American Journal of Kidney Diseases最新文献

{"title":"Considering Dialysis in Octogenarians and Nonagenarians Living With Kidney Failure.","authors":"Christina Miranda","doi":"10.1053/j.ajkd.2024.06.013","DOIUrl":"https://doi.org/10.1053/j.ajkd.2024.06.013","url":null,"abstract":"","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":" ","pages":""},"PeriodicalIF":9.4,"publicationDate":"2024-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142379881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Coprescribing of Gabapentinoid and Other Psychoactive Medications With Altered Mental Status and Falls in Adults Receiving Dialysis.","authors":"Rasheeda K Hall, Sarah Morton-Oswald, Jonathan Wilson, Devika Nair, Cathleen Colón-Emeric, Jane Pendergast, Carl Pieper, Julia J Scialla","doi":"10.1053/j.ajkd.2024.07.013","DOIUrl":"10.1053/j.ajkd.2024.07.013","url":null,"abstract":"<p><strong>Rationale & objective: </strong>Prescribing psychoactive medications for patients with kidney disease is common, but for patients receiving dialysis some medications may be inappropriate. We evaluated the association of coprescribing gabapentinoids and other psychoactive potentially inappropriate medications (PPIMs) (eg, sedatives or opioids) with altered mental status (AMS) and falls and whether the associations are modified by frailty.</p><p><strong>Study design: </strong>Observational cohort study.</p><p><strong>Setting & participants: </strong>Adults receiving dialysis represented in the US Renal Data System who had an active gabapentinoid prescription and no other PPIM prescriptions in the prior 6 months.</p><p><strong>Exposure: </strong>PPIM coprescribing, or the presence of overlapping prescriptions of a gabapentinoid and≥1 additional PPIM.</p><p><strong>Outcome: </strong>Acute care visits for AMS and injurious falls.</p><p><strong>Analytical approach: </strong>Prentice-Williams-Petersen Gap Time models estimated the association between PPIM coprescribing and each outcome, adjusting for demographics, comorbidities, and frailty, as assessed by a validated frailty index (FI). Each model tested for interaction between PPIM coprescribing and frailty.</p><p><strong>Results: </strong>Overall, PPIM coprescribing was associated with increased hazard of AMS (HR, 1.66 [95% CI, 1.44-1.92]) and falls (HR, 1.55 [95% CI, 1.36-1.77]). Frailty significantly modified the effect of PPIM coprescribing on the hazard of AMS (interaction P=0.01) but not falls. Among individuals with low frailty (FI=0.15), the HR for AMS with PPIM coprescribing was 2.14 (95% CI, 1.69-2.71); for individuals with severe frailty (FI=0.34), the hazard ratio for AMS with PPIM coprescribing was 1.64 (95% CI, 1.42-1.89). Individuals with PPIM coprescribing and severe frailty (FI=0.34) had the highest hazard of AMS (HR, 3.22 [95% CI, 2.55-4.06]) and falls (HR, 2.77 [95% CI, 2.27-3.38]) compared with nonfrail individuals without PPIM coprescribing.</p><p><strong>Limitations: </strong>Outcome ascertainment bias; residual confounding.</p><p><strong>Conclusions: </strong>Compared with gabapentinoid prescriptions alone, PPIM coprescribing was associated with an increased risk of AMS and falls. Clinicians should consider these risks when coprescribing PPIMs to patients receiving dialysis.</p><p><strong>Plain-language summary: </strong>Among people on dialysis, gabapentinoids may lead to confusion and falls. Often they are prescribed with other sedatives drugs or opioids, which can increase these risks. This study of adults with kidney failure receiving maintenance dialysis in the United States found that those who were prescribed both gabapentinoids and other psychoactive drugs were more likely to have confusion and falls compared with those who only took gabapentinoids. These relationships were seen at all levels of frailty although the relative risk of confusion related to an add","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":" ","pages":""},"PeriodicalIF":9.4,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations Among Circle-Based Kidney Allocation, Center Waiting Time, and Likelihood of Deceased-Donor Kidney Transplantation.","authors":"David C Cron, Arnold E Kuk, Layla