Renal Failure最新文献

{"title":"The association of plasma TMAO and body composition with the occurrence of PEW in maintenance hemodialysis patients.","authors":"Xinran Wang, Xinyue Peng, Jun Liu, Shiqi Tang, Xinyu Yang, Jianwen Wang","doi":"10.1080/0886022X.2025.2481202","DOIUrl":"10.1080/0886022X.2025.2481202","url":null,"abstract":"<p><strong>Introduction: </strong>This study aims to explore the relationship between trimethylamine N-oxide (TMAO), body composition, and protein-energy wasting (PEW) in patients undergoing maintenance hemodialysis (MHD).</p><p><strong>Methods: </strong>A total of 127 MHD patients participated in this study. Body composition was measured using the InBody770 multi-frequency body composition analyzer. Plasma TMAO concentrations were assessed by ELISA. Cross-sectional analysis was performed after collecting demographic data, dialysis-related data, laboratory parameters, and body composition data from MHD patients.</p><p><strong>Results: </strong>In MHD patients, the PEW group exhibited lower levels of hemoglobin (Hb), albumin (ALB), transferrin (TF), creatinine (Cr), triglycerides (TG), prealbumin (PALB), soft lean mass (SLM), body mass index (BMI), percent of body fat (PBF), arm muscle circumference (AMC), and phase angle (PHA) compared to the non-PEW group, while C-reactive protein (CRP) and trimethylamine-N-oxide (TMAO) levels, as well as Extracellular Water/Total Body Water (ECW/TBW) ratio, were higher in the PEW group than in the non-PEW group. After full adjustment, TMAO and ECW/TBW ratio were independent risk factors for PEW in MHD patients. Further, plasma TMAO levels correlated negatively with Cr, ALB, Hb, BMI, and PHA, and positively with ECW/TBW in MHD patients with PEW. The ROC curve analysis indicated that the area under the curve (AUC) for plasma TMAO in predicting PEW in MHD patients was 0.788.</p><p><strong>Conclusions: </strong>Plasma TMAO levels and certain body composition are associated with the occurrence of PEW in MHD patients. Plasma TMAO levels appear to serve as a potential predictive marker for the onset of PEW.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2481202"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11926894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143664419","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":"Integration of transcriptome and Mendelian randomization analyses in exploring the extracellular vesicle-related biomarkers of diabetic kidney disease.","authors":"Xu Yang, Rensong Yue, Liangbin Zhao, Qiyue Wang","doi":"10.1080/0886022X.2025.2458767","DOIUrl":"10.1080/0886022X.2025.2458767","url":null,"abstract":"<p><strong>Background: </strong>Diabetic Kidney Disease (DKD) is a common complication in patients with diabetes, and its pathogenesis remains incompletely understood. Recent studies have suggested that extracellular vesicles (EVs) may play a significant role in the initiation and progression of DKD. This study aimed to identify biomarkers associated with EVs in DKD through bioinformatics and Mendelian randomization (MR) analysis.</p><p><strong>Methods: </strong>This study utilized two DKD-related datasets, GSE96804 and GSE30528, alongside 121 exosome-related genes (ERGs) and 200 inflammation-related genes (IRGs). Differential analysis, co-expression network construction, and MR analysis were conducted to identify candidate genes. Machine learning techniques and expression validation were then employed to determine biomarkers. Finally, the potential mechanisms of action of these biomarkers were explored through Immunohistochemistry (IHC) staining, enrichment analysis, immune infiltration analysis, and regulatory network construction.</p><p><strong>Results: </strong>A total of 22 candidate genes were identified as causally linked to DKD. CMAS and RGS10 were identified as biomarkers, with both showing reduced expression in DKD. IHC confirmed low RGS10 expression, providing new insights into DKD management. CMAS was involved primarily in mitochondria-related pathways, while RGS10 was enriched in the extracellular matrix and associated pathways. Significant differences were observed in neutrophils and M2 macrophages between DKD and normal groups, correlating strongly with the biomarkers.