Renal Failure最新文献

{"title":"Prolonged sitting time and all-cause mortality: the mediating and predictive role of kidney function markers.","authors":"Li Wang, Xuelei Wu, Ziyi Guo, Yishan Dong, Bin Yu","doi":"10.1080/0886022X.2025.2486568","DOIUrl":"https://doi.org/10.1080/0886022X.2025.2486568","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the association between daily sitting time and all-cause mortality, with a focus on the mediating effect and predictive value of the makers relating to kidney.</p><p><strong>Methods: </strong>The cross-sectional study utilized data from the National Health and Nutrition Examination Survey (NHANES) from 2003 to 2020. The makers relating to kidney were assessed through estimated glomerular filtration rate (eGFR), urine albumin creatinine ratio (UACR), and other relevant markers.</p><p><strong>Results: </strong>A total of 9,707 adults were included in the analysis. There was a significant increase in the levels of blood urea nitrogen (BUN), creatinine, uric acid, osmolality, and UACR with extended daily sitting time, while eGFR significantly decreased. Notably, individuals sitting ≥ 8 h per day exhibited a 67% higher risk of all-cause mortality (HR = 1.67, 95% CI: 1.43-1.94). A nonlinear (L-shaped) relationship was observed between eGFR (<i>p</i> < 0.001) or UACR (<i>p</i> < 0.001) and all-cause mortality. Mediation analysis revealed that eGFR accounted for 20.98% of the association between sitting time and mortality (<i>p</i> < 0.01). An addition of eGFR or UACR would increase the AUC from 0.585 to 0.762 and 0.656, respectively(<i>p</i> < 0.001). The main mortality caused by daily sitting time included chronic lower respiratory diseases, diabetes mellitus, cerebrovascular diseases and heart diseases.</p><p><strong>Conclusions: </strong>Prolonged daily sitting time is significantly associated with an increased risk of all-cause mortality, potentially mediated by impaired kidney function. Incorporating kidney function markers such as eGFR and UACR enhances the predictive value for mortality risk assessment in sedentary populations.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2486568"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12016242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018531","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":"Endothelial injury is one of the risk factors for the progression of vascular calcification in patients receiving maintenance dialysis.","authors":"Dan-Dan Yao, Xiao-Wei Yan, Yan Zhou, Zuo-Lin Li, Fang-Xin Qiu","doi":"10.1080/0886022X.2025.2456690","DOIUrl":"10.1080/0886022X.2025.2456690","url":null,"abstract":"<p><strong>Background: </strong>Vascular calcification is common and progressive in patients with chronic kidney disease. However, the risk factors associated with the progression of vascular calcification in patients receiving maintenance dialysis have not been fully elucidated. Here, we aimed to evaluate vascular calcification and identify the factors associated with its progression in patients receiving maintenance hemodialysis.</p><p><strong>Methods: </strong>This is a prospective longitudinal study that included 374 patients receiving maintenance hemodialysis. The participants received assessments of coronary artery calcification (CAC) and abdominal aortic calcification (AAC), as measured by computed tomography. After the baseline investigation, a 2 years follow-up was performed. We also detected the markers of endothelial injury [E-selectin and soluble intercellular adhesion molecule-1 (sICAM-1)]. Finally, the risk factors affecting the CAC and AAC progression were examined by multivariate logistic regression analysis.</p><p><strong>Results: </strong>Among 374 patients, the median [interquartile range (IQR)] age was 54.0 (40.0-62.0) years; 59.9% of patients were male. The median (IQR) follow-up time was 1.9 (1.8-2.0) years for all patients. By the end of 2-year follow-up, progression of vascular calcification (including CAC and AAC) was observed in 58.0% of patients. Further, compared with the patients without progression of vascular calcification, the endothelial injury (including E-selectin and sICAM-1) of patients with progression of vascular calcification was markedly enhanced. Moreover, after adjustment for the confounders, endothelial injury was a risk factor for the progression of vascular calcification.</p><p><strong>Conclusion: </strong>The present study indicated that endothelial injury is one of the risk factors for the progression of vascular calcification in patients receiving maintenance hemodialysis.