BMC Nephrology最新文献

{"title":"Retrospective comparison of left ventricular systolic dysfunction assessed by left ventricular global longitudinal strain in hemodialysis patients with preserved left ventricular ejection fraction and patients with hypertensive left ventricular hypertrophy.","authors":"Michiya Ohno, Tomonori Segawa, Tetsuo Noda, Yoshinari Yasuda, Junichiro Yamamoto","doi":"10.1186/s12882-025-04368-w","DOIUrl":"https://doi.org/10.1186/s12882-025-04368-w","url":null,"abstract":"<p><strong>Background: </strong>Multiple factors, including hypertension, affect left ventricular remodeling in hemodialysis (HD) patients. Therefore, this retrospective study used left ventricular global longitudinal strain (GLS), an excellent method for detecting mild left ventricular systolic dysfunction, to compare left ventricular systolic function in HD patients with preserved left ventricular ejection fraction (LVEF) and patients with hypertensive left ventricular hypertrophy (HLVH).</p><p><strong>Methods: </strong>Participants were aged 60 years or older and had an LVEF of 60% or higher. We compared 20 HD patients (HD group) with 20 HLVH patients matched for age and sex (HLVH group) and 20 healthy control individuals (C group). GLS decline was defined as a GLS value greater than the GLS reference value, which was the mean value of + 2×standard deviation in the C group.</p><p><strong>Results: </strong>LVEF was not significantly different between the 3 groups, but GLS was significantly worse in the HD group (-15.8%±1.4%) than in the C group (-19.3%±1.1%, p < 0.01) and HLVH group (-17.0%±1.4%, p < 0.05). Relative wall thickness (RWT) and left ventricular mass index (LVMI) were significantly higher in the HLVH and HD groups than in the C group (p < 0.01), and hemoglobin (Hb) levels were significantly lower in the HD group than in the C and HLVH groups (p < 0.01). The frequency of GLS decline (i.e., GLS > -17.0%) was significantly higher in the HD group than in the HLVH group (p < 0.01). Multiple regression analysis of the 3 groups showed that increased RWT and LVMI and decreased Hb were significantly associated with GLS decline (p < 0.01).</p><p><strong>Conclusions: </strong>HD patients with preserved LVEF have a significantly greater decline in GLS than HLVH patients. Increased RWT and LVMI with renal anemia may contribute to GLS decline in HD patients with LVEF.</p><p><strong>Clinical trial number: </strong>2023-01-02.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"425"},"PeriodicalIF":2.4,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144759080","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":"Epidemiology, clinical features and outcomes of patients with kidney biopsy proven IgA vasculitis in Auckland and Northland, Aotearoa, New Zealand presenting between 2003-2020.","authors":"Janak Rashme de Zoysa, Zhenqiang Wu","doi":"10.1186/s12882-025-04362-2","DOIUrl":"https://doi.org/10.1186/s12882-025-04362-2","url":null,"abstract":"<p><strong>Aims: </strong>Immunoglobulin A vasculitis is a small vessel vasculitis. Here we describe the epidemiology, clinical features, treatment and outcomes in patients, over the age of 16 years, with kidney biopsy proven cases seen in two regions of Aotearoa, New Zealand over an 18-year period.</p><p><strong>Methods: </strong>Potential cases were identified, in patients over the age of 16 years, who underwent kidney biopsy between 2003 and 2020. A retrospective review of all potential cases was performed.</p><p><strong>Results: </strong>Thirty-four patients were identified, 10 females and 24 males, of whom 15 were European, 5 Māori, 7 Pacific Peoples, and 7 Asians. The incidence was 1.16 per 1,000,000 patient-years (95% CI: 0.82-1.61), there was an excess in males (RR = 2.42 95% CI 1.16-5.06, p = 0.016) with no excess by ethnicity. Mean age at presentation was 42.8 years (range 16.4-70.5). Mean creatinine at presentation was 118µmol/L (range 51-410). Twenty-six patents received corticosteroids, with two patients also receiving cyclophosphamide and five patients receiving azathioprine. Six patients (17.6%) needed long-term kidney replacement therapy, 12 were left with significant chronic kidney disease (35.3%) and 4 died (11.8%) at the end of study follow up. Elevated serum creatinine at presentation was predictive of need for kidney replacement therapy. Age was predictive of mortality.</p><p><strong>Conclusions: </strong>Immunoglobulin A vasculitis is not overrepresented among indigenous people in Aotearoa New Zealand. The majority of patients receive immunosuppression, however, were left with significant kidney disease.