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Real-World Diagnostic Coding and Biomarker Testing for CKD Across Diabetes, Hypertension, and Cancer: A Multisite OMOP Study. 糖尿病、高血压和癌症慢性肾病的真实世界诊断编码和生物标志物检测:一项多位点OMOP研究
IF 3.6
Kidney360 Pub Date : 2026-10-12 DOI: 10.34067/KID.0000001367
Susan Ziolkowski, Sam Patnoe, Hannah Morgan-Cooper, Anna Ostropolets, Thomas Falconer, James M Luther, Jiang Bian, Hao Dai, Sharon M Moe, Paul Drawz
{"title":"Real-World Diagnostic Coding and Biomarker Testing for CKD Across Diabetes, Hypertension, and Cancer: A Multisite OMOP Study.","authors":"Susan Ziolkowski, Sam Patnoe, Hannah Morgan-Cooper, Anna Ostropolets, Thomas Falconer, James M Luther, Jiang Bian, Hao Dai, Sharon M Moe, Paul Drawz","doi":"10.34067/KID.0000001367","DOIUrl":"https://doi.org/10.34067/KID.0000001367","url":null,"abstract":"<p><strong>Background: </strong>The increasing prevalence of CKD necessitates standardized assessment of kidney function across various healthcare sites.1 Patients at risk, particularly those with diabetes, hypertension, or cancer, frequently do not receive recommended laboratory monitoring.2,3 This study assesses guideline recommended testing among various medical centers using the Observational Medical Outcomes Partnership (OMOP) common data model (CDM). The objectives are to report methodologies for extracting relevant measurements within OMOP and assess the frequency of specific biomarker evaluations and diagnosis codes in select cohorts.</p><p><strong>Methods: </strong>Retrospective cohort study of adult patients at 6 medical centers throughout the U.S. with a healthcare encounter to determine the frequency of diagnosis codes and biomarker measurements [eGFR, urine albumin-creatinine ratio (UACR), cystatin C, and aldosterone levels] among patients with relevant risk factors and probable CKD (sustained eGFR < 60 ml/min/1.73m2).</p><p><strong>Results: </strong>Among 9,212,799 patients with medical visits in 2024, 3% had a documented diagnosis of CKD, while 8% and 17% had a diagnosis of diabetes or hypertension, respectively. Also in 2024, only 47% of patients with probable CKD had a diagnosis code for CKD. Of the patients with diagnosed and probable CKD by eGFR, 25% had an UACR in 2024. Only 30% of patients with a diagnosis of diabetes, and 14% of patients with a diagnosis of hypertension had an UACR and eGFR in 2024. From 2021-2024, Cystatin C values were more common in patients with cancer compared to patients without cancer (1% vs 0.5%). The highest frequency of aldosterone testing (7%) was observed in patients with a diagnosis code for hypertension, serum potassium level <3 meq/L, eGFR> 60 ml/min/1.73m2, and albuminuria.</p><p><strong>Conclusions: </strong>This study demonstrates low frequency of guideline-recommended kidney health assessments and CKD diagnosis across multiple U.S. medical centers, including albuminuria, cystatin C, and aldosterone testing.</p>","PeriodicalId":17882,"journal":{"name":"Kidney360","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Urgent Start of Peritoneal Dialysis Versus Hemodialysis in Kidney Failure in Severe Metabolic Acidosis: A Prospective Study. 紧急开始腹膜透析与血液透析治疗严重代谢性酸中毒肾衰竭:一项前瞻性研究。
IF 3.6
Kidney360 Pub Date : 2026-10-09 DOI: 10.34067/KID.0000001377
Eduardo Mendoza-Gaitán, Jose J Zaragoza, Jeffrey Perl, Karla Y Vargas-Langarica, Jarumi A Tanaka-Gutiérrez, Alma I Martínez-Aguilar, Gerardo Martínez-Higuera, Gabriela Palomino-Navarrao, Gael Chávez-Alonso, Guillermo Navarro-Blackaller, Ramón Medina-González, Alejandro Martínez Gallardo-González, Luz Alcantar-Vallin, Juan A Gómez-Fregoso, Manuel Arizaga-Nápoles, Karina Renoirte-López, Gabriela Abundis-Mora, Guillermo García-García, Jonathan S Chávez-Iñiguez
