Renal Failure最新文献

{"title":"Impact of intrarenal arterial lesions on prognosis of IgA nephropathy: insights from a retrospective cohort study.","authors":"Jingying Tu, Xiaoqian Chen, Haichun Yang, Yiqin Zuo, Fanfan Li, Ji Zhang, Bo Chen, Yinqiu Lv, Chaosheng Chen, Zhen Su, Duo Li","doi":"10.1080/0886022X.2025.2476052","DOIUrl":"10.1080/0886022X.2025.2476052","url":null,"abstract":"<p><strong>Background: </strong>IgA nephropathy (IgAN) presents a challenging spectrum of outcomes, often complicated by intrarenal arterial/arteriolar lesions (IALs) in affected individuals. Despite their clinical relevance, existing criteria for classifying and assessing the severity of these lesions remain undefined. This study aimed to establish semi-quantitative assessment criteria for grading IALs and to evaluate their prognostic significance in patients with IgAN.</p><p><strong>Method: </strong>We conducted a retrospective cohort study of 417 cases of primary IgAN in which IALs were meticulously scored in individual biopsies. Kaplan-Meier survival analysis was employed to compare the time to the renal composite endpoint between different IALs severity groups. The association between the severity of IALs and clinical outcomes was further evaluated using multivariate Cox regression models to control for potential confounders.</p><p><strong>Results: </strong>Among the 417 patients studied, 230 (55.2%) exhibited IALs. Kaplan-Meier curve analysis showed a higher cumulative incidence of the composite endpoint in patients with IALs (<i>p</i> < 0.001). In a compelling multivariate analysis, we identified IALs and its subclassifications, including moderate to severe intimal fibrosis and hyalinosis, as strong independent risk factors for poor prognosis (IALs: HR = 2.15, <i>p</i> = 0.009; moderate to severe hyalinosis: HR = 3.58, <i>p</i> = 0.001; moderate to severe intimal fibrosis: HR = 3.56, <i>p</i> = 0.001).</p><p><strong>Conclusion: </strong>Our findings underscore the prognostic significance of IALs in IgAN, particularly moderate to severe intimal fibrosis and hyalinosis and highlight the urgent need for novel therapeutic strategies specifically designed to mitigate the impact of IALs in high-risk IgAN patients.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2476052"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617160","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":"Exploring the association of natriuretic peptides with QTc interval in hemodialysis patients.","authors":"Yoshihiro Matsumoto, Yasuo Mori, Shinji Kageyama, Kazuaki Yoshimura, Takao Saito, Risako Terada, Yohichi Nojima","doi":"10.1080/0886022X.2025.2460720","DOIUrl":"10.1080/0886022X.2025.2460720","url":null,"abstract":"<p><strong>Background: </strong>In patients undergoing hemodialysis (HD), cardiovascular (CV) disease, particularly sudden cardiac death (SCD), is a major cause of mortality. Independent predictors of SCD include a prolonged QT interval on electrocardiography (ECG) and elevated levels of natriuretic peptides (NPs). This study explores the association between the QTc interval and NPs in HD patients.</p><p><strong>Methods: </strong>This cross-sectional study involved 207 HD patients, having a heart rate of 57 to 103 bpm, displaying sinus rhythm and no extrasystoles in ECG reports. Before the 2nd HD of the week, we conducted ECG and blood tests for atrial NP (ANP), brain NP (BNP), and N-terminal proBNP (NT-proBNP). The heart rate-corrected QT (QTc) was calculated using Bazett formula. Our analysis focused on the association between QTc and each NP, along with evaluating clinically relevant variables related to the QTc interval.</p><p><strong>Results: </strong>Univariate analyses indicated robust correlations among the NPs, with each NP significantly associated with the QTc interval. Multiple regression analyses of the three NPs revealed that NT-proBNP demonstrated the strongest predictive ability for the QTc interval. Independent predictors of prolonged QTc included lower corrected calcium (cCa) levels (<i>p</i> = 0.001), lower potassium (K) levels (<i>p</i> < 0.001), and higher log NT-proBNP (<i>p</i> = 0.004).</p><p><strong>Conclusion: </strong>In HD patients, NT-proBNP shows a stronger link with the QTc interval than BNP or ANP. Integrating clinical management considering both QTc and log NT-proBNP levels might help reduce CV events. Additionally, vigilance regarding low K or cCa levels is recommended from the perspective of the QTc interval.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2460720"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11837943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441710","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":"Interactive effect of sleep duration and trouble sleeping on frailty in chronic kidney disease: findings from NHANES, 2005-2018.","authors":"Xi-Zhe Zhang, Jiong-Ao Xiang, Jun-Jie Xu, Wen-Feng Wang, Yao-Dong Li","doi":"10.1080/0886022X.2025.2471008","DOIUrl":"10.1080/0886022X.2025.2471008","url":null,"abstract":"<p><strong>Background: </strong>Both sleep disorders and chronic kidney disease (CKD) are recognized as significant public health concerns. In the general population, sleep disorders have been shown to be associated with frailty in the elderly. This study aims to evaluate the association between sleep duration and trouble sleeping with frailty in CKD patients, as well as the potential interactive effect between these two factors.</p><p><strong>Methods: </strong>This cross-sectional study analyzed data from the National Health and Nutrition Examination Survey (NHANES) spanning 2005-2018. Sleep duration and trouble sleeping was self-reported. Frailty was assessed using a 49-item frailty index. The associations between sleep duration, trouble sleeping, and frailty were analyzed using weighted multivariate logistic regression and restricted cubic splines. Subgroup analysis was conducted to determine the consistency of the study's conclusions across various subgroups.