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2456690"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11774155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047730","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":"Bibliometric study and visual analysis of postoperative diabetes mellitus in kidney transplant recipients based on WoSCC database.","authors":"Minhua Qiu, Sheng Chen, Jibing Chen, Hongjun Gao","doi":"10.1080/0886022X.2024.2444383","DOIUrl":"10.1080/0886022X.2024.2444383","url":null,"abstract":"<p><strong>Background: </strong>In recent years, the increase of the post-transplantation diabetes mellitus (PTDM) after renal transplantation encourages people to do a lot of research on the disease. This paper conducted a bibliometric study on PTDM related literature to explore the risk factors of diabetes after kidney transplantation, as well as the current status, hotspots and development trends of PTDM research, so as to provide reference for researchers in related fields.</p><p><strong>Methods: </strong>We searched the Web of Science Core Collection (WoSCC) database for PTDM literature from January 1, 1990, to August 20, 2023, and used VOSviewer, CiteSpace, and the R package 'bibliometrix' to do bibliometric analysis.</p><p><strong>Results: </strong>Obesity, 3 months after transplantation tacrolimus concentration >10 ng/mL, temporary hyperglycemia, delayed graft function, acute rejection is specific risk factors related to PTDM in renal transplant recipients. In addition, 74 countries led by China and the United States published 1546 papers, and the number of PTDM-related publications is increasing every year. Primary institutions included the University of California, Los Angeles, Mayo Clinic, University of Oslo, and University of Toronto. The Journal of Transplantation is the most widely read journal in the subject. The authors with the most published literature are Trond Jenssen and Adnan Sharif, and the most cited author is Kasiske BL. Expectations for continued growth in global PTDM research are increasingly high. Future studies will mainly focus on exploring the risk factors of PTDM and identifying new therapeutic approaches and targets.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2444383"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11734397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142979213","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":"Acute kidney injury in hospitalized children with diphtheria in northwestern Nigeria: incidence and hospitalization outcomes.","authors":"Olayinka Rasheed Ibrahim, Abdurrazzaq Alege, Michael Abel Alao, Olanrewaju Timothy Adedoyin","doi":"10.1080/0886022X.2025.2465817","DOIUrl":"10.1080/0886022X.2025.2465817","url":null,"abstract":"<p><strong>Background: </strong>Despite the kidney being affected by diphtheria exotoxin, the extent of acute kidney injury (AKI) and its possible impact on outcomes remain unknown. This study examined the incidence, risk factors, and outcomes of AKI in children with diphtheria.</p><p><strong>Methods: </strong>This was a prospective cohort study of confirmed diphtheria managed from July 1, 2023, to April 30, 2024, at a health facility in Nigeria. We obtained data on clinical and laboratory features and treatments received. AKI was defined using Kidney Disease: Improving Global Outcomes (KDIGO) criteria.</p><p><strong>Results: </strong>We included 237 children with a median [interquartile range] age of 7.0 [4-10] years. Using KDIGO, 139 (58.6%) had AKI [stage 1:88 (37.1%); stage 2: 18 (7.6%); and stage 3: 33 (13.9%)]. Variables associated with AKI included age, sore throat, inability to swallow, difficulty breathing, nasal blockade, hypoxemia, nasal discharge, pallor, abnormal chest findings, hospitalization duration, vaccination status, white blood cells, lymphocytes, platelets, serum bicarbonate, sodium and potassium, and treatments received, <i>p</i> < 0.05. On multivariable logistic regression, predictors of AKI included age ≤ 60 months [AOR 2.75, 95% CI 1.27-5.95], dexamethasone [AOR 2.57, 95% CI 1.11-4.60], oxygen therapy [4.85, 95% CI 1.24-18.99], and ibuprofen [AOR 2.74, 95 CI% 1.16-6.44]. Mortality rate was 24.5% (58/237) and 33.1% (46/139) in AKI. The odds of deaths with AKI were 3.56 (95% CI 1.76-7.14).</p><p><strong>Conclusion: </strong>There is a high incidence of AKI among children with diphtheria and increased odds of death. Factors that predicted AKI included younger age, oxygen therapy, and medications (ibuprofen and dexamethasone).