BMC Nephrology最新文献

{"title":"lncRNA TUG1 and kidney diseases.","authors":"Tong Chen, Jian Lu, Qiuling Fan","doi":"10.1186/s12882-025-04047-w","DOIUrl":"10.1186/s12882-025-04047-w","url":null,"abstract":"<p><p>Long noncoding RNAs (lncRNAs) cover a large class of transcribed RNA molecules that are more than 200 nucleotides in length. An increasing number of studies have shown that lncRNAs control gene expression through different mechanisms and play important roles in a range of biological processes including growth, cell differentiation, proliferation, apoptosis, and invasion. TUG1 was originally discovered in a genomic screen of taurine-treated mouse retinal cells. Previous evidences pointed out that lncRNA TUG1 could inhibit apoptosis and the release of inflammatory factors, improve mitochondrial function, thereby protecting cells from damage, and showing a protective role of TUG1 in diseases. Given that TUG1 has multiple targets and can interfere with multiple steps in the oncogenic process, it has been proposed as a therapeutic target. In this review, we summarize the research progress of lncRNA TUG1 in kidney diseases in the past 8 years, and discuss its related molecular mechanisms.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"139"},"PeriodicalIF":2.2,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662429","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 of a multiple urinary biomarker model to predict the tubulointerstitial fibrosis area in patients with primary IgA Nephropathy.","authors":"Jorge González Rodríguez, Jose Manuel Valdivielso, Elías Jatem Escalante, Mercè Borràs Sans, Alicia García Carrasco, Jacqueline Del Carpio Salas, Andrea Muijsenberg Alcalá, Miquel Pinyol Ribas, Elena Ostos Roldán, Alfons Segarra Medrano, Maria Luisa Martín Conde","doi":"10.1186/s12882-025-04049-8","DOIUrl":"10.1186/s12882-025-04049-8","url":null,"abstract":"<p><strong>Background: </strong>Previous studies highlighted the utility of individual urinary biomarkers in the prediction of interstitial fibrosis in IgA Nephropathy patients. However, it´s uncertain which biomarker or combination of biomarkers provides a more accurate estimation of renal interstitial fibrosis Surface. Herein, we measured the urinary excretion of a set of seven tubular injury biomarkers in a group of patients with primary IgA Nephropathy and analyzed their utility as non-invasive estimators of interstitial fibrosis area found on kidney biopsy.</p><p><strong>Methods: </strong>Two hundred forty-seven adults with primary IgA Nephropathy diagnosed by kidney biopsy and a control group of 50 healthy control were included. The urinary excretion of EGF, MCP-1, NGAL, KIM-1, L-FABP, β2-microglobulin and DKK-3 was measured in urine samples collected at the day of the renal biopsy. Estimated glomerular filtration rate was measured by the CKD-EPI formula. Interstitial fibrosis area was quantified using a quantitative morphometric procedure and graded according to Oxford Classification. Predictive multivariate models were developed to predict the interstitial fibrosis surface.</p><p><strong>Results: </strong>Patients with primary IgA Nephropathy showed significantly higher urinary levels of DKK-3, L-FABP and β2-microglobulin, and lower EGF levels than healthy controls. Interstitial fibrosis was negatively correlated with urinary EGF levels and positively with age, proteinuria, eGFR and urinary DKK-3, L-FABP and β2-microglobulin. The best model to predict interstitial fibrosis area accounted for > 60% of its variability and included age, eGFR, proteinuria, DKK-3, EGF, L-FABP and β2-microglobulin.</p><p><strong>Conclusions: </strong>Our study provides a model to estimate the IFS in IgA Nephropathy which could be useful to monitor the progression of chronic kidney injury.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"141"},"PeriodicalIF":2.2,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143668930","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 of patent ductus arteriosus treatment in extremely low gestational age neonates with two year kidney outcomes: a secondary analysis of the preterm erythropoietin neuroprotection trial (PENUT).","authors":"Paige E Condit, Ronnie Guillet, Dinushan Kaluarachchi, Russell L Griffin, Shina Menon, David J Askenazi, Matthew W Harer","doi":"10.1186/s12882-025-04065-8","DOIUrl":"10.1186/s12882-025-04065-8","url":null,"abstract":"<p><strong>Background: </strong>Management of patent ductus arteriosus (PDA) is variable and includes expectant, medical, and procedural options. Both the hemodynamic effects of a PDA and its treatment put neonates at risk for acute kidney injury (AKI). Little is known about how different management approaches to a PDA, either conservative management or active management and either medical or surgical treatment, in preterm neonates impact kidney function over the longer term. The objective of this study is to evaluate rates of kidney dysfunction at two years of age in extremely low gestational age neonates (ELGANs) with treated compared to untreated PDAs.