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Afatinib-associated pseudo-acute kidney injury. 阿法替尼相关假性急性肾损伤。
IF 4.6 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2025-11-03 eCollection Date: 2025-12-01 DOI: 10.1093/ckj/sfaf333
Jacqueline Nguyen, Devika Das, Chintan V Shah
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引用次数: 0
Genetic testing in autosomal dominant polycystic kidney disease: why it matters in 2025. 常染色体显性多囊肾病的基因检测:为什么它在2025年很重要。
IF 4.6 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2025-10-31 eCollection Date: 2025-12-01 DOI: 10.1093/ckj/sfaf331
Emilie Cornec-Le Gall, Albert C M Ong

Autosomal dominant polycystic kidney disease (ADPKD) is the most common monogenic cause of kidney failure globally, and a significant cause of morbidity and mortality. It is now recognized that it may result from both major and minor genes with associated differences in disease penetrance, symptom burden and clinical outcomes. Genetic testing is now readily available to discriminate between different genotypes and is being increasingly utilized for diagnostic and prognostic indications. In this short review, we summarize the reasons why testing should become part of standard care for ADPKD patients where available and highlight some current limitations and challenges to testing. Defining the genetic landscape in ADPKD for all ethnic groups will be key to the future development and deployment of individualized patient-centered management in this condition.

常染色体显性多囊肾病(ADPKD)是全球肾衰竭最常见的单基因原因,也是发病率和死亡率的重要原因。现在认识到,它可能是由主要和次要基因引起的,它们在疾病外显率、症状负担和临床结果方面存在相关差异。基因检测现在很容易用于区分不同的基因型,并越来越多地用于诊断和预后指征。在这篇简短的综述中,我们总结了为什么检测应该成为ADPKD患者标准治疗的一部分的原因,并强调了目前检测的一些局限性和挑战。确定所有种族的ADPKD的遗传景观将是未来发展和部署以患者为中心的个性化管理的关键。
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引用次数: 0
Dietary salt and protein intake and urinary cystine excretion in patients with cystinuria. 胱氨酸尿患者膳食盐和蛋白质摄入与尿胱氨酸排泄的关系。
IF 4.6 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2025-10-29 eCollection Date: 2025-11-01 DOI: 10.1093/ckj/sfaf329
Francesca Bermond, Laura Fabbrini, Laura Rivoli, Andrea Spasiano, Marta Leporati, Michele Petrarulo, Andrea Ricotti, Lucia Borsotti, Martino Marangella, Domenico Cosseddu, Pietro Manuel Ferraro, Corrado Vitale

Background: Cystinuria is a rare autosomal recessive disorder characterized by impaired renal reabsorption of cystine and dibasic amino acids, leading to recurrent nephrolithiasis. While dietary salt and protein restriction are commonly recommended, evidence supporting their effectiveness in reducing urinary cystine excretion is limited. This study investigated whether intra-individual changes in dietary salt and protein intake are associated with changes in cystine excretion over time.

Methods: We conducted a retrospective cohort study of 41 adult patients with recurrent cystine stones treated at a tertiary kidney stone clinic between 2004 and 2023. All patients underwent five 24-hour urine collections at intervals of 6-12 months. Urinary sodium and urea excretions were used as surrogates for salt and protein intake, respectively. Mixed-effects linear regression models assessed within-person associations between dietary intake and urinary cystine excretion, adjusting for age, sex, and time.

Results: Cystine excretion showed considerable intra-individual variability (intraclass correlation coefficient: 0.457). An increase in urinary urea of 3.5 g/24 h (reflecting ∼10 g/day higher protein intake) was associated with a 164 µmol/24 h increase in cystine excretion (95% CI: 57 to 271, P = .003). In contrast, a 17 mmol/24 h increase in urinary sodium (∼1 g/day salt intake) was associated with a non-significant 46 µmol/24 h increase in cystine excretion (95% CI: -5 to 97, P = .081).

Conclusions: Protein intake is moderately associated with urinary cystine excretion, whereas salt intake has minimal effect. These findings suggest that, while protein moderation may contribute to cystine reduction, fluid intake and urine alkalinization remain the primary determinants of urinary cystine levels.

