Rheumatology International最新文献

{"title":"Gender bias in Argentine rheumatology research: a bibliometric analysis.","authors":"Belén Navarro, Julieta Car, Gabriel Sequeira, Eduardo Mario Kerzberg","doi":"10.1007/s00296-025-05885-5","DOIUrl":"10.1007/s00296-025-05885-5","url":null,"abstract":"<p><p>Despite growing female participation in the workforce, gender disparities persist across sectors. Little is known about how these manifest in academic rheumatology in Argentina. To analyze recently published rheumatology research by Argentine authors from a gender perspective. A bibliometric analysis was conducted on rheumatology publications from 2018 to 2022 in the Argentine Journal of Rheumatology (AJR) and PubMed-indexed journals that included at least one Argentine author. Argentine authors were classified by gender, and authorship roles (overall, first, and corresponding authors) were assessed, along with pharmaceutical industry conflicts of interest (COIs). Of 130 AJR articles (1183 Argentine authors), 61.8% were women. In 440 PubMed-indexed articles (1957 Argentine authors), 55.2% were women. Women were more frequently first authors in both AJR and PubMed (67.7% vs. 58.4%; p = 0.13), but less often corresponding authors in PubMed (44%) than in AJR (60%; p = 0.02). In AJR, female authors had a higher median number per article (3, Interquartile range or IQR 2-6) than male authors (2, IQR 1-4; p = 0.002). In PubMed, male authors showed slightly greater median participation (1, IQR 1-2 vs. 1, IQR 0-2; p = 0.02). In industry-sponsored studies, only 28.1% of authors were women. In COI-declaring publications, 71.0% listed only male disclosures; of 153 total reports, just 26.8% were by women. Although women are the majority in Argentine rheumatology research, they remain underrepresented in leadership roles and industry-funded studies. Continued monitoring of gender and COI data is needed.</p>","PeriodicalId":21322,"journal":{"name":"Rheumatology International","volume":"45 5","pages":"126"},"PeriodicalIF":3.2,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015252","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":"Cardiogenic shock in systemic sclerosis: a retrospective study of acute ventricular dysfunction.","authors":"Aitor Uribarri, Alfredo Guillen-Del Castillo, Yassin Belahnech, Guillem Casas, Alejandra Gabaldón, Neus Bellera, Ruperto Oliveró, Toni Soriano-Colomé, Claudia Codina-Claveguera, José Rodriguez-Palomares, José A Barrabés, Ignacio Ferreira-González, Carmen P Simeon","doi":"10.1007/s00296-025-05874-8","DOIUrl":"10.1007/s00296-025-05874-8","url":null,"abstract":"<p><p>Cardiac involvement in systemic sclerosis (SSc) is a major cause of morbidity and mortality, with ventricular dysfunction and cardiogenic shock being among the most severe complications. The underlying causes of acute ventricular dysfunction in these patients remain unclear. This observational study included 10 SSc patients admitted with cardiogenic shock and acute ventricular dysfunction between 2010 and 2023, excluding those with prior heart disease. Clinical, laboratory, imaging, and pathological data were analyzed, with outcomes assessed at six months. The cohort was 90% female, with a mean age of 58.8 ± 3.8 years. Most had diffuse cutaneous SSc (70%) and musculoskeletal involvement (50%), with an average disease duration of 4.8 ± 5.2 years. All patients presented with severe hemodynamic instability, with a mean systolic blood pressure of 78.4 ± 6.7 mmHg and elevated troponin levels (2077 ± 3379 ng/L). Pericardial effusion was observed in all, and 30% required pericardiocentesis. CMR showed presence of late gadolinium enhancement and prolonged T2 relaxation time and reduced ventricular function (LVEF 31 ± 8%). Biopsies revealed myocarditis with T lymphocyte and macrophage infiltration. In-hospital mortality was 60%. Among survivors, partial ventricular recovery was seen at six months, with an average LVEF improvement of 10 ± 10%. SSc patients with cardiogenic shock and acute ventricular dysfunction face high mortality and limited recovery. The phenotype is associated with diffuse cutaneous SSc and musculoskeletal involvement, likely driven by myocarditis, highlighting the need for improved cardiac-focused treatments in SSc.