BMC Nephrology最新文献

{"title":"Severe hypercalcemia requiring emergency hemodialysis and multidrug therapy in a case of diffuse large B-cell lymphoma with multiple bone lesions.","authors":"Yusaku Watanabe, Shohei Kaneko, Rinka Yamamoto, Toshiaki Ogishi, Sachika Okamoto, Kosuke Yuyama, Akari Matsuoka, Yuhei Nakamura, Shiori Ando, Kiyonori Ito, Keiji Hirai, Susumu Ookawara, Yoshiyuki Morishita","doi":"10.1186/s12882-025-04422-7","DOIUrl":"https://doi.org/10.1186/s12882-025-04422-7","url":null,"abstract":"<p><strong>Background: </strong>Severe hypercalcemia is a rare but serious complication observed in patients with diffuse large B-cell lymphoma (DLBCL) with multiple bone lesions. Currently, no standard therapy has been established for this life-threatening condition.</p><p><strong>Case presentation: </strong>A 54-year-old Japanese woman with severe hypercalcemia (serum total calcium concentration of 23.0 mg/dL) was referred to our hospital. Initial management included multiple sessions of emergency hemodialysis, aggressive hydration, and administration of calcitonin. Although these interventions temporarily improved her condition, her serum calcium levels soon rebounded. The addition of bisphosphonates did not induce a prompt or sufficient reduction in serum calcium levels. Computed tomography revealed osteolytic lesions, strongly suggestive of malignancy. Given that the pathological condition was attributed to bone lesions, denosumab was administered, leading to a marked reduction in serum calcium levels and sustained control. A definitive diagnosis of DLBCL was established through bone biopsy and bone marrow aspiration. Based on these findings, severe hypercalcemia was determined to be secondary to DLBCL with multiple bone lesions. Following the initiation of chemotherapy, her serum calcium levels remained stable during follow-up.</p><p><strong>Conclusions: </strong>Severe hypercalcemia in this case was caused by DLBCL with multiple bone lesions. Successful management was achieved through a combination of emergency hemodialysis, aggressive hydration, and a multi-drug regimen, including calcitonin, bisphosphonates, and denosumab.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"488"},"PeriodicalIF":2.4,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12376524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942530","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 tonsillectomy plus steroid pulse therapy and renal outcomes in patients with IgA nephropathy: a retrospective cohort study.","authors":"Ayano Hayashi, Kayoko Mizuno, Kanna Shinkawa, Kazunori Sakoda, Satomi Yoshida, Masato Takeuchi, Motoko Yanagita, Koji Kawakami","doi":"10.1186/s12882-025-04408-5","DOIUrl":"https://doi.org/10.1186/s12882-025-04408-5","url":null,"abstract":"<p><strong>Background: </strong>IgA nephropathy (IgAN) is the most common disorder in chronic glomerulonephritis, and various treatment methods have been established. Tonsillectomy and steroid pulse therapy (TSP) are widely performed in Japan. However, their correlation with renal outcomes remains unclear. In this study, we aimed to examine the association between renal prognosis and steroid pulse therapy with or without tonsillectomy.</p><p><strong>Methods: </strong>In this retrospective cohort study, we identified patients diagnosed with IgAN between April 2002 and March 2021 using a Japanese healthcare records database. We selected patients with a prescription history of methylprednisolone for three consecutive days within one year of diagnosis and an estimated glomerular filtration rate (eGFR) of 30 mL/min/1.73 m² or above. We categorized the patients into TSP and steroid pulse therapy (SP) groups based on whether they underwent tonsillectomy within one year of diagnosis. The primary outcome was the composite outcome of a 30% decline in eGFR and initiation of dialysis, and the secondary outcomes comprised the composite outcome of end-stage renal failure and initiation of dialysis and eGFR slope. Inverse probability of treatment weighting (IPTW) using propensity score, Kaplan-Meier survival analysis, and weighted Cox regression analysis by applying IPTW were performed.</p><p><strong>Results: </strong>Overall, 550 patients were eligible for the main analysis, and approximately 40% underwent tonsillectomy within 1 year of IgAN diagnosis: 221 in the TSP group and 329 in the SP group. The primary outcome did not differ between the groups (hazard ratio, 0.58; [95% confidence interval: 0.22-1.54]; P = 0.28). The groups did not differ in terms of the secondary outcomes.