BMC Nephrology最新文献

{"title":"The impact of low-protein diet on residual renal function in dialysis patients: a systematic review and metaanalysis.","authors":"Jingyi Xie, Xiaoqin Liu, Yue Ling, Shuwang Ge, Ying Yao","doi":"10.1186/s12882-025-04042-1","DOIUrl":"10.1186/s12882-025-04042-1","url":null,"abstract":"<p><strong>Objective: </strong>A low-protein diet is essential for the nutritional management of chronic kidney diseases as it can reduce renal burden. However, the effect of low-protein diets on dialysis patients compared to pre-dialysis patients remains unclear. This study aims to compare residual renal function among dialysis patients following a low-protein diet versus a normal diet, offering valuable insights into the optimal nutritional strategy for preserving residual renal function.</p><p><strong>Methods: </strong>This meta-analysis has been registered on PROSPERO, an international registry of prospective systematic reviews. We conducted a comprehensive and systematic literature search using PubMed, Cochrane Library and Web of Science (WOS). Our search strategy was designed to discover all relevant studies investigating the influence of low-protein diets on residual renal function among dialysis patients. Four studies met the inclusion criteria. Heterogeneity was discussed through subgroup analysis of dialysis method, the addition of ketoacid and other relevant factors.</p><p><strong>Results: </strong>We included four prospective studies of low-protein diets among dialysis patients, each of which included at least 40 participants. Individuals receiving a 12-months low-protein diet had a higher GFR (MD = 1.37 ml/min; 95% CI:0.18 to 2.55), while daily urine volume decreasing more slowly (MD = 660 ml; 95% CI: 110 to 1210). In addition, dialysis patients undergoing a low-protein diet for 4 or 12 months had reduced serum phosphorus (MD=-0.74 g/dl; 95% CI: -1.04 to -0.45). Their serum albumin was higher than dialysis patients received a free-choice diet (MD = 4.00 g/dl; 95% CI: 2.46 to 5.54).</p><p><strong>Conclusion: </strong>Dialysis patients who adhere to a long-term low-protein diet may have a positive effect on residual kidney function. In addition, dialysis patients receiving a low-protein diet increased serum albumin, reduced serum phosphorus levels, and maintained a better nutritional status and electrolyte balance.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"122"},"PeriodicalIF":2.2,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143571640","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 uric acid to high-density lipoprotein cholesterol ratio with the presence or absence of hypertensive kidney function: results from the China Health and Retirement Longitudinal Study (CHARLS).","authors":"Siying Li, Zhen Liu, Chen Lu","doi":"10.1186/s12882-024-03939-7","DOIUrl":"10.1186/s12882-024-03939-7","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Some studies have shown that uric acid (UA) to high-density lipoprotein (HDL-C) ratio (UHR), as an indicator of inflammation, is associated with metabolic syndrome and hypertension, but its relationship with decreased renal function is unclear. This study intends to analyze the relationship between UHR and decline in renal function.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Data were obtained from the 2011-2015 data of the China Health and Aging Tracking Survey (CHARLS) of Peking University, and 7,198 study participants were included and followed up until 2015. The eGFR (Total glomerular filtration rate) was estimated according to the CKD-EPI [1] creatinine equation. eGFR ≥ 60mL/min/1.73 m² at baseline renal function was defined as normal renal function, and eGFR &lt; 60mL/min/1.73 m² at baseline renal function was defined as chronic kidney disease; new-onset eGFR &lt; 60mL/min/1.73 m² was defined as the occurrence of decline in renal function; in the chronic kidney disease population decrease in eGFR ≥ 5mL/min/1.73 m²/year or 30% from baseline or admission to dialysis was defined as rapid progression of chronic kidney disease. eGFR slope was defined as the ratio of the difference between the final eGFR and the baseline eGFR over 4 years of follow-up. Binary logistic regression was used to analyze the relationship between UHR and renal function decline or progression, as well as linear regression and non-linear regression to clarify the relationship between UHR and GFR slope in hypertensive patients, and the correlation between UHR and CRP, and to assess the relationship between UHR levels and the risk of renal function decline in hypertensive people.