Nefrologia最新文献

{"title":"Más allá de los libros de texto: cilindros vacuolados como marcador emergente en el sedimento urinario","authors":"Oscar D. Pons-Belda , Ana Calbet-Tur , Paloma Livianos-Arias-Camison , Emilia Moreno-Noguero , Cassandra E. Puig-Hooper","doi":"10.1016/j.nefro.2025.501428","DOIUrl":"10.1016/j.nefro.2025.501428","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"46 3","pages":"Article 501428"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147413752","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":"Enhancing chronic kidney disease care through risk prediction: A review of the kidney failure risk equation","authors":"Bernardo Marques da Silva ,&nbsp;Inês Silveira ,&nbsp;José António Lopes ,&nbsp;Joana Gameiro","doi":"10.1016/j.nefro.2025.501473","DOIUrl":"10.1016/j.nefro.2025.501473","url":null,"abstract":"<div><div>Chronic kidney disease (CKD) is a growing global health problem, with projections indicating a significant increase in its prevalence. The kidney failure risk equation (KFRE) has emerged as a valuable predictive tool to assess the risk of kidney failure in patients with CKD stages 3–5.</div><div>This narrative review presents a comprehensive analysis of the KFRE's development, validation, and clinical applications, and highlights its role in predicting disease progression, guiding nephrology referrals, and planning vascular access creation.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"46 3","pages":"Article 501473"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147413747","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":"Resultados de una encuesta nacional sobre el diagnóstico de la insuficiencia cardiaca en las consultas de nefrología: hora de actuar","authors":"María Marques Vidas ,&nbsp;Javier Diez ,&nbsp;Patricia de Sequera ,&nbsp;Alberto Ortiz ,&nbsp;Gregorio Romero-González ,&nbsp;María Fernanda Slon-Roblero ,&nbsp;Adriana Puente-García ,&nbsp;Borja Quiroga Gili","doi":"10.1016/j.nefro.2025.501433","DOIUrl":"10.1016/j.nefro.2025.501433","url":null,"abstract":"<div><h3>Introduction</h3><div>Heart failure (HF) is a common comorbidity with a major prognostic impact in patients with chronic kidney disease (CKD). However, screening and diagnostic practices for HF in nephrology clinics are not optimized. The aim was to assess routine clinical practice and identify gaps in HF diagnosis in the care of patients with CKD at any stage.</div></div><div><h3>Methods</h3><div>A nationwide survey of Spanish nephrologists was conducted using an electronic questionnaire. Data collection took place over a two-month period.</div></div><div><h3>Results</h3><div>A total of 73 centers completed the questionnaire. The estimated prevalence of HF among the patients seen was 44.1%, although only 30% of these cases were thought to be documented in the medical record. Although 55.4% of respondents reported performing active screening, the use of diagnostic tools such as echocardiography, natriuretic peptides, and electrocardiography was variable and often conditioned by the presence of symptoms.</div></div><div><h3>Conclusion</h3><div>These findings support a call to action based on the need to implement protocolized, multidisciplinary strategies to optimize HF diagnosis, as well as the early initiation of appropriate therapies for HF in patients with chronic kidney disease</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"46 3","pages":"Article 501433"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147413749","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":"Interpretation of glycaemic variability in type 2 diabetes mellitus patients on maintenance haemodialysis using continuous glucose monitoring","authors":"Asokan Arunkumar,&nbsp;Varadharajan Jayaprakash,&nbsp;Rajendran Rajasekar,&nbsp;Rishabh Gupta,&nbsp;Mathew Gerry George","doi":"10.1016/j.nefro.2025.501468","DOIUrl":"10.1016/j.nefro.2025.501468","url":null,"abstract":"<div><h3>Background</h3><div>Diabetes mellitus is the leading cause of end-stage renal disease, accounting for approximately 40% of cases. Data on glycaemic metrics in diabetic population on maintenance haemodialysis is sparse. The role of continuous glucose monitoring in this population remains underexplored.