BMC Nephrology最新文献

{"title":"Association of thrombomodulin with the severity of chronic kidney disease: a cross-sectional study.","authors":"Ming Guo, Shaoyuan Cui, Xiaoxiao Liu, Jingyi Feng, Mengfei Li, Zheyi Dong, Jie Wu, Guangyan Cai, Xiangmei Chen, Qinggang Li","doi":"10.1186/s12882-025-04200-5","DOIUrl":"https://doi.org/10.1186/s12882-025-04200-5","url":null,"abstract":"<p><strong>Background: </strong>Inflammatory disorders and endothelial dysfunction are prevalent in patients with chronic kidney disease (CKD). Thrombomodulin (TM) possesses both anticoagulant and anti-inflammatory properties. This study aimed to investigate the association between TM levels and the severity of CKD.</p><p><strong>Methods: </strong>This cross-sectional study included two cohorts of patients with CKD from the General Hospital of the Chinese People's Liberation Army. Patients with CKD were categorized into high and low TM groups based on the upper plasma TM reference value. The laboratory indices of patients were compared. Simultaneously, a correlation analysis was performed to identify the association between the TM and each parameter. Patients were categorized into two groups based on eGFR: preserved renal function (eGFR ≥ 60 mL/min/1.73 m²) and significantly impaired renal function (eGFR < 60 mL/min/1.73 m²). Logistic regression analysis and receiver operating characteristic (ROC) curves were used for analysis.</p><p><strong>Results: </strong>A total of 33 patients with CKD were included in the discovery cohort, and 150 were included in the validation cohort. In the discovery cohort, creatinine (P = 0.0028) and urea nitrogen (P = 0.0011) were significantly higher in the high TM group compared to the low TM group, whereas eGFR (P = 0.0005) was lower. In the validation cohort, high TM group exhibited significantly higher creatinine (P < 0.001), urea nitrogen (P < 0.001), and 24-hour proteinuria levels (P < 0.001) compared to the low TM group, while eGFR (P < 0.001) was lower. Merging the discovery and validation cohorts revealed significant positive correlations between TM and IL-2, TNF-α, vWF (Act), vWF (Ag), serum creatinine, urea nitrogen, and 24-hour proteinuria, while eGFR was negatively correlated with TM (P < 0.001). After adjusting for confounders, TM (adjusted odds ratio = 1.31; 95% CI: 1.10-1.57; P = 0.003) was independently and significantly correlated with CKD severity. Using a TM threshold of > 14.55 TU/ml derived from ROC analysis for severity stratification, the AUC was 0.7739 (95% CI: 0.71-0.84) in differentiating CKD severity stages.</p><p><strong>Conclusion: </strong>Serum TM levels demonstrated a significant correlation with CKD severity, suggesting its potential as a biomarker with clinical utility for CKD staging.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"268"},"PeriodicalIF":2.2,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186548","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":"Effect of serum magnesium level on carotid intima media thickness in hemodialysis patients.","authors":"Ali Veysel Kara, Ridvan Ozdemir, Hamza Inan, Beyza Ozerten Ozdemir, Serhat Hayme, Muharrem Said Cosgun","doi":"10.1186/s12882-025-04168-2","DOIUrl":"https://doi.org/10.1186/s12882-025-04168-2","url":null,"abstract":"<p><strong>Background: </strong>We aimed to examine whether serum magnesium level is related to cardiovascular events in hemodialysis patients by investigating the relationship between serum magnesium (Mg) level and carotid intima media thickness (CIMT).</p><p><strong>Methods: </strong>In this cross-sectional study, we evaluated 88 hemodialysis patients. The mean CIMT of these patients was measured and recorded by doppler ultrasonography. Patients were divided into two groups according to their serum magnesium level. Correlation analysis and linear regression analysis were used to define the relationship between study parameters. We divided our patients into 2 groups according to Mg value as group 1 (Mg ≥ 2.3 mg/dl) and group 2 (Mg < 2.3 mg/dl).</p><p><strong>Results: </strong>The mean CIMT of patients with group 1 and group 2 were respectively 0.93 ± 0.22 mm and 1.03 ± 0.22 mm. There was statistically significant difference between two groups in terms of the mean CIMT value (p = 0.045). We found negative, low-level, statistically significant correlations between Mg and mean CIMT ​​(r=-0.272; p = 0.010), calcium and mean CIMT (r: -0.221, p: 0.039) and hemoglobin and mean CIMT (r: -0.215, p: 0.044). According to regression analysis, serum magnesium level and age were found independent risk factors for mean CIMT value (p: 0.004 and p: 0.045).</p><p><strong>Conclusions: </strong>We found a significant relationship between serum Mg level and CIMT, which indicates carotid atherosclerosis.