Renal Failure最新文献

{"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}

{"title":"The value of triglyceride glucose-body mass index, fasting blood glucose to HDL-C ratio, and platelet to HDL-C ratio in predicting abdominal aortic calcification in maintenance hemodialysis patients.","authors":"Shanshan Chen, Qianqian Cao, Shuangshan Bu, Lingyuan Xu, Zijun Zhou, Yuemeng Wu, Huanhuan Zheng","doi":"10.1080/0886022X.2025.2505699","DOIUrl":"https://doi.org/10.1080/0886022X.2025.2505699","url":null,"abstract":"<p><strong>Background: </strong>The triglyceride glucose-body mass index (TyG-BMI), fasting blood glucose (FBG) to high-density lipoprotein cholesterol (HDL-C) ratio (GHR), and platelet (PLT) to HDL-C ratio (PHR) are well-established markers of insulin resistance (IR), closely linked to cardiovascular and cerebrovascular diseases. Abdominal aortic calcification (AAC), a key indicator of subclinical atherosclerotic, is highly prevalent in maintenance hemodialysis (MHD) patients. This study aimed to explore the cross-sectional relationship between these IR indices and AAC in MHD patients and identify the most reliable predictive marker.</p><p><strong>Methods: </strong>We recruited 391 MHD patients from two hemodialysis medical centers, with 297 meeting the inclusion criteria. AAC was detected via X-ray scanning of the lumbar spine, quantified by the Kauppila scoring system. Receiver operating characteristic (ROC) curve analysis determined optimal cutoff values for dividing the subjects into high-index and low-index groups. Multivariable logistic regression models evaluated the association between AAC and these IR indices.</p><p><strong>Results: </strong>The prevalence of AAC in the whole group was 72.4%. The occurrence of AAC in the high-index group was significantly higher than that in the low-index group. Among the three IR indices, PHR demonstrated the highest predictive stability when integrated into a combined model. Subgroup analyses confirmed the robustness of this association across different age groups, sex, hypertension levels, comorbidities (CVD and stroke history), and smoking status.</p><p><strong>Conclusion: </strong>TyG-BMI, GHR and PHR were independently associated with the presence of AAC among MHD patients. Notably, PHR showed the strongest correlation with AAC, suggesting its potential clinical utility in risk stratification.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2505699"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151310","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":"Investigation of the connection between triglyceride-glucose (TyG) index and the risk of acute kidney injury in septic patients - a retrospective analysis utilizing the MIMIC-IV database.","authors":"Pirun Zhang, Wenli Zhang, Yan Han, Tong Yang, Jiayi Zhong, Han Yun, Lai Fang","doi":"10.1080/0886022X.2024.2449199","DOIUrl":"10.1080/0886022X.2024.2449199","url":null,"abstract":"<p><p>The TyG index serves as a valuable tool for evaluating insulin resistance. An elevated TyG has shown a strong association with the occurrence of acute kidney injury (AKI). Nevertheless, existing literature does not address the relationship between the TyG index and acute kidney injury in patients with sepsis. Sepsis patients were identified from the MIMIC-IV database and categorized into four groups according to quadrilles of their TyG index values. The primary outcome of this study was the incidence of AKI. The relationship between the TyG index and the risk of AKI in septic patients was evaluated using Cox proportional hazards and restricted cubic spline models. Subgroup analyses were conducted to investigate the prognostic value of the TyG index in different subgroups. A total of 2,616 patients with sepsis (57% of whom were male) were included in this study. The incidence of AKI was found to be 78%. Cox proportional hazards analysis revealed a significant correlation between the TyG index and the occurrence of AKI in septic patients. Furthermore, a restricted cubic spline model revealed an approximately linear relationship between a higher TyG index and an elevated risk of AKI in septic patients. The trend of the hazard ratio (HR) remained consistent across various subgroups. These findings emphasize the reliability of the TyG index as an independent predictor for the occurrence of AKI and unfavorable renal outcomes in sepsis patients. Nevertheless, establishing a causal relationship between the two requires demonstration through larger prospective studies.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2449199"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11721622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142962430","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":"Mean arterial pressure at the initiation of continuous renal replacement therapy as a prognostic indicator in patients with acute kidney injury.","authors":"Haiying Song, Yuheng Liao, Haofei Hu, Qijun Wan","doi":"10.1080/0886022X.2024.2448582","DOIUrl":"10.1080/0886022X.2024.2448582","url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury (AKI) is a common complication in critically ill patients, with approximately 5% requiring continuous renal replacement therapy (CRRT). This study investigated the relationship between mean arterial pressure (MAP) and 28- and 90-day mortality in critically ill AKI patients treated with CRRT.</p><p><strong>Methods: </strong>This secondary analysis of a bicenter, retrospective, observational study included patients with AKI who were treated with CRRT from January 2009 to September 2016. Mortality at 28 and 90 days post-CRRT initiation was analyzed using multivariate regression, generalized additive models, smooth curve fitting, and sensitivity analyses.</p><p><strong>Results: </strong>A total of 1,142 patients were included, with 28-day and 90-day mortality rates of 62.1% and 71.8%, respectively. In multivariable-adjusted Cox models, MAP was inversely correlated with the risk of 28-day and 90-day mortality after adjusting for covariates. Hazard ratios (HRs) were calculated per 1 mmHg increment of MAP: adjusted HR for 28-day mortality 0.985 (<i>p</i> < 0.00001) and for 90-day mortality 0.987 (<i>p</i> = 0.00002). The adjusted HRs for 28-day and 90-day mortality in patients in the highest tertile of MAP compared with those in the lowest tertile were 0.682 (95% CI 0.543-0.857) and 0.730 (95% CI 0.592-0.899), respectively. Patients were grouped using MAP thresholds of <65 mmHg, 65-71.85 mmHg, and ≥71.85 mmHg, with similar results observed. Sensitivity analyses confirmed the inverse relationship between higher MAP before CRRT and lower mortality.</p><p><strong>Conclusion: </strong>The higher the MAP before CRRT is, the lower the 28- and 90-day mortality of critically ill patients with AKI who are treated with CRRT.</p>","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2448582"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11721759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142962431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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

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

{"title":"Corticosteroid and immunosuppressive treatment are effective for acquired pure red cell aplasia in chronic kidney disease: a case report and literature review.","authors":"Hongsha Yang, Yurong Zou, Guisen Li, Yunlin Feng","doi":"10.1080/0886022X.2024.2449202","DOIUrl":"10.1080/0886022X.2024.2449202","url":null,"abstract":"","PeriodicalId":20839,"journal":{"name":"Renal Failure","volume":"47 1","pages":"2449202"},"PeriodicalIF":3.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11721747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142965634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}