Renal Failure最新文献

{"title":"Association between weekend catch-up sleep and chronic kidney disease: insights from NHANES 2017-2020.","authors":"Sheng Chen, Ting Zhang, Hongjun Gao, Jianqiang Zhang","doi":"10.1080/0886022X.2025.2461682","DOIUrl":"10.1080/0886022X.2025.2461682","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to explore the association between weekend catch-up sleep (WCS) and chronic kidney disease (CKD) in American adults.</p><p><strong>Methods: </strong>Utilizing data from the National Health and Nutrition Examination Survey (NHANES) spanning 2017 to 2020, this study encompassed 4,934 individuals aged 20 years and above. We assessed the risk of CKD in relation to WCS. To evaluate CKD risk across various WCS durations, participants were categorized into four groups based on WCS length: < 1 h (reference group), ≥ 1 h and < 2 h, ≥ 2 h and < 3 h, and ≥ 3 h.</p><p><strong>Results: </strong>In the fully adjusted multivariate logistic regression model, the odds ratio (OR) of CKD to WCS response was 0.86 (95% CI = 0.61-1.22; <i>p</i> = 0.31). In addition, only CKD was significantly associated with WCS duration between 2-3 h (OR = 0.44, 95% CI = 0.21-0.88, <i>p</i> = 0.03). Subgroup analyses showed stronger negative associations (<i>p</i> < 0.05) for men and women with a WCS of 2-3 h, adults under 60 years of age with a WCS of 2-3 h, those with less than 1 h of catch-up sleep on weekends and a body mass index (BMI) of 25-29.9, those with a BMI of less than 25 or greater than or equal to 30 with a WCS of 2-3 h, and those with less than 7 h of sleep on weekdays and 2-3 h of catch-up sleep on weekends.</p><p><strong>Conclusion: </strong>Our findings suggest that when weekday sleep duration is < 7 h, WCS in 2-3 h is strongly associated with a lower prevalence of CKD.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2461682"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11803762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256416","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":"Copper-instigated modulatory cell mortality mechanisms and progress in kidney diseases.","authors":"Xiya Ren, Limei Zhao, Yajie Hao, Xiu Huang, Guangna Lv, Xiaoshuang Zhou","doi":"10.1080/0886022X.2024.2431142","DOIUrl":"10.1080/0886022X.2024.2431142","url":null,"abstract":"<p><p>Copper is a vital cofactor in various enzymes, plays a pivotal role in maintaining cell homeostasis. When copper metabolism is disordered and mitochondrial dysfunction is impaired, programmed cell death such as apoptosis, paraptosis, pyroptosis, ferroptosis, cuproptosis, autophagy and necroptosis can be induced. In this review, we focus on the metabolic mechanisms of copper. In addition, we discuss the mechanism by which copper induces various programmed cell deaths. Finally, this review examines copper's involvement in prevalent kidney diseases such as acute kidney injury and chronic kidney disease. The findings indicate that the use of copper chelators or plant extracts can mitigate kidney damage by reducing copper accumulation, offering novel insights into the pathogenesis and treatment strategies for kidney diseases.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2431142"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11734396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142979555","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":"Direct anastomosis indwelling needle puncture: a rapid and safe transitional hemodialysis access for patients with renal failure.","authors":"Chunyan Wu, Jianbo Qing, Xiaoping Wang, Yunmei Li, Xin Zhou, Junnan Wu","doi":"10.1080/0886022X.2024.2448255","DOIUrl":"10.1080/0886022X.2024.2448255","url":null,"abstract":"<p><strong>Objectives: </strong>Vascular access thrombosis (VAT) is a common complication in patients with end-stage renal disease (ESRD), significantly impacting hemodialysis efficacy and patient survival. Currently, temporary dialysis access is typically established <i>via</i> deep vein catheterization (VC), however, this method is highly invasive and associated with risks of infection and other complications. This study aims to explore the feasibility of using direct anastomosis indwelling needle puncture (DAINP) for temporary dialysis access.