BMC Nephrology最新文献

{"title":"Relationship of gene polymorphisms for complement components C3 and factor H and kidney allograft function.","authors":"Marija Milinkovic, Vladimir Perovic, Stefan Maksimovic, Irena Vukovic, Milica Kravljaca, Voin Brkovic, Iman Assi Milosevic, Milan Radovic, Mirjana Lausevic","doi":"10.1186/s12882-025-04004-7","DOIUrl":"10.1186/s12882-025-04004-7","url":null,"abstract":"<p><p>Complement plays a central role in organ ischemia/reperfusion injury (IRI) and allograft rejection. A retrospective observational study included a cohort of 73 non-diabetic deceased donor kidney allograft recipients. We collected data on donor and recipient demographic, clinical and laboratory parameters. The main outcomes of our study were delayed graft function (DGF) and kidney allograft function during five years posttransplant. Gene single nucleotide polymorphisms (SNPs) for complement components C3 (rs2230199, G_C) and FH (rs800292, G_A) were determined. The genotyping results for FH polymorphism (184G > A) showed a distribution of GG (71.2%) and GA (28.8%) genotypes, with the AA genotype not detected in the cohort. The genotype frequencies of the C3 polymorphism (304 C > G) were CC (71.2%), CG (26.0%) and GG (2.8%).Analysis of FH SNP demonstrated that patients with the GG genotype had a statistically higher frequency of DGF compared to those with the GA genotype (67.3% vs. 38.1%, p = 0.022). Univariate linear regression analysis confirmed that the FH GG genotype was the only significant determinant of DGF (p = 0.025). Analysis of C3 SNP showed that patients with the GC/GG genotype demonstrated significantly lower levels of creatinine clearance compared to those with the CC genotype at 1 year (p = 0.002), 3 years (p = 0.001) and 5 years (p = 0.010) posttransplant. These findings underscore the importance of genetic factors in influencing renal outcomes post-transplant.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"74"},"PeriodicalIF":2.2,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11823076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143405256","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 aberrant mineral metabolic markers with fracture risk in chronic kidney disease: a comprehensive meta-analysis.","authors":"Yao Liu, Zhen Xing Zhang, Chen Sheng Fu, Zhi Bin Ye, Hui Min Jin, Xiu Hong Yang","doi":"10.1186/s12882-025-03992-w","DOIUrl":"10.1186/s12882-025-03992-w","url":null,"abstract":"<p><strong>Background: </strong>This meta-analysis aims to investigate the impact of abnormalities in mineral metabolic markers, including serum phosphate and calcium, intact parathyroid hormone (iPTH), and fibroblast growth factor 23 (FGF23) on the risk of fractures in patients with chronic kidney disease (CKD).</p><p><strong>Methods: </strong>A systematic search was conducted across MEDLINE, Web of Science, EMBASE, ClinicalTrials.gov, and the Cochrane Central Register for Controlled Trials. The outcomes were association of mineral metabolic markers with the risk of fractures in patients with chronic kidney disease. Pooled risk estimates and 95% confidence intervals (CIs) were calculated using fixed-effects or random-effects models.</p><p><strong>Results: </strong>Thirty-two studies were included in the meta-analysis. High and low levels of serum phosphate in hemodialysis (HD) patients were both associated with an increased risk of fractures (RR = 1.08, 95% CI 1.02-1.15, P = 0.013; RR = 1.13, 95% CI 1.02-1.25, P = 0.022, respectively). Similarly, abnormal levels of iPTH in CKD patients, both high and low, were associated with increased fracture risk (RR = 1.25, 95% CI 1.20-1.31, P < 0.001; RR = 1.41, 95% CI 1.10-1.82, P = 0.007, respectively). Elevated FGF23 levels were also linked to an increased risk of fractures (RR = 1.32, 95% CI 1.06-1.66, P = 0.015). While a higher level of calcium exhibited a trend towards reduced fracture incidence without statistical significance (RR = 0.90, 95% CI 0.77-1.05, P = 0.181), lower calcium levels tended to increase fracture risk without statistical significance (RR = 1.11, 95% CI 0.99-1.24, P = 0.087). Notably, subjects treated with calcium and phosphorus modulating drugs demonstrated a statistically significant reduction in fractures among CKD patients undergoing dialysis (phosphate binders, RR = 0.79, 95% CI 0.70-0.89; cinacalcet, RR = 0.74, 95% CI 0.59-0.93; vitamin D analogues, RR = 0.82, 95% CI 0.74-0.92, respectively).</p><p><strong>Conclusion: </strong>This meta-analysis underscores the association between abnormal mineral metabolic markers, including high serum phosphate, iPTH, and FGF23, and an increased risk of fractures in CKD patients. Notably, both elevated and decreased levels of phosphate and iPTH contribute to fracture risk. The efficacy of active vitamin D, phosphorus binders, and cinacalcet in preventing fractures was observed in HD patients but not in the non-dialysis CKD population.