BMC Nephrology最新文献

{"title":"Evaluating Gates' GFR accuracy in renal tumor patients through integration of standalone CT-derived renal depth estimation via deep learning segmentation: a preliminary study.","authors":"Chunxing Wu, Guangfeng Chen, Qing Liao, Feng Zhang, Liangjun Xie, Yueming Zha","doi":"10.1186/s12882-026-05226-z","DOIUrl":"https://doi.org/10.1186/s12882-026-05226-z","url":null,"abstract":"<p><strong>Background: </strong>Gates' Glomerular Filtration Rate (GFR) measurement via SPECT dynamic renal scintigraphy is common in clinical practice. However, its accuracy is limited by the variability of renal depth (RD) estimated by the conventional height- and weight-based Tonnesen formula, particularly in patients with renal tumors. This study compared a novel standalone CT RD estimation via deep learning segmentation and GFR measurement method against the Tonnesen formula between renal tumor and non-tumor groups, using the double plasma sample method (DPSM) as the reference standard.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 99 patients from January to December 2024, categorized into renal tumor group (n = 23) and non-tumor group (n = 76). All patients underwent <sup>99m</sup>Tc-DTPA SPECT/CT dynamic renal scintigraphy, standalone abdominal CT, serum creatinine (Scr) testing, and DPSM. Five GFR measurement methods were compared and analyzed : (1) Gates' method with deep learning-based standalone CT segmentation and RD estimation, (2) Gates' method using Tonnesen's RD via Siemens software, (3) Gates' method using Tonnesen's RD via MMIS software, (4) Scr-based estimation, and (5) DPSM serving as the reference standard. Welch's independent t-tests were conducted statistically to compare various GFRs between tumor and non-tumor groups. Pearson correlation coefficients were used to evaluate relationships among the various GFR methods.</p><p><strong>Results: </strong>Standalone CT-derived RDs were greater than Tonnesen formula estimation. Particularly in the tumor group, CT-derived vs. Tonnesen RDs were 7.30 ± 1.51 cm vs. 5.97 ± 1.07 cm (left), and 7.15 ± 1.27 cm vs. 6.01 ± 1.08 cm (right). The mean total GFR measurements using the reference standard DPSM, CT-derived RD, Tonnesen's RD via Siemens and MMIS software, and Scr-based, were 87.91 ± 19.53, 94.61 ± 28.11, 77.29 ± 17.93, 79.28 ± 23.98, and 81.71 ± 23.31 mL/min for the tumor group, 77.56 ± 11.04, 81.30 ± 30.67, 68.07 ± 22.86, 68.22 ± 24.16, and 76.15 ± 30.65 mL/min for the non-tumor group. The CT-based measurements showed numerically higher correlation with DPSM (r = 0.915 for the tumor group; r = 0.825 for the non-tumor group), compared with Tonnesen-based measurements (r < 0.8 for both subgroups). In paired method-comparison analysis, the CT-based GFR calculation showed descriptively smaller absolute differences from DPSM (21.47 mL/min) than the Tonnesen-based GFR methods (Siemens: 32.57 mL/min, MMIS: 27.04 mL/min) in tumor group.</p><p><strong>Conclusions: </strong>In this preliminary cohort, Gates' GFR calculation incorporating standalone abdominal CT-derived RD estimation via deep learning-based segmentation was associated with a higher correlation with DPSM and descriptively smaller absolute differences from DPSM than conventional Gates GFR with Tonnesen-derived RD estimation in patients with renal tumor. By leveraging existing diagnostic CT imaging,","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"27 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149243009","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":"Examining commonly used equations for estimating the glomerular filtration rate (GFR) in a healthy cohort of children and adolescents.","authors":"Luise Trenkmann, Niels Ziegelasch, Katalin Dittrich, Anja Willenberg, Wieland Kiess, Mandy Vogel","doi":"10.1186/s12882-026-05219-y","DOIUrl":"10.1186/s12882-026-05219-y","url":null,"abstract":"<p><strong>Background: </strong>In this study, we compared established equations for estimating the glomerular filtration rate (GFR) in a cohort of apparently healthy children and adolescents and aimed to evaluate the equations' validity.