BMC Nephrology最新文献

{"title":"The protective effect of kaempferol on high glucose-stimulated renal tubular epithelial cells.","authors":"Xiao-Cui Jiao, Ying Li, Di Wu, Xue-Guang Zhang, Fei Hou","doi":"10.1186/s12882-025-04404-9","DOIUrl":"https://doi.org/10.1186/s12882-025-04404-9","url":null,"abstract":"<p><strong>Background: </strong>The oxidative stress and apoptosis of renal tubular epithelial play an important role in the progression of diabetic nephropathy. Blocking oxidative stress and apoptosis of renal tubular epithelial could be a novel therapeutic target for diabetic nephropathy. Kaempferol (KMP), a natural phytoestrogen and common dietary flavonoid, has various biological effects including anti-oxidation, anti-apoptosis and anti-inflammation. KMP has protective effect against oxidative stress-related diseases, such as ischemia-reperfusion induced myocardium injuries, osteoporosis, obesity and so on. In our research, we observed the influence of KMP on high glucose (HG) cultured HK-2 cells and explored its mechanisms from the aspect of oxidative stress and apoptosis.</p><p><strong>Methods: </strong>To find out the safety and effective concentration of KMP in our experiment, cell viability under different concentrations was detected using the MTS method. The protein and mRNA expression of SOD2 and catalase were detected by Western blot and Real-time PCR; the protein expression of Sirt3, Bax, Bcl-2, cleaved-caspase3, Akt, p-Akt, FoxO3a, p- FoxO3a were detected by Western blot; the ROS level in cellular was detected by cell flow cytometer.</p><p><strong>Results: </strong>We found that HK-2 cells stimulated with both 10µM KMP and HG exhibited higher viability compared to those stimulated by HG only. Incubation with KMP could reverse the undesirable effects of HG on SOD2, catalase, cleaved caspase-3, Bax/Bcl-2 ratio and the generation of ROS. Furthermore, Western blot and Real-time PCR results showed that the expression levels of Sirt3, p-Akt/Akt ratio and p-FoxO3a/FoxO3a ratio were markedly increased in the KMP plus HG group compared to the HG group. Furthermore, downregulating Sirt3 expression in HK2 cells impairs the protective effect of KMP, leading to a reduction in HK2 cell viability and an elevation in ROS levels.</p><p><strong>Conclusion: </strong>In summary, KMP could alleviate HG-induced oxidative stress and apoptosis, and its cytoprotection is associated with Sirt3 expression and the activation of ROS-sensitive Akt/FoxO3a signaling pathway.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"477"},"PeriodicalIF":2.4,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12366318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942642","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":"Intramuscular synthol injections cause hypercalcemia in long-term observation: a case report study.","authors":"Magdalena Markowska, Katarzyna Romejko, Zuzanna Moszyńska, Stanisław Niemczyk","doi":"10.1186/s12882-025-04397-5","DOIUrl":"https://doi.org/10.1186/s12882-025-04397-5","url":null,"abstract":"<p><strong>Background: </strong>Hypercalcemia is one of the most common ionic disorders. It is diagnosed when the serum calcium concentration is greater than 10.5 mg/dL. While mainly associated with primary hyperparathyroidism and malignancy, it can also be caused by multiple derangements. Almost every part of the body can be affected by excess calcium. Hypercalcemia might be very dangerous and even lethal.</p><p><strong>Case presentation: </strong>We report a rare trigger of increased serum calcium level - synthol intramuscular injections. A 60-year-old man who suffered from general weakness, weight loss and acute kidney injury, which were associated with unidentified hypercalcemia, was under review for proper diagnosis. We excluded endocrine disorders, malignancies, sarcoidosis, iatrogenic causes, which were defined as medication- related. Patient history, physical examination, blood chemistry, 24-hour urine collection, computed tomography and endoscopy were performed. Finally, the biopsy of muscle explained the source of the increased serum calcium concentrations.</p><p><strong>Conclusions: </strong>Hypercalcemia is a common disorder that has a wide range of triggers. Synthol intramuscular injections are among the causes of elevated serum calcium levels. It is important to make proper and quick diagnoses and begin therapy. Unfortunately, surgical resection of the synthol seems to be the only reasonable option for hypercalcemia treatment.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"476"},"PeriodicalIF":2.4,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12366343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of factors associated with the initiation of renal replacement therapy in patients on veno-arterial extracorporeal membrane oxygenation: a case-control study.","authors":"Michel Perez-Garzon, Ana Castillo-Castillo, Maria Ferro-Peñuela, Claudia Poveda-Henao, Mario Mercado-Diaz, Henry Robayo-Amortegui","doi":"10.1186/s12882-025-04395-7","DOIUrl":"https://doi.org/10.1186/s12882-025-04395-7","url":null,"abstract":"<p><strong>Background: </strong>Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is a therapeutic strategy for refractory cardiogenic shock. However, it is associated with a high risk of complications, including acute kidney injury (AKI), which increases the need of renal replacement therapy (RRT) and is linked to worse clinical outcomes.