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;(1) Hypertension was a risk factor for the decline of renal function (OR: 1.34, P = 0.03); (2) UHR was a risk factor for the decline of renal function in the hypertensive population (OR: 1.32, P = 0.02), and with the increasing level of UHR, the risk of developing CKD (Chronic Kidney Disease) in hypertension was higher (P for trend = 0.03); (3) The subgroup analyses showed that there was no interaction between hypertension and age, cystatin C and hemoglobin did not interact with each other; (4), In the hypertensive population, the slope of UHR and eGFR showed a J-shaped correlation, with UHR &gt; 7.6% as the cut-off point, and the slope of eGFR tended to increase with increasing UHR; in the non-hypertensive population UHR and eGFR showed a linear correlation, and the slope of the decline in eGFR was smaller than that of the hypertensive population; (5), After adjusting for confounders, UHR and CRP were positive correlation (t = 3.56, P &lt; 0.05); (6) In the hypertensive population with normal CRP, the risk of decline in renal function increased accordingly with increasing UHR (P = 0.003). UHR did not show a correlation with CRP in the hypertensive population with abnormal CRP (P = 0.24).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;In the hypertensive population, elev","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"123"},"PeriodicalIF":2.2,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572071","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":"Dietary energy intake predicts mortality in Chinese patients with peritoneal dialysis: a single-center 18 years' follow-up study.","authors":"Su-Xuan Liu, Ke Xu, Meng-Yuan Lu, Xiao-Qing Zhang, Chun-Yan Su, Wen Tang","doi":"10.1186/s12882-025-04051-0","DOIUrl":"10.1186/s12882-025-04051-0","url":null,"abstract":"<p><strong>Background: </strong>Lower dietary energy intake (DEI) may be associated with increased mortality risk. This study aims to analyze the influence of baseline DEI, time average DEI, and other factors on survival in peritoneal dialysis (PD) patients.</p><p><strong>Method: </strong>It was a single-center retrospective cohort study. Patients who started PD from January 2006 to June 2021 were included in this study and followed up until June 2023. Their baseline (six months after the beginning of PD) demographic, dietary intake, laboratory data, and time varying dietary intake data were collected and analyzed. The relationships between these data and survival were examined using Cox model to estimate death hazard ratios.</p><p><strong>Result: </strong>A total of 794 patients were included in this study, 424 males and 370 females, with a mean age of 58.87 ± 16.02 years. Their mean normalize baseline dietary energy intake (nDEI) was 25.46 ± 6.72 kcal/kg/day, time average nDEI was 24.87 ± 4.74 kcal/kg/day. The median follow-up duration was 46.58 (27.38, 78.52) months in the overall cohort. Based on multivariate Cox proportional hazard analysis, age (HR = 1.056, 95% Cl = 1.047-1.065, p < 0.001), diabetes (HR = 1.364, 95% Cl = 1.114-1.671, p = 0.003), serum albumin (HR = 0.945, 95% Cl = 0.923-0.967, p < 0.001), blood sodium (HR = 0.973, 95% Cl = 0.954-0.992, p = 0.002), serum urea (HR = 0.974, 95% Cl = 0.953-0.994, p = 0.025), and baseline nDEI (HR = 0.980, 95% Cl = 0.964-0.996, p = 0.017) were significantly associated with mortality. Baseline DPI, BMI and time average nDEI were not related to PD patients' survival. When classified baseline nDEI into 4 groups (< 25 kcal/kg/day, 25-29.99 kcal/kg/day, 30-34.99 kcal/kg/day, and ≥ 35 kcal/kg/day), the univariate and multivariate Cox proportional hazard analysis showed that the patients with nDEI 30-34.99 kcal/kg/day had the lowest mortality risk (using the DEI < 25 kcal/kg/day group as reference, p < 0.05).</p><p><strong>Conclusion: </strong>Our study revealed that DEI 30-34.99 kcal/kg/day might be beneficial to the long-term outcome for the Chinese PD population.