World journal of nephrology最新文献

{"title":"Lupus nephritis and kidney transplantation: A narrative review of patient and graft outcomes.","authors":"Tabassum Elahi, Saima Ahmed, Muhammed Mubarak","doi":"10.5527/wjn.v15.i2.117073","DOIUrl":"10.5527/wjn.v15.i2.117073","url":null,"abstract":"<p><p>Lupus nephritis (LN), a serious manifestation of systemic lupus erythematosus, continues to be a major cause of morbidity and mortality. Despite significant advances in immunosuppressive therapy, many patients progress to end-stage kidney disease (ESKD), for which kidney transplantation (KT) remains the treatment of choice. However, the survival advantage of KT in LN-related ESKD is not yet clearly defined. This narrative review synthesizes current guidelines and recent evidence to address the distinctive challenges of transplantation in patients with autoimmune conditions such as LN, particularly regarding the optimal timing of KT. While existing recommendations emphasize achieving disease quiescence prior to transplantation, emerging data support the benefits of preemptive KT and individualized immunosuppressive regimens in improving both patient and graft outcomes. Advances in immunosuppressive therapies, including newly approved agents such as voclosporin and belimumab, have further enhanced LN management. In addition, novel biomarkers such as urinary monocyte chemoattractant protein-1, B-cell activating factor and matrix metalloproteinase-7 show promise for monitoring disease activity and predicting post-transplant recurrence risk. A comprehensive appraisal of guidelines and contemporary studies is essential to refine management strategies and optimize long-term outcomes for patients with LN undergoing KT.</p>","PeriodicalId":94272,"journal":{"name":"World journal of nephrology","volume":"15 2","pages":"117073"},"PeriodicalIF":0.0,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13324391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148378821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is the metabolic dysfunction-associated steatotic liver disease a predictor of chronic kidney disease?","authors":"Nashwa M Azoz, Marwa A Shehata, Wael A Abbas, Rabea A Gadelkareem, Essam M Abdel Aziz","doi":"10.5527/wjn.v15.i2.118877","DOIUrl":"10.5527/wjn.v15.i2.118877","url":null,"abstract":"<p><strong>Background: </strong>Metabolic dysfunction-associated steatotic liver disease (MASLD) is increasingly recognized as a multisystem disorder strongly associated with metabolic dysfunction. Emerging evidence suggests a close association between MASLD and chronic kidney disease (CKD). However, the magnitude and determinants of renal involvement remain inconsistent across studies, particularly in relation to diabetes mellitus (DM) and hepatic fibrosis.</p><p><strong>Aim: </strong>To assess the association between CKD and MASLD and identify the predictors of renal impairment in patients with MASLD.</p><p><strong>Methods: </strong>A case-control study was conducted in the Internal Medicine Department, Faculty of Medicine, Assiut University, Egypt, between March 2024 and March 2025. It included 150 participants recruited from outpatient clinics. Participants were divided into three groups: Those with MASLD and type 2 DM (<i>n</i> = 50), those with MASLD without DM (<i>n</i> = 50), and healthy controls (<i>n</i> = 50). All participants underwent clinical and laboratory evaluation. Additionally, they were assessed for insulin resistance using Homeostasis Model Assessment of Insulin Resistance, abdominal ultrasound, and FibroScan. CKD was defined based on the estimated glomerular filtration rate and albuminuria. Multivariate logistic regression was used to assess the factors associated with CKD in patients with MASLD.</p><p><strong>Results: </strong>The three groups were similar in terms of mean age (<i>P</i> = 0.102) and gender (<i>P</i> = 0.553) distribution of the participants. However, the incidence of hypertension and ischemic heart disease was significantly higher in patients with MASLD than in those without. Patients with MASLD exhibited significantly higher serum creatinine, urea, and albuminuria levels, along with lower estimated glomerular filtration rate (<i>P</i> < 0.001). Advanced hepatic fibrosis was more prevalent in MASLD with DM, with F3-F4 fibrosis observed in 50% of patients compared to 14% in those with MASLD without DM. The severity of fibrosis and steatosis increased progressively with advancing CKD stage (<i>P</i> < 0.001). Factors associated with CKD included hepatic fibrosis score [odds ratio (OR) = 5.61], steatosis score (OR = 4.17), Homeostasis Model Assessment of Insulin Resistance (OR = 4.15), DM (OR = 3.10), and obesity (OR = 2.37).