Kidney & blood pressure research最新文献

{"title":"Primary hyperoxaluria type 1 - an unexpected diagnosis after kidney transplantation.","authors":"Katarzyna Sobczyńska, Katarzyna Krzanowska, Katarzyna Milan-Ciesielska, Ewa Ignacak, Agnieszka Murawska, Kamil Możdżeń, Marcin Krzanowski","doi":"10.1159/000547836","DOIUrl":"https://doi.org/10.1159/000547836","url":null,"abstract":"<p><p>Primary hyperoxaluria type 1 (PH1) is a rare autosomal recessive disorder caused by a deficiency of the hepatic peroxisomal enzyme alanine-glyoxylate aminotransferase (AGT), which catalyses the conversion of glyoxylate to glycine, resulting in increased oxalate production. The clinical consequences of the progressive build up of oxalates include nephrocalcinosis, nephrolithiasis, chronic kidney disease and ultimately renal failure with extra-renal involvement. The diagnosis of PH1 is challenging due to the non-specific nature of its symptoms and the need for costly genetic testing. For many years, the management of PH1 was mainly supportive care. Currently, we have access to novel RNA interference (RNAi) therapeutics such as lumasiran and nedosiran, which reduce hepatic oxalate production, however, they are prohibitively expensive in most countries. The only curative treatment is liver transplantation, and in cases that progress to end-stage kidney disease (ESKD), simultaneous dual kidney and liver transplantation is usually indicated. Case presentation: We present a case of a 46-year-old woman admitted to our clinic on the eighth day post-kidney transplantation for evaluating the causes of delayed graft function (DGF). During the diagnostic work-up, primary hyperoxaluria type 1 (PH1) was diagnosed. A biopsy of the transplanted kidney also revealed microvascular inflammation (MVI). The patient was treated with fluid therapy, a restrictive diet, pyridoxine and, initially, intensive haemodialysis. Given the identification of a genetic variant of the disease that responds well to pyridoxine treatment, and considering the exceedingly high cost of lumasiran therapy, this medication was not utilized. In addition, it was decided to administer methylprednisolone pulses, plasmapheresis and immunoglobulin infusions in response to MVI. This treatment resulted in improvements in both clinical and laboratory parameters. Conclusions: PH1 is a rare cause of calcium oxalate nephrolithiasis and nephrocalcinosis and should be considered in the differential diagnosis of patients with progressive renal failure. This case highlights the importance of early diagnosis, which allows optimal supportive and/or RNAi therapy and appropriate qualification for kidney transplantation in cases of end-stage kidney disease. This is particularly important as isolated kidney transplantation (without concomitant liver transplantation) can lead to rapid loss of graft function and may ultimately prove futile.</p>","PeriodicalId":17813,"journal":{"name":"Kidney & blood pressure research","volume":" ","pages":"1-9"},"PeriodicalIF":2.1,"publicationDate":"2025-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary aldosteronism results in a decline estimated glomerular filtration rate independent of blood pressure: A Case-Control Study.","authors":"Mingjie Xu, Yushuang Wei, Mingli Li, Boteng Yan, Xihui Jin, Xiaoyou Mai, Lingyu Ye, Shengzhu Huang, Chaoyan Tang, Zengnan Mo","doi":"10.1159/000547760","DOIUrl":"https://doi.org/10.1159/000547760","url":null,"abstract":"<p><strong>Background: </strong>Primary aldosteronism (PA) is the predominant cause of secondary hypertension, leading to cardiovascular and renal damage. However, current epidemiology findings on the association between PA and estimated glomerular filtration rate (eGFR) remain inconsistent.</p><p><strong>Methods: </strong>A 1:1 gender- and age-matched case-control study was conducted among participants with PA, essential hypertension (EH), and normotension, with 204 participants in each group. Multiple linear regression was used to explore the correlations of PA with eGFR. Subgroup analyses were conducted to examine variations in the PA-eGFR association. Mediation analysis was performed to explore the role of inflammatory markers in this relationship.