BMC Nephrology最新文献

{"title":"Fabry disease in the haemodialysis population: outcome of a UK screening study (SoFAH).","authors":"K P Ng, M Sandhu, D Banerjee, J O Burton, L Crowley, T Doulton, M A Hameed, R Hamer, M Menon, J Nicholas, S B Ramakrishna, K Shivakumar, T Geberhiwot, I Dasgupta","doi":"10.1186/s12882-025-04127-x","DOIUrl":"10.1186/s12882-025-04127-x","url":null,"abstract":"<p><strong>Background and hypothesis: </strong>Fabry disease (FD) is an X-linked inherited disorder with an estimated prevalence among the end-stage kidney disease (ESKD) population of 0.3% in men and 0.1% in women [1]. Due to its non-specific manifestations, FD (especially the later-onset variant) is often underdiagnosed [2]. We aimed to estimate its prevalence in a large haemodialysis (HD) population in the UK.</p><p><strong>Methods: </strong>This is a cross-sectional, multicentre study of eight renal centres in the UK. All male participants were tested via dried blood spot alpha-galactosidase A (AG) enzyme and globotriaosylsphingosine (Lyso-Gb3) assays. If either the AG (≤ 2.8 µmol/L/H) or Lyso-Gb3 (≥ 3.5 ng/mL) level was abnormal, genetic testing for GLA variant was performed. All females had AG, Lyso-GB3 and genetic tests.</p><p><strong>Results: </strong>In total, 1325 consented to participate in the study. The mean age of the participants was 64 (SD 15) years, 67% were male, 64% were of white ethnicity, the duration of dialysis was 32 (IQR 56) months, and 32% underwent renal biopsy. Diabetic nephropathy (28%) was the most common cause of ESKD, whereas 21% had an unknown aetiology. A total of 1,295 had both AG and Lyso-Gb3 tests, whereas 573 had GLA genetic tests. Among the 14% (n = 186) with an AG level ≤ 2.8 µmol/L/H, 48 were female and 138 were male, all of whom had Lyso-Gb3 < 3.5 ng/mL. Only 3 (0.2%) had abnormal Lyso-Gb3 but all had normal AG and negative genetic tests. Two females were found to have likely benign, non-pathogenic GLA variants: heterozygous c.937G > T (p.(Asp313Tyr) and heterozygous c.1102G > A (p.(Ala368Thr)).</p><p><strong>Conclusions: </strong>Despite the implementation of stringent screening criteria, we did not identify any new confirmed cases of Fabry disease in this large UK haemodialysis population.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"259"},"PeriodicalIF":2.2,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149208","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 relationship between multiple plasma biomarker levels and renal disease activity in Fabry disease.","authors":"Seyda Gul Ozcan, Necmi Eren, Mevlut Tamer Dincer, Zeynep Atli, Murat Bolayirli, Metin Ergul, Hakan Ozer, Kultigin Turkmen, Sinan Trabulus, Nurhan Seyahi","doi":"10.1186/s12882-025-04189-x","DOIUrl":"10.1186/s12882-025-04189-x","url":null,"abstract":"<p><strong>Background: </strong>Fabry disease is a rare lysosomal storage disorder. The genotypic and phenotypic heterogeneity of the disease complicates the prediction of disease activity. This study aimed to evaluate the association between multiple plasma biomarkers and disease activity in Fabry disease.</p><p><strong>Methods: </strong>A cross-sectional analysis was conducted involving 87 Fabry patients, 46 chronic kidney disease (CKD) patients, and 41 healthy controls. Plasma levels of KIM-1, MCP-1, YKL-40, TNFR-1, TNFR-2, and cystatin-C were measured using ELISA. eGFR was calculated using creatinine and creatinine-cystatin C-based CKD-EPI formulas. Fabry patients on renal replacement therapy were analyzed as a subgroup. Primary analyses focused on 62 Fabry patients receiving enzyme replacement therapy.</p><p><strong>Results: </strong>Although eGFR (cr) did not differ significantly between Fabry patients and healthy controls, eGFR(cr-cys) was significantly lower in Fabry patients. After adjusting for age, gender, and BMI, MCP-1 and TNFR-2 levels were significantly lower in Fabry patients than in CKD patients. Among Fabry patients, those with renal involvement, had significantly higher MCP-1 levels than those without. While KIM-1 and YKL-40 did not differ significantly between groups, both were significantly elevated in patients with Lyso-Gb3 > 4 ng/mL and positively correlated with Lyso-Gb3.</p><p><strong>Conclusion: </strong>MCP-1, TNFR-2, YKL-40, and cystatin C may serve as potential biomarkers for different aspects of Fabry disease activity. Further investigation into the associated pathogenic pathways may support the development of novel diagnostic tools or targeted therapies.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"258"},"PeriodicalIF":2.2,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149224","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":"Development and validation of a nomogram for predicting acute kidney injury risks in patients undergoing acute stanford type A aortic dissection repair surgery.","authors":"Wentao Li, Weiguang Yu, Ying Chen, Wenyun Tan, Fan Zhang, Yingqi Zhang","doi":"10.1186/s12882-025-04150-y","DOIUrl":"10.1186/s12882-025-04150-y","url":null,"abstract":"<p><strong>Background: </strong>This study aims to construct and internally validate a comprehensive nomogram designed for accurately predicting the incidence of acute kidney injury (AKI) in patients undergoing repair surgery for acute Stanford Type A aortic dissection (ATAAD), thereby enhancing postoperative risk management and patient care strategies.