Nefrologia最新文献

{"title":"Validación multicéntrica de la fórmula Kidney Failure Risk Equation (KFRE) en pacientes españoles con enfermedad renal crónica avanzada","authors":"Marco Montomoli","doi":"10.1016/j.nefro.2025.501389","DOIUrl":"10.1016/j.nefro.2025.501389","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 8","pages":"Article 501389"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145183865","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":"Dos casos de remisión de nefritis lúpica refractaria con voclosporina","authors":"Juan A. Martín Navarro , Ana S. Pareja Martínez , M. Angeles Matías de la Mano , M. Teresa Navío Marco , Eva M. Chavarría Mur , Elena Conde Montero , Santos Esteban Casado , Laura Medina Zahonero , Fabio L. Procaccini , Patricia Muñoz Ramos , Roberto Alcázar Arroyo , Patricia de Sequera Ortiz","doi":"10.1016/j.nefro.2025.501361","DOIUrl":"10.1016/j.nefro.2025.501361","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 8","pages":"Article 501361"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145183863","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":"The association between single nucleotide polymorphisms in NLRP gene and diabetic nephropathy","authors":"Eman A.E. Badr ,&nbsp;Safwa O. Toulan ,&nbsp;Yasser A. El Ghobashy ,&nbsp;Ahmed Mostafa Nofal ,&nbsp;Mohamed F.A. Assar","doi":"10.1016/j.nefro.2025.501339","DOIUrl":"10.1016/j.nefro.2025.501339","url":null,"abstract":"<div><h3>Background</h3><div>Diabetic nephropathy (DN) is a major cause of chronic kidney disease, influenced by genetic and inflammatory factors. SNPs in NLRP1 and NLRP3 genes, key regulators of inflammation, may contribute to DN susceptibility, offering insights into its pathogenesis and potential therapeutic targets. This study aims to investigate the association between single nucleotide polymorphisms (SNPs) in NLRP1 and NLRP3 genes and the susceptibility to diabetic nephropathy.</div></div><div><h3>Methods</h3><div>This cross-sectional study was conducted on 192 subjects, comprising 96 DN patients and 96 healthy controls. Diabetic nephropathy was diagnosed with albumin creatinine ratio in urine. Genotyping of SNPs rs878329 in NLRP1 and rs10754558 in NLRP3 was performed using the TaqMan® Allelic Discrimination assay.</div></div><div><h3>Results</h3><div>Significant differences were found in the distribution of both rs878329 and rs10754558 genotypes between cases and controls. The GG genotype of rs878329 and the CG genotype of rs10754558 were significantly more prevalent among DN patients (<em>p</em> <!-->=<!--> <!-->0.002 and <em>p</em> <!-->=<!--> <!-->0.005, respectively). Allelic analysis revealed a higher frequency of the G allele in both SNPs among DN cases (<em>p</em> <!-->=<!--> <!-->0.001 and <em>p</em> <!-->=<!--> <!-->0.002, respectively).</div></div><div><h3>Conclusion</h3><div>Our study supports the involvement of NLRP gene polymorphisms in the pathogenesis of DN, potentially offering new insights into genetic predispositions to this condition.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 8","pages":"Article 501339"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145183778","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":"Comentarios al artículo: «Validación multicéntrica de la fórmula Kidney Failure Risk Equation (KFRE) en pacientes españoles con enfermedad renal crónica avanzada»","authors":"Eduardo Gallego-Valcarce ,&nbsp;Amir Shabaka ,&nbsp;Ana Tato-Ribera ,&nbsp;Enrique Gruss","doi":"10.1016/j.nefro.2025.501364","DOIUrl":"10.1016/j.nefro.2025.501364","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 