</p><p><strong>Conclusions: </strong>Although we could not demonstrate the effectiveness of TSP on renal prognosis in patients with IgAN, this study may have been underpowered, and there are certain limitations due to the information available from the database, we were able to evaluate the association of TSP on renal outcomes using real-world data.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"484"},"PeriodicalIF":2.4,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12374458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942270","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":"Effects of different peritoneal dialysis solutions on serum lipid levels and lipid profile in end-stage chronic kidney disease patients undergoing peritoneal dialysis.","authors":"Gokhan Aydin, Cevat Topal, Kamil Konur, Oguzkan Ilmaz","doi":"10.1186/s12882-025-04417-4","DOIUrl":"https://doi.org/10.1186/s12882-025-04417-4","url":null,"abstract":"","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"483"},"PeriodicalIF":2.4,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12374408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942411","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":"Belatacept and non-melanoma skin cancer risk in kidney transplant recipients: a narrative review from a mechanistic and clinical perspective.","authors":"Hany M El Hennawy, Omar Safar, Ahmed Nassar, Mahmoud Z El Madawie, Mohammad F Zaitoun, Yasser M Almahdi, Abdullah S Al Faifi, Ibrahim Tawhari","doi":"10.1186/s12882-025-04373-z","DOIUrl":"https://doi.org/10.1186/s12882-025-04373-z","url":null,"abstract":"<p><p>Non-melanoma skin cancer is a prevalent complication in renal transplant recipients due to long-term immunosuppressive therapy. Calcineurin inhibitors, such as tacrolimus and cyclosporine, are effective in preventing graft rejection; however, they significantly increase the risk of non-melanoma skin cancer through broad immunosuppressive and pro-oncogenic mechanisms. Belatacept, a selective co-stimulation blocker targeting the CD80/CD86-CD28 axis, has emerged as a mechanistically distinct alternative with potential benefits for oncologic and renal outcomes. The primary objective of this review is to examine the impact of belatacept-based immunosuppression on the incidence and progression of non-melanoma skin cancer in renal transplant recipients, compared to conventional Calcineurin inhibitors. Secondary objectives include evaluating the immunologic mechanisms underlying its distinct cancer risk profile, exploring combinatory regimens (particularly with mammalian target of rapamycin inhibitors), assessing metabolic and nephrotoxic implications, and addressing ethical and clinical considerations in switching stable patients from Calcineurin inhibitors to belatacept. Although retrospective studies suggest a lower incidence of non-melanoma skin cancer with belatacept, robust prospective data remain limited, and its use is associated with increased early rejection and post-transplant lymphoproliferative disorder risk, particularly in Epstein-Barr virus seronegative patients. Emerging molecular biomarkers and transcriptomic insights may facilitate the development of personalized immunosuppression strategies. Further randomized controlled trials and longitudinal studies are essential to clarify belatacept's oncologic safety and optimize immunosuppressive protocols in high-risk transplant populations.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"487"},"PeriodicalIF":2.4,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12375278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942191","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":"Experiences of kidney transplantation for recipients in regional, rural, and remote Queensland - exploring the trials and tribulations.","authors":"Tara K Watters, Beverley D Glass, Nicole J Scholes-Robertson, Andrew J Mallett","doi":"10.1186/s12882-025-04412-9","DOIUrl":"https://doi.org/10.1186/s12882-025-04412-9","url":null,"abstract":"<p><strong>Background: </strong>People with kidney failure, unable to access kidney transplantation are disadvantaged in terms of their quality of life and overall survival. Despite this, regional, rural, and remote populations worldwide remain less likely to receive a kidney transplant and often experience unique difficulties throughout their transplant journey. This study aimed to explore the experiences of these kidney transplant recipients, including around current transplant processes to understand barriers to access for regional, rural, and remote populations.