Kidney Research and Clinical Practice最新文献

{"title":"Risk factors and predictive models about false-negative urine dipstick results in albuminuria patients: population-based study from Korea National Health and Nutrition Examination Survey 2019 to 2022.","authors":"Yeonhee Lee, Suein Choi, Seungpil Jung, Yaeni Kim, In Kyung Lee, Dae-Chul Jeong","doi":"10.23876/j.krcp.24.249","DOIUrl":"https://doi.org/10.23876/j.krcp.24.249","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease prognosis is determined based on glomerular filtration rate and albuminuria categories. However, the albumin-to-creatinine ratio (ACR) test is not performed on all patients as a screening test. The purpose of this study was to identify risk factors for patients with albuminuria confirmed by a urine dipstick negative and develop a model to predict underestimated patients.</p><p><strong>Methods: </strong>We analyzed data from 19,034 adult patients with a urine dipstick negative from the 2019- 2022 Korea National Health and Nutrition Examination Survey. The risk factor of albuminuria was analyzed by comparing patients with albuminuria with a urine dipstick negative with patients without albuminuria.</p><p><strong>Results: </strong>A total of 753 patients were identified as having albuminuria with a negative urine dipstick. The results of examinations that can be evaluated at the primary care site, such as sex, age, height, weight, body mass index, abdominal circumference, and blood pressure, were significant. Chronic diseases such as hypertension, diabetes mellitus, and dyslipidemia also showed significant differences. A prediction model was built using the additive score system for factors that showed significant differences, and it was confirmed that the logistic regression and score models had high agreement.</p><p><strong>Conclusion: </strong>We classified the ACR high-risk group by checking the medical history and physical measurement values that can be performed in the primary examination and applied the blood pressure value to the score model along with self-diagnosis items. In the long term, this model is expected to aid in the cost-effective management of CKD through selective ACR testing.</p>","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795740","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":"Referral to nephrologists is associated with the slow progression of kidney dysfunction in patients with type 2 diabetes mellitus.","authors":"Donghwan Yun, Sohyun Bae, Sehoon Park, Yong Chul Kim, Dong Ki Kim, Kook-Hwan Oh, Kwon Wook Joo, Yon Su Kim, Seung Seok Han","doi":"10.23876/j.krcp.24.217","DOIUrl":"https://doi.org/10.23876/j.krcp.24.217","url":null,"abstract":"<p><strong>Background: </strong>Although treatment guidelines exist, referrals and discussions among clinicians about the disease can lead to more appropriate treatment for the patient. This study evaluated the effects of referrals from diabetes clinics to nephrologists on kidney function in type 2 diabetic patients through causal inference analysis.</p><p><strong>Methods: </strong>This study included patients with type 2 diabetes who initially visited the diabetes clinic between 2004 and 2023. Patients were either referred to nephrologists (named the referral group) or continued under the care of diabetologists in the diabetes clinic (named the non-referral group). The slope of the estimated glomerular filtration rate (eGFR) per year was calculated based on the annual median difference in yearly eGFRs, and cases were censored when the values dropped below 10 mL/min/1.73 m2. We applied a difference-in-differences model to this time-series dataset with an inverse propensity weighting estimator to evaluate the effect of referral to nephrologists.</p><p><strong>Results: </strong>Among the 30,160 patients who initially visited the diabetes clinic, 3,885 (12.9%) were referred to nephrologists during follow-up. At the time of referral, the median (interquartile range) values of the eGFR and random urine albumin-to-creatinine ratio were 55.0 mL/min/1.73 m2 (40.3-76.8 mL/min/1.73 m2) and 107 mg/g (20-846 mg/g), respectively. The average treatment effect of referral to nephrologists was an improvement in the eGFR slope, with an increase of 5.8 mL/min/1.73 m2 (95% confidence interval, 4.8-6.8 mL/min/1.73 m2) per year. The effect of referral was greater in patients with a high risk of progression than in those with a low risk.</p><p><strong>Conclusion: </strong>Referral to nephrologists is associated with slow progression of kidney dysfunction in patients with type 2 diabetes, supporting the need to evaluate how to facilitate timely referral for each patient as a next step.</p>","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795738","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":"Necessity of induction agent modification for old age kidney transplant recipients.","authors":"Kyeong Deok Kim, Kyo Won Lee, Jae Berm Park, Woo Sung Sim, Manuel Lim, Eun Sung Jeong, Jieun Kwon, Jaehun Yang","doi":"10.23876/j.krcp.23.068","DOIUrl":"10.23876/j.krcp.23.068","url":null,"abstract":"<p><strong>Background: </strong>Immunosenescence gradually deteriorates the function of the immune system, making elderly patients susceptible to infection, while reducing rejection of organ transplants. Therefore, age-adaptive immunosuppression is necessary in the elderly. We evaluated clinical outcomes such as rejection and infection rate when using basiliximab and rabbit anti-thymocyte globulin (r-ATG) as induction agents in elderly and young organ transplant recipients.</p><p><strong>Methods: </strong>We retrospectively reviewed patients who underwent kidney transplantation (KT) between June 2011 and April 2019. We enrolled 704 adult KT patients and classified the patients into groups according to patient age. We compared the outcomes of infection and biopsy-proven acute rejection (BPAR) according to the type of induction agent (basiliximab and r-ATG [4.5 mg/kg]).</p><p><strong>Results: </strong>The patient group included 520 recipients (74.6%) in the younger recipient group and 179 recipients (25.4%) in the older recipient group. When r-ATG was used as an induction agent, BPAR within 6 months occurred less (p = 0.03); however, infections within 6 months were higher in older recipients. Deaths due to infection were more common in older recipients (p = 0.003).</p><p><strong>Conclusion: </strong>It may be necessary to use less intensive induction therapy for older recipients, of which dose reduction of r-ATG is one option.</p>","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":"349-360"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11985316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71424684","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}