</p><p><strong>Conclusion: </strong>MASLD is associated with CKD, particularly in patients with DM and advanced hepatic fibrosis. Incorporating non-invasive liver fibrosis assessment may aid in the early identification of patients with MASLD who are at a high risk of renal disease.</p>","PeriodicalId":94272,"journal":{"name":"World journal of nephrology","volume":"15 2","pages":"118877"},"PeriodicalIF":0.0,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13324396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148378791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multicentre comparative study of neural epidermal growth factor-like 1 protein <i>vs</i> M-type phospholipase A2 receptor-associated membranous nephropathy.","authors":"Subrahmanian Sathiavageesan, Abirami Krishnan, Krishnaswamy Sampathkumar, Ranjanee Muthu","doi":"10.5527/wjn.v15.i2.118160","DOIUrl":"10.5527/wjn.v15.i2.118160","url":null,"abstract":"<p><strong>Background: </strong>The understanding of membranous nephropathy (MN) has significantly evolved with the discovery of novel antigenic targets. M-type phospholipase A2 receptor-associated MN (PLA2R-MN) is the most common antigenic variant, followed by neural epidermal growth factor-like 1 protein-associated MN (NELL1-MN). Few studies have directly compared the outcomes of these two variants.</p><p><strong>Aim: </strong>To compare the outcomes of NELL1-MN with PLA2R-MN.</p><p><strong>Methods: </strong>In this retrospective cohort study, we compared the outcomes of NELL1-MN and PLA2R-MN using time-to-event analysis. Rate of remission - complete or partial - was the primary outcome of interest.</p><p><strong>Results: </strong>The 17 patients diagnosed with NELL1-MN during the study period were compared with 24 patients with PLA2R-MN diagnosed during the same month. Antecedent exposure to traditional indigenous medicines was more common in NELL1-MN than PLA2R-MN (70.6% <i>vs</i> 13%, <i>P</i> < 0.001). 11.8% with NELL1-MN had rheumatoid arthritis while none with PLA2R-MN had the same (<i>P</i> = 0.08). NELL1-MN showed a significantly higher remission-rate than PLA2R-MN (11.7 per 100-patient-months <i>vs</i> 5 per 100-patient-months, <i>P</i> = 0.01) and a shorter time-to-remission than PLA2R-MN (median: 7 months <i>vs</i> 13 months, <i>P</i> = 0.001). In multivariate Cox-regression, NELL1-MN was independently associated with a higher likelihood of remission compared with PLA2R-MN (hazard ratio = 2.65; 95% confidence interval: 1.25-5.64; <i>P</i> = 0.01). Spontaneous remission-rate was higher for NELL1-MN than PLA2R-MN (3.4 per 100-patient-months <i>vs</i> 0.3 per 100-patient-months, <i>P</i> = 0.01). Resistant nephrotic syndrome was more common among PLA2R-MN than NELL1-MN (2.5 per 100-patient-months <i>vs</i> 0 per 100-patient-months, <i>P</i> = 0.04).</p><p><strong>Conclusion: </strong>NELL1-MN has a favourable prognosis compared to PLA2R-MN. Antigen-specific outcomes research could inform prognosis and guide treatment strategies in MN.</p>","PeriodicalId":94272,"journal":{"name":"World journal of nephrology","volume":"15 2","pages":"118160"},"PeriodicalIF":0.0,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13324629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148378825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-transplant metabolic dysregulation: Insights and implications for kidney graft survival.","authors":"Tabassum Elahi, Saima Ahmed, Muhammed Mubarak","doi":"10.5527/wjn.v15.i2.118270","DOIUrl":"10.5527/wjn.v15.i2.118270","url":null,"abstract":"<p><p>Kidney transplantation is the preferred treatment for end-stage kidney disease, improving survival and quality of life. Yet, metabolic disorders including post-transplant diabetes mellitus, dyslipidemia, hyperuricemia, secondary hyperparathyroidism, and obesity are common in kidney transplant recipients and threaten graft function and patient outcomes. Post-transplant diabetes mellitus affects up to 30% of recipients within the first year, while transient hyperglycemia occurs in 60% of nondiabetic patients post-surgery. Dyslipidemia, obesity, and hyperuricemia exacerbate cardiovascular and metabolic risks, and secondary hyperparathyroidism impairs bone health and graft longevity. Immunosuppressive agents such as corticosteroids, calcineurin inhibitors, and mammalian target of rapamycin inhibitors contribute significantly to these complications, underscoring the need for tailored regimens. Management strategies should be comprehensive, combining lifestyle modification, pharmacological interventions (sodium-glucose cotransporter-2 inhibitors, glucagon-like peptide-1 receptor agonists), and, in selected cases, bariatric surgery. Close monitoring of post-transplant weight gain, particularly visceral fat, is essential to prevent insulin resistance and metabolic syndrome. Despite these advances, significant gaps persist in evidence-based guidelines, and emerging therapies alongside multidisciplinary collaboration hold promise in addressing these complex metabolic challenges. This review underscores the prevalence, pathophysiology, and clinical implications of post-transplant metabolic dysregulation, emphasizing the need for early detection, personalized management, and integrated care to optimize graft survival and long-term patient outcomes.