World journal of nephrology最新文献

{"title":"Letter to the Editor: Early identification of mortality risk in emergency patients with chronic kidney disease - insights from India with global implications.","authors":"Liang He","doi":"10.5527/wjn.v15.i2.114823","DOIUrl":"10.5527/wjn.v15.i2.114823","url":null,"abstract":"<p><p>Chronic kidney disease (CKD), has emerged as a global public health challenge, with persistently high mortality rates among patients presenting to the emergency department, particularly in resource-limited low- and middle-income countries. I read with great interest the recent article published in the <i>World Journal of Nephrology</i> by Prabhahar <i>et al</i>, conducting a retrospective analysis from a large tertiary referral center in northern India and identifying three independent predictors of in-hospital mortality at emergency department admission: Decreased Glasgow coma scale score, hyperglycemia, and low serum albumin. The significance of this study lies in underscoring the prognostic value of dynamic physiological parameters, which appear to more accurately reflect acute illness severity than traditional measures such as CKD stage or long-term comorbidity indices. This editorial highlight three key implications for clinical practice: First, it is crucial for emergency and nephrology teams to recognize high-risk patients early; Second, implementing standardized risk stratification within the emergency guideline is essential; Third, future multicenter prospective studies could help validate these predictive markers across diverse populations. In conclusion, early identification and systematic risk assessment of high-risk CKD patients in the emergency department are important steps toward improving in-hospital outcomes.</p>","PeriodicalId":94272,"journal":{"name":"World journal of nephrology","volume":"15 2","pages":"114823"},"PeriodicalIF":0.0,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13324491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148378777","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":"Glomerulonephritis through the lens of ultrasound and radiology.","authors":"Guido Gembillo, Salvatore Silipigni, Concetto Sessa, Lorenzo Lo Cicero, Luca Soraci, Annalisa Cozza, Rocco Bruccoleri, Luigi Peritore, Walter Morale, Andrea Corsonello, Antonio Bottari, Domenico Santoro","doi":"10.5527/wjn.v15.i2.118229","DOIUrl":"10.5527/wjn.v15.i2.118229","url":null,"abstract":"<p><p>Renal biopsy remains the diagnostic reference in glomerulonephritis, and no imaging modality has displaced its central role. The key question is whether imaging can complement histology by providing additional information on disease activity, prognosis, and treatment response. In clinical practice, conventional ultrasound is the first-line examination. Cortical thinning and elevated intrarenal resistive indices mainly reflect chronic structural damage and haemodynamic adaptation, without identifying the underlying pathological subtype. Techniques such as shear-wave elastography and contrast-enhanced ultrasound attempt to extend assessment beyond morphology by evaluating tissue stiffness and microvascular perfusion, with reported associations with fibrosis in immunoglobulin A nephropathy and microvascular changes in lupus nephritis and membranous nephropathy. Quantitative approaches integrating imaging features with clinical variables have also been explored for fibrosis staging, although broader validation remains limited. Computed tomography and magnetic resonance imaging continue to play a largely structural role, particularly in systemic diseases with renal involvement such as immunoglobulin G4-related nephropathy and vasculitis. Multiparametric magnetic resonance imaging can additionally assess perfusion and tissue microstructure through diffusion-weighted imaging, arterial spin labelling, and blood oxygenation level-dependent sequences. Nuclear medicine techniques may provide complementary molecular information, with exploratory applications in the assessment of inflammatory activity in antineutrophil cytoplasmic antibodies-associated vasculitis and in the evaluation of cortical or fibrotic involvement using newer tracers. Overall, evidence remains heterogeneous, and histological evaluation continues to determine diagnosis and guide treatment.