{"title":"Sarcopenia is independently associated with mortality and recovery from dialysis in critically ill patients with sepsis-induced acute kidney injury receiving continuous renal replacement therapy.","authors":"Il Young Kim, Byung Min Ye, Seo Rin Kim, Dong Won Lee, Soo Bong Lee","doi":"10.23876/j.krcp.24.015","DOIUrl":"10.23876/j.krcp.24.015","url":null,"abstract":"<p><strong>Background: </strong>Sarcopenia upon admission to the intensive care unit (ICU) consistently correlates with adverse outcomes, including heightened mortality, in critically ill patients. This study aims to investigate the independent association of sarcopenia with both mortality and recovery from dialysis in critically ill patients with sepsis-induced acute kidney injury (SIAKI) undergoing continuous renal replacement therapy (CRRT).</p><p><strong>Methods: </strong>This retrospective study included 618 patients with SIAKI who underwent CRRT in our ICU. All patients had abdominal computed tomography (CT) scans within 3 days preceding ICU admission. The cross-sectional area of skeletal muscles at the third lumbar vertebra was quantified, and the skeletal muscle index (SMI), a normalized measure of skeletal muscle mass, was computed. Using Korean-specific SMI cutoffs, patients were categorized into sarcopenic and non-sarcopenic groups.</p><p><strong>Results: </strong>Among the 618 patients, 301 expired within 28 days of ICU admission. Multivariable Cox regression analysis revealed that sarcopenia independently predicted 28-day mortality. Among survivors, sarcopenia was independently associated with recovery from dialysis within 28 days after ICU admission. Kaplan-Meier analysis illustrated that sarcopenic patients had a higher mortality rate and a lower rate of recovery from dialysis within 28 days after ICU admission compared to non-sarcopenic patients.</p><p><strong>Conclusion: </strong>This study underscores the independent association of sarcopenia, assessed via CT-derived SMI, with both mortality and recovery from dialysis in critically ill patients with SIAKI undergoing CRRT. The inclusion of sarcopenia assessment could serve as a valuable tool for physicians in effectively stratifying the risk of adverse outcomes in these patients.</p>","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":"324-337"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11985270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140912454","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}