</p><p><strong>Methods: </strong>Focus group discussions were conducted either in-person or online with kidney transplant recipients from regional, rural, and remote areas of northern Queensland. Transcripts were analysed thematically with emerging themes mapped against constructs of Levesque's patient-centred healthcare access framework.</p><p><strong>Results: </strong>Focus group participants (n = 30) included both deceased (90%) and living (10%) donor transplant recipients, with almost a third (30%) of which resided in rural or remote areas. Six themes were identified relating to access to kidney transplantation: facing hurdles to transplant assessment, insufficient communication and education, permeating psychosocial hazards, repercussions of distance, overwhelming financial strain, and troubling long-term adversities.</p><p><strong>Conclusions: </strong>Kidney transplant recipients from regional, rural, and remote areas of northern Queensland described significant barriers throughout their transplantation journey. These relate primary to their geographical distance from specialty kidney transplant services and the subsequent logistic, financial, and psychosocial challenges that arise.</p><p><strong>Clinical trial registration: </strong>This study was not a clinical trial.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"485"},"PeriodicalIF":2.4,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12374299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942451","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":"Use of urinary NGAL in steroid-resistant vs. steroid-sensitive nephrotic syndrome: a systematic review and meta-analysis.","authors":"Aymen Abdalla, Abdelrahman Ali, I O Abufatima, Saeed Majzoub, Tasneem A E Elbasheer, Sara M A O Ahmed, Seima Osman, Yousra K K Khalid, Ahmed Elamir, Hiba K K Khalid, Nihal M A Abdelmutalib, Sagad O O Mohamed","doi":"10.1186/s12882-025-04420-9","DOIUrl":"https://doi.org/10.1186/s12882-025-04420-9","url":null,"abstract":"<p><strong>Background: </strong>Nephrotic syndrome is a common glomerular disorder. Treatment typically begins with corticosteroids, but patient response varies. Differentiating between steroid-sensitive nephrotic syndrome (SSNS) and steroid-resistant nephrotic syndrome (SRNS) early in the disease course is important, as SRNS is associated with a higher risk of poor long-term outcomes. Neutrophil gelatinase-associated lipocalin (NGAL), a biomarker released in response to tubular injury, has emerged as a potential non-invasive marker for renal damage.</p><p><strong>Methods: </strong>We conducted a systematic review and meta-analysis of studies reporting NGAL levels in SSNS and SRNS, based on the PRISMA guidelines. A comprehensive literature search was conducted using PubMed, Scopus, Web of Science, ScienceDirect, and the WHO Virtual Health Library Regional. The statistical analysis was performed using a random-effects model to estimate the standardized mean difference (SMD) with a 95% confidence interval.</p><p><strong>Results: </strong>A total of 16 studies were included. Meta-analyses revealed significantly higher urinary NGAL levels in both SSNS and SRNS patients compared to healthy controls. Urinary NGAL levels were significantly higher in SSNS and SRNS patients compared to healthy controls, with SMD = 0.78 (95% CI: 0.434-1.128, P < .001) and SMD = 2.56 (95% CI: 1.152-3.971, P < .001), respectively. Patients with SRNS had markedly higher urinary NGAL levels than those with SSNS (SMD = 1.889, 95% CI: 0.819-2.959, P < .001). ROC analyses across several studies demonstrated moderate to strong discriminative ability of urinary NGAL in distinguishing between SRNS and SSNS.</p><p><strong>Conclusion: </strong>Urinary NGAL demonstrated strong potential as a non-invasive biomarker for distinguishing between SRNS and SSNS, supporting its clinical utility in early diagnosis, risk stratification, and management.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"486"},"PeriodicalIF":2.4,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12374481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942602","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":"Regional citrate anticoagulation for intermittent renal replacement therapy in critically ill patients: a retrospective case-control study.","authors":"Tao Zhao, Jie Yang, Zhongyuan Liu, Qizhuang Jin, Tao Su","doi":"10.1186/s12882-025-04406-7","DOIUrl":"https://doi.org/10.1186/s12882-025-04406-7","url":null,"abstract":"<p><strong>Background: </strong>Regional citrate anticoagulation (RCA) is gradually adopted for intermittent kidney replacement therapy (IRRT) in critically ill patients to mitigate circuit clotting. However, evidence comparing its efficacy and safety remains limited. This study aimed to (1) validate the safety and efficacy of regional citrate anticoagulation (RCA) compared to conventional anticoagulation avoidance during intermittent renal replacement therapy (IRRT) in a critical care nephrology cohort, and (2) establish practical criteria for selecting RCA protocols based on individualized patient bleeding and clotting risk assessments.