BMC Nephrology最新文献

{"title":"Infections and mortality in ICU patients undergoing continuous renal replacement therapy: a retrospective cohort study.","authors":"Danica Quickfall, Ashley La, Jennifer Pisano, Patrick Costello, Samantha Gunning, Jay L Koyner","doi":"10.1186/s12882-025-04272-3","DOIUrl":"https://doi.org/10.1186/s12882-025-04272-3","url":null,"abstract":"<p><strong>Background: </strong>Critically ill patients receiving continuous renal replacement therapy (CRRT) are at increased risk for multidrug-resistant infections and infection-related mortality. Altered pharmacokinetics in CRRT may contribute to inadequate antimicrobial exposure and therapeutic failure. However, limited data exist on infection burden and resistance patterns specific to this population.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of ICU patients receiving continuous venovenous hemodialysis (CVVHD) at a tertiary academic center between May 2016 and April 2020. Patients were included if they received CRRT for ≥ 48 h, had at least one positive microbial culture, and received at least one antimicrobial of interest. Data were collected on infection sources, pathogens, resistance patterns, and mortality.</p><p><strong>Results: </strong>Among 661 CRRT recipients, 394 (59.6%) had at least one positive culture. The most common infection sites were respiratory (69.0%), skin and soft tissue (53.8%), and intra-abdominal (38.8%). Intra-abdominal and bloodstream infections had the highest mortality (63.7% and 57.7%, respectively). Vancomycin-resistant E. faecium (83.3%), cefepime-resistant A. baumannii (100%), and P. aeruginosa with high β-lactam resistance were prominent. These resistance profiles diverged from general ICU trends.</p><p><strong>Conclusion: </strong>ICU patients receiving CRRT experience high rates of multidrug-resistant infections and associated mortality. Tailored dosing strategies, including dual empiric coverage in select cases, and CRRT-specific antimicrobial stewardship are essential to improve outcomes in this high-risk population.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"321"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538559","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":"Living with chronic kidney disease: future perspectives and prognostic needs of patients - a qualitative study.","authors":"Jet Milders, Yvette Meuleman, Chava L Ramspek, Willem Jan W Bos, Wieneke M Michels, Ype de Jong, Friedo W Dekker, Merel van Diepen","doi":"10.1186/s12882-025-04243-8","DOIUrl":"https://doi.org/10.1186/s12882-025-04243-8","url":null,"abstract":"<p><strong>Background: </strong>Individualized prognostic information can help patients with chronic kidney disease (CKD) understand and prepare for their future, facilitating informed shared decision-making. While research has indicated that CKD patients want more information about their future, little is known about their specific prognostic needs. Therefore, this study aims to explore how patients with CKD perceive their future and what their prognostic needs are.</p><p><strong>Methods: </strong>A survey was constructed with patient representatives, and distributed amongst adult CKD patients (all stages) through patient associations and healthcare professionals in two Dutch hospitals. Following an exploratory-descriptive qualitative approach, answers to four open-ended questions of 163 patients were analysed inductively using thematic analysis.</p><p><strong>Results: </strong>Patients described a wide range of emotions when thinking about their future with CKD, including negative emotions like uncertainty, fear, sadness, and to a lesser extent, anger. However, some patients maintained emotional neutrality or described experiencing positive emotions like calmness, hope and trust. Additionally, patients had diverse prognostic needs, focusing on different topics like CKD treatment, kidney disease progression, self-management, symptoms, life expectancy and life participation. While most patients wanted more personalized prognostic information on these topics, some felt like they were already sufficiently informed about their future or preferred to live in the present moment.</p><p><strong>Conclusions: </strong>Our findings show that CKD patients experience a wide variety of emotions regarding their future. Despite conversations about their future taking place in nephrological practice, there remain unmet questions regarding the future. These results underline the importance of adopting a personalized approach when discussing the future with CKD patients, acknowledging and taking the diverse emotional responses and individual preferences into account.