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":"Immune-microbiota dysregulation in maintenance hemodialysis: a 16S rRNA sequencing-based analysis of gut flora and T cell profiles.","authors":"Yan Lv, Xiuting Yang, Xiaowu Sun, Xiaohong Ren","doi":"10.1080/0886022X.2025.2498630","DOIUrl":"10.1080/0886022X.2025.2498630","url":null,"abstract":"<p><strong>Background: </strong>Maintenance hemodialysis (MHD) patients frequently exhibit immune dysregulation and gut dysbiosis, both of which contribute to increased infection risk and adverse outcomes. However, the relationship between gut microbial composition and immune competence in this population remains underexplored.</p><p><strong>Methods: </strong>This study assessed 45 MHD patients and 30 healthy controls, stratifying MHD patients into immunocompetent (HD-NLI, CD4⁺/CD8⁺ ≥ 1) and immunodeficient (HD-LI, CD4⁺/CD8⁺ < 1) groups. Circulating cytokines (IL-6, IL-10, IL-12, TNF-α, IFN-γ) were quantified using ELISA. Gut microbiota profiles were derived <i>via</i> 16S rRNA gene sequencing (V3-V4 regions), followed by QIIME2 and LEfSe-based bioinformatics analyses.</p><p><strong>Results: </strong>HD-LI patients displayed severe T cell dysregulation and elevated pro-inflammatory cytokines. Compared to controls, HD patients had reduced abundance of beneficial taxa (e.g., <i>Prevotella copri, Bacteroides vulgatus, Agathobacter</i>), and enrichment of pro-inflammatory taxa (e.g., <i>Escherichia-Shigella, Blautia, Citrobacter</i>). LEfSe identified 39 discriminatory taxa with distinct immune group signatures. Redundancy analysis revealed that CD4⁺ levels, CD4⁺/CD8⁺ ratios, and TNF-α significantly shaped microbiota composition. Correlation analysis confirmed strong associations between immune parameters and microbial taxa involved in short-chain fatty acid (SCFA) metabolism.</p><p><strong>Conclusion: </strong>This study provides novel evidence linking gut microbial dysbiosis to immune impairment in MHD patients. The findings suggest that SCFA-producing bacteria are depleted in immunodeficient states, offering a potential target for microbiota-directed immunomodulatory therapies in ESRD.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2498630"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12082729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079892","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":"Plasma brain-derived neurotrophic factor before hemodialysis reduces the risk of depression in patients with chronic renal failure.","authors":"Juan Antonio Suárez-Cuenca, Nuri Perla Campos-Nolasco, Ernesto Rodríguez-Ayala, Ana Daniela Zepeda-Làmbarry, Marta Georgina Ochoa-Madrigal, Diana Maldonado-Tapia, Eduardo Vera-Gómez, Alejandro Hernández-Patricio, Gustavo Martínez-Torres, Yareni Bernal-Figueroa, Juan Antonio Pineda-Juárez, José Gutiérrez-Salinas, Christian Gabriel Toledo-Lozano, Silvia García","doi":"10.1080/0886022X.2025.2463561","DOIUrl":"10.1080/0886022X.2025.2463561","url":null,"abstract":"<p><strong>Background: </strong>Neurotrophins are related with depressive disorders. Significant neurotrophins variations occur during renal replacement therapy, but whether peri-hemodialysis availability is associated with depression in patients with Chronic Kidney Disease (CKD) is yet unclear.</p><p><strong>Aim: </strong>To determine dynamic concentrations of neurotrophins in the peri-hemodialysis range and their association with depressive symptoms in patients with CKD.</p><p><strong>Methods: </strong>Pre-, and post-hemodialysis plasma concentrations of brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF), as well as their plasma clearance rates, were determined (multiplexing) in patients with stage 5 CKD. Depressive symptoms, as assessed by the Beck Depression Inventory-II (BDI-II), were determined. Finally, the bioavailability of BDNF and NGF was related to the score of depressive symptoms.</p><p><strong>Results: </strong>Fifty-three patients were divided according to depressive symptoms. Pre-hemodialysis plasma BDNF was lower in patients with depressive disorder; whereas basal BDNF value >220 pg/mL independently reduced the risk for depressive disorder (Odds Ratio 0.23, <i>p</i> = 0.047) at uni- and multivariate analysis. Post-hemodialysis concentration and clearance rate of neurotrophins were not related with depressive symptoms.</p><p><strong>Conclusion: </strong>Higher plasma BDNF before hemodialysis reduces the risk of mild depression in patients with CKD under renal replacement therapy.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2463561"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441743","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}