</p>","PeriodicalId":21322,"journal":{"name":"Rheumatology International","volume":"45 5","pages":"125"},"PeriodicalIF":3.2,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043851","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":"Prevalence and clinical features of early axial spondyloarthritis according to ASAS definition: a cross-sectional analysis from the reuma-check cohort.","authors":"Rodrigo Garcia-Salinas, Nataly Mejia-Maggi, Felicia Almada, Sebastian Magri, Victoria Navarro-Compán","doi":"10.1007/s00296-025-05873-9","DOIUrl":"10.1007/s00296-025-05873-9","url":null,"abstract":"<p><p>Objectives to estimate the prevalence at diagnosis of early axial spondyloarthritis in Argentinian Reuma-Check cohort, according to ASAS definition (early axSpA) and to identify clinical, laboratory, and imaging features associated with this group in a Latin American cohort. This single-center, observational, cross-sectional study included consecutive adult patients diagnosed with axSpA. Early axSpA was defined as ≤ 2 years of axial symptoms at diagnosis. Clinical, laboratory, and imaging assessments were performed following standardized protocols. A primary analysis was conducted on the entire cohort of diagnosed patients, followed by two subgroup analyses: one including only those fulfilling the ASAS 2009 criteria and another excluding patients with psoriasis. Logistic regression was conducted to identify factors independently associated with early axSpA. Among 124 patients, 38% (n = 47) had early axSpA at diagnosis. Significant differences between early and established axSpA included smoking habit (30 vs. 51%, p = 0.02), NSAID response (58 vs. 74%, p = 0.06), family history (38 vs. 23%, p = 0.04), and radiographic sacroiliitis (37 vs. 71%, p = 0.03). Logistic regression identified family history (OR: 2.4) as an independent risk factor, whereas smoking was inversely associated (OR: 0.4). Similar patterns were observed in the ASAS-fulfilling (33%) and psoriasis-excluded (36%) subgroups. At diagnosis, approximately one third of patients meet the ASAS definition of early axSpA. These patients are characterized by a higher frequency of family history, less smoking and structural damage. These results support the feasibility and relevance of future studies including patients with early axSpA to provide further scientific evidence at earlier stages of the disease.</p>","PeriodicalId":21322,"journal":{"name":"Rheumatology International","volume":"45 5","pages":"122"},"PeriodicalIF":3.2,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991888","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":"Publication activity trends in the field of social media in rheumatology: a Web of Science-based bibliometric analysis.","authors":"Maidan Mukhamediyarov, Dana Bekaryssova","doi":"10.1007/s00296-025-05867-7","DOIUrl":"10.1007/s00296-025-05867-7","url":null,"abstract":"<p><p>Social media (SoMe) is crucial in disseminating information and raising awareness about health conditions. In recent years, rheumatology specialists have increasingly utilized social networks to support and promote scientific research. This study presents a bibliometric analysis of global social media and rheumatology trends, identifying leading authors, citation patterns, and emerging research areas. The analysis used data exported from Web of Science (WoS) from 2015 to 2024. The search used MeSH-derived keywords, specifically \"social media rheumatology,\" without applying filters, covering January 2015 to December 2024 timeframe. A comprehensive search resulted in retrieving 251 publications. After ranking these publications and applying inclusion and exclusion criteria, 152 articles were included in the final analysis. A total of 152 publications were analyzed, revealing a significant positive trend in the number of publications over time (p = 0.001). The leading countries in terms of publication activity were the US (35.53%), the United Kingdom (32.24%), Australia (11.18%), Germany (9.87%), and France (9.21%). The research originated from 66 countries, but only 18 demonstrated substantial activity. The US led in scientific contributions relative to population and Gross Domestic Product (GDP). Regarding publication types, 137 (90.13%) were original research articles, while the remainder were review articles. The median citation count for original articles was 5 (range: 0-116), while review articles had a higher median citation count of 28 (range: 0-156), indicating that reviews were cited more frequently than original studies (p = 0.001). The median citation count for publications indexed in SCIE, SSCI, and ESCI was 5.5 (range: 0-116) and 6 (range: 0-116), respectively. Most publications were published in the following journals: Clinical Rheumatology (n = 25), Rheumatology Advances in Practice (n = 25), Rheumatology International (n = 16), BMJ Open (n = 12) and Journal of Medical Internet Research (n = 8). High-income countries, such as the US, the United Kingdom, and Australia, have significantly contributed to the field of social medicine in rheumatology, underscoring disparities in scientific research capacity across different regions.