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"301"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538562","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":"miR-769-5p has diagnostic value in acute kidney injury in intensive care unit patients and mediates disease development by targeting SIRT6.","authors":"Yanping Peng, Xiaodan Sun, Yao Ma, Xusheng Yang, Yang Zhao, Yunxiao Jia, Yunxing Guo","doi":"10.1186/s12882-025-04244-7","DOIUrl":"https://doi.org/10.1186/s12882-025-04244-7","url":null,"abstract":"<p><strong>Background: </strong>This investigation was designed to assess the diagnostic value of miR-769-5p in acute renal injury (AKI) among intensive care unit (ICU) patients and explore its mechanism by targeting silent information regulator 6 (SIRT6).</p><p><strong>Methods: </strong>80 sepsis patients without AKI and 82 with sepsis-induced AKI (S-AKI) were enrolled. HK-2 cells were induced with lipopolysaccharide (LPS) to construct an in vitro cell model. Real-time quantitative reverse transcription polymerase chain reaction (RT-qPCR) was performed to quantify mRNA levels of miR-769-5p, SIRT6, and renal tubular injury markers kidney injury molecule-1 (KIM-1) and Neutrophil gelatinase-associated lipocalin (NGAL). The receiver operating characteristic (ROC) curve was applied to assess miR-769-5p's diagnostic ability for S-AKI. Cell proliferation, apoptosis, inflammatory cytokines, and oxidative stress markers were assessed using CCK-8, flow cytometry, ELISA, and commercial kits, respectively. Finally, RNA immunoprecipitation assay and Dual-luciferase reporter assay confirmed miR-769-5p's direct targeting of SIRT6.</p><p><strong>Results: </strong>miR-769-5p expression was higher in S-AKI patients compared to Sepsis patients, while SIRT6 was downregulated. miR-769-5p with 87.8% sensitivity and 83.8% specificity, could identify S-AKI patients from Sepsis patients. In HK-2 cells, LPS increased miR-769-5p level and decreased cell viability. Additionally, inhibiting miR-769-5p alleviated LPS-induced cell growth restraint and apoptosis promotion, and the LPS-promoted expression of inflammatory factors, oxidative stress indicators, and tubular injury markers were also weakened by low miR-769-5p expression. miR-769-5p targeted SIRT6, which was downregulated in AKI.</p><p><strong>Conclusions: </strong>miR-769-5p has diagnostic value in identifying the occurrence of AKI in sepsis patients. Targeted regulation of miR-769-5p may offer a new treatment strategy for AKI.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"337"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538564","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":"Prevalence of chronic kidney disease in France - The constances cohort.","authors":"Jacques Blacher, Sofiane Kab, Lynda Cheddani, Jean-Michel Halimi, Bénédicte Stengel, Natalia Alencar De Pinho, Marcel Goldberg, Marie Zins, Valérie Olié","doi":"10.1186/s12882-025-04213-0","DOIUrl":"https://doi.org/10.1186/s12882-025-04213-0","url":null,"abstract":"<p><strong>Background: </strong>Prevention and early detection of chronic kidney disease (CKD) are major public health goals to prevent and slow its progression to kidney failure. In this respect, our main objective was to estimate the prevalence of CKD (stages 1 to 5 without replacement therapy) in French adults and to study its determinants.</p><p><strong>Methods: </strong>Constances is a population-based cohort designed as a national research infrastructure. Eligible population included participants (18-69 years) who had both isotope dilution mass spectrometry (IDMS) traceable creatinine-based estimated glomerular filration rate (eGFR) and urinary albumin-creatinine ratio measurements. Multivariable analysis was performed to assess the association between covariables of interest and CKD.</p><p><strong>Results: </strong>Of the 11,429 subjects included in our sample, (48% women; mean (± standard deviation) age: 52 ± 13 years), 715 have CKD (ACR ≥ 3 mg/mmol creatinine and/or eGFR < 60 mL/min per 1.73 m². Among these 715 subjects, only 136 had a decreased eGFR without increased albuminuria; 563 had increased albuminuria only, and 16 had both. Thus, the prevalence of all stage CKD was 6.26 [95% confidence interval, 5.81-6.70] %, including 4.93 [4.53-5.32] % for CKD stage 1-2 (ACR ≥ 3 mg/mmol creatinine and eGFR ≥ 60 mL/min per 1.73 m²), and 1.33 [1.12-1.54] % for CKD stage 3-5 (eGFR < 60 mL/min per 1.73 m². In the multivariable analysis, independent risk factors for CKD included age, lower education or socio-economic level, hypertension, diabetes, obesity, and history of cardiovascular disease or cancer.</p><p><strong>Conclusions: </strong>Our large population-based cohort estimated that 6.3% of individuals had CKD. The majority of subjects with CKD had increased albuminuria without decreased eGFR. Albuminuria should be assessed more frequently in order to detect CKD earlier and to implement preventive treatments, especially in selected populations at risk of CKD.