</p><p><strong>Methods: </strong>This retrospective study analyzed 141 critically ill patients requiring IRRT without systemic anticoagulation: RCA (n = 48) vs. heparin-free (n = 93). Primary outcomes included IRRT completion rates and circuit clotting events. Secondary outcomes comprised filter lifespan, net ultrafiltration (UF), solute clearance (Kt/V, URR), and adverse events. Multivariate regression identified clotting predictors.</p><p><strong>Results: </strong>Circuit clotting caused 93.9% of premature terminations. The RCA group demonstrated significantly higher IRRT completion rates (87.5% vs. 53.8%, p < 0.001). Net UF was superior with RCA (1.9 ± 1.0 kg vs. 1.4 ± 0.9 kg; P = 0.010), while Kt/V, URR and the occurrence of hypocalcemia and metabolic acidosis remained comparable. Platelet count, traditional clotting factors (such as fibrinogen, PT, and aPTT), and thromboelastograms-derived parameters (such as R time and maximum amplitude) were comparable between subgroups. Multivariate analysis confirmed RCA as an independent protective factor against clotting (OR 0.121; P < 0.001), particularly in patients with platelet counts > 130 × 10⁹/L and hemoglobin > 90 g/L.</p><p><strong>Conclusions: </strong>RCA with calcium-containing dialysate significantly improves IRRT completion rates, filter longevity, and ultrafiltration efficiency without increasing metabolic risks, in a specific group of patients with platelet counts > 130 × 10⁹/L and hemoglobin > 90 g/L, positioning RCA as a safer and more effective anticoagulation strategy for critically ill populations. Prospective trials are needed to validate these findings and to optimize RCA protocols.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"480"},"PeriodicalIF":2.4,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372272/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942512","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":"Factors shaping physical activity engagement in patients with moderate to advanced stage of chronic kidney disease from a hospital-based cross-sectional study, Bangladesh.","authors":"Tasmia Tasnim, Tanjina Rahman, Ashika Akter Lisha, Bodrun Nahar Swarna Moni, Kazi Muhammad Rezaul Karim","doi":"10.1186/s12882-025-04409-4","DOIUrl":"https://doi.org/10.1186/s12882-025-04409-4","url":null,"abstract":"<p><strong>Background: </strong>Patients with chronic kidney disease (CKD) may experience better health outcomes when they engage in physical activity (PA). The aim of the study was to assess the physical activity level of chronic kidney disease (CKD) patients and its potentials risk factor for health.</p><p><strong>Methods: </strong>A cross-sectional study was carried out at Mymensingh Medical College Hospital, Mymensingh, Bangladesh from October 2023 to January 2024. A total of 253 CKD patients aged 18 years and older at moderate to advanced stages were enrolled in the study. The global physical activity questionnaire (GPAQ) was used to measure the physical activity for health of CKD patients. Physical component summary (PCS) and mental component summary (MCS) scores were measured by Short-Form Health Survey (SF-12) questionnaire. Socio-demographic and medical records were also collected. Both logistic regression and descriptive statistics were used for data.</p><p><strong>Results: </strong>Of 253 participants (62.8% male, mean age 60.1 years), 41.1% did not meet PA recommendations. Median PA durations were 28.57 min/day for moderate PA (MPA), 8.57 min/day for transport, and 11.43 min/day for recreation. Poor physical function (PCS ≤ 41.04) was observed in 85.8% of participants, and 51.0% had depressive disorders (MCS ≤ 45.6). Logistic regression identified younger age [adjusted OR (AOR) 3.29], moderate stage of CKD (AOR 2.39), good physical function (AOR 3.01), absence of depression (AOR 4.87), and family history of CKD (AOR 2.65) were significant predictors of meeting PA recommendations (p < 0.05).