{"title":"Urgent Start of Peritoneal Dialysis Versus Hemodialysis in Kidney Failure in Severe Metabolic Acidosis: A Prospective Study.","authors":"Eduardo Mendoza-Gaitán, Jose J Zaragoza, Jeffrey Perl, Karla Y Vargas-Langarica, Jarumi A Tanaka-Gutiérrez, Alma I Martínez-Aguilar, Gerardo Martínez-Higuera, Gabriela Palomino-Navarrao, Gael Chávez-Alonso, Guillermo Navarro-Blackaller, Ramón Medina-González, Alejandro Martínez Gallardo-González, Luz Alcantar-Vallin, Juan A Gómez-Fregoso, Manuel Arizaga-Nápoles, Karina Renoirte-López, Gabriela Abundis-Mora, Guillermo García-García, Jonathan S Chávez-Iñiguez","doi":"10.34067/KID.0000001377","DOIUrl":"https://doi.org/10.34067/KID.0000001377","url":null,"abstract":"<p><strong>Background: </strong>Severe metabolic acidosis is a life-threatening complication of kidney failure and a common indication for urgent KRT. Although hemodialysis (HD) is traditionally considered the preferred modality for rapid acid-base correction, comparative evidence with urgent-start peritoneal dialysis (PD) remains limited.</p><p><strong>Methods: </strong>We conducted a prospective cohort study including 68 consecutive dialysis-naïve patients with kidney failure and severe metabolic acidosis requiring urgent KRT at a tertiary referral center (HD n=31; PD n=37). Modality selection was based on nephrologist clinical judgment and resource availability. The primary outcome was the trajectory of pH and serum bicarbonate from admission to 48 hours and discharge, analyzed using mixed-effects regression models with inverse probability of treatment weighting (IPTW). Secondary outcomes included in-hospital mortality and technique survival.</p><p><strong>Results: </strong>Both modalities associated with improvement in acid-base parameters over time (p<0.001). Baseline bicarbonate levels were 7.6 mEq/L in HD and 12.1 mEq/L in PD (p=0.18), increasing to 16.6 and 18.2 mEq/L at discharge, respectively. No significant interaction between modality and time was observed for pH or bicarbonate trajectories in unadjusted or IPTW-adjusted analyses (interaction p>0.05). The magnitude of bicarbonate change was comparable between groups (Δ +9.0 vs. +6.1 mEq/L, p=0.12). In-hospital mortality (39% vs. 42%) and technique survival were also similar.</p><p><strong>Conclusions: </strong>In patients with kidney failure and severe metabolic acidosis requiring urgent KRT, urgent-start PD was associated with similar trajectories of acid-base correction and similar short-term clinical outcomes compared with HD, supporting PD as a safe and metabolically effective alternative in this setting.</p>","PeriodicalId":17882,"journal":{"name":"Kidney360","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149147518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
AMAP-APP: Efficient Segmentation and Morphometry Quantification of Fluorescent Microscopy Images of Podocytes. AMAP-APP:足细胞荧光显微图像的高效分割和形态计量定量。
IF 3.6
Kidney360 Pub Date : 2026-10-09 DOI: 10.34067/KID.0000001348
Arash Fatehi, David Unnersjö-Jess, Linus Butt, Noémie Moreau, Thomas Benzing, Katarzyna Bozek
{"title":"AMAP-APP: Efficient Segmentation and Morphometry Quantification of Fluorescent Microscopy Images of Podocytes.","authors":"Arash Fatehi, David Unnersjö-Jess, Linus Butt, Noémie Moreau, Thomas Benzing, Katarzyna Bozek","doi":"10.34067/KID.0000001348","DOIUrl":"https://doi.org/10.34067/KID.0000001348","url":null,"abstract":"<p><strong>Background: </strong>Automated quantification of podocyte foot process morphology is essential for unbiased, high-throughput analysis in kidney disease research. The previously established \"Automatic Morphological Analysis of Podocytes\" (AMAP) method allows for such analysis but is limited by high computational demands requiring high-performance computing systems, the lack of a user interface, and restriction to Linux operating systems. This study aimed to develop AMAP-APP, an optimized, cross-platform desktop application designed to overcome these hardware and usability barriers while maintaining analytical accuracy.