BMC Nephrology最新文献

{"title":"Effect of reduced ultrafiltration rate on the cardiac biomarkers NT-proBNP and troponin T: a prospective crossover study.","authors":"Emelie Laveborn, Fredrik Uhlin, Nikolaos Tzimas, Anna Wärme, Ainhoa Indurain, Jan Flesche, Ellinor Bergdahl, Hans Furuland, Anders Fernström, Maria K Svensson, Bernd Stegmayr, Michael Ott","doi":"10.1186/s12882-026-05364-4","DOIUrl":"10.1186/s12882-026-05364-4","url":null,"abstract":"<p><strong>Background: </strong>High interdialytic weight gain (IDWG) and ultrafiltration rate have been associated with increased mortality in patients undergoing haemodialysis. Cardiac biomarkers reflecting strain, including N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity troponin T (TnT), are known to increase during haemodialysis sessions. Previous studies suggest that these intradialytic increases may be related to ultrafiltration rate, with a proposed threshold of 0.6 IDWG per hour. This study therefore aimed to prospectively evaluate whether reducing ultrafiltration rate attenuates the haemodialysis-associated increase in these cardiac biomarkers.</p><p><strong>Method: </strong>In this multicentre, prospective study prevalent haemodialysis patients with a relative IDWG > 2.5% of body weight and ultrafiltration rate ≥ 0.72 IDWG per hour underwent one standard and one prolonged haemodialysis session with a ≥ 20% reduction in ultrafiltration rate, targeting an ultrafiltration rate ≤ 0.6 IDWG per hour. NT-proBNP and TnT were analysed directly before dialysis, at 180 minutes, and at the end of each haemodialysis session.</p><p><strong>Results: </strong>Of 238 screened patients, 65 met the inclusion criteria and none of the exclusion criteria. Of these, 56 were enrolled and 41 included in the final analysis, meeting the pre-specified sample size required to detect a clinically relevant difference. NT-proBNP and TnT increased significantly during both dialysis sessions (p < 0.001). However, no difference was observed in ∆NT-proBNP (p = 0.967) or ∆TnT (p = 0.823) between treatments with different ultrafiltration rates. Achieving an ultrafiltration rate ≤ 0.6 IDWG per hour required a mean treatment duration of 423 ± 139 minutes (min 246, max 775). Among the 12 patients (29.3%) who achieved the targeted ultrafiltration rate of ≤0.6 IDWG per hour, changes in NT-proBNP (p = 0.062) and TnT (p = 0.114) did not differ significantly between sessions with different ultrafiltration rates.</p><p><strong>Conclusions: </strong>In stable, prevalent haemodialysis patients who tolerate their ordinary treatment, reducing the ultrafiltration rate by at least 20% did not attenuate the increase in NT-proBNP and TnT during a single haemodialysis session. In these patients, achieving an ultrafiltration rate ≤ 0.6 IDWG/h generally required treatment durations that are not feasible in routine in-centre haemodialysis.</p><p><strong>Trial registration: </strong>Registered at clinicaltrials.gov (NCT06153888) November 6 2023 (Retrospectively registered).</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"27 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13587309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148987985","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 associated factors of chronic kidney disease-associated pruritus in maintenance hemodialysis patients: a systematic review and meta-analysis.","authors":"Kaifeng Lin, Li Li, Jinghui Gao, Yipei Zhang, Hong Tan","doi":"10.1186/s12882-026-05379-x","DOIUrl":"10.1186/s12882-026-05379-x","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease-associated pruritus (CKD-aP) is a common and burdensome complication in patients undergoing maintenance hemodialysis (MHD). However, reported prevalence and associated factors remain inconsistent across studies.</p><p><strong>Methods: </strong>In accordance with PRISMA 2020 guidelines, we systematically searched eight electronic databases from inception to March 11, 2026 for observational studies reporting prevalence and/or associated factors of pruritus in adult MHD patients. Only multivariable-adjusted odds ratios were included in analyses of associated factors. Continuous and dichotomised estimates were analysed separately, and sensitivity analyses restricted to high-quality studies were performed where feasible.</p><p><strong>Results: </strong>A total of 25 studies involving 8,955 participants were included. The pooled prevalence of any pruritus among MHD patients was 60.0% (95% CI: 57.0-63.0%). Serum phosphorus was positively associated with pruritus in both continuous (OR = 2.03, 95% CI: 1.44-2.87) and dichotomised analyses (OR = 2.93, 95% CI: 1.83-4.69), although substantial heterogeneity remained in the continuous analysis. Associations for PTH/iPTH, CRP, β₂-microglobulin, dialysis vintage, and age varied according to variable definition and/or study quality. Diabetes mellitus was associated with higher odds of pruritus (OR = 2.64, 95% CI: 1.69-4.14), whereas high-flux hemodialysis showed an inverse association (OR = 0.31, 95% CI: 0.17-0.56). Exploratory meta-regression among continuous phosphorus studies suggested regional variation (P = 0.002), with a stronger association in Asian than non-Asian studies; however, only two non-Asian studies were available.