Nephrology最新文献

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Associations between bioelectrical impedance analysis-derived phase angle, protein-energy wasting and all-cause mortality in older patients undergoing haemodialysis. 生物电阻抗分析得出的相位角、蛋白质能量消耗与接受血液透析的老年患者全因死亡率之间的关系。
IF 2.4 4区 医学
Nephrology Pub Date : 2024-10-01 Epub Date: 2024-06-10 DOI: 10.1111/nep.14333
Sho Kojima, Naoto Usui, Akimi Uehata, Akihito Inatsu, Atsuhiro Tsubaki
{"title":"Associations between bioelectrical impedance analysis-derived phase angle, protein-energy wasting and all-cause mortality in older patients undergoing haemodialysis.","authors":"Sho Kojima, Naoto Usui, Akimi Uehata, Akihito Inatsu, Atsuhiro Tsubaki","doi":"10.1111/nep.14333","DOIUrl":"10.1111/nep.14333","url":null,"abstract":"<p><strong>Aim: </strong>Protein-energy wasting (PEW) is a common syndrome in patients undergoing haemodialysis (HD) and is associated with poor prognosis. Bioelectrical impedance analysis (BIA)-derived phase angle (PA) is useful for predicting PEW, but sex and age need to be considered. We aimed to reveal sex-specific cut-off values of PA predicting PEW in HD patients aged ≥65.</p><p><strong>Methods: </strong>This two-centre retrospective cohort study included patients on HD who underwent BIA. PEW was detected using the International Society of Renal Nutrition and Metabolism (ISRNM) criteria as a reference. The PA was measured using a multifrequency bioimpedance device. Sex-specific cut-off values of PA predicting PEW were detected by receiver-operator characteristic analysis. We investigated the association between PEW determined using sex-specific cut-off values for PA and all-cause mortality.</p><p><strong>Results: </strong>This study included 274 patients undergoing HD, with a median age of 75 (70-80) years, mean PA of 3.8 ± 1.1° and PEW of 43%. Over a median follow-up duration of 1095 (400-1095) days, 111 patients died. Cut-off values of PA predicting PEW were as follows: female, 3.00° (sensitivity, 87.3%; specificity, 77.5%), and male, 3.84° (sensitivity, 77.6%; specificity, 71.4%). The kappa coefficient between sex-specific cut-off values of the PA and ISRNM criteria had a moderate coincidence level of 0.55. PEW detected by PA was independently associated with all-cause mortality (hazard ratio: 2.40; 95% confidence interval: 1.51-3.85; p < .001).</p><p><strong>Conclusions: </strong>Sex-specific cut-off values for PA in older HD patients may be useful as a screening tool for predicting PEW and mortality.</p>","PeriodicalId":19264,"journal":{"name":"Nephrology","volume":" ","pages":"655-662"},"PeriodicalIF":2.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141301185","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}
引用次数: 0
The significance of serum SLC7A11 levels in the occurrence of vascular calcification in maintenance peritoneal dialysis patients. 维持性腹膜透析患者血清 SLC7A11 水平在血管钙化发生中的意义。
IF 2.4 4区 医学
Nephrology Pub Date : 2024-10-01 Epub Date: 2024-06-12 DOI: 10.1111/nep.14334
Jing Wu, Junling Zhang, Qiong Tang, Huixian Zhu, Yan Chen, Hua Xiong, Hongwei Jiang
{"title":"The significance of serum SLC7A11 levels in the occurrence of vascular calcification in maintenance peritoneal dialysis patients.","authors":"Jing Wu, Junling Zhang, Qiong Tang, Huixian Zhu, Yan Chen, Hua Xiong, Hongwei Jiang","doi":"10.1111/nep.14334","DOIUrl":"10.1111/nep.14334","url":null,"abstract":"<p><strong>Aim: </strong>This research aimed to explore the serum levels of solute carrier family 7 member 11 (SLC7A11) in patients with maintenance peritoneal dialysis (MPD) and its correlation with vascular calcification (VC) and clinical results.