</p><p><strong>Trial registration: </strong>PROSPERO CRD42023493951.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"68"},"PeriodicalIF":2.2,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11818153/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398157","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":"New insights in the treatment of DKD: recent advances and future prospects.","authors":"Meimei Zhao, Yongtong Cao, Liang Ma","doi":"10.1186/s12882-025-03953-3","DOIUrl":"10.1186/s12882-025-03953-3","url":null,"abstract":"<p><p>Diabetic kidney disease (DKD) represents the predominant and severe microvascular complication associated with diabetes, frequently culminating in End-Stage Kidney Disease (ESKD). The escalating prevalence of diabetes has correspondingly led to a rise in DKD incidence, imposing significant challenges on both individuals and society. The etiology of DKD is multifaceted and remains devoid of definitive therapeutic interventions. This article examines the pharmacological actions and mechanisms of different drugs used for the prevention and treatment of DKD that are currently in clinical use or undergoing development. The goal is to offer insights for early intervention based on therapeutic combinations to potentially slow kidney disease progression.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"72"},"PeriodicalIF":2.2,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11817338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398162","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":"Current strategies on kidney regeneration using tissue engineering approaches: a systematic review.","authors":"Parham Torabinavid, Mohammad Hossein Khosropanah, Ashkan Azimzadeh, Abdol-Mohammad Kajbafzadeh","doi":"10.1186/s12882-025-03968-w","DOIUrl":"10.1186/s12882-025-03968-w","url":null,"abstract":"<p><strong>Introduction: </strong>Over the past two decades, there has been a notable rise in the number of individuals afflicted with End-Stage Renal Disease, resulting in an increased demand for renal replacement therapies. While periodic dialysis is beneficial, it can negatively impact a patient's quality of life and does not fully replicate the secretory functions of the kidneys. Additionally, the scarcity of organ donors and complications associated with organ transplants have underscored the importance of tissue engineering. Regenerative medicine is revolutionized by developing decellularized organs and tissue engineering, which is considered a cutting-edge area of study with enormous potential. Developing bioengineered kidneys using tissue engineering approaches for renal replacement therapy is promising.</p><p><strong>Method and materials: </strong>We aimed to systematically review the essential preclinical data to promote the translation of tissue engineering research for kidney repair from the laboratory to clinical practice. A PubMed search strategy was systematically implemented without any linguistic restrictions. The assessment focused on complete circumferential and inlay procedures, thoroughly evaluating parameters such as cell seeding, decellularization techniques, recellularization protocols, and biomaterial types.</p><p><strong>Results: </strong>Of the 1,484 studies retrieved from the following primary searches, 105 were included. Kidneys were harvested from eight different species. Nine studies performed kidney decellularization from discarded human kidneys. Sixty-four studies performed whole organ decellularization. Some studies used acellular scaffolds to produce hydrogels, sheets, and solutions. Decellularization is achieved through physical, chemical, or enzymatic treatment or a combination of them. Sterilization of acellular scaffolds was also thoroughly and comparatively evaluated. Lastly, different recellularization protocols and types of cells used for further cell seeding were demonstrated.</p><p><strong>Conclusion: </strong>A comprehensive review of the existing literature about kidney tissue engineering was conducted to evaluate its effectiveness in preclinical investigations. Our findings indicate that enhancements in the design of preclinical studies are necessary to facilitate the successful translation of tissue engineering technologies into clinical applications.