</p><p><strong>Conclusions: </strong>Approximately 60% of patients undergoing MHD experience pruritus. Serum phosphorus showed the most consistent association with CKD-aP, whereas estimates for several other factors varied according to variable definition, methodological quality, and between-study heterogeneity. The observed regional variation in the phosphorus-pruritus association should be regarded as hypothesis-generating. Standardised exposure definitions and prospective studies are needed to clarify these associations.</p><p><strong>Trial registration: </strong>This study was registered in the PROSPERO platform (CRD420261337554).</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"27 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13621699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149073393","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":"Ultrasound radiomics-based machine learning models for differentiating diabetic kidney disease from non-diabetic kidney disease in type 2 diabetes.","authors":"Wenye Chen, Dan Zhao, Lehao Wu, Wenkun Bai, Xintong Wang, Ying Ying Zhang, Jian-Ying Niu, Chen Yu","doi":"10.1186/s12882-026-05353-7","DOIUrl":"10.1186/s12882-026-05353-7","url":null,"abstract":"<p><strong>Background and objective: </strong>Noninvasive differentiation of diabetic kidney disease (DKD) from non-diabetic kidney disease (NDKD) in patients with type 2 diabetes mellitus (T2DM) remains challenging, as conventional clinical markers and ultrasound imaging lack sufficient accuracy and reliability. This limitation often leads to unnecessary renal biopsies or delayed diagnosis. To address this gap, this study aimed to develop and validate a machine learning model integrating renal ultrasound radiomic features and clinical predictors to distinguish DKD from NDKD in T2DM patients.</p><p><strong>Methods: </strong>Patients with T2DM who underwent renal biopsy were retrospectively enrolled from three centers. Based on biopsy findings, patients were classified as DKD or NDKD, with overlapping lesions assigned to DKD. Renal ultrasound images were collected for ROI delineation and radiomic feature extraction. Clinical predictors were selected using logistic regression, correlation analysis, and LASSO. SVM, KNN, RF, and XGBoost models were developed using radiomic features alone or combined with clinical variables. Performance was evaluated by AUC, accuracy, precision, recall, and F1-score, and SHAP was used for model interpretation.</p><p><strong>Results: </strong>Univariate analysis identified serum creatinine, eGFR, albumin and LDL‑C as significant variables, and eGFR was selected as the final clinical predictor after LASSO and multivariable logistic regression. The radiomics‑only model performed well in the training cohort but showed lower performance in the validation cohorts. The integrated model combining radiomic features with eGFR achieved AUCs of 0.991, 0.895 and 0.721 in the training, internal validation and external validation cohorts, respectively, with corresponding F1‑scores of 0.939, 0.815 and 0.714. DeLong's test further showed that XGBoost performed better than several comparator algorithms in the training and internal validation cohorts, whereas no significant differences were observed among models in the external validation cohort.</p><p><strong>Conclusion: </strong>The XGBoost model integrating renal ultrasound radiomic features with eGFR showed favourable performance for differentiating DKD from NDKD in patients with T2DM. By using routinely available ultrasound images and a readily accessible clinical indicator, this model may serve as a non-invasive auxiliary tool for preliminary screening in primary-level hospitals or nephrology departments, providing supportive evidence for individualized assessment and renal biopsy decision-making.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"27 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13617703/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149073439","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":"Nafamostat mesylate versus low-molecular-weight heparin during continuous renal replacement therapy in critically Ill adults: a single-center retrospective cohort study.","authors":"Xianguo Zeng, Yutong Xiao, Chaoqun Zhang, Yide Li, Yongjun Liu, Liang Luo","doi":"10.1186/s12882-026-05351-9","DOIUrl":"10.1186/s12882-026-05351-9","url":null,"abstract":"<p><strong>Background: </strong>Nafamostat mesylate (NM) is frequently used for continuous renal replacement therapy (CRRT) anticoagulation when clinicians wish to avoid sustained systemic anticoagulation, whereas low-molecular-weight heparin (LMWH) is commonly selected when systemic anticoagulation is considered acceptable. However, direct evidence comparing NM with LMWH in adult intensive care unit (ICU) patients undergoing CRRT remains limited. This study compared filter lifespan, circuit-related failure and safety outcomes between NM and LMWH in a real-world ICU CRRT cohort.