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"120"},"PeriodicalIF":2.2,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566150","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":"Advances in the diagnosis of early biomarkers for acute kidney injury: a literature review.","authors":"Hongsha Yang, Yanqin Chen, Jiajia He, Yi Li, Yunlin Feng","doi":"10.1186/s12882-025-04040-3","DOIUrl":"10.1186/s12882-025-04040-3","url":null,"abstract":"<p><p>Acute kidney injury (AKI) is a critical condition with diverse manifestations and variable outcomes. Its diagnosis traditionally relies on delayed indicators such as serum creatinine and urine output, making early detection challenging. Early identification is essential to improving patient outcomes, driving the need for novel biomarkers. Recent advancements have identified promising biomarkers across various biological processes. Tubular injury markers, including neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), N-acetyl-β-D-glucosaminidase (NAG), and liver-type fatty acid-binding protein (L-FABP), offer insights into early tubular damage. Inflammatory and repair-associated biomarkers, such as interleukin-18 (IL-18), monocyte chemotactic protein-1 (MCP-1), osteopontin (OPN), and C-C motif chemokine ligand 14 (CCL14), reflect ongoing injury and recovery processes. Additionally, stress and repair markers like tissue inhibitor of metalloproteinase-2 (TIMP-2) and insulin-like growth factor-binding protein-7 (IGFBP-7), alongside filtration markers such as cystatin C (CysC) and proenkephalin (PenKid^®) e.tal, further enhance diagnostic precision. Oxidative stress-related markers, including Superoxide Dismutase 1 (SOD1), also contribute valuable information. Emerging candidates, such as microRNAs, soluble urokinase plasminogen activator receptor (SuPAR), and chitinase-3-like protein 1 (CHI3L1), hold substantial promise for AKI detection and prognosis. This review summarizes the progress in AKI biomarker research, highlighting their clinical utility and exploring their potential to refine early diagnosis and management strategies. These findings offer a new perspective for integrating novel biomarkers into routine clinical practice, ultimately improving AKI care.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"115"},"PeriodicalIF":2.2,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566147","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":"Podocyturia an emerging biomarker for kidney injury.","authors":"Charbel Hanna, Hady El Etry, Maroun Ibrahim, Lynn Khalife, Sola Aoun Bahous, Wissam H Faour","doi":"10.1186/s12882-025-04039-w","DOIUrl":"10.1186/s12882-025-04039-w","url":null,"abstract":"<p><p>Podocyte injury is an established hallmark of kidney disease progression. Podocyte loss is a widely proven hypothesis to explain, in part, glomerular damage. Regardless of the underlying kidney disease, the pathophysiologic processes frequently involve the glomerulus. A growing body of evidence considered that podocytes detachment (podocytopathy) and their presence in the urine (podocyturia) are the hallmark of glomerular disease progression. As such, developing new tools to monitor disease progression non-invasively is of major clinical importance. Detection of podocytes in the urine as a biomarker of disease progression would be a major achievement toward the development of such tools. This review summarizes current knowledge about podocyturia.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"118"},"PeriodicalIF":2.2,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143565891","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 status and influencing factors of social participation in patients undergoing maintenance haemodialysis: a Cross-sectional study following the international classification of functioning, disability, and health framework.","authors":"W W Ge, H L Zhang, P Liu, L X Yin","doi":"10.1186/s12882-025-04044-z","DOIUrl":"10.1186/s12882-025-04044-z","url":null,"abstract":"<p><strong>Background: </strong>Maintenance haemodialysis (MHD) has emerged as a primary treatment modality in individuals with end-stage kidney disease. However, haemodialysis not only affects physiological well-being but also significantly influences patients' social engagement and quality of life. Consequently, investigating the present status and repercussions on social participation among individuals undergoing MHD has evolved as a crucial area of research. This study aimed to investigate the current status of social participation among patients undergoing MHD and analyse the influencing factors, providing a theoretical basis for clinical intervention.