</p><p><strong>Results: </strong>Compared to the EH group, the PA group showed no significant differences in systolic blood pressure (SBP), diastolic blood pressure (DBP), or eGFR, but exhibited significantly higher levels of plasma aldosterone concentration (PAC) and aldosterone-to-renin ratio (ARR), along with lower plasma renin concentration (PRC) levels. PA was associated with a decline in eGFR after adjusted potential confounders. When stratified the PA patients into three groups according to the levels of PAC, PRC and ARR, patients in the highest PAC groups, the lowest PRC group, and the highest ARR group had much lower eGFR compared to the EH group. The inverse associations mentioned above remained significant even further adjusted for SBP or DBP, respectively. Age (β = -0.422, [95% CI: -1.28, -0.606], P<0.001), PRA (β = -0.225, [95% CI: -0.035, -0.006], P=0.005), and uric acid (UA) (β = -0.285, [95% CI: -0.035, -0.006], P<0.001) were inversely associated with eGFR (P < 0.05) in PA patients. lymphocyte-to-monocyte ratio (LMR) attributed a proportion of 7.62% for the total effect.</p><p><strong>Conclusion: </strong>Our study indicates that PA is associated with lower eGFR independent of blood pressure, and the adverse effects might be greater than negative controls or EH patients. Inflammation could be a potential mediator of this detrimental effect. In PA, elevated uric acid may promote crystal formation and glomerular obstruction, contributing to renal dysfunction.</p>","PeriodicalId":17813,"journal":{"name":"Kidney & blood pressure research","volume":" ","pages":"1-21"},"PeriodicalIF":2.1,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144835433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term Impact of Alpha-blockers on Renal Function - A Systematic Review and Meta-analysis.","authors":"Zdeněk Ramík, Martin Modrák, Tomáš Kvapil, Libor Jelínek, Martin Drápela, Zdeněk Lys, Bronislav Čapek, Dalibor Musil, Tomáš Veiser, Jan Václavík","doi":"10.1159/000547273","DOIUrl":"https://doi.org/10.1159/000547273","url":null,"abstract":"<p><strong>Introduction: </strong>Alpha-blockers are considered an additional option when the major antihypertensive drug classes are insufficient in reducing blood pressure. While the impact of alpha-blockers on blood pressure control seems comparable, data evaluating their effects on renal outcomes are lacking. This systematic review and meta-analysis assess the impact on renal function from a medium to long-term perspective.</p><p><strong>Methods: </strong>A search and analysis according to the PRISMA statement across Medline, the Web of Science, and ScienceDirect was conducted, covering articles in English on adult populations without time restrictions to December 14, 2023, including all types of studies with a minimum follow-up of 12 weeks.</p><p><strong>Results: </strong>Seventeen studies were included in the review, encompassing a total of 26,170 patients treated with alpha-blockers. Most studies were performed in the 20th century and often lacked an adequate number of participants and sufficient follow-up duration. Bayesian meta-analysis showed neutral effects of alpha-blockers on eGFR and serum creatinine, comparable with those of other antihypertensive agents. Compared with baseline, the data suggests an overall small but clinically unimportant increase in creatinine clearance in patients treated with alpha-blockers (95% credible interval: 1.61 to 9.97 ml/min/1.73 m2).</p><p><strong>Conclusion: </strong>A significant dearth of evidence concerning the long-term impact of alpha-blockers on renal function was revealed. The available evidence suggests that alpha-blockers have a neutral or non-inferior effect on renal function in comparison with other antihypertensive agents. Further research is needed to evaluate the role of alpha-blockers and their impact on preserving renal function.