背景:胱氨酸尿症是一种罕见的常染色体隐性遗传病,其特征是肾脏对胱氨酸和二碱性氨基酸的重吸收受损,导致肾结石复发。虽然通常建议限制饮食中的盐和蛋白质,但支持其减少尿胱氨酸排泄的有效性的证据有限。本研究调查了个体内饮食盐和蛋白质摄入量的变化是否与胱氨酸排泄随时间的变化有关。方法:我们对2004年至2023年间在三级肾结石诊所治疗的41例复发性胱氨酸结石成年患者进行了回顾性队列研究。所有患者每隔6-12个月进行5次24小时尿液收集。尿钠和尿素排泄量分别作为盐和蛋白质摄入量的替代物。混合效应线性回归模型评估了饮食摄入和尿胱氨酸排泄之间的人际关系,调整了年龄、性别和时间。结果:胱氨酸排泄具有显著的个体差异性(类内相关系数为0.457)。尿尿素增加3.5 g/24 h(反映蛋白质摄入量增加~ 10 g/天)与胱氨酸排泄增加164µmol/24 h相关(95% CI: 57至271,P = 0.003)。相比之下,尿钠增加17 mmol/24 h(约1 g/天盐摄入量)与胱氨酸排泄增加46µmol/24 h无关(95% CI: -5至97,P = 0.081)。结论:蛋白质摄入与尿胱氨酸排泄适度相关,而盐摄入影响最小。这些研究结果表明,虽然蛋白质调节可能有助于胱氨酸减少,但液体摄入和尿碱化仍然是尿胱氨酸水平的主要决定因素。
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引用次数: 0
The BestShape artificial intelligence system for real-time prediction of intradialytic hypotension-clinical outcomes after four-year follow-up. 用于实时预测分析性低血压的BestShape人工智能系统——四年随访后的临床结果。
IF 4.6 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2025-10-28 eCollection Date: 2025-11-01 DOI: 10.1093/ckj/sfaf323
Cheng-Jui Lin, Hong-Mou Shih, Ying-Ying Chen, Shiow-Huey Chen, Hui-Fang Su, Homtin Chen, Chih-Jen Wu

Background: Intradialytic hypotension (IDH) is a serious complication of chronic hemodialysis (HD). BestShape is a novel artificial intelligence-driven system developed recently for real-time prediction of IDH. This study aimed to report the clinical results and health-economic benefits following the implementation of BestShape.

Methods: Medical records from two institutions in Taiwan that incorporated BestShape into all HD practices were retrospectively reviewed. Data from HD sessions from January 2020 to December 2023, following BestShape implementation, constituted the "BestShape group." Data from January 2016 through the end of 2019 served as the historical control group. The primary outcome was IDH frequency, and secondary outcomes were rates of cardiopulmonary resuscitation (CPR), falls, mortality, medical personnel satisfaction, and estimated cost reduction.

Results: In total, 213 071 HD sessions of 18 141 patients were included (BestShape 152 792 sessions; control 60 279 sessions). The mean monthly IDH rate significantly reduced from 27% in 2019 to 21% in 2023 (P < .001). The need for CPR during dialysis decreased from eight to three times per month, and post-dialysis falls decreased from 21 to seven times. The estimated annual cost savings by implementing BestShape were USD 115 658. The mortality rate during HD was not significantly different before and after BestShape implementation (8% vs 9.3%, P = .260). Medical personnel expressed satisfaction with BestShape, with a mean satisfaction score of 86.

Conclusion: Preliminary clinical data show BestShape is associated with reductions in IDH, CPR, and falls in patients undergoing HD, and a reduction in healthcare costs and high medical personnel satisfaction.