</p><p><strong>Methods: </strong>This present prospective observational cohort study enrolled 189 patients with MPD who were undergoing regular peritoneal dialysis for over 3 months in our hospital from February 2020 to July 2022. The abdominal aortic calcification score was used to assess the VC condition of MPD patients. The serum SLC7A11, interleukin (IL)-6, IL-1β and C-reactive protein levels were measured by enzyme-linked immunosorbent assay (ELISA). Demographic and clinical statistics were collected. All patients were followed up for 1 year and the overall survival time (OS) of all patients were recorded. All data used SPSS 18.0 for statistical analyses.</p><p><strong>Results: </strong>Patients with moderate/severe calcification in MPD had a longer duration of dialysis, higher serum levels of phosphate (P) and calcium (Ca) and lower serum levels of SLC7A11. Spearman's analysis revealed a negative correlation between serum SLC7A11 levels and the levels of P, Ca and IL-1β. Additionally, we observed an association between serum SLC7A11 levels and clinical prognosis as well as the extent of VC in MPD patients. Multivariate logistic regression analysis indicated that dialysis duration, SLC7A11, and P were risk factors for VC in MPD patients.</p><p><strong>Conclusion: </strong>The serum SLC7A11 levels decreased remarkably in MPD patients with moderate/severe calcification. This study may provide new targets and comprehensive approach to cardiovascular protection in patients with chronic kidney disease.</p>","PeriodicalId":19264,"journal":{"name":"Nephrology","volume":" ","pages":"663-670"},"PeriodicalIF":2.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141311302","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}
引用次数: 0
The EKFC equation outperforms the CKD-EPI and CKiD equations for GFR estimation in adolescent and young adult kidney transplant patients. 在估算青少年和年轻成人肾移植患者的 GFR 方面,EKFC 方程优于 CKD-EPI 和 CKiD 方程。
IF 2.4 4区 医学
Nephrology Pub Date : 2024-10-01 Epub Date: 2024-05-27 DOI: 10.1111/nep.14328
Chloé Grosyeux, Asma Alla, Françoise Barbé, Laurence Derain Dubourg, Laurence Chardon, Jean-Louis Guéant, Luc Frimat, Abderrahim Oussalah, Isabelle Vrillon
{"title":"The EKFC equation outperforms the CKD-EPI and CKiD equations for GFR estimation in adolescent and young adult kidney transplant patients.","authors":"Chloé Grosyeux, Asma Alla, Françoise Barbé, Laurence Derain Dubourg, Laurence Chardon, Jean-Louis Guéant, Luc Frimat, Abderrahim Oussalah, Isabelle Vrillon","doi":"10.1111/nep.14328","DOIUrl":"10.1111/nep.14328","url":null,"abstract":"<p><strong>Aim: </strong>This study evaluated the bias and accuracy of the CKD-EPI/CKiD and EKFC equations compared with the reference exogenous tracer-based assessment of glomerular filtration rate (GFR) in adult and pediatric patients according to their renal transplant status.</p><p><strong>Methods: </strong>We assessed the bias and P<sub>30</sub> accuracy of the CKD-EPI/CKiD and EKFC equations compared with iohexol-based GFR measurement.</p><p><strong>Results: </strong>In the overall population (n = 59), the median age was 29 years (IQR, 16.0-46.0) and the median measured GFR was 73.9 mL/min/1.73m<sup>2</sup> (IQR, 57.3-84.6). Among non-kidney transplant patients, the median was 77.7 mL/min/1.73m<sup>2</sup> (IQR, 59.3-86.5), while among kidney transplant patients, it was 60.5 mL/min/1.73m<sup>2</sup> (IQR, 54.2-66.8). The bias associated with the EKFC and CKD-EPI/CKiD equations was significantly higher among kidney transplant patients than among non-kidney transplant patients, with a difference between medians (Hodges-Lehmann) of +10.4 mL/min/1.73m<sup>2</sup> (95% CI, 2.2-18.9; p = .02) for the EKFC and +12.1 mL/min/1.73m<sup>2</sup> (95% CI, 4.2-21.4; p = .006) for the CKD-EPI/CKiD equations. In multivariable analysis, kidney transplant status emerged as an independent factor associated with a bias of >3.4 mL/min/1.73m<sup>2</sup> (odds ratio, 7.7; 95% CI, 1.4-43.3; p = .02) for the EKFC equation and a bias of >13.4 mL/min/1.73m<sup>2</sup> (odds ratio, 15.0; 95% CI, 2.6-85.7; p = .002) for the CKD-EPI/CKiD equations.