</p><p><strong>Methods: </strong>Secondary analysis of prospectively collected data from the PENUT trial. Kidney dysfunction defined by: eGFR < 90 mL/min/1.73 m², systolic or diastolic blood pressures (SBP or DBP) > 90th percentile, or proteinuria measured by albumin to creatinine ratio (ACR) > 30 mg/g. Between-group, variables were compared using chi-square or t-test statistics. General estimating equations and multivariable logistic regression was used to evaluate the association with outcomes.</p><p><strong>Results: </strong>Of 780 ELGANs, 261 (43%) were treated for PDA. Of those treated, 168 (64.4%) received pharmacologic treatment, 12 (4.6%) received surgical treatment, 57 (21.8%) received both, and 24 (9.2%) were listed as having a treated PDA without specification of management. After adjusting for confounding factors, those actively treated for a PDA were less likely to have SBP > 90th percentile at two years (29.5% treated vs. 34.3% control, adjusted OR 0.59, CI 0.36-0.99). The adjusted odds-ratios for differences in other 2-year kidney outcomes did not differ. Among those medically treated, indomethacin was used more commonly than either ibuprofen or acetaminophen.</p><p><strong>Conclusions: </strong>ELGANs receiving treatment for a PDA were less likely to have elevated SBP at two years. Prospective studies are needed to examine the effects of a hemodynamically significant PDA and its management on long-term kidney outcomes.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"138"},"PeriodicalIF":2.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11924701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662427","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":"Incidence, risk factors and outcomes of AKI among trauma patients in a tertiary hospital in south-east, Nigeria.","authors":"Chinedu O Udeze, Monday U Nwobodo, Olaronke F Afolabi, Chinaka Ifeanyi, Onyinye J Nwikwu, Anthony C Agbo, Christiana Ologwu, Ngozi A Ifebunandu, Ifeoma I Ulasi","doi":"10.1186/s12882-025-04062-x","DOIUrl":"10.1186/s12882-025-04062-x","url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury is a preventable and treatable complication of trauma-related injuries associated with increased mortality. Data on the burden and predisposing factors to the development of AKI following trauma are lacking in our environment. This study aims to evaluate the incidence, predisposing risk factors, and short-term outcomes of AKI in trauma patients seen at the Accident and Emergency Unit of Alex Ekwueme Federal University Teaching Hospital Abakaliki, Nigeria.</p><p><strong>Methods: </strong>The study was a hospital-based cohort study of trauma patients. Consenting patients presenting after a trauma-related event were enrolled. Socio-demographic data, the time of the incident, the time of presentation to the hospital, the nature and extent of injuries, and the treatment received were recorded. Blood was taken at specified intervals for haemoglobin, white blood cell count, serum urea, and creatinine estimation. AKI was defined based on the Kidney Disease: Improving Global Outcomes guidelines. Multivariate logistic regression analysis was applied to determine independent risk factors for AKI in trauma patients.</p><p><strong>Results: </strong>186 trauma patients participated; 83.3% were males. The patients' mean age was 35.3 (± 11.1) years, and most were traders (31.7%). The commonest mechanism of trauma was road traffic accidents (62.9%). The incidence of AKI in this study was 27 (14.5%). Multivariate logistic regression analysis showed that the development of AKI was independently associated with injuries complicated by fractures and longer hospital stay. The 30-day outcome was: 26 (96.3%) recovered fully, and 1 (3.7%) had AKI requiring renal replacement therapy, with no in-hospital mortality.</p><p><strong>Conclusion: </strong>AKI is a frequent complication of trauma, and trauma patients presenting with fractures and have prolonged hospital stay require closer monitoring and care.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"135"},"PeriodicalIF":2.2,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11908019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623344","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":"Peritoneal dialysis-associated polymicrobial peritonitis with slow onset after root canal treatment: the first case and review of the literature.","authors":"Shiori Kubota, Yujiro Maeoka, Kosuke Okimoto, Ryo Yakushiji, Akira Takahashi, Mahoko Yoshida, Naoki Ishiuchi, Yosuke Osaki, Kensuke Sasaki, Takao Masaki","doi":"10.1186/s12882-025-04054-x","DOIUrl":"10.1186/s12882-025-04054-x","url":null,"abstract":"<p><strong>Background: </strong>Peritoneal dialysis (PD)-associated peritonitis is linked to an increased risk of mortality and catheter removal, with a higher incidence of these risks observed in polymicrobial peritonitis compared with single-organism infection. In PD patients, invasive procedures can cause peritonitis, typically within 7 days, through transient bacteremia. Although dental procedures are widely recognized as a cause of transient bacteremia, only a limited number of cases involving PD-associated peritonitis after dental procedures, and no cases of polymicrobial peritonitis, have been reported.