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"270"},"PeriodicalIF":2.2,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186549","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":"Valacyclovir-induced neurotoxicity and nephrotoxicity in an elderly patient with a history of nephrectomy: a case report.","authors":"Sondos Badran, Sylvia Li, Sabrina Nguyen, Johnny S Randhawa, Abdulrahman Badran, Farbod Farmand","doi":"10.1186/s12882-025-03941-7","DOIUrl":"https://doi.org/10.1186/s12882-025-03941-7","url":null,"abstract":"<p><strong>Background: </strong>Valacyclovir is a prodrug of acyclovir, both of which are commonly used in the treatment of varicella zoster and herpes simplex viruses. Its mechanism as a guanosine analog antiviral inhibits DNA polymerase via chain termination. It has selective action in infected cells with minimal effect on host cells, lending to fewer side effects, and is a well-tolerated medication often chosen for its better oral bioavailability over acyclovir. Its side effect profile includes thrombotic thrombocytopenic purpura (TTP), gastrointestinal symptoms such as nausea, and increased transaminases. Common adverse effects include headache, nausea, and vomiting. A rare adverse effect of valacyclovir is acute kidney injury (AKI) due to obstructive crystal-induced nephropathy, tubular dysfunction, or tubulointerstitial nephritis. To date, no case report has cited normal dosing of valacyclovir causing acute kidney injury in a patient status post nephrectomy.</p><p><strong>Case present: </strong>We present a 71-year-old female with history of chronic kidney disease (CKD), left nephrectomy due to renal agenesis and nephrolithiasis, type 2 diabetes mellitus, hypertension, and hyperlipidemia who presented to the emergency department due to visual and auditory hallucinations after taking two days of valacyclovir for shingles. Laboratory work demonstrates elevated creatinine at 6.19 mg/dL. Patient was monitored throughout hospitalization with cessation of valacyclovir. Patient's creatinine down-trended.</p><p><strong>Conclusion: </strong>This case report demonstrates a rare case of acute kidney injury due to an exaggerated response to valacyclovir-induced crystal nephropathy, presenting in tandem with valacyclovir-induced neurotoxicity, which has only been described in three case reports. This case highlights the importance of careful history and physical exam to facilitate a more accurate and timely diagnosis, especially in patients with a history of nephrectomy.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"269"},"PeriodicalIF":2.2,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186550","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":"Correlation between vascular access satisfaction and demoralization syndrome in elderly patients with maintenance hemodialysis: a multi-center study.","authors":"Xiangying Lv, Hong Zhang, Lan Yang, Xinmei Xing, Yao Huang","doi":"10.1186/s12882-025-04191-3","DOIUrl":"10.1186/s12882-025-04191-3","url":null,"abstract":"<p><strong>Objective: </strong>This multi-center study aimed to investigate the correlation between vascular access satisfaction (VAS) and demoralization syndrome (DS) in elderly patients undergoing maintenance hemodialysis (MHD). Secondary objectives included identifying predictors of VAS and comparing DS severity between patients with high and low VAS scores.</p><p><strong>Methods: </strong>A retrospective analysis was conducted from April 2024 to October 2024, involving 350 elderly MHD patients from three tertiary hospitals in China. Participants were stratified into two groups based on VAS scores: the VA dissatisfaction group (n = 220) and the VA satisfaction group (n = 130). Data collection utilized the Short Form Vascular Access Questionnaire (VAQ) and the Chinese Version of the Demoralization Syndrome Scale. Binary logistic regression and independent t-tests were employed to analyze predictors of VAS and DS scores.</p><p><strong>Results: </strong>Significant differences in VAS scores were observed between the dissatisfaction and satisfaction groups (p < 0.001). Multivariate analysis identified living alone (OR = 2.1, 95% CI 1.4-3.2), prolonged dialysis duration (OR = 1.8, 95% CI 1.2-2.7), and elevated parathyroid hormone (PTH) levels (OR = 1.5, 95% CI 1.1-2.0) as independent risk factors for VAS, while higher hemoglobin levels (OR = 0.6, 95% CI 0.4-0.9) served as a protective factor. Notably, the dissatisfaction group exhibited markedly higher DS scores (73.6 ± 8.7 vs. 51.2 ± 6.9, p < 0.01), indicating a strong association between VAS and psychological distress.