</p><p><strong>Methods: </strong>This cross-sectional study utilised a convenience sampling method to select 441 patients undergoing maintenance haemodialysis (MHD) at seven tertiary hospitals in Lianyungang between January and May 2024 as survey participants. The study employed a general information questionnaire along with several assessment tools, including the Chinese version of the Impact on Participation and Autonomy; Social Support Rating Scale; Hospital Anxiety and Depression Scale; Pittsburgh Sleep Quality Index; Chinese version of the Functional Assessment of Chronic Illness Therapy-Fatigue; and Medical Outcomes Study Health Status Short Form. Patients with end-stage renal disease aged ≥ 18 years and undergoing MHD for ≥ 3 months were included. Those with other severe illnesses, psychiatric disorders, personality disorders, or inability to cooperate with the study were excluded. Multivariate linear regression analysis was used to identify factors influencing social participation in MHD patients.</p><p><strong>Results: </strong>The total score of social participation among patients on MHD was 54. Multiple linear regression analysis indicated that, based on the International Classification of Functioning, Disability, and Health framework, total scores of depression, total scores of social support, age, total scores of the fatigue scale, smoking history, and employment status were the main influencing factors of social participation in patients on MHD (P < 0.05).</p><p><strong>Conclusions: </strong>The level of social participation among patients on MHD was moderate and in need of enhancement. Healthcare providers should prioritise older, unemployed patients and improve their social participation and quality of life by addressing issues such as fatigue, depression, and enhancing social support.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"116"},"PeriodicalIF":2.2,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566148","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":"Higher triglyceride-glucose index is associated with severe proteinuria and decreased renal function in patients with primary membranous nephropathy.","authors":"Yue-Ming Gao, Zi-Han Wang, Zhen-Ling Deng, Yue Wang","doi":"10.1186/s12882-025-04022-5","DOIUrl":"10.1186/s12882-025-04022-5","url":null,"abstract":"<p><strong>Background: </strong>In recent years, the triglyceride-glucose (TyG) index has emerged as a reliable surrogate marker of insulin resistance (IR). This study aimed to investigate the association between the TyG index and severe proteinuria or decreased renal function in patients with primary membranous nephropathy (PMN).</p><p><strong>Methods: </strong>We consecutively enrolled 536 patients with PMN hospitalized at Peking University Third Hospital from January, 2014 to December, 2023. The TyG index was calculated as Ln[fasting triglyceride (mg/dL)×fasting blood glucose (mg/dL)/2]. All participants were categorized into quantiles according to the TyG index. Severe proteinuria was defined as 24 h urine protein > 3.5 g/d, and decreased renal function was defined as the estimated glomerular filtration rate < 90 mL/min/1.73m². Multivariable logistic regression, restricted cubic spline (RCS) curves, and receiver operating characteristic (ROC) curves were used for analysis.</p><p><strong>Results: </strong>Among 536 patients with PMN, 355 patients had severe proteinuria and 149 patients had decreased renal function. The levels of TyG index was significantly elevated in PMN patients with severe proteinuria or decreased renal function. The RCS analysis revealed a positive linear relationship of the TyG index with the risk of severe proteinuria (P for non-linear = 0.317) or decreased renal function (P for non-linear = 0.199) in patients with PMN. Using the lowest quantile as the reference, multivariate-adjusted logistic regression indicated that patients in the highest quantile of the TyG index had a significantly increased risk of severe proteinuria [odds ratio (OR) = 2.08, 95% confidence interval (CI): 1.44-3.01, P < 0.001] and decreased renal function (OR = 1.57, 95% CI: 1.04-2.36, P = 0.032). The area under the ROC curve (AUC) of the TyG index is 0.613 (95% CI: 0.564-0.662) for severe proteinuria and 0.590 (95% CI: 0.536-0.643) for decreased renal function.</p><p><strong>Conclusion: </strong>Our findings indicated that the TyG index has a positive linear correlation with severe proteinuria or decreased renal function in patients with PMN.