</p><p><strong>Case presentation: </strong>A 60-year-old man undergoing PD presented with acute low abdominal pain, and was diagnosed with PD-associated peritonitis caused by Streptococcus (S.) oralis, S. vestibularis, and S. salivarius. The polymicrobial peritonitis was successfully treated with antibiotics and catheter removal was not required. Medical consultation after admission revealed a history of root canal treatment for dental caries in the right maxillary second molar, and a dental examination during hospitalization confirmed its success.</p><p><strong>Conclusions: </strong>We report a case of PD-associated peritonitis caused by co-infection with three species of viridans group streptococci, which developed 9 days after the completion of root canal treatment. This case history suggests that it may be important to carefully observe patients until 10 days after dental procedures, because of the slow onset of peritonitis following such procedures.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"137"},"PeriodicalIF":2.2,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623356","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 global, regional, and national patterns of change in the burden of chronic kidney disease from 1990 to 2021.","authors":"Jiaowei Guo, Wenyue Jiao, Shujun Xia, Xiadan Xiang, Yuan Zhang, Xiao Ge, Qice Sun","doi":"10.1186/s12882-025-04028-z","DOIUrl":"10.1186/s12882-025-04028-z","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease (CKD) is a major global public health problem with increasing prevalence and a huge health and economic burden. Diabetes mellitus and hypertension are major risk factors for CKD, and CKD is associated with cardiovascular disease and end-stage renal disease. Understanding the prevalence and burden of CKD is essential for the development of prevention and control strategies.</p><p><strong>Methods: </strong>Using data from the Global Burden of Disease Study (GBD) 2021 study, this study analyzed the incidence, prevalence, and disability-adjusted life years (DALYs) of CKD at global, regional, and national levels between 1990 and 2021. Decomposition analysis, health inequalities and frontier analysis were used to analyse the changes.</p><p><strong>Results: </strong>This study analyzed the global regional and national burden, trends, and disparities of CKD from 1990 to 2021 and found that the global burden of CKD had increased significantly, in line with trends in population ageing and population growth, and with significant variations between regions. There were 673.7 million people with CKD worldwide in 2021, accounting for 8.54% of the global population, a 92.0% increase from 1990. Despite a slight decline in age-standardized prevalence rate (ASPR), the absolute number of CKD cases increased. Central Asia had the highest prevalence of CKD, while Central Latin America had the highest rate of DALYs and incidence for CKD. In 2021, At the national level, China had the highest number of new CKD cases. The country with the highest ASPR and age-standardized DALYs rate (ASDR) of CKD was Mauritius. Globally, age-standardized incidence rate (ASIR) and ASDR were on the rise in almost all countries/regions, suggesting that the impact of CKD on global health is increasing. Population growth and ageing were major factors contributing to the increasing burden of CKD, especially in China and low Socio-demographic Index (SDI) regions. In addition, the cross-national study of health inequalities in CKD showed that, although there have been improvements in global health over time, health inequalities continue to exist. The frontier analysis revealed a considerable degree of heterogeneity in the effective differences across the spectrum of socio-demographic indices.</p><p><strong>Conclusion: </strong>CKD is a global health problem, the burden of which varies between regions and countries. A multifaceted approach is necessary to prevent and control CKD, including population-level interventions targeting risk factors, improvements in the accessibility and quality of health care, and measures to address health inequalities.