Renal Failure最新文献

{"title":"Renal impairment and in-hospital adverse renal events in critically ill patients assessed by age-adapted estimated glomerular filtration rate criteria.","authors":"Chong Zhang, Weiru Liang, Meng Ning, Bin Su, Tingting Guo, Kun Hu, Wei Su, Yi Chen, Wenjin Peng, Yingwu Liu","doi":"10.1080/0886022X.2025.2456110","DOIUrl":"10.1080/0886022X.2025.2456110","url":null,"abstract":"<p><strong>Background: </strong>Impaired renal function (IRF) is associated with an elevated risk of major adverse renal events (MARE). However, the relationship between age-adapted estimated glomerular filtration rate (eGFR) criteria and in-hospital MARE has not been extensively studied in critically ill patients. Furthermore, the impact of eGFR trajectory changes on in-hospital MARE in this patient population remains underexplored.</p><p><strong>Methods: </strong>In this study, we analyzed data from 7,423 critically ill patients using version 2.2 of the Medical Information Mart for Intensive Care IV database. Based on the age-adapted eGFR criteria, renal function status was classified as impaired renal function (IRF), subclinical impairment of renal function (SIRF), and normal renal function (NRF).</p><p><strong>Results: </strong>There were 2,438 patients (32.8%) of in-hospital MARE. The incidence of MARE and their individual endpoint components was higher in patients with SIRF and IRF than in patients with NRF. Group-based trajectory modeling revealed that, compared with patients with other renal function status, patients with SIRF demonstrated the most significant decline in eGFR as well as the highest risk of MARE based on the results of the low-level-to-decline trajectory. Additionally, a trend toward an increased risk of MARE was observed in patients with SIRF and IRF, particularly among younger patients, when compared with those with NRF.</p><p><strong>Conclusions: </strong>Critically ill patients with SIRF and IRF had an increased risk of in-hospital MARE. Patients with SIRF experienced the most notable decline in renal function during hospitalization, with the highest risk of MARE noted in this trajectory group. In addition, a trend toward an increased risk of MARE was observed in younger patients. Consequently, active monitoring and timely intervention in younger patients are imperative.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2456110"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11800333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190338","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":"Comparison of the patency rates of catheter placement <i>via</i> the right external jugular vein route versus the right brachiocephalic vein route in patients experiencing tunneled-cuffed catheter loss.","authors":"Jun Yin, Fengping Wang","doi":"10.1080/0886022X.2025.2457516","DOIUrl":"10.1080/0886022X.2025.2457516","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study is to compare the patency rates of catheter placement <i>via</i> cannulation of right external jugular vein (EJV) versus the right brachiocephalic (BCV) in patients experiencing tunneled-cuffed catheter (TCC) loss.</p><p><strong>Method: </strong>We conducted a retrospective analysis of 30 patients admitted to our department due to TCC loss. Among them, 11 patients underwent catheter reinsertion <i>via</i> the right EJV, while 19 patients underwent catheter reinsertion <i>via</i> the right BCV. We collected and compared the data of these patients.</p><p><strong>Results: </strong>In both groups of patients, there were no cases of pneumothorax, severe adjacent artery injury, or mediastinal hematoma observed. The one-year primary patency rates of the catheters in the EVJ group and the BCV group were 54.55% and 36.84%, and the primary patency rates of two years were found to be 27.27% and 21.05% respectively. There was no statistically significant difference in the patency rates at both 1 and 2 years (<i>p</i> = 0.55, <i>p</i> = 0.71).</p><p><strong>Conclusion: </strong>In the face of patients experiencing TCC loss, the practice of replacing dialysis catheters via the right EJV and right BCV routes emerges as a safe and efficacious alternative strategy. Notably, no difference in catheter patency rates is observed between these divergent access routes.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2457516"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11849010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468991","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 prediction for acute kidney disease and adverse outcomes in patients with chronic obstructive pulmonary disease: an interpretable machine learning approach.","authors":"Siqi Jiang, Lingyu Xu, Xinyuan Wang, Chenyu Li, Chen Guan, Lin Che, Yanfei Wang, Xuefei Shen, Yan Xu","doi":"10.1080/0886022X.2025.2485475","DOIUrl":"https://doi.org/10.1080/0886022X.2025.2485475","url":null,"abstract":"<p><strong>Background: </strong>Little is known about acute kidney injury (AKI) and acute kidney disease (AKD) in patients with chronic obstructive pulmonary disease (COPD) and COPD mortality based on the acute/subacute renal injury. This study develops machine learning models to predict AKI, AKD, and mortality in COPD patients, utilizing web applications for clinical decisions.