</p><p><strong>Results: </strong>A total of 5,211 adult CKD patients were included in this analysis. Regression analysis results indicated that short sleep duration (OR = 1.364, 95% CI: 1.152-1.616), long sleep duration (OR = 1.648, 95% CI: 1.259-2.157), and trouble sleeping (OR = 2.572, 95% CI: 2.102-3.147) were significantly associated with an increased risk of frailty in CKD patients, with an interaction between sleep duration and trouble sleeping. Subgroup analysis revealed that the effects of trouble sleeping and sleep duration on frailty symptoms in CKD patients exhibit significant variation across age groups (<i>p</i> < 0.05 for interaction), with no notable differences observed in other subgroups. RCS results demonstrated a U-shaped relationship between frailty and sleep duration, with the lowest risk of frailty at 7.12 h of sleep.</p><p><strong>Conclusion: </strong>Our findings indicated that both sleep duration and trouble sleeping were significantly associated with frailty in CKD patients, with a notable interaction between these two factors. Therefore, prevention and intervention strategies for frailty in CKD patients should address multiple aspects of sleep health.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2471008"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516528","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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11980186/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"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":"Peritoneal dialysis peritonitis due to <i>Neisseria</i>: clinicopathological features of 10 patients with a review of the literature.","authors":"Yue Sun, Xinyu Chen, Jun Ni, Jin Yu","doi":"10.1080/0886022X.2025.2466820","DOIUrl":"10.1080/0886022X.2025.2466820","url":null,"abstract":"<p><strong>Background: </strong>Peritoneal dialysis-associated peritonitis (PDAP) frequently arises as a complication in patients undergoing peritoneal dialysis. However, the understanding of the role of <i>Neisseria</i>, a gram-negative coccus, in PDAP is limited.</p><p><strong>Methods: </strong>This study retrospectively analyzed data for patients with <i>Neisseria</i>-associated PDAP who were treated at our center from January 2010 to June 2022. These patients were classified into the <i>Neisseria</i> group (Group N) and matched 1:2 by sex, age, dialysis duration, and residual kidney Kt/V with a coagulase-negative staphylococci group (Group CNS) and a <i>Staphylococcus aureus</i> group (Group S) as controls. Statistical analysis was conducted <i>via</i> SPSS 25.0 and was supplemented with a review of the relevant literature, to investigate clinical features, pathways of infection, and patient outcomes.</p><p><strong>Results: </strong>This study included 10 cases of <i>Neisseria</i>-associated PDAP, comprising 6 male and 4 female patients. The patients had an average age of 58.10 ± 14.52 years, and the average duration of peritoneal dialysis was 72.00 ± 46.99 months. Among these patients, 3 had first-time infections, while 7 had a prior history of PDAP. After treatment, 9 patients achieved medical cure, and 1 patient was transferred to hemodialysis (HD). Baseline comparisons across the 3 groups indicated notable differences in body temperature upon admission, which were statistically significant (<i>p</i> < 0.05), with patients in Group S having higher body temperatures compared to Group N and Group CNS. Compared with Group N, Group S presented a markedly elevated high-sensitivity C-reactive protein (hs-CRP) level, decreased serum albumin levels, reduced serum potassium levels, whereas Group CNS presented a significantly lower neutrophil percentage (N%) than did Group N (<i>p</i> < 0.05). Although survival analysis did not reveal statistically significant differences due to the limited sample size, Kaplan-Meier curves indicated a trend toward lower cure rates and slightly worse long-term outcomes in Group S than in Group N and Group CNS, with the latter 2 groups showing similar results.</p><p><strong>Conclusion: </strong><i>Neisseria</i>-associated PDAP generally has favorable outcomes, similar to those of CNS-related PDAP and better than those of S-related PDAP. Hypoalbuminemia, hypokalemia and elevated hs-CRP are key risk factors affecting outcomes, emphasizing the need to address them during treatment.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2466820"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516535","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":"Validation of a renal staging system and its association with renal amyloid deposition burden in AL amyloidosis.","authors":"Ying Yao, Shuang Wang, Dan-Yang Li, Xiao-Juan Yu, Jia-Yi Liu, Zhi-Xiang Qiu, Fu-De Zhou, Su-Xia Wang","doi":"10.1080/0886022X.2025.2499230","DOIUrl":"10.1080/0886022X.2025.2499230","url":null,"abstract":"<p><strong>Objectives: </strong>This study evaluates the relationship between renal amyloid deposition burden in kidney biopsy and a renal staging system based on proteinuria and estimated glomerular filtration rate (eGFR) in AL amyloidosis.</p><p><strong>Methods: </strong>A total of 248 patients diagnosed <i>via</i> renal biopsy were included. The extent of amyloid deposition in glomeruli, blood vessels, and tubulointerstitium were evaluated semiquantitatively. The total amyloid load (TA) was defined by the sum of glomerular, vascular and interstitial deposits.</p><p><strong>Results: </strong>Patients were categorized into three renal stages: I, II, and III. Findings showed that scores of pathological parameters increased progressive with advancing renal stage. The median TA values were 6 (IQR 3-8) in Stage I, 7 (IQR 5-8) in Stage II, and 8 (IQR 7-11) in Stage III (<i>p</i> < 0.001). Baseline eGFR was inversely correlated with TA (<i>r</i> = -0.363, <i>p</i> < 0.001), while proteinuria showed no significant association. Cox regression analysis identified eGFR <50 mL/min/1.73 m² as an independent risk factor for renal survival (HR, 6.519; 95% CI, 3.110-13.665; <i>p</i> < 0.001), whereas proteinuria did not show such an effect.</p><p><strong>Conclusions: </strong>These findings suggest that in the renal staging system, eGFR - but not proteinuria - is significantly associated with amyloid deposition and independently affects renal survival.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2499230"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094576","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":"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}