</p><p><strong>Methods: </strong>A retrospective analysis of 1471 consecutive patients diagnosed with ATAAD through computed tomography angiography (CTA) and confirmed by surgery at four tertiary medical centers from February 2010 to July 2023 was conducted. The study involved a comprehensive evaluation of 36 variables, categorizing patients into non-AKI and AKI groups. Advanced statistical techniques, including LASSO regression and Logistic regression, were employed. A sophisticated nomogram prediction model was developed using R language, and its efficacy was assessed using the concordance index (C-index), area under the receiver operating characteristic curve (AUC-ROC), and decision curve analysis.</p><p><strong>Results: </strong>Seven key factors independently predicting AKI were identified, including heart failure (a condition where the heart can't pump blood as well), hyperlipidemia (high levels of fats in the blood), arterial dissection (a serious condition where there is a tear in the wall of a blood vessel), renal insufficiency, blood urea nitrogen (BUN), abnormal electrocardiogram (ECG), and total cholesterol (TC). The AUC-ROC, a measure of the model's ability to distinguish between classes, was 0.850 (95% CI: 0.823-0.877) for the training set, with high sensitivity (76%) and specificity (99%). For the validation set, the AUC-ROC was 0.840 (95% CI: 0.798-0.833), with sensitivity and specificity of 78% and 94%, respectively. The nomogram demonstrated a recalibrated C-index of 0.854 for the training set and 0.752 for the validation set. Decision curve analysis revealed the nomogram's significant net benefit across various clinical threshold probabilities.</p><p><strong>Conclusion: </strong>The AKI nomogram exhibits robust predictive capabilities, establishing itself as a crucial clinical tool for the early identification of patients at risk for AKI following ATAAD repair surgery. By delivering personalized risk assessments, this nomogram not only optimizes postoperative management strategies but also plays a vital role in enhancing patient outcomes through timely and proactive interventions.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"257"},"PeriodicalIF":2.2,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149203","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":"Intermittent sodium zirconium cyclosilicate for the prevention of hyperkalemia in chronic kidney disease.","authors":"Jack Kit-Chung Ng, Winston Wing-Shing Fung, Gordon Chun-Kau Chan, Kai-Ming Chow, Cheuk-Chun Szeto","doi":"10.1186/s12882-025-04194-0","DOIUrl":"10.1186/s12882-025-04194-0","url":null,"abstract":"<p><strong>Background: </strong>Hyperkalemia is a common complication of chronic kidney disease (CKD) that often requires urgent dialysis and increases healthcare costs. Daily sodium zirconium cyclosilicate (SZC) is a safe and effective treatment for the control of serum potassium levels in CKD patients. We studied the efficacy and safety of intermittent SZC therapy for the prevention of hyperkalemia in CKD patients.</p><p><strong>Methods: </strong>In a retrospective study, we analyzed patients in the Hospital Authority Clinical Data Analysis and Reporting System (CDARS) receiving sodium zirconium cyclosilicate (Lokelma^®) therapy once to thrice weekly for at least 3 months from January 2021 to June 2023. Outcome measures included plasma potassium levels, hyperkalemia episodes, hospital admissions, and renal function changes, which were compared to the 6 months period before the initiation of SZC treatment.</p><p><strong>Results: </strong>We studied 36 adult CKD patients. SZC treatment significantly reduced plasma potassium levels from 5.10 (inter-quartile range [IQR] 4.91-5.40) to 4.73 (IQR 4.50-5.10) mmol/l (p = 0.0003). The median incidence of any hyperkalemia reduced from 5.0 (IQR 2.0-8.0) to 1.9 (IQR 0.0-4.7) episode per patient-year (p = 0.0001), and the incidence of urgent treatment for hyperkalemia decreased from 2.0 (IQR 0.0-4.0) to 0.0 (IQR 0.0-1.5) episode per patient-year (p = 0.007). The number of emergency room attendance and hospitalization were not significantly reduced.</p><p><strong>Conclusion: </strong>Intermittent SZC treatment may help prevent hyperkalemia in CKD patients. Further research is necessary to ascertain if this benefit translates into improvements in hard clinical outcomes.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"260"},"PeriodicalIF":2.2,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12107731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149212","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":"Development and validation of a nomogram for predicting CRBSI in hemodialysis: a retrospective cohort study.","authors":"Shan Wu, Fan Dai, Yanhong Wen, Chang Luo, Chuanfang Wu","doi":"10.1186/s12882-025-04172-6","DOIUrl":"10.1186/s12882-025-04172-6","url":null,"abstract":"<p><strong>Objectives: </strong>To develop and validate of a nomogram for predicting Catheter related bloodstream infection(CRBSI) in patients with maintenance hemodialysis.