</p><p><strong>Methods: </strong>We included 2,829 inpatients from January 2016 to December 2018. Data were split into 80% for training and 20% for testing. Eight machine learning algorithms were used, and model performance was evaluated using various metrics. SHAP was used to visualize the decision process. The best models, assessed using AUROC were used to develop web applications for identifying high-risk patients.</p><p><strong>Results: </strong>The incidence rates were 13.71% for AKI and 15.11% for AKD. The overall mortality rate was 4.84%. LightGBM performed best with AUROC of 0.815, 0.827, and 0.934 in AKI, AKD, and mortality, respectively. Key predictors for AKI were Scr, neutrophil percentage, cystatin c, BUN, and LDH. For AKD, the key predictors were age, AKI grade, HDL-C, Scr, and BUN. The key predictors for mortality included the use of dopamine and epinephrine drugs, cystatin c, renal function trajectory, albumin, and neutrophil percentage. Force plots visualized the prediction process for individual patients.</p><p><strong>Conclusions: </strong>The incidence of AKI and AKD is significant in patients with COPD. Renal function trajectory is crucial for predicting mortality in these patients. Web applications were developed to predict AKI, AKD, and mortality, improving prognosis by identifying high-risk patients and reducing adverse events and disease progression.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2485475"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dietary habits and risk of diabetic kidney disease: a two-sample and multivariate Mendelian randomization study.","authors":"Ziqi Zhang, Jieyu Niu, Wenhao Sun, Yuqing Sun, Ying Tan, Jiangyi Yu","doi":"10.1080/0886022X.2024.2438848","DOIUrl":"10.1080/0886022X.2024.2438848","url":null,"abstract":"<p><strong>Objective: </strong>We explored the causal relationship between certain dietary habits and the risk of developing diabetic kidney disease (DKD) using two-sample Mendelian randomization and multivariate Mendelian randomization.</p><p><strong>Research design and methods: </strong>This study is based on pooled data from a genome-wide association study (GWAS) of 83 dietary habits in a European population. We performed a two-sample Mendelian randomization analysis using GAWS data on diabetic nephropathy in a European population. Validation was then performed against positive results (<i>p</i> < 0.05) in different GAWS data on diabetic nephropathy of European origin. Finally, multivariate Mendelian randomization analyses were performed on dietary habits with positive results (<i>p</i> < 0.05) in both datasets and GWAS data on postprandial glucose in the European population.</p><p><strong>Results: </strong>This study showed causal relationships between 18 dietary habits and the risk of developing DKD. After validation, causal relationships were found between the risk of DKD and two dietary habits: abstaining from sugar consumption (OR 2.86; 95%CI 1.35, 6.08; <i>p</i> = 0.006) and consuming whole grain/multigrain bread (OR 0.53; 95%CI 0.32, 0.89; <i>p</i> = 0.016). Correcting for the effect of postprandial glucose, the multivariate MR results showed that never eating sugar increased the risk of developing DKD (OR 0.08; 95%CI 0.018, 0.36; <i>p</i> = 0.001), whereas eating whole grain/multigrain bread did not reduce the risk of developing DKD (OR 1.37; 95%CI 0.55, 3.41; <i>p</i> = 0.50).</p><p><strong>Conclusions: </strong>Our MR results suggest a causal relationship between never eating sugar and an increased risk of developing DKD. Therefore, people with diabetes need a reasonable range of sugar intake.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2438848"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912233/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617147","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":"Public interest in chronic kidney disease and dialysis: a 20-year data analysis.","authors":"Jose Arriola-Montenegro, Wisit Cheungpasitporn, Charat Thongprayoon, Iasmina M Craici, Jing Miao","doi":"10.1080/0886022X.2025.2462253","DOIUrl":"10.1080/0886022X.2025.2462253","url":null,"abstract":"<p><p>Chronic kidney disease (CKD) is a growing global health challenge. As the disease progresses, it can lead to end-stage renal disease, necessitating dialysis or kidney transplantation. However, access to these life-saving treatments is often limited by geographic, financial, and resource constraints, underscoring the importance of public awareness and interest. This study examined global and U.S. search trends related to CKD and dialysis