</div></div><div><h3>Methods</h3><div>This prospective observational study aimed to comprehensively characterize glycaemic variability using continuous glucose monitoring in patients with type 2 diabetes mellitus undergoing maintenance haemodialysis. 25 patients aged between 18 and 70 years with more than 3 months of dialysis vintage were included in the study. After collecting socio-demographic and clinical data, an ambulatory glucose profile sensor was applied to the patient's upper limb before starting their scheduled dialysis session. Sensors measured the interstitial fluid glucose every 15<!--> <!-->min, and a total of 96 readings were taken per day, continuously for 14 days (336<!--> <!-->h).</div></div><div><h3>Results</h3><div>For statistical analysis, the study population was broadly divided into 2 major groups, one which required insulin for their glycaemic management and the other requiring an oral hypoglycaemic agent, linagliptin. Statistical analysis was performed using SPSS software version 26.0 (IBM Corp., Armonk, NY). In both the groups, glycaemic excursion was observed, with dialysis days having high mean glucose values than non-dialysis days, and the observation was more prominent in the insulin-treated group. The mean glucose levels were lower in the nocturnal period in both the groups. It was noticed that the overall glycaemic variability, glycaemic variability in both dialysis and non-dialysis days were lower in linagliptin-treated group.</div></div><div><h3>Conclusion</h3><div>This study demonstrated significant differences in glycaemic variability based on antidiabetic treatment modality in haemodialysis population. Continuous glucose monitoring is an invaluable tool to study glycaemic metrics and guide therapy in haemodialysis population.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"46 3","pages":"Article 501468"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147413305","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":"Alfa-1-microglobulina en primera orina de la mañana. Interés clínico","authors":"María Carande del Río ,&nbsp;Nicolas R. Robles ,&nbsp;Alfonso Parejo Martín ,&nbsp;Cristina Xavier Aller ,&nbsp;Beatriz Sacristan Enciso ,&nbsp;Juan López Gómez","doi":"10.1016/j.nefro.2025.501447","DOIUrl":"10.1016/j.nefro.2025.501447","url":null,"abstract":"<div><h3>Introduction</h3><div>The reference sample for quantifying alpha-1-microglobulin is 24-hour urine. However, although it is usually quantified in the second urine sample of the morning, the first urine sample of the morning is the least influenced by the glomerular filtration rate. Likewise, there are conflicting opinions on the influence of age and gender on quantification.</div></div><div><h3>Patients and methods</h3><div>A total of 434 urine tests were selected, 182 with a glomerular filtration rate between 4 and 89<!--> <!-->ml/min/1.73 m² and 252 with a glomerular filtration rate &gt;90<!--> <!-->ml/min/1.73 m². Of these 252, 122 corresponded to first-morning urine samples with a density &gt;1015 and 130 to 24-hour urine samples with a urine volume between 400-3000<!--> <!-->m/24<!--> <!-->hours, without microalbuminuria. Of the 122, 30 had an alpha-1-microglobulin value &gt;4.3<!--> <!-->mg/l and corresponded to patients with diseases that cause tubular damage. The correlation between first morning and 24-hour alpha-1-microglobulin was performed with 42 urine samples, out of the 434 selected, for which both urine samples had been requested.