BMC Nephrology最新文献

{"title":"A two-person collaborative repositioning approach for high peritoneal dialysis catheter migration: case reports and literature review.","authors":"F Zhuangyan Yao, S Yanqing Li, T Liping Zhai","doi":"10.1186/s12882-025-03975-x","DOIUrl":"https://doi.org/10.1186/s12882-025-03975-x","url":null,"abstract":"<p><strong>Background: </strong>Peritoneal dialysis catheter migration, a common complication in patients undergoing peritoneal dialysis, often leads to poor dialysate drainage, infection, and abdominal pain. Timely and effective treatment of catheter migration is essential to ensure uninterrupted dialysis.</p><p><strong>Case presentation: </strong>This study presents three cases of peritoneal dialysis (PD) catheter displacement in patients with end-stage renal disease (ESRD), involving three elderly individuals aged 80, 81, and 76 years. All instances of catheter displacement were primarily localized to the upper abdominal region. Following unsuccessful attempts with traditional repositioning methods (such as positional adjustments, ambulation, and saline infusion), a two-person collaborative repositioning technique was employed, combining external manual pressure with rapid saline injection. Consequently, all catheters were successfully repositioned to the pelvic area and remained stable throughout the follow-up period.</p><p><strong>Conclusions: </strong>This re-port preliminarily demonstrated the feasibility and effectiveness of two-person collaborative repositioning approach in elderly patients with PD catheter displacement. Although the results have potential application value, further studies are needed to verify their generality and long-term efficacy in larger samples.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"50"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143073827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploration of rituximab treatment strategies for membranous nephropathy adapted to the Chinese healthcare environment.","authors":"Xiaolong Wang, Xueying Cao, Jie Wu, Shuang Liang, Jian Yang, Hong Wang","doi":"10.1186/s12882-025-03980-0","DOIUrl":"https://doi.org/10.1186/s12882-025-03980-0","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;This study aimed to explore the specific efficacy of rituximab (RTX) in the treatment of membranous nephropathy (MN) and compare and analyze the differences in effectiveness among various treatment regimens, with the objective of identifying the optimal treatment protocol suitable for the medical environment in China.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Patients and methods: &lt;/strong&gt;This retrospective study focused on patients with MN who were treated with RTX and hospitalized at the First Medical Center of PLA General Hospital between January 1, 2019, and December 30, 2022. These patients were followed up for more than one year. We collected clinical data from these patients and categorized them into three groups on the basis of their RTX treatment background: the combined glucocorticoids (GCs) and/or immunosuppressants (IMS) and RTX monotherapy treatment groups, the initial and non-initial treatment groups, and the standard RTX and non-standard RTX treatment groups. The study evaluated the comprehensive outcomes of complete or partial remission during follow-up, as well as relapses after remission. Additionally, Cox regression analysis was conducted to identify risk factors influencing patient remission and relapse.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 126 patients were enrolled in this study, with an average age of 49.0 ± 13.4 years. Among them, males accounted for up to 77.8%, with an average BMI of 26.7 ± 4.0. Among these patients, 59.5% (75/126) received RTX combined with GCs and/or IMS. Statistical results revealed that the combined use of GCs and/or the IMS had no significant effect on renal remission (P = 0.439), but it accelerated the process of renal remission (P = 0.010). A total of 34.9% (42/126) of patients chose RTX as the initial treatment. Compared with the non-initial treatment group, this choice did not significantly differ in terms of efficacy or faster remission speed (all P &gt; 0.05). On the other hand, 39.7% (50/126) of patients received the standard RTX