Renal Failure最新文献

{"title":"Unveiling the role of oxidative stress in ANCA-associated glomerulonephritis through integrated machine learning and bioinformatics analyses.","authors":"Liyuan Xie, Xianying Qiu, Junya Jia, Tiekun Yan, Pengcheng Xu","doi":"10.1080/0886022X.2025.2499905","DOIUrl":"10.1080/0886022X.2025.2499905","url":null,"abstract":"<p><p>Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a systemic autoimmune disease often leading to rapidly progressive glomerulonephritis. Oxidative stress plays a critical role in the development and progression of ANCA-associated glomerulonephritis (AAGN), but the underlying mechanisms remain poorly understood. Targeting genes related to oxidative stress may provide novel insights and supplementary therapeutic benefits for AAGN. In the current study, we obtained differentially expressed genes from AAGN-related microarray datasets in the Gene Expression Omnibus database, and oxidative stress-related genes (OSRGs) from the GeneCards and Gene Ontology databases to identify differentially expressed OSRGs. Then, by integrating weighted gene co-expression network analysis, and machine learning algorithms, we identified four upregulated hub OSRGs (all <i>p</i> < 0.01) with strong diagnostic potential (all AUC > 0.9)-CD44, ITGB2, MICB, and RAC2 - in the AAGN glomerular training dataset GSE104948 and validation dataset GSE108109, along with two hub OSRGs (all <i>p</i> < 0.05) with better diagnostic potential (all AUC > 0.7) - upregulated gene VCAM1 and downregulated gene VEGFA-in the AAGN tubulointerstitial training dataset GSE104954 and validation dataset GSE108112. The GSEA analysis suggested that these hub genes may play a role in inflammatory and immune response processes. Moreover, we constructed regulatory networks and identified drugs that potentially target these hub genes. It's to be noted that RAC2 and ITGB2 were associated with cyclophosphamide in the AAGN glomerular compartment, while VCAM1 and VEGFA were associated with dexamethasone in the tubulointerstitial compartment. This study offers novel insights into immune-associated OSRGs within the glomerular and tubulointerstitial compartments of AAGN which may serve as innovative targets for diagnosing and treating AAGN.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2499905"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12082741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079907","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":"Development and validation of a risk prediction model for autologous arteriovenous fistula thrombosis in patients receiving maintenance hemodialysis.","authors":"Jinping Ying, Genlian Cai, Yujiao Zhang, Minmin Zhu, Mengyan Pan, Ping Zhang","doi":"10.1080/0886022X.2025.2477832","DOIUrl":"10.1080/0886022X.2025.2477832","url":null,"abstract":"<p><strong>Background: </strong>Thrombosis can lead to fistula failure and affect the smooth progress of hemodialysis. This study aims to develop and validate a nomogram for predicting the risk of autologous arteriovenous fistula thrombosis in patients undergoing maintenance hemodialysis.</p><p><strong>Methods: </strong>A total of 1,016 patients who underwent hemodialysis at a tertiary A hospital in East China from February 2020 to March 2024 were retrospectively enrolled. The participants were randomly divided into a training set (711 people) and a validation set (305 people) at a ratio of 7:3. A risk prediction model was established according to the results of multivariate logistic regression analysis. The performance of the model was evaluated with the area under the receiver operating characteristic (ROC) curve (AUC), calibration curve analysis, the Hosmer-Lemeshow (H-L) test and decision curve analysis (DCA).</p><p><strong>Results: </strong>The incidence of autologous arteriovenous fistula thrombosis in patients on maintenance hemodialysis was 32%. High-sensitivity C-reactive protein (hs-CRP), catheterization history, hemodialysis duration, autologous arteriovenous fistula stenosis and non-high-density lipoprotein cholesterol (non-HDL-C) were independent risk factors for autologous arteriovenous fistula thrombosis. These five predictors were used to construct a predictive nomogram. The AUC was 0.818 in the training set and 0.826 in the validation set. The calibration curve of the nomogram was close to the standard curve, indicating that the model was well calibrated. The DCA results confirmed that the model provided good net clinical benefits.</p><p><strong>Conclusion: </strong>In this study, a predictive nomogram for arteriovenous fistula thrombosis was established and validated.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2477832"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12077441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995839","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":"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":"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":"IgG expressed by renal tubular epithelial cells in epithelial mesenchymal transformation and interstitial fibrosis in diabetic kidney disease.","authors":"Xinyao Wang, Zhenling Deng, Yue Wang","doi":"10.1080/0886022X.2025.2458764","DOIUrl":"10.1080/0886022X.2025.2458764","url":null,"abstract":"<p><p>Studies have reported that immunoglobulin G (IgG) \"deposited\" in the basement membrane of renal tubules is associated with tubulointerstitial damage in patients with diabetic kidney disease (DKD). Our previous study found that renal tubular epithelial cells (RTECs) can express and secrete IgG (RTEC-IgG) which may be associated with fibrosis. The present study aimed to explore the role of RTEC-IgG in renal tubulointerstitial fibrosis (TIF) in DKD. The results showed that RTEC-IgG expression was up-regulated in the renal tubulointerstitium of DKD patients and was associated with worse kidney function, more severe anemia, and higher interstitial fibrosis and tubular atrophy (IFTA) scores, and positively correlated with tubular epithelial mesenchymal transition (EMT) and TIF. IgG expression was also enhanced in the renal tubulointerstitium of DKD mice, which was positively correlated with TIF. High glucose induced an over expression of IgG in human renal tubular epithelial cells, and knockdown of IgG with siRNA relieved the expression of α-smooth muscle actin (SMA), collagen IV, fibronectin, and transforming growth factor (TGF)-β1 under high glucose conditions. In conclusion, our study suggests that RTEC-IgG is involved in the development of DKD by promoting EMT and interstitial fibrosis via TGF-β1.