</p>","PeriodicalId":94272,"journal":{"name":"World journal of nephrology","volume":"15 2","pages":"118229"},"PeriodicalIF":0.0,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13324392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148378768","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":"Slow continuous ultrafiltration and prolonged intermittent renal replacement therapy: Tailoring renal replacement therapy in intensive care unit.","authors":"Guido Gembillo, Matteo Floris, Lorenzo Lo Cicero, Giuseppe Spadaro, Luca Soraci, Domenico Santoro","doi":"10.5527/wjn.v15.i2.118219","DOIUrl":"10.5527/wjn.v15.i2.118219","url":null,"abstract":"<p><p>Acute kidney injury complicates the clinical course of nearly half of all critically ill patients admitted to intensive care, conferring a three- to five-fold elevation in mortality risk. The management of these patients has evolved considerably beyond standardized protocols toward individualized therapeutic strategies. Within this paradigm shift, two modalities warrant particular attention: Slow continuous ultrafiltration (SCUF) and prolonged intermittent renal replacement therapy (PIRRT). SCUF operates through isolated fluid extraction at rates between 100 mL and 500 mL per hour, targeting patients whose preserved kidney function nonetheless fails to manage severe volume overload. The clinical experience with SCUF reveals a complex picture, while certain patient populations, particularly those receiving extracorporeal membrane oxygenation or battling refractory cardiac failure, have shown encouraging results with shortened intensive care stays, equally robust cohorts have experienced concerning progression rates to complete renal replacement therapy and mortality approaching or exceeding 50%. The distinction appears to hinge on meticulous patient selection, with systolic perfusion pressure emerging as a pivotal hemodynamic threshold. PIRRT extends conventional intermittent therapy from the traditional 3-4 hours window to sessions lasting 6-12 hours. Multiple investigations support that this approach achieves comparable mortality and renal recovery outcomes to continuous modalities while reducing costs, facilitating patient mobilization, and decreasing nursing requirements. Current guideline recommendations increasingly favor restrictive, patient-centered approaches over rigid algorithmic initiation. Accumulating evidence supports ultrafiltration rates of 1-1.5 mL/kg/hour, adjusted dynamically according to hemodynamic tolerance and disease trajectory. Yet despite these refinements in our understanding of optimal therapy delivery, fundamental questions persist: Which patients derive maximal benefit from alternative modalities? When should these therapies be initiated or withdrawn, and how can we predict individual treatment response? This review synthesizes current evidence to establish practical decision frameworks for implementing SCUF and PIRRT in critically ill populations, examining clinical indications, safety parameters, fluid removal strategies, and outcome determinants. Our objective is to advance renal replacement therapy from a standardized intervention toward precision nephrology for high-acuity patients.</p>","PeriodicalId":94272,"journal":{"name":"World journal of nephrology","volume":"15 2","pages":"118219"},"PeriodicalIF":0.0,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13324488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148378868","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":"Trimethylamine N-oxide as a key microbial mediator in the progression of diabetic kidney disease.","authors":"Pranjal Kashiv, Manish Ramesh Balwani, Amit Pasari, Khushboo Saxena, Vivek B Kute","doi":"10.5527/wjn.v15.i2.117355","DOIUrl":"10.5527/wjn.v15.i2.117355","url":null,"abstract":"<p><p>In this editorial, we comment on the article by Song <i>et al</i> published in the recent issue of the <i>World Journal of Nephrology</i>, which investigates the mechanistic role of gut microbiota-derived trimethylamine N-oxide (TMAO) in accelerating diabetic kidney disease through renal fibrotic pathways. Diabetic kidney disease is increasingly recognised as a disorder influenced not only by intrinsic renal metabolic and inflammatory pathways. In the Zucker diabetic fatty model, the investigators demonstrate a reproducible pattern in which progression of renal injury is accompanied by distinct alterations in gut microbial composition and a marked rise in circulating TMAO concentrations. The incorporation of fecal microbiota transplantation further shows that the dysbiotic microbial environment characteristic of diabetic kidney disease possesses an intrinsically enhanced capacity to generate TMAO and can transfer this metabolic profile to recipient animals, establishing functional evidence that gut microbial changes can modify host metabolite production. Partial improvement in renal biochemical parameters, fibrotic protein expression, and histological abnormalities following inhibition of trimethylamine formation reinforces the mechanistic relevance of this pathway within the gut-kidney axis and supports the concept that therapeutic strategies targeting microbial metabolism may offer a promising direction for altering the clinical trajectory of diabetic kidney disease.