</p><p><strong>Methods: </strong>This was a retrospective cohort study.A total of 756 patients underwent hemodialysis between January 2017 to December 2021 in purification center of the Affiliated Hospital of Changsha Central Hospital, University of South China were enrolled in this research.The demographic data, hemodialysis data, laboratory indexes of the patients were analyzed. Univariate analysis and multivariate Logistic regression were used to analyze the influencing factors of CRBSI in hemodialysis patients and a nomogram model was established.Area under the receiver operating characteristic curve(AUC) and Hosmer-Lemeshow(H-L)test were used to verify the discrimination and calibration of the model.</p><p><strong>Results: </strong>Among the 756 hemodialysis patients,64 patients developed CRBSI, with an incidence rate of 8.5%(64/756).The results of multivariate analysis showed that combined with diabetes mellitus、dialysis age、catheter retention time、C-reactive protein and procalcitonin were independent risk factors for CRBSI in hemodialysis patients(P < 0.05).The receiver operating characteristic curve analysis showed that the AUC of the model was 0.88 and the H-L test results showed that the model had good goodness of fit(χ² = 5, P = 0.7).The internal validation of the prediction model showed an AUC of 0.82, and the H-L results showed (χ² = 11, P = 0.2), indicating that the model has a good prediction performance and high accuracy.</p><p><strong>Conclusion: </strong>An easy-to-use nomogram for prediction of CRBSI in hemodialysis patients is well developed.This risk assessment tool can effectively identify patients at high risk of CRBSI and may be useful for optimizing catheter management.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"255"},"PeriodicalIF":2.2,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12100912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132117","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 alcohol consumption and renal function in patients with diabetes mellitus and hypertension: insights from the Taiwan Biobank.","authors":"Fa-Chen Lin, Shih-Kai Luo, Hung-Pin Tu, Hung-Yi Chuang, Chen-Cheng Yang, Chih-Hsing Hung","doi":"10.1186/s12882-025-04174-4","DOIUrl":"10.1186/s12882-025-04174-4","url":null,"abstract":"<p><strong>Background: </strong>Alcohol consumption is linked to varied health outcomes. While alcohol appears to have a protective effect on renal function, the impact on patients with diabetes mellitus (DM) and hypertension (HTN) remains unclear. This cross-sectional observational study aims to explore the association between alcohol use and renal function, particularly for individuals with these comorbidities.</p><p><strong>Methods: </strong>Data from participants in the Taiwan Biobank were analyzed. Participants were divided into drinkers and non-drinkers. Drinkers were defined as an alcohol intake of 150 mL or more per week for at least six months. Renal function was assessed using creatinine levels and 2021 Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) creatinine for estimated glomerular filtration rate (eGFR). Multivariate multiple regression models were used to examine the relationships between alcohol consumption, DM, HTN, and renal function.</p><p><strong>Results: </strong>Drinkers had better renal function than non-drinkers, with higher eGFR values and lower creatinine levels. Alcohol consumption was linked to better renal function in DM patients but not HTN patients. A three-way interaction (drinking/DM/HTN) also revealed improved renal function.</p><p><strong>Conclusions: </strong>This study suggests that alcohol consumption may be associated with better renal function outcomes, particularly in patients with DM and HTN. However, these findings should be interpreted cautiously given the cross-sectional nature of the study. Further longitudinal and mechanistic research is warranted to validate the findings.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"256"},"PeriodicalIF":2.2,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12102977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132116","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":"Risk factors of acute kidney injury in children with diabetic ketoacidosis.","authors":"Naseem Alyahyawi, Dalal Alghamdi, Ahlam Almahmoudi, Ibrahim Sandokji, Shatha Bokhari, Osama Y Safdar, Mohammad Shalaby, Mohamed Shazly, Jameela A Kari","doi":"10.1186/s12882-025-04178-0","DOIUrl":"10.1186/s12882-025-04178-0","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Acute kidney injury (AKI) in pediatric patients has been linked to unfavorable short-term and long-term health outcomes. Despite the significance of AKI awareness in children with diabetes mellitus type 1 (T1D), the incidence of AKI in children admitted with diabetic ketoacidosis (DKA) has been under looked.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;The primary objective of this study was to investigate the incidence of acute kidney injury (AKI) in pediatric patients hospitalized for diabetic ketoacidosis (DKA), and to identify the clinical and biochemical markers associated with the development of AKI.