Renal Failure最新文献

{"title":"Causal relationship between chronic kidney disease, renal function, and venous thromboembolism: a bidirectional Mendelian randomization study.","authors":"Rongping Yang, Shuanglan Xu, Qian Liu, Xifeng Zhang, Huilin He, Yue Xu, Linna Chen, Xiqian Xing, Jiao Yang","doi":"10.1080/0886022X.2025.2496803","DOIUrl":"https://doi.org/10.1080/0886022X.2025.2496803","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease (CKD) and impaired renal function have been implicated in venous thromboembolism (VTE), but their causal relationships remain uncertain. This study employs Mendelian randomization (MR) to elucidate the potential bidirectional causal effects between CKD, renal function biomarkers, and VTE.</p><p><strong>Methods: </strong>We collated datasets from genome-wide association studies conducted among European individuals to perform MR analyses. The primary method utilized was the random-effect inverse variance-weighted (IVW) approach, with MR-Egger and the weighted median approaches employed as supplemental techniques. Several sensitivity studies were performed to assess the findings' robustness.</p><p><strong>Results: </strong>We identified a link between elevated serum creatinine levels and both VTE (OR: 1.14, 95% CI: 1.05-1.24, <i>p</i> = 0.001) and PE (OR: 1.20, 95% CI: 1.08-1.33, <i>p</i> = 0.001). After outlier removal and Bonferroni correction, the Cr-VTE association lost significance (<i>p</i> = 0.005). A suggestive causal relationship was found between eGFR and VTE (OR: 0.38, 95% CI: 0.20-0.73, <i>p</i> = 0.004), DVT (OR: 0.37, 95% CI: 0.16-0.87, <i>p</i> = 0.022), and PE (OR: 0.29, 95% CI: 0.12-0.66, <i>p</i> = 0.004). No causal effects of CKD or BUN on VTE or its subtypes were observed. Reverse causality inferences did not reveal any meaningful results.</p><p><strong>Conclusions: </strong>This MR analysis provides evidence that elevated serum creatinine is associated with a higher risk of VTE and PE, while reduced eGFR may be a potential risk factor for VTE and its subtypes. These findings highlight the need for proactive monitoring and preventive strategies in individuals with impaired renal function. Further studies are warranted to confirm these associations and explore underlying mechanisms.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2496803"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030674","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":"Pathophysiological changes in patients during hemodialysis and blood reinfusion predict potential development of hemodialysis reactions.","authors":"Ákos Géza Pethő, Csaba Révész, Tamás Mészáros, Orsolya Sáfár, László Rosivall, József Domán, Gábor Szénási, Tünde Gigacz, László Dézsi","doi":"10.1080/0886022X.2025.2500662","DOIUrl":"https://doi.org/10.1080/0886022X.2025.2500662","url":null,"abstract":"<p><p>Hemodialysis reactions (HDRs) are a type of hypersensitivity reactions (HSRs), such as complement activation-related pseudoallergy (CARPA) observed during nanoparticle infusions. Our study aimed to elucidate the mechanisms of human HDRs by focusing on hemodynamic and clinical chemistry changes of HSR-related or biocompatibility issues during human hemodialysis (HD) and the reinfusion of blood. Based on our recent animal experiments, we hypothesize that increased pulmonary arterial pressure (PAP), and increases in thromboxane B2 (TXB2) and complement 3a (C3a) plasma concentrations will likely manifest in, or at least predict, human HDRs during HD and blood reinfusion. To verify our hypothesis, we measured these parameters during high-flux HD in patients. Since direct PAP measurement was not possible, the plasma concentration of the N-terminal fragment of the brain natriuretic peptide (NT-proBNP) was determined for the noninvasive estimation of PAP. Our results show an increase in NT-proBNP and TXB2 during the reinfusion of extracorporeal blood. The plasma concentration of C3a increased in early HD already and remained elevated up to blood reinfusion. In conclusion, the observed changes in HSR-related parameters or biocompatibility issues in otherwise asymptomatic patients may suggest that a greater activation of these mechanisms could explain the development of human hemodialysis reactions.