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"312"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538491","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":"The therapeutic effect of Berberine on rodent models of kidney injury: a systematic review and meta - analysis.","authors":"Weixiong Xu, ChaoLan Fang, Ming Jian Jiang","doi":"10.1186/s12882-025-04231-y","DOIUrl":"https://doi.org/10.1186/s12882-025-04231-y","url":null,"abstract":"<p><strong>Background: </strong>Berberine, a potent bioactive compound extracted from the traditional herbal medicine Huanglian (Coptis chinensis), has garnered significant attention due to its diverse pharmacological effects, particularly in the treatment of renal diseases. Previous studies have highlighted berberine's therapeutic potential in ameliorating acute kidney injury (AKI) in murine animal models, suggesting its prospective use as a renal protective agent. Its mechanisms involve antioxidant and anti-inflammatory pathways, which are key to its effects.</p><p><strong>Methods: </strong>This systematic review and meta-analysis aimed to elucidate the effects and underlying biological mechanisms of berberine in murine models of AKI. To ensure comprehensive coverage, an exhaustive literature search was conducted across reputable databases, including PubMed, Web of Science, Cochrane Library, Ovid, and Embase. The search was performed in December 2024 and no limitations were applied regarding the publication date of the studies. The SYRCLE's risk of bias tool was employed for a rigorous quality assessment of each study. Statistical analyses were performed using Revman5.4.2 and STATA 15.1 software to ensure the accuracy and reliability of data interpretation.</p><p><strong>Results: </strong>We included a total of 19 relevant studies, Our research indicates that the animal studies included in our review demonstrate a significant improvement in renal function metrics of blood specimens in rodent models. The standard mean difference (SMD) for blood urea nitrogen (BUN) is - 3.31 (95% CI: - 4.19, - 2.42), and for Serum Creatinine (SCR) it's - 2.67 (95% CI: - 3.26, - 2.09), highlighting berberine's significant renal protective effects. Additionally, berberine favorably affects inflammatory markers, with SMD for IL - 18 at - 1.30 (95% CI: - 2.76, - 0.16) and for TNF - α at - 3.90 (95% CI: - 6.19, - 1.61).Berberine significantly reduced BUN and SCR.</p><p><strong>Conclusion: </strong>The beneficial effects of berberine in AKI are likely attributed to its diverse mechanisms, including antioxidant, anti-inflammatory pathways. However, to accurately delineate the efficacy and safety of berberine as a therapeutic intervention for AKI, future research should prioritize large-scale, long-term, and high-quality preclinical trials. Such endeavors are critical for validating our findings and establishing a solid foundation for clinical applications.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"315"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538511","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":"End-stage kidney disease patients during the current Gaza war: challenges and outcomes of care.","authors":"Joslin AlDadah, Razan R AbuMusameh, Dana A Salem, Bisan Al Habil, Rawan El-Ijla, Nour Abu Aqlain, Reham Hjela, Ayda Helles, Husam Jouda","doi":"10.1186/s12882-025-04256-3","DOIUrl":"https://doi.org/10.1186/s12882-025-04256-3","url":null,"abstract":"<p><strong>Background: </strong>This study aims to investigate the challenges and complications faced by End-Stage kidney Disease (ESKD) patients undergoing dialysis during the Gaza conflict.</p><p><strong>Methods: </strong>A cross-sectional study was conducted on 105 ESKD patients undergoing dialysis. Data were collected through a customized, interviewer-administered questionnaire at a single center, Al Aqsa Hospital in central Gaza (from October to November 2024). Statistical analysis was performed using SPSS software.</p><p><strong>Results: </strong>The mean age of participants was 49.9 years. 47.6% were male, resided in Deir Al Balah, lived in tents, and were displaced. Additionally, most patients faced difficulties accessing hospitals (70.5%), while 94.3% were unaffected by war-related injuries. Regarding dialysis, 73.3% of participants initially received three dialysis sessions per week, but this decreased to 68.6%. In terms of challenges, 81% reported damage to dialysis machines, 91.4% were affected by electricity cuts, 63.8% experienced gaps in dialysis due to displacement, and 33.3% cited a shortage of medical staff. With respect to diet and medications, 43.8% reported adherence, 54.3% faced difficulties obtaining their medications, 49.5% had lost their prior medical records, and 80% carried a list of their current medications. The most frequently reported complications included intradialytic hypotension (61.9%), hospitalization during dialysis (52.4%), and weight loss (70.5%). Our analysis revealed a statistically significant association between interruptions in dialysis therapy and hospitalization rates (p < 0.001). Additionally, displaced patients had a significantly higher loss of medical records compared to non-displaced patients (p = 0.014). A significant difference was also observed in dialysis session length changes in relation to hospitalization (p = 0.018). Logistic regression showed that patients with comorbidities were 2.5 times more likely to develop complications. However, this result wasn't statistically significant (p = 0.058).