</p>","PeriodicalId":94272,"journal":{"name":"World journal of nephrology","volume":"15 2","pages":"117355"},"PeriodicalIF":0.0,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13324568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148379020","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":"Bioelectrical impedance analysis for assessing hydration status in patients undergoing maintenance hemodialysis.","authors":"Geovanna L S Borges, Luana R Mendes, Isadora C Trombim, Cassiana R Goes, Barbara P Vogt","doi":"10.5527/wjn.v15.i2.118360","DOIUrl":"10.5527/wjn.v15.i2.118360","url":null,"abstract":"<p><strong>Background: </strong>Adequate hydration status is a concern in patients receiving hemodialysis, as fluid overload increases the risk of complications and mortality. Fluid overload in this population is associated with complications, including arterial hypertension, intradialytic hypotension, pulmonary and peripheral edema, cardiovascular events, reduced body mass index, malnutrition, and increased mortality. Several methodologies have been proposed to evaluate hydration status in hemodialysis patients using indices derived from Bioelectrical impedance analysis parameters.</p><p><strong>Aim: </strong>To assess the hydration status of patients receiving hemodialysis using different indices.</p><p><strong>Methods: </strong>Patients receiving hemodialysis for at least 3 months were included. Hydration status was evaluated before and after the hemodialysis session. The data provided by bioelectrical impedance analysis were total body water (TBW), intracellular water, and extracellular water (ECW). Fluid overload [overhydration (OH)] was calculated. Hydration status was classified according to the three indices: OH, OH/ECW, and ECW/body weight. Interdialytic weight gain (IDWG) and blood pressure (BP) were collected. N-terminal pro-brain natriuretic peptide were measured before and after the hemodialysis.</p><p><strong>Results: </strong>A total of 54 patients were evaluated, with mean age of 57.6 ± 13.1 years, 59.3% male. Before hemodialysis session, 23 patients were classified as having fluid overload, identified by at least one of the indices. IDWG and ECW showed significant positive correlation with all evaluated indices. BP, TBW, and intracellular water correlated only with the OH and OH/ECW indices. After hemodialysis session, 5 patients were identified with fluid overload by the OH and ECW/body weight indices. ECW was the only parameter that showed correlation with all indices. N-terminal pro-brain natriuretic peptide correlated with the OH and ECW/body weight indices. BP, IDWG, and TBW remained correlated with OH and OH/ECW.</p><p><strong>Conclusion: </strong>The OH index identified a greater number of patients with fluid overload and showed better correlation with hydration parameters provided by the bioelectrical impedance analysis.</p>","PeriodicalId":94272,"journal":{"name":"World journal of nephrology","volume":"15 2","pages":"118360"},"PeriodicalIF":0.0,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13324682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148378549","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":"Letter to the Editor: Post-transplant diabetes mellitus prevention in renal transplantation - are we missing vitamin D?","authors":"Adarsh Kumar, Himansu Sekhar Mahapatra","doi":"10.5527/wjn.v15.i2.117674","DOIUrl":"10.5527/wjn.v15.i2.117674","url":null,"abstract":"<p><p>Post-transplant diabetes mellitus (PTDM) affects 10% to 40% of solid organ transplant recipients and is associated with adverse graft and cardiovascular outcomes. We read with interest the observational study published in the <i>World Journal of Nephrology</i> by Singh <i>et al</i>. This study suggests an association between vitamin D status and the risk of post-transplant diabetes mellitus. Evidence from the general population demonstrates that low serum 25-hydroxyvitamin D levels are associated with an increased risk of type 2 diabetes mellitus. Vitamin D deficiency affects over 80% of patients with end-stage kidney disease and commonly persists after transplantation. Vitamin D deficiency may worsen post-transplant glucose control by impairing anti-inflammatory pathways, reducing insulin sensitivity, and compromising pancreatic β-cell function. These actions are particularly important in patients receiving calcineurin inhibitors and glucocorticoids, which are major contributors to impaired insulin secretion. In PTDM, vitamin D status merits renewed attention as a modifiable factor influencing post-transplant glycemic control. Well-designed supplementation trials are needed to determine whether correcting vitamin D deficiency can meaningfully reduce PTDM incidence and improve graft outcomes.