</p>","PeriodicalId":21322,"journal":{"name":"Rheumatology International","volume":"45 5","pages":"119"},"PeriodicalIF":3.2,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046318","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":"Sleep problems and insomnia are common and associated with pain intensity, number of comorbidities and analgesic use in patients with knee and hip osteoarthritis: a cross-sectional study using data from the good life with osteoarthritis in Denmark (GLA:D^®) registry.","authors":"Jonas B Thorlund, Eivind S Skarpsno, Jonas J Vestergaard, Søren T Skou, Dorte T Grønne, Ewa M Roos, Henrik B Vaegter","doi":"10.1007/s00296-025-05878-4","DOIUrl":"10.1007/s00296-025-05878-4","url":null,"abstract":"<p><p>To assess the difference in prevalence of sleep problems and insomnia in patients with knee or hip osteoarthritis (OA), and explore characteristics associated with sleep problems and insomnia. We included 8,162 knee/hip OA patients enrolled in supervised exercise and patient education through the Good Life with osteoArthritis in Denmark (GLA:D^®) program. We assessed presence of sleep problems (yes/no), followed by the Insomnia Severity Index 3-item (ISI-3) questionnaire among those with sleep problems (Insomnia: ISI-3 score ≥ 7). Characteristics associated with sleep problems/insomnia was estimated for knee and hip OA patients separately (prevalence ratios [PR]). In total, 68% (n = 3,539) and 64% (n = 1,807) of knee and hip OA patients reported sleep problems, respectively, corresponding to a PR of 1.06 (95% CI 1.03 to 1.10). Prevalence of insomnia was 17% (n = 943) and 20% (n = 528) for those with knee and hip OA, respectively (PR 1.18 [95% CI 1.07 to 1.30]). Large overlap between characteristics associated with sleep problems and insomnia were observed. Characteristics most strongly associated with higher prevalence of insomnia were pain intensity ≥40 mm VAS (knee: PR 2.39 [95% CI 2.08 to 2.74]; hip: PR 2.54 [95% CI 2.10 to 3.07], a high number of comorbidities, and analgesic use in both patients with knee and hip OA. Sleep problems and insomnia are highly prevalent among primary care patients with knee and hip OA, and slightly more common in hip OA patients. Prevalence of insomnia was substantially higher among patients with more comorbidities, higher pain intensity and analgesic use.</p>","PeriodicalId":21322,"journal":{"name":"Rheumatology International","volume":"45 5","pages":"123"},"PeriodicalIF":3.2,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12031806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036750","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":"Barriers and facilitators associated with diagnostic and treatment delays in lupus in the Global South and North: a systematic review of qualitative and mixed methods studies.","authors":"Amaranta Manrique de Lara, Tirsa Colmenares-Roa, Laura Athié, Yurilis Fuentes-Silva, Cinthya Cadena-Trejo, María Fernanda Ramírez-Flores, Alfonso Gastelum-Strozzi, Rosana Quintana, Bernardo A Pons-Estel, Ingris Peláez-Ballestas","doi":"10.1007/s00296-025-05875-7","DOIUrl":"10.1007/s00296-025-05875-7","url":null,"abstract":"<p><p>Currently, there is no specific definition of delay in the diagnosis and treatment of systemic lupus erythematosus. This study aimed to describe the experiences of diagnostic and treatment delays in lupus, along with their associated barriers and facilitators, and to contrast this phenomenon in the Global South and North. A qualitative systematic review of the literature was conducted following the Joanna Briggs Institute and PRISMA guidelines. A targeted electronic search strategy was performed in Scopus, PubMed, and Web of Science. This protocol was registered with the international prospective register of systematic reviews (PROSPERO CRD42023456508). From 1,135 identified registries, 12 (ten qualitative and two mixed methods) articles were included in the analysis, most from the Global North. None of the publications clearly define diagnostic delay in lupus. Patients, caregivers, and healthcare professionals identified a range of barriers and facilitators. Misdiagnosis, miscommunication, the lack of rheumatology knowledge and education, and the diagnostic pilgrimage were barriers reported in both regions. In the Global South, barriers were related to a fragmented and complex healthcare system, stigma, and economic and geographic difficulties. In the Global North, physician-patient interactions and reliance on antinuclear antibody testing were significant barriers. The reported facilitators mostly comprised individual-level factors like self-care and resilience. This review highlights the lack of a clear definition of diagnostic and treatment delays in lupus, integrating the perspectives of patients, family and caregivers, and healthcare providers. The contrasting emphasis on external context factors in the Global South may reflect underlying health inequalities.