</p><p><strong>Methods: </strong>Blood samples and anthropometric data from 4,776 apparently healthy participants (0.25-21 years) were analyzed. The glomerular filtration rate was estimated (eGFR) using the revised Schwartz Bedside (2009), the Cystatin C- and Serum Creatinine- based Schwartz equation, the Chronic Kidney Disease in Children (CKiD) equation, the 3 versions of the U25 (U25cys, U25scr, U25ave), the Serum Creatinine version, as well as the Cystatin-C based equation from the European Kidney Function Consortium (EKFCcr, EKFCcys), the CAPA equation, and the Cystatin C-Creatinine-based Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI). The resulting eGFR distributions were compared, and the percentages of eGFR values within the expected physiological eGFR range (90-120 ml/min/1.73 m²) were calculated stratified by age and sex. Subsequently, age ranges with implausible distributions were identified.</p><p><strong>Results: </strong>EKFCcr, CKiD, Schwartz, and U25scr yielded the highest proportion of eGFRs within the expected range and showed consistent values across age groups without large jumps. Bland-Altman analysis indicated extremely low biases between Schwartz and EKFCcr and very high biases especially between CKD-EPI, CAPA and Bedside in reference to the other equations. Males showed higher eGFRs than females.</p><p><strong>Conclusions: </strong>We found that the EKFC equations, Schwartz, and U25 resulted in eGFR distributions within the expected physiological range for an apparently healthy pediatric cohort. Estimates from simpler equations such as Bedside and CAPA were more prone to implausible results.</p><p><strong>Trial registration: </strong>Clinical trial number NCT02550236 (clinicaltrials.gov, date of registration: 2014-12-15).</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"27 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13410585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148599202","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":"ApoB/ApoA-I ratio and all-cause mortality in maintenance hemodialysis: a cohort study.","authors":"Zhen Zhang, Fangfang Xiang, Wuhua Jiang, Xuesen Cao, Xiaoqiang Ding, Bo Shen","doi":"10.1186/s12882-026-05224-1","DOIUrl":"10.1186/s12882-026-05224-1","url":null,"abstract":"<p><strong>Background: </strong>Traditional lipid markers have limited and inconsistent prognostic value in maintenance hemodialysis (MHD), a phenomenon often described as the lipid paradox. We evaluated whether lipid and apolipoprotein-related markers, particularly the ApoB/ApoA-I ratio, were associated with mortality in MHD patients.</p><p><strong>Methods: </strong>This single-center retrospective cohort study included 409 MHD patients. Lipid and apolipoprotein-related markers were analyzed as standardized continuous variables. Cox regression was used for all-cause mortality, and cause-specific Cox and Fine-Gray models were used for cardiovascular mortality.</p><p><strong>Results: </strong>During a median follow-up of 55.7 months, 148 all-cause deaths occurred, including 61 cardiovascular deaths. ApoB/ApoA-I was not associated with all-cause mortality in the unadjusted model, but was independently associated with all-cause mortality in Model 3 (hazard ratio [HR] 1.23, 95% confidence interval [CI] 1.05-1.44; p = 0.012). The association was similar in sensitivity analyses. ApoB/ApoA-I was not significantly associated with cardiovascular mortality in exploratory Fine-Gray regression (subdistribution hazard ratio [SHR] 1.12, 95% CI 0.89-1.43; p = 0.337) and did not improve discrimination beyond the base clinical model.</p><p><strong>Conclusions: </strong>These findings suggest that ApoB/ApoA-I may contribute to risk characterization and etiologic understanding in MHD, but do not support its use as a stand-alone clinical prediction marker.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"27 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13689163/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149236823","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 between prediabetes and nephropathy: a comprehensive systematic review and meta-analysis.","authors":"Raheleh Karimi, Roya Riahi, Mojgan Mortazavi, Setayesh Sindarreh, Ashraf Aminorroaya, Mohammad Reza Maracy","doi":"10.1186/s12882-026-05212-5","DOIUrl":"10.1186/s12882-026-05212-5","url":null,"abstract":"<p><strong>Background: </strong>This study examines the association between prediabetes and nephropathy, focusing on chronic kidney disease and key indicators such as glomerular filtration rate and urinary albumin-to-creatinine ratio.