</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2465817"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11852218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483927","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":"Prediction of intradialytic hypotension based on heart rate variability and skin sympathetic nerve activity using LASSO-enabled feature selection: a two-center study.","authors":"Yike Zhang, Shuang Su, Zhenye Chen, Yaoyu Huang, Yujun Qian, Chang Cui, Yantao Xing, Ningning Wang, Hongwu Chen, Huijuan Mao, Jing Wang","doi":"10.1080/0886022X.2025.2478487","DOIUrl":"10.1080/0886022X.2025.2478487","url":null,"abstract":"<p><strong>Background: </strong>Intradialytic hypotension (IDH) is a prevalent complication during hemodialysis (HD). However, conventional predictive models are imperfect due to multifaceted etiologies underlying IDH.</p><p><strong>Methods: </strong>This study enrolled 201 patients undergoing maintenance HD across two centers. Seventy percent of the patient cohort was randomly allocated to the training cohort (<i>n</i> = 136), while the remaining 30% formed the validation cohort (<i>n</i> = 65). IDH was defined as a reduction in systolic blood pressure (SBP) ≥20 mmHg or mean arterial pressure (MAP) ≥10 mmHg. Clinical data and autonomic nervous parameters, including skin sympathetic nerve activity (SKNA) and heart rate variability (HRV) during the initial 30 min of HD, were employed to construct the model. The least absolute shrinkage and selection operator (LASSO) regression facilitated variable selection associated with IDH. Subsequently, a multivariable logistic regression model was formulated to predict the risk of IDH and establish the nomogram.</p><p><strong>Results: </strong>Sixty-six baseline features were included in the LASSO-regression model. In the final multivariable logistic regression model, 5 variables (SBP₀, aSKNA₀, △aSKNA_0-30, SDNN₀, △SDNN_0-30) were incorporated into the nomogram. The AUC was 0.920 (95% CI, 0.878-0.962) in the training cohort and 0.855 (95% CI, 0.763-0.947) in the validation cohort, indicating concordance between the nomogram prediction and actual observation of IDH.</p><p><strong>Conclusion: </strong>The LASSO-enabled model, based on clinical characteristics and autonomic nervous system parameters from the first 30 min of HD, shows promise in accurately predicting IDH.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2478487"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11926897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664403","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":"Stress hyperglycemia ratio as an independent predictor of acute kidney injury in critically ill patients with acute myocardial infarction: a retrospective U.S. cohort study.","authors":"Xudong Li, Yong Qiao, Liang Ruan, Shuailei Xu, Zhongguo Fan, Shiqi Liu, Junxian Shen, Chengchun Tang, Yuhan Qin","doi":"10.1080/0886022X.2025.2471018","DOIUrl":"10.1080/0886022X.2025.2471018","url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury (AKI) is a frequent and severe complication in critically ill patients with acute myocardial infarction (AMI), significantly worsening prognosis. Identifying early risk markers for AKI in AMI patients is critical for timely intervention. The stress hyperglycemia ratio (SHR), a marker of acute glycemic response to physiological stress, has been proposed as a predictor of AKI, but its role remains unclear.</p><p><strong>Objective: </strong>This study investigates the association between SHR and AKI development in critically ill patients with AMI, using data from the MIMIC-III and MIMIC-IV databases.</p><p><strong>Methods: </strong>A total of 4,663 critically ill AMI patients were analyzed. SHR was evaluated for its association with AKI incidence using logistic regression, restricted cubic splines, and mediation analysis. Subgroup and sensitivity analyses were performed to confirm robustness. Additionally, Cox regression and Kaplan-Meier survival analysis were used to explore SHR's association with in-hospital mortality in the overall cohort and AKI subgroup.</p><p><strong>Results: </strong>Higher SHR levels were independently associated with an increased risk of AKI, demonstrating a J-shaped relationship. Mediation analysis revealed that neutrophil count and albumin partially mediated this effect. Kaplan-Meier survival curves showed significant differences in in-hospital mortality among SHR quartiles (log-rank <i>p</i> < 0.001). However, Cox regression analysis indicated that SHR was not an independent predictor of in-hospital mortality in either the full cohort or the AKI subgroup.</p><p><strong>Conclusions: </strong>SHR serves as an early and independent marker for AKI risk in critically ill AMI patients, offering potential utility in clinical risk stratification. However, its role in predicting in-hospital mortality appears limited. These findings underscore the importance of glycemic monitoring and management in AMI patients at risk of AKI.