Kidney & blood pressure research最新文献

{"title":"Drugs to Slow Progression of Chronic Kidney Disease: It Is a Whole New World!","authors":"Jennifer A Schoonmaker, Bhavna Bhasin-Chhabra, Adam Abow Alkhier, Sundararaman Swaminathan, Musab S Hommos","doi":"10.1159/000552776","DOIUrl":"10.1159/000552776","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease (CKD) affects approximately 14% of adults in the USA and about 10% worldwide and remains a major public health concern. Diabetes and hypertension are the leading causes of CKD and contribute to progressive nephron loss through disturbances in glomerular hemodynamics and filtration barrier, tubular and vascular function, and pathways of inflammation and fibrosis.</p><p><strong>Summary: </strong>Over the past 2 decades, an expanding set of therapeutic interventions has been developed that target key mechanisms of CKD progression. Renin-angiotensin-aldosterone system (RAAS) blockers remain foundational and are now complemented by sodium-glucose cotransporter-2 inhibitors (SGLT2i), non-steroidal mineralocorticoid receptor antagonists, glucagon-like peptide-1 receptor agonists (GLP-1 RAs), and emerging therapies including endothelin receptor antagonists and angiotensin receptor-neprilysin inhibitors. These agents act across multiple renal compartments to reduce hyperfiltration, proteinuria, inflammation, and fibrosis.</p><p><strong>Key messages: </strong>This review outlines a unified framework of CKD pathophysiology, summarizes disease-specific mechanisms in diabetic and hypertensive kidney disease, and integrates mechanistic and clinical evidence for current and emerging therapies. It also provides a structured approach to combination therapy, highlighting how complementary mechanisms can be leveraged to slow CKD progression and improve kidney and cardiovascular outcomes.</p>","PeriodicalId":17813,"journal":{"name":"Kidney & blood pressure research","volume":" ","pages":"530-541"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148218328","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":"A Comprehensive Report on the Self-Reported Chronic Kidney Disease Patients in the NHANES Cross-Sectional Cohort from 2001 to 2020.","authors":"Muhammad Sohaib Asghar, Muhammad Nadeem Ahsan, Sadia Iqbal, Afsana Ansari Shaik, Maria Duharte, Mohammed Mahmmoud Fadelallah Eljack, Moustafa Hegazi, Chad K Brands","doi":"10.1159/000551875","DOIUrl":"10.1159/000551875","url":null,"abstract":"<p><strong>Background: </strong>This study was a comprehensive review of the Centers for Disease Control and Prevention (CDC) National Health and Nutrition Examination (NHANES) databases. The primary objectives were to ascertain patterns of demographic and clinical data among chronic kidney disease (CKD) and dialysis patients.</p><p><strong>Methods: </strong>This study examines participants from the CDC NHANES database to identify the population diagnosed with CKD or dialysis patients from 2001 to 2020. The total cohort of 51,743 patients were included in each group; i.e., CKD group included 1,509 patients (out of which 173 patients have received dialysis in the past 12 months), while non-CKD group included 50,234 patients. Exclusion criteria included age >85 years (n = 624), pregnancy (n = 1,375), and history of malignancy (n = 5,575). Logistic regression was performed to identify conditions that were more frequently observed with CKD and those on dialysis with reported odds ratios (ORs). Receiver operating characteristic analysis was used to calculate diagnostic accuracies of different cut-offs for urinary albumin-to-creatinine ratio (UACR).