</p><p><strong>Methods: </strong>This single-center retrospective cohort study included adult ICU patients receiving CRRT with NM or LMWH between January 2022 and January 2023. The primary outcome was filter lifespan. In the primary time-to-event analysis, circuit-related filter failure was defined as clotting-related failure or access/device-related failure, while planned and clinical-event-related terminations were censored. Kaplan-Meier analysis, Cox regression with patient-level cluster-robust standard errors, shared-frailty Cox regression, and propensity score-matched analyses were used to compare filter survival, account for repeated circuits within patients, adjust for CRRT prescription factors, and assess robustness.</p><p><strong>Results: </strong>A total of 116 patients contributing 344 filters were included: 31 patients with 132 filters in the NM group and 85 patients with 212 filters in the LMWH group. NM-treated patients had greater illness severity and more pronounced coagulation abnormalities. Unadjusted Kaplan-Meier analysis showed shorter filter survival with NM than with LMWH (log-rank P = 0.007). However, anticoagulant strategy was not significantly associated with circuit-related filter failure in the primary Cox model (HR 1.41; 95% CI 0.88-2.25; P = 0.15), shared-frailty Cox model (HR 1.57; 95% CI 0.85-2.90; P = 0.15), extended Cox model (HR 1.16; 95% CI 0.70-1.90; P = 0.56), or propensity score-matched analyses. Bleeding events were infrequent, precluding a precise comparison of bleeding risk between groups.</p><p><strong>Conclusions: </strong>Anticoagulant strategy was not significantly associated with circuit-related filter failure after adjustment for measured covariates. Because of substantial baseline differences, residual confounding, and limited statistical precision, these findings should not be interpreted as evidence of comparative efficacy, equivalence, noninferiority, or comparable safety. Larger prospective studies with standardized treatment protocols are needed.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"27 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13587378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148987608","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":"Urine dipstick test for assessing albumin-to-creatinine ratio: a pilot study and the potential impact on chronic kidney disease screening.","authors":"Farid Samaan, Cristiane Akemi Vicente, Amilton Mouro, Vitória Ângela Lorenzini Bellotto Bellini, Renata Santos, Letícia de Souza, Carlos Augusto Lima de Campos, José Arnaldo Shiomi Cruz, Ricardo Sesso, Gianna Mastroianni-Kirsztajn","doi":"10.1186/s12882-026-05339-5","DOIUrl":"10.1186/s12882-026-05339-5","url":null,"abstract":"<p><strong>Background: </strong>The objectives of this study were to compare the sensitivity of two urine dipstick tests commercially available for detecting proteinuria and to project the potential impact of replacing one with the other for chronic kidney disease (CKD) screening in a large Brazilian health insurance company.</p><p><strong>Methods: </strong>Urine spot tests were prospectively collected from a convenience sample of 410 adults with ≥ 1 CKD risk factor from a specialized outpatient clinic. Proteinuria was assessed by three methods: (1) total protein strip (\"S10\", the method currently used); (2) albumin-to-creatinine ratio strip (\"S12\", the index test), and (3) quantitative measurement of albumin-to-creatinine ratio (UACR, the standard reference test). The UACR measurements were categorized into three severity levels, in accordance with current guidelines: mild (< 30 mg/g), moderate (30-300 mg/g), and severe (> 300 mg/g). To project the potential impact of replacing S10 with S12, the one-year amount of ambulatory routine urinalysis tests was assessed.</p><p><strong>Results: </strong>Out of 410 study participants, 200 had quantitative UACR ≥ 30 mg/g. S12 showed greater sensitivity than S10 for detecting UACR ≥ 30 mg/g (95% [95%CI: 92-98%] vs. 64% [95%CI: 57-71%], p < 0.001), UACR 30-300 mg/g (56% [95%CI: 47-65%] vs. 36% [95%CI: 27-45%], p = 0.009), and UACR > 300 mg/g (95% [95%CI: 90-100%] vs. 79% [95%CI: 70-88%], p = 0.001). Considering the 777,096 routine urinalysis performed within the private health insurance and the prevalence of the main CKD risk factors in Brazilian population, replacing S10 with S12 would reduce the number of false negatives individuals with UACR ≥ 30 mg/g, UACR 30-300 mg/g, and UACR > 300 mg/g by 12,045 (86%), 6,217 (31%), and 1,243 (76%), respectively.