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"136"},"PeriodicalIF":2.2,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907979/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623359","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, microbiology, and outcome of peritonitis in peritoneal dialysis patients in vietnam: a multicenter study.","authors":"Nguyen Bach, Trinh Thi Kim Chi, Lu Cong Trung, Nguyen Hoang Bao Ngoc, Thai Pham Thi Hoa, Thao Ngoc Phuong Huynh, Truong Hoang Khai, Dang Anh Dao, Phan Xuan Tuoc, Vuong Quoc Dung","doi":"10.1186/s12882-025-04061-y","DOIUrl":"10.1186/s12882-025-04061-y","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease (CKD) is a substantial contributor to global mortality, requiring interventions like kidney transplantation and dialysis. Peritoneal dialysis (PD) has emerged as an effective dialytic modality despite the susceptibility to peritonitis. The study aimed to determine the prevalence of peritonitis among PD patients, elucidating pivotal factors affecting its occurrence, causative bacterial agents, and treatment outcomes (mortality rates, removal of the Tenckhoff catheter, and switch to hemodialysis).</p><p><strong>Methods: </strong>A retrospective cohort study was conducted, which included patients who underwent PD between January 2019 and December 2021 at nine dialysis centers in Vietnam. The prevalence rate of peritonitis was estimated as the quotient of total peritonitis episodes and cumulative patient-years. The association of peritonitis with factors such as age, care (self-care or helper-assisted PD), comorbidities, education level was analyzed using regression analysis. Peritonitis outcomes including mortality rate, Tenckhoff catheter removal, and transitions to hemodialysis were evaluated. PD-related infections were assessed. Additionally, the causative bacterial agents and the negative culture rate were determined.</p><p><strong>Results: </strong>A total of 691 PD patients from nine centers from the south of Vietnam were recruited for the study. Peritonitis was reported in 32.42% of the patients during the study period of 2019-2021. An increase in the number of patients reporting peritonitis was observed over the years. A significant association (p = 0.01) between peritonitis rate and level of literacy was found. The mortality rate among patients who underwent PD was 2.68%. About 16.18% of patients with peritonitis had to have the Tenckhoff catheter removed and needed to be switched to hemodialysis. Around 46.98% of the peritonitis cases were culture-positive.</p><p><strong>Conclusion: </strong>The prevalence of peritonitis among PD patients in Vietnam increased from 2019 to 2021. Lower literacy positively correlated with peritonitis, regardless of the type of PD. The high prevalence of culture-negative peritonitis cases indicated gaps in diagnostic procedures or the presence of unusual pathogens. These outcomes highlight the need for improved education, diagnostic practices, and interventions to reduce peritonitis risks and enhance patient care in PD programs in Vietnam.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"134"},"PeriodicalIF":2.2,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11899019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603789","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":"Combating chronic kidney disease-associated cachexia: A literature review of recent therapeutic approaches.","authors":"Yalda Rahbar Saadat, Amin Abbasi, Seyyed Sina Hejazian, Yalda Hekmatshoar, Mohammadreza Ardalan, Farahnoosh Farnood, Sepideh Zununi Vahed","doi":"10.1186/s12882-025-04057-8","DOIUrl":"10.1186/s12882-025-04057-8","url":null,"abstract":"<p><p>In 2008, the Society on Sarcopenia, Cachexia, and Wasting Disorders introduced a generic definition for all types of cachexia: \"a complex metabolic syndrome associated with the underlying illness characterized by a loss of muscle, with or without fat loss\". It is well-known that the presence of inflammatory burden in end-stage renal disease (ESRD) patients may lead to the evolution of cachexia. Since the etiology of cachexia in chronic kidney disease (CKD) is multifactorial, thus the successful treatment must involve several concomitant measures (nutritional interventions, appetite stimulants, and anti-inflammatory pharmacologic agents) to provide integrated effective therapeutic modalities to combat causative factors and alleviate the outcomes of patients. Given the high mortality rate associated with cachexia, developing new therapeutic modalities are prerequisite for ameliorating patients with CKD worldwide. The present review aims to discuss some therapeutic strategies and provide an update on advances in nutritional approaches to counteract cachexia.