</p>","PeriodicalId":17813,"journal":{"name":"Kidney & blood pressure research","volume":" ","pages":"1-27"},"PeriodicalIF":2.1,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urine pH and urine ammonium as biomarkers in kidney disease.","authors":"Gheun-Ho Kim, Jin Suk Han","doi":"10.1159/000547775","DOIUrl":"https://doi.org/10.1159/000547775","url":null,"abstract":"<p><strong>Background: </strong>Urinary acidification is a crucial aspect of kidney tubular function that helps maintain the body's acid-base balance. The primary component of net acid excretion is ammonium (NH4+), which is formed when hydrogen ions (H+) secreted from the tubule combine with the major urinary buffer, ammonia (NH3). Consequently, both H+ and NH3 influence urine NH4+ excretion. While urine NH4+ is the standard measure of renal acid excretion, urine pH is also valuable for assessing urinary acidification, as it reflects the extent of H+ secretion from the collecting duct. Urine pH can be accurately measured using a pH meter, and urine NH4+ can be quantified through an enzymatic method adapted from plasma ammonia assays.</p><p><strong>Summary: </strong>A low urinary NH4+ excretion < 40 mmol/day is a hallmark of renal tubular acidosis (RTA) and is essential for excluding non-renal causes of hyperchloremic metabolic acidosis. Urine pH is valuable in the differential diagnosis of RTA; Type 1 distal RTA is characterized by a urine pH > 5.3, while Type 4 RTA is characterized by a urine pH < 5.3. In Type 2 proximal RTA, urine pH is variable and depends on the serum HCO3- level. Low urine NH4+ levels in patients with chronic kidney disease (CKD) may indicate that acid is retained in the kidneys, leading to tubulointerstitial inflammation and fibrosis. A post-hoc analysis of the AASK trial found that low urinary NH4+ excretion < 20 mmol/day was associated with end-stage kidney disease (ESKD) even before metabolic acidosis developed. In the NephroTest cohort, lower tertile urinary NH4+ excretion was linked to ESKD during a median follow-up of 4.3 years. Typically, CKD patients exhibit acidic urine pH, indicative of renal acid retention. A Japanese observational study found that lower urine pH was associated with the incidence of CKD. When urine pH was considered alongside urine NH4+, the prognostic value for CKD progression was significantly enhanced.</p><p><strong>Key messages: </strong>Urine pH serves as a valuable tool for the differential diagnosis of RTA, but direct measurement of urine NH4+ is essential. In CKD, low urine NH4+ levels may indicate a diminished capacity for acid excretion causing systemic acid retention, which can contribute to the progression of CKD. Additionally, the low urine pH observed in CKD reflects renal acid retention and may be associated with both incident and prevalent CKD. The integration of urine pH and NH4+ measurements would enhance the predictability of CKD progression.</p>","PeriodicalId":17813,"journal":{"name":"Kidney & blood pressure research","volume":" ","pages":"1-22"},"PeriodicalIF":2.1,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144784567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive performance correlated with hemoglobin level in patients with chronic kidney disease: a data analysis from the National Health and Nutrition Examination Survey (NHANES) 2011- 2014.","authors":"Linpei Jia, Lixiao Hao, Hong-Liang Zhang","doi":"10.1159/000547517","DOIUrl":"10.1159/000547517","url":null,"abstract":"<p><strong>Introduction: </strong>Given the increased incidence of renal anemia and cognitive dysfunction in patients with chronic kidney disease (CKD), the association between hemoglobin levels and cognitive function in these patients remains elucidated. An optimal level of hemoglobin for the best cognitive performance in CKD has yet to be determined.</p><p><strong>Methods: </strong>A retrospective cross-sectional study was conducted using data from 2011-2014 of the National Health and Nutrition Examination Survey (NHANES). Enrolled subjects for analysis were divided into the CKD and the non-CKD groups. The Animal Fluency Test (AF), Digit Symbol Substitution Test (DSST), Consortium to Establish a Registry for Alzheimer's Disease Word Learning Test (CERAD-WL) and Word List Recall Test (CERAD-DR) were used to evaluate cognitive performances. We quantified the association between hemoglobin levels and cognitive function in patients with CKD and non-CKD subjects by using the logistic regression analysis. Plotted curves and inflection points were calculated by a recursive algorithm.