</p>","PeriodicalId":94272,"journal":{"name":"World journal of nephrology","volume":"15 2","pages":"118270"},"PeriodicalIF":0.0,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13324431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148378930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microparticles at the crossroads of the gut-kidney axis: Mechanistic drivers and therapeutic horizons in hemodialysis.","authors":"Thansita Bhunyakarnjanarat, Asada Leelahavanichkul, Wiwat Chancharoenthana","doi":"10.5527/wjn.v15.i2.118565","DOIUrl":"10.5527/wjn.v15.i2.118565","url":null,"abstract":"<p><p>Chronic kidney disease (CKD) and end-stage kidney disease (ESKD) pose significant global health challenges, with hemodialysis serving as a vital treatment for ESKD patients. Despite its life-sustaining role, hemodialysis is associated with elevated cardiovascular morbidity and mortality, driven in part by the accumulation of uremic toxins. Recent research underscores the gut-kidney axis as a pivotal contributor to CKD progression and its complications, with gut microbiota dysbiosis amplifying uremic toxin production. Microparticles (MPs)-small extracellular vesicles released from cells-have emerged as key mediators in intercellular communication, inflammation, and vascular dysfunction. This review examines the role of MPs in the gut-kidney axis, with a focus on their contribution to uremic toxicity and clinical outcomes in hemodialysis patients. We explore how MPs, originating from endothelial cells, platelets, and gut microbiota, transport bioactive molecules, intensify inflammation, and impair endothelial function, thereby heightening cardiovascular risk. Furthermore, we assess their potential as biomarkers of disease severity and as novel therapeutic targets. By integrating current evidence, this review elucidates the intricate interplay between MPs, the gut-kidney axis, and uremic toxicity, offering fresh insights into improving outcomes for hemodialysis patients.</p>","PeriodicalId":94272,"journal":{"name":"World journal of nephrology","volume":"15 2","pages":"118565"},"PeriodicalIF":0.0,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13324619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148378761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Video-assisted minithoracotomy for right atrial hemodialysis catheter placement after vascular access exhaustion: Two case reports.","authors":"Gutenberg C Navarro-Zambrano, Jorge W Pozo-Obando, Rommel O Espinoza de Los Monteros-Duche, Washington X Osorio-Chuquitarco, Jorge W Huertas-Garzón, Amaury León-Sosa, Henry G Cabezas-Tapia, Isabel Echevarría-Frutos","doi":"10.5527/wjn.v15.i2.118080","DOIUrl":"10.5527/wjn.v15.i2.118080","url":null,"abstract":"<p><strong>Background: </strong>End-stage renal disease (ESRD) continues to increase worldwide, and long-term hemodialysis requires reliable vascular access. Progressive exhaustion of peripheral and central venous routes poses a major therapeutic challenge and may necessitate unconventional surgical strategies.</p><p><strong>Case summary: </strong>We report two patients with ESRD and complete depletion of conventional vascular access who underwent direct right atrial hemodialysis catheter placement <i>via</i> video-assisted thoracoscopic minithoracotomy. The first patient was a 68-year-old man with extensive central venous thrombosis and multiple failed catheterizations. The second was a 32-year-old woman with lupus-related ESRD, recurrent catheter infections, and previous thoracic surgeries. In both cases, intra-atrial catheter placement was successfully achieved under direct thoracoscopic visualization. Both patients experienced uneventful postoperative courses, immediate catheter functionality, and sustained hemodialysis efficacy during an eight-month follow-up period.</p><p><strong>Conclusion: </strong>Video-assisted minithoracotomy is a safe, effective salvage approach for right atrial hemodialysis catheter placement in patients with exhausted vascular access.