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"114"},"PeriodicalIF":2.2,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11884001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566151","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":"Perirenal fat differs in patients with chronic kidney disease receiving different vitamin D-based treatments: a preliminary study.","authors":"Ana Checa-Ros, Antonella Locascio, Owahabanun-Joshua Okojie, Pablo Abellán-Galiana, Luis D'Marco","doi":"10.1186/s12882-025-04041-2","DOIUrl":"10.1186/s12882-025-04041-2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Chronic kidney disease (CKD) patients show high rates of cardiovascular disease (CVD) and mortality. In the general population, obesity, hypertension, and diabetes are known as the classical CVD risk factors. However, CKD patients have other predisposing CVD factors more associated with bone and mineral metabolism disorders (BMD). BMD originates from reduced 1,25-dihydroxy vitamin D and hypocalcemia, which lead to secondary hyperparathyroidism, with increased parathyroid hormone (PTH) levels and hyperphosphatemia as the progression of renal damage. Due to their pleiotropic effects, vitamin D and its analogs, such as cholecalciferol, calcitriol, or paricalcitol, have proven effective in controlling BMD and CVD. On the other hand, visceral adiposity has been shown to increase the risk for CVD in both the general and CKD populations via complex autocrine and paracrine hormonal mechanisms. This seems to be the case with fat surrounding the epicardium. Although it has not been widely evaluated, the fat surrounding the kidneys, or the perirenal adipose tissue (PAT), could also share similarities with the epicardial in terms of its potential contribution to the CVD risk observed in these patients. We conducted a preliminary study to assess differences in PAT on a sample of patients with CKD presenting diverse CVD history and who were receiving different vitamin D-receptor activators.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods/results: &lt;/strong&gt;An observational study was performed at UNIRENAL Center (Venezuela), from January to November 2015. Analytical and clinical parameters were evaluated. The PAT thickness was measured in centimeters through a B-mode ultrasound. Thus, we included 83 CKD patients treated with vitamin D or analogs (mean age 58.3 ± 16y); 57.83% were females. Nearly half of the sample was classified as CKD-G3 (n = 40). Prior history of CVD was present in 55.4% (N = 46) of participants. Must of the patients (n = 46;55.42%) receiving oral cholecalciferol (1000 IU/day) as part of the treatment for lower levels of vitamin D or BMD related to CKD (mainly elevated PTH), followed by those under calcitriol at 0.5 mcg/day (n = 27;32.53%), and around 12% (n = 10;12.05%) on paricalcitol (1 mcg/day). The mean treatment vintage was 20 ± 6 months for cholecalciferol, 18 ± 4 months for calcitriol, and 16 ± 2 months for paricalcitol. Those with a history of CVD (n = 46) showed higher levels of urea (mean 62.0vs45.2 mg/dl, p &lt; 0.05), uric acid (mean 5.5vs4.3 mg/dl; p &lt; 0.03), and iPTH (mean 186.2vs65.2pcg/dl; p &lt; 0.05) than patients free of CVD events (n = 37). These findings were also in parallel with decreased renal function in the group with previous CVD history, as evidenced by a significantly lower eGFR (mean 53.55vs89.00 ml/min/1.73 m&lt;sup&gt;2&lt;/sup&gt;,p &lt; 0.001). Similarly, the mean PAT thickness was elevated in the group with a history of CVD in relation to those with no previous CVD events (0.99vs0.80 cm; SD ± 0.30;p ~ 0.05). The comparat","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"119"},"PeriodicalIF":2.2,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11883930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence of acute kidney injury-associated mortality in hospitalized children: a systematic review and meta-analysis.","authors":"Hamed Zarei, Amir Azimi, Arash Ansarian, Arian Raad, Hossein Tabatabaei, Shayan Roshdi Dizaji, Narges Saadatipour, Ayda Dadras, Neamatollah Ataei, Mostafa Hosseini, Mahmoud Yousefifard","doi":"10.1186/s12882-025-04033-2","DOIUrl":"10.1186/s12882-025-04033-2","url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury (AKI) is a significant health concern in hospitalized children and is associated with increased mortality. However, the true burden of AKI-associated mortality in pediatric populations remains unclear.</p><p><strong>Objective: </strong>To determine the pooled incidence of mortality independently associated with AKI in hospitalized children globally.</p><p><strong>Data sources: </strong>Medline and Embase were searched for studies published by March 2024.