{"title":"Efficacy of intradialytic neuromuscular electrical stimulation and oral nutritional supplementation in hemodialysis patients: a multicenter, randomized controlled trial.","authors":"Jae Hyeon Park, Jae Yoon Park, Geum Sil Lee, Ran-Hui Cha","doi":"10.23876/j.krcp.23.146","DOIUrl":"10.23876/j.krcp.23.146","url":null,"abstract":"<p><strong>Background: </strong>Sarcopenia is common in hemodialysis patients. This study aimed to evaluate the effect of simultaneous nutritional support and intradialytic neuromuscular electrical stimulation (NMES) in hemodialysis patients.</p><p><strong>Methods: </strong>We performed a 12-week, multicenter, randomized controlled trial. The participants were randomly assigned to the control group, the protein group (25 g of protein at every dialysis session), the NMES group (intradialytic NMES to quadriceps femoris muscles), and the NMES + P group (NMES with protein supplementation). The primary outcome was the difference in hand grip strength (HGS) and leg muscle strength (LMS) among groups. Secondary outcomes included body composition, physical performance (the 10-m walk test and the timed up and go test [TUG]), and questionnaires about quality of life (QoL), physical activity, and depression. In addition, subgroup analysis was performed by dividing NMES and NMES + P groups into high- and low-intensity NMES groups.</p><p><strong>Results: </strong>Fifty-nine patients completed all the study outcomes. There was no difference in muscle strength (HGS and LMS) and muscle mass among groups. Gait speed improved in NMES and NMES + P groups. Subscale scores for QoL (kidney disease effect, role limitations due to physical or emotional problems, and overall health ratings) improved in the NMES + P group. In subgroup analysis, LMS and TUG improved only in the high-intensity NMES group.</p><p><strong>Conclusion: </strong>In this study, NMES and-/or- protein supplementation did not make a significant difference in HGS and LMS. However, NMES or NMES + P improved functional capacity and QoL. Furthermore, higher NMES was superior in improving LMS and functional capacity.</p>","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":"288-298"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11985289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139702859","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}

{"title":"Associations of metabolic variabilities and cardiovascular outcomes according to estimated glomerular filtration rate in chronic kidney disease: a nationwide observational cohort study.","authors":"Jeong Min Cho, Kyungdo Han, Kwon Wook Joo, Soojin Lee, Yaerim Kim, Semin Cho, Hyuk Huh, Seong Geun Kim, Minsang Kim, Eunjeong Kang, Dong Ki Kim, Sehoon Park","doi":"10.23876/j.krcp.23.135","DOIUrl":"10.23876/j.krcp.23.135","url":null,"abstract":"<p><strong>Background: </strong>The impact of baseline estimated glomerular filtration rate (eGFR) on the risk of adverse outcomes according to metabolic parameter variabilities in chronic kidney disease has rarely been investigated.</p><p><strong>Methods: </strong>We conducted a retrospective nationwide cohort study using the National Health Insurance System data in Korea from 2007 to 2013 to identify individuals with three or more health screenings. The metabolic components variability was defined as intraindividual variability between measurements using the variability independent of the mean. The metabolic variability score was defined as the total number of high-variability metabolic components. Multivariable-adjusted Cox regression analysis was conducted to evaluate the risks of all-cause mortality, myocardial infarction, and ischemic stroke.</p><p><strong>Results: </strong>During a mean follow-up of 6.0 ± 0.7 years, 223,531 deaths, 107,140 myocardial infarctions, and 116,182 ischemic strokes were identified in 9,971,562 patients. Low eGFR categories and higher metabolic variability scores were associated with a higher risk of adverse outcomes. The degree of association between metabolic variability and adverse outcomes was significantly larger in those with low eGFR categories than in those with preserved eGFR (p for interaction < 0.001). Representatively, those with high metabolic variability in the eGFR of <15 mL/min/1.73 m2 group showed a prominently higher risk for all-cause mortality (adjusted hazard ratio [aHR], 5.28; 95% confidence interval [CI], 4.02-6.94) when the degree was compared to the findings in those with preserved (eGFR of ≥60 mL/min/1.73 m2) kidney function (aHR, 2.55; 95% CI, 2.41-2.69).</p><p><strong>Conclusion: </strong>The degree of adverse association between metabolic variability and poor prognosis is accentuated in patients with impaired kidney function.</p>","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":"265-276"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11985315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139425050","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}

