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":"Moderate-severe aortic arch calcification and high serum alkaline phosphatase co-modify the risk of cardiovascular events and mortality among chronic hemodialysis patients.","authors":"Cheng-Hao Chang, Hung-Hsiang Liou, Chung-Kuan Wu","doi":"10.1080/0886022X.2024.2449572","DOIUrl":"10.1080/0886022X.2024.2449572","url":null,"abstract":"<p><strong>Background: </strong>Patients with end-stage kidney disease undergoing chronic hemodialysis (HD) have an unparalleled risk of vascular calcification (VC) and high alkaline phosphatase (Alk-P) levels. However, whether VC contributed to the cardiovascular risk modified by serum Alk-P levels was not addressed in the population.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted on chronic HD patients, between October 1 and December 31, 2018, with aortic arch calcification (AoAC) scores and serum Alk-P levels. Patients were categorized into four groups: non-to-mild AoAC/low Alk-P, non-to-mild AoAC/high Alk-P, moderate-to-severe AoAC/low Alk-P, and moderate-to-severe AoAC/high Alk-P. The Cox proportional hazard model and Kaplan-Meier analysis were used to evaluate the risks of major adverse cardiovascular effects (MACEs) and cardiovascular and all-cause mortality after multivariate adjustment.</p><p><strong>Results: </strong>Among 376 chronic HD patients recruited, 125 (33%) had non-to-mild AoAC/low Alk-P, 76 (20%) had non-to-mild AoAC/high Alk-P, 89 (24%) had moderate-to-severe AoAC/low Alk-P, and 86 (23%) had moderate-to-severe AoAC/high Alk-P. After 3 years of follow-up, patients with coexisting moderate-to-severe AoAC and high Alk-P had a higher risk of MACEs (aHR 1.76; 95% CI 1.06-2.92), and cardiovascular (aHR 2.49; 95% CI 1.21-5.11) and all-cause mortality (aHR 2.67; 95% CI 1.39-5.13) compared to those with non-to-mild AoAC/low Alk-P even after adjustments for significant clinical variables.</p><p><strong>Conclusions: </strong>In chronic HD patients, moderate to severe AoAC co-existed with high Alk-P levels and enhanced the risk of MACEs and cardiovascular and all-cause mortality. Interventions to attenuate these risk factors simultaneously should be emphasized in this population.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2449572"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11731357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972058","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":"IGFBP2 and IGFBP4 interact to activate complement pathway in diabetic kidney disease.","authors":"Jieling Liang, Yangxiao Huang, Daping Peng, Yali Xie, Yifei Liu, Xiuxia Lu, Junfa Xu","doi":"10.1080/0886022X.2024.2440528","DOIUrl":"10.1080/0886022X.2024.2440528","url":null,"abstract":"<p><strong>Background: </strong>Diabetic kidney disease (DKD) is the leading cause of chronic kidney disease globally. Recent research has identified insulin-like growth factor-binding proteins 2 (IGFBP2) and 4 (IGFBP4) as potential biomarkers for DKD. Overactivation of the complement pathway in DKD remains poorly understood.</p><p><strong>Methods: </strong>Blood samples were collected from patients for proteomic analysis, complemented by both <i>in vitro</i> and <i>in vivo</i> experiments to investigate the roles of IGFBP2, IGFBP4, and the complement pathway in DKD.</p><p><strong>Results: </strong>Elevated levels of IGFBP2 and IGFBP4 were observed in DKD patients. The levels of IGFBP2 and IGFBP4 increased in DKD mice, accompanied by the activation of the complement pathway, and a deterioration in renal function. High glucose and serum from DKD mice stimulated an increase in the levels of IGFBP2 and IGFBP4 in HK-2 cells. The supernatant from HK-2 cells was used to culture THP-1 cells, resulted in an increase in the M1 type of THP-1 cells, a decrease in the M2 type, and activation of the complement pathway. The supernatant from THP-1 cells affected the growth of primary human renal podocytes. The exogenous addition of IGFBP2 and IGFBP4 proteins to primary human renal podocytes did not affect their growth. However, when human renal podocytes were cultured with the supernatant from THP-1 cells, the growth of the podocytes was affected.</p><p><strong>Conclusions: </strong>IGFBP2 and IGFBP4 interact to stimulate the activation of the complement pathway in macrophages, which induces podocyte apoptosis and subsequently promotes the development of DKD.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2440528"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11734388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142979691","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":"Artificial intelligence assisted risk prediction in organ transplantation: a UK Live-Donor Kidney Transplant Outcome Prediction tool.","authors":"Hatem Ali, Arun Shroff, Tibor Fülöp, Miklos Z Molnar, Adnan Sharif, Bernard Burke, Sunil Shroff, David Briggs, Nithya Krishnan","doi":"10.1080/0886022X.2024.2431147","DOIUrl":"10.1080/0886022X.2024.2431147","url":null,"abstract":"<p><p><b>Introduction:</b> Predicting the outcome of a kidney transplant involving a living donor advances donor decision-making donors for clinicians and patients. However, the discriminative or calibration capacity of the currently employed models are limited. We set out to apply artificial intelligence (AI) algorithms to create a highly predictive risk stratification indicator, applicable to the UK's transplant selection process.