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"426"},"PeriodicalIF":2.4,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144759079","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":"Epidemiology and economic burden of end-stage kidney disease by age, gender, and province among Iranian Hajj pilgrims in 2012-22: a retrospective study of 469,581 participants.","authors":"Pirhossein Kolivand, Samad Azari, Hossein Saffari, Taher Doroudi, Ali Marashi, Masoud Behzadifar, Fereshte Karimi, Soheila Rajaie, Behzad Raei, Seyed Jafar Ehsanzadeh, Arash Parvari, Majid Keyvan Khesal, Peyman Saberian","doi":"10.1186/s12882-025-04248-3","DOIUrl":"https://doi.org/10.1186/s12882-025-04248-3","url":null,"abstract":"<p><strong>Introduction: </strong>Annually, over 3.5 million Hajj pilgrims from approximately 180 countries worldwide travel to Mecca for Hajj rituals. End-stage kidney disease (ESKD) is a high-morbidity condition that necessitates high-cost and time-intensive care, the present study aims to investigate the prevalence and economic burden of ESKD among Iranian Hajj pilgrims during the last decade.</p><p><strong>Methods: </strong>All demographic information, risk factors, prevalence and Hospital costs of ESKD were extracted from the database and medical records of the Hajj Pilgrimage Medical Centre, Iranian Red Crescent Society through file reading. Also, the multiple logistic regression model was used.</p><p><strong>Results: </strong>In total, the study encompassed data on 469,581 Hajj pilgrims. According to the findings, the highest prevalence of ESKD was observed in pilgrims aged 70 years and above. Results show that for the gender variable, the odds of having ESKD among women is 0.523 times that of men, for the creatinine (Cr), for each unit increase in the level of blood creatinine, the odds of having ESKD will be 1.383 times, Additionally, in pilgrims with diabetes (1) and hypertension (HTN), the odds of ESKD are 2.33 and 3.345 times, respectively. Results show that the mean total hospital costs are $4178.4.</p><p><strong>Conclusion: </strong>The present study shows a significant difference in the prevalence of ESKD in age, gender, and distribution in different provinces. To reduce the mortality and morbidity of ESKD patients, appropriate medication prescriptions, on-time dialysis, lifestyle modifications, and the reduction of disease complications through consultation with a nephrologist are essential during Hajj.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"424"},"PeriodicalIF":2.4,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144752339","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":"Dioscin regulates oxidative stress and autophagy in uric acid-induced HK-2 cells through the P62-KEAP1-NRF2 signaling pathway.","authors":"Jiashu Feng, Weiliang Zhang, Ruiqi Liu, Ting Xiang, Xinlin Wu","doi":"10.1186/s12882-025-04311-z","DOIUrl":"10.1186/s12882-025-04311-z","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to explore the therapeutic effects and mechanisms of dioscin on the UA-induced HK-2 cells fibrosis model by modulating oxidative stress and autophagy.</p><p><strong>Methods: </strong>HK-2 cells fibrosis was constructed by UA stimulation. CCK8 was used to assess cell proliferation. Flow cytometry was employed to detect apoptosis. MDC staining was performed to observe the formation of autophagosomes. Western blot was used to evaluate the levels of oxidative stress, autophagy and fibrosis markers. The detection of ROS and Elisa assay were used to analyze the changes of oxidative stress.</p><p><strong>Results: </strong>Dioscin significantly inhibits cell apoptosis. Dioscin increases the expression of LC3, Beclin-1 and NRF2 and decreases the expression of P62 and KEAP1. Furthermore, dioscin inhibits the levels of ROS and MDA, and promotes the levels of SOD and CAT. Moreover, dioscin significantly downregulates the expression of TGF-β, FN, and Collagen I. However, the regulatory effects of dioscin on these indicators are inhibited when NRF2 is knocked down.</p><p><strong>Conclusion: </strong>These results suggest that dioscin treats the UA-induced HK-2 cells fibrosis model by targeting the modulation of NRF2 to regulate oxidative stress and promote protective autophagy. The mechanism may be associated with the restoration of the P62-KEAP1-NRF2 signaling pathway.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"422"},"PeriodicalIF":2.4,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12309051/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144741171","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":"Effects of the pretransplant obesity on kidney transplant outcomes in Korea: a nationwide cohort study.","authors":"Eun-Young Cho, You Hyun Jeon, Kyu Ha Huh, Seun Deuk Hwang, Sangil Min, Jaeseok Yang, Myoung Soo Kim, Yu Jin Seo, Jeong-Hoon Lim, Hee-Yeon Jung, Ji-Young Choi, Sun-Hee Park, Yong-Lim Kim, Jang-Hee Cho, Chan-Duck Kim","doi":"10.1186/s12882-025-04359-x","DOIUrl":"10.1186/s12882-025-04359-x","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of obesity is steadily increasing in patients with end-stage kidney disease. However, it is still debatable whether obesity affects outcomes after kidney transplantation. This study evaluated the relationship between pretransplant obesity, defined as a body mass index (BMI) ≥ 25 kg/m², and posttransplant outcomes in Korean kidney transplant recipients (KTRs).