</p><p><strong>Objective: </strong>To identify clinical and biochemical factors independently associated with the initiation of renal replacement therapy (RRT) in adult patients receiving veno-arterial extracorporeal membrane oxygenation (VA-ECMO).</p><p><strong>Methods: </strong>A retrospective case-control study that included patients who received VA-ECMO and were admitted to the intensive care unit between 2019 and 2023. The incidence of RRT, along with associated severity and mortality scores, was analyzed using multivariate analysis.</p><p><strong>Results: </strong>A total of 279 patients were included, among whom 98 received VA-ECMO support. Of these, 26.5% required RRT, and the mortality rate was 57.7%. The majority of patients were male (62.2%), with a mean age of 45.3 years (SD ± 13.8). Factors associated with the need for RRT included the duration of mechanical ventilation (OR, 1.03; 95% CI, 1.00-1.06), history of hypothyroidism (OR, 4.05; 95% CI, 1.27-12.86), and elevated creatinine levels prior to ECMO initiation (OR, 1.54; 95% CI, 1.12-2.09). Additionally, the APACHE II score (OR, 1.04; 95% CI, 0.98-1.10) and renal angina index (OR, 5.29; 95% CI, 1.77-15.77) were predictors of mortality.</p><p><strong>Conclusions: </strong>Patients undergoing VA-ECMO who require RRT have a high mortality risk. Associated factors include hypothyroidism, elevated creatinine levels before ECMO initiation, and a higher renal angina index. The early identification of these factors may facilitate the early detection of AKI risk and optimize clinical management.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"478"},"PeriodicalIF":2.4,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12366055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942665","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 red blood cell distribution width to serum calcium ratio and all-cause mortality in critically ill patients with diabetic nephropathy: a retrospective analysis of the MIMIC-IV database.","authors":"Yanyi Huang, Kaiwen Jiang, Yang Liu, Wei Mo, Yanping Zeng, Ying Yang, Jianlu Bi","doi":"10.1186/s12882-025-04402-x","DOIUrl":"https://doi.org/10.1186/s12882-025-04402-x","url":null,"abstract":"<p><strong>Background: </strong>Diabetic nephropathy (DN) is a critical diabetes complication that raises mortality risk, particularly in intensive care unit (ICU) settings where metabolic disturbances are more pronounced. The prevalence and economic burden of DN are growing globally, posing a major public health challenge. Red blood cell distribution width (RDW) and serum calcium (SC) levels, which frequently exhibit significant alterations in critically ill patients, are linked to DN progression. However, the role of the RDW to SC (RCR) ratio in predicting mortality among critically ill DN patients remains understudied. This study aims to explore the RCR index's relationship with mortality in ICU patients with DN, aiding high-risk patient identification and prognostic strategy formulation in critical care settings.</p><p><strong>Methods: </strong>Data was sourced from the Medical Information Mart for Intensive Care (MIMIC-IV) database. Patients were categorized into four groups based on their RCR index. Primary endpoints were 30-day and 365-day all-cause mortality; secondary endpoints were 90-day and 180-day mortality. Kaplan-Meier curves were used to visualize outcomes by quartiles. Cox proportional hazards regression and restricted cubic spline (RCS) methods assessed the RCR index's impact on prognosis. Subgroup analyses were also conducted.</p><p><strong>Results: </strong>Among 1,265 participants (median age: 73.00 years; 64.27% male), higher RCR index values were associated with increased all-cause mortality risks at 30, 90, 180, and 365 days (Kaplan-Meier curves, log-rank P < 0.01). Cox regression revealed higher mortality risks for patients in the highest quartile. RCS analysis showed a linear relationship between the RCR index and all-cause mortality, with inflection points at 2.361 (30-day mortality) and 2.098 (365-day mortality). Specifically, each unit increase below 2.361 in the RCR index was associated with a 414.0% increased 30-day mortality risk (P < 0.001; 95% CI: 3.041-8.688). For 365-day mortality, each additional unit below 2.098 increased risk by 494.2% (P < 0.001; 95% CI: 3.733-9.458).</p><p><strong>Conclusion: </strong>The RCR index exhibits a linear relationship with all-cause mortality in DN patients. It may serve as a useful indicator for assessing disease severity and guiding ICU treatment decisions, enhancing clinician decision-making and patient outcomes.