</p><p><strong>Conclusions: </strong>A substantial proportion of Bangladeshi CKD patients do not meet PA recommendations, with younger age, moderate CKD, better physical function, absence of depression, and family history of CKD predicting higher PA engagement. Targeted interventions addressing these factors, particularly early in CKD progression, are needed to promote PA and improve health outcomes in this population.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"481"},"PeriodicalIF":2.4,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12372280/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942427","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":"Biocompatibility in hemodialysis: artificial membrane and human blood interactions.","authors":"Eduardo Ávila, Rodrigo A Sepúlveda, Jaime Retamal, Daniel Hachim","doi":"10.1186/s12882-025-04401-y","DOIUrl":"https://doi.org/10.1186/s12882-025-04401-y","url":null,"abstract":"<p><p>Hemodialysis, a cornerstone therapy for chronic kidney disease, represented a crucial advance in the evolution of artificial organs. While its success is largely due to its efficiency in removing uremic toxins, an equally important challenge is to uphold the primum non nocere principle by minimizing the harmful effects of membrane-blood interactions. This review examines the complex mechanisms and key interactions underlying membrane biocompatibility, including complement activation, inflammation, and coagulation disturbances, paving the way for their clinical implications. We also summarize recent innovations in membrane materials and surface engineering aimed at improving hemocompatibility and promoting safer hemodialysis treatments for improved clinical outcomes.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"482"},"PeriodicalIF":2.4,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12374333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942225","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 of undiagnosed stage 3 chronic kidney disease in the Tabari Cohort: a population-based study.","authors":"Mahmood Moosazadeh, Farhad Gholami, Pedram Ebrahimnejad, Alireza Rafiei, Maryam Khazaee-Pool, Mahdi Abastabar, Fatemeh Mardanshah, Motahareh Kheradmand","doi":"10.1186/s12882-025-04383-x","DOIUrl":"https://doi.org/10.1186/s12882-025-04383-x","url":null,"abstract":"<p><strong>Background: </strong>Chronic kidney disease (CKD) is a well-established public health concern worldwide. Considering the asymptomatic nature of early-stage CKD and its importance, we aimed to investigate the prevalence of undiagnosed stage 3 CKD in a large-scale, population-based cohort study.</p><p><strong>Methods: </strong>In this cross-sectional study, data collected during the enrollment phase of the Tabari Cohort Study (TCS) were utilized. Between June 2015 and November 2017, 10,255 men and women aged 35-70 years were enrolled. CKD was determined based on the estimated glomerular filtration rate (eGFR). The Modification of Diet in Renal Disease (MDRD) equation, utilizing serum creatinine, was used to calculate eGFR. In the present study, participants with 30 ≤ GFR < 60 mL/min/1.73 m² were considered to have stage 3 CKD, and undiagnosed stage 3 CKD was defined as those unaware of CKD at enrollment but had an eGFR between 30 and 60 mL/min/1.73 m². Chi-square tests and univariate and multivariate logistic regression analyses were used to analyze the data.</p><p><strong>Results: </strong>Out of 10,255 TCS participants, 25.6% (N = 2,630) had stage 3 CKD (30 ≤ eGFR < 60 mL/min/1.73 m²), with 98.1% (N = 2,579) being unaware of their disease. Multivariate logistic regression results showed that the risk of undiagnosed stage 3 CKD was significantly lower in mountainous residents (OR: 0.30, 95% CI: 0.13-0.73, P = 0.008) and participants with hypertension (OR: 0.35, 95% CI: 0.18-0.66, P = 0.001), diabetes (OR: 0.52, 95% CI: 0.29-0.95, P = 0.032), and cardiovascular disease (OR: 0.44, 95% CI: 0.23-0.82, P = 0.010) compared to urban residents and those without hypertension, diabetes, and cardiovascular diseases, respectively.</p><p><strong>Conclusion: </strong>The present study demonstrated a substantially high prevalence of undiagnosed stage 3 CKD. Urban residency and the absence of medical history of hypertension, diabetes, or cardiovascular disease were predictive factors of undiagnosed stage 3 CKD.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"479"},"PeriodicalIF":2.4,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12369254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942536","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}