</p>","PeriodicalId":21322,"journal":{"name":"Rheumatology International","volume":"45 5","pages":"121"},"PeriodicalIF":3.2,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049895","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":"Anterior segment alterations in fibromyalgia syndrome: a cross-sectional study on dry eye disease, meibomian gland dysfunction, and astigmatism.","authors":"Duygu Topaktaş Emekli, Eda Sahutoglu, Gülşah Yaşa Öztürk, Burhan Fatih Kocyigit","doi":"10.1007/s00296-025-05872-w","DOIUrl":"10.1007/s00296-025-05872-w","url":null,"abstract":"<p><p>Fibromyalgia syndrome (FMS) is an ongoing disorder distinguished by its multifaceted characteristics. There has been increasing interest in its ophthalmologic aspects. This study evaluated the anterior segment parameters of the eye in patients with FMS, comparing them to healthy controls. Furthermore, correlations with disease activity were analyzed. This research was structured as a cross-sectional and comparative analysis. Data was collected at a tertiary care education and research hospital from August 20, 2024, to November 15, 2024. The participants' central corneal thickness, uncorrected and best-corrected visual acuities, refraction parameters, intraocular pressure, meibomian gland dysfunction (MGD), and dry eye disease (DED) parameters were evaluated. There were no significant differences in visual acuity, spherical equivalent, intraocular pressure, and central corneal thickness between FMS and healthy controls (p > 0.05). The median astigmatism in the right eye (diopter) was - 0.50 (-8.25-0) for the FMS group and - 0.12 (-1.75-0.50) for the control group (p = 0.012). The left eye data were - 0.50 (-2-1.50) for the FMS group and 0 (-1.75-0.75) for the control group (p = 0.056). MGD was identified in 26 (36.6%) individuals in the FMS group, whereas it was identified in 3 (4.3%) participants in the control group (p < 0.001). DED was detected in 43 (60.6%) participants in the FMS group and 15 (21.4%) participants in the control group (p < 0.001). FMS patients had higher rates of astigmatism, MGD, and DED compared to healthy controls, underscoring the necessity for routine anterior segment assessments. These data suggest possible ocular involvement in FMS, which warrants further research.</p>","PeriodicalId":21322,"journal":{"name":"Rheumatology International","volume":"45 5","pages":"120"},"PeriodicalIF":3.2,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12031864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978075","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":"Clinical features and diagnostic challenges in crowned dens syndrome: a systematic review and meta-analysis.","authors":"Omar Hamdan, Yazeed Alajlouni, Qais Mussa, Ahmad Alsawalmeh, Qutaiba Sabbah, Muna Al-Zou'bi, Asem Abuhamdan, Fatima Alnaimat","doi":"10.1007/s00296-025-05884-6","DOIUrl":"10.1007/s00296-025-05884-6","url":null,"abstract":"<p><p>Crowned Dens Syndrome (CDS) is an acute inflammatory neck pain linked to Calcium Pyrophosphate crystal deposition surrounding the odontoid process. This systematic review and meta-analysis aim to illuminate the Features and Diagnostic Challenges of CDS. PubMed, Web of Sciences, and Scopus databases were searched in July 2024 to include all studies on CDS without publication year or language restrictions. Demographic, clinical, laboratory, and radiological data, in addition to treatment regimens and outcomes, were extracted and analyzed. PROSPERO registration number is CRD42024575491. We analyzed 153 reports, including 196 CDS patients, with a mean age of 73.13 ± 12.95 years and an almost equal female-to-male ratio. Neck pain was the most common symptom (96.8%). CRP and ESR were elevated in 91.4% and 80.7% of cases, respectively. CT scans had the highest detection rate for abnormalities (97.3%), compared to MRI (68.4%) and plain radiographs (79.4%). NSAIDs were the most frequently used treatment (62.5%), with improvement observed in 96.6% of cases. Meningitis was the most common misdiagnosis (21.4%), leading to a higher likelihood of plain radiographs and lumbar punctures. In contrast, patients with neck tenderness and restricted range of motion had a lower risk of misdiagnosis. Patients who were initially misdiagnosed were more likely to undergo LP (13.1% Vs. 34.8%; P-value < 0.001). CDS is an elderly disease that usually presents as acute neck pain with elevated inflammatory markers and is frequently misdiagnosed as meningitis. Recognizing key clinical features may improve diagnosis and management.