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2471018"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516538","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":"Impact of dialysis on intravesical recurrence and survival outcomes in upper tract urothelial cancer patients undergoing radical nephroureterectomy.","authors":"Chi-Chun Hsieh, Ching-Chia Li, Yung-Shun Juan, Wei-Ming Li, Wen-Jeng Wu, Tsu-Ming Chien","doi":"10.1080/0886022X.2025.2458762","DOIUrl":"10.1080/0886022X.2025.2458762","url":null,"abstract":"<p><strong>Background: </strong>Upper tract urothelial carcinoma (UTUC) presents a significant recurrence risk following radical nephroureterectomy (RNU). Patients on dialysis may experience unique clinical trajectories due to uremic states and altered immune responses.</p><p><strong>Objective: </strong>To evaluate the impact of dialysis on intravesical recurrence and survival outcomes in patients with UTUC undergoing RNU, and to identify predictive factors influencing prognosis.</p><p><strong>Methods: </strong>A retrospective cohort study analyzed 402 patients with non-metastatic UTUC treated with RNU between 2001 and 2014. Patients were stratified into dialysis (<i>n</i> = 66) and non-dialysis (<i>n</i> = 336) groups. Survival and recurrence outcomes were assessed using Kaplan-Meier and Cox regression analyses.</p><p><strong>Results: </strong>Dialysis patients were predominantly female, younger, and exhibited less advanced pathological tumor stages. Dialysis was associated with higher intravesical recurrence rates (<i>p</i> = 0.009), which were largely attributable to a history of bladder cancer (42.4% vs. 26.5%; <i>p</i> = 0.009). After adjustment for bladder cancer history, dialysis was not an independent predictor of bladder recurrence-free survival (BRFS). Advanced pT stages (HR: 3.9, <i>p</i> = 0.012) and prior bladder cancer were the primary factors influencing BRFS.</p><p><strong>Conclusions: </strong>Dialysis does not independently worsen surgical outcomes or BRFS in UTUC patients post-RNU when accounting for prior bladder cancer. Prognostic models should integrate these findings to enhance individualized surveillance and treatment strategies.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2458762"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143371097","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":"Quality indicators and clinical outcomes: the role of care quality in nondiabetic chronic kidney disease management.","authors":"Yun-Fang Hsieh, Le-Yin Hsu, Ping-Hsiu Tsai, Wan-Chuan Tsai, Mei-Ju Ko, Kuo-Liong Chien, Hon-Yen Wu","doi":"10.1080/0886022X.2025.2469748","DOIUrl":"10.1080/0886022X.2025.2469748","url":null,"abstract":"<p><p>Quality indicators (QIs) are essential for evaluating healthcare quality, but their validation for nondiabetic chronic kidney disease (CKD) populations is limited. We aimed to assess the association between QIs and outcomes in nondiabetic CKD patients. Using Taiwan's National Health Insurance claims data and death registries, we analyzed 27,842 nondiabetic adults with stage 3B-5 CKD from 2016 to 2019. Three QIs were assessed: renin-angiotensin system (RAS) inhibitor prescription, proteinuria testing, and nonsteroidal anti-inflammatory drug (NSAID) avoidance. Each patient received an overall QI score (range: 0-3) based on the sum of the individual QI scores. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between QI scores and outcomes, including long-term dialysis, all-cause death, hospitalization for acute kidney injury (AKI), hyperkalemia, and acidosis. The study population had a mean age of 68.7 years and a female prevalence of 41.7%. Only 33.5% of patients received the highest QI score. During a median follow-up period of 23 months, higher overall QI scores were associated with lower risks of long-term dialysis (HR 0.891, 95% CI 0.846-0.938), all-cause death (HR 0.900, 95% CI 0.864-0.939), and acidosis (HR 0.882, 95% CI 0.799-0.972). Notably, the prescription of RAS inhibitors was consistently correlated with better outcomes. These findings underscore the importance of quality indicators, particularly the continued use of RAS inhibitors, in improving outcomes for nondiabetic CKD patients. Future research should focus on refining existing QIs and expanding their validation to broader populations and healthcare settings.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2469748"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11852228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483845","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":"Age, creatinine, and ejection fraction score is a risk factor for acute kidney injury after surgical aortic valve replacement.","authors":"Tingting Wu, Rui Li, Jing Chen, Xiaqiu Tian, Ran Zhang, Xiaotong Hou","doi":"10.1080/0886022X.2024.2444401","DOIUrl":"10.1080/0886022X.2024.2444401","url":null,"abstract":"<p><strong>Background: </strong>The incidence of acute kidney injury (AKI) increases after surgical aortic valve replacement (SAVR). This study aimed to characterize the risk factors of AKI after SAVR.