</p><p><strong>Methods: </strong>We investigated prospective nationwide cohort data from the Korean Organ Transplantation Registry (KOTRY) from 2014 to 2021. KTRs were categorized into 4 groups based on pretransplant BMI: underweight (< 18.5), normal weight (18.5-22.9), overweight (23-24.9), and obesity (≥ 25). Posttransplant outcomes, including death-censored allograft loss, cardiovascular events, and all-cause mortality, were compared using Kaplan-Meier curves with the log-rank test. Cox proportional hazard regression analysis was employed to assess associations between BMI and posttransplant outcomes.</p><p><strong>Results: </strong>A total of 9,130 KTRs were finally analyzed. The mean age was 49.9 ± 11.6 and 60.2% of KTRs were male. The prevalence of obesity in KTRs was 28.6% and continued to increase (24.8% in 2014 to 32.5% in 2021). Obese KTRs were characterized by male predominance, shorter dialysis vintage, and more diabetes as primary kidney disease. Kaplan-Meier curve showed a significant difference in death-censored allograft loss among BMI groups (P = 0.007). Obesity (BMI ≥ 25 kg/m²) was as an independent risk factor for death-censored allograft loss (adjusted hazard ratio 1.511, 95% confidence interval 1.063-2.148, P = 0.021), but not for cardiovascular events or mortality.</p><p><strong>Conclusions: </strong>Our study evaluated BMI across a spectrum of categories, suggesting that obesity is an independent risk factor for graft survival in KTRs. Risk stratification using BMI and strategies to prevent obesity should be considered in the preparation for kidney transplantation.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"423"},"PeriodicalIF":2.4,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12309211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144741172","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":"Prognostic value of neutrophil-to-lymphocyte ratio for the clinical outcomes of chronic kidney diseases: an update systematic review and meta-analysis.","authors":"Yangjing Xu, Yongtong Chen, Xiaolu Mai, Min Zhang","doi":"10.1186/s12882-025-04363-1","DOIUrl":"10.1186/s12882-025-04363-1","url":null,"abstract":"<p><strong>Background: </strong>The correlation between the neutrophil-to-lymphocyte ratio (NLR) and clinical outcomes in patients with chronic kidney disease (CKD) remains inconsistent.</p><p><strong>Methods: </strong>PubMed, Embase, Web of Science, and the Cochrane Library were searched for relevant literature through March 8, 2025. All-cause mortality, major adverse cardiovascular events (MACE), cardiovascular death, and progression to end-stage renal disease (ESRD) or dialysis were evaluated. Odds ratios (OR) and 95% confidence intervals (CI) were used for effect estimation.</p><p><strong>Results: </strong>Thirty-six studies involving 26,074 patients were included. Meta-analysis indicated that high NLR was significantly associated with an increased risk of all-cause mortality (OR = 1.22, 95% CI: 1.15-1.29; p < 0.00001), MACE (OR = 1.42, 95% CI: 1.14-1.77; p = 0.002), cardiovascular mortality (OR = 1.21, 95% CI: 1.09-1.35; p = 0.0004), and ESRD (OR = 1.68, 95% CI: 1.17-2.43; p = 0.005). NLR levels were significantly higher in patients who died from all causes (SMD = 0.84, 95% CI: 0.58-1.11; p < 0.00001) and cardiovascular causes (SMD = 1.44, 95% CI: 0.77-2.11; p < 0.0001) compared to survivors. Sensitivity and subgroup analyses affirmed the robustness of the results. All indicators were rated as very low in the GRADE system.</p><p><strong>Conclusion: </strong>NLR is significantly associated with all-cause mortality, MACE, cardiovascular mortality, and adverse renal outcomes in CKD. The results are relatively stable, but due to high heterogeneity and publication bias, its clinical application should be approached with caution. Given the study's limitations, further large-scale prospective studies are required to confirm the association between NLR and CKD prognosis.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"419"},"PeriodicalIF":2.4,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12306010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144727769","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":"Concurrent IgG4-related membranous nephropathy and proliferative diabetic kidney disease: a diagnostic dilemma and therapeutic strategy in long-standing diabetes.","authors":"Yue Yang, Binbin Guo, Xianqiao Li, Shuhua Duan","doi":"10.1186/s12882-025-04366-y","DOIUrl":"10.1186/s12882-025-04366-y","url":null,"abstract":"<p><strong>Background: </strong>IgG4-related kidney disease (IgG4-RKD) overlapping with diabetic nephropathy (DND) poses diagnostic challenges in terms of histopathological mimicry. This report highlights the first case of concurrent IgG4-related membranous nephropathy (IgG4-MN) and