using Google Trends™ data from 2004 to 2024. Public search activity was measured using the Relative Search Interest (RSI) index, which ranges from 0 to 100. Both CKD and dialysis exhibited an upward trend in search activity worldwide and in the U.S., as indicated by a positive slope in linear regression analysis (all <i>p</i> < .0001), though some fluctuations and regional differences were observed. Pearson's correlation analysis demonstrated a strong relationship between the U.S. dialysis RSI scores from Google Trends and real-world dialysis incidence rates from the United States Renal Data System (USRDS) (<i>r</i> = 0.961, <i>p</i> < .0001). Notably, in 2020, search activity for both CKD and dialysis declined, likely due to disruptions caused by the COVID-19 pandemic. The study highlights the potential of Google Trends as a valuable tool for assessing public interest and awareness of kidney health, providing insights that can inform public health strategies and educational initiatives. However, relying solely on Google Trends data to assess public interest is insufficient, due to inherent limitations and biases. Findings derived from search trends should be interpreted with caution and ideally supplemented with additional research methodologies.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2462253"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433566","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":"Vitexin enhances mitophagy and improves renal ischemia-reperfusion injury by regulating the p38/MAPK pathway.","authors":"Jianan Chen, Chaowei Chen, Chang Lv, Runtao Feng, Weibo Zhong, Yongguang Liu, Song Zhou, Ming Zhao","doi":"10.1080/0886022X.2025.2463572","DOIUrl":"10.1080/0886022X.2025.2463572","url":null,"abstract":"<p><p>Vitexin (VI) is a naturally occurring flavonoid derived from the leaves and seeds of Vitex, recognized for its strong antioxidant properties. This study aims to explore its effects on renal ischemia-reperfusion injury (IRI) and investigate the underlying mechanisms. We utilized hypoxia-reoxygenation (H/R) models with HK-2 cell lines and renal ischemia-reperfusion (I/R) models in mice, applying vitexin preconditioning to assess its influence on renal IRI. Our findings reveal that vitexin mitigated oxidative stress, decreased cell apoptosis, and reduced the expression of renal damage indicators such as kidney injury molecule-1 (KIM-1) and neutrophil gelatinase-associated lipocalin (NGAL), along with an overall improvement in renal function. To further investigate the mechanism, we used network pharmacology and molecular docking techniques to predict potential vitexin targets in renal IRI. Results from Western blotting and immunofluorescence assays indicate that vitexin may promote mitophagy by suppressing the phosphorylation of the pivotal p38 protein in the p38/MAPK signaling pathway, offering protection against renal IRI. The findings indicate that vitexin could potentially be used as a therapeutic agent to alleviate renal IRI.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2463572"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441714","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":"Investigation of the connection between triglyceride-glucose (TyG) index and the risk of acute kidney injury in septic patients - a retrospective analysis utilizing the MIMIC-IV database.","authors":"Pirun Zhang, Wenli Zhang, Yan Han, Tong Yang, Jiayi Zhong, Han Yun, Lai Fang","doi":"10.1080/0886022X.2024.2449199","DOIUrl":"10.1080/0886022X.2024.2449199","url":null,"abstract":"<p><p>The TyG index serves as a valuable tool for evaluating insulin resistance. An elevated TyG has shown a strong association with the occurrence of acute kidney injury (AKI). Nevertheless, existing literature does not address the relationship between the TyG index and acute kidney injury in patients with sepsis. Sepsis patients were identified from the MIMIC-IV database and categorized into four groups according to quadrilles of their TyG index values. The primary outcome of this study was the incidence of AKI. The relationship between the TyG index and the risk of AKI in septic patients was evaluated using Cox proportional hazards and restricted cubic spline models. Subgroup analyses were conducted to investigate the prognostic value of the TyG index in different subgroups. A total of 2,616 patients with sepsis (57% of whom were male) were included in this study. The incidence of AKI was found to be 78%. Cox proportional hazards analysis revealed a significant correlation between the TyG index and the occurrence of AKI in septic patients. Furthermore, a restricted cubic spline model revealed an approximately linear relationship between a higher TyG index and an elevated risk of AKI in septic patients. The trend of the hazard ratio (HR) remained consistent across various subgroups. These findings emphasize the reliability of the TyG index as an independent predictor for the occurrence of AKI and unfavorable renal outcomes in sepsis patients. Nevertheless, establishing a causal relationship between the two requires demonstration through larger prospective studies.