8","pages":"Article 501364"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145183864","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":"Safety and efficacy of sodium-glucose co-transporter-2 inhibitors and aldosterone inhibitors combinations in chronic kidney disease: A systematic review and meta-analysis","authors":"Ahmed W. Hageen ,&nbsp;Reem Sayad ,&nbsp;Alyaa Khaled Abdelmonem ,&nbsp;Katia Latifa ,&nbsp;Lina Musallam ,&nbsp;Moustafa Abouelkheir ,&nbsp;Sherif Mira ,&nbsp;Ahmed Awad ,&nbsp;Ahmed Afsa ,&nbsp;Waleed Nassar ,&nbsp;Gehad El Ashal ,&nbsp;Mohamed Elmasry ,&nbsp;Eshak I. Bahbah","doi":"10.1016/j.nefro.2025.501345","DOIUrl":"10.1016/j.nefro.2025.501345","url":null,"abstract":"<div><div>Sodium-glucose co-transporter-2 inhibitors (SGLT2i) and aldosterone inhibitors show promise for treating chronic kidney disease (CKD). This systematic review and meta-analysis explored the efficacy and safety of aldosterone inhibitors plus SGLT2i combination compared to their effects. We searched PubMed, Scopus, Web of Science, Cochrane Central Register of Controlled Trials [CENTRAL], and EBSCOhost. We reported dichotomous outcomes as pooled relative ratios and continuous outcomes as standardized mean differences with a 95% confidence interval. Three studies were included in this meta-analysis. The combination therapy was associated with a significantly higher rate of 30% reduction of urine albumin creatinine ratio (UACR) compared to SGLT2i (RR<!--> <!-->=<!--> <!-->2.38, 95% CI, 1.46–3.46, <em>P</em> <!-->&lt;<!--> <!-->0.001; <em>I</em>² <!-->=<!--> <!-->0%, <em>P</em> <!-->=<!--> <!-->0.54) and compared to MRA (RR<!--> <!-->=<!--> <!-->1.34, 95% CI, 1.12–1.60, <em>P</em> <!-->=<!--> <!-->0.001; <em>I</em>² <!-->=<!--> <!-->13%, <em>P</em> <!-->=<!--> <!-->0.28). It also showed a significant reduction in the UACR compared to SGLT2i (SMD<!--> <!-->=<!--> <!-->−1.47, 95% CI, −2.25 to −0.68, <em>P</em> <!-->=<!--> <!-->0.0003; <em>I</em>² <!-->=<!--> <!-->78%, <em>P</em> <!-->=<!--> <!-->0.03) but no significant reduction compared to aldosterone inhibitors (SMD<!--> <!-->=<!--> <!-->−0.10, 95% CI, −0.38 to 0.19, <em>P</em> <!-->=<!--> <!-->0.51; <em>I</em>² <!-->=<!--> <!-->67%, <em>P</em> <!-->=<!--> <!-->0.05). The pooled data showed no significant difference in the incidence of serious adverse events between the combination therapy and SGLT2i (RR<!--> <!-->=<!--> <!-->1.01, 95% CI, 0.72–1.41, <em>P</em> <!-->=<!--> <!-->0.96; <em>I</em>² <!-->=<!--> <!-->0%, <em>P</em> <!-->=<!--> <!-->0.58) or MRA (RR<!--> <!-->=<!--> <!-->1.01, 95% CI, 0.79–1.30, <em>P</em> <!-->=<!--> <!-->0.92; <em>I</em>² <!-->=<!--> <!-->0%, <em>P</em> <!-->=<!--> <!-->0.90). In conclusion, combining SGLT2i and aldosterone inhibitors may offer a promising approach for managing albuminuria and potentially slowing kidney disease progression in CKD patients.</div><div>We registered the protocol in PROSPERO CRD42024511675.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 8","pages":"Article 501345"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145183779","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":"Cardiovascular and renal outcomes according to KDIGO stages of chronic kidney disease in the Spanish population: Insights from real-world evidence","authors":"Rafael Santamaria ,&nbsp;Carlos Escobar ,&nbsp;Unai Aranda ,&nbsp;Beatriz Palacios ,&nbsp;Margarita Capel ,&nbsp;Ignacio Hernández ,&nbsp;Ana Cebrián ,&nbsp;Roberto Alcázar ,&nbsp;Manuel Gorostidi","doi":"10.1016/j.nefro.2025.501340","DOIUrl":"10.1016/j.nefro.2025.501340","url":null,"abstract":"<div><h3>Objective</h3><div>Real-world analysis of the clinical profile, treatments, major adverse cardiovascular and renal events (MACE and MARE) in patients with different stages of chronic kidney disease (CKD) as defined by KDIGO guidelines.