</p><p><strong>Methods: </strong>AMAP-APP replaces the computationally intensive instance segmentation method of the original AMAP with efficient classic image processing algorithms while retaining the original semantic segmentation model. Additionally, a new Region of Interest algorithm was introduced to improve precision. The tool was validated using 175 mouse and 189 human super-resolution stimulated emission depletion (STED) and confocal microscopy images. Performance was evaluated by benchmarking execution times on consumer hardware. Agreement with the original AMAP was assessed using Pearson correlation, Lin's concordance correlation coefficient (CCC), Bland-Altman plots, and paired Two One-Sided T-tests (TOST) for equivalence at both the image and animal level.</p><p><strong>Results: </strong>AMAP-APP achieved an approximately 147-fold higher processing speed compared to the original GPU-accelerated AMAP. Morphometric quantifications (foot process area, perimeter, circularity, and slit diaphragm length density) demonstrated high agreement (Pearson r > 0.80 for all features and r > 0.90 for most, with comparably high Lin's CCC) and statistical equivalence to the original AMAP method across both mouse and human datasets (paired TOST P < 0.05 at both the image and animal level). Furthermore, the new ROI algorithm exhibited reduced deviation from manual delineations compared to the original AMAP ROI algorithm, enhancing the accuracy of slit diaphragm length density measurements.</p><p><strong>Conclusions: </strong>AMAP-APP provides substantially higher efficiency and accessibility for deep learning-based podocyte morphometry. By eliminating the need for high-performance computing clusters and providing a user-friendly interface for Windows, macOS, and Linux, it makes this analytical method broadly available for nephrology research.</p>","PeriodicalId":17882,"journal":{"name":"Kidney360","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149148084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
APOL1 Risk Genotypes and Sickle Cell Trait are Associated with Kidney Disease Progression in an Afro-Brazilian Population. APOL1风险基因型和镰状细胞性状与非裔巴西人肾脏疾病进展相关
IF 3.6
Kidney360 Pub Date : 2026-10-08 DOI: 10.34067/KID.0000001378
Dona Jeanne Alladagbin, Vitória Brito Fontoura Lima, Maria B Tavares, Tatiana Regia Suzana Amorim Boa Sorte, Nadia de A Khouri, Epitácio R da Luz Neto, Naiara R Dos Santos, Debora L Viana, Jean Tadeu Brito, Luciano Kalabric Silva, Adne Geisla Silva de Oliveira, Guilherme S Ribeiro, Carlos Gustavo Regis-Silva, Marilda S Gonçalves, Geraldo G S Oliveira, Washington L C Dos-Santos
{"title":"APOL1 Risk Genotypes and Sickle Cell Trait are Associated with Kidney Disease Progression in an Afro-Brazilian Population.","authors":"Dona Jeanne Alladagbin, Vitória Brito Fontoura Lima, Maria B Tavares, Tatiana Regia Suzana Amorim Boa Sorte, Nadia de A Khouri, Epitácio R da Luz Neto, Naiara R Dos Santos, Debora L Viana, Jean Tadeu Brito, Luciano Kalabric Silva, Adne Geisla Silva de Oliveira, Guilherme S Ribeiro, Carlos Gustavo Regis-Silva, Marilda S Gonçalves, Geraldo G S Oliveira, Washington L C Dos-Santos","doi":"10.34067/KID.0000001378","DOIUrl":"https://doi.org/10.34067/KID.0000001378","url":null,"abstract":"<p><strong>Background: </strong>Apolipoprotein L1 (APOL1) risk alleles and sickle cell trait (HbAS) are established risk factors for CKD, but their distribution and clinical impact in admixed populations remain incompletely defined. We conducted a Brazilian population-based study integrating APOL1 genotypes, sickle cell trait, kidney histopathology, and longitudinal clinical outcomes.</p><p><strong>Methods: </strong>We studied 889 newborns from a population-based survey and 424 patients with biopsy-proven kidney disease. APOL1 genotypes and hemoglobin variants were determined by PCR-based sequencing and high-performance liquid chromatography, and their associations with histopathologic chronicity markers and clinical outcomes were evaluated.