Renal Failure最新文献

{"title":"Association of live microbes intake and risk of all-cause, cardiovascular disease, and cancer-related mortality in patients with chronic kidney disease.","authors":"Debin Chen, Yongju Ye, Yining Li, Erxu Xue, Qijun Zhang, Youlan Chen, Jianhui Zhao","doi":"10.1080/0886022X.2024.2449196","DOIUrl":"10.1080/0886022X.2024.2449196","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease (CKD) is a prevalent chronic, non-communicable disease. The long-term health effects of dietary live microbes, primarily probiotics, on CKD patients remain insufficiently understood. This study aims to investigate the association between dietary intake of live microbes and long-term health outcomes among individuals with CKD.</p><p><strong>Methods: </strong>Utilizing the National Health and Nutrition Examination Survey (NHANES) database, Cox regression analysis assessed the association between medium and high categories dietary live microbe intake and health outcomes (all-cause, cardiovascular disease [CVD], and cancer-related mortality) in CKD patients.</p><p><strong>Results: </strong>A total of 3,646 CKD patients were enrolled. During the follow-up period, 1,593 all-cause mortality events were recorded, including 478 CVD deaths and 268 cancer deaths. In the fully adjusted model, compared to CKD patients in the lowest quartile (quartile 1) of live microbes intake, those in quartiles 3 and 4 exhibited a 20% and 26% reduced risk of all-cause mortality, with hazard ratios (HR) of 0.80 (95% confidence interval, CI: 0.69, 0.94) and 0.74 (95% CI: 0.62, 0.90), respectively. Additionally, compared to those with low live microbe intake (quartile 1), higher live microbe intake in quartile 4 was associated with a 37% reduction in the risk of CVD mortality for CKD patients, with an HR of 0.63 (95% CI: 0.45, 0.88). Consistent results were observed in subgroup and sensitivity analyses. A significant negative association was observed between live microbe intake and the risk of all-cause mortality as well as CVD mortality in the CKD population, with a p-value for trend < 0.05.</p><p><strong>Conclusion: </strong>Our study indicated that high dietary live microbe intake could mitigate the risk of all-cause and CVD mortality in CKD patients. These findings support the inclusion of live microbes in dietary recommendations, highlighting their significant roles in CKD.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2449196"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11721851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142962428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics and prognostic values of abdominal aortic branches calcification in hemodialysis patients.","authors":"Wen Shi, Xiaotong Xie, Yu Zhao, Yuqiu Liu, Xiaoliang Zhang","doi":"10.1080/0886022X.2024.2432538","DOIUrl":"10.1080/0886022X.2024.2432538","url":null,"abstract":"<p><strong>Background: </strong>Vascular calcification is highly prevalent and associated with mortality in hemodialysis patients. However, extreme splanchnic arterial calcification in calciphylaxis with poor prognosis raises questions regarding the reliability of previous vascular calcification scoring methods. Therefore, this study aimed to examine the distribution characteristics of abdominal aortic branch calcification and identify a more reliable predictor of mortality in hemodialysis patients.</p><p><strong>Methods: </strong>The cohort study included 237 hemodialysis patients. The distribution characteristics of abdominal aortic branch calcification were determined by quantifying the calcification volumes. The primary and secondary outcomes were all-cause mortality and new-onset cardiovascular events, respectively. We compared the prognostic values of abdominal aortic branch calcification and constructed a predictive nomogram model.</p><p><strong>Results: </strong>The prevalence of abdominal vascular calcification in hemodialysis patients was 95.36%, with the highest prevalence in the abdominal aorta (88.61%) and internal iliac artery (85.65%). During a median follow-up period of 3.92 years, 137 patients died. Internal iliac artery and mesenteric artery calcification showed the greatest predictive values for mortality. Internal iliac artery calcification and serum albumin level were independently associated with mortality in hemodialysis patients (<i>p</i> < .001). The nomogram model constructed with internal iliac artery calcification, serum albumin level, age, and comorbid cardiovascular disease was well discriminative, calibrated, and clinically applicable for predicting 3-year survival.</p><p><strong>Conclusion: </strong>Abdominal aortic branch calcification, particularly internal iliac artery calcification, is a preferable prognostic predictor than abdominal aorta or coronary artery calcification in hemodialysis patients.