</p><p><strong>Methods: </strong>Between March 2023 and March 2024, patients VAT were recruited at Sir Run Run Shaw Hospital of Zhejiang University School of Medicine to undergo DAINP. Clinical data, including age, gender, dry and wet body weight, and blood biochemical parameters, were collected. Patient VA types, locations, and insertion vessels were documented. Detailed assessments and records of VAT were performed for all patients, including the distance of thrombus from the anastomosis, residual blood flow at the VA anastomosis, and corresponding selection of the DAINP insertion site. Ultrasound was utilized to measure and record the puncture depth. Concurrently, clinical data of patients undergoing venous catheterization (VC) for temporary dialysis access were collected. The operative time for both groups, defined as the interval from ultrasound assessment initiation to completion of the procedure, was recorded and compared.</p><p><strong>Results: </strong>A total of 74 patients successfully underwent DAINP, with a 100% puncture success rate. Among them, 20 patients had residual blood flow at the VA stump, and the distance between the anastomosis and arterial flow was ≥ 1 cm. Patients with VA located at the elbow demonstrated the greatest puncture depth. Moreover, the operative time for the DAINP group was significantly shorter compared to the 17 patients who underwent VC for VAT during the same period. However, patients with VA located in the groin required a longer operative time for DAINP.</p><p><strong>Conclusions: </strong>This study demonstrates that DAINP provides a rapid and safe method for establishing temporary hemodialysis access in VAT patients, effectively reducing the invasiveness and risks associated with traditional VC.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2448255"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11749010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010475","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":"Effects of high-sensitivity C-reactive protein and left ventricular hypertrophy on cognitive function in hemodialysis patients.","authors":"Yu Zhang, Yu-Lu Gu, Wan-Fen Zhang, Xiao-Ping Li, Lin-Fang Xu, Tong-Qiang Liu","doi":"10.1080/0886022X.2025.2450522","DOIUrl":"10.1080/0886022X.2025.2450522","url":null,"abstract":"<p><strong>Objectives: </strong>To examine the effects of high-sensitivity C-reactive protein (hs-CRP) and left ventricular hypertrophy (LVH) on the cognitive function of hemodialysis (HD) patients, and to explore the relationship between hs-CRP, LVH, and cognitive impairment (CI).</p><p><strong>Methods: </strong>A cross-sectional study was conducted on 232 HD patients. Besides, general clinical data were gathered, and patients' cognitive functions were assessed using the Beijing version of the Montreal Cognitive Assessment (MoCA-BJ). CI risk factors were screened using logistic regression modeling based on hs-CRP values (low risk <1 mg/L, intermediate risk 1-3 mg/L, and high risk >3 mg/L) and LVH status (normal and hypertrophic) groupings. The synergistic effect of hs-CRP and LVH on CI was also analyzed using the EpiR package.</p><p><strong>Results: </strong>Among HD patients, 122 (52.59%) patients had CI. Multifactorial logistic regression analysis showed that the following factors were associated with an increased risk of CI in HD patients: age (OR = 1.048; 95% CI 1.014-1.083; <i>p</i> = 0.005), LVH (OR = 3.741; 95% CI 1.828-7.657; <i>p</i> < 0.001), and high-risk hs-CRP levels (>3 mg/L; OR = 3.238; 95% CI 1.349-7.768; <i>p</i> = 0.009). In addition, there was a significant synergy between hs-CRP high risk (>3 mg/L) and LVH.</p><p><strong>Conclusion: </strong>Age, LVH, and high risk of hs-CRP (>3 mg/L) were independent risk factors for CI in HD patients. Moreover, HD patients with both hs-CRP high risk (>3.0 mg/L) and LVH were at higher risk of developing CI, and lowering hs-CRP levels and preventing LVH may prevent CI.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2450522"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11749012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010480","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":"Proteomics reveals the key transcription-related factors mediating obstructive nephropathy in pediatric patients and mice.","authors":"Hualin Cao, Yuandong Tao, Ruyue Jin, Pin Li, Huixia Zhou, Jiwen Cheng","doi":"10.1080/0886022X.2024.2443032","DOIUrl":"https://doi.org/10.1080/0886022X.2024.2443032","url":null,"abstract":"<p><strong>Background: </strong>Obstructive nephropathy is one of the leading causes of kidney injury in infants and children. Increasing evidence has shown that transcription-related factors (TRFs), including transcription factors and cofactors, are associated with kidney diseases. However, a global landscape of dysregulated TRFs in pediatric patients with obstructive nephropathy is lacking.