Parast, S Ali Husain, Kristen L King, Miko Yu, Sumit Mohan, Joel T Adler","doi":"10.1053/j.ajkd.2024.07.014","DOIUrl":"10.1053/j.ajkd.2024.07.014","url":null,"abstract":"<p><strong>Rationale & objective: </strong>The kidney allocation system (KAS250), using circle-based distribution, attempts to address geographic disparities through broader sharing of deceased-donor kidney allografts. This study sought to evaluate the association between KAS250 and likelihood of deceased-donor kidney transplantation (DDKT) among waitlisted candidates, and whether the policy has differentially affected centers with shorter vs. longer waiting time.</p><p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>& Participants: 160,941 candidates waitlisted at 176 transplant centers between 3/2017-3/2024.</p><p><strong>Exposure: </strong>KAS250 allocation policy.</p><p><strong>Outcome: </strong>Rate of DDKT.</p><p><strong>Analytical approach: </strong>Multivariable Cox regression, modeling KAS250 as a time-dependent variable.</p><p><strong>Results: </strong>KAS250 was not independently associated with likelihood of DDKT overall (HR=1.01 vs. pre-KAS250, 95% C.I. 0.97-1.04). KAS250's association with likelihood of DDKT varied across centers from HR=0.18 (DDKT less likely after KAS250) to HR=17.12 (DDKT more likely) and varied even among neighboring centers. KAS250 was associated with decreased DDKT at 25.6% and increased DDKT at 18.2% of centers. Centers with previously long median waiting times (57+ months) experienced increased likelihood of DDKT after KAS250 (HR=1.20, 95% C.I. 1.15-1.26), whereas centers with previously short median waiting times (6-24mo.; HR=0.88, 0.84-0.92) experienced decreased likelihood of DDKT.</p><p><strong>Limitations: </strong>Retrospective study of allocation policy changes, confounded by multiple changes over the study timeframe.</p><p><strong>Conclusion: </strong>Association between KAS250 and DDKT varied across centers. For one-in-four centers, DDKT was less likely after KAS250 relative to pre-KAS250 trends. Candidates at centers with previously long waiting times experienced increased likelihood of DDKT after KAS250. Thus, broader distribution of kidneys may be associated with improved equity in access to DDKT, but additional strategies may be needed to minimize disparities between centers.</p>","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":" ","pages":""},"PeriodicalIF":9.4,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142374970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leveraging the End-Stage Renal Disease Patient Life Goals Survey (PaLS) to Improve Quality of Care: Avoiding a \"Checkbox Measure\".","authors":"Samantha L Gelfand, Joshua R Lakin, Mallika L Mendu","doi":"10.1053/j.ajkd.2024.07.008","DOIUrl":"10.1053/j.ajkd.2024.07.008","url":null,"abstract":"","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":" ","pages":""},"PeriodicalIF":9.4,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142370733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case of Severe Acute Kidney Injury Due to an Antibiotic-Loaded Cement Spacer for Infected Knee Arthroplasty.","authors":"Evan Finger, Larab Giniyani, Yevgeniy A Korshunov, Jordan L Rosenstock","doi":"10.1053/j.ajkd.2024.07.012","DOIUrl":"https://doi.org/10.1053/j.ajkd.2024.07.012","url":null,"abstract":"<p><p>The treatment for periprosthetic joint infection frequently involves the placement of a high-dose antibiotic-loaded bone cement spacer (ALCS) into the debrided joint. Typical antibiotics in the spacer include aminoglycosides and vancomycin. It has been believed that systemic absorption of intraarticular antibiotics would be low and early experience suggested that the risk of acute kidney injury (AKI) from ALCS was minimal. However, recent case reports and case series have suggested a risk of acute kidney injury due to antibiotic absorption, though confounding factors are common. We report a case of severe AKI requiring hemodialysis with extremely high systemic tobramycin levels after the placement of an ALCS with increased dosing of antibiotics after previous failure to resolve a periprosthetic joint infection with a prior ALCS. There was no concomitant use of intravenous nephrotoxic antibiotics nor other confounding factors. Despite dialysis, the patient needed urgent removal of the ALCS to control tobramycin levels with subsequent resolution of the AKI. This case highlights the potentially serious nephrotoxicity of ALCS's, the importance of antibiotic type and dosing, and the value of close monitoring after ALCS placement, especially in a patient with chronic kidney disease.