BMC Nephrology最新文献

{"title":"Clinical and financial impacts of nursing education programs on recurrent urinary tract infections after kidney transplant: a cohort study.","authors":"Hany M El Hennawy, Omar Safar, Mahmoud Z El Madawie, Jayson Gopiechand, Ibrahim Tawhari, Weam El Nazer, Mohammad F Zaitoun, Abdullah S Al Faifi","doi":"10.1186/s12882-025-04153-9","DOIUrl":"https://doi.org/10.1186/s12882-025-04153-9","url":null,"abstract":"<p><strong>Background: </strong>Urinary tract infections (UTIs) are the most prevalent infections among kidney transplant recipients, with recurrent cases imposing a significant financial burden due to increased hospitalizations and treatment costs.</p><p><strong>Objective: </strong>This study aims to investigate the incidence of recurrent UTIs and evaluate the financial impact of a comprehensive nursing education initiative.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted with kidney transplant patients, divided into two groups: a control group prior to the intervention and a study group following the implementation of the education program. The intervention consisted of weekly training sessions focusing on infection prevention, catheter care, and hygiene. Patient outcomes were monitored for one year post-transplant, with a focus on UTI rates, patient adherence, knowledge, and healthcare costs.</p><p><strong>Results: </strong>The nursing education program resulted in a 26% reduction in UTI incidence and decreased average hospital stays from 8 days to 4 days. Healthcare costs per admission fell from $10,000 to $6,000, leading to total savings of $700,000 based on 175 admissions. The program resulted in a net saving of $650,000. Additionally, significant improvements were observed in patient knowledge, satisfaction, and compliance.</p><p><strong>Conclusions: </strong>Nursing education on UTI prevention for kidney transplant patients effectively enhances clinical outcomes and reduces healthcare costs. These findings underscore the importance of integrating structured education programs into transplant care protocols to achieve sustainable health and economic benefits.</p><p><strong>Clinical trial number: </strong>Not Applicable.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"232"},"PeriodicalIF":2.2,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12065213/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958479","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":"Plasma concentrations of neurofilament light, p-Tau231 and glial fibrillary acidic protein are elevated in patients with chronic kidney disease and correlate with measured glomerular filtration rate.","authors":"Torunn Axelsson, Henrik Zetterberg, Kaj Blennow, Burak Arslan, Nicholas J Ashton, Markus Axelsson, Maria K Svensson, Aso Saeed, Gregor Guron","doi":"10.1186/s12882-025-04130-2","DOIUrl":"https://doi.org/10.1186/s12882-025-04130-2","url":null,"abstract":"<p><strong>Background: </strong>Patients with chronic kidney disease (CKD) have a high prevalence of cerebrovascular disease and cognitive impairment. The objective was to analyse whether plasma concentrations of neurofilament light chain (NfL), glial fibrillary acidic protein (GFAP) and phosphorylated Tau231 (p-Tau231) are elevated in patients with CKD and to identify independent predictors of these biomarkers, with an emphasis on the role of measured glomerular filtration rate (mGFR).</p><p><strong>Methods: </strong>In this cross-sectional cohort study, we included 110 patients with CKD stages 3 and 4 (estimated GFR 15-59 ml/min/1.73 m²) without manifest cerebrovascular disease or dementia, and 55 healthy controls. Biomarkers of neurological disorders were measured with ultrasensitive single molecule array methods.</p><p><strong>Results: </strong>Plasma concentrations (median [IQR]) of NfL (37.5 [22.1-47.5] vs. 13.4 [10.5-16.7] ng/L, p < 0.001), p-Tau231 (25.7 [19.1-38.7] vs. 13.9 [10.5-16.3] ng/L, p < 0.001) and GFAP (190 [140-281] vs. 153 [116-211] ng/L, p < 0.001) were elevated in patients with CKD vs. controls. Measured GFR was negatively correlated with NfL (r = - 0.706, p < 0.001), p-Tau231 (r = - 0.561, p < 0.001), and GFAP (r = - 0.385, p < 0.001). In multivariable linear regression models, mGFR was an independent predictor of log-transformed plasma concentrations of NfL (standardized beta coefficient [β] = - 0.439, p < 0.001) and GFAP (β = - 0.321, p < 0.001).