</p><p><strong>Results: </strong>The ratio of cognitive impairment was higher in the CKD group than in the non-CKD group. Hemoglobin levels were correlated with CERAD-DR and DSST in patients with CKD. For non-CKD subjects, the hemoglobin level was not correlated with any test results. The potential range of the hemoglobin level was 11.0 - 12.7 mg/dL for keeping better cognitive performance of patients with CKD.</p><p><strong>Conclusion: </strong>Hemoglobin levels are associated with cognitive performance in patients with CKD. The treatment of renal anemia would be meaningful to reduce cognitive impairment in CKD.</p>","PeriodicalId":17813,"journal":{"name":"Kidney & blood pressure research","volume":" ","pages":"1-26"},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144775766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting long-term kidney graft failure using novel multi-omic blood-based biomarkers and artificial intelligence tools.","authors":"Krzysztof Batko, Jolanta Małyszko, Anna Sączek, Katarzyna Sobczyńska, Jacek A Małyszko, Marcin Krzanowski, Marcelo Cantarovich, Katarzyna Krzanowska","doi":"10.1159/000547039","DOIUrl":"10.1159/000547039","url":null,"abstract":"<p><p>Kidney transplantation (KT) remains the preferred treatment for end-stage renal disease. With advancements in immunosuppressive regimens and KT surveillance, graft survival has improved, though mainly in short-term. Meanwhile, aging populations with multimorbidity and expanding donor criteria shape a new landscape for KT management. Numerous prediction tools, including genomic, transcriptomic and/or proteomic panels or biomarkers, have been developed for short-to-interim outcomes, yet variable outcome definitions, modest samples and limited external replication preclude clinical utility. The temporal nature of association strength for graft failure risk factors reflects changes in underlying pathomechanisms and underscores the need for extensive validation. Chronic allograft rejection is a progressive process intertwined with variable T cell and antibody-mediated rejection patterns. On a molecular level, both innate and adaptive immune cells interface within the local graft microenvironment and release donor cell products (eg, exosomes, peptides, apoptotic bodies) that prime both T and B cell, but also IFNγ driven NK cell-mediated responses. Complement and Ig deposits along capillary lining lead to activated endothelium that promotes immune cell influx and aberrant differentiation patterns. Under cytokine and growth factor stimulation, mesenchymal transition of graft epithelial cells leads to altered extracellular turnover and TGFβ-mediated fibrosis. These mechanistic processes remain incompletely understood but represent a biologically plausible source for urine/blood biomarkers and omic profiling. Artifical intelligence and machine-learning tools provides a promise for elucidating the nature of these mechanisms due to their ability to capture non-linear trends and complex interactions. However, early efforts still remain unsatisfactory as the data demand increases, with concomitant requirements for high feature quality and sample representativeness.</p>","PeriodicalId":17813,"journal":{"name":"Kidney & blood pressure research","volume":" ","pages":"1-19"},"PeriodicalIF":2.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cystinuria: a genetic and molecular view. What is known about animal models and cells.","authors":"Iris Iuliano, Anna Iervolino, Yoko Suzumoto, Abbas Shams, Consiglia Longobardi, Giovambattista Capasso, Alessandra F Perna, Giovanna Capolongo","doi":"10.1159/000547038","DOIUrl":"https://doi.org/10.1159/000547038","url":null,"abstract":"<p><strong>Background: </strong>Cystinuria is a rare genetic tubulopathy caused by mutations on SLC7A9 and SLC3A1 genes encoding for the apical membrane rBAT/b0,+AT transporter. The mean worldwide frequency of cystinuria is estimated to be 1:7000 with significant ethnogeographic variation in prevalence. Cystine builds up in the urine as a result of the transporter deficit, which can cause cystine crystals to form or even stones. Several strategies must be used in treatment to stop the growth or creation of stones. Although the prognosis is favorable, renal insufficiency can very rarely be brought on by poor patient compliance, stone formation recurrence and subsequent interventions.