</p><p><strong>Study eligibility criteria: </strong>The inclusion criteria encompassed observational studies involving hospitalized pediatric patients (< 18 years old) with AKI. Only studies that identified AKI as an independent risk factor for increased mortality in multivariate analysis were considered.</p><p><strong>Study appraisal and synthesis methods: </strong>Studies with at least 100 AKI patients were included in the meta-analysis. Two authors extracted data on the study and patients' characteristics and mortality across AKI stages and assessed the risk of bias. We used a random-effects meta-analysis to generate pooled estimates of mortality.</p><p><strong>Results: </strong>Analysis of 60 studies including 133,876 children with AKI revealed a pooled in-hospital mortality rate of 18.27% (95% CI: 14.89, 21.65). Mortality increased with AKI severity; 8.19% in stage 1, 13.44% in stage 2, and 27.78% in stage 3. Subgroup analyses showed no significant differences across geographical regions, income levels, or AKI definition criteria. The pooled post-discharge mortality rate was 6.84% (95% CI: 5.86, 7.82) in a 1-9-year follow-up period.</p><p><strong>Conclusions: </strong>This meta-analysis demonstrates a substantial global burden of AKI-associated mortality in hospitalized children, with higher mortality rates in more severe AKI stages. These findings highlight the critical need for early detection and intervention strategies in pediatric AKI management.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"117"},"PeriodicalIF":2.2,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11883935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566163","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 neutrophil percentage-to-albumin ratio and mortality in Hemodialysis patients: insights from a prospective cohort study.","authors":"Jiaxin Zhu, Rui Shi, Xunliang Li, Mengqian Liu, Linfei Yu, Youwei Bai, Yong Zhang, Wei Wang, Lei Chen, Guangcai Shi, Zhi Liu, Yuwen Guo, Jihui Fan, Shanfei Yang, Xiping Jin, Fan Zhang, Xiaoying Zong, Xiaofei Tang, Jiande Chen, Tao Ma, Bei Xiao, Deguang Wang","doi":"10.1186/s12882-025-04027-0","DOIUrl":"10.1186/s12882-025-04027-0","url":null,"abstract":"<p><strong>Background: </strong>The neutrophil percentage-to-albumin ratio (NPAR) emerges as a novel inflammation marker, demonstrating prognostic ability in a variety of cardiovascular diseases. However, its impact on mortality among patients undergoing maintenance hemodialysis (MHD) remains uncertain. Our research aims to determine whether NPAR is a reliable predictor of mortality in MHD patients.</p><p><strong>Methods: </strong>A total of 1803 MHD patients were recruited in this prospective cohort. Patients were stratified into three groups based on baseline NPAR levels. The association between NPAR and all-cause and cardiovascular mortality was evaluated using multivariate Cox proportional risk model and sensitivity analysis. NPAR's predictive performance was assessed using the receiver operating characteristic (ROC) curve, compared to several conventional biomarkers, including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), neutrophil count, and serum albumin. The area under the curve (AUC) values of NPAR and these biomarkers were compared using the DeLong's test.</p><p><strong>Results: </strong>Throughout a median follow-up period of 28 months, 239 (13.3%) patients died, with 91 (5.0%) dying of cardiovascular disease. Both all-cause mortality and cardiovascular mortality exhibited remarkably higher within the high NPAR group compared to the middle and low NPAR groups in the multivariate Cox regression analysis. The adjusted hazard ratio was 1.550 (95% CI: 1.110-2.166, P = 0.010) for all-cause mortality and 1.844 (95% CI: 1.058-3.212, P = 0.031) for cardiovascular mortality. This association was further corroborated by sensitivity analyses. The AUC values of NPAR for all-cause mortality and cardiovascular mortality were 0.612 (95% CI: 0.572-0.652, P < 0.001) and 0.618 (95% CI: 0.557-0.678, P < 0.001), separately. The p-values for comparing NPAR's AUC with those of NLR, PLR, neutrophils, and albumin were 0.307, 0.094, 0.014, and 0.154 for all-cause mortality, and 0.879, 0.126, 0.119, and 0.596 for cardiovascular mortality.</p><p><strong>Conclusion: </strong>High NPAR level was independently associated with a higher increased risk of death in MHD patients.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"112"},"PeriodicalIF":2.2,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11881449/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555759","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}