</div></div><div><h3>Results</h3><div>The correlation between the first morning urine and 24-hour urine measurements was 0.92. No statistically significant differences were found between creatinine-corrected alpha-1-microglobulin with age, or between men and women in the first morning urine or 24-hour urine samples (<em>P</em>&gt;.05). The upper limit P_97.5 in normal individuals was 12.9<!--> <!-->mg/24<!--> <!-->hours and 7.08 mg/l/g creatinine in first morning urine. Approximately 77% of patients with creatinine-corrected alpha-1-microglobulin &gt;7.08 in first morning urine, without decreased glomerular filtration or microalbuminuria, were patients with hypertension or diabetes.</div></div><div><h3>Conclusion</h3><div>The first urine sample of the morning can be used to quantify alpha-1-microglobulin due to its good correlation with 24-hour urine samples, as well as not being affected by age or gender. A quantification &gt;7.08 mg/l/g creatinine in the first morning urine should raise suspicion of the onset of tubular damage, especially in hypertensive or diabetic patients.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"46 3","pages":"Article 501447"},"PeriodicalIF":2.6,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147413307","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":"Intoxicación por metformina: características clínicas, tratamiento y pronóstico","authors":"Isabel Galcerán Herrera ,&nbsp;Clara Rosales Escorihuela ,&nbsp;Silvia Collado Nieto ,&nbsp;Mª Jesús López Casanova ,&nbsp;Oriol Pallas Villaronga ,&nbsp;Leire García Campo ,&nbsp;Marta Crespo ,&nbsp;August Supervía","doi":"10.1016/j.nefro.2025.501429","DOIUrl":"10.1016/j.nefro.2025.501429","url":null,"abstract":"<div><h3>Objectives</h3><div>To identify potential severity predictive factors in patients with metformin intoxication (MI), defined as the need for renal replacement therapy (RRT) and/or patient death.</div></div><div><h3>Methods</h3><div>Retrospective observational study of patients who presented to the Emergency Department of Hospital del Mar in Barcelona and were diagnosed of MI between January 2010 and April 2024. Data were collected through medical record review.</div></div><div><h3>Results</h3><div>Seventy-two patients were included (43.1% men and 56.9% women), with an average age of 74.8<!--> <!-->±<!--> <!-->10.9 years. We defined the primary end point as need for RRT and/or patient death. Fifty patients (69.4%) met the criteria for the primary end point, 39 needed RRT (54.2%) and 21 patients died (28%). Patients who met the primary end point had higher levels of creatinine (7.0<!--> <!-->±<!--> <!-->3.2 vs 5.1<!--> <!-->±<!--> <!-->3.6<!--> <!-->mg/dl, p<!--> <!-->=<!--> <!-->0.03, lactate (14.1<!--> <!-->±<!--> <!-->7.3 vs 7.4<!--> <!-->±<!--> <!-->4.1 mmol/l, p&lt;<!--> <!-->0.001) and gap anion (37.1<!--> <!-->±<!--> <!-->11.5 vs 30.4<!--> <!-->±<!--> <!-->9.8, p<!--> <!-->=<!--> <!-->0.002), and lower levels of pH (7.02<!--> <!-->±<!--> <!-->0.22 vs 7.17<!--> <!-->±<!--> <!-->0.15, p<!--> <!-->=<!--> <!-->0.005) and bicarbonate (8.8<!--> <!-->±<!--> <!-->5.4 vs 12.7<!--> <!-->±<!--> <!-->5.3, p<!--> <!-->=<!--> <!-->0.005) at diagnosis. Metformin levels were determined in 52 patients (72.2%), being higher in patients who met the primary end point (20.1 [12.7-44.3] vs 8.4 [3.8-22.4] μg/ml, p<!--> <!-->=<!--> <!-->0.05). Multivariate analysis identified that lactate levels at admission was the only predictive factor for the primary end point, with an area under the ROC curve of 0.78. The cut-off point for lactate as a predictor for the primary end point was established at ≥9.6 nmol/l, p<!--> <!-->=<!--> <!-->0.01. Also, multivariate analysis identified that metformin levels at admission were a predictive factor for the need for RRT, with an area under the ROC curve of 0.75 and a cut-off point for metformin levels of ≥9.4<!--> <!-->μg/ml, p<!--> <!-->=<!--> <!-->0.002.