</p><p><strong>Results: </strong>The mean age of study participants (n = 51,743) was 48.50 ± 17.43 years. Age was significantly higher in CKD group, but there was no difference in dialysis versus nondialysis patients (p = 0.833). There was no gender predisposition in CKD patients; however, males were more likely to undergo dialysis with 13.3% vs. 9.8% in females (p = 0.032). Among racial differences, non-Hispanic Whites were predominantly affected by CKD (37.0%) followed by non-Hispanic Blacks (29.3%), but non-Hispanic Blacks are mostly undergoing dialysis (48.6% vs. 17.3%). BMI (kg/m2) was significantly higher in CKD group (p < 0.001), but lower in dialysis group (p = 0.039). Among urinary complaints, history of kidney stones was prevalent in CKD patients (7.7% vs. 2.6%, p < 0.001). Frequent coexisting comorbidities were congestive heart failure (OR: 9.8), diabetes (OR: 5.4), coronary artery disease (OR: 5.0), and hypertension (OR: 4.7). UACR (>30 mg/g) is able to categorize CKD patients (AUC: 0.73), at a sensitivity of 44.9% and a specificity of 88.8%.</p><p><strong>Conclusion: </strong>Certain clinical factors were identified as highly associated with CKD, as disseminated by the NHANES database findings. These findings emphasize the need for targeted interventions to address CKD disparities and inform public health strategies.</p>","PeriodicalId":17813,"journal":{"name":"Kidney & blood pressure research","volume":" ","pages":"354-363"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13262993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147619020","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":"Prognostic Value of Claims Data for Chronic Kidney Disease-Associated Health Risks.","authors":"Sebastian Schwab, Volquart Stoy, Olga Dortmann, Janika Raudzus, Thomas Mayrhofer, Sibylle von Vietinghoff","doi":"10.1159/000553419","DOIUrl":"10.1159/000553419","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease (CKD) associates with kidney failure and overall health risks. We here investigated the prognostic value of claims data in the absence of biochemical data.</p><p><strong>Methods: </strong>A total of 29,144 persons insured at AOK Rhineland-Hamburg with a diagnosis of CKDIII or CKDIV in 2016 were included in analyses of renal replacement therapy (rRT), death, hospital admissions and diagnoses, and prescription of CKD-related therapies during the ensuing 6-year period (2017-2022) using corresponding billing codes.</p><p><strong>Results: </strong>In 22,228 individuals diagnosed with CKDIII and 6,916 with CKDIV during the base year, rRT was prescribed in 3.8% and 14.3% during the observation period; 7.0% and 13.3% were admitted to the hospital for acute kidney injury (AKI). A combination of claims data significantly contributed to the prognosis of rRT (AUC 0.87) and AKI (AUC 0.68) and overall outcomes, death (AUC 0.97), hospital admission for heart failure (AUC 0.76), and intensive care unit (ICU) therapy (AUC 0.67). All AUCs significantly improved after inclusion of CKD stage into the model. Outpatient prescriptions of renin-angiotensin system and sodium-glucose cotransporter 2 (SGLT2) inhibitors are associated with significantly better renal and cardiovascular outcomes. Prescription of CKD-related pharmacotherapy for calcium metabolism (AUC 0.74), hyperkalemia/hyperphosphatemia (AUC 0.83), metabolic acidosis (AUC 0.81), erythropoiesis-stimulating agents (AUC 0.65), and hyperuricemia therapy (AUC 0.72) was prognosticated by claims data with significant contribution of CKD stage.</p><p><strong>Summary and conclusion: </strong>Claims data provide prognostic information for renal and overall outcomes in CKDIII and CKDIV patients even in the absence of laboratory measurements. Inclusion of additional values should be evaluated in patients with and without CKD for individualized risk calibration.</p>","PeriodicalId":17813,"journal":{"name":"Kidney & blood pressure research","volume":" ","pages":"798-812"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13592793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148592323","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":"A Multi-National Survey on Immunosuppressive Regimens and Mycophenolate Monitoring Practices after Kidney Transplantation.","authors":"Sonia Sharma, Joshua Kausman, Simon Craig, David Metz","doi":"10.1159/000549997","DOIUrl":"10.1159/000549997","url":null,"abstract":"<p><strong>Background: </strong>Kidney transplantation (KT) offers substantial improvements in both survival and quality of life compared to dialysis in patients