</div></div><div><h3>Methods</h3><div>This was an observational, retrospective study using the BIG-PAC database. Adults with ≥1 measurement of estimated glomerular filtration rate (eGFR) and albumin-to-creatinine ratio (UACR) closest to 1st January 2018 (up to 6 months) were included. Patients were followed for two years.</div></div><div><h3>Results</h3><div>Among 70,385 subjects, 21,127 (30.0%) had CKD based on impaired renal function or increased albuminuria. Age and prevalence of diabetes and cardiovascular disease increased as kidney function decreased, or albuminuria rose. Renin–angiotensin system inhibitors were prescribed in 47.1–76.4% patients classified as G3a–G5 and mildly increased albuminuria (A1), 63.2–79.6% in G1–G5 and moderately increased albuminuria (A2), and 51.2–85.9% in G1–G5 and severely increased albuminuria (A3). The prescription of sodium-glucose cotransporter-2 inhibitors was marginal across KDIGO categories. The incidence rates (per 1000 patient-year) of MACE ranged 102.9–245.2 in patients classified as G3a–G5 A1, 40.7–261.1 in G1–G5 A2, and 69.1–362.3 in G1–G5 A3. Incidence rates of MARE ranged 14.9–454.4 in G3a–G5 A1, 29.8–588.5 in G1–5 A2, and 11.8–637.2 in G1–5 A3.</div></div><div><h3>Conclusions</h3><div>In real-world, the risk of cardiovascular and renal complications rises as kidney function declines and albuminuria worsens. Guideline-recommended therapies remain underused.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 8","pages":"Article 501340"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145183732","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":"Efficacy of renal denervation with and without antihypertensives in patients with resistant hypertension: A systematic review and meta-analysis","authors":"Maryam Adnan ,&nbsp;Hamza Naveed ,&nbsp;Mohammad Hamza ,&nbsp;Burhan Khalid ,&nbsp;Wasif Safdar ,&nbsp;Jawad Basit ,&nbsp;Sameh Nassar ,&nbsp;Prakash Upreti ,&nbsp;Maha Zafar ,&nbsp;Zainab Javeed ,&nbsp;Marloe Prince ,&nbsp;Yasar Sattar ,&nbsp;M. Chadi Alraies","doi":"10.1016/j.nefro.2025.501333","DOIUrl":"10.1016/j.nefro.2025.501333","url":null,"abstract":"<div><h3>Background</h3><div>Resistant hypertension presents a clinical challenge. The efficacy of renal denervation (RDN) as a potential treatment has conflicting data. Multiple randomized controlled trials have been conducted to assess the impact of RDN.</div></div><div><h3>Methods</h3><div>We performed systematic search of the PubMed and EMBASE from inception to April 2024 to identify studies comparing various interventions for resistant hypertension. We employed a frequentist network meta-analysis model, utilizing the <em>net</em>-<em>meta</em> module and applying a random effects model in CRAN-R software.</div></div><div><h3>Results</h3><div>Data of 2553 patients from 20 RCTs was analyzed. Standard mean differences (SMDs) for diastolic blood pressure (DBP) and systolic blood pressure (SBP) were assessed at different time points, including daytime, nighttime, over 24<!--> <!-->h, and during office visits. Our results demonstrate an improvement in various BP parameters when comparing RDN with sham: daytime DBP (3.46, 95%CI: [1.89–5.02], <em>P</em> <!-->&lt;<!--> <!-->0.0001), nighttime SBP (2.87, 95%CI: [1.43–4.31], <em>P</em> <!-->&lt;<!--> <!