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"475"},"PeriodicalIF":2.4,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12366078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942029","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":"Renal drug dosing practices and clinical outcomes in patients with kidney disease admitted at two referral hospitals in Northwest Ethiopia.","authors":"Gebeyaw Addis Bezie, Meseret Adugna, Gizachew Tadesse Wassie","doi":"10.1186/s12882-025-04410-x","DOIUrl":"https://doi.org/10.1186/s12882-025-04410-x","url":null,"abstract":"","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"474"},"PeriodicalIF":2.4,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12366039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942550","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":"Insight into blood proteinase-inhibitor system and pathogenesis of renal tuberculosis induced by phylogenomically different Mycobacterium tuberculosis strains in rabbit model.","authors":"Dilyara Esmedlyaeva, Igor Mokrousov, Nina Alekseeva, Natalia Blum, Marina Dyakova, Marine Dogonadze, Anna Vyazovaya, Dmitrii Polev, Boris Ariel, Tatiana Vinogradova, Petr Yablonsky","doi":"10.1186/s12882-025-04411-w","DOIUrl":"https://doi.org/10.1186/s12882-025-04411-w","url":null,"abstract":"","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"473"},"PeriodicalIF":2.4,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12366148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942469","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 the triglyceride to high-density lipoprotein cholesterol ratio and diabetes mellitus likelihood in patients with chronic kidney disease.","authors":"Mijie Guan, Shuang Cui, Haiying Song, Haofei Hu, Bo Hu","doi":"10.1186/s12882-025-04377-9","DOIUrl":"10.1186/s12882-025-04377-9","url":null,"abstract":"<p><strong>Background: </strong>Patients with chronic kidney disease (CKD) are at an increased risk of diabetes mellitus (DM) and dyslipidemia, yet the specific relationship between lipid profiles, particularly triglyceride-to-high-density lipoprotein cholesterol ratio (TG/HDL-C ratio), and DM likelihood in this population has not been thoroughly elucidated.</p><p><strong>Methods: </strong>We conducted a cross-sectional analysis of 20,310 unselected patients with CKD enrolled from 2006 to 2015. The relationship between the TG/HDL-C ratio and the likelihood of DM was evaluated using binary logistic regression. Sensitivity and subgroup analyses were performed, and a generalized additive model with smooth curve fitting assessed potential non-linear associations. We also performed the receiver operating characteristic (ROC) curve and decision curve analysis to assess the determination and clinical use, respectively.</p><p><strong>Results: </strong>Among the participants (mean age 60.907 ± 10.044 years; 79.580% male), 1,758 (8.656%) had DM. The median TG/HDL-C ratio was 0.655(interquartile range 0.465-0.920). After adjusting for covariates, a significant positive association was found between the TG/HDL-C ratio and DM likelihood (odds ratio [OR], 1.494; 95% confidence interval [CI], 1.354-1.648; P < 0.001). A non-linear relationship was observed with an inflection point at a TG/HDL-C ratio of 1.030. The ORs below and above this point were 1.866 (95% CI, 1.472-2.365) and 1.297 (95% CI, 1.094-1.538), respectively. The area under curve (AUC) of the nomogram was of 0.580 (95% CI, 0.566-0.594). Subgroup analyses indicated a stronger association in patients without hypertension, in female and patients with AF.</p><p><strong>Conclusion: </strong>The TG/HDL-C ratio is independently associated with DM likelihood in patients with CKD, exhibiting a non-linear relationship particularly significant when the ratio is below 1.030. The TG/HDL-C ratio may serve as a useful marker for DM likelihood assessment in CKD patients, though prospective studies are needed to determine its role in prevention strategies.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"470"},"PeriodicalIF":2.4,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144882100","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":"Efficacy and safety of PCSK9 inhibitors in patients with chronic kidney disease.","authors":"Haixia Tang, Xiaomin Li, Fengmei Wang, Hong Liu, Xiaoliang Zhang, Bicheng Liu, Bin Wang","doi":"10.1186/s12882-025-04347-1","DOIUrl":"10.1186/s12882-025-04347-1","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to assess the efficacy and safety of proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors in lowering lipid levels among chronic kidney disease (CKD) patients, including those with stages 4-5 CKD.</p><p><strong>Methods: </strong>CKD patients with atherosclerotic cardiovascular disease treated between January 2022 and December 2022 at Zhong Da Hospital affiliated with Southeast University were enrolled in this study. Patients received either evolocumab or alirocumab for three months, either in combination with statin therapy with or without ezetimibe. Efficacy and safety measures were compared among the different groups before and after treatment.</p><p><strong>Results: </strong>A total of 496 CKD patients were included in the study, comprising 263 with stages 1-2 CKD, 170 with stage 3 CKD, and 63 with stages 4-5 CKD. Among them, 301 patients were classified into the atherosclerotic cardiovascular disease (ASCVD) group, whereas 195 were classified into the very-high-risk ASCVD group. LDL-C, total cholesterol (TC), and lipoprotein (a) (Lp(a)) levels decreased significantly in all groups, including stages 4-5 CKD patients, after treatment (P < 0.05). The serum creatinine (Scr) level and estimated glomerular filtration rate (eGFR) remained stable during treatment (P > 0.05). The incidence of adverse drug events did not differ significantly among the different kidney function groups (P ≥ 0.05).