Renal Failure最新文献

{"title":"Impact of dialysis on intravesical recurrence and survival outcomes in upper tract urothelial cancer patients undergoing radical nephroureterectomy.","authors":"Chi-Chun Hsieh, Ching-Chia Li, Yung-Shun Juan, Wei-Ming Li, Wen-Jeng Wu, Tsu-Ming Chien","doi":"10.1080/0886022X.2025.2458762","DOIUrl":"10.1080/0886022X.2025.2458762","url":null,"abstract":"<p><strong>Background: </strong>Upper tract urothelial carcinoma (UTUC) presents a significant recurrence risk following radical nephroureterectomy (RNU). Patients on dialysis may experience unique clinical trajectories due to uremic states and altered immune responses.</p><p><strong>Objective: </strong>To evaluate the impact of dialysis on intravesical recurrence and survival outcomes in patients with UTUC undergoing RNU, and to identify predictive factors influencing prognosis.</p><p><strong>Methods: </strong>A retrospective cohort study analyzed 402 patients with non-metastatic UTUC treated with RNU between 2001 and 2014. Patients were stratified into dialysis (<i>n</i> = 66) and non-dialysis (<i>n</i> = 336) groups. Survival and recurrence outcomes were assessed using Kaplan-Meier and Cox regression analyses.</p><p><strong>Results: </strong>Dialysis patients were predominantly female, younger, and exhibited less advanced pathological tumor stages. Dialysis was associated with higher intravesical recurrence rates (<i>p</i> = 0.009), which were largely attributable to a history of bladder cancer (42.4% vs. 26.5%; <i>p</i> = 0.009). After adjustment for bladder cancer history, dialysis was not an independent predictor of bladder recurrence-free survival (BRFS). Advanced pT stages (HR: 3.9, <i>p</i> = 0.012) and prior bladder cancer were the primary factors influencing BRFS.</p><p><strong>Conclusions: </strong>Dialysis does not independently worsen surgical outcomes or BRFS in UTUC patients post-RNU when accounting for prior bladder cancer. Prognostic models should integrate these findings to enhance individualized surveillance and treatment strategies.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2458762"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143371097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between the initiation of loop diuretics and changes in 2-hour creatinine clearance in critically ill patients.","authors":"Kwok M Ho, Prakkash Ananthan, David J R Morgan","doi":"10.1080/0886022X.2025.2457514","DOIUrl":"10.1080/0886022X.2025.2457514","url":null,"abstract":"","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2457514"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11795764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endothelial injury is one of the risk factors for the progression of vascular calcification in patients receiving maintenance dialysis.","authors":"Dan-Dan Yao, Xiao-Wei Yan, Yan Zhou, Zuo-Lin Li, Fang-Xin Qiu","doi":"10.1080/0886022X.2025.2456690","DOIUrl":"10.1080/0886022X.2025.2456690","url":null,"abstract":"<p><strong>Background: </strong>Vascular calcification is common and progressive in patients with chronic kidney disease. However, the risk factors associated with the progression of vascular calcification in patients receiving maintenance dialysis have not been fully elucidated. Here, we aimed to evaluate vascular calcification and identify the factors associated with its progression in patients receiving maintenance hemodialysis.</p><p><strong>Methods: </strong>This is a prospective longitudinal study that included 374 patients receiving maintenance hemodialysis. The participants received assessments of coronary artery calcification (CAC) and abdominal aortic calcification (AAC), as measured by computed tomography. After the baseline investigation, a 2 years follow-up was performed. We also detected the markers of endothelial injury [E-selectin and soluble intercellular adhesion molecule-1 (sICAM-1)]. Finally, the risk factors affecting the CAC and AAC progression were examined by multivariate logistic regression analysis.</p><p><strong>Results: </strong>Among 374 patients, the median [interquartile range (IQR)] age was 54.0 (40.0-62.0) years; 59.9% of patients were male. The median (IQR) follow-up time was 1.9 (1.8-2.0) years for all patients. By the end of 2-year follow-up, progression of vascular calcification (including CAC and AAC) was observed in 58.0% of patients. Further, compared with the patients without progression of vascular calcification, the endothelial injury (including E-selectin and sICAM-1) of patients with progression of vascular calcification was markedly enhanced. Moreover, after adjustment for the confounders, endothelial injury was a risk factor for the progression of vascular calcification.