 10.23876/j.krcp.23.039

Harin Rhee, Meeyoung Park, Il Young Kim

{"title":"Nephrology consultation improves the clinical outcomes of patients with acute kidney injury.","authors":"Harin Rhee, Meeyoung Park, Il Young Kim","doi":"10.23876/j.krcp.23.039","DOIUrl":"10.23876/j.krcp.23.039","url":null,"abstract":"Background: Acute kidney injury (AKI) is prevalent in critically ill patients and is associated with an increased risk of in-hospital mortality. Nephrology consultation may be protective, but this has rarely been evaluated in South Korea.Methods: This multicenter retrospective study was based on the electronic medical records (EMRs) of two third-affiliated hospitals. We extracted the records of patients admitted to intensive care units (ICUs) between 2011 and 2020, and retrospectively detected AKI using the modified serum creatinine criteria of the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines. The AKI diagnosis date was defined as the first day of a significant change in serum creatinine level (≥0.3 mg/dL) within 48 hours. Nephrology consultation status was retrieved from the EMRs.Results: In total, 2,461 AKI patients were included; the median age was 65 years (interquartile range [IQR], 56-75 years), 1,459 (59.3%) were male, and 1,065 (43.3%) were of AKI stage 3. During a median of 5 days (IQR, 3-11 days) of ICU admission, nephrology consultations were provided to 512 patients (20.8%). Patients who received such consultations were older, had more comorbidities, and more commonly required dialysis. In a multivariable model, nephrology consultation reduced the risk of in-hospital mortality by 30% (hazard ratio, 0.71; 95% confidence interval, 0.57-0.88). Other factors significant for in-hospital mortality were older age, a higher sequential organ failure assessment (SOFA) score, sepsis, diabetes, hypertension, heart disease, and cancer.Conclusion: For AKI patients in ICUs, nephrology consultation reduced the risk of in-hospital mortality, particularly among those with multiple comorbidities. Therefore, nephrology consultation should not be omitted during ICU care.","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":"102-110"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11838846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41099956","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

Clinical significance of the living kidney donor profile index for predicting long-term posttransplant outcomes: results from the Korean Organ Transplantation Registry. 活体肾脏捐献者档案指数预测移植后长期结果的临床意义：来自韩国器官移植登记处的结果。

IF 2.9 3区医学

Kidney Research and Clinical Practice Pub Date : 2025-01-01 Epub Date: 2023-10-19 DOI: 10.23876/j.krcp.22.266

Jong Ho Kim, Sang Ho Lee, Jin Sug Kim, Hyeon Seok Hwang, Hyunmin Ko, Cheol-Woong Jung, Deok Gie Kim, Yeong Hoon Kim, Jaeseok Yang, Curie Ahn, Kyung Hwan Jeong

{"title":"Clinical significance of the living kidney donor profile index for predicting long-term posttransplant outcomes: results from the Korean Organ Transplantation Registry.","authors":"Jong Ho Kim, Sang Ho Lee, Jin Sug Kim, Hyeon Seok Hwang, Hyunmin Ko, Cheol-Woong Jung, Deok Gie Kim, Yeong Hoon Kim, Jaeseok Yang, Curie Ahn, Kyung Hwan Jeong","doi":"10.23876/j.krcp.22.266","DOIUrl":"10.23876/j.krcp.22.266","url":null,"abstract":"Background: The usefulness of the living kidney donor profile index (LKDPI) has not been widely demonstrated; therefore, it requires verification before clinical application. We analyzed the LKDPI using data from the Korean Organ Transplantation Registry (KOTRY) to confirm whether the LKDPI can be used to predict the survival of allografts in living donor kidney transplantation (LDKT) patients in Korea.Methods: The study population was obtained from the KOTRY database. A total of 2,598 kidney recipients registered in the KOTRY database were enrolled between May 2014 and December 2020. Donor and recipient information was observed, and the LKDPI was measured.Results: Median LKDPI score was 15.5 with a follow-up duration of 33.7 ± 16.1 months. According to LKDPI scores (group 1, <0; group 2, 0-20; group 3, 20-40; and group 4, >40), LKDPI group 4 had significantly higher death-censored graft loss than LKDPI group 1 (hazard ratio [HR], 1.89; 95% confidence interval [CI], 1.06- 3.40; p = 0.03). When divided based on the cutoff value (LKDPI, 36.6), the high LKDPI group had higher graft loss than the low LKDPI group (HR, 2.14; 95% CI, 1.37-3.34; p < 0.001). When follow-up was repeated after transplantation, it was confirmed that the higher the LKDPI value was, the lower the average estimated glomerular filtration rate (p < 0.001).Conclusion: This study confirmed that LKDPI can serve as an independent predictor for assessing the risk of allograft failure and transplant outcomes in Korean LDKT patients.","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":"189-199"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11838853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"54229817","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