背景:分析性低血压(IDH)是慢性血液透析(HD)的严重并发症。BestShape是最近开发的用于IDH实时预测的新型人工智能驱动系统。本研究旨在报告实施BestShape后的临床结果和健康经济效益。方法:回顾性分析台湾两家机构将BestShape纳入所有HD实践的医疗记录。在BestShape实施之后,从2020年1月到2023年12月的高清会话数据构成了“BestShape组”。2016年1月至2019年底的数据作为历史对照组。主要结局是IDH频率,次要结局是心肺复苏(CPR)率、跌倒、死亡率、医务人员满意度和估计成本降低。结果:共纳入18141例患者的213071例HD (BestShape 152 792例,对照组60 279例)。平均每月IDH率从2019年的27%显著下降到2023年的21% (P P = 0.260)。医务人员对BestShape表示满意,平均满意度为86分。结论:初步临床数据显示,BestShape与HD患者IDH、心肺复苏术和跌倒的减少、医疗费用的降低和医务人员的高满意度有关。
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引用次数: 0
Age-adapted versus age-independent eGFR thresholds to diagnose CKD: integrating the debate and charting a balanced path forward. 年龄适应与年龄独立的eGFR阈值诊断CKD:整合争论并绘制平衡的前进路径。
IF 4.6 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2025-10-24 eCollection Date: 2025-11-01 DOI: 10.1093/ckj/sfaf328
Pierre Delanaye, Priya Vart, Jürgen Floege, Carmine Zoccali

The debate over whether to use age-adapted or age-independent estimated glomerular filtration rate (eGFR) cut-offs for diagnosing chronic kidney disease (CKD) reflects a fundamental tension between physiological understanding and clinical pragmatism. Age-adapted proponents highlight robust evidence that GFR declines naturally with age, with many healthy older adults falling below the traditional 60 ml/min/1.73 m2 threshold. They argue that fixed cut-offs risk overdiagnosing CKD in the elderly, potentially leading to unnecessary anxiety and treatment, while underrecognizing risk in younger individuals whose GFRs are abnormal for their age. Physiological and longitudinal studies support this view, suggesting age-specific percentiles may better reflect true pathology. Conversely, advocates for age-independent thresholds emphasize that age-related GFR decline is not benign. Large epidemiological studies show that older adults with an eGFR of 45-59 ml/min/1.73 m2 are at increased risk of kidney failure, cardiovascular events and mortality, even in the absence of albuminuria. They caution that redefining CKD based on age could exclude high-risk older adults from beneficial therapies and research and that 'healthy' reference populations may harbour undiagnosed disease. A balanced approach recognizes the physiological realities of aging while not ignoring the clinical risks associated with reduced kidney function in older adults. Individualized risk prediction tools and shared decision-making can help tailor diagnosis and management. Ultimately, moving beyond arbitrary thresholds toward a patient-centred, risk-based strategy may best serve individuals across their lifespans, ensuring that CKD diagnosis and care are both scientifically sound and clinically meaningful.

关于是否使用年龄适应或年龄无关的肾小球滤过率(eGFR)临界值来诊断慢性肾脏疾病(CKD)的争论反映了生理理解和临床实用主义之间的根本紧张关系。年龄适应的支持者强调了GFR随年龄自然下降的有力证据,许多健康老年人的GFR低于传统的60 ml/min/1.73 m2阈值。他们认为,在老年人中,固定的临界值可能会导致过度诊断CKD的风险,这可能会导致不必要的焦虑和治疗,而在年轻人中,他们的gfr在他们的年龄中是异常的。生理学和纵向研究支持这一观点,表明特定年龄的百分位数可能更好地反映真实的病理。相反,年龄无关阈值的倡导者强调,与年龄相关的GFR下降不是良性的。大型流行病学研究表明,即使没有蛋白尿,eGFR为45-59 ml/min/1.73 m2的老年人发生肾衰竭、心血管事件和死亡的风险也会增加。他们警告说,根据年龄重新定义CKD可能会将高风险的老年人排除在有益的治疗和研究之外,并且“健康”的参考人群可能存在未确诊的疾病。一个平衡的方法认识到衰老的生理现实,同时不忽视与老年人肾功能下降相关的临床风险。个性化的风险预测工具和共同决策可以帮助定制诊断和管理。最终,超越任意阈值,转向以患者为中心、以风险为基础的策略,可能最好地服务于整个生命周期的个体,确保CKD的诊断和护理既科学合理又有临床意义。
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引用次数: 0
Novel biomarkers of crescentic glomerulonephritis identified by urinary proteomics. 通过尿蛋白质组学鉴定新月状肾小球肾炎的新生物标志物。
IF 4.6 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2025-10-23 eCollection Date: 2025-11-01 DOI: 10.1093/ckj/sfaf280
Shuo Zhang, Xin Chen, Jiatong Xu, Yuting Hu, Yin Wang, Peng Xia, Bintao Qiu, Limeng Chen