</p><p><strong>Conclusion: </strong>This study underscores a robust correlation between VAS and DS in elderly MHD patients. Interventions targeting social support optimization, anemia management, and mineral metabolism regulation may improve vascular access outcomes and mitigate demoralization, thereby enhancing quality of life.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"265"},"PeriodicalIF":2.2,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12121221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172747","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":"Prevalence and influencing factors of pruritus in maintenance hemodialysis patients in China: a meta-analysis.","authors":"Mengjiao Li, Ping Jiang, Xujie Zhao, Yuping Ning, Liwen Huang","doi":"10.1186/s12882-025-04163-7","DOIUrl":"https://doi.org/10.1186/s12882-025-04163-7","url":null,"abstract":"<p><strong>Objective: </strong>To explore the prevalence and influencing factors of Chronic Kidney Disease-associated Pruritus (CKD-aP) among maintenance hemodialysis (MHD) patients in China through a meta-analysis.</p><p><strong>Methods: </strong>A systematic computerized search was conducted across ten databases, including CNKI, VIP, Wanfang, PubMed, Web of Science, and The Cochrane Library, to identify studies on the prevalence and influencing factors of pruritus among Chinese hemodialysis patients up to January 2025. Two independent graduate students conducted literature screening, data extraction, and bias risk assessment for the included studies. Data analysis was performed using Stata 17.0 software.</p><p><strong>Results: </strong>A comprehensive meta-analysis of 27 studies involving 10,346 participants identified 5,968 cases of CKD-ap among hemodialysis patients, examining 30 potential influencing factors. The meta-analysis revealed that the prevalence of CKD-ap in China was 52%, with 26% of patients experiencing mild CKD-ap, 22% moderate CKD-ap, and 8% severe CKD-ap. Factors associated with an increased risk of CKD-ap included duration of dialysis treatment (OR = 1.51, 95% CI: 1.15-1.88), primary disease (OR = 1.43, 95% CI: 0.87-1.99), dry skin disease (OR = 2.46, 95% CI: 1.74-3.19), phosphorus (OR = 1.18, 95% CI: 0.55-1.81), Ca - P product (OR = 2.18, 95% CI: 1.14-3.22), C - reactive protein (CRP) (OR = 1.14, 95% CI: 0.78-1.51), iPTH (OR = 2.45, 95% CI: 0.81-4.09), β₂ - MG(OR = 2.24, 95% CI: 0.94-3.53), and SCr (OR = 1, 95% CI: 1.001-1.005). Conversely, factors including blood calcium levels (OR = 0.33, 95% CI: 0.31-0.35), dialysis modality (OR = 0.54, 95% CI: 0.23-0.85), and Kt/V (OR = 0.60, 95% CI: 0.24-0.96) were associated with a reduced risk of CKD-ap.</p><p><strong>Conclusion: </strong>This meta-analysis demonstrates a high prevalence of CKD-ap among Chinese MHD patients, underscoring the urgent need for improved awareness, preventive interventions, and management strategies in clinical practice.</p><p><strong>Clinical trial number: </strong>Not applicable.</p><p><strong>Trial number: </strong>The study was registered in PROSPERO: No. CRD42024562865.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"266"},"PeriodicalIF":2.2,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144179702","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":"Explore the effect of HIF-PHI on blood pressure variation rate and anemia efficacy in maintenance hemodialysis patients.","authors":"Yu-Ting Yang, Yu Wang, Yuan Qi, Zhi-Hui Fu, Yan-Ping Hu, Jun-Hui Wan, Xin-Tian Shi, Jia-Yan Huang, Hong He, Qin-Kai Chen, Qing Zhao","doi":"10.1186/s12882-024-03928-w","DOIUrl":"https://doi.org/10.1186/s12882-024-03928-w","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to investigate the impact of hypoxia-inducing factor prolyl hydroxylase inhibitor (HIF-PHI), specifically Roxadustat, on blood pressure variability, blood pressure indices, hemoglobin, and other biochemical markers in maintenance hemodialysis (MHD) patients.</p><p><strong>Methods: </strong>In this retrospective, self-controlled study, regular hemodialysis and consistent use of Roxadustat for at least six months were conducted at the Hemodialysis Unit of the First Affiliated Hospital of Nanchang University between June 2019 and November 2022. The study involved MHD patients who had been using erythropoiesis-stimulating agents (ESAs) for at least six months prior to transitioning to Roxadustat. Blood pressure, routine blood data, biochemical parameters, and clinical data were collected before, during, and after dialysis over a 12-month period. Statistical comparisons were made of systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and true variability in SBP (SBP-ARV), DBP (DBP-ARV), and MAP (MAP-ARV) in the patients before and after the transition to Roxadustat. Hemoglobin levels and daily antihypertensive drug dosage (DDD) were also analyzed.