</p><p><strong>Conclusion: </strong>Patients with CKD had elevated plasma concentrations of NfL, p-Tau231 and GFAP compared with controls, and these biomarkers were inversely correlated with mGFR. Measured GFR was a significant, independent predictor of plasma concentrations of NfL and GFAP in patients with CKD. The mechanisms underlying this association need further investigation. Plasma levels of NfL and GFAP should be interpreted cautiously in patients with marked reductions in GFR.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"231"},"PeriodicalIF":2.2,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12065258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954293","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":"Role of exosomes in pathogenesis, diagnosis, and treatment of diabetic nephropathy.","authors":"Shaimaa I Barr, Eman M Abd El-Azeem, Sahar S Bessa, Tarek M Mohamed","doi":"10.1186/s12882-025-04120-4","DOIUrl":"https://doi.org/10.1186/s12882-025-04120-4","url":null,"abstract":"<p><p>Diabetic nephropathy (DN) is a serious microvascular complication that can progress to end-stage renal disease, with its prevalence and associated mortality increasing globally. However extensive research, the precise mechanisms underlying DN pathogenesis remain unclear, and the current treatment options for DN are limited to dialysis or renal replacement therapy, although several experimental approaches have shown potential, they remain investigational and lack clinical translation. Exosomes play a pivotal role in disease diagnosis and prognosis. Urinary exosomes, originating from various kidney cells, reflect the kidney's pathological condition and are involved in cell-to-cell communication through autocrine or paracrine signaling; therefore, they could contribute to the pathogenesis of DN and potential therapeutic approaches. Additionally, due to their diverse cargo, which depend on cellular origin and pathological state, exosomes may act as biomarkers for the early prediction of DN. This review presents a comprehensive overview of the latest findings on the role of exosomes in the diagnosis, pathogenesis, and treatment of DN.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"230"},"PeriodicalIF":2.2,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974178","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":"Miliary Tuberculosis due to Mycobacterium tuberculosis and Mycobacterium smegmatis associated with invasive aspergillosis in a renal transplant recipient.","authors":"Andrade Sierra Jorge, Carvallo-Venegas Mauricio, Andrade-Ortega Antonio de Jesús, Andrade-Ortega Jorge, Cerrillos-Gutiérrez José Ignacio, Aguilar-Fletes Laura Elizabeth, Briseño-Hernández Andres Alejandro, Carrasco-Carrizosa Aldo","doi":"10.1186/s12882-025-04159-3","DOIUrl":"10.1186/s12882-025-04159-3","url":null,"abstract":"<p><p>Infections in renal transplant recipients (RTRs) carry great risk of morbidity-mortality, and the risk of graft loss. Concomitant infections, although common in immunosuppressed patients, should be highly suspected. The present case involves a RTR with opportunistic pulmonary co-infections caused by Mycobacterium tuberculosis (MTb), Mycobacterium smegmatis (MSm), and Aspergillus spp. While MSm can be a colonizing microorganism, we demonstrate that it can also be pathogenic.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"229"},"PeriodicalIF":2.2,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969491","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":"Inflammatory and nutritional indices for overall survival in Hemodialysis patients: a multicenter cohort study.","authors":"Xinpan Chen, Gang Wang, Xiayan Yin, Wenhu Liu, Hongdong Huang, Dishan Li","doi":"10.1186/s12882-025-04121-3","DOIUrl":"https://doi.org/10.1186/s12882-025-04121-3","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to re-evaluate the prognostic value of inflammation and nutrition-related indices in a large multicenter cohort of hemodialysis patients from 138 dialysis centers in Beijing.