proliferative diabetic kidney disease (DKD) in a patient with diabetes, emphasizing the use of multidisciplinary diagnostic approaches. A 74-year-old male with a 24-year history of diabetes presented with nephrotic syndrome (proteinuria: 6.9 g/24 h), hypoalbuminemia (26.6 g/L), and lymphadenopathy. The patient's serum IgG4 levels were markedly elevated (2774.7 mg/L). Renal biopsy revealed IgG4-dominant subepithelial deposits (PLA2R-negative) with diabetic glomerulosclerosis, whereas lymph node histopathology confirmed the diagnosis of IgG4-related disease (IgG4-RD). Despite the absence of classic IgG4 + tubulointerstitial nephritis (TIN), integrative serological (hypergammaglobulinemia, IgE elevation), radiological (lymphadenopathy), and histological evidence confirmed the diagnosis of IgG4-MN. Low-dose prednisone and mycophenolate mofetil achieved partial remission (50% proteinuria reduction) without compromising glycemic control.</p><p><strong>Conclusion: </strong>This case highlights the diagnostic complexity of dual renal pathologies in individuals with diabetes and underscores the necessity of multidisciplinary evaluation to differentiate IgG4-MN from DND or primary membranous nephropathy. Early recognition of IgG4-RKD in patients with diabetes and disproportionate proteinuria or systemic inflammation is critical to guide targeted immunosuppression while mitigating metabolic risk. The favorable outcome in this case emphasizes the efficacy of tailored, low-intensity regimens in comorbid populations.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"421"},"PeriodicalIF":2.4,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12305925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144727767","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":"Management of radioiodine ablation therapy in haemodialysis patients with thyroid cancer: a case series of two patients.","authors":"Raymond Lin, Alessandra L Malaroda, William J Ryder, Veronica C K Wong, Nikki L Wong","doi":"10.1186/s12882-025-04348-0","DOIUrl":"10.1186/s12882-025-04348-0","url":null,"abstract":"<p><strong>Background: </strong>Radioiodine (¹³¹I) therapy in treatment of thyroid cancer, has a biological clearance that is significantly reduced in end-stage kidney disease (ESKD), leading to increased radiation exposure and potential myelotoxicity. For ESKD patients on haemodialysis (HD), there is no standardized approach to ¹³¹I administration and subsequent HD schedule.</p><p><strong>Case presentation: </strong>Two patients with ESKD on HD were treated with ¹³¹I therapy for thyroid cancer. Rationale for treatment and local ¹³¹I treatment protocol modifications are discussed. Modifications were made to existing infrastructure and additional patient and staff safety precautions were undertaken, including serum radioactivity measurements to monitor for myelotoxicity.</p><p><strong>Outcomes: </strong>HD at 24-,72- and 144-hours post-¹³¹I results in a retained radiation activity profile comparable to patients with normal renal function. Radiation dose to bone marrow throughout treatment was assessed at < 0.3 Gy for both patients, within safe limits. The highest contribution of radiation dose to bone marrow (60% and 47% for patient 1 and patient 2 respectively) was due to the radioactivity retained in blood before the first HD session. Cumulative radiation exposure to dialysis staff was well within local safety constraints (300μSv per year) at 7μSv and 23μSv for patient 1 and 2 respectively. At 24 months post-therapy, thyroglobulin levels remained undetectable for both patients.</p><p><strong>Conclusions: </strong>¹³¹I therapy can be safely administered in patients with ESKD on HD with low-risk thyroid cancer through modifications to existing infrastructure and protocols. Serum radioactivity measurements is a simple and minimally invasive method to assess bone marrow safety during treatment. Ongoing pooling of experiences is needed to inform a standardized protocol for therapy in this population.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"420"},"PeriodicalIF":2.4,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12306126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144727768","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":"Association between high-sensitivity C-reactive protein and diabetic nephropathy: a systematic review and meta-analysis.","authors":"Fattaneh Bassami, Maryam Yavari, Awat Feizi, Mansour Siavash, Mojtaba Akbari, Mozhgan Karimifar","doi":"10.1186/s12882-025-04358-y","DOIUrl":"10.1186/s12882-025-04358-y","url":null,"abstract":"<p><strong>Background: </strong>Diabetic nephropathy (DN) is a major complication of diabetes, driven by inflammation and progressive kidney damage. High-sensitivity C-reactive protein (hs-CRP), a marker of systemic inflammation, has been linked to DN progression, but study findings are inconsistent. This systematic review and meta-analysis aimed to evaluate the association between hs-CRP levels and DN risk.