</p>","PeriodicalId":94272,"journal":{"name":"World journal of nephrology","volume":"15 2","pages":"118080"},"PeriodicalIF":0.0,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13324701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148379031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of one-year mortality in hemodialysis patients with end-stage renal disease at a Kenyan county hospital.","authors":"Felix Pius Omullo, Thomas Kimanzi Kitheghe, Maureen Mueni Mark, Allan Kariuki Ng'ang'a, Magdalene Wanjiru Parsimei, Wambugu Charles Kanyi, Ooko Anyang'o Emma, Ismail Abdi Sheikh, Joshua Macharia Gitumu, Abel Mwangi Gakuya, Glory Kawira Gitonga, John Alex Ndung'u, Elisheba Moraa Nyaro","doi":"10.5527/wjn.v15.i2.118111","DOIUrl":"10.5527/wjn.v15.i2.118111","url":null,"abstract":"<p><strong>Background: </strong>In Kenya, end-stage renal disease (ESRD) poses a significant public health burden. While hemodialysis is primarily delivered through county hospitals, comprehensive outcome data from these routine clinical settings remain scarce.</p><p><strong>Aim: </strong>To evaluate one-year clinical outcomes and identify independent predictors of mortality among ESRD patients undergoing hemodialysis at a Kenyan county hospital.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of all patients who initiated hemodialysis for ESRD at Murang'a County Referral Hospital between January 2024 and January 2025. Data on demographics, clinical characteristics, comorbidities, and treatment parameters were extracted from electronic medical records and dialysis unit logs. Cox proportional hazards regression was used to identify factors associated with one-year mortality.</p><p><strong>Results: </strong>Among 79 patients analyzed [median age 62.0 years, interquartile range (IQR) 48.0-74.0; 65.8% male], the cumulative all-cause mortality rate during the study period was 34.2% (27/79). The cohort demonstrated a heavy reliance on central venous catheters (CVCs) (89.9%, 71/79) rather than arteriovenous fistulas (10.1%, 8/79). Non-survivors were significantly older (median 73.0 years <i>vs</i> 58.0 years, P < 0.001) and had lower baseline hemoglobin (7.1 g/dL <i>vs</i> 8.6 g/dL, <i>P</i> = 0.008). In multivariable analysis, older age [adjusted hazard ratio (aHR) = 1.05 per year, 95%CI: 1.01-1.09, <i>P</i> = 0.012] and CVC use (aHR = 3.12, 95%CI: 1.08-9.01, <i>P</i> = 0.036) remained independent predictors of mortality. While lower baseline hemoglobin and estimated glomerular filtration rate were significant in univariate analysis, they lost significance after adjustment. Comorbidities, including human immunodeficiency virus and diabetes, were not statistically significant predictors.</p><p><strong>Conclusion: </strong>Mortality among hemodialysis patients in this Kenyan cohort is high, with older age and CVC use strongly associated with poorer survival. The near-universal reliance on CVCs highlights systemic challenges in pre-dialysis care, underscoring the urgent need for robust vascular access programs and early intervention strategies to improve patient outcomes.</p>","PeriodicalId":94272,"journal":{"name":"World journal of nephrology","volume":"15 2","pages":"118111"},"PeriodicalIF":0.0,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13324625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148378917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of point-of-care ultrasonography in kidney disease management: A single solution for multiple challenges.","authors":"Salvatore Silipigni, Luca Soraci, Guido Gembillo","doi":"10.5527/wjn.v15.i2.109910","DOIUrl":"10.5527/wjn.v15.i2.109910","url":null,"abstract":"<p><p>In this editorial, we comment on the article by Diniz <i>et al</i> published in the recent issue of the <i>World Journal of Nephrology</i>. Point-of-care ultrasound (POCUS) is rapidly becoming a transformative tool in nephrology and medicine in general, which can be used in both inpatient and outpatient settings. With approximately 850 million people living with chronic kidney disease worldwide, POCUS offers nephrologists a real-time, non-invasive method to avoid diagnostic delays and accelerate complex treatment pathways. Its clinical applications include the assessment of hemodynamics, volume status, vascular access guidance, and dialysis-related complications. By improving clinical decision-making at the bedside and thereby reducing unnecessary testing and healthcare inefficiencies, POCUS can transform and implement nephrology practice. The inclusion of a certifiable, standardized POCUS curriculum in undergraduate medical education is a worthy and feasible goal. Early exposure to ultrasound-based diagnostic tools would greatly enhance nephrology education and equip future physicians with important skills that could transform clinical practice.