</p><p><strong>Methods: </strong>This retrospective cohort study included 6,679 hemodialysis patients. Indices were calculated from routine laboratory parameters. Survival analyses included Kaplan-Meier curves and multivariate Cox models. C-index, receiver operating characteristic curves and decision curve analysis were used to evaluate the predictive ability of the different indicators.</p><p><strong>Results: </strong>All indicators (including Prognostic Nutritional Index [PNI], Lymphocyte-to-CRP Ratio [LCR], CRP-to-Albumin Ratio [CAR], Systemic Immune-Inflammation Index [SII], Platelet-to-Lymphocyte Ratio [PLR], and Neutrophil-to-Lymphocyte Ratio [NLR]) except for PLR were identified as independent predictors of OS (overall survival). Among these indicators, the PNI consistently demonstrated superior discriminatory ability in predicting outcomes among hemodialysis patients. Multivariate Cox regression analysis showed that the risk of mortality in hemodialysis decreased with an increase in PNI (adjusted HR 0.78, 95% CI: 0.75-0.82, P < 0.01). The optimal cut-off value for PNI was determined to be 42.3.</p><p><strong>Conclusions: </strong>PNI has demonstrated better reliability as a prognostic indicator for hemodialysis patients compared with LCR, CAR, SII, PLR and NLR. The efficient assessment of PNI effectively identifies high-risk individuals and highlights its significance as a valuable prognostic tool in clinical settings.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"228"},"PeriodicalIF":2.2,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961098","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":"Sodium zirconium cyclosilicate versus sodium polystyrene sulfonate for treatment of hyperkalemia in hemodialysis patients: a randomized clinical trial.","authors":"Mohamed Mamdouh Elsayed, Marwa Ahmed Abdelrahman, Abdelrazik Mohamed Sorour, Islam Ghanem Rizk, Mohamed Aly Abdelhalim Hassab","doi":"10.1186/s12882-025-04129-9","DOIUrl":"10.1186/s12882-025-04129-9","url":null,"abstract":"<p><strong>Background: </strong>Hyperkalemia is a frequent life-threatening condition in hemodialysis (HD) patients. Data comparing the usage of various K + binders in HD patients is still scarce. This study aimed to compare the efficacy and safety of Sodium zirconium cyclosilicate (SZC) and sodium polystyrene sulfonate (SPS) for treatment of hyperkalemia in HD patients.</p><p><strong>Methods: </strong>This prospective, double-blinded, randomized multicenter clinical trial enrolled 120 HD patients with predialysis serum potassium > 5 mmol/L. Patients were randomized to receive SZC (5 g, 3 times/wk on non-dialysis days, 15 gm/wk) or SPS (15 g, 3 times/wk on non-dialysis days, 45 gm/wk) for 8 weeks. The change in serum potassium through the 8 weeks of the study was our primary outcome.</p><p><strong>Results: </strong>Serum potassium significantly decreased in both groups compared to baseline values from the first week till the end of the study with p value of < 0.001 and < 0.001 respectively. Serum K levels in the SZC group were significantly lower (achieved normokalemia after 2 weeks) than K levels in the SPS group (achieved normokalemia after 6 weeks) through the study period (p < 0.001). Rescue therapy for hyperkalemia was less frequent in the SZC group (3.3%) than the SPS group (6.6%) (p = 0.678). Gastrointestinal side effects were non significantly fewer with SZC (5%) compared to SPS (11.6%). However, SPS was less palatable (p < 0.001).</p><p><strong>Conclusions: </strong>When compared to SPS treatment, SZC was associated with a more rapid and efficacious resolution of hyperkalemia with potentially a better safety profile and palatability among HD patients.</p><p><strong>Clinical trials registration: </strong>ClinicalTrials.gov Identifier: NCT06029179. First registration date: 9/01/2023.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"227"},"PeriodicalIF":2.2,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054224/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977367","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":"Navigating strategies used to manage fatigue by patients undergoing hemodialysis: a qualitative exploratory design.","authors":"Zakariya Al-Naamani, Kevin Gormley, Helen Noble, Olinda Santin, Omar Al Omari, Huda Al-Noumani, Norah Madkhali","doi":"10.1186/s12882-025-04140-0","DOIUrl":"https://doi.org/10.1186/s12882-025-04140-0","url":null,"abstract":"<p><strong>Background: </strong>Fatigue among patients with end-stage kidney disease (ESKD) undergoing hemodialysis significantly impacts quality of life and anticipated treatment results. This study explores how Omani patients undergoing hemodialysis manage their fatigue.