</p><p><p><b>Methodology:</b> Pre-transplant characteristics from 12,661 live-donor kidney transplants (performed between 2007 and 2022) from the United Kingdom Transplant Registry database were analyzed. The transplants were randomly divided into training (70%) and validation (30%) sets. Death-censored graft survival was the primary performance indicator. We experimented with four machine learning (ML) models assessed for calibration and discrimination [integrated Brier score (IBS) and Harrell's concordance index]. We assessed the potential clinical utility using decision curve analysis.</p><p><p><b>Results:</b> XGBoost demonstrated the best discriminative performance for survival (area under the curve = 0.73, 0.74, and 0.75 at 3, 7, and 10 years post-transplant, respectively). The concordance index was 0.72. The calibration process was adequate, as evidenced by the IBS score of 0.09.</p><p><p><b>Conclusion:</b> By evaluating possible donor-recipient pairs based on graft survival, the AI-based UK Live-Donor Kidney Transplant Outcome Prediction has the potential to enhance choices for the best live-donor selection. This methodology may improve the outcomes of kidney paired exchange schemes. In general terms we show how the new AI and ML tools can have a role in developing effective and equitable healthcare.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2431147"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11755740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010468","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":"Preoperative systemic immune-inflammation index as a predictor of contrast-induced acute kidney injury in coronary artery disease: a multicenter cohort study.","authors":"Jinlong Zhu, Pei Yu, Xiaoying Zhang, Xiaoming Li, Jiaming Huang, Shumin Zhao, Qingyan Ruan, Yibo He, Yang Zhou, Kunming Bao, Jiaming Xiu, Lin Deng, Yunchen Liu, Yong Liu, Shiqun Chen, Kaihong Chen, Liling Chen","doi":"10.1080/0886022X.2025.2474204","DOIUrl":"10.1080/0886022X.2025.2474204","url":null,"abstract":"<p><strong>Background: </strong>Inflammation is a key contributor to contrast-induced acute kidney injury (CI-AKI), yet its predictive role remains unclear. The systemic immune-inflammation index (SII) is a novel inflammatory biomarker, but its association with CI-AKI risk in coronary artery disease (CAD) patients undergoing coronary angiography is not well established. This study aimed to evaluate the relationship between preoperative SII and CI-AKI in a large multicenter cohort.</p><p><strong>Methods: </strong>This retrospective cohort study analyzed CAD patients from five tertiary hospitals in China (2007-2020). Patients were stratified into SII tertiles, and multivariable logistic regression, restricted cubic splines (RCS), and two-piecewise logistic regression models were employed to assess the association between SII and CI-AKI risk.</p><p><strong>Results: </strong>Among 30,822 patients, 3,246 (10.5%) developed CI-AKI. Higher preoperative SII levels were associated with increased CI-AKI risk ([SII-M vs. SII-L]: OR = 1.22, 95% CI [1.09-1.36], <i>p</i> = 0.001; [SII-H vs. SII-L]: OR = 1.70, 95% CI [1.53-1.90], <i>p</i> < 0.001). RCS analysis demonstrated a nonlinear relationship (p for nonlinearity = 0.008). The inflection point was at 19.12 × 10¹¹/L. Below this inflection point, each 100-unit increase in SII correlated with a 5% higher CI-AKI risk (OR = 1.05, 95% CI [1.04-1.06], <i>p</i> < 0.001), while no significant association was observed above this level.</p><p><strong>Conclusion: </strong>Preoperative SII may be an independent predictor of CI-AKI risk in CAD patients undergoing undergoing coronary angiography, demonstrating a nonlinear dose-response relationship with a significant threshold effect. These findings suggest that SII may serve as a useful biomarker for early CI-AKI risk stratification in clinical practice.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2474204"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693160","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":"Related factors for kidney disease and high chronic kidney disease progression risk in adult-onset type 1 diabetes mellitus patients from China: a multi-center cross-sectional study.","authors":"Jun Jiang, Wenjuan Huang, Lei Lan, Xueying Zheng, Sihui Luo, Yu Ding, Jinhua Yan, Wei Ren, Kuanxiao Tang, Daizhi Yang","doi":"10.1080/0886022X.2025.2483389","DOIUrl":"10.1080/0886022X.2025.2483389","url":null,"abstract":"<p><strong>Background/aim: </strong>Concerning the related factors for kidney disease and high chronic kidney disease (CKD) progression risk, there is still a lack of study in the adult-onset type 1 diabetes mellitus (T1DM) patients from China.