Introduction: Crescentic glomerulonephritis (CrGN) with rapidly progressive renal function loss necessitates prompt pathology diagnosis and treatment. Non-invasive biomarkers are crucial in cases where renal biopsy is unavailable or unsuitable. Urinary proteomics, particularly data-independent acquisition (DIA) proteomics, might provide potential indicators.

Methods: We recruited crescentic nephritis proved by renal biopsy at Peking Union Medical College Hospital (PUMCH) from May 2022 to April 2023 and age-matched nephritis, acute kidney injury (AKI), and health controls. The CrGN group is the patients with extensive glomerular crescents over 50%. We performed liquid chromatography with tandem mass spectrometry analysis to identify differentially expressed proteins (DEPs), ingenuity pathway analysis (IPA), and the proteome map for significant pathways and crucial proteins among patients and controls, then validated using enzyme-linked immunosorbent assay analysis.

Results: We enrolled a total of 137 participants, 55 in the proteomics cohort [15 CrGN (Type I: n = 1, II: n = 3, III: n = 11), 10 AKI, 15 non-crescentic nephritis, 15 healthy controls] and 82 in the validation cohort (33 CrGN, 6 AKI, 43 nephritis). Males occupied 42.3%, and the average age was 48 years of age. IPA analysis showed that neutrophil degranulation and complement cascade were the top two pathways in CrGN but not in the healthy and nephritis groups. Pathway analysis revealed activation of the neddylation pathway in CrGN compared to AKI patients. After integrating the DEPs among three groups via the Venn plot, we observed eight DEPs significantly associated with the CrGN, among which Coagulation factor V (F5), Phospholipid transfer protein (PLTP), and alcohol dehydrogenase 1C were significant proteins. The area under the curve values of F5 and PLTP in the validation cohort for predicting CrGN were 0.831 and 0.780 (P < .001).

Conclusion: By non-invasive urine proteomics, the new biomarkers F5/UCr and PLTP/UCr hold promise in identifying the CrGN patient.