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2500662"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034701","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":"Comment on 'bibliometric insights into systemic sclerosis with renal involvement: trends, contributions, and future directions'.","authors":"Yiran Chen, Jingyuan Zhang","doi":"10.1080/0886022X.2025.2486563","DOIUrl":"https://doi.org/10.1080/0886022X.2025.2486563","url":null,"abstract":"","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2486563"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11995759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042442","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":"Long non-coding RNA in IgA nephropathy: a comprehensive review.","authors":"Xiaoxuan Huang, Lan Chen, Jinxuan He, Jianhui Tang, Zhixiang Mou","doi":"10.1080/0886022X.2025.2495836","DOIUrl":"https://doi.org/10.1080/0886022X.2025.2495836","url":null,"abstract":"<p><p>Immunoglobulin A nephropathy (IgAN) stands as the most prevalent primary glomerulonephritis globally, almost half of patients progress to end-stage kidney disease (ESKD). However, the precise pathogenesis of IgAN remains elusive. Long non-coding RNAs (lncRNAs), non-protein-coding transcripts that regulate gene expression, have been found to exhibit distinct expression patterns in various disease states. Comprehensive bioinformatic analyses from IgAN patients have uncovered differential expression of lncRNAs such as <i>HOTAIR</i>, <i>H19</i>, and <i>MALAT1</i>. Furthermore, a single nucleotide polymorphism in <i>MIR31HG</i> has been linked to IgAN susceptibility and correlated with clinical markers like urinary red blood cells and hemoglobin levels. <i>Lnc-TSI</i> and <i>lnc-CHAF1B-3</i>, specifically expressed in the kidneys of IgAN patients, exhibit associations with renal fibrosis indices and the degree of kidney function deterioration, influencing the progression of renal fibrosis through distinct signaling pathways. Additionally, renal intercellular adhesion molecule 1 (ICAM-1) related long noncoding RNA (<i>ICR</i>) levels positively correlate with IgAN severity and contribute to renal fibrosis, whereas serum <i>H19</i> serves as an independent protective factor against IgAN. Notably, experiments have validated the involvement of <i>PTTG3P</i>, <i>lnc-CHAF1B-3</i>, and <i>CRNDE</i> in the pathogenesis of IgAN. Nevertheless, data on the roles of lncRNAs in IgAN pathogenesis and their potential as biomarkers remain limited, and effective therapeutic options for IgAN are similarly rare. Therefore, there is an urgent need to bridge this knowledge gap. This article presents a review of current literature on lncRNAs related to IgAN, aiming to consolidate existing findings and identify future research avenues.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2495836"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042656","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":"Autosomal dominant polycystic kidney disease: an overview of recent genetic and clinical advances.","authors":"Abdul Hamid Borghol, Marie Therese Bou Antoun, Christian Hanna, Mahdi Salih, Frederic F Rahbari-Oskoui, Fouad T Chebib","doi":"10.1080/0886022X.2025.2492374","DOIUrl":"https://doi.org/10.1080/0886022X.2025.2492374","url":null,"abstract":"<p><p>Autosomal Dominant Polycystic Kidney Disease (ADPKD) is the most common inherited kidney disease, characterized by the progressive development of multiple kidney cysts, leading to a gradual decline in kidney function. ADPKD is also the fourth leading cause of kidney failure (KF) in adults. In addition to kidney manifestations, ADPKD is associated with various extrarenal features, including liver cysts, cardiovascular abnormalities, intracranial aneurysms, and chronic pain with significant impact on patients' quality of life. While several disease-modifying agents have been tested in ADPKD, tolvaptan remains the only approved drug by the US Food and Drug Administration. The Mayo Imaging Classification is currently the most practical tool for predicting rate of kidney disease progression in ADPKD. This review provides a comprehensive overview of ADPKD, focusing on its genetics, pathophysiology, clinical presentation, management, and prognostic tools. Advances in diagnostic imaging and genetic testing have improved the early detection of ADPKD, allowing better classification of patients and prediction of KF. The review also discusses current therapeutic approaches to ADPKD, including tolvaptan, a vasopressin V2-receptor antagonist. Additionally, we address specific issues in children and pregnant individuals with ADPKD. Despite substantial progress in understanding ADPKD, there is a large need for additional effective treatments and prognostic markers to provide a more personalized care for these patients.