The overlooked tool: kidney biopsy in progressive renal decline of type 2 diabetes patients. 您要对肾功能进行性减退的患者进行肾活检吗？

IF 2.9 3区医学

Kidney Research and Clinical Practice Pub Date : 2025-01-01 Epub Date: 2024-12-11 DOI: 10.23876/j.krcp.24.999

Sang Youb Han

引用次数: 0

Constipation and risk of death and cardiovascular events in patients on hemodialysis. 血液透析患者便秘与死亡和心血管事件的风险

IF 2.9 3区医学

Kidney Research and Clinical Practice Pub Date : 2025-01-01 Epub Date: 2025-01-09 DOI: 10.23876/j.krcp.24.174

Sang Cheol Park, Juyoung Jung, Young Eun Kwon, Song In Baeg, Dong-Jin Oh, Do Hyoung Kim, Young-Ki Lee, Hye Min Choi

{"title":"Constipation and risk of death and cardiovascular events in patients on hemodialysis.","authors":"Sang Cheol Park, Juyoung Jung, Young Eun Kwon, Song In Baeg, Dong-Jin Oh, Do Hyoung Kim, Young-Ki Lee, Hye Min Choi","doi":"10.23876/j.krcp.24.174","DOIUrl":"10.23876/j.krcp.24.174","url":null,"abstract":"Background: Constipation is a common gastrointestinal disorder and is often accompanied by alteration in the gut microbiota. Recently, several studies have disclosed its association with an increased risk of cardiovascular disease and mortality in the general population. Despite the high prevalence of constipation, data on the clinical impact of constipation in patients with chronic kidney disease are limited. We aimed to explore the prevalence of constipation and its association with cardiovascular disease in chronic kidney disease using a nationally representative cohort of hemodialysis patients.Methods: This study used hemodialysis quality assessment and health insurance claims data from patients undergoing maintenance hemodialysis in South Korea. Chronic constipation was defined using the total number of laxatives prescribed during the 1-year baseline period. The primary outcome was a composite of acute ischemic stroke, hemorrhagic stroke, myocardial infarction, or all-cause death. Secondary outcomes were the individual components of the primary outcome.Results: Among 35,230 patients on hemodialysis, 9,133 (25.9%) were identified as having constipation. During a median follow-up of 5.4 years, patients with constipation had a 15% higher incidence of the composite outcome, 16% higher incidence of ischemic stroke, and 14% higher all-cause mortality, after multivariate adjustment.Conclusion: Chronic constipation requiring laxatives was associated with a higher risk of the composite outcome of cardiovascular events or all-cause death in patients on hemodialysis. Further studies are needed to confirm whether constipation is an independent predictor or a possible causal factor of cardiovascular disease.","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":"155-163"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11838856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007214","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

A comparative study of epidemiological characteristics, treatment outcomes, and mortality among patients undergoing hemodialysis by health insurance types: data from the Korean Renal Data System. 按健康保险类型划分的血液透析患者的流行病学特征、治疗结果和死亡率的比较研究：来自韩国肾脏数据系统的数据。