</p><p><strong>Conclusion: </strong>The present study indicated that endothelial injury is one of the risk factors for the progression of vascular calcification in patients receiving maintenance hemodialysis.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2456690"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11774155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world assessment of sparsentan's drug safety framework.","authors":"Wenjing Fu, Jingyu Wang, Yuzhou Xue, Dikang Pan","doi":"10.1080/0886022X.2025.2461668","DOIUrl":"10.1080/0886022X.2025.2461668","url":null,"abstract":"<p><strong>Background: </strong>Sparsentan has been approved for reducing proteinuria in adult patients with primary IgA nephropathy (IgAN) at risk of rapid disease progression, yet comprehensive studies evaluating its drug safety framework are lacking.</p><p><strong>Methods: </strong>Adverse event (AE) reports following the market release of sparsentan were collected from the U.S. Food and Drug Administration AE Reporting System. Disproportionate analysis was used to identify previously unrecognized positive novel signals at both the system organ class and preferred term levels. Additionally, analysis on clinical priorities and subgroup analysis were conducted.</p><p><strong>Results: </strong>A total of 504 patients with IgAN were included. Two novel system organ classes and 14 novel preferred terms were identified. Hypotension and dizziness were established as moderate clinical priority events. Males had a higher relative risk of nausea, peripheral edema, feeling abnormal, decreased blood pressure, and hypotension, while females were at greater risk for fatigue, pain, increased blood creatinine, dizziness, and somnolence. Among those aged 18-45, the relative risk of experiencing fatigue, pain, and dizziness was higher, individuals aged 45 and older had a higher relative risk of peripheral edema, decreased blood pressure, and hypotension.</p><p><strong>Conclusions: </strong>Based on the available AE reporting data, sparsentan exhibits a favorable safety profile, with no high-priority clinical events identified. Our findings offer valuable insights to optimize the use of sparsentan and understand its potential side effects.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2461668"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11843636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality indicators and clinical outcomes: the role of care quality in nondiabetic chronic kidney disease management.","authors":"Yun-Fang Hsieh, Le-Yin Hsu, Ping-Hsiu Tsai, Wan-Chuan Tsai, Mei-Ju Ko, Kuo-Liong Chien, Hon-Yen Wu","doi":"10.1080/0886022X.2025.2469748","DOIUrl":"10.1080/0886022X.2025.2469748","url":null,"abstract":"<p><p>Quality indicators (QIs) are essential for evaluating healthcare quality, but their validation for nondiabetic chronic kidney disease (CKD) populations is limited. We aimed to assess the association between QIs and outcomes in nondiabetic CKD patients. Using Taiwan's National Health Insurance claims data and death registries, we analyzed 27,842 nondiabetic adults with stage 3B-5 CKD from 2016 to 2019. Three QIs were assessed: renin-angiotensin system (RAS) inhibitor prescription, proteinuria testing, and nonsteroidal anti-inflammatory drug (NSAID) avoidance. Each patient received an overall QI score (range: 0-3) based on the sum of the individual QI scores. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between QI scores and outcomes, including long-term dialysis, all-cause death, hospitalization for acute kidney injury (AKI), hyperkalemia, and acidosis. The study population had a mean age of 68.7 years and a female prevalence of 41.7%. Only 33.5% of patients received the highest QI score. During a median follow-up period of 23 months, higher overall QI scores were associated with lower risks of long-term dialysis (HR 0.891, 95% CI 0.846-0.938), all-cause death (HR 0.900, 95% CI 0.864-0.939), and acidosis (HR 0.882, 95% CI 0.799-0.972). Notably, the prescription of RAS inhibitors was consistently correlated with better outcomes. These findings underscore the importance of quality indicators, particularly the continued use of RAS inhibitors, in improving outcomes for nondiabetic CKD patients. Future research should focus on refining existing QIs and expanding their validation to broader populations and healthcare settings.