</div></div><div><h3>Conclusions</h3><div>MI is a severe intoxication, with high mortality and need for RRT. In our study, the only predictive factor for the need of RRT and/or patient death was the level of lactate. Metformin levels at admission were related with the need for RRT.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"46 2","pages":"Article 501429"},"PeriodicalIF":2.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146090853","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 intravenous ferric carboxymaltose on physical performance and patient-reported outcomes in elderly patients with non-dialysis CKD, mild anemia, and iron deficiency: A pilot study","authors":"Maria Jesús Puchades ,&nbsp;Juan Casas ,&nbsp;Julio Nuñez ,&nbsp;Elena Gimenez-Civera ,&nbsp;Boris Gonzales ,&nbsp;Marco Montomoli ,&nbsp;Rafael de la Espriella ,&nbsp;Miguel Gonzalez-Rico ,&nbsp;Isidro Torregrosa ,&nbsp;Carlos J. Peña ,&nbsp;Aleix Cases ,&nbsp;Jose Luis Gorriz","doi":"10.1016/j.nefro.2025.501418","DOIUrl":"10.1016/j.nefro.2025.501418","url":null,"abstract":"<div><h3>Background</h3><div>Iron deficiency (ID) is highly prevalent in chronic kidney disease (CKD) and it's associated with poorer quality of life (QoL) and functional capacity. Intravenous iron therapy is limited to CKD patients with ID and anemia to avoid/delay the need or reduce the dose of erythropoiesis-stimulating agents, according to guidelines. We hypothesized that treatment with IV iron in CKD patients with ID and borderline anemia may improve their physical performance and QoL, independently of its effects on hemoglobin.</div></div><div><h3>Methods</h3><div>Prospective, single-arm study in CKD patients with ID and mild anemia. The 6-min walk test (6-MWT), Piper fatigue scale, Patient's global assessment (PGA) and QoL (EQ-5D) questionnaires were evaluated at baseline, and at weeks 1 and 4 after receiving IV ferric carboxymaltose. Changes in continuous endpoints and their longitudinal trajectories were estimated with linear mixed regression models (LMRMs).</div></div><div><h3>Results</h3><div>Forty-one patients completed the study. The 6-MWT increased from 296<!--> <!-->±<!--> <!-->101<!--> <!-->m to 314<!--> <!-->±<!--> <!-->106<!--> <!-->m at week 1 (<em>p</em> <!-->&lt;<!--> <!-->0.01), and to 325<!--> <!-->±<!--> <!-->111 meters at week 4 (<em>p</em> <!-->&lt;<!--> <!-->0.01). PGA, EQ-5D questionnaire and Piper Fatigue scale significantly improved at week 4 from baseline (<em>p</em> <!-->&lt;<!--> <!-->0.05), after adjustment in the last 2 variables. Hemoglobin levels did not increase significantly during the follow-up.</div></div><div><h3>Conclusions</h3><div>IV ferric carboxymaltose (IV FCM) was associated with a significant short-term improvement in the 6-MWT in CKD patients with iron deficiency and mild anemia. PGA, EQ-5D and Piper Fatigue Scale also improved at 4 weeks. These findings suggest a potential short-term benefit of IV ferric carboxymaltose on physical performance and PROMs in this population, independent of hemoglobin changes; however, given the small sample size and absence of a control group, results should be interpreted with caution and considered hypothesis-generating.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"46 2","pages":"Article 501418"},"PeriodicalIF":2.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146090851","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":"Irisin and the kidney: Key points to know?","authors":"Danilo Candido de Almeida ,&nbsp;Juan Sebastian Henao Agudelo","doi":"10.1016/j.nefro.2025.501443","DOIUrl":"10.1016/j.nefro.2025.501443","url":null,"abstract":"<div><div>Irisin, a myokine generated through the proteolytic cleavage of fibronectin type III domain-containing protein 5 (FNDC5), has been increasingly recognized as a critical mediator of the salutary effects of physical exercise on metabolic homeostasis, energy metabolism, and the regulation of inflammatory, oxidative, and fibrotic pathways. Recent investigations have delineated a significant association between irisin levels and renal pathophysiology, particularly within the context of chronic kidney disease. Emerging evidence suggests that irisin may play a modulatory role in renal function, with particular relevance to diabetic nephropathy and acute kidney injury. Therefore, this mini-review consolidates current findings on the mechanistic underpinnings of irisin's involvement in renal pathophysiology, elucidating its intricate interplay with kidney disease. Additionally, we highlight the potential of irisin as a promising biomarker and therapeutic target in nephrology.