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2492374"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12020221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012479","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":"Risk factors for IgA nephropathy recurrence and impact on graft survival in a cohort of kidney transplanted patients.","authors":"Angelodaniele Napoletano, Michele Provenzano, Federica Maritati, Valeria Corradetti, Vania Cuna, Elisa Gessaroli, Chiara Abenavoli, Simona Barbuto, Marcello Demetri, Matteo Ravaioli, Giorgia Comai, Gaetano La Manna","doi":"10.1080/0886022X.2025.2472041","DOIUrl":"10.1080/0886022X.2025.2472041","url":null,"abstract":"<p><p>Recurrence of IgA nephropathy (IgAN) after kidney transplant (KT) appears associated with worse graft survival; thus, the identification of risk factors is worthwhile to improve pre-transplant evaluation of KT recipients and to identify the optimal treatment strategy. The aim of this study was to determine incidence, risk factors and impact on renal function and graft survival of IgAN recurrence after KT. We performed a retrospective study including 110 patients with biopsy-proven IgAN, who underwent KT at Policlinico di Sant'Orsola Hospital - University of Bologna from 2005 to 2021. IgAN recurred in 14 patients (12.7%) with a median time-to-recurrence of 59 (16-90) months. We found that a faster progression from IgAN diagnosis to end-stage kidney disease (ESKD), a younger age at ESKD, and a younger age at KT were associated with a higher risk of recurrence. During the first 2 years after KT, 24 h proteinuria was higher in patients with IgAN recurrence than in patients without (0.40 (0.11-1.8) vs 0.22 (0.18-0.37) g/day, <i>p</i> = 0.0003). During the follow-up period, a more rapid decline in eGFR was observed in the Recurrence group (<i>p</i> = 0.023). Additionally, graft survival at 10 years post-kidney transplant was significantly lower in this group (log-rank test <i>p</i> = 0.015). In conclusion, we found that patients with a more aggressive form of IgAN, who reached ESKD before 36 years of age, had an higher risk of recurrence in KT. Moreover we confirmed that recurrent IgAN, especially if clinically relevant, is associated with a worse graft outcome.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2472041"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573702","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":"Nafamostat mesylate versus regional citrate anticoagulation for chronic hemodialysis in patients at high risk of bleeding: a single-center, retrospective study.","authors":"Jiangtao Li, Lirui Wang, Yuqiu Lu, Ying Zhou, Yue Chen","doi":"10.1080/0886022X.2025.2464830","DOIUrl":"10.1080/0886022X.2025.2464830","url":null,"abstract":"<p><strong>Introduction: </strong>For hemodialysis patients at high risk of bleeding, a regional anticoagulant can be used, such as citrate or nafamostat mesylate (NM). The objective of this study was to evaluate NM as an alternative to citrate for anticoagulation in hemodialysis patients at high risk of bleeding.</p><p><strong>Methods: </strong>This retrospective single-center study included consecutive patients in our dialysis center treated with either citrate or NM anticoagulation for hemodialysis from January 2022 to December 2023.The primary outcome was major clotting, defined as premature dialysis due to extracorporeal circuit clotting. The secondary outcome was the incidence of a major bleeding episode during or after hemodialysis.