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2469748"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11852228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Right ventricular-pulmonary arterial coupling and pulmonary hypertension in hemodialysis: insights into structural cardiac changes and clinical implications.","authors":"Kristina Buryskova Salajova, Jan Malik, Lucie Kaiserova, Zuzana Hladinova, Zdenka Hruskova, Simona Janakova, Vladimir Tesar, Satu Sinikka Pesickova, Kristyna Michalickova, Katarina Rocinova, Barbora Szonowska, Anna Valerianova","doi":"10.1080/0886022X.2025.2466822","DOIUrl":"10.1080/0886022X.2025.2466822","url":null,"abstract":"<p><strong>Objectives: </strong>This cross-sectional analysis from the CZecking Heart Failure in patients with advanced Chronic Kidney Disease trial (ISRCTN18275480) examined pulmonary hypertension and right ventricular-pulmonary arterial coupling in patients on chronic hemodialysis. The aims of this analysis were: 1. To analyze relations between pulmonary hypertension and right ventricular-pulmonary arterial coupling with dialysis access flow and current hydration; 2. To analyze structural heart changes associated with right ventricular-pulmonary arterial uncoupling; 3. To reveal the prevalence, etiology and severity of pulmonary hypertension in the Czech hemodialysis population.</p><p><strong>Methods: </strong>We performed expert echocardiography, vascular access flow measurements, bioimpedance analysis, and laboratory testing in 336 hemodialysis patients.</p><p><strong>Results: </strong>Pulmonary hypertension was present in 34% (114/336) patients and right ventricular-pulmonary arterial uncoupling was present in 25% of patients with pulmonary hypertension. Only weak associations between the flow of the dialysis arteriovenous access and estimated pulmonary arterial systolic pressure and right ventricular-pulmonary arterial coupling was proved. There was a strong association between hydration status assessed by estimated central venous pressure with pulmonary arterial systolic pressure (Rho 0.6, <i>p</i> < 0.0001) and right ventricular-pulmonary arterial coupling (Rho -0.52, <i>p</i> < 0.0001) and association between overhydration to extracellular water ratio with pulmonary arterial systolic pressure (Rho 0.31, <i>p</i> = 0.0001) and right ventricular-pulmonary arterial coupling (Rho -0.29, <i>p</i> = 0.002). The prevalence of heart failure was significantly higher in patients with right ventricular-pulmonary arterial uncoupling (88% vs. 52%, <i>p</i> = 0.0003).</p><p><strong>Conclusion: </strong>These findings suggest that optimizing volume status and treating heart failure should be prioritized in hemodialysis patients to prevent pulmonary hypertension progression and right ventricular-pulmonary arterial uncoupling.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2466822"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11852216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute kidney injury in hospitalized children with diphtheria in northwestern Nigeria: incidence and hospitalization outcomes.","authors":"Olayinka Rasheed Ibrahim, Abdurrazzaq Alege, Michael Abel Alao, Olanrewaju Timothy Adedoyin","doi":"10.1080/0886022X.2025.2465817","DOIUrl":"10.1080/0886022X.2025.2465817","url":null,"abstract":"<p><strong>Background: </strong>Despite the kidney being affected by diphtheria exotoxin, the extent of acute kidney injury (AKI) and its possible impact on outcomes remain unknown. This study examined the incidence, risk factors, and outcomes of AKI in children with diphtheria.</p><p><strong>Methods: </strong>This was a prospective cohort study of confirmed diphtheria managed from July 1, 2023, to April 30, 2024, at a health facility in Nigeria. We obtained data on clinical and laboratory features and treatments received. AKI was defined using Kidney Disease: Improving Global Outcomes (KDIGO) criteria.</p><p><strong>Results: </strong>We included 237 children with a median [interquartile range] age of 7.0 [4-10] years. Using KDIGO, 139 (58.6%) had AKI [stage 1:88 (37.1%); stage 2: 18 (7.6%); and stage 3: 33 (13.9%)]. Variables associated with AKI included age, sore throat, inability to swallow, difficulty breathing, nasal blockade, hypoxemia, nasal discharge, pallor, abnormal chest findings, hospitalization duration, vaccination status, white blood cells, lymphocytes, platelets, serum bicarbonate, sodium and potassium, and treatments received, <i>p</i> < 0.05. On multivariable logistic regression, predictors of AKI included age ≤ 60 months [AOR 2.75, 95% CI 1.27-5.95], dexamethasone [AOR 2.57, 95% CI 1.11-4.60], oxygen therapy [4.85, 95% CI 1.24-18.99], and ibuprofen [AOR 2.74, 95 CI% 1.16-6.44]. Mortality rate was 24.5% (58/237) and 33.1% (46/139) in AKI. The odds of deaths with AKI were 3.56 (95% CI 1.76-7.14).