</p><p><strong>Results: </strong>A total of 54 MHD patients (32 males and 22 females) were included in the study. Primary diagnoses included chronic nephritis, hypertensive nephropathy, diabetic nephropathy, obstructive nephropathy, polycystic kidney disease, nephrotic syndrome, scleroderma-related kidney injury, and cases of unknown etiology. Repeated measures variance analysis indicated that blood pressure fluctuations during Roxadustat treatment were significantly smaller than during ESA treatment. Statistically significant differences were observed in SBP, DBP, and MAP before and after dialysis (P-values: 0.046, < 0.001, 0.028, and 0.014, respectively). Paired t-tests revealed a significant reduction in SBP-ARV and MAP-ARV before and during dialysis in the Roxadustat group (P = 0.0018, 0.008, and 0.006). Hemoglobin, erythrocyte count, and serum calcium were significantly higher in the Roxadustat group compared to ESA treatment (P = 0.013, 0.012, and 0.003, respectively). In the high SBP variability group, a higher proportion of males, increased hospitalization rates, older age, and a higher prevalence of diabetes were observed.</p><p><strong>Conclusion: </strong>MHD patients treated with Roxadustat experienced fewer fluctuations in blood pressure compared to those treated with rHuEPO, and Roxadustat was more effective at increasing hemoglobin levels without compromising efficacy relative to ESAs.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"267"},"PeriodicalIF":2.2,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180640","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":"Peritoneal dialysis-associated peritonitis caused by acremonium sclerotigenum: a case report.","authors":"Ju Wang, Yamei Cheng, Qiqi Yan, Dandan Li, Ruifeng Wang, Guiling Liu","doi":"10.1186/s12882-024-03884-5","DOIUrl":"10.1186/s12882-024-03884-5","url":null,"abstract":"<p><strong>Background: </strong>Acremonium sclerotigenum exhibits antagonistic properties against various detrimental organisms, including bacteria, nematodes, and mites. As the predominant species within the Acremonium genus, it is characterized as an opportunistic pathogenic fungus that commonly inhabits soil and plants as a saprotroph. Additionally, it has been identified as the etiological agent of superficial infections, such as onychomycosis, and, less frequently, invasive infections.</p><p><strong>Case presentation: </strong>This study presents a unique case involving a 79-year-old male who developed peritoneal dialysis-associated peritonitis (PDAP) attributed to Acremonium sclerotigenum. To the best of our knowledge, this represents the first documented instance of PDAP caused by this fungal species.</p><p><strong>Conclusion: </strong>The identification of pathogens is essential for diagnosing PDAP.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"264"},"PeriodicalIF":2.2,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12121040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172749","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":"Pregnancy in chronic hemodialysis in a resource-limited country: case report and literature review.","authors":"Aboubacar Sidiki Fofana, Magara Samaké, Seydou Sy, Sitapha Dembélé, Ousmane Massa Sissoko, Niagalé Diakité, Sah Dit Baba Coulibaly, Pinda Tounkara, Moctar Coulibaly, Singadou Ousmane Youssouf Djiguiba, Hamadoun Yattara, Saharé Fongoro","doi":"10.1186/s12882-025-04202-3","DOIUrl":"10.1186/s12882-025-04202-3","url":null,"abstract":"<p><strong>Background: </strong>Conception in hemodialysis is a rare event with an incidence of 0.5-1.4% of women of childbearing age, and associated with a high maternal-fetal risk. We report a case of full-term pregnancy with live child that occurred in our hemodialysis center at Kayes Hospital in Mali.</p><p><strong>Case presentation: </strong>The patient was 38 years old and had been on chronic hemodialysis for 4 years for hypertensive nephropathy. She was dialyzed twice a week for 8 h. We discovered a pregnancy of 17 weeks' amenorrhea (WA) in a context of acute pelvic pain. Hemodialysis was immediately intensified to 3 times/week for 4 h 30 min until 32 weeks' amenorrhea, then 4 times/week for 4 h 30 min until term. Thanks to blood pressure control, dry weight control and hemoglobin control at around 12 g/dl on erythropoietin, the pregnancy was carried to 36 SA + 6 days, with vaginal delivery resulting in a live infant weighing 2800 g. The newborn's renal function at 24 and 48 h was normal, with a mean hemoglobin level of 17 g/dl.</p><p><strong>Conclusion: </strong>Pregnancy in chronic hemodialysis is a very high-risk maternal and fetal condition. This first observation in Mali shows that procreation is possible for hemodialysis recipients despite limited resources. Multidisciplinary management, combined with blood pressure control, intensification of hemodialysis and correction of anemia, guarantee the best results.