</p><p><strong>Results: </strong>The prevalence of the APOL1 high-risk genotype was higher among patients than among the general population (4.7% vs. 1.2%; P < 0.001), whereas HbAS frequency was similar in both groups (4.7%). Among patients, the APOL1 high-risk genotype was associated with greater histopathologic chronicity, including increased tubular atrophy and interstitial fibrosis. A progressive increase in the frequency of progression to ESKD was observed in accordance with the number of APOL1 risk alleles (10%, 14%, and 56% for individuals carrying 0, 1, and 2 risk alleles, respectively; p < 0.001). Progression to ESKD was more frequent among individuals with sickle cell trait than among those with HbAA (39% vs. 13%; p = 0.01). Under univariate analysis, carrying two APOL1 alleles (RR = 4.8; 95% CI: 2.8, 8.4; p < 0.001) or possessing the sickle cell trait (RR = 2.7; 95% CI: 1.4, 5.1; p = 0.03) were significantly associated with the composite outcome of ESKD or death.</p><p><strong>Conclusions: </strong>In this Afro-Brazilian population, APOL1 high-risk genotypes were enriched among individuals with kidney disease, whereas sickle cell trait prevalence resembled that of the general population. Both APOL1 risk alleles and sickle cell trait were associated with adverse kidney outcomes, highlighting their clinical relevance in admixed populations.</p>","PeriodicalId":17882,"journal":{"name":"Kidney360","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Heavy Numbers: When Obesity Tips the Balance between Creatinine- and Cystatin C-Based eGFR. 当肥胖打破了肌酐和胱抑素c为基础的eGFR之间的平衡。
IF 3.6
Kidney360 Pub Date : 2026-10-08 DOI: 10.34067/KID.0000001392
Felix S Seibert, Maximilian Seidel, Jonas Franz Kolodziej, Adrian Doevelaar, Sebastian Bertram, Nina Babel, Timm H Westhoff
{"title":"Heavy Numbers: When Obesity Tips the Balance between Creatinine- and Cystatin C-Based eGFR.","authors":"Felix S Seibert, Maximilian Seidel, Jonas Franz Kolodziej, Adrian Doevelaar, Sebastian Bertram, Nina Babel, Timm H Westhoff","doi":"10.34067/KID.0000001392","DOIUrl":"https://doi.org/10.34067/KID.0000001392","url":null,"abstract":"<p><strong>Background: </strong>Obesity may distort eGFR because creatinine and cystatin C are influenced by non-GFR determinants. We quantified discordance between creatinine- and cystatin C-based eGFR across BMI strata and assessed its impact on KDIGO G-stage classification. We hypothesized that higher BMI would be associated with greater discordance and more frequent KDIGO G-stage reclassification.</p><p><strong>Methods: </strong>In this observational cohort of 2207 patients with paired routine-care measurements at a German university hospital, non-indexed eGFR was calculated using the 2009 CKD Epidemiology Collaboration (CKD-EPI) creatinine equation and the 2012 CKD-EPI cystatin C and combined creatinine-cystatin C equations. We compared BMI ≤25 kg/m2 (n=776) with BMI ≥35 kg/m2 (n=309). Clinically relevant discordance thresholds and KDIGO G-stage reclassification were assessed, and multivariable models examined predictors of discordance. Agreement between eGFR equations was additionally assessed using Bland-Altman analyses, overall and stratified by BMI.</p><p><strong>Results: </strong>Among 2207 participants, those with BMI ≥35 kg/m2 had significantly lower eGFRcys and eGFRcr-cys than those with BMI ≤25 kg/m2, whereas eGFRcr differed only borderline. The discrepancy between eGFRcys and eGFRcr was greater in participants with BMI ≥35 kg/m2, and clinically relevant discordance occurred more frequently. Bland-Altman analysis showed wide limits of agreement and a more negative bias in participants with BMI ≥35 kg/m2. Switching from eGFRcr to eGFRcys resulted in KDIGO G-stage up-classification in 43% versus 26%, despite similar albuminuria and proteinuria. Using eGFRcr-cys as reference, eGFRcr caused more frequent down-classification in participants with BMI ≥35 kg/m2, whereas eGFRcys caused more frequent up-classification. Independent predictors of discordance were higher BMI, CRP, prednisolone use, and current smoking, while high urea was inversely associated.</p><p><strong>Conclusions: </strong>Participants with BMI ≥35 kg/m2 had frequent, clinically relevant divergence between creatinine- and cystatin C-based eGFR, leading to substantial KDIGO G-stage reclassification. Because measured GFR was unavailable, the study demonstrates disagreement between equations but cannot determine which estimate is more accurate. Combined-marker equations or measured GFR should be considered when discordance could change clinical decisions.</p>","PeriodicalId":17882,"journal":{"name":"Kidney360","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Acute Kidney Injury Duration After Cisplatin Treatment and Subsequent CKD Risk: A Single-Center Retrospective Study. 顺铂治疗后急性肾损伤持续时间和随后的CKD风险:单中心回顾性研究。