-->0.0001), 24-h SBP (2.82, 95%CI: [1.24–4.41], <em>P</em> <!-->=<!--> <!-->0.001), and in-office DBP (2.70, 95%CI: [1.04–4.36], <em>P</em> <!-->=<!--> <!-->0.002). However, no statistically significant difference was found in daytime SBP (3.60, 95% CI: [−0.67–7.87], <em>P</em> <!-->=<!--> <!-->0.10), nighttime DBP (1.65, 95% CI: [−0.57–3.86], <em>P</em> <!-->=<!--> <!-->0.15) and in-office SBP (3.89, 95% CI: [−10.07–17.86], <em>P</em> <!-->=<!--> <!-->0.60) and in 24-h DBP.</div></div><div><h3>Conclusion</h3><div>Our study supports the efficacy of RDN, when combined with antihypertensive treatment when compared to sham treatment, in the management of resistant hypertension.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 8","pages":"Article 501333"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145183731","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":"Unidad Cardiorrenal en enfermedad cardiorrenal avanzada: impacto clínico y reducción de costes hospitalarios","authors":"Eliecer Soriano Payá ,&nbsp;Ismael Arco Adamuz ,&nbsp;Ana María García Girón ,&nbsp;Francisco José Bermúdez-Jiménez ,&nbsp;Elisa Berta Pereira Pérez ,&nbsp;Laura Jordán Martínez ,&nbsp;María Carmen Olvera-Porcel ,&nbsp;Leticia García Mochón ,&nbsp;Silvia López Fernández ,&nbsp;María José Espigares Huete","doi":"10.1016/j.nefro.2025.501350","DOIUrl":"10.1016/j.nefro.2025.501350","url":null,"abstract":"<div><h3>Background and objective</h3><div>Cardiorenal syndrome (CRS) reflects a bidirectional interaction between heart failure (HF) and chronic kidney disease (CKD), with high associated healthcare costs. Hospitalizations due to cardiovascular (CV) events, particularly for decompensated HF, represent most CKD-related costs. Cardiorenal units (CRU) emerge as an innovative strategy to address this complexity through a multidisciplinary approach. This study analyzes the effectiveness and efficiency of CRUs.</div></div><div><h3>Material and methods</h3><div>Observational, longitudinal, ambispective, and single-center study using an adapted interrupted time-series design. Patients with advanced CKD (eGFR<!--> <!-->&lt;<!--> <!-->30<!--> <!-->mL/min/1.73<!--> <!-->m²) and HF with reduced left ventricular ejection fraction (LVEF) were included. Clinical, demographic, and care-related data were analyzed during the year before and the year after enrolment. Economic costs were derived from healthcare resource consumption associated with hospital care activities.</div></div><div><h3>Results</h3><div>In 55 patients (mean age 73.9<!--> <!-->±<!--> <!-->8.6<!--> <!-->years; 78% male), a 65% reduction in emergency department visits (<em>P</em> <!-->=<!--> <!-->.0001) and a 60.5% reduction in hospitalizations (<em>P</em> <!-->=<!--> <!-->.0015) were observed. The economic analysis revealed cost savings of approximately €700,000, with an average reduction of almost €13,000 per patient/year. After inclusion in the CRU, there was an increased prescription of prognostic drugs, with no significant changes in serum potassium concentration (<em>P</em> <!-->=<!--> <!-->.26) and no evidence of renal function deterioration (pre-vs. post-eGFR: 23.36<!--> <!-->±<!--> <!-->7.6<!--> <!-->mg/dL vs. 22.44<!--> <!-->±<!--> <!-->8.5<!--> <!-->mg/dL; <em>P</em> <!-->=<!--> <!-->.17). A significant differential impact was observed in all healthcare outcomes, particularly among patients receiving quadruple therapy.</div></div><div><h3>Conclusion</h3><div>CRUs emerge as effective and efficient models for the management of cardiorenal syndrome. Randomized controlled studies are needed to validate these findings and optimize healthcare policies.