</p>","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":" ","pages":""},"PeriodicalIF":9.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142370732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical Suitability and Willingness for Living Kidney Donation Among Older Adults.","authors":"Cédric Villain, Natalie Ebert, Richard J Glassock, Nina Mielke, Tim Bothe, Muhammad Helmi Barghouth, Anna Pöhlmann, Anne-Katrin Fietz, John S Gill, Elke Schaeffner","doi":"10.1053/j.ajkd.2024.07.010","DOIUrl":"https://doi.org/10.1053/j.ajkd.2024.07.010","url":null,"abstract":"<p><strong>Rationale & objective: </strong>The benefits of kidney transplantation compared to treatment with dialysis, including in older adult, are primarily limited by the number of donated kidneys. We studied the potential to expand the use of older living kidney donors.</p><p><strong>Study design: </strong>Secondary analysis of the Berlin Initiative Study, a population-based cohort.</p><p><strong>Setting: </strong>& Participants: 2069 adults aged ≥70 years in Germany.</p><p><strong>Exposures: </strong>Age and sex.</p><p><strong>Outcomes: </strong>Suitability for living donation assessed by the absence of kidney-related exclusions for donation including albuminuria and low estimated glomerular filtration rate (eGFR) as well as absence of other medical exclusions. Willingness for living and deceased kidney donation assessed by participant survey.</p><p><strong>Analytical approach: </strong>Descriptive analysis.</p><p><strong>Results: </strong>Among the 2069 participants (median age 80 years, 53% women, median eGFR 63 ml/min/1.73m²), 93% had ≥1 medical contraindication for living donation at study entry unrelated to eGFR or albuminuria. Using two published eGFR and albuminuria thresholds for donor acceptance, 38% to 54% of participants had kidney-related exclusions for donation. Among the 5% to 6% of participants with neither medical nor kidney-related exclusions for living donation at baseline, 11% to 12% remained suitable for donation during 8 years of follow-up. Willingness for living or deceased donation was high (73% and 60%, respectively).</p><p><strong>Limitations: </strong>GFR was not measured and medical exclusions unrelated to eGFR and albuminuria were assessed using a cohort database complemented by claims data.</p><p><strong>Conclusions: </strong>One in twenty older adults were potentially suitable for living kidney donation and willingness for living donation was high. Further studies are warranted to define the feasibility of expanding living kidney donation among older adults.</p>","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":" ","pages":""},"PeriodicalIF":9.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142370734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urea to Treat Hyponatremia Due to Syndrome of Inappropriate Antidiuretic Hormone Secretion: A Systematic Review and Meta-Analysis.","authors":"Subhash Chander, Roopa Kumari, Abhi Chand Lohana, Zubair Rahaman, Om Parkash, Sheena Shiwlani, Yaqub Nadeem Mohammed, Hong Yu Wang, Hao Chi, Wenchy Tan, Sanjay Kirshan Kumar, Fnu Sindhu","doi":"10.1053/j.ajkd.2024.07.011","DOIUrl":"10.1053/j.ajkd.2024.07.011","url":null,"abstract":"<p><strong>Rationale & objective: </strong>The use of urea to treat hyponatremia related to the syndrome of inappropriate antidiuretic hormone secretion (SIADH) has not been universally adopted due to questions about effectiveness, safety, and tolerability. This systematic review and meta-analysis of observational studies addresses these questions.</p><p><strong>Study design: </strong>This PRISMA-guided study examined published research across 4 electronic databases.