</p><p><strong>Results: </strong>In total, 651hemodialysis sessions were performed in 196 patients and were compared (289 citrate and 362 NM anticoagulation). A lower number of premature dialysis due to clotting occurred in the NM sessions compared to citrate sessions (0.84% vs.5.19%, <i>p</i> = 0.001). NM was associated with a lower risk of major clotting compared with citrate during treatment (OR:0.063; CI: 0.008-0.475; <i>p</i> = 0.007). Regarding second outcome, no more major bleeding events related to NM occurred compared to citrate.</p><p><strong>Conclusion: </strong>Among hemodialysis patients with high risk of bleeding, anticoagulation with NM, compared with citrate anticoagulation, provided relatively better efficacy, with no bleeding increment. NM is a valid alternative to citrate for hemodialysis patients at high risk of bleeding.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2464830"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11849013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469003","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":"Outcomes of BTD vs. BCD as initial treatment of renal amyloid light-chain amyloidosis: a retrospective cohort study in China.","authors":"Sheng Li, Weiting He, Hok-Him Yau, Jianteng Xie, Yaxi Zhu, Xiaojie Chen, Shaogui Zhang, Yifan Zhang, Pengjun Liao, Hui Liu, Liwen Li, Liye Zhong, Wenjian Wang","doi":"10.1080/0886022X.2025.2453006","DOIUrl":"10.1080/0886022X.2025.2453006","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the efficacy and safety of bortezomib with thalidomide and dexamethasone (BTD) and bortezomib with cyclophosphamide and dexamethasone (BCD) as the initial treatment for renal amyloid light chain (AL) amyloidosis in Chinese cohort.</p><p><strong>Methods: </strong>A cohort of 174 patients with AL amyloidosis was studied in Guangdong Provincial People's Hospital from January 2008 to August 2023. Propensity-score matching cases were applied to assess the outcomes of patients treated with BTD and BCD regimen. Primary outcomes were patients achieving hematologic response and organ responses, and the secondary endpoints were patients progressing to end-stage renal disease or all-cause death.</p><p><strong>Results: </strong>44 Patients were included. The hematologic complete response rate (CR) in the BTD group was comparable between the groups of BTD group and BCD. However, the time to achieve hematologic CR was significantly shorter in the BTD group compared to the BCD group (4.97 vs. 7.71 mon, <i>p</i> = 0.010). Furthermore, when reaching hematologic response, the cumulative dose of bortezomib that standardized by body surface area (BSA) was lower in BTD group than in the BCD group (10.4 vs. 15.6 mg/m², <i>p</i> = 0.013). There was no significant difference of renal and cardiac response between groups. However, post-treatment proteinuria levels after treatment were significantly lower in the BTD group compared to those in the BCD group (747 mg/24h vs. 2928 mg/24h, <i>p</i> = 0.048).</p><p><strong>Conclusions: </strong>Compared to BCD regimen for renal AL amyloidosis, initial treatment with BTD regimen demonstrated similar rates of hematologic CR but showed superior reduction in proteinuria, reduced cumulative dose of bortezomib and faster time-to-response.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2453006"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11863997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493293","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 triglyceride-glucose index and acute kidney injury risk in critically ill patients with coronary artery disease.","authors":"Yi Zhang, Gang Li, Junjie Li, Bohao Jian, Keke Wang, Jiantao Chen, Jian Hou, Jianbo Liao, Zhuoming Zhou, Zhongkai Wu, Mengya Liang","doi":"10.1080/0886022X.2025.2466818","DOIUrl":"10.1080/0886022X.2025.2466818","url":null,"abstract":"<p><strong>Background: </strong>The triglyceride-glucose (TyG) index, proven a reliable and simple surrogate of insulin resistance, has shown potential associations with cardiovascular outcomes and renal diseases. This research delved into the utility of the TyG index in predicting the risk of acute kidney injury (AKI) in patients with coronary artery disease (CAD), an area not extensively covered in existing literature.