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"46 2","pages":"Article 501443"},"PeriodicalIF":2.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146090858","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":"Registro de aféresis terapéutica de la Sociedad Española de Nefrología. Análisis de la actividad en los últimos 5 años","authors":"E. Rodríguez ,&nbsp;L. Sánchez-Cámara ,&nbsp;E. Márquez ,&nbsp;A. Herreros ,&nbsp;S. Benito ,&nbsp;M. Fernández-Lucas ,&nbsp;M.V. Rubio ,&nbsp;R. Franquelo ,&nbsp;R. Escaño ,&nbsp;N. Ramos ,&nbsp;E. Tamarit ,&nbsp;J.M. Benlliure ,&nbsp;O. Siverio ,&nbsp;M.I. Gallardo ,&nbsp;M.P. Valenzuela ,&nbsp;E. Davin ,&nbsp;N. Martín-Alemany ,&nbsp;L.M. Cueto ,&nbsp;M.T. Padrón ,&nbsp;M.T. Rodrigo de Tomás ,&nbsp;D. Barraca","doi":"10.1016/j.nefro.2025.501413","DOIUrl":"10.1016/j.nefro.2025.501413","url":null,"abstract":"<div><h3>Introduction</h3><div>Therapeutic apheresis (TA) is an extracorporeal technique used to treat various renal and non-renal pathologies, for which the ASFA guidelines provide recommendations. In Spain, nephrology services have progressively adopted various forms of TA, and since 2018, the Spanish Society of Nephrology (SEN) has maintained a national TA registry to monitor its use.</div></div><div><h3>Objective</h3><div>To describe the activity of nephrology services participating in the TA registry of the SEN (AFT-SEN) between 2019 and 2023.</div></div><div><h3>Material and methods</h3><div>A descriptive observational study was conducted that included all treatments consecutively recorded in the AFT-SEN registry between 2019 and 2023. A total of 4,331 procedures performed on 525 patients across 19 nephrology services were analysed.</div></div><div><h3>Results</h3><div>The median age was 43.7 years, and 49.6% of patients were female. The main indications were neurological diseases (33%), renal diseases (22%), and metabolic diseases (19.6%). Sixty percent of the procedures were performed for acute episodes and 40% in chronic programmes. The most commonly used technique was plasma exchange (72.2%), followed by double filtration (19.7%). Adverse effects occurred in 7% of sessions, primarily hypotension and vascular access issues.</div></div><div><h3>Conclusions</h3><div>The AFT-SEN registry represents the first multicentre initiative in Spanish nephrology. The data demonstrate the expansion and diversification of TA techniques and the implementation of chronic programmes. They also show that TA is being integrated into clinical nephrology practice, with an acceptable safety profile.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"46 2","pages":"Article 501413"},"PeriodicalIF":2.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146090855","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":"Kidney transplantation for the treatment of ESRD caused by hereditary type 2 Dent Nephropathy which carries a rare ORCL mutation","authors":"Chuanyou Xia ,&nbsp;Lingquan Meng ,&nbsp;Guanbao Tang ,&nbsp;Shuo Wang ,&nbsp;Panpan Han ,&nbsp;Xiaoming Zhang ,&nbsp;Jianning Wang ,&nbsp;Jiwei Yang","doi":"10.1016/j.nefro.2025.501415","DOIUrl":"10.1016/j.nefro.2025.501415","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"46 2","pages":"Article 501415"},"PeriodicalIF":2.6,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146090852","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}