{"title":"Disaster emergency meal plans for Korean patients who require hemodialysis.","authors":"Yumi Jang, Seong Geun Kim, Sua Lee, Hyun Ho Oh, Nara Shin, Young-Ki Lee, Kyung Don Yoo","doi":"10.23876/j.krcp.24.242","DOIUrl":"10.23876/j.krcp.24.242","url":null,"abstract":"<p><p>Proactive planning and preparation are critical to the safety of patients on dialysis during emergencies, such as natural disasters, and pandemics, such as coronavirus disease 2019. Patients with end-stage kidney disease are particularly vulnerable to disruptions such as power outages, water shortages, transportation issues, and dialysis center closures because they can result in missed dialysis sessions and severe health deterioration. This study aimed to develop tailored dietary guidelines for Korean patients on hemodialysis by applying the U.S. Centers for Disease Control and Prevention guidelines and considering the dietary limitations of these patients. The proposed guidelines impose strict potassium, phosphorus, sodium, and fluid restrictions and include two 3-day emergency meal plans: one for scenarios involving disruptions of electricity and water supply and another for situations in which these utilities are available. The use of a food exchange list enhances the dietary flexibility of these patients. Although these guidelines cannot replace dialysis, they could mitigate the impact of emergencies on patient health by providing essential support during critical periods.</p>","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":"228-237"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11985318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying the optimal blood pressure target among Korean hemodialysis patients: current evidence and future directions.","authors":"Young Su Joo, Tae-Hyun Yoo","doi":"10.23876/j.krcp.25.044","DOIUrl":"https://doi.org/10.23876/j.krcp.25.044","url":null,"abstract":"","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":"44 2","pages":"213-216"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016961","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}

{"title":"Association between dementia diagnosis at dialysis initiation and mortality in older patients with end-stage kidney disease in South Korea.","authors":"Byung Min Ye, Seongmin Kang, Woo Yeong Park, 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, Eunjin Bae, In O Sun, Hyunsuk Kim, Won Min Hwang, Sung Joon Shin, Soon Hyo Kwon, Seo Rin Kim, Kyung Don Yoo","doi":"10.23876/j.krcp.23.151","DOIUrl":"10.23876/j.krcp.23.151","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of dementia is 2- to 7-fold higher among patients with end-stage kidney disease (ESKD) than among the general population; however, its clinical implications in this population remain unclear. Therefore, this study aimed to determine whether comorbid dementia increases mortality among older patients with ESKD undergoing newly initiated hemodialysis.</p><p><strong>Methods: </strong>We analyzed data from the Korean Society of Geriatric Nephrology retrospective cohort, which included 2,736 older ESKD patients (≥70 years old) who started hemodialysis between 2010 and 2017. Kaplan-Meier survival and Cox regression analyses were used to examine all-cause mortality between the patients with and without dementia in this cohort.</p><p><strong>Results: </strong>Of the 2,406 included patients, 8.3% had dementia at the initiation of dialysis; these patients were older (79.6 ± 6.0 years) than patients without dementia (77.7 ± 5.5 years) and included more women (male:female, 89:111). Pre-ESKD diagnosis of dementia was associated with an increased risk of overall mortality (hazard ratio, 1.503; p < 0.001), and this association remained consistent after multivariate adjustment (hazard ratio, 1.268; p = 0.009). In subgroup analysis, prevalent dementia was associated with mortality following dialysis initiation in female patients, those aged <85 years, those with no history of cerebrovascular accidents or severe behavioral disorders, those not residing in nursing facilities, and those with no or short-term hospitalization.</p><p><strong>Conclusion: </strong>A pre-ESKD diagnosis of dementia is associated with mortality following dialysis initiation in older Korean population. In older patients with ESKD, cognitive assessment at dialysis initiation is necessary.</p>","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":"277-287"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11985317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139702858","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}

{"title":"Diffuse subcutaneous oxalosis masquerading as lower limb cellulitis.","authors":"Gerry George Mathew, Anand Alwan","doi":"10.23876/j.krcp.24.282","DOIUrl":"10.23876/j.krcp.24.282","url":null,"abstract":"","PeriodicalId":17716,"journal":{"name":"Kidney Research and Clinical Practice","volume":" ","pages":"396-397"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11985304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}