IF 2.9 3区医学

Kidney Research and Clinical Practice Pub Date : 2025-01-01 Epub Date: 2023-09-12 DOI: 10.23876/j.krcp.22.220

Kyeong Min Kim, Soyoung Lee, Jong Ho Shin, Mira Park

{"title":"A comparative study of epidemiological characteristics, treatment outcomes, and mortality among patients undergoing hemodialysis by health insurance types: data from the Korean Renal Data System.","authors":"Kyeong Min Kim, Soyoung Lee, Jong Ho Shin, Mira Park","doi":"10.23876/j.krcp.22.220","DOIUrl":"10.23876/j.krcp.22.220","url":null,"abstract":"Background: The prevalence of end-stage renal disease (ESRD) requiring dialysis has progressively increased. Therefore, to achieve financial stability by managing the increasing numbers of patients undergoing hemodialysis (HD), a fixed-payment system was introduced in 2001 for medical aid (MA) beneficiaries receiving HD in Korea.Methods: We identified patients in the Korean Renal Data System that received HD between 2001 and 2017 and stratified them into the following two groups: the National Health Insurance (NHI) and MA groups. Then, we compared the two groups that differed in demographic characteristics, the treatment process and outcomes, and mortality based on health insurance type.Results: Among 52,574 patients, the number of patients aged 65 years or older, hypertension was higher in the NHI group, but diabetes was higher in the MA group. Additionally, the MA group had more weekly dialysis sessions, and expensive drugs tended to be used less frequently. Regarding treatment outcomes, including laboratory test results, the MA group achieved significantly lower goals than the NHI group (p < 0.001). Furthermore, the mortality rate per 1,000 persons was 31 and 27 in the MA and NHI groups, respectively, and the mortality rate ratio was 1.2 (95% confidence interval [CI], 1.076-1.230). Moreover, the hazard ratio for mortality was 1.39 (95% CI, 1.30-1.49, p < 0.001) after adjusting for age, sex, causes of ESRD, and comorbidities.Conclusion: There were significant differences in the treatment and mortality indicators between the groups. Therefore, policy support should be strengthened to provide better medical services to MA beneficiaries undergoing HD.","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":"164-175"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11877827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41135342","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

Kidney biopsy can help to predict renal outcomes of patients with type 2 diabetes mellitus. 肾活检有助于预测 2 型糖尿病患者的肾脏预后。

IF 2.9 3区医学

Kidney Research and Clinical Practice Pub Date : 2025-01-01 Epub Date: 2024-01-12 DOI: 10.23876/j.krcp.23.059

Wook-Joon Kim, Taehoon Oh, Nam Hun Heo, Kyungsup Kwon, Ga-Eun Shin, Se-Hwi Jeong, Ji Hye Lee, Samel Park, Nam-Jun Cho, Hyo-Wook Gil, Eun Young Lee