</p><p><strong>Methods and results: </strong>We conducted a retrospective registry study based on data from 299 consecutive patients undergoing SAVR. At 48 h after SAVR, 41 patients developed AKI. There was a significantly higher prevalence of older age, higher body mass index (BMI), and diabetes mellitus in the AKI group. Previous use of angiotensin-converting enzyme inhibitors/angiotensin receptor blocker (ACEI/ARB) and β-blocker, intake and output volumes within 24 h, mechanical ventilation time, length of intensive care unit and hospital stay, baseline creatinine, baseline, 24 h, and 48 h estimated glomerular filtration rate were strongly associated with the incidence of AKI. BMI >24, history of hypertension, use of ACEI/ARB and β-blocker, and mechanical ventilation time were associated with AKI. Univariate logistic regression indicated that overweight, hypertension, use of ACEI/ARB and β-blocker, and mechanical ventilation time were associated with AKI. Notably, the ACEF score was an independent predictor of AKI. The receiver operating characteristic curve was employed to assess the ACEF score for predicting AKI and the best cutoff was 1.1. After dividing ACEF into quartiles, each one-unit increment in ACEF led to a 2.27-fold risk in the incidence of AKI among patients.</p><p><strong>Conclusions: </strong>AKI is a generalizable phenomenon occurring frequently after SAVR. The ACEF score is an independent predictor of AKI among patients undergoing SAVR.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2444401"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11734393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142979901","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":"Right ventricular-pulmonary arterial coupling and pulmonary hypertension in hemodialysis: insights into structural cardiac changes and clinical implications.","authors":"Kristina Buryskova Salajova, Jan Malik, Lucie Kaiserova, Zuzana Hladinova, Zdenka Hruskova, Simona Janakova, Vladimir Tesar, Satu Sinikka Pesickova, Kristyna Michalickova, Katarina Rocinova, Barbora Szonowska, Anna Valerianova","doi":"10.1080/0886022X.2025.2466822","DOIUrl":"10.1080/0886022X.2025.2466822","url":null,"abstract":"<p><strong>Objectives: </strong>This cross-sectional analysis from the CZecking Heart Failure in patients with advanced Chronic Kidney Disease trial (ISRCTN18275480) examined pulmonary hypertension and right ventricular-pulmonary arterial coupling in patients on chronic hemodialysis. The aims of this analysis were: 1. To analyze relations between pulmonary hypertension and right ventricular-pulmonary arterial coupling with dialysis access flow and current hydration; 2. To analyze structural heart changes associated with right ventricular-pulmonary arterial uncoupling; 3. To reveal the prevalence, etiology and severity of pulmonary hypertension in the Czech hemodialysis population.</p><p><strong>Methods: </strong>We performed expert echocardiography, vascular access flow measurements, bioimpedance analysis, and laboratory testing in 336 hemodialysis patients.</p><p><strong>Results: </strong>Pulmonary hypertension was present in 34% (114/336) patients and right ventricular-pulmonary arterial uncoupling was present in 25% of patients with pulmonary hypertension. Only weak associations between the flow of the dialysis arteriovenous access and estimated pulmonary arterial systolic pressure and right ventricular-pulmonary arterial coupling was proved. There was a strong association between hydration status assessed by estimated central venous pressure with pulmonary arterial systolic pressure (Rho 0.6, <i>p</i> < 0.0001) and right ventricular-pulmonary arterial coupling (Rho -0.52, <i>p</i> < 0.0001) and association between overhydration to extracellular water ratio with pulmonary arterial systolic pressure (Rho 0.31, <i>p</i> = 0.0001) and right ventricular-pulmonary arterial coupling (Rho -0.29, <i>p</i> = 0.002). The prevalence of heart failure was significantly higher in patients with right ventricular-pulmonary arterial uncoupling (88% vs. 52%, <i>p</i> = 0.0003).</p><p><strong>Conclusion: </strong>These findings suggest that optimizing volume status and treating heart failure should be prioritized in hemodialysis patients to prevent pulmonary hypertension progression and right ventricular-pulmonary arterial uncoupling.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2466822"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11852216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483925","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}