</p><p><strong>Methods: </strong>A qualitative design was employed. Data were collected from 25 participants through semi-structured interviews, which were transcribed verbatim and analyzed using thematic analysis. Data management, memo creation, and annotation were completed using NVivo 11.</p><p><strong>Results: </strong>Findings highlighted one main overarching theme, Self-initiated management strategies, outlining the coping mechanisms patients used to reduce fatigue and adapt their daily activities to its ongoing presence. This overarching theme encapsulates six subthemes that describe patients' self-initiated strategies to manage fatigue, which include (1) self-regulating weight gain and negotiating accumulated fluid removal with healthcare providers (HCPs); (2) Increased appetite and desire for rest; (3) expanding self-awareness for change; (4) engaging in regular physical activity; (5) seeking deeper understanding and support from others and (6) immersing in faith and religious practices.</p><p><strong>Conclusions: </strong>The study findings emphasize that patients used several management strategies to manage both physical and mental fatigue and improve their quality of daily living. Although these techniques used to manage fatigue by patients were helpful, healthcare professionals must provide a holistic approach to support the patient's self-initiated fatigue management strategies. Therefore, further studies would be required both within nationally and internationally to validate study findings, and find methods to promote the positive coping techniques used.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"226"},"PeriodicalIF":2.2,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12051296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143953338","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":"Informing transplant candidate and donor education in living kidney donation: mapping educational needs through a rapid review.","authors":"Tayler E Truhan, James McMahon, Aisling E Courtney, Paul Gill, Holly Mansell, Helen Noble, Joanne Reid, Nicola Rosaasen, Alison Wood, Clare McKeaveney","doi":"10.1186/s12882-025-04116-0","DOIUrl":"https://doi.org/10.1186/s12882-025-04116-0","url":null,"abstract":"<p><strong>Objectives: </strong>Living donor kidney transplantation (LDKT) is a complex medical procedure requiring extensive education for both donors and transplant candidates. With technological advances in healthcare, video educational resources are becoming more widely used. This study aimed to synthesize the existing qualitative evidence on LDKT educational experiences, preferences, and needs from the perspectives of kidney transplant candidates and recipients, donors, and HCPs, to establish the essential LDKT education considerations for candidates and potential donors interested in kidney transplantation.</p><p><strong>Methods: </strong>A rapid review of qualitative studies on LDKT educational needs was conducted. A literature search was undertaken across MEDLINE, Embase, and CINAHL databases from 2013 to 2023. Cochrane Rapid Reviews Methods Group guidance was utilized.</p><p><strong>Results: </strong>Of 1,802 references, 27 qualitative studies were eligible for inclusion. Qualitative data was analyzed from 803 transplant candidates/recipients, 512 living donors, 104 healthcare providers, and 102 family/friends. Three main themes were identified, including Extensive LDKT Education Throughout Treatment; Shared Learning, Social Support, and Family Dynamics in LDKT; and Diversity and Inclusivity for Minorities.</p><p><strong>Conclusions: </strong>Improvements and innovations are needed regarding LDKT education for kidney transplant candidates, donors, and support networks.