月牙状肾小球肾炎(CrGN)伴肾功能迅速丧失,需要及时病理诊断和治疗。非侵入性生物标志物在肾活检无法获得或不合适的情况下至关重要。尿液蛋白质组学,特别是数据独立获取(DIA)蛋白质组学,可能提供潜在的指标。方法:我们招募了2022年5月至2023年4月在北京协和医院(PUMCH)接受肾活检证实的新月性肾炎患者,以及年龄匹配的肾炎、急性肾损伤(AKI)患者和健康对照者。CrGN组为肾小球月牙超过50%的患者。我们使用液相色谱和串联质谱分析来鉴定差异表达蛋白(DEPs),独创性途径分析(IPA),以及患者和对照组中重要途径和关键蛋白的蛋白质组图,然后使用酶联免疫吸附分析进行验证。结果:我们共招募了137名参与者,其中55名来自蛋白质组学队列[15名CrGN (I型:n = 1, II型:n = 3, III型:n = 11), 10名AKI, 15名非新月性肾炎,15名健康对照],82名来自验证队列(33名CrGN, 6名AKI, 43名肾炎)。男性占42.3%,平均年龄48岁。IPA分析显示,中性粒细胞脱颗粒和补体级联是CrGN中最主要的两条途径,而在健康组和肾炎组中则不是。通路分析显示,与AKI患者相比,CrGN中的类化修饰通路激活。通过Venn图整合三组间的DEPs后,我们观察到8个与CrGN显著相关的DEPs,其中凝血因子V (F5)、磷脂转移蛋白(PLTP)和乙醇脱氢酶1C是显著蛋白。F5和PLTP预测CrGN的曲线下面积分别为0.831和0.780 (P)。结论:F5/UCr和PLTP/UCr在无创尿蛋白组学诊断CrGN患者中具有良好的应用前景。
{"title":"Novel biomarkers of crescentic glomerulonephritis identified by urinary proteomics.","authors":"Shuo Zhang, Xin Chen, Jiatong Xu, Yuting Hu, Yin Wang, Peng Xia, Bintao Qiu, Limeng Chen","doi":"10.1093/ckj/sfaf280","DOIUrl":"10.1093/ckj/sfaf280","url":null,"abstract":"<p><strong>Introduction: </strong>Crescentic glomerulonephritis (CrGN) with rapidly progressive renal function loss necessitates prompt pathology diagnosis and treatment. Non-invasive biomarkers are crucial in cases where renal biopsy is unavailable or unsuitable. Urinary proteomics, particularly data-independent acquisition (DIA) proteomics, might provide potential indicators.</p><p><strong>Methods: </strong>We recruited crescentic nephritis proved by renal biopsy at Peking Union Medical College Hospital (PUMCH) from May 2022 to April 2023 and age-matched nephritis, acute kidney injury (AKI), and health controls. The CrGN group is the patients with extensive glomerular crescents over 50%. We performed liquid chromatography with tandem mass spectrometry analysis to identify differentially expressed proteins (DEPs), ingenuity pathway analysis (IPA), and the proteome map for significant pathways and crucial proteins among patients and controls, then validated using enzyme-linked immunosorbent assay analysis.</p><p><strong>Results: </strong>We enrolled a total of 137 participants, 55 in the proteomics cohort [15 CrGN (Type I: <i>n</i> = 1, II: <i>n</i> = 3, III: <i>n</i> = 11), 10 AKI, 15 non-crescentic nephritis, 15 healthy controls] and 82 in the validation cohort (33 CrGN, 6 AKI, 43 nephritis). Males occupied 42.3%, and the average age was 48 years of age. IPA analysis showed that neutrophil degranulation and complement cascade were the top two pathways in CrGN but not in the healthy and nephritis groups. Pathway analysis revealed activation of the neddylation pathway in CrGN compared to AKI patients. After integrating the DEPs among three groups via the Venn plot, we observed eight DEPs significantly associated with the CrGN, among which Coagulation factor V (F5), Phospholipid transfer protein (PLTP), and alcohol dehydrogenase 1C were significant proteins. The area under the curve values of F5 and PLTP in the validation cohort for predicting CrGN were 0.831 and 0.780 (<i>P</i> < .001).</p><p><strong>Conclusion: </strong>By non-invasive urine proteomics, the new biomarkers F5/UCr and PLTP/UCr hold promise in identifying the CrGN patient.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 11","pages":"sfaf280"},"PeriodicalIF":4.6,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12596191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145487902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Continuous measurement of pulse arrival time for identification of blood pressure changes in patients undergoing hemodialysis-a feasibility study. 连续测量脉搏到达时间以识别血液透析患者血压变化的可行性研究。
IF 4.6 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2025-10-23 eCollection Date: 2025-11-01 DOI: 10.1093/ckj/sfaf255
Michael Wunderle, Martin Bachler, David Stadler, Bernhard Hametner, Stefan Orter, Claudius Küchle, Simon Krenn, Uwe Heemann, Siegfried Wassertheurer, Christoph Schmaderer, Christopher C Mayer

Background and hypothesis: Intradialytic hypotension (IDH) is a common complication during hemodialysis, associated with immediate and long-term risks. Current monitoring methods lack timely warning signals for preemptive intervention. Continuous non-invasive measurement of blood pressure providing real-time insights into hemodynamic changes might enable the early detection of impending IDH. Pulse arrival time (PAT), which can be measured non-invasively and continuously by electrocardiogram (ECG) and photoplethysmography (PPG), is inversely correlated with blood pressure and might serve as such. Thus, this study explores the feasibility of using PAT to track blood pressure changes in end-stage renal disease patients undergoing hemodialysis.

