Renal Failure最新文献

{"title":"Causal relationships between gut microbiota and IgA nephropathy: evidence from Mendelian randomization and microbiome validation.","authors":"Xin Wang, Jiong Liu, Wuda Huoshen, Jing Liu, Xue Qiao, Hong Zhang, Xu-Jie Zhou","doi":"10.1080/0886022X.2025.2522979","DOIUrl":"https://doi.org/10.1080/0886022X.2025.2522979","url":null,"abstract":"<p><strong>Background: </strong>Emerging evidence links gut microbiota strongly with IgA Nephropathy (IgAN). However, the causal role of specific gut microbiota in IgAN remains unclear. This study used a two-sample Mendelian randomization (MR) approach, validated with 16S rRNA datasets, to identify these causal relationships.</p><p><strong>Methods: </strong>We performed MR analysis using genetic instruments for 412 gut microbiota taxa from genome-wide association studies (GWAS) as exposures and IgAN GWAS data as outcomes. The inverse-variance weighted method was used as the primary analysis, supplemented by MR-Egger regression, weighted median methods, and Cochran's Q test to assess pleiotropy and heterogeneity. Significant findings were validated using reverse, multivariable, and mediation MR analyses. Results were validated using genus-level 16S rRNA datasets with batch correction (ConQuR), and microbial function was inferred <i>via</i> PICRUSt2.</p><p><strong>Results: </strong>Three gut microbiota species were protective against IgAN: <i>s_Alistipes_senegalensis</i> (OR = 0.64, <i>p</i> = .002), <i>s_Ruminococcus_bromii</i> (OR = 0.75, <i>p</i> = .040), and <i>s_Bilophila_unclassified</i> (OR = 0.68, <i>p</i> = .040). Six species were associated with increased IgAN risk, including <i>g_Barnesiella</i> (OR = 1.32, <i>p</i> = .030) and <i>s_Rothia_mucilaginosa</i> (OR = 1.52, <i>p</i> = .040). After multiple-testing correction, significant associations persisted for <i>s_Alistipes_senegalensis</i> (<i>p</i> = .043), <i>s_Bacteroides_clarus</i> (<i>p</i> = .035), and <i>s_Bilophila_unclassified</i> (<i>p</i> = .002). Sensitivity analyses confirmed robust results without pleiotropy or heterogeneity. Genus-level validation confirmed consistent microbial shifts. Functional predictions showed upregulation of carbohydrate/fatty acid metabolism and downregulation of the urea cycle.</p><p><strong>Conclusions: </strong>This study reveals specific gut microbes and metabolic pathways potentially driving IgAN, offering novel biomarkers and therapeutic targets for microbiome-based interventions.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2522979"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497945","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":"Seasonal variations in acute kidney injury incidence and outcomes: a multicenter prospective observational study highlighting socioeconomic disparities.","authors":"Ali AlSahow, Omar Alkandari, Naser AlSabti, Bassam AlHelal, Anas AlYousef, Heba AlRajab, Ahmed AlQallaf, Yousif Bahbahani, Monther AlSharekh, Abdulrahman AlKandari, Gamal Nessim, Bassem Mashal, Ahmad Mazroue, Alaa Abdelmoteleb, Mohamed Saad, Ali Abdelzaher, Emad Abdallah, Mohamed Abdellatif, Ziad ElHusseini, Ahmed Abdelrady","doi":"10.1080/0886022X.2025.2520421","DOIUrl":"10.1080/0886022X.2025.2520421","url":null,"abstract":"<p><strong>Background: </strong>Kuwait experiences cool winters and hot summers. We evaluated the impact of ambient temperature in these two seasons on acute kidney injury (AKI) incidence and outcomes, and assessed difference between Kuwaitis and non-Kuwaitis.</p><p><strong>Method: </strong>Clinical and 30-day outcome data from AKI patients who were admitted to seven public hospitals during winter and summer of 2021 were prospectively collected.</p><p><strong>Results: </strong>Total number of AKI cases during both seasons was 1,493. Incidence was same in both seasons (50.0% each). Kuwaitis accounted for 56.7% of cases. Most AKI cases for Kuwaitis occurred in winter (52.4%), while most for non-Kuwaitis occurred in summer (53.2%). AKI patients in winter were significantly older (64.8 vs. 62.0 years, <i>p</i> = 0.001), had lower baseline eGFR (57.7 vs. 69.4 mL/min/1.73 m², <i>p</i> < 0.001), and had more cardiovascular (60.1% vs. 50.6%, <i>p</i> < 0.001), and chronic kidney diseases (59.3% vs. 43.6%, <i>p</i> < 0.001). Fluid utilization was higher in summer (83.1% vs. 75.3%, <i>p</i> < 0.001). No difference in mechanical ventilation and dialysis reported. Dialysis utilized slightly more frequently in summer (24.8% vs. 27.3%, <i>p</i> = 0.6), with significantly higher dialysis utilization for non-Kuwaitis in summer (30.6% vs. 23.0% for Kuwaitis, <i>p</i> < 0.001). Mortality rate was 26.1%, and complete kidney recovery occurred in 56.1% of cases with no difference between groups.</p><p><strong>Conclusion: </strong>No seasonal variations in AKI incidence, dialysis need, or mortality rate. In winter, AKI occurred more in older with more comorbidities among Kuwaitis but better socioeconomically, while in summer, AKI occurred more in younger, healthier non-Kuwaitis but socioeconomically disadvantaged.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2520421"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497951","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":"Chronic kidney disease management in patients with a failing graft: a comparative study with incident non-transplant hemodialysis patients.","authors":"Ana Rita Silva, Maria Guedes Marques, Luís Rodrigues, Lídia Santos, Catarina Romãozinho, Francisco Caramelo, Helena Sá, Arnaldo Figueiredo, Rui Alves, Rita Leal","doi":"10.1080/0886022X.2024.2447791","DOIUrl":"10.1080/0886022X.2024.2447791","url":null,"abstract":"","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2447791"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11731143/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972057","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}