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2432538"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11721613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142962429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of the estimated glomerular filtration rate and body roundness index in the risk assessment of uric acid-lowering therapy-resistant gout in U.S. adults: evidence from the National Health and Nutrition Examination Survey (2007-2018).","authors":"Mengyuan Zhu, Xingqiang Wang, Zining Peng, Weitian Yan, Qian Deng, Meihui Li, Nian Liu, Ling Zhang","doi":"10.1080/0886022X.2024.2441398","DOIUrl":"10.1080/0886022X.2024.2441398","url":null,"abstract":"<p><strong>Objective: </strong>To explore the risk factors for uric acid-lowering therapy-resistant gout (UALT-RG) and its relationships with the estimated glomerular filtration rate (eGFR), body roundness index (BRI), and visceral adiposity index (VAI) <i>via</i> 2007-2018 National Health and Nutrition Examination Survey (NHANES) data.</p><p><strong>Methods: </strong>We calculated the BRI using waist circumference and standing height; the VAI using triglycerides (TGs), high-density lipoprotein cholesterol (HDL-C), and body mass index (BMI); and the eGFR from serum creatinine levels. We also collected gout data. We explored the relationships of the eGFR, BRI, and VAI with UALT-RG risk <i>via</i> univariable and multivariable weighted logistic regression, trend analysis, and restricted cubic splines.</p><p><strong>Results: </strong>Among the 1,811 patients with gout, ∼9.08% had UALT-RG; these patients were more likely to have obesity, comorbid diabetes (36% [27-47%] <i>vs.</i> 25% [22-28%]) or impaired kidney function (eGFR < 60 mL/min/1.73 m², 34.5% [27-43%] <i>vs.</i> 22.5% [20-26%]); be former smokers; and take colchicine (10% [5.6-19%] <i>vs.</i> 4.3% [2.8-6.7%]). Logistic regression and trend analysis suggested that an elevated BRI and decreased eGFR were independent risk factors and potential screening indicators for UALT-RG. Restricted cubic spline analysis revealed a negative linear trend between the eGFR and UALT-RG risk (<i>p</i>-overall < 0.0001) and a significant positive correlation between the BRI and UALT-RG risk (<i>p</i>-overall < 0.0001).</p><p><strong>Conclusion: </strong>An increased BRI and decreased eGFR may be independent risk factors and assessment indicators for UALT-RG in U.S. adults. It is necessary to monitor serum urate levels more closely and conduct early multidisciplinary comanagement when gout is comorbid with visceral obesity and chronic kidney disease stages 3-5.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2441398"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11803761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brachial plexus block versus local anesthesia for percutaneous transluminal angioplasty of dysfunctional arteriovenous fistula: 12-month results of a propensity score weighted study.","authors":"Xiaojing Wang, Yuli Wang, Yiping Zhao, Yinan Li, Xiangjiang Guo, Lan Zhang, Jiaquan Chen, Qihong Ni","doi":"10.1080/0886022X.2025.2477834","DOIUrl":"10.1080/0886022X.2025.2477834","url":null,"abstract":"<p><strong>Objective: </strong>The study aimed to compare ultrasound-guided brachial plexus block (BPB) with local anesthesia (LA) on efficacy, safety and 12-month patency rate for percutaneous transluminal angioplasty (PTA) treatment of dysfunctional arteriovenous fistula (AVF).</p><p><strong>Methods: </strong>Consecutive patients with dysfunctional AVF who underwent PTA from January 2021 to December 2022 were included. Overlap weighting was performed to adjust for significant differences between the two groups. The primary efficacy outcomes included visual analogue scale (VAS) score and 12-month target-lesion primary patency rate. The secondary efficacy outcomes included target-lesion primary-assisted patency rate, secondary patency rate, access-circuit thrombosis rate, access-circuit reintervention rate, and number of reinterventions within 12 months. Univariate analysis and multivariate analysis by log-binomial regression were used to identify the independent factors associated with intraoperative pain.</p><p><strong>Results: </strong>218 patients were included in the study: 82 patients underwent PTA under BPB and 136 patients underwent PTA under LA. After overlap weighting, the baseline, lesion characteristics and intraoperative details had no significant difference between the two groups. Patients under BPB had significantly lower VAS scores than those under LA (2.4 ± 1.4 vs 5.1 ± 1.9, <i>p</i> < 0.001). The 12-month target-lesion primary patency rate was significantly higher in the BPB group than that in the LA group (58.3% vs 40.0%, <i>p</i> = 0.037). The 12-month target-lesion primary-assisted patency rate and access-circuit secondary patency rate were significantly higher in the BPB group than those in the LA group (<i>p</i> = 0.023 and <i>p</i> = 0.028). The access-circuit thrombosis rate was significantly lower in the BPB group (10.0%) than that in the LA group (28.3%) (<i>p</i> = 0.011). BPB was the only independent factor associated with mild pain (<i>p</i> < 0.001, OR: 0.037, 95%CI: 0.011-0.119).