</p><p><strong>Methods: </strong>A cohort of patients with CAD was recruited from the Medical Information Mart for Intensive Care-IV database, and categorized into quartiles based on their TyG index. The primary outcome was AKI incidence, and the secondary outcome was renal replacement therapy (RRT). Scatterplot histograms, cox proportional hazards models, Kaplan-Meier survival curves, and restricted cubic splines were employed to investigate the association between the TyG index and the risk of AKI in patients with CAD.</p><p><strong>Results: </strong>A total of 1,501 patients were enrolled in this study, predominantly male (61.56%), with a median age of 69.80 years. The AKI incidence was 67.22% among all patients, with the AKI stages increased with higher TyG levels (<i>P</i> for trend <0.001). The Kaplan-Meier survival analyses demonstrated statistically significant differences in AKI incidence and RRT application throughout the entire cohort, stratified by the TyG index quartiles (<i>p</i> < 0.001). Additionally, the restricted cubic spline analysis revealed a non-linear association between the TyG index and the risk of AKI (<i>P</i> for non-linear =0.637). Both multivariate Cox proportional hazards analyses (HR 1.62; 95% CI 1.15-2.27; <i>p</i> = 0.005) and multivariate logistic regression analyses (OR 2.16; 95% CI 1.18-3.94; <i>p</i> = 0.012) showed that the elevated TyG index was significantly related to AKI incidence. The association between TyG index and the risk of AKI is more significant in patients without diabetes (HR 1.27; 95% CI 1.14-1.42; <i>p</i> < 0.001), compared to patients with diabetes (<i>P</i> for interaction =0.013).</p><p><strong>Conclusions: </strong>In summary, the TyG index emerged as a reliable predictor for the occurrence of AKI in CAD patients during ICU stay. Furthermore, it is also anticipated to serve as a valuable indicator for non-diabetic patients in predicting the incidence of AKI.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2466818"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11843639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459299","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":"Long-term outcomes of refractory central venous occlusive disease treated by stent deployment in patients undergoing maintenance hemodialysis.","authors":"Yuqin Xiong, Yan Wang, Xiaoqin He, Yi Ruan, Yue Wen, Yang Yu, Ping Fu","doi":"10.1080/0886022X.2025.2463579","DOIUrl":"10.1080/0886022X.2025.2463579","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the long-term outcomes of stent deployment in the treatment of refractory central venous occlusive disease (CVOD) in patients undergoing maintenance hemodialysis (MHD).</p><p><strong>Methods: </strong>MHD patients who were successfully treated with stenting for symptomatic CVOD that was resistant to balloon angioplasty alone were consecutively included in this retrospective study. The primary (PPR) and assisted (APR) patency rates of the central vein and hemodialysis vascular access (VA), reintervention, and survival rates after stenting were followed. Multivariate logistic regression analyses were conducted to determine the factors influencing VA abandonment and mortality.</p><p><strong>Results: </strong>The cohort comprised 65 patients (52.3% male) aged 61.5 ± 13.5 years, with a mean dialysis vintage of 54.7 ± 39.1 months. During 40 (20-54) months of follow-up, symptomatic CVOD recurred in 32 (49.2%) patients, accounting for 51 secondary angioplasties, including 34 stenting procedures. The PPR and APR at 12, 24, 36, 48, and 60 months were 81%, 52%, 47%, 41%, and 41% and 98%, 98%, 82%, 82%, and 82%, respectively. VA abandonment was noted in 10 (15.4%) patients. Six (9.2%) and 17 (26.2%) patients died due to cardiovascular conditions and all causes, respectively. The number of secondary stenting procedures was significantly associated with decreased VA abandonment [odds ratio (OR) = 0.089, 95% confidence interval (CI): 0.008-0.992, <i>p</i> = 0.049] and all-cause mortality (OR = 0.104, 95% CI: 0.011-0.947, <i>p</i> = 0.045).</p><p><strong>Conclusions: </strong>Angioplasty with stenting is an effective and promising strategy for MHD patients with refractory CVOD.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2463579"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433564","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}