</p><p><strong>Conclusion: </strong>This study highlights the challenges faced by ESKD patients during the Gaza conflict and their associated complications. International support is crucial to protecting ESKD patients in conflict zones. Telemedicine and patient education may help mitigate complications. Further studies are needed to improve the care of ESKD patients in conflict-affected areas.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"339"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538546","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":"Global, regional, and national burden of congenital anomalies of the kidney and urinary tract from 1990 to 2021, with projections to 2036: a systematic analysis of the global burden of disease study 2021.","authors":"Ting Chen, Jia Wei, Qiang Shu, Xiang Yan","doi":"10.1186/s12882-025-04269-y","DOIUrl":"https://doi.org/10.1186/s12882-025-04269-y","url":null,"abstract":"<p><strong>Background: </strong>Congenital anomalies of the kidney and urinary tract (CAKUT) represents an important global health challenge. However, the emerging analysis of the burden of CAKUT is limited and outdated. This study aimed to evaluate the global burden and temporal trends of CAKUT across 204 countries and territories from 1990 to 2021.</p><p><strong>Methods: </strong>Data on the prevalence, incidence, mortality, and disability-adjusted life years (DALYs) of CAKUT from 1990 to 2021 were obtained from the Global Burden of Disease Study 2021. Temporal trends were analyzed using Joinpoint regression. The association between CAKUT burden and the socio-demographic index (SDI) was examined via Spearman correlation analysis. Decomposition analysis was used to estimate the effects of population growth, aging, and epidemiological changes on overall change of CAKUT burdens. The Bayesian age-period-cohort model was utilized to predict the CAKUT burden through 2036.</p><p><strong>Results: </strong>From 1990 to 2021, the global prevalence of CAKUT increased by 21.50%, reaching 6.34 million (95% uncertainty interval [UI]: 5.07, 7.90), with a modest rise of 3.96% in the age-standardized prevalence rate (ASPR). In contrast, the incidence, mortality, and DALYs of CAKUT declined, with the age-standardized incidence rate (ASIR) decreasing by 2.86%, the age-standardized mortality rate (ASMR) by 20.00%, and the age-standardized DALY rate (ASDR) by 18.46%. In 2021, Southern Sub-Saharan Africa exhibited the highest ASPR and ASIR, while Central Latin America recorded the highest ASMR, and Southern Latin America had the highest ASDR. Furthermore, ASPR, ASIR, ASMR, and ASDR were all negatively correlated with SDI. Decomposition analysis revealed that population growth drove the increase in CAKUT prevalence. Projections to 2036 suggest further increases in ASPR and ASIR, whereas ASMR and ASDR are expected to decline.</p><p><strong>Conclusion: </strong>Despite reductions in ASIR, ASMR, and ASDR, the increasing ASPR underscores the persistent global burden of CAKUT. Targeted interventions are urgently needed, particularly in high-burden regions such as Southern Sub-Saharan Africa.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"334"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538552","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":"Combined predictive value of prognostic nutritional index and neutrophil to lymphocyte ratio for all-cause mortality risk in maintenance hemodialysis patients: a cohort study followed for 5 years.","authors":"Fang Xu, Shuang Cheng, Peng Shu, Yilan Liang, Xia Wang, Haitao Bai","doi":"10.1186/s12882-025-04273-2","DOIUrl":"https://doi.org/10.1186/s12882-025-04273-2","url":null,"abstract":"<p><strong>Background: </strong>To assess the prognostic value of the prognostic nutritional index (PNI) alongside the neutrophil-to-lymphocyte ratio (NLR) in forecasting all-cause mortality in patients undergoing maintenance hemodialysis (MHD), and to pinpoint independent risk factors linked to all-cause mortality, thereby facilitating the guidance of prompt clinical interventions.