</p><p><strong>Conclusions: </strong>BPB could decrease the intraoperative pain and improve the 12-month primary patency rates compared with LA for patients underwent PTA treatment of dysfunctional AVF.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2477834"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11915726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143650369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine learning algorithms for diabetic kidney disease risk predictive model of Chinese patients with type 2 diabetes mellitus.","authors":"Lu-Xi Zou, Xue Wang, Zhi-Li Hou, Ling Sun, Jiang-Tao Lu","doi":"10.1080/0886022X.2025.2486558","DOIUrl":"10.1080/0886022X.2025.2486558","url":null,"abstract":"<p><strong>Background: </strong>Diabetic kidney disease (DKD) is a common and serious complication of diabetic mellitus (DM). More sensitive methods for early DKD prediction are urgently needed. This study aimed to set up DKD risk prediction models based on machine learning algorithms (MLAs) in patients with type 2 DM (T2DM).</p><p><strong>Methods: </strong>The electronic health records of 12,190 T2DM patients with 3-year follow-ups were extracted, and the dataset was divided into a training and testing dataset in a 4:1 ratio. The risk variables for DKD development were ranked and selected to establish forecasting models. The performance of models was further evaluated by the indexes of sensitivity, specificity, positive predictive value, negative predictive value, accuracy, as well as F1 score, using the testing dataset. The value of accuracy was used to select the optimal model.</p><p><strong>Results: </strong>Using the importance ranking in the random forest package, the variables of age, urinary albumin-to-creatinine ratio, serum cystatin C, estimated glomerular filtration rate, and neutrophil percentage were selected as the predictors for DKD onset. Among the seven forecasting models constructed by MLAs, the accuracy of the Light Gradient Boosting Machine (LightGBM) model was the highest, indicated that the LightGBM algorithms might perform the best for predicting 3-year risk of DKD onset.</p><p><strong>Conclusions: </strong>Our study could provide powerful tools for early DKD risk prediction, which might help optimize intervention strategies and improve the renal prognosis in T2DM patients.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2486558"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11983574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Smoking as a causative factor in chronic kidney disease: a two-sample Mendelian randomization study.","authors":"Yue Yang, Zheng Zhang, Hai-Tao Lu, Qian-Qian Xu, Li Zhuo, Wen-Ge Li","doi":"10.1080/0886022X.2025.2453014","DOIUrl":"10.1080/0886022X.2025.2453014","url":null,"abstract":"<p><p>Smoking is widely acknowledged for its harmful effects on multiple organs. However, its specific causal relationship with chronic kidney disease (CKD) remains uncertain. This study applied bivariate causal analysis and two-sample Mendelian randomization (MR) methods to examine the association between various smoking behaviors - initiation, cessation, age at initiation, cigarettes smoked per day, and lifetime smoking - and CKD, using genome-wide data. The inverse variance weighted (IVW) method was the primary analytical tool, supported by sensitivity analyses, pleiotropy assessments, and mediation analyses. External validation was conducted using independent datasets. The results revealed positive associations between CKD and smoking initiation (Pivw = 1.8 × 10^-2, OR = 1.192), earlier age at initiation (Pivw = 2.3 × 10^-3, OR = 1.481), cigarettes smoked per day (Pivw = 8.8 × 10^-3, OR = 1.216), and lifetime smoking (Pivw = 2.3 × 10^-7, OR = 2.445). In contrast, smoking cessation demonstrated a protective effect against CKD (Pivw = 4.0 × 10^-12, OR = 0.791). External validation results aligned with the primary findings, and the absence of significant heterogeneity confirmed the robustness of the MR analysis. Additionally, the effect of smoking on CKD was mediated by factors such as body mass index, cardiovascular disease, hypertension, and type 2 diabetes. These findings identify smoking as a contributing factor to CKD and suggest that reducing smoking prevalence could significantly lower the incidence of CKD in the population.