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"225"},"PeriodicalIF":2.2,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12048991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977364","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 a shared decision-making program in reducing unplanned dialysis in advanced chronic kidney disease: a retrospective cohort study.","authors":"Pannawat Mongkolrattanakul, Kittiphan Chienwichai","doi":"10.1186/s12882-025-04144-w","DOIUrl":"https://doi.org/10.1186/s12882-025-04144-w","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the effectiveness of a Shared Decision-Making (SDM) program in reducing unplanned dialysis among patients with advanced chronic kidney disease (CKD) and to identify factors predictive of unplanned dialysis.</p><p><strong>Methods: </strong>This retrospective cohort study was conducted at Phanatnikhom Hospital in Chonburi, Thailand, from October 2021 to September 2023. Patients aged 18 years and older with CKD stages 4 and 5 who were receiving renal replacement therapy (RRT) were included. Starting in October 2022, the Shared Decision-Making (SDM) program was implemented as the standard of care. Baseline demographic data, dialysis modalities, and the incidence of unplanned dialysis were collected. Unplanned dialysis was defined as dialysis initiated through a temporary catheter or within a short time frame after the initial dialysis decision.</p><p><strong>Results: </strong>Among 111 patients, 66 received SDM, and 45 received usual care. The incidence of unplanned dialysis was significantly lower in the SDM group compared to the usual care group (33.3% vs. 66.7%, p < 0.001). Multivariate analysis indicated that participation in the SDM program (OR = 0.19, p = 0.001), peritoneal dialysis (OR = 0.26, p = 0.032), and higher serum albumin at the initiation of dialysis (OR = 0.33, p = 0.014) were protective factors against unplanned dialysis.</p><p><strong>Conclusions: </strong>The SDM program effectively reduces unplanned dialysis in patients with advanced CKD by aligning medical decisions with patient preferences and priorities. Peritoneal dialysis and higher serum albumin levels at dialysis initiation are also associated with lower rates of unplanned dialysis.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"224"},"PeriodicalIF":2.2,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of a nomogram for predicting low Kt/V_urea in peritoneal dialysis patients.","authors":"Danfeng Zhang, Tian Zhao, Liting Gao, Huan Zhu, Haowei Jin, Guiling Liu, Deguang Wang","doi":"10.1186/s12882-025-04124-0","DOIUrl":"https://doi.org/10.1186/s12882-025-04124-0","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to develop a nomogram to predict peritoneal dialysis (PD) adequacy in incident PD patients and identify those at high risk for low Kt/Vurea PD function.</p><p><strong>Methods: </strong>We retrospectively analyzed 141 incident PD patients from January 2021 to January 2024. Baseline characteristics, including BMI, hemoglobin levels, and high transport PD membrane, were compared between patients with and without adequate PD function. Univariate logistic regression, LASSO analysis, and Random Forest (RF) algorithms were employed to identify potential biomarkers. Significant predictors were integrated into a multivariable logistic regression model to construct a predictive nomogram.</p><p><strong>Results: </strong>The study found that 32.1% of patients had low total Kt/Vurea. Significant predictors of low Kt/Vurea included smoking (OR 2.23, CI 1.47-5.85), BMI (OR 1.35, CI 1.17-1.59), hemoglobin levels (OR 0.98, CI 0.95-0.99), and High transport (OR 0.2., CI 0.04-0.72). These factors were incorporated into a nomogram, which demonstrated strong predictive accuracy, with a C-Index of 0.802 in the main study group. The model's AUC was 0.778 (95% CI: 0.686-0.870), and Decision Curve Analysis (DCA) confirmed its clinical utility across a wide range of threshold probabilities.</p><p><strong>Conclusions: </strong>We developed a nomogram that accurately predicts PD total Kt/Vurea in incident PD patients. This model can be a valuable tool for identifying patients at risk of low PD total Kt/Vurea, facilitating timely interventions to improve patient outcomes.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"223"},"PeriodicalIF":2.2,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954117","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}