</p>","PeriodicalId":21322,"journal":{"name":"Rheumatology International","volume":"45 5","pages":"124"},"PeriodicalIF":3.2,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036761","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":"Gout and rheumatoid arthritis are associated with subclinical vascular damage, reduced brachial vasoreactivity and coronary microvascular dysfunction: a case-control study.","authors":"Oğuz Konal, Furkan Bölen, Tolga Sinan Güvenç, Özlem Pehlivan, Sevilay Batıbay, Fatma Betül Özcan, Ayşe Paralı, Feyza Aksu, Şeref Kul, Mustafa Çalışkan","doi":"10.1007/s00296-025-05868-6","DOIUrl":"10.1007/s00296-025-05868-6","url":null,"abstract":"<p><p>Gout and rheumatoid arthritis (RA) are distinct disorders, but both of these inflammatory arthropaties are associated with a relatively similar risk of atherosclerotic cardiovascular disease. We aimed to assess carotid intima-media thickness (CIMT), flow-mediated vasodilatation (FMD) and coronary flow reserve (CFR) in both disorders to understand and compare the extent of vascular damage. Patients with recently diagnosed gout (n = 30) and RA (n = 40) without previous cardiovascular disease were included to the present study, and 45 healthy volunteers served as controls. All participants underwent ultrasonographic examinations to measure CIMT, FMD and CFR. In unadjusted analysis, both gout and RA were associated with a significantly higher CIMT and significantly lower CFR as compared to controls, while FMD was only lower in the gout group. After adjustment, there was a significantly higher odds ratio (OR) for CIMT (OR:7.02, 95%CI:2.45-20.58 for gout and OR:2.86, 95%CI:1.27-6.57 for RA) and a lower OR for CFR (OR:0.21, 95%CI:0.08-0.55 for gout and OR:0.17, 95%CI:0.07-0.45 for RA) in both groups, while only gout patients had a lower OR for FMD (OR:0.21, 95%CI:0.08-0.55). There were no significant differences or evidence of a difference between gout and RA patients for CIMT, FMD or CFR. Gout and RA are associated with a similar degree of vascular damage, which may explain the similar incidence of atherosclerotic cardiovascular disease in both diseases.</p>","PeriodicalId":21322,"journal":{"name":"Rheumatology International","volume":"45 5","pages":"117"},"PeriodicalIF":3.2,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12018609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021604","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 of acute kidney injury with 1-year mortality in granulomatosis with polyangiitis patients: a cohort study using mediation analyses and machine learning.","authors":"Si Chen, Rui Nie, Haixia Luan, Xiaoran Shen, Yan Wang, Yuan Gui, Xiaoli Zeng, Hui Yuan","doi":"10.1007/s00296-025-05822-6","DOIUrl":"10.1007/s00296-025-05822-6","url":null,"abstract":"<p><p>To investigate the correlation between acute kidney injury (AKI) and 1-year mortality in patients with granulomatosis with polyangiitis (GPA). Clinical data for GPA patients were extracted from the MIMIC-IV (version 3.0) database. Logistic and Cox regression analyses, Kaplan-Meier (KM) survival analysis, and mediation effect analysis were used to assess the association between AKI, renal function indicators, and 1-year mortality in GPA patients. Predictive models were constructed using machine learning algorithms, and tree-based feature selection was applied to evaluate the contributions of AKI and renal function indicators to mortality prediction. A total of 127 GPA patients were included in the analysis. Multivariate logistic regression identified AKI (OR > 1, P < 0.05) as a significant predictor of 1-year mortality. Similarly, multivariate Cox regression analysis revealed AKI (HR > 1, P < 0.05) as an independent risk factor for 1-year mortality. KM survival analysis demonstrated that GPA patients with AKI had significantly lower survival rates than those without AKI (P < 0.0001). Additionally, renal function indicators modestly mediated the relationship between AKI and 1-year mortality in GPA patients. The machine learning analysis indicated that the random forest algorithm performed the best, with an area under the curve of 0.894. Feature selection using tree model analysis highlighted both AKI and renal function indicators as significant contributors to mortality prediction in GPA patients. Our study suggested AKI was an independent risk factor for increased 1-year mortality in GPA patients. Additionally, renal function indicators partially mediated the relationship between AKI and 1-year mortality in these patients.</p>","PeriodicalId":21322,"journal":{"name":"Rheumatology International","volume":"45 5","pages":"118"},"PeriodicalIF":3.2,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144010120","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}