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2449199"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11721622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142962430","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":"Mean arterial pressure at the initiation of continuous renal replacement therapy as a prognostic indicator in patients with acute kidney injury.","authors":"Haiying Song, Yuheng Liao, Haofei Hu, Qijun Wan","doi":"10.1080/0886022X.2024.2448582","DOIUrl":"10.1080/0886022X.2024.2448582","url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury (AKI) is a common complication in critically ill patients, with approximately 5% requiring continuous renal replacement therapy (CRRT). This study investigated the relationship between mean arterial pressure (MAP) and 28- and 90-day mortality in critically ill AKI patients treated with CRRT.</p><p><strong>Methods: </strong>This secondary analysis of a bicenter, retrospective, observational study included patients with AKI who were treated with CRRT from January 2009 to September 2016. Mortality at 28 and 90 days post-CRRT initiation was analyzed using multivariate regression, generalized additive models, smooth curve fitting, and sensitivity analyses.</p><p><strong>Results: </strong>A total of 1,142 patients were included, with 28-day and 90-day mortality rates of 62.1% and 71.8%, respectively. In multivariable-adjusted Cox models, MAP was inversely correlated with the risk of 28-day and 90-day mortality after adjusting for covariates. Hazard ratios (HRs) were calculated per 1 mmHg increment of MAP: adjusted HR for 28-day mortality 0.985 (<i>p</i> < 0.00001) and for 90-day mortality 0.987 (<i>p</i> = 0.00002). The adjusted HRs for 28-day and 90-day mortality in patients in the highest tertile of MAP compared with those in the lowest tertile were 0.682 (95% CI 0.543-0.857) and 0.730 (95% CI 0.592-0.899), respectively. Patients were grouped using MAP thresholds of <65 mmHg, 65-71.85 mmHg, and ≥71.85 mmHg, with similar results observed. Sensitivity analyses confirmed the inverse relationship between higher MAP before CRRT and lower mortality.</p><p><strong>Conclusion: </strong>The higher the MAP before CRRT is, the lower the 28- and 90-day mortality of critically ill patients with AKI who are treated with CRRT.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2448582"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11721759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142962431","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":"Kidney function and cognitive impairment: a systematic review and meta-analysis.","authors":"Xiaohua Pei, Nazia Begum Bakerally, Zhan Wang, Yun Bo, Yao Ma, Zhenzhu Yong, Sizhu Zhu, Fei Gao, Zhu Bei, Weihong Zhao","doi":"10.1080/0886022X.2025.2463565","DOIUrl":"10.1080/0886022X.2025.2463565","url":null,"abstract":"<p><strong>Background: </strong>A worldwide evaluation exploring the link between a broad-spectrum kidney function and cognitive impairment (CI) prevalence, and related risk factors has yet to be conducted.</p><p><strong>Methods: </strong>Studies published before November 2024 were retrieved from PubMed and Web of Science. R software (R Foundation for Statistical Computing, Vienna, Austria) and Review Manager (Cochrane Collaboration, London, UK) were used to analyze the relationship of CI with various estimated glomerular filtration rate (eGFR) level and the associated risk factors. A random model effect was adopted for a heterogeneity (<i>I</i>²) of more than 50%.</p><p><strong>Results: </strong>Seventeen (involving 32,141 participants) out of 5892 studies were included. The MMSE and MoCA were the most commonly used tests to assess cognitive function. The prevalence of CI raised significantly with declining kidney function: 10% for eGFR ≥60 mL/min/1.73 m², 47.3% for 60-30 mL/min/1.73 m², and 60.6% for <30 mL/min/1.73 m², totaling 16.7% overall. Thirteen potential risk factors were ascertained and analyzed. In the forest-plot analysis, T2DM, cardiovascular diseases, cerebrovascular diseases, and lower education emerged as strong predictors of risk, with odds ratios of 1.55, 1.63, 1.95, and 2.59, respectively. A mean meta-analysis of the continuous variable indicators revealed that advanced age and elevated parathyroid hormone (PTH) levels were statistically significant in the occurrence of CI.</p><p><strong>Conclusions: </strong>The poorer the renal function, the higher the prevalence rate of CI. Patients with chronic kidney disease (CKD) have multiple risk factors that lead to CI.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2463565"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557910","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}