</p><p><strong>Methods: </strong>A systematic review of studies published before November 2024 included 26 articles, 15 cohort studies, and 11 cross-sectional studies, covering 350,546 individuals with normal glucose tolerance and 146,547 with prediabetes. A random-effects restricted maximum likelihood model was used to assess chronic kidney disease, glomerular filtration rate, and urinary albumin-to-creatinine ratio. The risk of chronic kidney disease was reported using relative risk (RR) with 95% confidence intervals, while mean difference (MD) was used for glomerular filtration rate and urinary albumin-to-creatinine ratio. Publication bias and methodological quality were assessed using the Egger regression test and the National Heart, Lung, and Blood Institute quality assessment tools. Sensitivity was tested using a leave-one-out method.</p><p><strong>Results: </strong>Data from 19 studies showed that individuals with prediabetes had a higher risk of developing chronic kidney disease (RR: 1.53; 95% CI: 1.30-1.81; P < 0.001), rising to 1.21 (95% CI: 1.78-2.73) when all three diagnostic methods were used. Across 31 observations, glomerular filtration rate declined by (MD: - 2.85; 95% CI: - 4.57 to - 1.13; P = 0.001). Urinary albumin-to-creatinine ratio increased in 21 observations (MD: 0.87; 95% CI: 0.19-1.55; P = 0.012). Stronger associations were observed in Asia than in Europe or the United States.</p><p><strong>Conclusion: </strong>Prediabetes is linked to lower glomerular filtration rate and higher urinary albumin-to-creatinine ratio, indicating increased risk of chronic kidney disease. Early intervention may be beneficial.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"27 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13689277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149236901","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":"95% ethanol rinse combined with lauromacrogol injection versus lauromacrogol injection alone for ultrasound-guided percutaneous sclerotherapy of simple renal cysts in elderly patients: Which is safer and more effective?","authors":"Kan Gao, Feiliang Wang, Lengnan Xu, Weide Dai","doi":"10.1186/s12882-026-05220-5","DOIUrl":"10.1186/s12882-026-05220-5","url":null,"abstract":"<p><strong>Objective: </strong>To compare the efficacy and safety of 95% ethanol rinse combined with lauromacrogol injection versus lauromacrogol injection alone in sclerotherapy for simple renal cysts in elderly patients.</p><p><strong>Methods: </strong>This retrospective analysis included 94 patients (63 males, 31 females; mean age, 70.15 years) with symptomatic simple renal cysts who underwent ultrasound-guided percutaneous sclerotherapy between 2019 and 2025. Forty-eight patients received lauromacrogol injection alone, while 46 patients received 95% ethanol rinse combined with lauromacrogol injection. All patients were followed up at 1, 6, and 12 months after the procedure.</p><p><strong>Results: </strong>The volume of simple renal cysts decreased during follow-up, from a mean initial volume of 113.2 mL to a final volume of 0.30 mL. At 12 months, the total resolution rate was 98.9% (93/94), and the cure rate was 97.9% (92/94). No significant differences were observed between the two groups in volume reduction rate, resolution rate, or cure rate during follow-up (all P > 0.05). The adverse event rate was significantly higher in the ethanol-combination group than in the lauromacrogol-monotherapy group (56.5% [26/46] vs. 29.2% [14/48]; P < 0.05). Ethanol use was associated with significantly more pain and a higher incidence of fever, even when limited to rinsing the cyst lumen prior to lauromacrogol injection.</p><p><strong>Conclusion: </strong>Percutaneous sclerotherapy was successful in both groups of elderly patients with simple renal cysts. Lauromacrogol injection alone was associated with a significantly lower incidence of minor adverse events.