</p><p><strong>Conclusion: </strong>In our study, which included adolescent and young adult kidney transplant patients, both the CKD-EPI/CKiD and EKFC equations tended to overestimate the measured glomerular filtration rate, with the EKFC equation exhibiting less bias. Renal transplant status significantly influenced the degree of estimation bias.</p>","PeriodicalId":19264,"journal":{"name":"Nephrology","volume":" ","pages":"680-687"},"PeriodicalIF":2.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141158951","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}
引用次数: 0
Hydrogen sulphide reduces renal ischemia-reperfusion injury by enhancing autophagy and reducing oxidative stress. 硫化氢通过增强自噬和减少氧化应激减轻肾缺血再灌注损伤
IF 2.4 4区 医学
Nephrology Pub Date : 2024-10-01 Epub Date: 2024-07-29 DOI: 10.1111/nep.14368
Hui Li, Shuaiwei Wang, Shuangshuang An, Biao Gao, Dongdong Wu, Yanzhang Li
{"title":"Hydrogen sulphide reduces renal ischemia-reperfusion injury by enhancing autophagy and reducing oxidative stress.","authors":"Hui Li, Shuaiwei Wang, Shuangshuang An, Biao Gao, Dongdong Wu, Yanzhang Li","doi":"10.1111/nep.14368","DOIUrl":"10.1111/nep.14368","url":null,"abstract":"<p><strong>Aim: </strong>Renal ischemia-reperfusion injury (IRI) is a major cause of acute kidney injury. Hydrogen sulphide (H<sub>2</sub>S) exerts a protective effect in renal IRI. The present study was carried out to investigate the effects of exogenous H<sub>2</sub>S on renal IRI by regulating autophagy in mice.</p><p><strong>Methods: </strong>Mice were randomly assigned to control, IRI and NaHS (an H<sub>2</sub>S donor, 28, 56 and 100 μmol/kg) groups. Renal IRI was induced by clamping the bilateral renal pedicles with non-traumatic arterial clamp for 45 min and then reperfused for 24 h. Mice were administered intraperitoneally with NaHS 20 min prior to renal ischemia. Sham group mice underwent the same procedures without clamping. Serum and kidney tissues were harvested 24 h after reperfusion for functional, histological, oxidative stress, and autophagic determination.</p><p><strong>Results: </strong>Compared with the control group, the concentrations of serum creatinine (Scr), blood urea nitrogen (BUN), and malondialdehyde (MDA), the protein levels of LC3II/I, Beclin-1 and P62, as well as the number of autophagosomes were significantly increased, but the activity of superoxide dismutase (SOD) was decreased after renal IRI. NaHS pre-treatment dramatically attenuated renal IRI-induced renal dysfunction, histological changes, MDA concentration and p62 expression in a dose-dependent manner. However, NaHS increased the SOD activity and the protein levels of LC3II/I and Beclin-1.</p><p><strong>Conclusion: </strong>These results indicate that exogenous H<sub>2</sub>S protects the kidney from IRI through enhancement of autophagy and reduction of oxidative stress. Novel H<sub>2</sub>S donors could be developed in the treatment of renal IRI.</p>","PeriodicalId":19264,"journal":{"name":"Nephrology","volume":" ","pages":"645-654"},"PeriodicalIF":2.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141792979","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}
引用次数: 0
Intracardiac vascular access in haemodialysis: A last resort for exhausted traditional access. 血液透析中的心内血管通路:用尽传统通路的最后手段。
IF 2.4 4区 医学
Nephrology Pub Date : 2024-10-01 Epub Date: 2024-07-18 DOI: 10.1111/nep.14370
Carlos Narváez Mejía, Arshdeep Singh, Florentino Villanego, Javier Naranjo, Juan Manuel Cazorla Lopez, Tomas Daroca Martínez, Marta Alonso Mozo, Jose Manuel Amaro Martín, Manuel Ceballos, Auxiliadora Mazuecos