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"66"},"PeriodicalIF":2.2,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11816546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A unique case report of wilkie syndrome in a middle-aged female with posterior nutcracker syndrome.","authors":"Roxana Elena Mirică, Bogdan Apan","doi":"10.1186/s12882-025-04003-8","DOIUrl":"10.1186/s12882-025-04003-8","url":null,"abstract":"<p><p>Nutcracker syndrome and Wilkie syndrome are rare and often diagnosed incidentally during imaging investigations for other conditions and, on occasion, together. In this paper, we present the case of a 36-year-old patient with quasi-permanent symptoms including epigastralgia, loss of appetite, early satiety, left lumbar colic pain, normal stool and dysuria. The clinical examination revealed a non-distended abdomen, sensitivity to palpation in the epigastrium and hypogastrium regions, frequent urination in small amounts, and a body mass index (BMI) of 15 kg/m2, indicating severe protein calorie malnutrition. Laboratory tests indicated persistent microscopic hematuria without proteinuria with repeated urinary infections. Abdominal-pelvic ultrasound with Doppler revealed a left renal vein dilated up to 10 mm in the left paraaortic region (Nutcracker syndrome) and distal duodenal obstruction with distension in the same region, which was also confirmed by gastroduodenoscopy (Wilkie syndrome). Abdominal‒pelvic computed tomography angiography revealed a malformed and dilated left renal vein that was compressed as a result of aorto-mesenteric obstruction and communicating with an aberrant left paravertebral and paraspinal network extending to L1 and L5 and thrombosis of the left ovarian vein. The patient benefitted from conservative treatment, which intended to correct the malabsorption syndrome with the help of a nutritionist, who suggested a personalized diet to help gain weight. As a result, the patient was able to avoid surgical treatment. The case is peculiar in that the patient presented with a very rare form of Nutcracker syndrome (posterior type) associated with another rare syndrome, Wilkie syndrome.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"70"},"PeriodicalIF":2.2,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11816764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398082","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":"Kidney dysfunction and associated factors among adults living with human immuno-deficiency virus in Africa: a systematic review and meta-analysis.","authors":"Worku Chekol Tassew, Agerie Mengistie Zeleke, Yeshiwas Ayale Ferede, Girum Meseret Ayenew","doi":"10.1186/s12882-025-04011-8","DOIUrl":"10.1186/s12882-025-04011-8","url":null,"abstract":"<p><strong>Background: </strong>Kidney dysfunction among adults living with Human Immuno-Deficiency Virus (HIV) increases the risk of drug-related side effects, acute kidney injury, hospitalization, and progression to end-stage kidney disease. In developing regions like Africa, where access to kidney transplants and dialysis is limited, early detection of kidney disease among adults living with HIV has significant clinical and financial implications. Therefore, the objective of this review was to determine the pooled prevalence and identify associated factors of kidney dysfunction among adults living with HIV in Africa.</p><p><strong>Methods: </strong>The report was presented according to the Preferred Reporting Items for Systematic Review and Meta-Analyses checklists. The articles were searched using PubMed/MEDLINE, EMBASE, Scopus, Wiley Online Library, CINAHL/EBSCO, OVID/Wolters Kluwer, Cochrane Library, Google Scholar, Science Direct, and African Journal Online. Data were extracted using Microsoft Excel and exported to STATA MP Version 11 Software for analysis. Heterogeneity of studies was assessed by Cochran's Q test and I² statistics. Publication bias was detected by the visual inspection of the funnel plot and statistical Egger's test.</p><p><strong>Results: </strong>In this study, the pooled prevalence of kidney dysfunction among adults living with HIV in Africa is estimated to be 16.85% (95% CI: 13.08 - 20.62, I²=96.2%, p-value = 0.000). Female sex (POR = 1.82; 95% CI; 1.31, 2.53), age ≥ 50 years (POR = 8.94; 95% CI: 1.82, 43.93), body mass index ≥ 30 kg/m² (POR = 4.70; 95% CI: 3.07, 7.22), diabetes mellitus (POR = 2.84; 95% CI: 1.59, 5.07), CD4 count < 200 cells/mm³ (POR = 3.64; 95% CI: 1.63, 8.13) and anemia (POR = 3.73, 95% CI = 2.00-6.94) were factors associated with kidney dysfunction among adults living with HIV.</p><p><strong>Conclusions: </strong>This study revealed that the pooled prevalence of kidney dysfunction among adults living with HIV in Africa remains significant. Female sex, age ≥ 50 years, body mass index ≥ 30 kg/m², diabetes mellitus, CD4 count < 200 cells/mm³ and anemia were factors associated with kidney dysfunction. To reduce the morbidity and mortality associated with kidney dysfunction, it is advisable to create awareness and initiating early interventions through health education during their follow-up time, and initiating suitable medication at an early stage.