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective medical record review was conducted at King Abdulaziz University Hospital, a tertiary hospital in Jeddah, Saudi Arabia. The study included 373 children aged 18 years or younger from 2012 to 2022 with complete medical records available for analysis. We collected baseline and diabetes characteristics, in addition to clinical variables at presentation. Acute kidney injury (AKI) was diagnosed using the serum creatinine criteria established by the kidney disease: Improving Global Outcomes (KDIGO) organization. Descriptive comparisons were performed. Uni- and multivariable logistic regression analyses were employed to identify potential risk factors associated with the development of AKI.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;299 patients (80.2%) developed AKI including 98 (26.3%) stage 1, and 118 (31.6%) stage 2 and 83 (22.3%) stage 3. The frequency of AKI was higher in patients with severe DKA (26.9% vs. 19.7%, p=0.01) while in mild DKA the percentage of AKI was less than non-AKI (31.9% vs. 45.1%, p&lt;0.01The median last HbA1C prior to DKA presentation was 12%, and majority (88.2%) had DKA episodes in past. children who developed AKI had a significantly higher median heart rate (120 bpm, IQR 104-138) compared to those without AKI (108 bpm, IQR 98-124, p&lt;0.01). A high percentage of children with AKI had low Glasgow coma scale (&lt;15) compared to non-AKI (5.7% vs. 1.7%) but the difference was not statistically significant (p=0.22). Half of the children presented with DKA had poor outpatient follow up visits. The proven infections were observed in 53 (14.2%) children in DKA. It was higher in non-AKI group compared to AKI group (15.1% vs. 10.8%, p=0.46). At the time of discharge 131 (44%) patients with AKI showed persistent acute kidney disease. We did not observe mortality. Children with AKI had longer hospital stay compared to non-AKI (4 days vs. 3 days, p=0.02). None of the study participant have died during the studied hospital encounters.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Our findings indicate that AKI is common in children admitted with DKA. Longer duration and poor controlled T1D; previous episodes of DKA, severe DKA, infection and higher heart rate are risk factors to develop AKI. At the time of discharge, 131 (44%) patients AKI showed persistent acute kidney disease (AKD). The longer","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"254"},"PeriodicalIF":2.2,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12100906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126591","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":"Molecular insights and clinical implications of DNA methylation in sepsis-associated acute kidney injury: a narrative review.","authors":"Lili Liu, Saisai Ni, Lianna Zhang, Yingying Chen, Mengqi Xie, Xiaojing Huang","doi":"10.1186/s12882-025-04179-z","DOIUrl":"10.1186/s12882-025-04179-z","url":null,"abstract":"<p><p>Sepsis-induced acute kidney injury (S-AKI) is a life-threatening complication of sepsis, marked by dysregulated inflammation, metabolic derangements, and immune dysfunction, driving high mortality. Its multifactorial pathogenesis increasingly implicates DNA methylation-a core epigenetic mechanism-as a critical disease modulator. This review synthesizes current knowledge of DNA methylation in S-AKI, covering molecular mechanisms, cellular dysfunction, and translational potential. In immune cells, sepsis-induced aberrant DNA methylation promotes hypomethylation of pro-inflammatory genes and hypermethylation of anti-inflammatory loci, exacerbating cytokine storms and immunosuppression. In renal tubular epithelial cells, abnormal methylation disrupts apoptosis, oxidative stress responses, and mitochondrial bioenergetics, impairing repair and accelerating S-AKI progression. Renal vascular endothelial cells exhibit methylation-dependent dysregulation of vasoactive and inflammatory pathways, compromising microvascular homeostasis and renal hemodynamics. DNA methylation signatures offer promise as early S-AKI biomarkers, with cell-type-specific patterns reflecting severity, injury, and prognosis. Targeting DNA methyltransferases with epigenetic modifiers represents a novel therapy, though challenges arise from sepsis's complex epigenetic landscape-bidirectional methylation changes, histone crosstalk, and context-dependent responses. A key paradox lies in DNA methylation's dual traits: stability underpinning biomarker reliability and plasticity enabling dynamic inflammatory adaptation, yet introducing therapeutic heterogeneity. Future research should prioritize dissecting cell-specific methylation mechanisms, integrating multi-omics to identify epigenetic subnetworks, and developing real-time monitoring tools for precision diagnosis and tailored interventions. Advancing these frontiers may translate epigenetic insights into transformative strategies to improve outcomes for this devastating condition.