</p><p><strong>Methods: </strong>We mined the data from our previous proteomic study for the TRF profile in pediatric patients with obstructive nephropathy and unilateral ureteral obstruction (UUO) mice. Gene ontology (GO) analysis was performed to determine pathways that were enriched in the dysregulated TRFs. We then took advantage of kidney samples from patients and UUO mice to verify the selected TRFs by immunoblots.</p><p><strong>Results: </strong>The proteomes identified a total of 140 human TRFs with 28 upregulated and 1 downregulated, and 160 murine TRFs with 88 upregulated and 1 downregulated (fold change >2 or <0.5). These dysregulated TRFs were enriched in the inflammatory signalings, such as janus kinase/signal transducer and activator of transcription (JAK-STAT) and tumor necrosis factor (TNF) pathways. Of note, the transforming growth factor (TGF)-β signaling pathway, which is the master regulator of organ fibrosis, was enriched in both patients and mice. Cross-species analysis showed 16 key TRFs that might mediate obstructive nephropathy in patients and UUO mice. Moreover, we verified a significant dysregulation of three previously unexplored TRFs; prohibitin (PHB), regulatory factor X 1 (RFX1), and activity-dependent neuroprotector homeobox protein (ADNP), in patients and mice.</p><p><strong>Conclusions: </strong>Our study uncovered key TRFs in the obstructed kidneys and provided additional molecular insights into obstructive nephropathy.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2443032"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915349","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":"Piezo1 aggravates ischemia/reperfusion-induced acute kidney injury by Ca²⁺-dependent calpain/HIF-1α/Notch signaling.","authors":"Xiaoting Chen, Jintao Jiang, Bin He, Shangfei Luo, Qiaorui Tan, Youfen Yao, Rentao Wan, Honglin Xu, Silin Liu, Xianmei Pan, Xin Chen, Jing Li","doi":"10.1080/0886022X.2024.2447801","DOIUrl":"10.1080/0886022X.2024.2447801","url":null,"abstract":"<p><p>Macrophages play a vital role in the inflammation and repair processes of ischemia/reperfusion-induced acute kidney injury (IR-AKI). The mechanosensitive ion channel Piezo1 is significant in these inflammatory processes. However, the exact role of macrophage <i>Piezo1</i> in IR-AKI is unknown. The main purpose of this study was to determine the role of macrophage <i>Piezo1</i> in the injury and repair process in IR-AKI. Genetically modified mice with targeted knockout of <i>Piezo1</i> in myeloid cells were established, and acute kidney injury was induced by bilateral renal vascular clamping surgery. Additionally, hypoxia treatment was performed on bone marrow-derived macrophages <i>in vitro</i>. Our data indicate that Piezo1 is upregulated in renal macrophages in mice with IR-AKI. Myeloid <i>Piezo1</i> knockout provided protective effects in mice with IR-AKI. Mechanistically, the regulatory effects of Piezo1 on macrophages are at least partially linked to calpain signaling. Piezo1 activates Ca²⁺-dependent calpain signaling, which critically upregulates HIF-1α signaling. This key pathway subsequently influences the Notch and CCL2/CCR2 pathways, driving the polarization of M1 macrophages. In conclusion, our findings elucidate the biological functions of Piezo1 in renal macrophages, underscoring its role as a crucial mediator of acute kidney injury. Consequently, the genetic or pharmacological inhibition of Piezo1 presents a promising strategy for treating IR-AKI.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2447801"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11721879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142953537","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 estimated glomerular filtration rate, urinary albuminuria-creatinine ratio, and stroke prevalence in patients with chronic kidney disease.","authors":"Jianfeng Xiang, Mengli Tong, Dongrong Yu, Yinfeng Chen","doi":"10.1080/0886022X.2025.2452219","DOIUrl":"10.1080/0886022X.2025.2452219","url":null,"abstract":"<p><strong>Background: </strong>With the global increase in chronic diseases, chronic kidney disease (CKD) and stroke have become major public health concerns. This study aims to investigate the relationship between estimated glomerular filtration rate (eGFR), urine albumin-to-creatinine ratio (UACR), and the incidence of stroke in a CKD population.