{"title":"Intracardiac vascular access in haemodialysis: A last resort for exhausted traditional access.","authors":"Carlos Narváez Mejía, Arshdeep Singh, Florentino Villanego, Javier Naranjo, Juan Manuel Cazorla Lopez, Tomas Daroca Martínez, Marta Alonso Mozo, Jose Manuel Amaro Martín, Manuel Ceballos, Auxiliadora Mazuecos","doi":"10.1111/nep.14370","DOIUrl":"10.1111/nep.14370","url":null,"abstract":"<p><p>Depletion of veins for dialysis access is a challenging life threatening situation for patients in need of haemodialysis. The utilisation of intracardiac catheter is a rare procedure with scarce reported experience. We describe the case of a 68-year-old male that contributes to the limited knowledge of performing a life-saving intracardiac catheter placement for emergency haemodialysis in a patient without immediate alternative renal replacement therapy available. We also retrospectively analyse the experience reported so far and summarise complications and outcomes. In our case, the patient was able to pursue haemodialysis after intracardiac catheter placement without any complications. Two weeks later, the patient successfully received a kidney transplant from a deceased donor and has a serum creatinine of 1.7 mg/dL after 2 years of follow-up. There are only four reported cases of kidney transplantation after the procedure, including our own. Intracardiac catheter is an emerging option that could be considered in certain patients as the last resort. Further investigation with regards to patient candidacy and procedure security are necessary.</p>","PeriodicalId":19264,"journal":{"name":"Nephrology","volume":" ","pages":"699-702"},"PeriodicalIF":2.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141634102","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}
引用次数: 0
2,5-Dihydroxyacetophenone attenuates acute kidney injury induced by intra-abdominal infection in rats. 2,5-二羟基苯乙酮可减轻大鼠腹腔内感染引起的急性肾损伤。
IF 2.4 4区 医学
Nephrology Pub Date : 2024-10-01 Epub Date: 2024-07-25 DOI: 10.1111/nep.14335
Tao Han, Ye Jiang, Weixing Ge, Yuyu Lu, Rongming Liu, Zunpeng Sun
{"title":"2,5-Dihydroxyacetophenone attenuates acute kidney injury induced by intra-abdominal infection in rats.","authors":"Tao Han, Ye Jiang, Weixing Ge, Yuyu Lu, Rongming Liu, Zunpeng Sun","doi":"10.1111/nep.14335","DOIUrl":"10.1111/nep.14335","url":null,"abstract":"<p><strong>Aims: </strong>As one of the most serious complications of sepsis, acute kidney injury (AKI) is pathologically associated with excessive inflammation. 2,5-Dihydroxyacetophenone (DHAP) is isolated from Radix rehmanniae praeparata and exhibit potent anti-inflammatory property. This research aimed at determining the role of DHAP in sepsis-associated AKI (SA-AKI) and the underlying mechanism.</p><p><strong>Methods: </strong>Plasma creatinine (Cre), blood urea nitrogen (BUN), tumour necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) levels of SA-AKI patients were detected to evaluate their clinical characteristics. SA-AKI rat models were established by using caecum ligation puncture (CLP) surgery. CLP-induced rats were administered via oral gavage with 20 or 40 mg DHAP after 2 h of CLP surgery. Subsequently, survival rates, serum indexes, histopathological changes, inflammatory factors, renal function indexes and extracellular regulated protein kinases (ERK) and nuclear factor-κB (NF-κB) signalling pathways were detected.</p><p><strong>Results: </strong>SA-AKI patients exhibited markedly higher levels of plasma Cre, BUN, TNF-α and IL-1β than healthy people. Compared with sham rats, CLP-induced septic rats showed significantly decreased survival rate, increased serum lactate dehydrogenase activity and serum lactate level, obvious renal histopathological injury, upregulated TNF-α, IL-1β and TGF-β1 levels, elevated serum creatinine, BUN and serum cystatin C concentrations, serum neutrophil gelatinase-associated lipocalin and kidney injury molecule-1 levels and reduced renal artery blood flow. All the above CLP-induced changes in septic rats were mitigated after DHAP administration. Additionally, CLP-induced elevation in phosphorylated-ERK1/2 and nuclear NF-κB p65 protein levels was inhibited by DHAP treatment.</p><p><strong>Conclusion: </strong>DHAP hinders SA-AKI progression in rat models by inhibiting ERK and NF-κB signalling pathways.</p>","PeriodicalId":19264,"journal":{"name":"Nephrology","volume":" ","pages":"636-644"},"PeriodicalIF":2.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141760086","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}