</p>","PeriodicalId":94272,"journal":{"name":"World journal of nephrology","volume":"15 2","pages":"109910"},"PeriodicalIF":0.0,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13324626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148378931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Renal involvement in Fabry disease from Tunisian families: Six case reports.","authors":"Syrine Tlili, Hiba Ghabi, Ikram Mami, Fethi Ben Hmida, Lamia Rais, Mohamed Karim Zouaghi","doi":"10.5527/wjn.v15.i2.109420","DOIUrl":"10.5527/wjn.v15.i2.109420","url":null,"abstract":"<p><strong>Background: </strong>Fabry disease (FD) is a rare X-linked metabolic disorder caused by a deficiency or absence of alpha-galactosidase A activity. It leads to the progressive accumulation of glycosphingolipids in various organs, resulting in multisystem dysfunction. Renal involvement has been reported in 50% of affected males and 20% of females, with a wide phenotypic spectrum-even within the same family.</p><p><strong>Case summary: </strong>We identified six cases of FD with renal involvement from our institutional database, originating from three unrelated families (A, B, and C). Five patients were male, aged 16 to 29 years (mean: 21.3; median: 22.5), and one was a 16-year-old female. All patients presented with proteinuria, including one with nephrotic syndrome. Hypertension was documented in two cases. Renal function varied from hyperfiltration in four patients to advanced chronic kidney disease in two, one of whom progressed to end-stage renal disease requiring hemodialysis. Renal biopsy, performed in two cases, revealed characteristic vacuolated podocytes consistent with Fabry nephropathy. Four patients received enzyme replacement therapy.</p><p><strong>Conclusion: </strong>Renal involvement in FD is often underdiagnosed due to the heterogeneity of clinical presentation. Early diagnosis and timely initiation of enzyme replacement therapy can delay progression to chronic kidney disease and improve long-term outcomes.</p>","PeriodicalId":94272,"journal":{"name":"World journal of nephrology","volume":"15 2","pages":"109420"},"PeriodicalIF":0.0,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13324585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148378933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors of mortality in patients with acute kidney injury: Retrospective cohort study with longitudinal follow-up.","authors":"Nouha Ben Mahmoud, Mouna Hamouda, Meriem Ben Salem, Manel Ben Salah, Faten Ghabi, Khouloud Hafi, Sirine Bchir, Ahmed Letaief, Habib Skhiri","doi":"10.5527/wjn.v15.i2.117833","DOIUrl":"10.5527/wjn.v15.i2.117833","url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury (AKI) is a clinical syndrome that, even after recovery of normal renal function, increases the short-term risk of developing chronic kidney disease and may contribute to mortality in hospitalized patients.</p><p><strong>Aim: </strong>To assess patient survival and identify risk factors for mortality.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study with longitudinal follow-up of patients hospitalized between January 2002 and December 2015, who had an episode of AKI as defined by the Kidney Disease Improving Global Outcomes 2012 guidelines, with return to normal renal function with follow-up extending up to 5 years after discharge, with a median follow-up of 7 years. Patient survival was verified using civil status records and by telephoning patients or their relatives. Risk factors were assessed using univariate and multivariate survival analyses. Short-term mortality was assessed between 3 months and 1 year, medium-term between 1 year and 5 years, and long-term beyond 5 years.</p><p><strong>Results: </strong>A total of 214 patients were included, with mortality data available for 193. Of these, 18 patients (9.3%) died within the short term (mean: 9.22 ± 0.67 months), 18 patients (10.2%) died within the medium term (mean: 36.27 ± 2.73 months), and 26 patients (16.5%) died within the long term (mean: 103.6 ± 6.63 months). The overall mean survival was 159 months. The Kaplan-Meier survival curve showed overall survival rates of 79%, 68%, and 57% at 5 years, 10 years, and 14 years, respectively. Identified mortality risk factors included age over 65, hypertension, diabetes, vascular disease, high Charlson comorbidity index, potassium levels above 5.5 mmol/L, pre-renal AKI, and the short-term development of chronic kidney disease.</p><p><strong>Conclusion: </strong>These findings highlight the need to identify patients at higher risk of mortality following an AKI episode.</p>","PeriodicalId":94272,"journal":{"name":"World journal of nephrology","volume":"15 2","pages":"117833"},"PeriodicalIF":0.0,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13324468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148378915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}