</p><p><strong>Conclusion: </strong>This study identified two EV-associated biomarkers, CMAS and RGS10, linked to DKD and elucidated their potential roles in disease progression. These results offer valuable insights for further exploration of DKD pathogenesis and the development of new therapeutic targets.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2458767"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433642","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 and validation of a nomogram to predict 1-year mortality risk in patients with HIV/AIDS undergoing maintenance hemodialysis.","authors":"Zhurui Xian, Xiaofei Song, Yongfu Wang, Tingting Yang, Nan Mao","doi":"10.1080/0886022X.2025.2461665","DOIUrl":"10.1080/0886022X.2025.2461665","url":null,"abstract":"<p><p>This single-center retrospective study aimed to explore the 1-year mortality risk factors in 166 patients with human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) undergoing maintenance hemodialysis (MH) between 6 June 2017 and 6 June 2023, and construct a 1-year mortality prediction model. The patients were classified into survival and mortality groups based on the 1-year follow-up results, and into training and validation sets at a ratio of 1:1 (53 mortalities and 53 survivors in the training set and 48 mortalities and 58 survivors in the validation set). Stepwise logistic regression was used to construct a 1-year mortality prediction model and to visualize it as a nomogram. Receiver operating characteristic (ROC) analysis, calibration curves, and decision curves were used for nomogram evaluation in the training set and validation in the validation set. Age (≥52 years) (OR (95% CI): 2.05 (3.191-18.892), <i>p < .001</i>), neutrophil to albumin ratio (NAR) (≥0.135) (OR (95% CI): 4.753 (2.011-11.234), <i>p < .001</i>), and HIV-RNA (≥24,650) (OR (95% CI): 13.786 (5.493-34.598), <i>p < .001</i>), represents three of five independent risk factors of 1-year mortality in HIV/AIDS undergoing MH. The AUC of the nomogram for the training and validation sets were 0.908 (95% CI: 0.853-0.963) and 0.939 (95% CI: 0.896-0.983), respectively. The 1-year mortality prediction showed good separation capacity, calibration capacity, and clinical net benefit, which may benefit the management of patients with HIV/AIDS undergoing MH.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2461665"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11837922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441619","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":"Brain natriuretic peptide is a biomarker of atrial fibrillation in hemodialysis patients.","authors":"Ling Yu, Jia Huang, Yanchun Li, Han Li","doi":"10.1080/0886022X.2025.2463563","DOIUrl":"10.1080/0886022X.2025.2463563","url":null,"abstract":"<p><strong>Objectives: </strong>Atrial fibrillation (AF) is the most common persistent arrhythmia and has adverse outcomes in hemodialysis patients. It is obscure the relationship between BNP and AF in hemodialysis patients. This study investigated the interventionable predictors of AF in hemodialysis patients.</p><p><strong>Methods: </strong>In this retrospectively observational cohort study, a total of 205 hemodialysis patients were screened and 140 were enrolled. The anthropometrics, laboratory parameters, electrocardiogram and echocardiogram were collected. The patients were divided into three groups based on the tertiles of BNP value. Kaplan-Meier curves were used to compare the incidence of AF among different BNP groups. Restricted cubic spline curves and receiver operator characteristic curves were drawn, and Cox proportional hazards models were applied to identify the predictive value of BNP and the other related factors for incident AF.</p><p><strong>Results: </strong>During the 5-year follow-up period, 33 (23.6%) individuals developed incident AF. The incidence of AF increased significantly with an increase in the BNP. Cox proportional hazards models indicated that age, dialysis vintage, left atrial diameter, ultrafiltration rate, hs-CRP and BNP were independent risk factors for incident AF. The hazard ratios of BNP (per 100 pg/mL) were 1.038 (95% confidence interval, 1.012-1.064, <i>p</i> = 0.004). BNP had a predictive value for the occurrence of AF (area under the curve = 0.734).