IF 3.6
Kidney360 Pub Date : 2026-10-08 DOI: 10.34067/KID.0000001414
Kazuki Saito, Satoru Nihei, Junichi Asaka, Kenzo Kudo
{"title":"Acute Kidney Injury Duration After Cisplatin Treatment and Subsequent CKD Risk: A Single-Center Retrospective Study.","authors":"Kazuki Saito, Satoru Nihei, Junichi Asaka, Kenzo Kudo","doi":"10.34067/KID.0000001414","DOIUrl":"https://doi.org/10.34067/KID.0000001414","url":null,"abstract":"<p><strong>Background: </strong>AKI commonly occurs after cisplatin treatment and is associated with long-term kidney dysfunction. Whether its duration is associated with subsequent CKD remains unclear.</p><p><strong>Methods: </strong>This retrospective cohort study included adults treated with cisplatin from 2014 through 2023 who survived and remained under observation at a 90-day landmark after final administration. AKI was classified as transient (≤48 hours), persistent (>48 hours to 7 days), or acute kidney disease (>7 days). CKD incidence was estimated with death as a competing event, and associations were assessed using multivariable Fine-Gray models.</p><p><strong>Results: </strong>Among 1,643 patients reaching the landmark, 181 (11%) developed AKI and 408 (25%) developed CKD. At 1 year, CKD incidence was 20% without AKI, 22% with transient AKI, 46% with persistent AKI, and 46% with acute kidney disease. Compared with no AKI, adjusted subdistribution hazard ratios were 1.45 (95% confidence interval [CI], 0.70-3.03) for transient AKI, 2.66 (95% CI, 1.66-4.26) for persistent AKI, and 2.94 (95% CI, 1.72-5.03) for acute kidney disease. Additional adjustment for severity in exploratory analyses among patients with AKI did not materially attenuate the estimates, although CIs were wide.</p><p><strong>Conclusions: </strong>AKI duration after cisplatin treatment was associated with subsequent CKD risk. Persistent AKI and acute kidney disease may identify higher-risk patients, but the prognostic value of duration beyond conventional severity staging requires external confirmation.</p>","PeriodicalId":17882,"journal":{"name":"Kidney360","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Targeted-Release Formulation Budesonide (Nefecon) for the Treatment of IgA Nephropathy in Three Adolescents. 靶向释放制剂布地奈德治疗3例青少年IgA肾病。
IF 3.6
Kidney360 Pub Date : 2026-10-08 DOI: 10.34067/KID.0000001436
Tong Yiming, Zhu Xinyi, Ouyang Yan, Xu Jing, Hu Xiaofan, Pan Xiaoxia, Yin Lei, Xie Jingyuan
{"title":"Targeted-Release Formulation Budesonide (Nefecon) for the Treatment of IgA Nephropathy in Three Adolescents.","authors":"Tong Yiming, Zhu Xinyi, Ouyang Yan, Xu Jing, Hu Xiaofan, Pan Xiaoxia, Yin Lei, Xie Jingyuan","doi":"10.34067/KID.0000001436","DOIUrl":"https://doi.org/10.34067/KID.0000001436","url":null,"abstract":"<p><p>IgA nephropathy (IgAN) is the most prevalent primary glomerular disease in adolescents, with 20% progressing to end-stage kidney disease within 20 years[1]. Targeted-release formulation (TRF) budesonide (Nefecon-IgAN-specific TRF-budesonide) is FDA-approved for adult IgAN but lacks evidence in adolescents[2]. We describe three adolescents with biopsy-proven IgAN treated with 16 mg/d Nefecon for 9-12 months (one patient with extension). All showed marked reductions in proteinuria and hematuria with stable renal function. No serious AEs were reported. These cases provide preliminary clinical experience regarding the feasibility and tolerability of Nefecon in selected adolescents with IgAN.</p>","PeriodicalId":17882,"journal":{"name":"Kidney360","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Handgrip Strength for Mortality Prediction in Hemodialysis Patients Using the Chronological-to-Metabolic Age Ratio: A Multicenter Prospective Cohort Study. 握力对血液透析患者死亡率预测的时间代谢年龄比:一项多中心前瞻性队列研究。