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"27 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148849725","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":"Real-world epidemiology and renal outcomes of ADPKD in Türkiye: the PKD-TURK cohort.","authors":"Serpil Muge Deger, Necmi Eren, Sibel Yucel Kocak, Gulay Ulusal Okyay, Beyhan Güvercin, Abdulmecit Yildiz, Halime Soyak Kabaca, Sabahat Alisir Ecder, Tahsin Karaaslan, Ayca Inci, Mehmet Asi Oktan, Mine Sebnem Karakan, Asil Demirezen, Ulver Boztepe Derici, Bartu Ediz, Ilhan Kurultak, Bulent Huddam, Ozlem Usalan, Ilker Atay, Aysun Toraman, Haci Hasan Yeter, Kursad Onec, Alper Azak, Kenan Turgutalp, Belda Dursun, Onur Tunca, Sinan Kazan, Tulin Akagun, Saliha Yıldırım, Emre Yasar, Hulya Colak, Hayri Ustun Arda, Selma Alagoz, Hamad Dheir, Musa Pinar, Ramazan Danis, Eren Eynel, Berna Yelken, Gursel Yildiz, Funda Sari, Serkan Bakirdogen, Bulent Kaya, Ozgur Can, Melike Betul Ogutmen, Metin Ergul, Sibel Gokcay Bek, Tevfik Ecder","doi":"10.1186/s12882-026-05217-0","DOIUrl":"10.1186/s12882-026-05217-0","url":null,"abstract":"<p><strong>Introduction: </strong>Real-world epidemiological and longitudinal outcome data on autosomal dominant polycystic kidney disease (ADPKD) remain limited in underrepresented populations, including Türkiye. We aimed to characterize the epidemiology, regional distribution, and renal outcomes of ADPKD in a large multicenter national cohort.</p><p><strong>Methods: </strong>In this retrospective multicenter study, adult patients with ADPKD were identified across tertiary nephrology centers in six regions of Türkiye (2010-2025). Study-based prevalence was calculated using Turkish Statistical Institute population data. Longitudinal renal outcomes were evaluated using serial eGFR measurements and Cox regression models identified predictors of ≥ 40% eGFR decline.</p><p><strong>Results: </strong>A total of 2361 patients were included (mean age 38.6 ± 14 years; 51.8% female). Median province-level study-based prevalence was 3.86 per 100,000 population (IQR 2.92-5.49), with substantial regional variation, highest in the Black Sea region (13.46 per 100,000). Study-based prevalence increased significantly over time (annual percent change 14.4%; 95% CI 13.1-15.6; p < 0.001). During a median follow-up of 6 years, 23.9% experienced a ≥ 40% eGFR decline and 10.5% progressed to kidney failure (eGFR < 15 ml/min/1.73m2). Median annual eGFR decline was - 3.33 mL/min/1.73 m²/year. In multivariable analysis, age (adjusted HR 1.02; 95% CI 1.00-1.03; p = 0.010) and hypertension (adjusted HR 2.33; 95% CI 1.25-4.32; p = 0.007) were independently associated with renal progression, whereas tolvaptan use was associated with a lower risk of progression (adjusted HR 0.56; 95% CI 0.37-0.85; p = 0.004). The Mayo Imaging Classification remained independently predictive of renal outcomes (p = 0.027).</p><p><strong>Conclusions: </strong>This large real-world multicenter cohort highlights the geographically heterogeneous study-based burden of ADPKD across participating regions of Türkiye. Increasing prevalence over time likely reflects improved disease recognition, whereas the relatively low study-based prevalence suggests persistent under-recognition of ADPKD. These findings provide important longitudinal outcome data from an underrepresented population and support the need for earlier detection and improved risk stratification in ADPKD.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"27 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13685119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227234","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":"Rituximab and corticosteroids for M-protein-negative PGNMID: case report.","authors":"Zhuolin Huang, Shuopeng Yang, Jun Cai, Fengying Tang","doi":"10.1186/s12882-026-05225-0","DOIUrl":"10.1186/s12882-026-05225-0","url":null,"abstract":"<p><strong>Background: </strong>We report a case of a 69-year-old patient negative for serum M-protein who was diagnosed with proliferative glomerulonephritis with monoclonal immunoglobulin deposits (PGNMID) via renal biopsy.</p><p><strong>Case presentation: </strong>A 69-year-old male presented with hematuria, edema, and rapidly progressive renal failure. Serum M-protein was negative, but renal biopsy confirmed IgG3-κ PGNMID with intense C3 deposition and an MPGN-like pattern. Rituximab was initiated, but due to a pulmonary infection, only one of the planned rituximab doses was administered. After infection resolution, the patient's renal function gradually improved (serum creatinine from 914 to 134 µmol/L) under long-term corticosteroid maintenance. Whether this improvement resulted from the single rituximab dose, prolonged corticosteroids, resolution of sepsis-associated AKI, or natural disease course remains uncertain. This case underscores that PGNMID, though rare, should be considered in seronegative patients with unexplained glomerulonephritis, and highlights the critical role of renal biopsy.