treatment regimen. Compared with the non-standard group, the standard RTX treatment group presented a better remission rate (P &lt; 0.001) and a faster remission speed (P = 0.027). During 13.0 (12.0, 20.0) months of follow-up, the cumulative remission rate reached 73% (92/126), including 47.6% (60/126) of patients with partial remission (PR) and 25.4% (32/126) of patients with complete remission (CR). The cumulative relapse rate was 20.7% (26/126). In addition, 17.5% (22/126) of patients experienced adverse reactions. Multivariate Cox regression analysis revealed that the standard RTX treatment regimen was associated with a better remission rate, whereas comorbid diabetes reduced the remission rate. Older age and higher white blood cell counts may lead to a higher relapse rate.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This study revealed that RTX treatment has a high remission rate and a low relapse rate in MN patients. The standard RTX treatment regimen can provide bett","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"49"},"PeriodicalIF":2.2,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143073828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hyperuricemia prevalence and its risk factors in uremic patients undergoing maintenance hemodialysis.","authors":"Meng Zhang, Gaoqiankun Huang, Xiaorong Bao, Qingmei Yang","doi":"10.1186/s12882-025-03978-8","DOIUrl":"10.1186/s12882-025-03978-8","url":null,"abstract":"<p><strong>Background: </strong>To explore the prevalence of hyperuricemia and its associated factors in uremic patients undergoing maintenance hemodialysis (MHD).</p><p><strong>Methods: </strong>Two hundred two uremic patients undergoing MHD for ≥ 3 months, in Jinshan Hospital, Fudan University, were enrolled. Pre-dialysis blood samples were tested during March 1st, 2023 to April 30th, 2023. Demographic characteristics were recorded. The prevalence of hyperuricemia, defined as serum uric acid (SUA) ≥ 420 μmol/L, was investigated. Individuals were divided into hyperuricemia (HUA) and non-hyperuricemia (n-HUA) groups. The demographic characteristics, residual kidney function, nutritional status, acid-base metabolism, electrolyte and lipid metabolism were compared between groups. The associated factors for hyperuricemia in MHD patients were identified by logistic regression.</p><p><strong>Results: </strong>The median SUA level of the enrolled patients was 458.50 (392.25, 510.75) μmol/L. 134 (66.34%) candidates met the diagnostic criteria of hyperuricemia. The median SUA level in HUA group was 491.00 (459.50, 543.50) μmol/L. Compared to those in n-HUA group, subjects in HUA group showed lower estimated glomerular filtration rate and blood CO₂ level, but higher levels of body mass index, geriatric nutritional risk index, plasma phosphate, potassium, pre-albumin, albumin, serum creatinine (Scr) and urea nitrogen. Logistic regression indicated that Scr (OR 1.002, 95% CI 1.001-1.004, P = 0.003), albumin (OR 1.165, 95%CI 1.011-1.342, P = 0.035), and blood potassium (OR 1.673, 95% CI 1.009-2.773, P = 0.046) were associated factors for hyperuricemia in uremic patients undergoing MHD.</p><p><strong>Conclusion: </strong>Hyperuricemia was highly prevalent among uremic MHD patients. Elevated levels of Scr, albumin and plasma potassium were independent associated factors for hyperuricemia.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"46"},"PeriodicalIF":2.2,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11780984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ursodeoxycholic acid protects against sepsis-induced acute kidney injury by activating Nrf2/HO-1 and inhibiting NF-κB pathway.","authors":"Yunpeng Lou, Hongguang Shi, Ning Sha, Feifei Li, Xiaofeng Gu, Huiyan Lin","doi":"10.1186/s12882-025-03977-9","DOIUrl":"10.1186/s12882-025-03977-9","url":null,"abstract":"<p><strong>Background: </strong>Ursodeoxycholic acid (UDCA), traditionally recognized for its hepatoprotective effects, has also shown potential in protecting kidney injury. This study aimed to evaluate the protective effects of UDCA against sepsis-induced acute kidney injury (AKI) and to elucidate the underlying mechanisms.