</p><p><strong>Conclusion: </strong>This diagnostic accuracy pilot study revealed that the albumin/creatinine urine dipstick had higher sensitivity than the total protein strip currently used by a private health insurance provider. The projection impact of replacing one with another suggests a significant reduction of undiagnosed cases. Further studies in representative screening populations are warranted to determine whether its implementation improves CKD detection in clinical practice.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"27 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149147869","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":"Comment - Louis XIV's terminal illness clinical chronology favors necrotizing soft-tissue infection.","authors":"Alexis Demas","doi":"10.1186/s12882-026-05328-8","DOIUrl":"10.1186/s12882-026-05328-8","url":null,"abstract":"<p><p>Louis XIV's rapidly progressive terminal illness may be better explained by necrotizing soft-tissue infection than primary calciphylaxis. Severe distal pain, ascending gangrene, and fatal sepsis within three weeks suggest fulminant infection, plausibly arising from a diabetic foot lesion. Clinical chronology should remain central when evaluating competing retrospective clinicopathological hypotheses.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"27 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148878992","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":"Comparison of efficacy and safety among four therapeutic regimens in primary membranous nephropathy with high anti-PLA2R antibody titers: a single-center retrospective cohort study.","authors":"Yuxiu Huang, Xinxuan Meng, Shengqin Wu, Xia Miao, Lili Qin, Kunying Zhang, Jingshu Sun, Jianying Wang","doi":"10.1186/s12882-026-05327-9","DOIUrl":"10.1186/s12882-026-05327-9","url":null,"abstract":"<p><strong>Background: </strong>Patients with primary membranous nephropathy (PMN) and high anti-PLA2R antibody titers (> 150 RU/mL) often respond poorly to conventional treatments, and the optimal immunosuppressive regimen remains unclear. We conducted a retrospective study to compare the efficacy and safety of four regimens in this high-risk population: rituximab monotherapy (RTX regimen), tacrolimus plus glucocorticoids (TAC regimen), rituximab plus cyclosporine (RTX plus CsA regimen), and cyclophosphamide plus glucocorticoids (CTX regimen).</p><p><strong>Methods: </strong>We retrospectively enrolled 185 patients with biopsy-proven PMN and anti-PLA2R titers > 150 RU/mL. All patients completed the full treatment course and the 24-month follow-up period. The primary outcome was total remission (TR) at 24 months, and the secondary outcomes included complete remission (CR), partial remission (PR), immunological remission (IR), relapse rate, time to remission, and adverse events.</p><p><strong>Results: </strong>At 24 months, the TR rates were 54.5% (24/44) for the RTX regimen, 52.2% (24/46) for the TAC regimen, 76% (38/50) for the RTX plus CsA regimen, and 73.3% (33/45) for the CTX regimen. Kaplan-Meier analysis revealed significant differences in cumulative IR rate (log-rank P = 0.0009), cumulative CR rate (log-rank P = 0.0072), and cumulative TR rate (log-rank P = 0.0005) among the four regimens. The TAC regimen had a significantly higher relapse rate (36.8%, 14/38) than the RTX plus CsA regimen (13.6%, 6/44) (log-rank P = 0.013).</p><p><strong>Conclusion: </strong>In this retrospective cohort, the RTX plus CsA regimen demonstrated durable efficacy, with a more favorable safety profile and a lower relapse rate. These preliminary findings support formal comparison of this regimen with current therapies in randomized controlled trials (RCTs).</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"27 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148879000","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":"Acute peritoneal dialysis adequacy among children at a national referral hospital in Kenya: a cross-sectional study in a resource-limited setting.","authors":"Doreen Nganga, Bashir Admani, Dalton Wamalwa, Cyriaque Mbarubukeye","doi":"10.1186/s12882-026-05338-6","DOIUrl":"10.1186/s12882-026-05338-6","url":null,"abstract":"<p><strong>Background: </strong>Acute peritoneal dialysis (PD) is an important renal replacement therapy for children with acute kidney injury (AKI), particularly in resource-limited settings. Inadequate PD may result in persistent uremia, prolonged hospitalization, increased mortality, and transition to hemodialysis. Dialysis adequacy is commonly assessed using urea and creatinine clearance, which are influenced by prescription parameters such as fill volume, dwell time, and dialysate dextrose concentration. However, there is limited data on target clearance values for children undergoing acute PD. This study aimed to assess PD adequacy and describe urea and creatinine clearance among children receiving acute PD at a national referral hospital in Kenya.