</p><p><strong>Methods: </strong>We searched PubMed, Scopus, Web of Science, Cochrane Central Register of Controlled Trials, and Embase from inception to July 22, 2024, for observational studies examining hs-CRP and DN. Although IL-6 and ESR were initially considered for analysis, they were excluded from the meta-analysis due to insufficient data for pooling. Fifteen studies involving 16,324 participants were included. A random-effects model pooled effect sizes, with heterogeneity assessed using the I² statistic and Cochran Q test. Subgroup analyses explored variations by study design and sample size.</p><p><strong>Results: </strong>From 8312 citations, 15 studies met the inclusion criteria, comprising 16,324 participants from diverse geographic locations. Meta-analysis of the 15 studies showed that elevated hs-CRP levels (above vs. below a clinical threshold of 2.5 mg/L) were associated with 65% increased odds of DN (OR = 1.65, 95% CI: 1.36-1.99, P = 0.002), with substantial heterogeneity (I² = 79.4%, P < 0.001).</p><p><strong>Conclusion: </strong>Elevated hs-CRP levels are significantly associated with increased DN risk, supporting its clinical utility for risk stratification in diabetic patients and its relevance for guiding future research into anti-inflammatory therapies. However, high heterogeneity, likely due to differences in study design, population characteristics, and measurement methods, limits the generalizability of these findings. Future research should clarify causal mechanisms and validate hs-CRP's role in clinical decision-making for DN prevention.</p><p><strong>Clinical trial number: </strong>It is not applicable.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"418"},"PeriodicalIF":2.4,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12297661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717482","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 efficiency of blood cell counts and inflammatory indices in prediction of need for acute kidney injury in patients with crush syndrome.","authors":"Zikret Koseoglu, Deniz Gezer, Ahmet Uzan","doi":"10.1186/s12882-025-04318-6","DOIUrl":"10.1186/s12882-025-04318-6","url":null,"abstract":"<p><strong>Background: </strong>Disasters are inevitable causes of trauma, resulting in a high number of deaths and morbidity in survivors requiring prolonged treatment. Crush syndrome (CS), also known as traumatic rhabdomyolysis, is a syndrome with a wide clinical spectrum. A series of clinical complications caused by CS, hyperkalemia, myoglobinuria and especially acute kidney injury (AKI) are the main causes of death.</p><p><strong>Objectives: </strong>This study has been designed to investigate the effectiveness of neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), lymphocyte-monocyte ratio (LMR) and systemic immune-inflammatory index (SIII) in predicting the need for hemodialysis (HD) in patients with CS following rescue from earthquake.</p><p><strong>Methods: </strong>This study was conducted as a single-center retrospective research. which focused on patients with CS among the earthquake victims who were admitted to the hospital after the earthquake centered in Southern Türkiye on February 6, 2023. Demographic, clinical and laboratory data of patients from the earthquake zone were used. T-Test was applied to compare two independent numerical variables. Receiver operating characteristic (ROC) curve analysis was used to assess the predictive capacity of NLR, PLR, LMR and SIII on AKI, HD and mortality (Area Under the Curve (AUC) > 0.600). The level of significance was accepted as p < 0.05.</p><p><strong>Results: </strong>Of the 464 patients included in the study, 45.3% (n = 210) were male and the mean age was 41.2 ± 15.9 years. The most common trauma mechanism was entrapment under debris (46.8%, n = 217). AKI was present in 42% (n = 195) of the cases and 30.1% (n = 140) required HD. The mortality rate was 7.3% (n = 34). The need for HD, hyperbaric therapy and blood replacement was significantly higher in patients who developed AKI (p < 0.001, p = 0.011 and p < 0.001, respectively). The predictive power of NLR on the need for hemodialysis, the development of AKI, and mortality was higher than PLR, LMR and SIII. In the ROC analysis to determine the need for hemodialysis, NLR (AUC = 0.828) was found to be higher in predicting power than PLR (AUC = 0.651), LMR (AUC = 0.787) and SIII (AUC = 0.792).</p><p><strong>Conclusions: </strong>Parameters obtained from blood cell counts such as NLR, PLR, LMR and SIII can be used to predict the severity of AKI and the need for hemodialysis in these patients rescued from earthquake.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"417"},"PeriodicalIF":2.4,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12297812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717484","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}