</p><p><strong>Methods: </strong>Sixty male C57BL/6 N mice were utilized to establish a sepsis-induced AKI model through intravenous injection of lipopolysaccharides (LPS, 10 mg/kg). UDCA (15, 30, and 60 mg/kg) was administered intraperitoneally once daily for 7 days before LPS injection. Kidney injury was evaluated by HE staining and biochemical markers, including serum creatinine (Cr), blood urea nitrogen (BUN), urinary protein, neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), N-acetyl-β-D-glucosaminidase (NAG), and retinol binding protein (RBP). Oxidative stress parameters and nuclear factor erythroid 2-related factor 2 (Nrf2)/ heme oxygenase-1 (HO-1) pathway, pro-inflammatory cytokines and nuclear factor-kappa B (NF-κB) pathway were also evaluated. Additionally, HK-2 cells were treated with LPS in vitro, and cell viability and apoptosis were detected using CCK-8 kit and flow cytometer, respectively.</p><p><strong>Results: </strong>UDCA significantly attenuated LPS-induced renal histopathological damage and improved renal function, as evidenced by reduction in serum Cr, BUN, and urinary protein levels. UDCA also up-regulated the protein expression of zonula occludens-1 (ZO-1) and Ezrin in the kidney, and reduced the urinary levels of NGAL, KIM-1, NAG, and RBP. Moreover, UDCA inhibited NF-κB p65 phosphorylation and reduced pro-inflammatory cytokines levels (TNF-α, IL-1β, and IL-6) in both serum and kidney. UDCA alleviated oxidative stress by activating the Nrf2/HO-1 pathway in the kidney. In vitro, UDCA reduced LPS-induced cell injury and apoptosis in HK-2 cells, with these protective effects being blocked by the Nrf2 inhibitor ML385.</p><p><strong>Conclusions: </strong>Our present study demonstrated that UDCA exerts protective effects against sepsis-induced AKI by attenuating oxidative stress and inflammation, primarily through the activation of the Nrf2/HO-1 pathway and inhibition of the NF-κB pathway. These findings highlight the therapeutic potential of UDCA in preventing sepsis-induced AKI.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"45"},"PeriodicalIF":2.2,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11780800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Employment before and after initiation of dialysis or kidney transplantation- a Danish nationwide registry-based cohort study.","authors":"Rasmus Kirkeskov Carlsen, Lilli Kirkeskov, Margit S Riis, Rikke K Jacobsen, Frederikke Hørdam Gronemann, Merete Osler, Janne Petersen, Niels Henrik Buus","doi":"10.1186/s12882-025-03969-9","DOIUrl":"10.1186/s12882-025-03969-9","url":null,"abstract":"<p><strong>Background: </strong>Patients treated with chronic dialysis or kidney transplantation have difficulties in maintaining employment. We aimed to estimate employment rates among dialysis and kidney transplant patients from 3 years before to 3 years after initiating dialysis or undergoing transplantation.</p><p><strong>Methods: </strong>All first-time dialysis and kidney transplantation patients aged 18-65 years in Denmark from 2005 to 2019 were identified using the Danish Nephrological Register and linked with information about social security benefits. Each dialysis or kidney transplant patient was matched with 3 references.</p><p><strong>Results: </strong>In total, 4,469 patients undergoing dialysis (median age 55 years, 65% males) and 2,294 patients receiving kidney transplants (median age 49 years, 64% males) were included together with 13,262 and 6,790 matched references, respectively. The employment rate was 11% when initiating dialysis compared to 61% for the reference group. Kidney transplantation patients had an employment rate of 20% compared to 67% for the reference group. At all time points (3 years before, 1 year before, at the time of intervention, 1 year after, and 3 years after) both dialysis and kidney transplant patients had lower employment rates compared to references (P < 0.001). There was only a partial return to work after transplantation. Employment rates increased in ESKD patients in the period 2005-2019, however, the increase was not different from corresponding reference groups.</p><p><strong>Conclusions: </strong>Employment rates in ESKD patients are very low and decline long before initiation of dialysis or kidney transplantation. Of concern, kidney transplantation only leads to a small increase in employment. There has been no improvement in the employment of ESKD patients from the period 2005-2009 to 2015-2019.