</p><p><strong>Conclusions: </strong>BNP was a good predictor of incident AF in hemodialysis patients. Higher BNP had an increasing adverse event rate of AF. Further research should be needed to clarify the best reference range of BNP in hemodialysis patients.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2463563"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11849019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468988","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":"Integrative analysis of mitochondrial and immune pathways in diabetic kidney disease: identification of AASS and CASP3 as key predictors and therapeutic targets.","authors":"Xinxin Yu, Yongzheng Hu, Wei Jiang","doi":"10.1080/0886022X.2025.2465811","DOIUrl":"10.1080/0886022X.2025.2465811","url":null,"abstract":"<p><strong>Objectives: </strong>Diabetic kidney disease (DKD) is driven by mitochondrial dysfunction and immune dysregulation, yet the mechanistic interplay remains poorly defined. This study aimed to identify key molecular networks linking mitochondrial and immune pathways to DKD progression, with a focus on uncovering biomarkers and therapeutic targets.</p><p><strong>Methods: </strong>We conducted an integrative analysis of human DKD cohorts (GSE30122, GSE96804) using weighted gene co-expression network analysis (WGCNA) to identify gene modules enriched for immune response genes and mitochondrial pathways (from MitoCarta3.0). Machine learning algorithms were employed to prioritize key biomarkers for further investigation. Experimental validation was performed using a DKD rat model.</p><p><strong>Results: </strong>WGCNA revealed significant gene modules associated with immune responses and mitochondrial functions. Machine learning analysis highlighted two central biomarkers: aminoadipate-semialdehyde synthase (AASS) and caspase-3 (CASP3). In the DKD rat model, elevated levels of AASS and CASP3 were found to correlate with increased oxidative stress. Mechanistically, AASS was shown to drive mitochondrial damage via lysine metabolism, while CASP3 amplified inflammatory apoptosis pathways.</p><p><strong>Conclusions: </strong>Our findings establish AASS and CASP3 as dual biomarkers and therapeutic targets, bridging mitochondrial-immune crosstalk to DKD pathogenesis. This multi-omics framework provides actionable insights for targeting kidney damage in diabetes.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2465811"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11852243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483896","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":"Safety and tolerability of molnupiravir and nirmatrelvir/ritonavir in patients with advanced chronic kidney disease and kidney failure; a cohort study.","authors":"Rani Sawtell, Tianqi Ouyang, Daiana Moreno, Ian Strohbehn, Sherley M Mejia, Meghan E Sise","doi":"10.1080/0886022X.2025.2466823","DOIUrl":"10.1080/0886022X.2025.2466823","url":null,"abstract":"<p><p>Patients with advanced chronic kidney disease (CKD) and kidney failure were excluded from clinical trials that led to approval of molnupiravir and nirmatrelvir/ritonavir for COVID-19. Between November 2022 and February 2024 there were 100 patients with advanced CKD (<i>N</i> = 81) or kidney failure (<i>N</i> = 19) who received either molnupiravir (<i>N</i> = 40) or nirmatrelvir/ritonavir (<i>N</i> = 60) for COVID-19 within a large healthcare network. Ten (10%) patients were hospitalized within 30 days; 5 hospitalizations were COVID-19 related and 5 were unrelated to COVID-19. Adverse events documented in the electronic health record were uncommon and all were mild to moderate (grade 1 or 2). Despite use of numerous concomitant medications known to interact with nirmaltrelvir/ritonavir, we found no adverse events attributed to a drug-drug interaction. All patients survived >30 days and 3 (3%) died prior to 90 days. Molnupiravir and nirmatrelvir/ritonavir were safe and well tolerated in patients with advanced CKD and kidney failure.