</p><p><strong>Summary: </strong>All the identified mutations of these genes to be responsible for the genotype have been reported, many aspects of the disease phenotype are yet unclear and need to be elucidated. The molecular mechanism of the rBAT/b0,+AT is described under both physiological and pathological conditions. Its dysfunction in cystinuria leads to the accumulation of cystine and subsequent stone formation, which is detailed through the steps involved in stone development. In vitro studies using different cell lines enable to identify potential methodologies for generating cellular models of cystinuria and to assess therapeutic approaches. In vivo studies done on mice and rats have created different models of cystinuria, including types A, B, and AB, to find the best way to make a model that closely resembles human cystinuria.</p><p><strong>Key message: </strong>To turn the light on the disease progression and potential treatments, we outlined and carefully examined some of the animal and cellular models of cystinuria.</p>","PeriodicalId":17813,"journal":{"name":"Kidney & blood pressure research","volume":" ","pages":"1-16"},"PeriodicalIF":2.3,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relation of Serum Creatinine Twitches and Outcomes among STEMI Patients.","authors":"Shir Frydman, Ophir Freund, Lior Zornitzki, Nevo Barel, Shmuel Banai, Yacov Shacham","doi":"10.1159/000545523","DOIUrl":"https://doi.org/10.1159/000545523","url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury (AKI) is notoriously associated with adverse outcomes and mortality in patients with acute coronary syndrome. However, using the general cutoff of 0.3 mg/dL increase from baseline for AKI definition and neglecting smaller changes could result in late diagnosis and impaired prognostication. We aimed to assess the prognostic utility of minor creatinine changes (\"twitches\") in a large cohort of ST-segment-elevation myocardial infraction (STEMI) patients and determine an optimal cutoff value for future use.</p><p><strong>Methods: </strong>This retrospective analysis of a prospective database included 2933 consecutive patients admitted with STEMI between 2008-2022 to the cardiac intensive care unit of a large tertiary medical center. Renal function was assessed upon admission and at-least once daily thereafter. Creatinine twitches were defined as a change from baseline to peak creatinine level of between 0.1 to 0.3 mg/dl. 30-day and 1-year mortality were the main outcomes.</p><p><strong>Results: </strong>From the study cohort (mean age 62 ±13, 19% female, 16% with prior MI), 551 (19%) subjects presented creatinine twitches and 254 (9%) developed AKI. Compared to subjects with stable creatinine, those with creatinine twitches had higher rates of 30-day (1% vs. 2.5%, p<0.001) and 1-year (1.6% vs. 4.4%, p<0.001) mortality. In cox multivariate analysis, creatinine twitches had a higher hazard for 1-year mortality (HR 1.87, 95% CI 1.1-3.2) and only a trend for 30-day mortality (HR 1.52, 95% CI 0.96-2.96). Creatinine rise had an area under the curve of 0.780 (95% CI 0.73-0.83) for 1-year mortality prediction, and 0.12 mg/dl was the optimal cutoff for prediction, with a sensitivity of 71%, specificity of 79%. In sub-group multivariate analysis, only twitches that did not resolve during hospitalization had higher hazard for mortality (HR 3.42, 95% CI 1.65-7.05).</p><p><strong>Conclusion: </strong>Serum creatinine twitches are common among STEMI patients and correlate with elevated 30 days and 1-year mortality. These seemingly minor changes should prompt renal protective strategies for early detection and treatment.</p>","PeriodicalId":17813,"journal":{"name":"Kidney & blood pressure research","volume":" ","pages":"1-20"},"PeriodicalIF":2.