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2453014"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11753011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"miR-1225-3p regulates fibrosis in mesangial cells via SMURF2-mediated ubiquitination of ChREBP in diabetic kidney disease.","authors":"Juntai Zhang, Yan Cai, Yan Qin, Jie Liu, Jie Ding, Mengying Xu, Li Yang, Yuanxin Zheng, Xi Zhang","doi":"10.1080/0886022X.2025.2484632","DOIUrl":"https://doi.org/10.1080/0886022X.2025.2484632","url":null,"abstract":"<p><strong>Background: </strong>Diabetic kidney disease (DKD), characterized by mesangial fibrosis and renal dysfunction, is a major microvascular complication of diabetes. Studies have shown that miRNAs are closely related to the progression of DKD. Therefore, in this study, we aimed to explore whether miR-1225-3p can regulate Smad ubiquitin regulatory factor 2 (SMURF2)-mediated carbohydrate response element binding protein (ChREBP) ubiquitination through Rho GTPase-activating protein 5 (ARHGAP5) to affect fibrosis in DKD.</p><p><strong>Methods: </strong>DKD mice were established by intraperitoneally injecting streptozocin (STZ), and a DKD cell model was generated by culturing in media supplemented with 25 mmol/L glucose (high glucose, HG). StarBase was used to predict the target binding sites between miR-1225-3p and ARHGAP5, and a dual-luciferase reporter gene assay was used to verify this relationship. Western blotting, RT-qPCR, flow cytometry, immunoprecipitation, ELISAs, HE staining, and Masson staining were used to detect relevant indicators.</p><p><strong>Results: </strong>ARHGAP5 and SMURF2 expression was decreased, but ChREBP was highly expressed in the renal tissue of DKD mice and HG-induced mouse mesangial cells (MMCs). miR-1225-3p could target and regulate the transcription of ARHGAP5, and an association between ARHGAP5 and SMURF2 was revealed. miR-1225-3p facilitated fibrosis and oxidative stress in MCCs by inhibiting ARHGAP5. In addition, SMURF2 promoted the ubiquitination of HA-ChREBP, and miR-1225-3p facilitated fibrosis and oxidative stress by mediating the ARHGAP5/SMURF2-mediated ubiquitination of ChREBP in MCCs. Furthermore, the miR-1225-3p inhibitor inhibited fibrosis and inflammation in the renal tissues of DKD mice.</p><p><strong>Conclusion: </strong>miR-1225-3p facilitates fibrosis and oxidative stress by mediating ARHGAP5/SMURF2-mediated ubiquitination of ChREBP.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2484632"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11995769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of a nomogram for predicting acute kidney injury in elderly patients in intensive care unit.","authors":"Li Zhao, Xunliang Li, Wenman Zhao, Deguang Wang","doi":"10.1080/0886022X.2025.2499911","DOIUrl":"https://doi.org/10.1080/0886022X.2025.2499911","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to develop and validate a nomogram for predicting acute kidney injury (AKI) in elderly patients in the intensive care unit (ICU).</p><p><strong>Methods: </strong>Population data regarding elderly patients in ICU were derived from the Medical Information Mart for Intensive Care IV database from 2008 to 2019. The nomogram model was constructed from the training set using LASSO regression and logistic regression analysis, and the performance of the model was evaluated by decision curve analysis, calibration curve, and receiver operating characteristic (ROC) curve.</p><p><strong>Results: </strong>According to inclusion and exclusion criteria, 14,373 elderly ICU patients were studied, of which 10,061 (70%) were assigned to the training set, and 4,312 (30%) were allocated to the validation set. Multivariate logistic analysis revealed that age, weight, myocardial infarction, congestive heart failure, dementia, diabetes, paraplegia, cancer, sepsis, body temperature, blood urea nitrogen, mechanical ventilation, urine volume, Sequential Organ Failure Assessment (SOFA) score, and Simplified Acute Physiology Score II (SAPS II) were independent risk factors for AKI in elderly ICU patients. The AUC values for the 15-factor nomogram were 0.812 (95% CI 0.802-0.822) and 0.802 (95% CI 0.787-0.818) in the training and validation sets, respectively. For clinical application, a simplified nomogram was constructed, which included age, weight, urine volume, SOFA score, and SAPS II, with the AUCs of 0.780 (95% CI 0.769-0.790) and 0.776 (95% CI 0.760-0.793), respectively. Calibration curve and decision curve analyses confirmed the models' high prediction accuracy and clinical value.</p><p><strong>Conclusions: </strong>The nomogram developed in this study shows excellent predictive performance for AKI in elderly patients in the ICU.