{"title":"Association between weight change across adulthood and risk of chronic kidney disease: NHANES 1999-2020.","authors":"Xunliang Li, Mengqian Liu, Qihui Ye, Jiaxin Zhu, Wenman Zhao, Haifeng Pan, Deguang Wang","doi":"10.1080/0886022X.2024.2448261","DOIUrl":"10.1080/0886022X.2024.2448261","url":null,"abstract":"<p><strong>Background: </strong>Obesity is a recognized risk factor for chronic kidney disease (CKD), but whether weight change is associated with CKD remains unclear. This research aimed to investigate the relationship between weight change patterns across adulthood and the risk of CKD.</p><p><strong>Methods: </strong>Data for 34,187 adults participating in the National Health and Nutrition Examination Survey 1999-2020 were analyzed. The weight change patterns of participants were assessed across different time intervals, including transitions from obesity to non-obesity, non-obesity to obesity, and remaining stable obesity. Absolute weight changes were also analyzed, categorizing participants into various weight gain and loss groups. Furthermore, stratified analyses were conducted to explore potential interactions between age, sex, and smoking status about CKD risk.</p><p><strong>Results: </strong>The study found that individuals transitioning from obesity to non-obesity, non-obesity to obesity, and remaining stable obesity had an elevated risk of developing CKD throughout adulthood compared to those maintaining stable non-obesity weight patterns. Moreover, a J-shaped or U-shaped relationship was observed between CKD risk and absolute weight changes, with both extreme weight gain (≥20 kg) and substantial weight loss (>2.5 kg) associated with increased CKD risk. Stratified analyses revealed that age and sex played significant roles in these associations, with stronger effects observed among participants under 60 years at baseline.</p><p><strong>Conclusions: </strong>This study underscores the link between weight change across adulthood and the risk of CKD. Maintaining a stable weight and avoiding extreme weight fluctuations may reduce CKD risk. These insights can be considered when developing CKD prevention and management strategies.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2448261"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11792130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080785","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":"Dietary habits and risk of diabetic kidney disease: a two-sample and multivariate Mendelian randomization study.","authors":"Ziqi Zhang, Jieyu Niu, Wenhao Sun, Yuqing Sun, Ying Tan, Jiangyi Yu","doi":"10.1080/0886022X.2024.2438848","DOIUrl":"10.1080/0886022X.2024.2438848","url":null,"abstract":"<p><strong>Objective: </strong>We explored the causal relationship between certain dietary habits and the risk of developing diabetic kidney disease (DKD) using two-sample Mendelian randomization and multivariate Mendelian randomization.</p><p><strong>Research design and methods: </strong>This study is based on pooled data from a genome-wide association study (GWAS) of 83 dietary habits in a European population. We performed a two-sample Mendelian randomization analysis using GAWS data on diabetic nephropathy in a European population. Validation was then performed against positive results (<i>p</i> < 0.05) in different GAWS data on diabetic nephropathy of European origin. Finally, multivariate Mendelian randomization analyses were performed on dietary habits with positive results (<i>p</i> < 0.05) in both datasets and GWAS data on postprandial glucose in the European population.</p><p><strong>Results: </strong>This study showed causal relationships between 18 dietary habits and the risk of developing DKD. After validation, causal relationships were found between the risk of DKD and two dietary habits: abstaining from sugar consumption (OR 2.86; 95%CI 1.35, 6.08; <i>p</i> = 0.006) and consuming whole grain/multigrain bread (OR 0.53; 95%CI 0.32, 0.89; <i>p</i> = 0.016). Correcting for the effect of postprandial glucose, the multivariate MR results showed that never eating sugar increased the risk of developing DKD (OR 0.08; 95%CI 0.018, 0.36; <i>p</i> = 0.001), whereas eating whole grain/multigrain bread did not reduce the risk of developing DKD (OR 1.37; 95%CI 0.55, 3.41; <i>p</i> = 0.50).</p><p><strong>Conclusions: </strong>Our MR results suggest a causal relationship between never eating sugar and an increased risk of developing DKD. Therefore, people with diabetes need a reasonable range of sugar intake.