</p><p><strong>Study populations: </strong>Patients with SIADH-related hyponatremia.</p><p><strong>Selection criteria: </strong>Clinical trials and observational studies reporting at least 1 outcome related to serum sodium concentration, symptom resolution, or adverse effects after oral or nasogastric urea administration.</p><p><strong>Data extraction: </strong>Data extraction was performed independently by 2 reviewers using a standardized form recording study characteristics, participant demographics, intervention details, and treatment outcomes.</p><p><strong>Analytical approach: </strong>A meta-analysis was conducted using the restricted maximum likelihood method for the random effects model to assess the effect of urea treatment on serum sodium and serum urea compared with other treatment modalities. Subgroup analyses were conducted based on treatment duration and SIADH severity.</p><p><strong>Results: </strong>Urea treatment significantly increased serum sodium (mean difference [MD], 9.08 [95% CI, 7.64-10.52], P<0.01) and urea (MD, 31.66 [95% CI, 16.05-47.26], P<0.01) in patients with SIADH, albeit with significantly high heterogeneity. Subgroup analysis based on the treatment duration showed a significant rise in the serum sodium level after 24 hours and 2, 5, 7, and 14 days, as well as after 1 year of treatment. Greater increases in serum sodium levels after treatment with urea occurred in patients with severe (<120 mEq/L) (MD, 18.04 [95% CI, 13.68-22.39]) than with moderate (120-129 mEq/L) (MD, 7.86 [95% CI, 6.78-8.94]) or mild (130-135 mEq/L) (MD, 8.00 [95% CI, 7.31-8.69]) SIADH-induced hyponatremia. Urea treatment was comparable to fluid restriction (MD, 0.81 [95% CI, -0.93 to 2.55], P = 0.4) and vaptans (MD, -1.96 [95% CI, -4.59 to 0.66], P=0.1) but superior to no treatment (MD, 7.99 [95% CI, 6.25-9.72], P<0.01). Urea was associated with minor adverse events, with poor palatability being the most common.</p><p><strong>Limitations: </strong>As no randomized controlled trials investigating urea as a treatment for hyponatremia were identified for inclusion, these analyses were based on observational studies.</p><p><strong>Conclusions: </strong>Urea is safe and effective for managing SIADH-induced hyponatremia. These finding suggest that urea may be a useful treatment modality in resource-limited settings or when other treatments are contraindicated or poorly tolerated.</p><p><strong>Trial registration: </strong>Registered at PROSPERO with study number CRD42024511685.</p>","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":" ","pages":""},"PeriodicalIF":9.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142370735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal Patterns of Ankle-Brachial Index and Their Association With Progression of CKD in Patients With Type 2 Diabetes and Elevated Body Mass Index.","authors":"Mengyi Liu, Yanjun Zhang, Yuanyuan Zhang, Panpan He, Chun Zhou, Ziliang Ye, Sisi Yang, Xiaoqin Gan, Fan Fan Hou, Xianhui Qin","doi":"10.1053/j.ajkd.2024.06.024","DOIUrl":"10.1053/j.ajkd.2024.06.024","url":null,"abstract":"<p><strong>Rationale & objective: </strong>Ankle-brachial index (ABI) is used to screen for vascular complications in the setting of diabetes. This study sought to examine the relationship of longitudinal ABI data and chronic kidney disease (CKD) progression in patients with type 2 diabetes mellitus (T2DM) and increased body mass index.</p><p><strong>Study design: </strong>A post hoc analysis of the Look AHEAD (Action for Health in Diabetes) trial.</p><p><strong>Setting & participants: </strong>This study included 3,631 participants in the Look AHEAD trial with a baseline estimated glomerular filtration rate>60mL/min/1.73m².</p><p><strong>Exposures: </strong>Average ABI and average annual change in ABI were calculated based on annual ABI measurements during the first 4 years of the study.</p><p><strong>Outcome: </strong>CKD progression, defined as kidney failure requiring maintenance dialysis or the occurrence of an estimated glomerular filtration rate<60mL/min/1.73m² with a decrease of≥30% versus baseline at a follow-up visit.