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2499911"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143980806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dihydromyricetin protects against cisplatin-induced renal injury and mitochondria-mediated apoptosis via the EGFR/HSP27/STAT3 signaling pathway.","authors":"Zheming Xu, Minjing Zhang, Xue Zhang, Huirong Han, Weifeng Ye, Zhenjie Chen, Zhisu Lv, Yang Liu, Zhengye Liu, Jianguang Gong, Bin Zhu, Suhan Zhou, Runzhi Zhu, Chang Tao, Gensheng Zhang, Xiang Yan","doi":"10.1080/0886022X.2025.2490202","DOIUrl":"https://doi.org/10.1080/0886022X.2025.2490202","url":null,"abstract":"<p><strong>Background: </strong>Cisplatin (CP) has been used as an effective chemotherapy drug for different types of cancers. Despite its therapeutic benefits, the clinical utility of CP is often hindered by adverse effects, notably acute kidney injury (AKI), which restricts its widespread application. Dihydromyricetin (DHM) is a flavonoid acquired from <i>Ampelopsis grossedentata</i>, exhibiting a range of pharmacological activities. The major objective of this research was to examine the possible molecular mechanism involved in CP-induced AKI and the protective function of DHM.</p><p><strong>Methods: </strong>In this study, the protective function of DHM against CP-induced AKI was assessed in both mice and HK-2 cells. Kidney dysfunction parameters and renal morphology were evaluated to ascertain the extent of protection. Additionally, proteomics techniques were employed to investigate the protective effect of DHM and elucidate the underlying molecular mechanisms involved in mitigating CP-induced AKI. In addition, protein levels of epidermal growth factor receptor (EGFR), p-EGFR, heat shock protein 27 (HSP27), p-HSP27, STAT3, and p-STAT3 in renal tissues were investigated. Furthermore, an EGFR-blocking agent (gefitinib) or si-RNA of HSP27 was used to study the effects of inhibiting EGFR or HSP27 on CP-induced renal injury.</p><p><strong>Results: </strong>DHM decreased blood urea nitrogen (BUN) and creatinine in serum, alleviated renal morphological injury and downregulated the expression of CP-induced kidney injury molecule-1 and neutrophil gelatinase-related lipocalin. Proteomic data revealed HSP27 as a potential therapeutic target for AKI. DHM treatment resulted in the downregulation of EGFR, HSP27, and STAT3 phosphorylation, ultimately mitigating CP-induced AKI. In addition, the inhibition of EGFR or HSP27 reduced mitochondria-mediated apoptosis and CP-induced cell damage in HK-2 cells.</p><p><strong>Conclusions: </strong>DHM effectively inhibited CP-induced oxidative stress, inflammation, and mitochondria-mediated apoptosis through the EGFR/HSP27/STAT3 pathway.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2490202"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12001862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HIF-PHIs associated with embolic and thrombotic events: a real-world pharmacovigilance study based on the Japan Adverse Drug Event Report database.","authors":"Danna Wu, Shuxin Jiao, Hongru Lin, Peitao Xie, Guohao Cai, Mingdao Lin","doi":"10.1080/0886022X.2025.2491655","DOIUrl":"https://doi.org/10.1080/0886022X.2025.2491655","url":null,"abstract":"<p><strong>Background: </strong>Hypoxia-inducible factor prolyl hydroxylase inhibitors (HIF-PHIs) play an important role in the treatment of renal anemia. However, some studies suggest a potential link between HIF-PHIs and increased thrombosis risk, though these findings are inconsistent and lack large-scale clinical support. We aim to summarize embolic and thrombotic events associated with HIF-PHIs in different populations in real world, especially among high-risk patients.</p><p><strong>Methods: </strong>Using the Japan Adverse Drug Event Report (JADER) database from January 1, 2020, to September 30, 2023, a disproportionality analysis was employed to identify embolic and thrombotic events associated with HIF-PHIs using the reporting odds ratios (ROR) and information component (IC). We also evaluated the time to onset among different populations.</p><p><strong>Results: </strong>From January 2020 to September 2023, the JADER database reported a total of 253,599 cases, including 1,222 cases of embolic and thrombotic events, which represented 30.44% of all HIF-PHIs reported. Embolic and thrombotic events (ROR = 6.68) related to HIF-PHIs is positive signal, with the strongest signal observed for vessel type unspecified and mixed arterial and venous (ROR = 7.97). The signal intensity is higher in females than in males (<i>p</i> = 0.008) and also greater in the non-dialysis population compared to the dialysis population (<i>p</i> < 0.001). The median onset time was shorter in the dialysis population than in the non-dialysis population (days: 27 vs. 47, <i>p</i> = 0.016).</p><p><strong>Conclusion: </strong>Attention to embolic and thrombotic events associated with HIF-PHIs is essential, with careful selection of specific types based on underlying diseases, sex, age, and indications.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2491655"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}