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143764235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of renal artery stenosis on renovascular hypertension and the therapeutic role of renal artery stenting: a comprehensive review.","authors":"Changgang Shao, Guoqing Chi, Fang Li, Hongcheng Ren, Liyan Zhang, Jinming Yang, Bin Wang, Mingchao Ding","doi":"10.1159/000545135","DOIUrl":"https://doi.org/10.1159/000545135","url":null,"abstract":"<p><p>Background Renal artery stenosis (RAS) is characterized by reduced renal perfusion, activating the renin-angiotensin-aldosterone system (RAAS), which can lead to secondary hypertension, ischemic nephropathy, and cardiac destabilization syndrome. These conditions have significant healthcare implications. Renovascular hypertension (RVH) in RAS patients can be managed through medical therapy and revascularization, either endovascular or surgical. While renal artery stenting (RAS) was once viewed as the most effective treatment for atherosclerotic renovascular disease, recent trials suggest no significant difference in RVH management between medical therapy alone and combined with renal artery stenting. However, certain subgroups have exhibited favorable outcomes in blood pressure control post-stenting. Summary This comprehensive review synthesizes data, including findings from the HERCULES trial, which showed a reduction in blood pressure from 162.3±18.5/77.7±11.5 mmHg to 145.7±20.7/75.4±11.0 mmHg over 36 months (P<0.0001). Additionally, the ASPIRE-2 study demonstrated significant decreases in blood pressures from 168±25/82±13 mmHg to 149±25/77±12 mmHg at 24 months (P<0.001). The review delves into the prevalence, pathophysiology, clinical manifestations, diagnosis, and treatment of RAS-related RVH, specifically analyzing the efficacy and safety of renal artery stenting. Key Messages The analysis indicates that renal artery stenting may be particularly advantageous for certain patient subgroups, enhancing blood pressure outcomes and overall clinical status. Nevertheless, the criteria for selecting candidates for this intervention remain under debate. Future research should focus on high-risk RAS patients to explore long-term benefits and refine the utilization of renal artery stents, ultimately improving RVH management.</p>","PeriodicalId":17813,"journal":{"name":"Kidney & blood pressure research","volume":" ","pages":"1-15"},"PeriodicalIF":2.3,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Interplay of Factors in Chronic Kidney Disease: Insights from The Malaysian Cohort Study.","authors":"Noraidatulakma Abdullah, Norfazilah Ahmad, Azmawati Mohammed Nawi, Mohd Rohaizat Hassan, Ying-Xian Goh, Norliza Ismail, Nazihah Abd Jalal, Raihannah Othman, Azwa Shawani Kamalul Arifin, Mohd Arman Kamaruddin, Rahman Jamal","doi":"10.1159/000542732","DOIUrl":"10.1159/000542732","url":null,"abstract":"<p><strong>Introduction: </strong>There is an increasing prevalence of chronic kidney disease (CKD) in Malaysia; hence, identifying factors associated with the early stage of CKD is crucial for preventive measures. This study investigated the association between various factors and their interaction in a multi-ethnic Malaysian cohort.</p><p><strong>Methods: </strong>A nested case-control analysis was conducted on 3,160 eligible participants with renal profile data from The Malaysian Cohort project. CKD status was determined by estimated glomerular filtration rate using the Chronic Kidney Disease Epidemiology Collaboration equation. Multiple logistic regression analysis using the likelihood ratio method was used to identify the factors and their interaction with CKD.</p><p><strong>Results: </strong>This study suggested five factors associated with CKD: gender, ethnicity, physical activity, atherogenic plasma index (AIP), and systolic blood pressure. There was an interaction between AIP and gender, with increased odds of CKD among men with high AIP.</p><p><strong>Conclusions: </strong>As CKD is mainly asymptomatic until it is in the later stages, these five factors serve as valuable tools for predicting CKD and enhancing the identification of at-risk individuals, particularly among men with elevated AIP. Future studies should focus on using these factors, especially in preventing new CKD cases and their progression.</p>","PeriodicalId":17813,"journal":{"name":"Kidney & blood pressure research","volume":" ","pages":"210-220"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}