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"133"},"PeriodicalIF":2.2,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11895341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603741","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 of abdominal aortic calcification with cognitive impairment in peritoneal dialysis patients.","authors":"Conghui Liu, Yanan Shi, Jiajie Cai, Tingting Bai, Jingjing Li, Lingju Yue, Zhongxin Li","doi":"10.1186/s12882-025-04056-9","DOIUrl":"10.1186/s12882-025-04056-9","url":null,"abstract":"<p><strong>Background: </strong>Patients on peritoneal dialysis (PD) frequently have cognitive impairment, which is linked to a poor prognosis. The purpose of this study was to determine whether abdominal aortic calcification (AAC) may have an impact on PD patients' cognitive function.</p><p><strong>Methods: </strong>In this cross-sectional study of 110 PD patients, cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), and AAC severity was quantified via lateral lumbar radiography (Kauppila method). Participants were stratified by AAC severity into high (HAAC; score ≥ 4) and low (LAAC; score < 4) groups.</p><p><strong>Results: </strong>Cognitive impairment (MoCA < 26) was present in 65.45% of patients. The HAAC group (71.8% of cohort) exhibited distinct metabolic profiles compared to LAAC: older age (63.2 ± 9.8 vs. 47.4 ± 12.1 years, P < 0.001), higher diabetes prevalence (68.4% vs. 22.6%, P < 0.001), elevated serum phosphorus (1.62 ± 0.45 vs. 1.30 ± 0.42 mmol/L, P < 0.001), and lower diastolic blood pressure (79.2 ± 10.8 vs. 86.6 ± 13.4 mmHg, P = 0.005). Notably, HAAC patients had reduced serum creatinine (898.4 ± 251.9 vs. 1190.7 ± 243.5 µmol/L, P < 0.001) and iPTH levels (142.5 vs. 218.0 pg/mL, P = 0.011), suggesting concurrent mineral bone disorder. Multivariate analysis identified AAC severity (OR = 1.28 per 1-point increase, 95%CI = 1.09-1.50) and age (OR = 1.12/year, 95%CI = 1.06-1.19) as independent predictors of cognitive impairment.</p><p><strong>Conclusion: </strong>AAC severity demonstrates a strong, dose-dependent association with cognitive dysfunction in PD patients, independent of traditional risk factors. The combination of elevated phosphorus and suppressed iPTH in high-AAC patients highlights the potential role of mineral metabolism dysregulation in both vascular calcification and neurocognitive decline.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"132"},"PeriodicalIF":2.2,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11895183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596206","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":"Effectiveness of phosphate binders on mortality and cardiovascular disease in end-stage renal disease patients with hyperphosphatemia: a multicenter real-world cohort study.","authors":"Kamolpat Chaiyakittisopon, Oraluck Pattanaprateep, Wanchana Ponthongmak, Patratorn Kunakorntham, Anan Chuasuwan, Atiporn Ingsathit, Gareth J Mckay, John Attia, Ammarin Thakkinstian","doi":"10.1186/s12882-025-04058-7","DOIUrl":"10.1186/s12882-025-04058-7","url":null,"abstract":"<p><strong>Background: </strong>Uncontrolled hyperphosphatemia in end stage renal disease (ESRD) increases the risk of cardiovascular disease (CVD), bone disorders, and premature mortality. Randomized controlled trials show reduced CVD risk of non-calcium-based phosphate-binders (NCBPBs) compared to CBPBs although evidence from real world data is less consistent. This study aimed to compare the effectiveness of NCBPBs, CBPBs, to no phosphate-binder (PB) on mortality and cardiovascular disease in Thai hyperphosphatemic ESRDs.</p><p><strong>Methods: </strong>A retrospective-cohort was conducted by using data from 2 university hospitals between January 2010 and July 2020 (COA. MURA2020/1398 and IRB No.100/63). Primary outcomes were overall survival (OS) and CVD-free time. Secondary outcomes included bone disorders following ESRD. An inverse-probability weighting with regression adjustment was used to assess treatment effects.</p><p><strong>Results: </strong>A total of 8,005 patients were included. Initial CBPBs were associated with both longer OS and CVD-free time compared to no-PBs, while initial treatment with aluminum hydroxide was the highest risk of bone disorders. Patients who received CBPBs-NCBPBs had longest OS, followed by aluminum hydroxide, and CBPBs, with average OS of 13.5, 11.0, and 10.9 years, respectively. The average CVD-free time was longest for the CBPBs-NCBPBs, followed by CBPBs-CBPBs compared to no-PBs. However, these comparisons were insignificantly different.</p><p><strong>Conclusions: </strong>initial hyperphosphatemic ESRD treatment with CBPBs provided longer OS and CVD-free time compared to no-PBs, while aluminum hydroxide was the highest risk of bone disorders. CBPBs followed by NCBPBs achieved the longest OS and CVD-free time, although these were statistical non-significance.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"131"},"PeriodicalIF":2.2,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11895186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596150","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}