</p><p><strong>Analytical approach: </strong>Restricted cubic spline and Cox proportional hazards models were fit to estimate associations and to explore nonlinearity.</p><p><strong>Results: </strong>During a median follow-up of 10.1 years, CKD progression developed in 1,051 participants. There was a reversed J-shaped relationship of CKD progression with average ABI (ABI<1.17: HR per 1-SD decrement, 1.23; 95% CI, 1.06-1.42; ABI≥1.17: HR per 1-SD increment, 1.10; 95% CI, 1.00-1.22) and average annual change in ABI (change in ABI less than-0.007: HR per 1-SD decrement, 1.37; 95% CI, 1.12-1.66; change in ABI of at least-0.007: HR per 1-SD increment, 1.13; 95% CI, 1.03-1.24).</p><p><strong>Limitations: </strong>Observational study, potential unmeasured confounding.</p><p><strong>Conclusions: </strong>Low and high-average ABI, even at clinically normal values, as well as decreasing and increasing average annual ABI, were associated with a higher risk of CKD progression in patients with T2DM and increased body mass index. Monitoring ABI and its changes over time may facilitate CKD risk stratification in patients with T2DM.</p><p><strong>Plain-language summary: </strong>The ankle-brachial index (ABI) has recently become a routine screening parameter for vascular complications in patients with diabetes. In this post hoc analysis of the Look AHEAD (Action for Health in Diabetes) trial including 3,631 participants with type 2 diabetes mellitus and increased body mass index, we examined the longitudinal relationship of average ABI and annual change in ABI with chronic kidney disease progression. We observed that low and high-average ABI, even at clinically normal values, as well as decreases and increases in average annual ABI, were associated with a higher risk of chronic kidney disease progression in patients with type 2 diabetes mellitus and increased body mass index.</p>","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":" ","pages":""},"PeriodicalIF":11.3,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142363950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-plasmapheresis Approaches for Managing Severe Renal Thrombotic Microangiopathy: A Report of 7 Cases.","authors":"Marie Frimat, Mehdi Maanaoui, Nora Schwotzer, Celine Lebas, Arnaud Lionet, Sylvain Dubucquoi, Viviane Gnemmi, Fadi Fakhouri, François Provôt","doi":"10.1053/j.ajkd.2024.06.022","DOIUrl":"10.1053/j.ajkd.2024.06.022","url":null,"abstract":"<p><p>C5-blockers are the established treatment for complement-mediated hemolytic uremic syndrome (CM-HUS). However, CM-HUS, lacking a definitive test, prompts plasma exchanges as a common first-line therapy, pending further assessments, despite complications and limited evidence in this indication. Recent experts' opinion endorses C5-blockers as the initial treatment for severe renal thrombotic microangiopathy (TMA). This retrospective, single-center study reports a series of 7 patients treated with a plasmapheresis-free approach. All patients presented with severe renal TMA symptoms and low French score and received prompt 900mg eculizumab within a median of 9 hours from admission. Hematological recovery was rapid, and renal function improved in 6 patients within 6.5 days, with a median hospital stay of 16 days. No rescue plasmapheresis was used. We report 7 cases of an early C5-blocker and plasmapheresis-free strategy in severe renal TMA suspicious for CM-HUS, demonstrating promising initial results. Clinical trials are needed to confirm the efficacy and safety of this approach. Addressing the high cost of C5-blocking therapies and exploring cost-effective alternatives is also crucial for broader implementation and accessibility in targeted therapies for adult renal TMA.</p>","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":" ","pages":""},"PeriodicalIF":9.4,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Free Hormone Theory of Vitamin D Can Be an Important Alternative Consideration.","authors":"Chia-Ter Chao","doi":"10.1053/j.ajkd.2024.06.023","DOIUrl":"10.1053/j.ajkd.2024.06.023","url":null,"abstract":"","PeriodicalId":7419,"journal":{"name":"American Journal of Kidney Diseases","volume":" ","pages":""},"PeriodicalIF":9.4,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}