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"48"},"PeriodicalIF":2.2,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11783836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing individual glomerular filtration rate assessment: can we trust the equation? Development and validation of machine learning models to assess the trustworthiness of estimated GFR compared to measured GFR.","authors":"Antoine Lanot, Anna Akesson, Felipe Kenji Nakano, Celine Vens, Jonas Björk, Ulf Nyman, Anders Grubb, Per-Ola Sundin, Björn O Eriksen, Toralf Melsom, Andrew D Rule, Ulla Berg, Karin Littmann, Kajsa Åsling-Monemi, Magnus Hansson, Anders Larsson, Marie Courbebaisse, Laurence Dubourg, Lionel Couzi, Francois Gaillard, Cyril Garrouste, Lola Jacquemont, Nassim Kamar, Christophe Legendre, Lionel Rostaing, Natalie Ebert, Elke Schaeffner, Arend Bökenkamp, Christophe Mariat, Hans Pottel, Pierre Delanaye","doi":"10.1186/s12882-025-03972-0","DOIUrl":"10.1186/s12882-025-03972-0","url":null,"abstract":"<p><strong>Background: </strong>Creatinine-based estimated glomerular filtration rate (eGFR) equations are widely used in clinical practice but exhibit inherent limitations. On the other side, measuring GFR is time consuming and not available in routine clinical practice. We developed and validated machine learning models to assess the trustworthiness (i.e. the ability of equations to estimate measured GFR (mGFR) within 10%, 20% or 30%) of the European Kidney Function Consortium (EKFC) equation at the individual level.</p><p><strong>Methods: </strong>This observational study used data from European and US cohorts, comprising 22,343 participants of all ages with available mGFR results. Four machine learning and two traditional logistic regression models were trained on a cohort of 9,202 participants to predict the likelihood of the EKFC creatinine-derived eGFR falling within 30% (p30), 20% (p20) or 10% (p10) of the mGFR value. The algorithms were internally and then externally validated on cohorts of respectively 3,034 and 10,107 participants. The predictors included in the models were creatinine, age, sex, height, weight, and EKFC.</p><p><strong>Results: </strong>The random forest model was the most robust model. In the external validation cohort, the model achieved an area under the curve of 0.675 (95%CI 0.660;0.690) and an accuracy of 0.716 (95%CI 0.707;0.725) for the P30 criterion. Sensitivity was 0.756 (95%CI 0.747;0.765) and specificity was 0.485 (95%CI 0.460; 0.511) at the 80% probability level that EKFC falls within 30% of mGFR. At the population level, the PPV of this machine learning model was 89.5%, higher than the EKFC P30 of 85.2%. A free web-application was developed to allow the physician to assess the trustworthiness of EKFC at the individual level.</p><p><strong>Conclusions: </strong>A strategy using machine learning model marginally improves the trustworthiness of GFR estimation at the population level. An additional value of this approach lies in its ability to provide assessments at the individual level.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"47"},"PeriodicalIF":2.2,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11780799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An autopsy case with tubular obstruction by impacted swollen blebs due to ischemic acute kidney injury.","authors":"Yukako Akiyama, Mitsuhiro Sato, Yoshio Taguma","doi":"10.1186/s12882-025-03949-z","DOIUrl":"10.1186/s12882-025-03949-z","url":null,"abstract":"<p><strong>Background: </strong>Oliguric acute kidney injury (AKI) is one of the critical conditions which needs emergent treatment due to the lack of the capacity of excreting toxins and fluids, and plasma membrane bleb formation is considered as one of the characteristic morphologic alterations in ischemic AKI in both animal models and human. We present here an autopsy case with clear electron microscopy images capturing a definitive instance of blebbing in ischemic AKI.