with end-stage kidney disease. However, the success of KT is critically dependent on effective immunosuppression. There has been improvement in short-term graft survival outcomes, but chronic rejection and cumulative drug toxicities continue to present significant challenges. Regarding immunosuppression monitoring strategies, calcineurin inhibitor trough concentrations is a standard practice, but for the mycophenolate mofetil (MMF), fixed dosing remains widespread despite considerable evidence supporting for dose optimization based on mycophenolic acid (MPA) area under the curve (AUC) monitoring. To elucidate current immunosuppressive practices and mycophenolate dosing strategies, we conducted a survey of multiple transplant centres in India, Australia, and New Zealand.</p><p><strong>Methods: </strong>An internet-based questionnaire was sent via professional societies and direct correspondence to practitioners across Australia, New Zealand and India.</p><p><strong>Results: </strong>We received responses from 142 centres across the three regions. Most respondents (90%) reported use of antibody induction therapy in standard risk recipients. Maintenance immunosuppression overwhelmingly involved \"triple therapy\" with tacrolimus (98%), mycophenolate (78% as MMF), long-term corticosteroid continuation (96%). Overall, 78% never used MPA concentrations to guide management, though with geographic differences: 90% of respondents from India reported never measuring MPA, compared to only 32% from Australia and New Zealand (p < 0.001). Major reasons for not measuring MPA were difficulty in attaining MPA concentrations (56%), cost (33%), and uncertainty around techniques to assess exposure and concentration targets (36%). Only a minority (11%) of respondents questioned the clinical value of monitoring in clinical care.</p><p><strong>Conclusion: </strong>Across distinct geographic regions, immunosuppression regimen including tacrolimus, MMF, and long-term corticosteroids in standard risk kidney transplant recipients was homogenous. MPA concentration measurement to guide therapy is rarely used in India, though not uncommon across Australia and New Zealand at least in specific circumstances. Overcoming practical barriers and ensuring accessible clinical guidance may provide opportunities to improve the uptake of MPA monitoring.</p>","PeriodicalId":17813,"journal":{"name":"Kidney & blood pressure research","volume":" ","pages":"27-35"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12810970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145743237","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":"Embracing Good Practices of Confirmatory Studies.","authors":"Pedro Henrique Imenez Silva, Min Jun, Miriam Zacchia, Francesco Trepiccione, Giovambattista Capasso","doi":"10.1159/000551239","DOIUrl":"10.1159/000551239","url":null,"abstract":"","PeriodicalId":17813,"journal":{"name":"Kidney & blood pressure research","volume":" ","pages":"243-244"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13155730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147390164","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":"Ascitic Fluid Drainage before Dialysis Catheter Removal for Peritoneal Dialysis-Related Peritonitis.","authors":"Chih-Yuan Lee, Yen-Ya Chen, Jenq-Wen Huang, Chien-Chia Chen, Meng-Kun Tsai","doi":"10.1159/000553461","DOIUrl":"10.1159/000553461","url":null,"abstract":"<p><strong>Introduction: </strong>Persistent ascites requiring drainage following catheter removal because of peritoneal dialysis (PD)-related peritonitis is a common complication associated with prolonged hospitalization and increased mortality. To mitigate this risk, a free drainage protocol was introduced before catheter removal. This study evaluated its impact on post-removal paracentesis incidence.</p><p><strong>Methods: </strong>This study retrospectively reviewed patients who underwent catheter removal because of refractory PD-related peritonitis between January 2009 and December 2021. Before 2015, 47 patients underwent catheter removal and were transitioned to hemodialysis without prior ascitic drainage. After 2015, 70 patients were transitioned to hemodialysis following free drainage of ascitic fluid before catheter removal.