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"67"},"PeriodicalIF":2.2,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11816536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398161","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":"Analysis of efficacy factors in unilateral obstructive severe renal insufficiency: a single-centre retrospective study.","authors":"Jia Li, Hua Pang, Wenbo Li","doi":"10.1186/s12882-025-03996-6","DOIUrl":"10.1186/s12882-025-03996-6","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the predictors of renal function recovery after treatment of severe renal impairment in unilateral upper urinary tract obstruction (UUTO).</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 153 patients with unilateral UUTO-induced severe renal injury admitted to the First Affiliated Hospital of Chongqing Medical University from January 2014 to January 2023. Independent variables included pre-treatment estimated glomerular filtration rate (eGFR), pre-treatment ^99mTc-diethylenetriaminepentaacetic acid (^99mTc-DTPA) dynamic renal scintigraphy GFR values, C-reactive protein (CRP) levels, and body mass index. These variables were subjected to multiple linear regression analysis to predict changes in GFR (GFRd) post-treatment, with statistical significance set at P < 0.05. Categorical variables, including sex, site of obstruction, eGFR value and nephrectomy were compared with GFRd using two-sample t-tests or one-way ANOVA, with significance at P < 0.05.</p><p><strong>Results: </strong>Multiple linear regression identified a significant correlation between pre-treatment ^99mTc-DTPA dynamic renal scintigraphy GFR values and CRP levels with GFRd. Female patients and those with renal pelvic obstruction exhibited a higher mean GFRd compared to males and those with ureteral obstruction, although this did not reach statistical significance.</p><p><strong>Conclusion: </strong>Pre-treatment ^99mTc-DTPA dynamic renal scintigraphy GFR values and CRP levels are pivotal in assessing treatment efficacy for severe renal insufficiency secondary to UUTO, with the former being indispensable for evaluating compromised unilateral renal function.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"69"},"PeriodicalIF":2.2,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11817891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398156","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 for relapse and aggravation in membranous nephropathy after COVID-19 infection.","authors":"Yue Shu, Jing Huang, Yi-Miao Zhang, Fang Wang, Xin Wang, Li-Qiang Meng, Xu-Yang Cheng, Gang Liu, Ming-Hui Zhao, Zhao Cui","doi":"10.1186/s12882-025-04000-x","DOIUrl":"10.1186/s12882-025-04000-x","url":null,"abstract":"<p><strong>Background: </strong>Relapse of membranous nephropathy (MN) and other glomerular diseases has been observed after COVID-19 infection. The risk factors contributing to disease progression in MN patients after contracting COVID-19 remain unclear.</p><p><strong>Methods: </strong>This retrospective study included 656 consecutive patients with biopsy-proven primary MN who received treatment and were regularly followed up for over six months. Logistic regression analyses were conducted to identify risk factors for disease progression.</p><p><strong>Results: </strong>Among the cohort, 555 patients (84.6%) contracted COVID-19 from November 11th, 2022, to February 22nd, 2023. Of them, 112 patients (20.2%) experienced a > 50% increase in proteinuria, including 30 patients (5.4%) who experienced nephrotic syndrome relapse. Sixteen patients (2.9%) showed immune aggravation with elevated anti-PLA2R antibody levels, and five patients (0.9%) had immune relapse characterized by antibody reoccurrence. Kidney dysfunction, defined as an eGFR reduction > 30% from baseline, occurred in 10 patients (1.8%), with two patients (0.4%) progressing to ESKD. Four patients (0.7%) died of respiratory failure. Overall, 132 patients (24.0%) experienced disease progression after COVID-19 infection. Multivariate logistic regression identified longer fever duration (OR 1.118, 95% CI 1.029-1.356, P = 0.018), withdrawal of immunosuppressants and/or steroids (OR 2.571, 95% CI 1.377-4.799, P = 0.003) and extended drug cessation (OR 1.113, 95% CI 1.045-1.186, P = 0.001) as independent risk factors for MN progression.</p><p><strong>Conclusions: </strong>These findings suggest prompt antiviral treatment and minimizing the duration of immunosuppressant withdrawal to optimize kidney outcomes in MN patients with COVID-19.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"71"},"PeriodicalIF":2.2,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11817977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143398163","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":"Decline in eGFR and mortality among type II diabetic patients: a 3-year prospective cohort study from Palestine.","authors":"Mohammad Jaber, Anas Sharabati, Khaled Nofal, Mohanad Hassan, Zakaria Hamdan, Zaher Nazzal","doi":"10.1186/s12882-025-03947-1","DOIUrl":"10.1186/s12882-025-03947-1","url":null,"abstract":"<p><strong>Introduction: </strong>Diabetic nephropathy is a significant complication of diabetes and a leading cause of chronic kidney disease (CKD) globally. This study aimed to assess the decline of renal function and all-cause mortality and identify the contributing risk factors among Palestinian patients with diabetes.