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2458764"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11795750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123493","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":"Curcumin alleviates renal fibrosis in chronic kidney disease by targeting the circ_0008925-related pathway.","authors":"Peng An, Xingyao Li, Yanhong Zhao, Liuyun Li, Yafeng Wang, Wenfang Wang, Tao Zhang, Sicen Wang, Xili Wu","doi":"10.1080/0886022X.2024.2444393","DOIUrl":"10.1080/0886022X.2024.2444393","url":null,"abstract":"<p><strong>Background: </strong>Curcumin has been shown to inhibit renal fibrosis, but whether curcumin mediates renal fibrosis progression by regulating the circular RNA (circRNA)-related pathway remain unclear.</p><p><strong>Methods: </strong>TGF-β1 was used to construct renal injury and fibrosis cell model. Cell growth was evaluated by cell counting kit 8 assay, EdU assay and flow cytometry. Fibrosis marker and interleukin 6 signal transducer (IL6ST) protein levels were measured using western bolt analysis. Inflammation factor concentrations were determined by ELISA. Circ_0008925, miR-204-5p and IL6ST expression was assessed by qRT-PCR. Unilateral ureteral obstruction (UUO) mice models were constructed to assess the role of curcumin <i>in vivo</i>.</p><p><strong>Results: </strong>Curcumin treatment alleviated TGF-β1-induced HK-2 cell apoptosis, inflammation and fibrosis <i>in vitro</i>, as well as relieved renal injury in UUO mice models <i>in vivo</i>. Circ_0008925 was highly expressed in TGF-β1-induced HK-2 cells and its expression was inhibited by curcumin. Circ_0008925 could sponge miR-204-5p to positively regulate IL6ST. The inhibition effect of curcumin on TGF-β1-induced HK-2 cell injury and fibrosis was reversed by circ_0008925 overexpression, miR-204-5p inhibitor or IL6ST upregulation. Besides, circ_0008925 knockdown inhibited TGF-β1-induced HK-2 cell injury and fibrosis by suppressing IL6ST expression.</p><p><strong>Conclusion: </strong>Curcumin relieved renal fibrosis through regulating circ_0008925/miR-204-5p/IL6ST axis.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2444393"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557907","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":"Construction of a C-reactive protein-albumin-lymphocyte index-based prediction model for all-cause mortality in patients on maintenance hemodialysis.","authors":"Junmin Huang, Junfeng Hao, Huasheng Luo, Lu Chen, Hongying Luo, Huafeng Liu, Yongzhi Xu, Peng Wang","doi":"10.1080/0886022X.2024.2444396","DOIUrl":"10.1080/0886022X.2024.2444396","url":null,"abstract":"<p><strong>Objective: </strong>The mortality rate of patients undergoing maintenance hemodialysis (MHD) remains high. The C-reactive protein-albumin-lymphocyte (CALLY) index is a novel biomarker that reflects inflammation, nutritional and immune status, all merged into one single derived parameter. No study has yet linked the CALLY index to survival in hemodialysis. This study aims to explore the correlation between the CALLY index and mortality in MHD patients, and develop and validate a nomogram to estimate the likelihood of death in this population.</p><p><strong>Methods: </strong>This retrospective cohort study collected data from 436 patients and they were divided into survival group (<i>n</i> = 335) and non-survival group (<i>n</i> = 101). Multivariate logistic regression analysis was used to screen factors associated with death, and nomograms were developed to estimate the risk of death in MHD patients. The discrimination and calibration of nomograms were validated using the area under the receiver operating characteristic (ROC) curve (AUC) and calibration curve. In the study, stratification analysis and covariate adjustment were conducted to explore the correlation between the CALLY index and the mortality of MHD patients.</p><p><strong>Results: </strong>In the final model, logistic regression showed that the CALLY index, creatinine, triglycerides, dialysis duration, absolute neutrophil count, blood urea nitrogen, sodium and ferritin were variables associated with mortality in MHD patients. A nomogram was developed to assess the risk of death in MHD patients. The AUC of the model was 0.821 (95% CI: 0.778-0.861). The results of stratified analysis and calibration model showed that the CALLY index was a protective factor for maintaining the mortality of MHD patients.</p><p><strong>Conclusions: </strong>The CALLY index is closely related to the mortality of MHD patients. A nomogram constructed based on CALLY index can effectively evaluate the mortality risk of MHD patients.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2444396"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11734386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984616","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":"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":"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":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11983531/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}