</p><p><strong>Results: </strong>Among 117 patients who underwent catheter removal, 98 recovered uneventfully, whereas 19 patients (16.24%) developed drainage-requiring ascites. Patients in the free drainage group (n = 70) had reduced need for paracentesis (8.57% vs. 27.66%, p = 0.01) and a lower incidence of PD-related complications (15.71% vs. 42.55%, p = 0.002) compared with those who did not undergo free drainage. Further multivariate analysis revealed free drainage and fungal infection as significant factors for post-removal paracentesis.</p><p><strong>Conclusions: </strong>Pre-removal free drainage of ascitic fluid is a safe and potentially beneficial approach in patients requiring PD catheter removal because of peritonitis. Implementing this strategy may reduce the incidence of drainage-requiring ascites post-removal, thereby improving patient outcomes.</p>","PeriodicalId":17813,"journal":{"name":"Kidney & blood pressure research","volume":" ","pages":"695-704"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13466441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148405130","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":"Clinical Profile and Outcome of C3-Dominant Glomerulonephritis: Retrospective Study.","authors":"Vishrut Khullar, Attur Ravindra Prabhu, Shankar Prasad Nagaraju, Dharshan Rangaswamy, Indu Ramachandra Rao, Srinivas Vinayak Shenoy, Mohan V Bhojaraja, Gaurvi Piplani, Mahesha Vankalakunti","doi":"10.1159/000550422","DOIUrl":"10.1159/000550422","url":null,"abstract":"<p><strong>Background: </strong>Complement 3 (C3)-dominant glomerulonephritis (GN) are rare diseases resulting from alternative complement pathway dysregulation; they include C3 glomerulopathy (C3G), paraprotein-associated GN, and C3-dominant infection-related GN (IRGN). To our knowledge, long-term follow-up studies of clinical profile and outcomes of this rare disorder are sparse. We studied kidney histopathology baseline findings, outcomes, treatment, and its complications of C3-dominant GN in our setting.</p><p><strong>Objectives: </strong>We studied the clinical, pathological profiles, and outcomes of patients with C3-dominant GN.</p><p><strong>Methods: </strong>This study was a single centre, retrospective, case record based observational study at a tertiary care hospital in Southern India. Consecutive patients of C3-dominant GN on kidney biopsy from 2013 to 2023 were included. Demography, laboratory and histopathological data, treatment and outcomes were studied.</p><p><strong>Results: </strong>Of 2,175 kidney biopsies, 141 (6.48%) showed C3-dominant GN; 74 (52.5%) C3G, 67 (47.5%) IRGN. Median age was 43 years (IQR 29-59.5), males 90 (63.8%). Preceding skin/throat infections were seen in 32/141 (22.7%). At presentation, median serum creatinine was 1.7 mg/dL (IQR: 1.2-3.6), eGFR <60 mL/min/1.73 m2 in 91/141 (64.5%), 111/141 (78.7%) had low serum C3 levels. Nephrotic proteinuria was seen in 65/141 (46%), Crescents in 45 (31.9%). Remission was partial in 38/141 (27%), complete in 45/141 (31.9%) and 31/141 (22%) progressed to end-stage kidney disease (ESKD). On immunosuppression, commonest infection was pneumonia in 15/70 (21.4%) and 27/141 (19.1%) died at an average follow-up of 25.7 months. Diabetes mellitus, percentage sclerosis, and presence of crescents predicted development of CKD stage 5.</p><p><strong>Conclusion: </strong>Over 10 years, C3-dominant GN represented 6.48% of kidney biopsies. Nephrotic proteinuria and kidney failure are common at presentation with 58% achieving some remission, 22% going on to ESKD and mortality of 19%.