</p><p><strong>Conclusions: </strong>PGNMID should be considered in rapidly progressive glomerulonephritis, even when M-protein is negative. In this patient, a single reduced dose of rituximab combined with prolonged corticosteroids was associated with a favorable renal outcome, suggesting that a B-cell-directed, clone-directed approach may be a reasonable option worth further evaluation in seronegative PGNMID. Nonetheless, causality cannot be established from a single case, and the relative contributions of the individual therapies remain uncertain. Further studies are needed to define the optimal treatment for this rare entity.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"27 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13689235/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149236836","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 reliability and validity study of the Turkish version of the Uncertainty about Disease and Treatment Scale in hemodialysis patients.","authors":"Reva Gündoğan, Onur Çetinkaya, Mümin Savaş","doi":"10.1186/s12882-026-05227-y","DOIUrl":"10.1186/s12882-026-05227-y","url":null,"abstract":"<p><strong>Background: </strong>Uncertainty is common in chronic illness and can weaken treatment adherence and psychosocial well-being. Hemodialysis involves persistent symptoms and treatment unpredictability, making uncertainty assessment clinically important. This study was methodologically designed to test the psychometric properties of the Turkish form of the Uncertainty about Disease and Treatment Scale (UC-D&TS) in hemodialysis patients.</p><p><strong>Method: </strong>Adult patients receiving maintenance hemodialysis in a state hospital and a private dialysis center in southern Turkey were recruited between February and June 2025 (n = 155). The scale underwent linguistic and cultural adaptation using the forward-backward translation method. Test-retest reliability was evaluated in a randomly selected subgroup of 50 participants from the original sample after a 2-week interval. Data were collected using a Descriptive Information Form and the 17-item UC-D&TS (5-point Likert). Content validity was assessed via expert review and content validity index (CVI). Construct validity was examined with Kaiser-Meyer-Olkin (KMO), Bartlett's test, exploratory factor analysis (EFA; principal axis factoring extraction, varimax), and confirmatory factor analysis (CFA) in LISREL. Internal consistency was evaluated using Cronbach's alpha and stability using test-retest reliability.</p><p><strong>Results: </strong>Content validity was acceptable (CVI = 0.80). Sampling adequacy supported factor analysis (KMO = 0.821) and Bartlett's test was significant (χ²=992.856, p < 0.001). EFA produced a four-factor solution explaining 59.13% of variance; all loadings were ≥ 0.30 and no items were removed. CFA indicated acceptable fit (χ²/df = 1.77; NNFI = 0.93; CFI = 0.94; IFI = 0.95; PNFI = 0.74; SRMR = 0.072; RMSEA = 0.071). Reliability was high (total α = 0.872; subscales α = 0.641-0.824) and test-retest reliability was excellent (r = 0.986).</p><p><strong>Conclusions: </strong>The Turkish UC-D&TS, which underwent Exploratory Factor Analysis (EFA) to determine its factor structure, demonstrated satisfactory content validity, a stable four-factor structure, acceptable model fit, high internal consistency, and test-retest reliability.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"27 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13682106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223228","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":"Assessing frailty in hemodialysis patients: utility of a self-rated visual analogue scale and the role of routine parameters in clinical prediction.","authors":"Lena Schulte-Kemna, M Künzig, C Hertneck, M Denkinger, R van Erp, W Koch, D Dallmeier, M Kächele, L Bettac, B Schröppel","doi":"10.1186/s12882-026-05218-z","DOIUrl":"10.1186/s12882-026-05218-z","url":null,"abstract":"<p><strong>Background: </strong>There is still no established consensus on the optimal frailty screening tool for routine clinical application in patients with chronic kidney disease (CKD). We evaluated the accuracy of a visual analogue scale (VAS) for frailty screening and identified clinical predictors of frailty based on the modified Fried criteria.