</p><p><strong>Case presentation: </strong>A 66-year-old man was admitted for oliguric AKI with nephrotic syndrome (NS). Because of the existence of hematuria with red blood cell casts and rapid deterioration of renal function and severe systemic symptoms such as loss of appetite and general fatigue, we started immunosuppressive therapy with steroids, considering a vasculitis-like condition with NS, and hemodialysis was also started for oliguria. However, he suddenly died of hemorrhagic shock due to gastric ulcer. Histological findings of the kidney by autopsy showed segmental sclerosis and acute tubular necrosis (ATN) in paraffin sections, which suggests that this is the case with ATN showing oliguric AKI as a clinical presentation. Interestingly, in electron microscopical study, not only apical membrane blebbing but also numerous cytoplasmic bodies were observed in proximal tubules (PT), and this bleb formation was also observed as foamy blebs in the Toluidine blue stained Epon section, where it appeared to fill the tubular lumen.</p><p><strong>Conclusion: </strong>Our distinct finding of bleb formation with tubular obstruction strongly indicates that blebbing could be related to the mechanism of oliguric AKI in human, which supports the tubular obstruction theory as a contributing factor to the pathogenesis of ischemic AKI.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"44"},"PeriodicalIF":2.2,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11776321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of estimated glomerular filtration rate (eGFR) on in-hospital mortality: an age- and HIV status-specific retrospective cohort study in Uganda.","authors":"Odong Christopher, Wang Yanmei, Makabayi Emmanuel Yeko, Doreen Mary Nanyunja, Kuule Julius Kabbali","doi":"10.1186/s12882-025-03976-w","DOIUrl":"10.1186/s12882-025-03976-w","url":null,"abstract":"<p><strong>Background: </strong>Limited studies have explored the relationship between estimated Glomerular Filtration Rate(eGFR) and in-hospital mortality(IHM) in low-income sub-Saharan African countries. This study aimed to explores this association, offering insights into its impact in resource-limited settings.</p><p><strong>Methods and results: </strong>We retrospectively included 226 patients(age 45.35 ± 18.85yrs, 54.4% women) admitted to Naguru-referral hospital between January 1st and June 30th, 2024. Baseline demographics and clinical variables, including eGFR, were recorded at admission. Patients were followed from date of admission to discharge and primary outcome was IHM. Multivariable Hazard regression analysis assessed the association between eGFR and IHM, respectively. During follow-up, 45(19.9%) of patients died. Per-standard deviation(SD) increase in eGFR(48.60 mL/min/1.73m²) was associated with Hazard Ratio(HR) of 0.46[95%CI: 0.282-0.759, p = 0.002, β = -0.77] for IHM in fully adjusted models. When stratified by eGFR quartiles, using highest quartile(≥ 120 mL/min/1.73m²) as reference, HR was 1.08[95%CI: 0.276-4.226, p = 0.912, β =  + 0.08] for 99.0-120 mL/min/1.73m²; 4.08[95%CI: 1.284-12.954, p = 0.017, β =  + 1.41] for 66.8-99.0 mL/min/1.73m², and 4.08[95%CI: 1.284-12.954, p = 0.037, β =  + 1.25] for < 66.8 mL/min/1.73m². Among age stratification-subgroups: age < 40yrs: 0.93[95%CI: 0.89-0.97, p < 0.001, β = -0.07]; 40-60yrs: 0.98[95%CI: 0.966-0.999, p = 0.039, β = -0.02]; ≥ 60yrs, p < 0.005 with p-value_-interaction for age = 0.046; and HIV-positive: 0.94[95%CI: 0.905-0.974, p < 0.001, β = -0.06] with p-value_-interaction = 0.021. Significant Pearsons-correlation(r) was observed only in: [< 40yrs, HIV(-)] with p = 0.016, r = -0.275; [40-60yrs, HIV( +)] with p = 0.020, r = -0.397; and [≥ 60yrs,HIV( +)] with p = 0.003, r = -0.997.</p><p><strong>Conclusions: </strong>We report that eGFR was associated with in-hospital mortality, with a stronger association observed in HIV-negative patients(< 40yrs) and HIV-positive patients (aged ≥ 60yrs yrs). Further research is warranted to validate these findings.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"43"},"PeriodicalIF":2.2,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11776265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Facilitating active participation in anticoagulant decisions in advanced kidney disease: co-production of a question prompt list.","authors":"Kathrine Parker, Abigail Needham, Jecko Thachil, Sandip Mitra, Penny Lewis","doi":"10.1186/s12882-025-03966-y","DOIUrl":"10.1186/s12882-025-03966-y","url":null,"abstract":"<p><strong>Background: </strong>People with chronic kidney disease are at increased risk of thrombotic and bleeding episodes making anticoagulant treatment decisions challenging. Currently, there are no support tools for people with chronic kidney disease regarding anticoagulant therapy decisions. This work aimed to co-produce materials to support shared-decision making when considering anticoagulant use in advanced chronic kidney disease.