</p>","PeriodicalId":17813,"journal":{"name":"Kidney & blood pressure research","volume":" ","pages":"91-100"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12912761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145959503","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":"Long Noncoding RNA MIR205HG Elevates FSTL1 Expression to Drive Calcium Oxalate Nephrolithiasis in vitro through Absorbing miR-5581-3p.","authors":"Min Zhou, Chuntao Chen, Zhenhai Zou, Fei Feng, Li Dong, Chuantao Hou, Mingxing Wang, Liangdong Zhao, Daojun Cao","doi":"10.1159/000552339","DOIUrl":"10.1159/000552339","url":null,"abstract":"<p><strong>Introduction: </strong>Nephrolithiasis is a clinical entity with long-term course, facing rising global prevalence and recurrence rates. Long noncoding RNAs (LncRNAs) have emerged as regulators implicated in the progression of nephrolithiasis, yet the functional role of lncRNA MIR205HG remains poorly characterized. Our research attempted to investigate the function of the lncRNA MIR205HG in calcium oxalate (CaOx) nephrolithiasis and focus on its in-depth competitive endogenous RNA regulatory network.</p><p><strong>Methods: </strong>MIR205HG expression in the Randall's plaque tissues of CaOx nephrolithiasis patients and calcium oxalate monohydrate (COM)-stimulated HK2 cells was examined with GSE117518 dataset from GEO database and Reverse Transcription-Quantitative PCR (RT-qPCR). Cell Counting Kit-8 and flow cytometry assays separately estimated cell viability and apoptosis. DCFH-DA probe and Western blotting measured oxidative stress mediators. RT-qPCR also tested miR-5581-3p and follistatin-like protein 1 (FSTL1) expressions. A targeting relationship among MIR205HG, miR-5581-3p and FSTL1 was determined using bioinformatics software and luciferase reporter assays. Besides, cellular morphology was observed and cell adhesion was detected. Western blotting assessed epithelial-mesenchymal transition (EMT) markers.</p><p><strong>Results: </strong>A total of 62 upregulated and 17 downregulated genes were identified. MIR205HG expression was elevated both in the Randall's plaque tissues of CaOx nephrolithiasis patients and COM-stimulated HK2 cells. MIR205HG silencing promoted the viability, inhibited the apoptosis, and ameliorated the oxidative stress in COM-induced HK2 cells. MIR205HG could sequester miR-5581-3p which directly targeted FSTL1. In addition to the impacts on FSTL1 expression, cell viability, apoptosis and oxidative stress, miR-5581-3p inhibitor could also restore the suppressive role of MIR205HG knockdown in the morphological changes, EMT and adhesion of COM-induced HK2 cells.</p><p><strong>Conclusion: </strong>Conclusively, lncRNA MIR205HG participated in the process of CaOx nephrolithiasis through mediating the miR-5581-3p/FSTL1 pathway.</p>","PeriodicalId":17813,"journal":{"name":"Kidney & blood pressure research","volume":" ","pages":"488-499"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13368025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147941853","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":"Estimated Pulse Wave Velocity for Cardiovascular Risk Assessment in Rural Populations: The ENAH Study.","authors":"Marija Domislović, Ana Jelaković, Vladimir Prelević, Danilo Radunović, Lana Gellineo, Krešimir Đapić, Mirjana Fuček, Josipa Josipović, Jelena Kos, Viktor Domislović, Ivan Pećin, Mirta Abramović Barić, Krunoslav Capak, Bojan Jelaković","doi":"10.1159/000552567","DOIUrl":"10.1159/000552567","url":null,"abstract":"<p><strong>Introduction: </strong>Arterial stiffness, typically measured by pulse wave velocity (PWV), is a recognized biomarker of cardiovascular (CV) risk and mortality. Our study assesses the predictive value of arterial stiffness measured by estimated pulse wave velocity (ePWV) for fatal and nonfatal outcomes in a general rural adult population.</p><p><strong>Methods: </strong>This prospective observational cohort study was conducted within the ENAH project, which initially included 3,305 adults, with 2,232 participants followed up over a median of 11.3 years. Baseline demographic, clinical, and laboratory data, including blood pressure, anthropometry, and biochemical analyses of blood and urine, were collected using standardized protocols. The primary outcome was all-cause mortality, while secondary outcomes comprised nonfatal CV, cerebrovascular, and renal events, analyzed using Kaplan-Meier survival curves and multivariable regression models.