Methods: A feasibility study was conducted with 44 patients [mean age 64.9 (18.1 SD) years] undergoing hemodialysis, collecting data at the Klinikum rechts der Isar of the Technical University of Munich, School of Medicine. The PAT was determined by an algorithm for detecting the R-wave in the ECG and the beginning of the pulse curve in the PPG. The study focused on changes in PAT and blood pressure during three predefined time periods of 1 hour during dialysis. Statistical analysis included equivalence testing using the TOST (two one-sided t-tests) approach, correlation analysis, and classification analysis.

Results: Patients' mean systolic blood pressure (BP) was 137 (30.1 SD) mmHg, diastolic BP 68.4 (18.4 SD) mmHg and PAT 233 (42.3 SD) ms. The study revealed an inverse association between PAT and BP changes, demonstrating significant correlations [systolic/diastolic blood pressures (SBP/DBP) r = -0.45, P < .001; DBP r = -0.25, P = .003] and equivalence (inverted changes in PAT and SBP (P1 = .002 and P2 = .013) and DBP (P1 < .001 and P2 = .037), respectively). Classification analysis using relative PAT changes showed moderate results for categorizing patients as SBP decliners, risers, or stable, with an F1-score of 0.67 (sensitivity 62.7%; specificity 70.9%) and an area under the curve of 0.70 from receiver operating characteristic analysis.

Conclusions: The study demonstrates that tracking BP changes using PAT as a non-invasive method in hemodialysis patients is feasible. However, the reliability of PAT measurements appears to vary among patients, indicating that this method may not be universally applicable. The observed inverse association between PAT and BP changes, especially during the start to middle phase of dialysis, highlights the potential of this technique to complement traditional monitoring methods. These exploratory findings open avenues for further research to validate the utility of PAT, particularly in predicting IDH episodes and assessing its behavior in scenarios of low BP or minimal variations.