</p><p><strong>Methods: </strong>This cross-sectional, multicenter study included 122 adult patients on hemodialysis. Frailty status was assessed using modified Fried criteria and a 5-point self-rated VAS. The agreement between these two methods was evaluated using Cohen's Kappa. For the frailty prediction model we applied logistic regression with backwards selection among a set of clinical parameters associated with this condition. Pre-frail and robust individuals were analyzed as non-frail.</p><p><strong>Results: </strong>Median age was 68 years, 71% were male and 42.6% were considered frail according to Fried criteria. Cohen's Kappa was 0.36 (95% CI [0.21, 0.51]), indicating a fair level of agreement between VAS and Fried criteria. The VAS correctly identified most non-frail patients (specificity 94.3%, PPV 82.6%) while it missed a significant number of frail patients (sensitivity 36.5%, NPV 67.0%). Patients at risk for frailty based on the modified Fried criteria were more likely to have a central venous hemodialysis catheter, lower diuresis, lower creatinine and albumin, a higher prevalence of cardiovascular disease and use of analgesics. A model including these factors demonstrated good predictive performance with an AUC of 0.816 [95% CI 0.74, 0.90].</p><p><strong>Conclusion: </strong>A self-rated VAS for frailty has the potential to simplify frailty screening and enhance its integration into routine nephrology care. A model based on routine parameters can support the identification of frail patients.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"27 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13397956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148577011","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":"Non-technique-related healthcare utilization and costs among dialysis and kidney transplant recipients in Spain: a real-world analysis.","authors":"Rafael Santamaria, Carlos Escobar, Unai Aranda, Beatriz Palacios, Margarita Capel, Ignacio Hernández, Ana Cebrián, Manuel Gorostidi, Roberto Alcázar","doi":"10.1186/s12882-026-05223-2","DOIUrl":"10.1186/s12882-026-05223-2","url":null,"abstract":"<p><strong>Background: </strong>Kidney failure requiring kidney replacement therapy (KRT) is associated with a substantial and growing economic burden. While the costs directly attributable to KRT modalities are well documented, the resource use and costs unrelated to KRT modalities remain unclear.</p><p><strong>Objective: </strong>To quantify healthcare resource utilization (HCRU) and costs in patients receiving dialysis or kidney transplantation, excluding technique-related costs.</p><p><strong>Methods: </strong>This retrospective observational study used BIG-PAC real-world data to analyze dialysis or kidney transplant patients as of January 1, 2018, with a two-year follow-up. Patients were identified based on related diagnostic or procedure codes recorded in electronic health records (EHRs) prior to the index date. Major adverse cardiovascular events (MACE), hospitalization for CKD and mortality were evaluated. HCRU, direct healthcare costs, and indirect productivity costs due to sick leave were assessed, excluding technique-related KRT costs.</p><p><strong>Results: </strong>Of 70,973 individuals, 356 (0.5%) were on dialysis and 232 (0.3%) had kidney transplantation. Over two years, MACE per 1000 patient-years were 276.3 for dialysis and 85.9 for transplantation. CKD hospitalization rates were 245.7 and 183.0, with mortality rates of 253.8 and 35.6, respectively. First-year health costs averaged €25,410.4 (SD €17,369.0) for dialysis patients and €4,472.8 (SD €2,859.1) for transplant recipients. Most costs among dialysis and kidney transplant patients were driven by hospitalization, 72.4% and 39.8%, respectively. Indirect costs due to sick leave were also substantial.</p><p><strong>Conclusion: </strong>Non-technique-related costs represent a substantial component of the overall economic burden in patients receiving KRT, largely driven by hospitalizations. These findings provide important context for healthcare planning, although they do not represent total costs of care and should be interpreted as descriptive estimates.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"27 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13681900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223381","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}