</p><p><strong>Methods: </strong>A cross-sectional study was conducted at Kenyatta National Hospital, a teaching and referral hospital in Nairobi, Kenya. We enrolled children who were starting PD over a period of 5 months in the paediatric renal unit. Records of total drain volumes and serum and effluent concentrations of electrolytes, urea, and creatinine before and after 24 h of dialysis were obtained via questionnaires. Daily urea and creatinine clearance were calculated for each child. Wilcoxon test was used to compare mean serum urea and creatinine concentrations before and after the first 24 h of dialysis. Descriptive analysis was used to compare solute clearance between groups of dialysate dextrose concentrations.</p><p><strong>Results: </strong>64 children were enrolled at a median age of 18 days, and 43% were female. The median daily creatinine clearance was 5.13 L/day/1.73m², and the median daily Kt/V urea was 1.03. There was a statistically significant reduction in mean serum urea and creatinine after the first day of dialysis. Sick neonates were at a higher risk of developing AKI than infants and older children.</p><p><strong>Conclusion: </strong>Peritoneal dialysis achieved measurable clearance of urea and creatinine among patients admitted to the paediatric renal unit at Kenyatta National Hospital.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"27 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13595644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149015573","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":"Correction to: Bone marrow-derived cells can acquire renal stem cells properties and ameliorate ischemia-reperfusion induced acute renal injury.","authors":"Xiaohua Jia, Xiaoqiang Xie, Guowei Feng, He Lű, Qinjun Zhao, Yongzhe Che, Yizhou Zheng, Zhongchao Han, Yong Xu, Zongjin Li, Deling Kong","doi":"10.1186/s12882-026-04892-3","DOIUrl":"10.1186/s12882-026-04892-3","url":null,"abstract":"","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"27 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148849701","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":"Study protocol for a target trial emulation: CHoosing the right diAlysis Modality in clinical PractIce: hemOdiafiltratioN or hemodialysis (CHAMPION).","authors":"Sanne Roos, John Larkin, Linda H Ficociello, Len A Usvyat, Yue Jiao, Luca Neri, Vivi Zhou, Menno Brandjes, Peter J Blankestijn, Michiel L Bots, Saskia Haitjema, Marianne C Verhaar, Roemer J Janse, Robin W M Vernooij","doi":"10.1186/s12882-026-05315-z","DOIUrl":"10.1186/s12882-026-05315-z","url":null,"abstract":"<p><strong>Background: </strong>Randomized studies have demonstrated that high-volume hemodiafiltration results in reduced mortality compared to conventional hemodialysis treatment. However, eligibility criteria in these trials may limit generalizability to routine clinical practice. Some of these trials reported a limited number of events, underscoring the need to further evaluate the effect of hemodiafiltration on mortality. We will conduct a target trial emulation study using data from routine clinical practice. The primary aim of this study is to evaluate whether high-volume hemodiafiltration reduces all-cause mortality. The secondary aim is to assess cause-specific mortality. Other aims include assessing all-cause and cause-specific hospitalizations, as well as cumulative length of hospital stay and the dose-response relationship between convection volume in hemodiafiltration and the outcomes.</p><p><strong>Methods: </strong>Data will be obtained from the second version of ApolloDialDb (Apollo), an anonymized dialysis dataset capturing over 1000 variables from patients from all over the world. For this study, we will include adult patients from European countries with kidney failure who initiated with at least one treatment of high-flux hemodialysis or hemodiafiltration between 01 January 2018 and 30 June 2024, and who were prescribed a thrice-weekly dialysis schedule at the start. Patients starting with home dialysis will be excluded. We will use a target trial emulation approach with a clone-censor-weight design and marginal structural models, controlling for selection bias, survivor bias, and competing risk bias. Sub-analyses will be performed to investigate the effect of high-volume hemodiafiltration (≥ 23 L of convection volume). Inverse probability weighting will be applied to adjust for predefined confounders including sociodemographic, clinical, and anthropometric factors, as well as comorbidities to achieve balance between treatment groups.</p><p><strong>Discussion: </strong>In addition to randomized studies, prior large observational studies have indicated a survival benefit for hemodiafiltration, as well as a possible reduction of hospitalizations. The target trial emulation study outlined in this protocol will expand this knowledge and provide generalizable insights on the effects of hemodiafiltration on outcomes by using real-world data representative of routine clinical practice while appropriately addressing sources of bias.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"27 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148849774","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}