背景与假设:分析性低血压(IDH)是血液透析过程中常见的并发症,具有近期和长期风险。目前的监测方法缺乏及时的预警信号,无法进行先发制人的干预。持续的无创血压测量提供了对血流动力学变化的实时洞察,可能有助于早期发现即将发生的IDH。脉搏到达时间(PAT)可以通过心电图(ECG)和光电容积脉搏波描记仪(PPG)无创地连续测量,它与血压呈负相关,可能起到这样的作用。因此,本研究探讨PAT在终末期肾脏疾病血液透析患者中追踪血压变化的可行性。方法:对44例血液透析患者(平均年龄64.9 (18.1 SD)岁)进行可行性研究,收集慕尼黑工业大学医学院Klinikum rets der Isar的数据。通过检测ECG中的r波和PPG中的脉冲曲线开始的算法确定PAT。这项研究的重点是在透析过程中预先设定的三个1小时时间段内PAT和血压的变化。统计分析包括使用TOST(双单侧t检验)方法进行等价检验、相关分析和分类分析。结果:患者的平均收缩压(BP)为137 (30.1 SD) mmHg,舒张压为68.4 (18.4 SD) mmHg, PAT为233 (42.3 SD) ms。研究显示PAT与BP变化呈负相关,显示出显著的相关性[收缩压/舒张压(SBP/DBP) r = -0.45, P r = -0.25, P = 0.003]和等效性(PAT和SBP (P1 = 0.002, P2 = 0.013)和DBP (P1 = 0.037)的倒置变化)。使用相对PAT变化进行分类分析,结果显示,将患者分为收缩压下降、上升或稳定,f1评分为0.67(敏感性62.7%,特异性70.9%),受试者工作特征分析的曲线下面积为0.70。结论:本研究表明,PAT作为血透患者无创追踪血压变化的方法是可行的。然而,PAT测量的可靠性似乎因患者而异,表明这种方法可能不是普遍适用的。观察到的PAT和血压变化之间的负相关,特别是在透析开始到中期,突出了该技术补充传统监测方法的潜力。这些探索性发现为进一步的研究开辟了道路,以验证PAT的效用,特别是在预测IDH发作和评估其在低血压或最小变化情况下的行为。
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引用次数: 0
Time trends in home dialysis: ERA Registry Figure of the month. 家庭透析的时间趋势:每月ERA注册数据。
IF 4.6 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2025-10-23 eCollection Date: 2025-10-01 DOI: 10.1093/ckj/sfaf325
Vianda S Stel, Alberto Ortiz, Anneke Kramer
{"title":"Time trends in home dialysis: ERA Registry Figure of the month.","authors":"Vianda S Stel, Alberto Ortiz, Anneke Kramer","doi":"10.1093/ckj/sfaf325","DOIUrl":"https://doi.org/10.1093/ckj/sfaf325","url":null,"abstract":"","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 10","pages":"sfaf325"},"PeriodicalIF":4.6,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12580887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145444316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Accuracy of ICD-10 coding for identifying immunoglobulin A nephropathy (IgAN) prior to 2023. 2023年前ICD-10编码识别免疫球蛋白A肾病(IgAN)的准确性
IF 4.6 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2025-10-23 eCollection Date: 2025-11-01 DOI: 10.1093/ckj/sfaf327
Alesya P Sumantri, Carolyn K Kim, Qiaoling Chen, Nancy T Cannizzaro, John J Sim
{"title":"Accuracy of ICD-10 coding for identifying immunoglobulin A nephropathy (IgAN) prior to 2023.","authors":"Alesya P Sumantri, Carolyn K Kim, Qiaoling Chen, Nancy T Cannizzaro, John J Sim","doi":"10.1093/ckj/sfaf327","DOIUrl":"10.1093/ckj/sfaf327","url":null,"abstract":"","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 11","pages":"sfaf327"},"PeriodicalIF":4.6,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12605792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145512095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical and genetic features of Gitelman syndrome patients with hyperuricemia. Gitelman综合征合并高尿酸血症的临床和遗传特征。
IF 4.6 2区 医学 Q1 UROLOGY & NEPHROLOGY Pub Date : 2025-10-23 eCollection Date: 2025-12-01 DOI: 10.1093/ckj/sfaf311
Lei Zhang, Ning Lv, Hongqiang Zhao, Bingbin Zhao, Xiaoyan Peng, Lubin Xu, Minxian Wang, Limeng Chen

Background: Gitelman syndrome (GS) is a rare inherited salt-losing tubulopathy caused by dysfunction of the thiazide-sensitive sodium-chloride cotransporter (NCC). Hyperuricemia is frequently observed in patients with GS, yet its risk factors and associations with GS remain unclear. This study aimed to investigate the percentage, clinical characteristics, and genetic mechanisms in GS patients with hyperuricemia.

Methods: We reanalyzed the GS cohort at Peking Union Medical College Hospital, investigated the baseline clinical, laboratory, and genetic data of GS patients, and utilized the Illumina Human Asian Screening Array-24+v1.0 gene chip and IMPUTE2 for single nucleotide polymorphism (SNP) analysis.

Results: The average serum uric acid of 132 GS patients was 352.3 ± 96.9 μmol/l (5.9 ± 1.6 mg/dl), with 21.2% hyperuricemia [mean 486.1 μmol/l (8.2 mg/dl)] and two cases of gout. The GS patients with hyperuricemia had higher body mass index (BMI) (24.3 ± 3.9 vs 21.7 ± 3.5 kg/m2, = .001), lower fractional excretion of uric acid (FEUA) (median 4.22% vs 6.17%, < .001), and urinary calcium/creatinine ratio (0.05 vs 0.12 mmol/mmol, = .004). In GS patients with or without hyperuricemia, the impairment of NCC function indicated by the value of increase of chloride excretion fraction (△FECl) in the hydrochlorothiazide test was median 0.49% vs 0.82% (= .10). We focused on the SLC12A3 genotype and 33 SNPs linked to uric acid levels and found no significant genetic differences between patients with or without hyperuricemia.

Conclusions: Hyperuricemia is common in patients with GS in China, associated with elevated BMI and potentially more severe NCC dysfunction.