</p>","PeriodicalId":94272,"journal":{"name":"World journal of nephrology","volume":"15 2","pages":"117674"},"PeriodicalIF":0.0,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13324570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148378836","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":"Artificial intelligence in chronic kidney disease: Early detection, risk prediction, and personalized treatment strategies.","authors":"Kirolos Eskandar","doi":"10.5527/wjn.v15.i2.117719","DOIUrl":"10.5527/wjn.v15.i2.117719","url":null,"abstract":"<p><p>Chronic kidney disease (CKD) is a heterogeneous and frequently underdiagnosed condition in which conventional diagnostic and prognostic approaches based on static biomarkers and linear risk models offer limited sensitivity for early detection and individualized risk stratification. Artificial intelligence (AI) enables integration of longitudinal, high-dimensional, and multimodal clinical data, providing opportunities to address key limitations in current CKD care. This narrative review synthesizes human clinical studies published between 2019 and 2025 evaluating AI applications across the CKD continuum, including early detection, risk prediction, disease progression, treatment personalization, complication management, dialysis, and kidney transplantation. Evidence was analyzed thematically with emphasis on model performance, validation strategies, explainability, and translational readiness. Across multiple domains, AI-based models generally demonstrated improved discrimination and risk stratification compared with traditional statistical approaches, particularly when incorporating longitudinal trajectories and multimodal inputs. However, most models were exploratory or internally validated, with limited external validation and minimal prospective evaluation. Reported applications included earlier CKD identification, improved prediction of progression and acute kidney injury, optimization of pharmacologic and dialysis strategies, and enhanced prognostication in kidney transplantation. Overall, AI holds promise for more precise CKD detection and management, but real-world impact will require prospective validation, standardized reporting, and rigorous assessment of clinical utility.</p>","PeriodicalId":94272,"journal":{"name":"World journal of nephrology","volume":"15 2","pages":"117719"},"PeriodicalIF":0.0,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13324581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148378622","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":"Critical care considerations in rhabdomyolysis-associated acute kidney injury and kidney replacement therapy.","authors":"Faith Hui Ai Wong, Kay Choong See","doi":"10.5527/wjn.v15.i2.118309","DOIUrl":"10.5527/wjn.v15.i2.118309","url":null,"abstract":"<p><p>Rhabdomyolysis is a frequently seen and potentially severe condition in intensive care, resulting from causes like trauma, infection, drug toxicity, or prolonged immobility. When muscle cells break down, substances such as myoglobin enter the bloodstream, increasing the risk of acute kidney injury (AKI), which greatly affects patient outcomes. Prompt diagnosis, effective fluid management, and supportive care are crucial for reducing kidney-related complications. In more critical situations, standard treatments may not be enough, and kidney replacement therapy (KRT) may be required. This review offers practical, evidence-based guidance on managing AKI associated with rhabdomyolysis, focusing on decision-making in critical care settings. Main topics include understanding disease mechanisms and assessing risk, strategies for fluid resuscitation, managing electrolytes and acid-base balance, and considering additional medications. It also discusses when and how to start KRT, comparing continuous and intermittent methods, and reviews practical aspects of removing myoglobin from circulation. The article highlights new developments, such as early detection biomarkers for AKI and advanced extracorporeal techniques. By combining scientific knowledge with hands-on clinical recommendations, this review helps healthcare professionals provide the best possible care for patients with rhabdomyolysis who develop AKI, including those needing KRT.