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2466823"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11843654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459297","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":"Lactate metabolism and lactylation in kidney diseases: insights into mechanisms and therapeutic opportunities.","authors":"Yuhua Cheng, Linjuan Guo","doi":"10.1080/0886022X.2025.2469746","DOIUrl":"10.1080/0886022X.2025.2469746","url":null,"abstract":"<p><p>The kidney is essential for lactate metabolism. Under normal conditions, the renal cortex mainly absorbs and metabolizes lactate, with minimal amounts excreted in urine. This process is part of a glucose-lactate recycling system between the cortex and medulla. In conditions such as acute kidney injury (AKI) and diabetic kidney disease (DKD), the kidney's ability to metabolize lactate is impaired, leading to lactate accumulation and exacerbated renal dysfunction. Novel post-translational modifications, such as lactylation, are critical in kidney disease pathophysiology by modulating gene transcription, protein function, and cellular metabolism. Lactylation is involved in inflammatory responses and tumor promotion in AKI, mitochondrial dysfunction in DKD, and tumor progression in clear cell renal cell carcinoma (ccRCC). The lactate-lactylation axis is central to the Warburg effect in ccRCC, where tumor cells preferentially rely on glycolysis rather than oxidative phosphorylation. Understanding the mechanisms of lactate metabolism and lactylation in kidney diseases may offer new therapeutic strategies. This review examines the role of lactate esters, especially lactylation, in kidney diseases, with a focus on their regulatory mechanisms and potential as therapeutic targets.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2469746"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516530","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":"Global, regional, and national burden of cardiovascular disease attributable to kidney dysfunction (1990-2021) with projections to 2050: analysis of the 2021 Global Burden of Disease study.","authors":"Tian Zhang, Ting Li, Pengfei Jin","doi":"10.1080/0886022X.2025.2472039","DOIUrl":"10.1080/0886022X.2025.2472039","url":null,"abstract":"<p><strong>Aims: </strong>This study examines global trends in cardiovascular disease (CVD) associated with kidney dysfunction (KD) from 1990 to 2021 and projects future trends through 2050.</p><p><strong>Methods: </strong>This study analyzed the 2021 Global Burden of Disease (GBD) database, focusing on age-standardized mortality rate (ASMR), age-standardized disability-adjusted life years rate (ASDR), absolute numbers, estimated annual percentage change, and average annual percent change. A Bayesian age-period-cohort model was employed to project global trends from 2022 to 2050. Variables included age, gender, national levels, and Socio-demographic Index (SDI) regions.</p><p><strong>Results: </strong>From 1990 to 2021, the CVD burden from KD increased, with deaths rising from 1,312,393 to 2,095,800 and DALYs from 27,382,767 to 41,589,861. However, the ASMR decreased from 40.58 per 100,000 in 1990 to 25.55 in 2021, while ASDR fell from 742.17 to 489.81 during the same period. The burden was higher in men, peaking at ages 70-74 and in women at ages 85-89. Regions with lower-middle and low SDI recorded the highest CVD burden, inversely related to SDI levels. Geographically, Central Asia and Eastern Europe recorded the highest rates, while high-income Asia Pacific and Southern Latin America had the lowest. Projections suggest a sustained decline in global CVD burden due to KD from 2022 to 2050, although disparities between sexes are expected to persist, with men bearing a heavier burden.</p><p><strong>Conclusion: </strong>CVD attributable to KD remains a major global public health challenge, especially for men, the elderly, and low SDI regions. These spatial and temporal variations highlight the need for region-specific healthcare strategies.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2472039"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524283","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":"Factors associated with chronic calcineurin inhibitor nephrotoxicity in children with minimal-change disease.","authors":"Bei Jin, Ziji Lu, Cheng Cheng, Yuxin Pei, Lizhi Chen, Zhihui Yue, Aihua Lin, Shicong Yang, Ying Mo, Xiaoyun Jiang","doi":"10.1080/0886022X.2025.2474743","DOIUrl":"10.1080/0886022X.2025.2474743","url":null,"abstract":"<p><strong>Background: </strong>Calcineurin inhibitors (CNIs), such as cyclosporine (CsA) and tacrolimus (TAC), are commonly used to treat children with complicated minimal change nephrotic syndrome. However, chronic nephrotoxicity associated with CNIs poses a significant safety concern. This study aimed to identify the risk factors that contribute to chronic nephrotoxicity in these patients.