</p><p><strong>Methodology: </strong>The study employed a prospective cohort design, enrolling 311 patients with type 2 diabetes mellitus (T2DM) attending primary health care centers in Palestine. Baseline data were collected in 2018 to determine the prevalence of CKD in patients with T2DM. Subsequently, the patients were followed up for three years to assess renal function and identify significant associated risk factors. The primary outcomes examined were estimated glomerular filtration rate (eGFR) decline and all-cause mortality.</p><p><strong>Results: </strong>During the three-year follow-up, 37.5% of the patients experienced eGFR decline, averaging 4.2 ml/min/1.73 m² per year. Males showed a significant association with eGFR decline with 5 times higher risk of developing eGFR decline. Hypertensive patients were 2.4 times more likely to experience decline. Regarding all-cause mortality, 14.1% of the patients died, with an incidence rate of 51.3 deaths per 1000 person-years. The risk of all-cause mortality was 5.5 times greater for patients with impaired renal function at baseline and 10.8 times greater for patients who had eGFR decline.</p><p><strong>Conclusion: </strong>This study highlights the importance of early detection of CKD in patients with diabetes, prompting more comprehensive management of risk factors related to eGFR decline and mortality. Furthermore, it underscores the need for future research in this patient population, including investigations about other relevant risk factors and the impact of different medications, such as anti-diabetic and antihypertensive medications, on the GFR decline and mortality rate.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"64"},"PeriodicalIF":2.2,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11808952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143389921","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 prevalence of frailty according to kidney function and its association with cognitive impairment, nutritional status, and clinical outcome.","authors":"Tae-Won Yang, YooMee Kang, Do-Hyung Kim, Young-Soo Kim, Oh-Young Kwon, Tae Won Lee, Dong Jun Park, Eunjin Bae","doi":"10.1186/s12882-025-04006-5","DOIUrl":"10.1186/s12882-025-04006-5","url":null,"abstract":"<p><strong>Background: </strong>Frailty is a state of vulnerability to poor homeostatic resolution of after a stressful event. The prevalence of frailty in patients with chronic kidney disease (CKD) is more common than in the general population. Frailty is associated with a poor clinical prognosis, malnutrition, and cognitive impairment; however, studies on these factors in patients with CKD are lacking. Therefore, we aimed to evaluate the relationship between CKD and frailty, nutritional status, and cognitive impairment and their influence on clinical outcomes.</p><p><strong>Methods: </strong>We prospectively enrolled participants from June 2019 to December 2020 and divided them into three CKD groups according to kidney function (CKD G1-2, CKD G3-4, and CKD G5D). Clinical outcomes were defined as the composite outcomes of all-cause death, hospitalization, and cardiovascular outcomes, including nonfatal myocardial infarction, revascularization, or stroke. To calculate the relative risk of frailty, cognitive impairment, nutritional status, and clinical outcome, odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using logistic regression analysis.</p><p><strong>Result: </strong>A total of 83 patients were included, of whom 31.3% had frailty and 18.1% had cognitive impairment. In the CKD G5D group, the prevalence of frailty (56.7%, n = 17) was significantly higher, and the nutritional quotient score was lower in the other groups. The Korean-Montreal Cognitive Assessment score was significantly lower in the CKD G5D group; however, cognitive impairment did not differ among the three groups. Frailty was significantly associated with cognitive impairment and CKD G5D group. Cognitive impairment was significantly associated with older age and higher BMI. Well-nourished status was significantly associated with BMI and CKD G5D group. Patients in the CKD G5D group were significantly more likely to have adverse clinical outcomes.</p><p><strong>Conclusions: </strong>The prevalence of frailty increased significantly as the CKD stage progressed. Particularly, CKD G5D group correlated with frailty and nutritional status, leading to poor clinical outcomes.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"65"},"PeriodicalIF":2.2,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11808967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143389927","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}