IF 3.6
Kidney360 Pub Date : 2026-10-08 DOI: 10.34067/KID.0000001391
Fatemeh Navab, Zahra Heidari, Shirin Hassanizadeh, Firouzeh Moeinzadeh, Mohammad Hossein Rouhani
{"title":"Handgrip Strength for Mortality Prediction in Hemodialysis Patients Using the Chronological-to-Metabolic Age Ratio: A Multicenter Prospective Cohort Study.","authors":"Fatemeh Navab, Zahra Heidari, Shirin Hassanizadeh, Firouzeh Moeinzadeh, Mohammad Hossein Rouhani","doi":"10.34067/KID.0000001391","DOIUrl":"https://doi.org/10.34067/KID.0000001391","url":null,"abstract":"<p><strong>Background: </strong>Hemodialysis patients face disproportionately high mortality, with sarcopenia and reduced muscle strength as major contributors. In this study, we aimed to investigate whether the prognostic value of handgrip strength for all-cause mortality is modified by the chronological-to-metabolic age ratio, a marker of biological aging and cumulative physiological stress.</p><p><strong>Methods: </strong>This multicenter prospective cohort study enrolled 307 adult hemodialysis patients. handgrip strength was measured with a standardized dynamometer prior to dialysis, and metabolic age was estimated via multifrequency bioelectrical impedance analysis to calculate the chronological-to-metabolic age ratio. Demographic, clinical, anthropometric, and dialysis-related parameters were also collected. Participants were followed every three months through three years for all-cause mortality, and the prognostic value of handgrip strength was assessed using Cox proportional hazards models, and discriminative performance was evaluated using receiver operating characteristic (ROC) curve analysis.</p><p><strong>Results: </strong>Higher handgrip strength was associated with reduced all-cause mortality in hemodialysis patients, particularly among those whose metabolic age exceeded chronological age (HR = 0.879; 95% CI: 0.812-0.953; P = 0.002). While handgrip strength showed poor discrimination across chronological (AUC = 0.550-0.578) and metabolic age categories (AUC = 0.571-0.648), it demonstrated relatively higher discriminative performance in patients with accelerated metabolic aging (AUC = 0.810; cut-off = 22.16; sensitivity 65%; specificity 94%).</p><p><strong>Conclusions: </strong>Handgrip strength was associated with all-cause mortality in hemodialysis patients, and this association may be modified by the chronological-to-metabolic age ratio. However, the chronological-to-metabolic age ratio did not provide incremental prognostic value beyond conventional clinical variables and handgrip strength. The observed subgroup-specific discriminative performance and HGS cut-off values are exploratory and require external validation before clinical application.</p>","PeriodicalId":17882,"journal":{"name":"Kidney360","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Revamping the ESKD Dialysis Program in Syria: An Update on Progress, Challenges, and Lessons Learned. 改进叙利亚ESKD透析项目:进展、挑战和经验教训的最新情况。
IF 3.6
Kidney360 Pub Date : 2026-10-06 DOI: 10.34067/KID.0000001439
Muawya Alahmad, Khaled Haj Nasan, Saleh Kaysi, Mohamed Sekkarie
{"title":"Revamping the ESKD Dialysis Program in Syria: An Update on Progress, Challenges, and Lessons Learned.","authors":"Muawya Alahmad, Khaled Haj Nasan, Saleh Kaysi, Mohamed Sekkarie","doi":"10.34067/KID.0000001439","DOIUrl":"https://doi.org/10.34067/KID.0000001439","url":null,"abstract":"","PeriodicalId":17882,"journal":{"name":"Kidney360","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149111643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Rapid Targeted Long-Read Sequencing for Acute Management of Thrombotic Microangiopathy. 快速靶向长读测序用于血栓性微血管病的急性管理。
IF 3.6
Kidney360 Pub Date : 2026-10-02 DOI: 10.34067/KID.0000001430
Cyril Mousseaux, Nadhir Yousfi, David De Saint Gilles, Yosu Luque, Aurelie Waernessyckle, Paul Gabarre, Cedric Rafat, Camille Petit-Hoang, Caroline Nava, Patricia Moreau, Boris Keren, Mathieu Georget, Laurent Mesnard
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