引用次数: 0
Nephrotic syndrome in a child with neurofibromatosis type 1: A case report and literature review 一名神经纤维瘤病 1 型患儿的肾病综合征:病例报告和文献综述
IF 2.5 4区 医学
Nephrology Pub Date : 2024-09-18 DOI: 10.1111/nep.14393
Bingjie Cheng, Huihui Yang, Lin Huang, Panli Liao, Fei Peng, Xiaowen Wang
{"title":"Nephrotic syndrome in a child with neurofibromatosis type 1: A case report and literature review","authors":"Bingjie Cheng, Huihui Yang, Lin Huang, Panli Liao, Fei Peng, Xiaowen Wang","doi":"10.1111/nep.14393","DOIUrl":"https://doi.org/10.1111/nep.14393","url":null,"abstract":"Neurofibromatosis type 1 (NF1) is an autosomal dominant genetic disorder that caused by <jats:italic>NF1</jats:italic> mutations. <jats:italic>NF1</jats:italic> gene encodes neurofibromin (a GTPase‐activating protein) and plays a regulatory role in many signalling pathway such as the Ras/MAPK pathway, which is important for regulating cell growth, proliferation and neural development. Therefore, <jats:italic>NF1</jats:italic> gene mutations causes the excessive activation of signalling pathways and uncontrolled cell growth. NF1 exhibits complete genetic penetrance and clinical heterogeneity. Glomerular disease has rarely been reported in patients with NF1, especially in children. Currently, the relationship between NF1 and nephrotic syndrome is unclear. Here, we present a case of NF1 with nephrotic syndrome and further explore the association between NF1 and glomerular diseases. It also reminds clinicians that NF1 has complex and highly variable clinical manifestations and that a comprehensive workup is essential for patients.","PeriodicalId":19264,"journal":{"name":"Nephrology","volume":"15 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142258913","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}
引用次数: 0
A rare multisystemic disorder with chronic kidney disease: Karyomegalic interstitial nephritis due to homozygous FAN1 c.2260C>T variant. 一种伴有慢性肾病的罕见多系统疾病:由同型 FAN1 c.2260C>T 变异引起的巨细胞性间质性肾炎。
IF 2.5 4区 医学
Nephrology Pub Date : 2024-09-18 DOI: 10.1111/nep.14394
Merve Guzel Dirim,Ahmet Burak Dirim,Berker Kaya,Naci Senkal,Tugba Kalayci,Ayca Aslanger,Neslihan Berker,Murat Kose,Isin Kilicaslan,Halil Yazici
{"title":"A rare multisystemic disorder with chronic kidney disease: Karyomegalic interstitial nephritis due to homozygous FAN1 c.2260C>T variant.","authors":"Merve Guzel Dirim,Ahmet Burak Dirim,Berker Kaya,Naci Senkal,Tugba Kalayci,Ayca Aslanger,Neslihan Berker,Murat Kose,Isin Kilicaslan,Halil Yazici","doi":"10.1111/nep.14394","DOIUrl":"https://doi.org/10.1111/nep.14394","url":null,"abstract":"Karyomegalic interstitial nephritis (KIN) is a rare entity associated with biallelic FAN1 (FANCD2/FANCI-Associated Nuclease 1) gene variants. In FAN1-related KIN, abnormal liver function tests and respiratory involvement are common, in addition to chronic kidney disease. Karyomegalic changes have also been reported in many other organs in patients with FAN1-related KIN in various studies. We report the case of a 35-year-old male with chronic kidney disease of unknown aetiology, concurrent recurrent upper and lower respiratory tract infections, and elevated liver function test results with unidentified aetiology. The patient's family history was remarkable for consanguineous parent marriage and history of kidney transplantation in his aunt. A kidney biopsy was performed, which was consistent with KIN. Clinical exome