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 8","pages":"Article 501350"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145183734","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":"Afectación renal en el síndrome de Sjögren: más allá de la nefritis tubulointersticial","authors":"Óscar Porto Fuentes ,&nbsp;Javier González Cepeda ,&nbsp;Cristina Vega Cabrera ,&nbsp;José Manuel Martín de Bustamante ,&nbsp;Ángel Robles Marhuenda ,&nbsp;Jorge Álvarez Troncoso ,&nbsp;Elena Martínez Robles ,&nbsp;Ana Noblejas Mozo ,&nbsp;Juan José Ríos Blanco ,&nbsp;Eugenia García Fernández ,&nbsp;Clara Itzíar Soto Abánades","doi":"10.1016/j.nefro.2025.501341","DOIUrl":"10.1016/j.nefro.2025.501341","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 7","pages":"Article 501341"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144721735","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":"External validation of a predictive model for one-year mortality in incident hemodialysis patients: A Portuguese cohort","authors":"Telma Pais ,&nbsp;Beatriz Teixeira ,&nbsp;Miguel Carrilho ,&nbsp;José Agapito Fonseca ,&nbsp;Cristina Outerelo ,&nbsp;Sofia Jorge ,&nbsp;Cristina Resina ,&nbsp;José António Lopes ,&nbsp;Joana Gameiro","doi":"10.1016/j.nefro.2025.501346","DOIUrl":"10.1016/j.nefro.2025.501346","url":null,"abstract":"<div><h3>Background</h3><div>Prognostic assessment after starting hemodialysis is challenging, with mortality in the first year estimated to be 15%. Clark et al. developed the Recovery and Death Outcome risk score, which accurately predicted the likelihood of renal recovery to dialysis independence and of death within 1 year after in-hospital dialysis initiation, respectively. We aimed to validate the Death Outcome risk score to predict one-year mortality after dialysis start in our population.</div></div><div><h3>Methods</h3><div>Retrospective analysis of hospitalized patients starting hemodialysis in a tertiary-care hospital from January 1st, 2016, to December 31st, 2019. All-cause mortality risk one year after discharge was calculated according to the ReDO Death score. Patients were classified into death outcome risk groups and Cox regression was used to determine if the risk score was predictive of one-year mortality. The discriminatory ability for the ReDO Death score to predict mortality was determined using the receiver operating characteristic (ROC) curve.</div></div><div><h3>Results</h3><div>Three hundred sixty-nine patients were included, mostly male (59.9%), with mean age 71.1<!--> <!-->±<!--> <!-->14.3 years and median Charlson score 7<!--> <!-->±<!--> <!-->3. The one-year mortality rate was 22.2%. The ReDO Death score accurately predicted the one-year risk of mortality, with an area under the ROC of 0.741 [95% CI (0.687–0.794), <em>p</em> <!-->&lt;<!--> <!-->0.001]. The optimal REDO Death risk cut-off was &gt;30%, with a hazard ratio of 6.57 [95% CI (3.48–12.2), <em>p</em> <!-->&lt;<!--> <!-->0.001] for one-year mortality risk (sensitivity 78.0% and specificity 60.6%).</div></div><div><h3>Conclusion</h3><div>We validated the ReDO Death score for 1-year mortality prediction after starting hemodialysis during hospitalization in a Portuguese population. This score can be used as a tool to inform goals-of-care discussion at the time of transition to out-of-hospital care.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 7","pages":"Article 501346"},"PeriodicalIF":2.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144721732","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}