</p><p><strong>Methods: </strong>This cross-sectional study analyzed the relationship between eGFR, UACR, and prevalence of self-reported stroke in 6,037 participants using data from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2018. Multivariate logistic regression analysis was used to evaluate the association of eGFR, UACR with the incidence of stroke, and smoothing curve fitting was applied to explore the linear relationship between eGFR and stroke. To further explore the effect of eGFR on stroke risk, we performed subgroup analyses of demographic factors.</p><p><strong>Results: </strong>After adjusting for confounding factors, eGFR was found to be significantly negatively associated with stroke risk. Compared with participants with an eGFR ≥ 90 mL/min/1.73 m², the risk of stroke was increased in those with an eGFR of 60-90 (OR = 1.78; 95% CI = 1.18-2.69), 30-60 (OR = 2.26; 95% CI = 1.49-3.44), and <30 mL/min/1.73 m² (OR = 3.14; 95% CI = 1.74-5.65). In the unadjusted model, patients with UACR of 30-300 mg/g had a slightly lower risk of stroke than those with UACR < 30 mg/g (OR = 0.70, 95% CI = 0.57-0.86); however, this association was not seen after adjusting for potential confounders.</p><p><strong>Conclusions: </strong>This study identified a negative linear correlation between eGFR and stroke in CKD patients.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2452219"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11774156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053164","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":"Mediated roles of oxidative stress and kidney function to leukocyte telomere length and prognosis in chronic kidney disease.","authors":"Jiahong Yi, Chang Jiang, Liangping Xia","doi":"10.1080/0886022X.2025.2464828","DOIUrl":"10.1080/0886022X.2025.2464828","url":null,"abstract":"<p><strong>Background: </strong>Few studies have focused on the correlation between leukocyte telomere length (LTL) and cancer-related mortality or identified potential factors that mediate the relationship between LTL and mortality among chronic kidney disease (CKD) patients. Our study aimed to explore the associations between LTL and all-cause and cause-specific mortality and to identify the underlying mediators.</p><p><strong>Methods: </strong>CKD patients were obtained from the National Health and Nutrition Examination Survey (NHANES) 1999-2002. Cox regression analysis and restricted cubic spline analysis were used to explore the associations between LTL and all-cause or specific-cause mortality and their nonlinear connections. Stratified analyses were executed to assess the relationships among the different subgroups. The latent mediated factors were confirmed using mediation analysis. Sensitivity analyses were used to evaluate the robustness of our findings.</p><p><strong>Results: </strong>Longer LTL associated with the lower risk of all-cause mortality, cardiovascular disease (CVD) and cancer-related mortality, and U-shaped relationships were detected. Patients younger than 65 years with greater LTL or who had hypertension had better prognoses. Age and history of hypertension were associated with LTL and overall mortality. In addition, estimated glomerular filtration rate (eGFR), albumin, and total bilirubin mediated the association, and the proportions of indirect effects were 7.81%, 3.77%, and 2.50%, respectively. Six sensitivity analyses confirmed the robustness of our findings.</p><p><strong>Conclusions: </strong>This study revealed that LTL was a protective factor for survival among patients with CKD and emphasized the mediating roles of oxidative stress and kidney function.