</p><p><strong>Results: </strong>In this cohort of 1,175 adults followed for a mean of 11.3 years, 263 participants died (22.4%), and 171 (14.5%) experienced a nonfatal event (myocardial infarction, atrial fibrillation, heart failure, stroke, transient ischemic attack, or dialysis). Kaplan-Meier analysis showed lower survival in participants with ePWV of >10 m/s compared to those with ePWV of <10 m/s (hazard ratio [HR] = 12.8, 95% CI 9.9-16.6, p < 0.001). Similarly, event-free survival was lower for nonfatal outcomes in the higher ePWV group (HR = 1.50, 95% CI 1.0-2.1, p = 0.008). In multivariable analysis for mortality, male sex and ePWV remained significant predictors (HR 1.75, 95% CI 1.18-2.61, p = 0.006; HR 1.81, 95% CI 1.08-3.04, p = 0.030). No independent predictors were found for nonfatal outcomes. However, for the composite endpoint, both male sex (HR = 1.54, 95% CI 1.14-2.08, p = 0.006) and ePWV (HR = 1.94, 95% CI 1.50-2.51, p < 0.001) were associated with increased risk.</p><p><strong>Conclusion: </strong>ePWV was an independent predictor of overall mortality as well as composite fatal and nonfatal outcomes. These findings suggest that this simple measure of arterial stiffness may be useful in clinical practice, particularly in rural settings where direct measurements are not available.</p>","PeriodicalId":17813,"journal":{"name":"Kidney & blood pressure research","volume":" ","pages":"637-647"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13432930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148265308","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":"Neutrophil Gelatinase-Associated Lipocalin for the Assessment of Persistent Renal Dysfunction after Acute Kidney Injury.","authors":"Shir Frydman, Ophir Freund, Lior Zornitzki, Yasmin Adam, Shmuel Banai, Yacov Shacham","doi":"10.1159/000551273","DOIUrl":"10.1159/000551273","url":null,"abstract":"<p><strong>Introduction: </strong>Renal injury is a significant complication in ST-segment elevation myocardial infarction (STEMI) and is associated with poor outcomes. The recently introduced term acute kidney disease (AKD) describes persistent renal dysfunction lasting 7-90 days post-acute kidney injury (AKI). Neutrophil gelatinase-associated lipocalin (NGAL), a biomarker for tubular injury, has shown promise in predicting AKI. This study aimed to evaluate NGAL's diagnostic utility for predicting AKD in STEMI patients.</p><p><strong>Methods: </strong>This prospective observational study included 312 patients admitted with STEMI. NGAL levels were measured within 2 h of admission. AKI and AKD were defined using KDIGO criteria, and patients with chronic inflammation or end-stage renal disease were excluded. Receiver operating characteristic (ROC) analysis was performed to evaluate NGAL's predictive value for AKD and its optimal value for prediction.</p><p><strong>Results: </strong>Overall, 64 patients developed AKI (21%), with 30 (47%) progressing to AKD. Patients with AKD had higher admission NGAL levels (median 165 ng/mL) compared to those with resolved AKI (112 ng/mL) or no AKI (88 ng/mL, p < 0.001). NGAL had a good predictive ability for AKD (area under the ROC of 0.784), with a threshold of >150 ng/mL having 65% sensitivity and 77% specificity for correct prediction. Multivariate analysis confirmed NGAL >150 ng/mL as an independent predictor of AKD (HR 6.4, 95% CI 1.94-21.06, p < 0.001)).</p><p><strong>Conclusion: </strong>Elevated NGAL levels are independently associated with AKD development in STEMI patients. These findings suggest NGAL could be a valuable biomarker for early risk stratification, supporting timely interventions to mitigate persistent renal injury. Further research is warranted to confirm its clinical utility.</p>","PeriodicalId":17813,"journal":{"name":"Kidney & blood pressure research","volume":" ","pages":"209-217"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13108941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147317290","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}