{"title":"Kidney biopsy can help to predict renal outcomes of patients with type 2 diabetes mellitus.","authors":"Wook-Joon Kim, Taehoon Oh, Nam Hun Heo, Kyungsup Kwon, Ga-Eun Shin, Se-Hwi Jeong, Ji Hye Lee, Samel Park, Nam-Jun Cho, Hyo-Wook Gil, Eun Young Lee","doi":"10.23876/j.krcp.23.059","DOIUrl":"10.23876/j.krcp.23.059","url":null,"abstract":"Background: In patients with type 2 diabetes mellitus (T2DM), diabetic kidney disease (DKD) is diagnosed based on clinical features. A kidney biopsy is used only in selected cases. This study aimed to reconsider the role of a biopsy in predicting renal outcomes.Methods: Clinical and laboratory parameters and renal biopsy results were obtained from 237 patients with T2DM who underwent renal biopsies at Soonchunhyang University Cheonan Hospital between January 2000 and March 2020 and were analyzed.Results: Of 237 diabetic patients, 29.1% had DKD only, 61.6% had non-DKD (NDKD), and 9.3% had DKD with coexisting NDKD (DKD/NDKD). Of the patients with DKD alone, 43.5% progressed to end-stage kidney disease (ESKD), while 15.8% of NDKD patients and 36.4% of DKD/NDKD patients progressed to ESKD (p < 0.001). In the DKD-alone group, pathologic features like ≥50% global sclerosis (p < 0.001), tubular atrophy (p < 0.001), interstitial fibrosis (p < 0.001), interstitial inflammation (p < 0.001), and the presence of hyalinosis (p = 0.03) were related to worse renal outcomes. The Cox regression model showed a higher risk of progression to ESKD in the DKD/NDKD group compared to the DKD-alone group (hazard ratio [HR], 2.73; p = 0.032), ≥50% global sclerosis (HR, 3.88; p < 0.001), and the degree of mesangial expansion (moderate: HR, 2.45; p = 0.045 and severe: HR, 6.22; p < 0.001).Conclusion: In patients with T2DM, a kidney biopsy can help in identifying patients with NDKD for appropriate treatment, and it has predictive value.","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":"91-101"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11838855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139425052","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

Erythropoiesis-stimulating agent responsiveness and hemoglobin variability is associated with fat tissue index in hemodialysis patients with darbepoetin-alfa treatment: a prospective observational cohort study. 一项前瞻性观察队列研究：在接受达伯培汀- α治疗的血透患者中，促红细胞生成剂反应性和血红蛋白变异性与脂肪组织指数相关。

IF 2.9 3区医学

Kidney Research and Clinical Practice Pub Date : 2024-12-31 DOI: 10.23876/j.krcp.24.070

Hyokyeong Yu, Dong-Jin Oh, Do Hyoung Kim

{"title":"Erythropoiesis-stimulating agent responsiveness and hemoglobin variability is associated with fat tissue index in hemodialysis patients with darbepoetin-alfa treatment: a prospective observational cohort study.","authors":"Hyokyeong Yu, Dong-Jin Oh, Do Hyoung Kim","doi":"10.23876/j.krcp.24.070","DOIUrl":"https://doi.org/10.23876/j.krcp.24.070","url":null,"abstract":"Background: Although the introduction of erythropoietin-stimulating agents (ESAs) has led to better clinical outcomes in patients undergoing hemodialysis (HD), fluctuations in hemoglobin (Hb) levels, known as Hb variability, are frequently observed. However, only a few studies have evaluated the association between Hb variability and nutritional status in patients undergoing HD.Methods: In this prospective study conducted between March 1, 2020, and June 1, 2022, we included 109 patients aged over 20 years undergoing HD and receiving darbepoetin. We checked the average NESP (darbepoetin-alfa; Kyowa Kirin Korea Co., Ltd.) dose weekly and nutritional parameters such as body mass index (BMI), fat tissue index (FTI), and lean tissue index obtained by body composition monitoring. Additionally, the ESA resistance index (ERI) and the coefficient of variation of Hb (Hb-CV) were evaluated.Results: In this study, the mean age of the patients was 64.0 ± 11.9 years, and 55.0% were male. Mean Hb was 10.7 ± 1.3 g/dL. Patients were categorized into three groups according to the ERI or Hb-CV tertiles. The highest ERI tertile was associated with lower Hb levels, BMI, and FTI. The highest Hb-CV tertile was associated with lower BMI and FTI. In multiple linear regression analysis, FTI was negatively associated with ERI (β = -0.218, p = 0.01) and Hb-CV (β = -0.181, p = 0.04).Conclusion: These findings suggest that FTI is negatively associated with ERI and Hb-CV, and that ESAs responsiveness and Hb variability are associated with FTI in patients undergoing HD with darbepoetin treatment.","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921979","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