</p>","PeriodicalId":94272,"journal":{"name":"World journal of nephrology","volume":"15 2","pages":"118309"},"PeriodicalIF":0.0,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13324666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148378800","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":"Factors associated with acute kidney injury in rhabdomyolysis: Insights from a prospective study.","authors":"Hiba Ghabi, Amani Smai, Syrine Tlili, Lamia Rais, Fethi Ben Hmida, Bouthaina Mesbahi, Ines Bounaouas, Ikram Mami, Yosri Messaoudi, Mouhamed Karim Zouaghi","doi":"10.5527/wjn.v15.i2.110379","DOIUrl":"10.5527/wjn.v15.i2.110379","url":null,"abstract":"<p><strong>Background: </strong>Rhabdomyolysis is a common condition in intensive care units (ICUs), but data on acute kidney injury (AKI) associated with rhabdomyolysis remain limited, particularly in North Africa.</p><p><strong>Aim: </strong>To determine the incidence of AKI during rhabdomyolysis and to identify its associated factors among ICU patients.</p><p><strong>Methods: </strong>We conducted a prospective, single-center correlational study from January to July 2024 in the ICU of Rabta University Hospital in Tunisia, including patients diagnosed with rhabdomyolysis. Clinical and laboratory parameters, along with the McMahon score, were assessed at the time of inclusion. Patients were then monitored during their ICU stay to detect the occurrence of AKI.</p><p><strong>Results: </strong>AKI occurred in 51.9% of the 54 patients included in the study. Univariate analysis identified several admission parameters associated with AKI, including elevated levels of creatine phosphokinase, lactate dehydrogenase (LDH), phosphorus, creatinine, and transaminases, as well as low bicarbonate and albumin levels. The optimal McMahon score threshold for predicting AKI was 4.75, with a sensitivity of 78.6% and specificity of 76.9%. In multivariate analysis, only initial LDH [<i>P</i> = 0.012; odds ratio (OR) = 0.993; 95%CI: 0.988-0.999] and initial bicarbonate (<i>P</i> = 0.025; OR = 1.553; 95%CI: 1.058-2.280) levels were independently associated with AKI occurrence.</p><p><strong>Conclusion: </strong>Simple admission biomarkers such as LDH and bicarbonate should be considered for early AKI risk assessment in rhabdomyolysis, particularly in settings with limited access to advanced diagnostic tools.</p>","PeriodicalId":94272,"journal":{"name":"World journal of nephrology","volume":"15 2","pages":"110379"},"PeriodicalIF":0.0,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13324529/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148378824","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":"Comparison of carotid intima-media thickness between hemodialysis and peritoneal dialysis patients.","authors":"Nur Samsu, Mala Hayati, Eden Suryoiman Winoto, Hani Susianti","doi":"10.5527/wjn.v15.i2.120396","DOIUrl":"10.5527/wjn.v15.i2.120396","url":null,"abstract":"<p><strong>Background: </strong>Patients with chronic kidney disease (CKD) are at high risk of developing cardiovascular disease (CVD). Carotid intima-media thickness (cIMT) is a strong predictor of CVD. Klotho has been associated with increased atherosclerotic plaque stability in CKD patients.</p><p><strong>Aim: </strong>To investigate the association between dialysis modality and cIMT in dialysis patients.</p><p><strong>Methods: </strong>A cross-sectional study of 83 dialysis patients, 40 hemodialysis (HD) patients and 43 peritoneal dialysis (PD) patients, who met the inclusion criteria. Anamnesis, carotid artery ultrasonography (USG), and laboratory tests were performed on all patients. cIMT measurements were performed in 6 carotid territories using arterial USG.</p><p><strong>Results: </strong>PD patients had lower cIMT [0.53 (0.47; 0.67) <i>vs</i> 0.63 (0.54; 0.70); <i>P</i> = 0.005]. Younger age in PD patients was independently associated with lower cIMT (β = 0.006; <i>P</i> = 0.003). PD patients had a lower FGF23/Klotho ratio compared to HD patients [26.26 (13.32; 69.45) <i>vs</i> 67.34 (16.56; 131.35); <i>P</i> = 0.039]. Similarly, in PD patients, a moderate positive correlation was found between calcium, phosphorus, and CaxP product levels with fibroblast growth factor 23 (FGF-23) levels. However, the strength of the correlation was reduced when correlated with the FGF-23/Klotho ratio.</p><p><strong>Conclusion: </strong>This study showed that PD patients have lower cIMT than HD patients. Younger age was independently associated with lower cIMT. On the other hand, FGF-23 and the FGF-23/Klotho ratio were significantly positively correlated with CaxP product in PD patients, but not in HD patients. Klotho reduces the strength of this correlation, thus appearing play an important role in the lower cIMT in these PD patients.</p>","PeriodicalId":94272,"journal":{"name":"World journal of nephrology","volume":"15 2","pages":"120396"},"PeriodicalIF":0.0,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13324702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148378593","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}