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2438848"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11912233/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heart failure subphenotypes based on mean arterial pressure trajectory identify patients at increased risk of acute kidney injury.","authors":"Xiya Wang, Wenqing Ji, Shuxing Wei, Zhong Dai, Xinzhen Gao, Xue Mei, Shubin Guo","doi":"10.1080/0886022X.2025.2452205","DOIUrl":"10.1080/0886022X.2025.2452205","url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury (AKI) is a common complication in heart failure (HF) patients. Patients with heart failure who experience renal injury tend to have a poor prognosis. The objective of this study is to examine the correlation between the occurrence of AKI in heart failure patients and different mean arterial pressure (MAP) trajectories, with the goal of improving early identification and intervention for AKI.</p><p><strong>Methods: </strong>A retrospective study was conducted on patients with heart failure using data from the Medical Information Mart for Intensive Care IV (MIMIC-IV). We utilized the group-based trajectory modeling (GBTM) method to classify the 24-hour MAP change trajectories in heart failure patients. The occurrence of AKI within the first 7 days of intensive care unit (ICU) admission was considered the outcome. The impact of MAP trajectories on AKI occurrence in heart failure patients was analyzed using Cox proportional hazards models, competing risk models, and doubly robust estimation methods.</p><p><strong>Results: </strong>A cohort of 8,502 HF patients was analyzed, with their 24-hour MAP trajectories categorized into five groups: Low MAP group (Class 1), Medium MAP group (Class 2), Low-medium MAP group (Class 3), High-to-low MAP group (Class 4), and High MAP group (Class 5). The results from the doubly robust analysis revealed that Class 4 exhibited a significantly increased AKI risk than Class 3 (HR 1.284, 95% CI 1.085-1.521, <i>p</i> = 0.003; HR 1.271, 95% CI 1.074-1.505, <i>p</i> = 0.005). Conversely, the risks of Class 2 were significantly lower than those of Class 3 (HR 0.846, 95% CI 0.745-0.960, <i>p</i> = 0.009; HR 0.879, 95% CI 0.774-0.998, <i>p</i> = 0.047).</p><p><strong>Conclusions: </strong>The 24-hour MAP trajectory in HF patients influences the risk of AKI. A rapid decrease in MAP (Class 4) is associated with a higher AKI risk, while maintaining MAP at a moderate level (Class 2) significantly reduces this risk. Therefore, closely monitoring MAP changes is crucial for preventing AKI in HF.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2452205"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11749146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010485","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 difference in estimated GFR based on cystatin C versus creatinine in coronary artery diseases.","authors":"Zechen Liu, Wangying Jiang, Yanjun Song, Kefei Dou, Weihua Song","doi":"10.1080/0886022X.2025.2482127","DOIUrl":"https://doi.org/10.1080/0886022X.2025.2482127","url":null,"abstract":"<p><strong>Background: </strong>The difference in estimated glomerular filtration rate (eGFR) derived from creatinine and cystatin C (eGFR_diff) has been noticed recently and the relationship with poor cardiovascular prognosis has been proven. However, primary prevention of the risk of coronary artery disease (CAD) is equally important but there is a lack of studies specifically investigating this implication.</p><p><strong>Methods: </strong>This prospective cohort study utilized data from the UK Biobank, including 437,536 participants without CAD at baseline. The primary outcome was defined as CAD. The eGFR_diff was calculated by subtracting creatinine-based eGFR from cystatin C-based eGFR. Participants were then categorized into a negative, intermediate range, and positive group based on thresholds of -15 mL/min/1.73 m² and 15 mL/min/1.73 m². Cox proportional risk models were used to evaluate the associations of eGFR_diff with CAD and the relationship among different genetic risks of CAD.</p><p><strong>Results: </strong>During a median follow-up of 13.8 years, CAD occurred in 36,797 participants. In the fully adjusted model, compared to midrange eGFR_diff, participants with a positive eGFR_diff had a lower risk of CAD (HR 0.717, 95%CI 0.675-0.762), while with a negative eGFR_diff had a higher risk (HR 1.433, 95%CI 1.399-1.468). When eGFR_diff was treated as a continuous variable, a statistically significant trend toward a lower risk of CAD as eGFR_diff increased (HR 0.982, 95% CI 0.981-0.982). Moreover, this relationship is independent of genetic susceptibility.</p><p><strong>Conclusions: </strong>eGFR_diff was associated with CAD risk, where a high eGFR_diff corresponded to a decreased likelihood of CAD onset no matter genetic susceptibility.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2482127"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12042239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042441","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}