</p><p><strong>Methods: </strong>A retrospective cohort investigation was carried out with the gathering of comprehensive demographic and clinical biochemical information. The follow-up period ended in December 2024, with all-cause mortality serving as the primary outcome measure. The predictive capabilities of PNI and NLR regarding all-cause mortality in MHD patients were evaluated through receiver operating characteristic (ROC) curve analysis. In addition to the plotting of Kaplan-Meier curves, the Cox model was utilized to pinpoint risk factors affecting 5-year all-cause mortality in MHD patients.</p><p><strong>Results: </strong>A sum of 632 patients receiving MHD was analyzed during the follow-up. The area under the curve (AUC) for PNI and NLR was 0.739 and 0.668, with an optimal cutoff value of 43.094 and 2.937, respectively. Furthermore, patients presenting a PNI of ≥ 43.094 showed a better cumulative survival rate throughout the follow-up when compared to those with a PNI of < 43.094 (χ² = 56.461, P < 0.001). In contrast, patients with an NLR of ≥ 2.937 exhibited a diminished cumulative survival rate as opposed to those with an NLR under 2.937 (χ² = 125.414, P < 0.001). The Cox regression model identified male sex, utilization of central venous catheters (CVCs), an NLR of ≥ 2.937, increased absolute neutrophil count, and elevated aspartate aminotransferase (AST) levels for predicting 5-year all-cause mortality independently (P < 0.05). Conversely, a PNI of ≥ 43.094, along with high levels of hemoglobin, urea, and uric acid, were recognized as protective factors (P < 0.05).</p><p><strong>Conclusion: </strong>Both PNI and NLR have significant predictive value concerning all-cause mortality in MHD patients.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"319"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538543","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":"Expanding the scope of shared decision-making in vascular access planning for hemodialysis: a case for interprofessional collaboration.","authors":"Andrea Yu-Ling Liu, Mary Hammes, Peter Angelos, Neil Kondamuri, Lauren Harriett, Ashley Suah, Ted Albert Skolarus","doi":"10.1186/s12882-025-04261-6","DOIUrl":"https://doi.org/10.1186/s12882-025-04261-6","url":null,"abstract":"<p><p>Vascular access planning guidelines have shifted from a fistula-centered to a patient-centered approach. We advocate for expansion of the shared decision-making dyad between the nephrology team and patient to include other vascular access planning stakeholders. We propose earlier and consistent interprofessional collaboration facilitates more constructive discussions that could improve outcomes.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"297"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538549","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":"Haemodynamically irrelevant pericardial effusion is associated with increased mortality in maintenance hemodialysis patients with end-stage renal disease.","authors":"Lizheng Song, Jian Chen, Junwei Xu, Liyun Luo, Mei Xu, Wenyi Tang, Yuxi Huang, Hsi Huang, Man Li, Jianting Ke","doi":"10.1186/s12882-025-04233-w","DOIUrl":"https://doi.org/10.1186/s12882-025-04233-w","url":null,"abstract":"<p><strong>Background: </strong>Pericardial effusion (PE) is common in patients with end-stage renal disease (ESRD) undergoing maintenance haemodialysis (MHD). The prognostic value of a small, haemodynamically non-compromising PE in patients with ESRD who undergo MHD, is currently lacking.</p><p><strong>Objective: </strong>The purpose of this study was to determine the predictive significance of a small, haemodynamically non-compromising PE in MHD patients with ESRD.</p><p><strong>Methods and results: </strong>Patients with ESRD who received regular dialysis in the Hemodialysis Center of the Fifth Affiliated Hospital of Sun Yat-sen University from January 2017 to December 2020 were retrospectively analyzed. A total of 352 patients with ESRD receiving MHD were enrolled in this study, including 82 patients with PE and 270 patients without PE. The overall median follow-up time was 2.4 years. Compared to the non-PE group, the mortality rate was higher in the PE group (31.7% vs. 18.5%; P = 0.011). PE was associated with an increased all-cause mortality. The Cox proportional hazard model showed that PE was the risk factor for all-cause death (HR: 1.964; 95%CI: 1.020-3.784; P = 0.044), as well as age (HR: 1.049; 95%CI: 1.022-1.076; P = 0.001), diabetes (HR: 2.404; 95%CI: 1.226-4.713; P = 0.011), hemoglobin (HR: 0.983; 95%CI: 0.969-0.997; P = 0.020) and ultrafiltration rate (HR: 1.082; 95%CI: 1.015-1.153; P = 0.015). Echocardiographic follow-up results showed that the mortality rate in the PE persistence group was significantly higher than that in the PE regression group (44.1% vs. 20.7%, P = 0.049).</p><p><strong>Conclusion: </strong>In MHD patients with ESRD, even haemodynamically irrelevant PE is associated with an increased risk of all-cause mortality.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"308"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144538553","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}