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"253"},"PeriodicalIF":2.2,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12100964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126568","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":"Exploring interventions to support life participation for adults with chronic kidney disease: a scoping review.","authors":"Mikaela Correa, Roaa Hussam, Janine Farragher","doi":"10.1186/s12882-025-04162-8","DOIUrl":"10.1186/s12882-025-04162-8","url":null,"abstract":"<p><strong>Background: </strong>Individuals with chronic kidney disease (CKD) can experience significant health-related challenges that affect their life participation. Recent studies have identified life participation as a top priority for adults with CKD. This scoping review aims to comprehensively identify studies of interventions that targeted life participation outcomes in adults with predialysis CKD, and identify gaps in the literature.</p><p><strong>Methods: </strong>This scoping review followed the Joanna Briggs Institute (JBI) methodology. Five electronic databases were searched with additional sources identified through backwards chaining. Title and abstract screening were conducted independently by four screeners after initial inter-rater calibration, and full text screening and data extraction were undertaken by two researchers in duplicate. Data analysis was completed using descriptive statistics and narrative synthesis.</p><p><strong>Results: </strong>This scoping review identified twenty-three studies that examined interventions to support life participation in the CKD population. No studies targeted life participation as a primary outcome. When categorizing studies via the Canadian Model of Occupational Performance and Engagement (CMOP-E) the majority (87%) of interventions targeted personal-physical mechanisms of disability, with a predominant focus on pharmacological (48%) or exercise (35%) interventions. Dedicated outcome measures for life participation were rarely used, with the role-physical, role-emotional and social functioning subscales of the SF-36 quality of life assessment being the most common life participation outcome measures.</p><p><strong>Conclusions: </strong>This scoping review highlights a lack of research and prioritization of life participation in CKD. It demonstrates the narrow scope of intervention approaches used to support life participation, and limitations in how studies assess life participation. These gaps indicate a need for further research to support this top priority health outcome for the CKD community.</p><p><strong>Clinical trial number: </strong>As this is a scoping review, no clinical trial number is provided.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"251"},"PeriodicalIF":2.2,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12100810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126562","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":"Prevailing insights into anastomotic angles of surgically created arteriovenous fistulas: a literature review.","authors":"Xinyang Li, Chong Liu, Haidi Hu","doi":"10.1186/s12882-025-04182-4","DOIUrl":"10.1186/s12882-025-04182-4","url":null,"abstract":"<p><strong>Objective: </strong>An arteriovenous fistula (AVF) is the most common type of vascular access, given its low infection rate, few complications, good patency potential, and long service life. Although preferred for most patients with chronic kidney disease (CKD), those undergoing dialysis continue to experience AVF surgical failures and complications, with 60% of AVFs failing to mature. The anastomotic angles chosen for AVF creation are usually ones that surgeons find easiest to manually control. At present, many sources have confirmed that variations in anastomotic angle culminate in differing geometric parameters of perianastomotic blood vessels, thus affecting the AVF maturation process.</p><p><strong>Methods: </strong>This publication was intended to highlight the progress achieved with respect to AVF anastomotic angle conventions through collective outcomes of clinical analyses, basic research, computational fluid dynamics (CFD) studies, and VasQ external stent trials. The insights gained may well fuel clinical efforts to implement more durable blood channels in patients with end-stage kidney disease (ESKD). For our purposes, we described anastomotic angles as acute (< 30°), intermediate (30-70°), or obtuse (> 70°), rather than invoking mathematical standards.</p><p><strong>Results: </strong>In clinical research, two studies support the acute angle, three studies support the intermediate angle, three studies support the obtuse angle. In CFD research, one article supports the acute angle, six articles support the intermediate angle, and one article supports obtuse angles.</p><p><strong>Conclusions: </strong>Our analysis demonstrates an intermediate angle of 30-70° would be an optimal angle for AVF anastomosis, according to the existing research results. VasQ external stent devices have yielded superior AVF maturity and patency by maintaining anastomosed arteries and veins at angles of 40-50°, resulting in improved patient outcomes clinically, which supports the use of the device in the clinical practice.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"252"},"PeriodicalIF":2.2,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12100794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126575","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}