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"262"},"PeriodicalIF":2.2,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12117694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172751","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":"A qualitative study on the perceived barriers to accessing haemodialysis for patients with kidney failure (KF) in Northern Ghana: perspectives of healthcare providers.","authors":"Aduni Amina Iddrisu, Edward Appiah Boateng","doi":"10.1186/s12882-025-04190-4","DOIUrl":"10.1186/s12882-025-04190-4","url":null,"abstract":"<p><strong>Background: </strong>Managing kidney failure (KF) often necessitates dialysis. In Ghana, there are considerable challenges in providing dialysis services due to limited and unevenly distributed resources. This study explored healthcare providers' perspectives on the challenges of caring for patients with KF in northern Ghana.</p><p><strong>Method: </strong>This study was conducted in three major hospitals in northern Ghana. A qualitative research approach was used to explore the experiences of healthcare providers. The participants were selected using purposive sampling, and the interviews were conducted via telephone.</p><p><strong>Results: </strong>Access to dialysis in northern Ghana faces multiple challenges. These include a shortage of nephrology specialists, limited dialysis centers, the high cost of dialysis, and the geographical location of treatment centers. Additionally, healthcare providers experience emotional and psychological stress due to their inability to deliver adequate care under such constraints.</p><p><strong>Conclusion: </strong>Policy reforms are needed to ensure equitable access to dialysis services across all regions. Recommendations include increasing dialysis centers, expanding the health care workforce, particularly nephrologists and dialysis nurses, and integrating dialysis services into national health insurance coverage. Policymakers should address these gaps, strengthen healthcare delivery, and improve outcomes for patients with kidney failure in northern Ghana.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"263"},"PeriodicalIF":2.2,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12117837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172745","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":"Circulating RIPK3 level predicts all-cause mortality in patients on maintenance hemodialysis: a 4-year prospective cohort study.","authors":"Min Wu, Qian Sun, Kai-Di Zhang, Qing Wei, Wei Sun, Min Gao, Meng-Ting Li, Liu-Ping Zhang","doi":"10.1186/s12882-025-04184-2","DOIUrl":"10.1186/s12882-025-04184-2","url":null,"abstract":"<p><strong>Background: </strong>Maintenance hemodialysis (MHD) is a well-established modality of renal replacement treatment for patients with end-stage renal disease. Currently, receptor-interacting protein kinase-3 (RIPK3) is considered as a key regulator of inflammation. But its association with mortality in MHD patients remains unclear. Thus, the aim of the present study was to observe the predictive value of plasma RIPK3 for all-cause mortality in patients undergoing MHD with a 4-year follow-up.</p><p><strong>Methods: </strong>148 patients undergoing MHD treatment during June 2020 were enrolled. The plasma RIPK3 levels were measured via enzyme-linked immunosorbent assay. Patients were followed up for 4 years to record all-cause mortality until June 2024.</p><p><strong>Results: </strong>During the 4-year follow-up period, the total incidence of all-cause mortality was 34.46% (51 of 148 participants). Compared with the survival group, the non-survival group presented significantly greater age, diabetes prevalence, serum hs-CRP, plasma RIPK3, and lower serum albumin levels. Cox multivariate analysis revealed an independent association between plasma RIPK3 levels and all-cause mortality. The optimal cutoff value to predict all-cause mortality in patients receiving MHD was 251.54 ng/mL with the AUC of 0.7 (95% CI 0.61-0.79). Kaplan-Meier estimates showed a significantly greater overall survival probability for patients with RIPK3 concentrations lower than 251.5 ng/mL than for those with RIPK3 concentrations ≥ 251.5 ng/mL (p < 0.001).</p><p><strong>Conclusion: </strong>Plasma RIPK3 level may serve as an independent predictor for all-cause mortality in MHD patients.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"261"},"PeriodicalIF":2.2,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12107853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144156882","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}