背景:Gitelman综合征(GS)是一种罕见的遗传性失盐小管病,由噻嗪类敏感氯化钠共转运体(NCC)功能障碍引起。高尿酸血症常见于GS患者,但其危险因素及其与GS的关系尚不清楚。本研究旨在探讨GS合并高尿酸血症患者的比例、临床特征和遗传机制。方法:重新分析北京协和医院GS队列,调查GS患者的基线临床、实验室和遗传资料,利用Illumina Human Asian Screening Array-24+v1.0基因芯片和IMPUTE2进行单核苷酸多态性(SNP)分析。结果:132例GS患者血清尿酸平均值为352.3±96.9 μmol/l(5.9±1.6 mg/dl),高尿酸血症发生率为21.2%(平均486.1 μmol/l (8.2 mg/dl)),痛风发生率为2例。GS合并高尿酸血症患者的身体质量指数(BMI)较高(24.3±3.9 vs 21.7±3.5 kg/m2, P = 0.001),尿酸排泄分数(FEUA)较低(中位数4.22% vs 6.17%, P = 0.004)。在伴有或不伴有高尿酸血症的GS患者中,氢氯噻嗪试验中氯化物排泄分数(△FECl)增加值所指示的NCC功能损害的中位数为0.49% vs 0.82% (P = 0.10)。我们集中研究了SLC12A3基因型和与尿酸水平相关的33个snp,发现高尿酸血症患者与非高尿酸血症患者之间没有显著的遗传差异。结论:高尿酸血症在中国GS患者中很常见,与BMI升高和可能更严重的NCC功能障碍相关。
{"title":"Clinical and genetic features of Gitelman syndrome patients with hyperuricemia.","authors":"Lei Zhang, Ning Lv, Hongqiang Zhao, Bingbin Zhao, Xiaoyan Peng, Lubin Xu, Minxian Wang, Limeng Chen","doi":"10.1093/ckj/sfaf311","DOIUrl":"10.1093/ckj/sfaf311","url":null,"abstract":"<p><strong>Background: </strong>Gitelman syndrome (GS) is a rare inherited salt-losing tubulopathy caused by dysfunction of the thiazide-sensitive sodium-chloride cotransporter (NCC). Hyperuricemia is frequently observed in patients with GS, yet its risk factors and associations with GS remain unclear. This study aimed to investigate the percentage, clinical characteristics, and genetic mechanisms in GS patients with hyperuricemia.</p><p><strong>Methods: </strong>We reanalyzed the GS cohort at Peking Union Medical College Hospital, investigated the baseline clinical, laboratory, and genetic data of GS patients, and utilized the Illumina Human Asian Screening Array-24+v1.0 gene chip and IMPUTE2 for single nucleotide polymorphism (SNP) analysis.</p><p><strong>Results: </strong>The average serum uric acid of 132 GS patients was 352.3 ± 96.9 μmol/l (5.9 ± 1.6 mg/dl), with 21.2% hyperuricemia [mean 486.1 μmol/l (8.2 mg/dl)] and two cases of gout. The GS patients with hyperuricemia had higher body mass index (BMI) (24.3 ± 3.9 vs 21.7 ± 3.5 kg/m<sup>2</sup>, <i>P </i>= .001), lower fractional excretion of uric acid (FEUA) (median 4.22% vs 6.17%, <i>P </i>< .001), and urinary calcium/creatinine ratio (0.05 vs 0.12 mmol/mmol, <i>P </i>= .004). In GS patients with or without hyperuricemia, the impairment of NCC function indicated by the value of increase of chloride excretion fraction (△FECl) in the hydrochlorothiazide test was median 0.49% vs 0.82% (<i>P </i>= .10). We focused on the <i>SLC12A3</i> genotype and 33 SNPs linked to uric acid levels and found no significant genetic differences between patients with or without hyperuricemia.</p><p><strong>Conclusions: </strong>Hyperuricemia is common in patients with GS in China, associated with elevated BMI and potentially more severe NCC dysfunction.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 12","pages":"sfaf311"},"PeriodicalIF":4.6,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12673208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145676369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Clinical Kidney Journal
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