sequencing revealed a homozygous nonsense variant NM_014967.5 (FAN1): c. 2260C > T (p.Arg754Ter). According to the American College of Medical Genetics (ACMG) criteria, this variant is pathogenic and, to the best of our knowledge, has not been previously reported, homozygously. Therefore, the histopathological and clinical diagnoses of KIN were confirmed by genetic studies in our patient. This case report expands the genetic spectrum of FAN1-related KIN, and briefly reviews the current literature data.","PeriodicalId":19264,"journal":{"name":"Nephrology","volume":"17 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142258911","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}
引用次数: 0
Sepsis-associated acute kidney injury in patients with chronic kidney disease: Patient characteristics, prevalence, timing, trajectory, treatment and associated outcomes. 慢性肾病患者败血症相关急性肾损伤:患者特征、发病率、发病时间、发病轨迹、治疗及相关结果。
IF 2.5 4区 医学
Nephrology Pub Date : 2024-09-18 DOI: 10.1111/nep.14392
Kyle C White,Rinaldo Bellomo,Alexis Tabah,Antony G Attokaran,Hayden White,James McCullough,Kiran Shekar,Mahesh Ramanan,Peter Garrett,Philippa McIlroy,Siva Senthuran,Stephen Luke,Ary Serpa-Neto,Tom Larsen,Kevin B Laupland,
{"title":"Sepsis-associated acute kidney injury in patients with chronic kidney disease: Patient characteristics, prevalence, timing, trajectory, treatment and associated outcomes.","authors":"Kyle C White,Rinaldo Bellomo,Alexis Tabah,Antony G Attokaran,Hayden White,James McCullough,Kiran Shekar,Mahesh Ramanan,Peter Garrett,Philippa McIlroy,Siva Senthuran,Stephen Luke,Ary Serpa-Neto,Tom Larsen,Kevin B Laupland,","doi":"10.1111/nep.14392","DOIUrl":"https://doi.org/10.1111/nep.14392","url":null,"abstract":"AIMThe features and outcomes of sepsis-associated acute kidney injury (SA-AKI) may be affected by chronic kidney disease (CKD). Accordingly, we aimed to compare SA-AKI in patients with or without CKD.METHODSRetrospective cohort study in 12 intensive care units (ICU). We studied the prevalence, patient characteristics, timing, trajectory, treatment and outcomes of SA-AKI with and without CKD.RESULTSOf 84 240 admissions, 7255 (8.6%) involved patients with CKD. SA-AKI was more common in patients with CKD (21% vs 14%; p < .001). CKD patients were older (70 vs. 60 years; p < .001), had a higher median Charlson co-morbidity index (5 vs. 3; p < .001) and acute physiology and chronic health evaluation (APACHE) III score (78 vs. 60; p < .001) and were more likely to receive renal replacement therapy (RRT) (25% vs. 17%; p < .001). They had less complete return to baseline function at ICU discharge (48% vs. 60%; p < .001), higher major adverse kidney events at day 30 (MAKE-30) (38% vs. 27%; p < .001), and higher hospital and 90-day mortality (21% vs. 13%; p < .001, and 27% vs. 16%; p < .001, respectively). After adjustment for patient characteristics and severity of illness, however, CKD was not an independent risk factor for increased 90-day mortality (OR 0.88; 95% CI 0.76-1.02; p = .08) or MAKE-30 (OR 0.98; 95% CI 0.80-1.09; p = .4).CONCLUSIONSA-AKI is more common in patients with CKD. Such patients are older, more co-morbid, have higher disease severity, receive different ICU therapies and have different trajectories of renal recovery and greater unadjusted mortality. However, after adjustment day-90 mortality and MAKE-30 risk were not increased by CKD.","PeriodicalId":19264,"journal":{"name":"Nephrology","volume":"75 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142258914","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}
引用次数: 0
Hydrogen sulfide as a therapeutic agent in renal ischemia‐reperfusion injury: Mechanistic insights and clinical potential 硫化氢作为肾缺血再灌注损伤的治疗药物:机理认识与临床潜力
IF 2.5 4区 医学
Nephrology Pub Date : 2024-09-11 DOI: 10.1111/nep.14384
Chih‐Ning Chen, Vin‐Cent Wu
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