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2464828"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11866651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516533","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":"Effectiveness of abdominal bracing core exercises as rehabilitation therapy for reducing abdominal symptoms in patients with autosomal dominant polycystic kidney disease and significant polycystic liver disease.","authors":"Jaeyeong Yoo, Jin Eop Kim, Jisu Kim, Sohyun Jeon, Young-Jin Song, Kwang-Ho Choi, Gwangeon Sim, Myunkyu Cho, Jong-Woo Yoon, Hyunsuk Kim","doi":"10.1080/0886022X.2025.2457519","DOIUrl":"10.1080/0886022X.2025.2457519","url":null,"abstract":"<p><p>In patients with autosomal dominant polycystic kidney disease (ADPKD) who also have polycystic liver disease (PLD), organomegaly often leads to abdominal symptoms. Abdominal bracing core (ABC) exercises have been validated as effective for alleviating chronic back pain. The purpose of this study was to assess the effectiveness of ABC rehabilitation exercises in reducing pain in ADPKD patients with significant PLD. Significant PLD was defined as a height-adjusted total liver volume (htTLV) exceeding 1,600 mL/m. Both the control groups (<i>n</i> = 11) and intervention (<i>n</i> = 12) and received an outpatient consultation on nutrition and exercise; however, only the intervention group participated in ABC exercises. After a 3-month biweekly intervention, changes in pain assessed by the Korean Oswestry Disability Index, abdominal symptoms, quality of life (QoL) by the second version of the short-form 36-item Health Survey, and bioelectrical impedance analysis (BIA) were analyzed. The participants comprised 23 individuals (male: 4, female: 19). Their mean age was 54, and the mean ± SD of htTLV was 2,706 ± 1,335 mL/m. The mean ± SD of eGFR was 53.9 ± 29.0 mL/min/1.73 m². After the intervention, pain and pressure-related symptoms significantly decreased in some cases; however, gastrointestinal symptoms did not improve. Pain (control vs. intervention: -1.9 vs. 1.0) and QoL (1.20 vs. 0.93) and showed significant improvements. The results of BIA indicated a noticeable change in the soft lean mass of the proximal body (0.4 vs. -0.2). Our study demonstrates that ABC exercise is effective in alleviating pain and increasing soft lean mass in ADPKD patients who have significant PLD.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2457519"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606204","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 blood urea nitrogen-to-creatinine ratio is associated with acute kidney injury among COVID-19 patients.","authors":"Xiaoli Zhong, Xuejie Wang, Xiaobei Feng, Haijin Yu, Zijin Chen, Xiaonong Chen","doi":"10.1080/0886022X.2024.2442049","DOIUrl":"10.1080/0886022X.2024.2442049","url":null,"abstract":"<p><strong>Introduction: </strong>To explore the associations between the blood urea nitrogen-to-creatinine ratio (BCR), acute kidney injury (AKI), and in-hospital mortality in coronavirus disease 2019 (COVID-19) patients.</p><p><strong>Methods: </strong>COVID-19 patients from Ruijin Hospital LuWan Branch, Shanghai Jiao Tong University School of Medicine were enrolled in this study. Clinical data and laboratory parameters were collected. AKI was defined using two serum creatinine tests according to KDIGO guidelines. Cox regression and receiver operating characteristic (ROC) curve analyses were performed.</p><p><strong>Results: </strong>Five hundred and sixty-seven COVID-19 patients were enrolled, 44.1% of whom were male. The mean age was 75 years. Among all patients, 17 patients developed AKI, and 30 patients died during hospitalization. Compared to non-AKI patients, the BCR in AKI patients was significantly greater. BCR was significantly associated with AKI (unadjusted HR 1.04, 95% CI: 1.02-1.05, <i>p</i> < 0.001; adjusted HR 1.06, 95% CI 1.02-1.10, <i>p</i> = 0.001). BCR was also a risk factor of in-hospital mortality (unadjusted HR 1.03, 95% CI: 1.02-1.05, <i>p</i> < 0.001; adjusted HR 1.04, 95% CI: 1.01-1.08, <i>p</i> = 0.019). The BCR threshold was 38.9, with 70.6% sensitivity and 87.1% specificity for predicting AKI, while a threshold of 33.0 predicted mortality. Subgroup analysis revealed that BCR could predict AKI and mortality in different subgroups according to sex, age, diabetes mellitus, and estimated glomerular filtration rate.</p><p><strong>Conclusions: </strong>The BCR, a simple index, is associated with AKI onset and mortality in COVID-19 patients. The BCR possesses certain specificity for AKI screening, which indicates an effective clinical indicator for screening patients at high risk of AKI.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2442049"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543226","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}