</p><p><strong>Conclusion: </strong>There is a high incidence of AKI among children with diphtheria and increased odds of death. Factors that predicted AKI included younger age, oxygen therapy, and medications (ibuprofen and dexamethasone).</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2465817"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11852218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stress hyperglycemia ratio as an independent predictor of acute kidney injury in critically ill patients with acute myocardial infarction: a retrospective U.S. cohort study.","authors":"Xudong Li, Yong Qiao, Liang Ruan, Shuailei Xu, Zhongguo Fan, Shiqi Liu, Junxian Shen, Chengchun Tang, Yuhan Qin","doi":"10.1080/0886022X.2025.2471018","DOIUrl":"10.1080/0886022X.2025.2471018","url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury (AKI) is a frequent and severe complication in critically ill patients with acute myocardial infarction (AMI), significantly worsening prognosis. Identifying early risk markers for AKI in AMI patients is critical for timely intervention. The stress hyperglycemia ratio (SHR), a marker of acute glycemic response to physiological stress, has been proposed as a predictor of AKI, but its role remains unclear.</p><p><strong>Objective: </strong>This study investigates the association between SHR and AKI development in critically ill patients with AMI, using data from the MIMIC-III and MIMIC-IV databases.</p><p><strong>Methods: </strong>A total of 4,663 critically ill AMI patients were analyzed. SHR was evaluated for its association with AKI incidence using logistic regression, restricted cubic splines, and mediation analysis. Subgroup and sensitivity analyses were performed to confirm robustness. Additionally, Cox regression and Kaplan-Meier survival analysis were used to explore SHR's association with in-hospital mortality in the overall cohort and AKI subgroup.</p><p><strong>Results: </strong>Higher SHR levels were independently associated with an increased risk of AKI, demonstrating a J-shaped relationship. Mediation analysis revealed that neutrophil count and albumin partially mediated this effect. Kaplan-Meier survival curves showed significant differences in in-hospital mortality among SHR quartiles (log-rank <i>p</i> < 0.001). However, Cox regression analysis indicated that SHR was not an independent predictor of in-hospital mortality in either the full cohort or the AKI subgroup.</p><p><strong>Conclusions: </strong>SHR serves as an early and independent marker for AKI risk in critically ill AMI patients, offering potential utility in clinical risk stratification. However, its role in predicting in-hospital mortality appears limited. These findings underscore the importance of glycemic monitoring and management in AMI patients at risk of AKI.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2471018"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corticosteroid and immunosuppressive treatment are effective for acquired pure red cell aplasia in chronic kidney disease: a case report and literature review.","authors":"Hongsha Yang, Yurong Zou, Guisen Li, Yunlin Feng","doi":"10.1080/0886022X.2024.2449202","DOIUrl":"10.1080/0886022X.2024.2449202","url":null,"abstract":"","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2449202"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11721747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142965634","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":"Letter to the editor: \"Association of Geriatric Nutritional Risk Index with short-term mortality in patients with severe acute kidney injury: retrospective cohort study\".","authors":"Mariana Dias Pais, Sílvia Coelho","doi":"10.1080/0886022X.2024.2448575","DOIUrl":"10.1080/0886022X.2024.2448575","url":null,"abstract":"","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2448575"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11722023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142953515","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}