</p><p><strong>Material and methods: </strong>Clinical and pathological data of MCD children treated with CsA or TAC in our center between 1 January 2003 and 31 December 2022, were retrospectively reviewed. Kidney biopsies were performed on 80 patients who received CNI treatment for more than 6 months.</p><p><strong>Results: </strong>Chronic CNI nephrotoxicity (striped interstitial fibrosis with tubular atrophy) was observed in 15% (12/80) of patients. Higher CNI culminating amounts were shown in patients who developed nephrotoxicity regardless of CsA or TAC treatment. Risk factors for chronic CNI nephrotoxicity included persistent nephrotic-range proteinuria for more than 30 days during CNI treatment, increased urinary NAG level, and CNI resistance. Multivariate analysis revealed that increased urinary NAG level and CNI resistance were the independent risk factors for chronic CNI nephrotoxicity in children with MCD.</p><p><strong>Conclusion: </strong>MCD children who developed CNI resistance were susceptible to chronic CNI nephrotoxicity. Urinary NAG might be a valuable biomarker for CNI nephrotoxicity prediction in MCD children.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2474743"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11915743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649668","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":"Genetic insights into blood urea nitrogen as a risk factor for coronary artery disease: a Mendelian randomization study in East Asians.","authors":"Lijuan Shen, Qianxin Zhang, Zhouyang Zhu, Zhouqing Huang","doi":"10.1080/0886022X.2025.2477318","DOIUrl":"10.1080/0886022X.2025.2477318","url":null,"abstract":"<p><strong>Background: </strong>Previous studies have reported the association between blood urea nitrogen (BUN) and cardiovascular diseases (CVDs) but the causality has not yet been proved. Our study aimed to assess the causal effect of BUN levels on several CVDs using the two-sample Mendelian randomization (MR) method. This is the first MR study examining causal relationships between BUN and multiple cardiovascular diseases.</p><p><strong>Methods: </strong>Using data from genome-wide association studies (GWAS) of East Asians, we identified single nucleotide polymorphisms (SNPs) associated with BUN levels as instrumental variables. Specifically, SNPs reaching genome-wide significance (<i>p</i> < 5 × 10^-8) were selected from a large-scale BUN dataset comprising (<i>n</i> = 148,767). To ensure robustness, multiple MR methods, including MR-Egger, weighted median, inverse variance weighting (IVW), simple mode, and weighted mode, were employed to evaluate the causal relationship between BUN levels and CVDs. Sensitivity analyses were conducted to assess the reliability and stability of the results.</p><p><strong>Result: </strong>The IVW approach showed that a higher level of BUN was associated with an increased risk of coronary artery disease (CAD) (OR = 1.42, 95% CI = 1.226 - 1.644, <i>p</i> = 2.89 × 10^-6). For atrial fibrillation (OR = 0.868, 95% CI = 0.678 - 1.110, <i>p</i> = 0.258), arrhythmia (OR = 0.907, 95% CI = 0.777 - 1.059, <i>p</i> = 0.216), and congestive heart failure (OR = 0.924, 95% CI = 0.781 - 1.092, <i>p</i> = 0.353), no significant associations were found. Sensitivity analyses indicated the results were robust.</p><p><strong>Conclusion: </strong>This MR work shows that elevated BUN levels are a potential biomarker for CAD risk but lack causal associations with other CVDs. These findings suggest avenues for risk stratification and CAD prevention strategies, emphasizing the clinical utility of BUN monitoring in at-risk populations.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2477318"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11915739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649933","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}