</p><p><strong>Methods: </strong>Four hundred and eighty-one adult-onset T1DM patients from the Guangdong T1DM translational medicine study were included. Logistic regression analysis (Forward: LR) was utilized to identify glycemic- and nonglycemic-related factors associated with moderate albuminuria, severe albuminuria, mildly reduced estimated glomerular filtration rate (eGFR), decreased eGFR, and high CKD progression risk, and to calculate the odds ratio (OR) and 95% confidence interval (CI).</p><p><strong>Results: </strong>High CKD progression risk was positively associated with males (OR = 3.13, 95% <i>CI</i>:1.20 - 8.14, <i>p =</i> 0.019), duration of T1DM (OR =1.13, 95% <i>CI</i>:1.05 - 1.21, <i>p</i> < 0.001), triglyceride (OR =1.52, 95% CI:1.11 - 2.08, <i>p</i> = 0.008), and systolic blood pressure (SBP) (OR =1.04, 95% CI:1.02 - 1.07, <i>p</i> = 0.001), and negatively correlated with BMI (OR = 0.80, 95% CI:0.68 - 0.95, <i>p</i> = 0.011). Meanwhile, moderate albuminuria, severe albuminuria, mildly reduced eGFR and decreased eGFR had different each of glycemic- and nonglycemic-related factors.</p><p><strong>Conclusions: </strong>Hyperglycemia, hypertension, hyperuricemia, and BMI may be associated with different stages of kidney disease in adult-onset T1DM patients. Early-stage adult-onset T1DM patients with male, low BMI, prolonged diabetes duration, and comorbid hypertension and dyslipidemia should undergo a thorough evaluation of albuminuria and renal function to detect those at high CKD progression risk, who should be timely transferred to the nephrology specialty to receive professional treatment for kidney disease.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2483389"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754237","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":"Critical appraisal of systematic reviews and meta-analyses: a step-by-step guide for nephrologists.","authors":"Wisit Cheungpasitporn, Wannasit Wathanavasin, Charat Thongprayoon, Wisit Kaewput, Mihály Tapolyai, Tibor Fülöp","doi":"10.1080/0886022X.2025.2476736","DOIUrl":"10.1080/0886022X.2025.2476736","url":null,"abstract":"<p><strong>Background: </strong>Systematic reviews and meta-analyses play a pivotal role in evidence-based medicine, including nephrology, by consolidating findings from multiple studies. To maximize their utility, rigorous quality assessment during peer review is essential. Challenges such as heterogeneity, bias, and methodological flaws often undermine these studies, necessitating a structured appraisal process.</p><p><strong>Methods: </strong>This guide outlines a framework for nephrologists on appraising systematic reviews and meta-analyses. Key areas include heterogeneity assessment using the I² statistic, interpretation of forest plots for pooled effect estimates, and the use of funnel plots with Egger's test to identify potential publication bias. Risk of bias is evaluated using RoB 2 for randomized controlled trials and ROBINS-I for non-randomized studies. Subgroup and sensitivity analyses, along with meta-regression, address heterogeneity and examine the robustness of findings.</p><p><strong>Results: </strong>The I² statistic quantifies heterogeneity by estimating the proportion of variability in a meta-analysis. Funnel plots and Egger's test help detect publication bias. Major biases, such as selection, performance, detection, and publication bias, are identified using structured tools like AMSTAR 2, Cochrane RoB 2, and ROBINS-I. The GRADE framework further assesses the overall certainty of the evidence. Emphasis is placed on PRISMA compliance, protocol pre-registration, and transparent reporting of statistical analyses, subgroup, and sensitivity assessments. The inclusion of grey literature remains optional.</p><p><strong>Conclusion: </strong>By focusing on key areas such as heterogeneity, risk of bias, and robust statistical methods, this guide enables nephrologists to critically appraise systematic reviews and meta-analyses, fostering better clinical decision-making and improved patient care in nephrology.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2476736"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11951313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721229","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":"Antiphospholipid antibody positivity and its potential impact on stent patency and long-term outcomes in central venous occlusive disease among hemodialysis patients: a call for targeted therapeutic strategies.","authors":"Maxime Taghavi, Lucas Jacobs, Marc Laureys, Joëlle Nortier","doi":"10.1080/0886022X.2025.2486566","DOIUrl":"https://doi.org/10.1080/0886022X.2025.2486566","url":null,"abstract":"","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2486566"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}