</p><p><strong>Methods: </strong>Focus groups were undertaken to explore the views of people with kidney disease towards anticoagulant prescribing. Data was thematically analysed based on Makoul and Clayman's model of shared-decision making. Co-production methods were used to develop a question prompt list based on themes from the focus groups in conjunction with people with kidney disease over three meetings.</p><p><strong>Results: </strong>A question prompt list, to be used by patients when initiated on anticoagulant therapy, was co-produced. These questions were based upon participants' experiences of the various stages of shared-decision making within the context of anticoagulant use in advanced chronic kidney disease. Of particular importance to participants was the individualised discussion around treatment risks and follow up arrangements.</p><p><strong>Conclusion: </strong>Shared-decision making is important when initiating medication to ensure the best outcomes for patients, yet it can be difficult to engage in shared-decision making without prompts or guidance. This co-produced question prompt list could be included as part of national guideline to support shared-decision making for anticoagulant initiation in patients with advanced chronic kidney disease.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"42"},"PeriodicalIF":2.2,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11773976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The incidence of inflow and drain pain and associated risk factors for patients on peritoneal dialysis.","authors":"Shun Hua, Peiyi Cao, Guanji Zhang, Guanglan Li, Simin Jiang, Yiping Xu, Jianbo Li, Jianwen Yu, Naya Huang, Jianxiong Lin, Xiao Yang, Wei Chen, Haiping Mao, Zhong Zhong","doi":"10.1186/s12882-025-03962-2","DOIUrl":"10.1186/s12882-025-03962-2","url":null,"abstract":"<p><strong>Background: </strong>The high prevalence and prolonged duration of inflow pain and drain pain experienced by peritoneal dialysis (PD) patients following PD catheter implantation impact their quality of life. However, there is limited data on the frequency and predisposing factors of these pains in the Chinese population undergoing peritoneal dialysis.</p><p><strong>Methods: </strong>This study encompassed individuals who underwent peritoneal dialysis catheter implantation at our institution from September 1, 2023, to March 31, 2024. Patients' experiences of inflow pain and drain pain were evaluated using a questionnaire survey and the visual analog scale (VAS), with pain status followed up via telephone for 3 months post-surgery.</p><p><strong>Results: </strong>A total of 141 patients were included in this study. Inflow pain occurred at rates of 56.0%, 20.9%, 16.9%, and 17.3% at 1-week, 1-month, 2-month, and 3-month postoperatively, respectively, while drain pain rates were 51.8%, 24.3%, 22.3%, and 19.5% for the same period. Slowing down the infusion rate of dialysate (57.0%) or stopping its drainage (60.3%) proved effective in reducing pain. Logistic regression analysis revealed that age (OR = 0.96, P = 0.02), gender (OR = 0.37, P = 0.03), and the method of PD catheter implantation (OR = 2.37, P = 0.04) were independent factors associated with inflow or drain pain within 1-week postoperatively.</p><p><strong>Conclusion: </strong>The occurrence of inflow pain and drain pain following peritoneal dialysis catheter implantation is notable. Age, gender, and the method of catheter implantation were identified as independent factors influencing the incidence of inflow or drain pain within the first postoperative week.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"41"},"PeriodicalIF":2.2,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11762884/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143036757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}