</p><p><strong>Conclusions: </strong>PCSK9 inhibitors can be effectively and safely utilized for lipid-lowering therapy in CKD patients, even those with stages 4-5 CKD.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"472"},"PeriodicalIF":2.4,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144882101","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":"From sting to STING: role of inflammation in wasp sting induced AKI - a narrative review.","authors":"Liang Xu, Zilin Zhou, Ying Lv, Ling Li, Hai Yuan, Yaping Sun, Fengqi Hu","doi":"10.1186/s12882-025-04403-w","DOIUrl":"10.1186/s12882-025-04403-w","url":null,"abstract":"<p><p>Multiple wasp stings that induce acute kidney injury (AKI) pose a significant threat to human health. This review focuses on the roles and mechanisms of inflammation in wasp sting-induced AKI. Relevant clinical studies, although limited in scope, have reported elevated levels of various inflammatory mediators in patients. These increased inflammatory mediators serve as indicators of inflammation and are potential predictors of wasp sting-induced AKI. However, clinical research is impeded by factors such as inconsistent patient baselines and lack of standardization for the use of wasp venom. To further explore the mechanisms, animal and cellular models have been developed to mimic the clinical manifestations. Basic studies have confirmed that inflammation plays a crucial role in such injuries. Importantly, mitochondrial DNA release and the cyclic GMP-AMP synthase-stimulator of interferon genes (STING) signaling axis have been identified as key regulators of the inflammatory response in wasp sting-induced AKI. These studies on inflammation present potential targets for therapeutic interventions, and plasma exchange has been proven effective. Overall, this review provides in-depth insights into the mechanisms and basis of therapeutic strategies for the treatment of wasp sting-induced AKI pathogenesis.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"471"},"PeriodicalIF":2.4,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12362855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144882102","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":"Hemoglobin stability impact on healthcare resource utilization and costs among dialysis-dependent patients with anemia of end-stage kidney disease.","authors":"Anna D Coutinho, Malena Mahendran, Maral DerSarkissian, Sophie A Kitchen, Christopher F Bell, Mary Muoneke, Anna Richards","doi":"10.1186/s12882-025-04390-y","DOIUrl":"10.1186/s12882-025-04390-y","url":null,"abstract":"<p><strong>Background: </strong>The impact of hemoglobin stability on healthcare resource utilization (HCRU) and costs in dialysis-dependent patients with anemia of end-stage kidney disease (ESKD) was evaluated.</p><p><strong>Methods: </strong>This retrospective, observational study used Optum's de-identified Market Clarity Data (Optum^® Market Clarity) (2017-2019). Dialysis-dependent patients with anemia of ESKD were stratified by mean hemoglobin level (below, within, or above the target range of 10.0-11.5 g/dL) and time within hemoglobin target range (TiR; high, ≥ 60% or low, < 60% of hemoglobin measurements within the target range) over a 9-month exposure assessment period following initiation of anemia treatment. Incidence rates of HCRU per-person year and annual mean costs were compared between groups weighted by inverse probability weighting during the outcomes assessment period (day after exposure assessment period until earliest of renal transplantation date, end of eligibility, or data availability [March 31, 2022], or death).</p><p><strong>Results: </strong>Of 2,279 eligible patients, 37.1%, 44.1%, and 18.8% had mean hemoglobin levels below, within, and above the target range, respectively, and 78.2% had low TiR. Patients with hemoglobin levels within the target range had a significant cost reduction of $6,201 in red blood cell (RBC) transfusions, and significantly lower incidence of RBC transfusions (46%) and inpatient visits (20%) compared to those below the target range. Mean hemoglobin level within versus above the target range was associated with a significantly higher incidence rate of inpatient visits (14%) and annual costs ($1,958) for RBC transfusions. Patients with high versus low TiR had significantly lower incidence rate of RBC transfusion visits (43%) and inpatient visits (19%), and a significant total healthcare cost reduction of $33,921.</p><p><strong>Conclusions: </strong>Increasing hemoglobin levels to within the target range, and having a higher TiR, was associated with positive impacts on RBC transfusion frequency, HCRU, and costs among dialysis-dependent patients with anemia of ESKD.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":9089,"journal":{"name":"BMC Nephrology","volume":"26 1","pages":"466"},"PeriodicalIF":2.4,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12363002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144871416","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}