Pub Date : 2024-08-13DOI: 10.1007/s40620-024-02061-z
Ghada A Ankawi, Giorgina Barbara Piccoli
{"title":"Pregnancy-related acute kidney injury (PrAKI): a call for a uniform reporting approach : Editorial comment on Risk factors and outcomes associated with pregnancy-related acute kidney injury in a high-risk cohort of women in Nigeria.","authors":"Ghada A Ankawi, Giorgina Barbara Piccoli","doi":"10.1007/s40620-024-02061-z","DOIUrl":"https://doi.org/10.1007/s40620-024-02061-z","url":null,"abstract":"","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141971315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-12DOI: 10.1007/s40620-024-02031-5
Muhammad Junaid Tahir, Zoha Aftab, Zahid Nabi, Muhammad Ishaque
Dengue is the most prevalent arthropod-transmitted infection worldwide. Its clinical presentation ranges from subclinical illness to multi-organ failure. Acute kidney injury (AKI) is one of its complications, having a number of different pathogeneses. The patient herein described presented with thrombotic microangiopathy (TMA) and rhabdomyolysis, a combination never previously reported in the literature. He was diagnosed with dengue at a primary care hospital, after which he was referred to us with fever and oliguria. His blood workup and kidney biopsy revealed a picture of combined TMA and rhabdomyolysis-induced AKI. He developed sepsis after his first session of plasmapheresis, that had to be discontinued and he was further managed with dialysis and supportive care. The patient showed remarkable recovery, regaining kidney function after one month.
{"title":"Beyond the norm: a rare presentation of dengue fever resulting in combined rhabdomyolysis and TMA-induced AKI-a case report.","authors":"Muhammad Junaid Tahir, Zoha Aftab, Zahid Nabi, Muhammad Ishaque","doi":"10.1007/s40620-024-02031-5","DOIUrl":"https://doi.org/10.1007/s40620-024-02031-5","url":null,"abstract":"<p><p>Dengue is the most prevalent arthropod-transmitted infection worldwide. Its clinical presentation ranges from subclinical illness to multi-organ failure. Acute kidney injury (AKI) is one of its complications, having a number of different pathogeneses. The patient herein described presented with thrombotic microangiopathy (TMA) and rhabdomyolysis, a combination never previously reported in the literature. He was diagnosed with dengue at a primary care hospital, after which he was referred to us with fever and oliguria. His blood workup and kidney biopsy revealed a picture of combined TMA and rhabdomyolysis-induced AKI. He developed sepsis after his first session of plasmapheresis, that had to be discontinued and he was further managed with dialysis and supportive care. The patient showed remarkable recovery, regaining kidney function after one month.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141916987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-12DOI: 10.1007/s40620-024-02050-2
Debargha Basuli, Akil Kavcar, Sasmit Roy
Diabetic kidney disease (DKD) is a significant complication of type 2 diabetes, posing a global health risk. Detecting and predicting diabetic kidney disease at an early stage is crucial for timely interventions and improved patient outcomes. Artificial intelligence (AI) has demonstrated promise in healthcare, and several tools have recently been developed that utilize Machine Learning with clinical data to detect and predict DKD. This review aims to explore the current landscape of AI and machine learning applications in DKD, specifically examining existing literature on risk scores and machine learning approaches for predicting DKD development. A literature search was conducted using Medline (PubMed), Google Scholar, and Scopus databases until July 2023. Relevant keywords were used to extract studies that described the role of AI in DKD. The review revealed that AI and machine learning have been successfully used to predict DKD progression, outperforming traditional risk score models. Artificial intelligence-driven research for DKD extends beyond prediction models, offering opportunities for integrating genetic and epigenetic data, advancing understanding of the disease's molecular basis, personalizing treatment strategies, and fostering the development of novel drugs. However, challenges remain, including the requirement for large datasets and the lack of standardization in AI-driven tools for DKD. Artificial intelligence and machine learning have the potential to revolutionize the management and care of DKD patients, surpassing the limitations of traditional methods reliant on existing knowledge. Future research should address the challenges associated with AI and machine learning in DKD and focus on developing AI-driven tools for clinical practice.
{"title":"From bytes to nephrons: AI's journey in diabetic kidney disease.","authors":"Debargha Basuli, Akil Kavcar, Sasmit Roy","doi":"10.1007/s40620-024-02050-2","DOIUrl":"https://doi.org/10.1007/s40620-024-02050-2","url":null,"abstract":"<p><p>Diabetic kidney disease (DKD) is a significant complication of type 2 diabetes, posing a global health risk. Detecting and predicting diabetic kidney disease at an early stage is crucial for timely interventions and improved patient outcomes. Artificial intelligence (AI) has demonstrated promise in healthcare, and several tools have recently been developed that utilize Machine Learning with clinical data to detect and predict DKD. This review aims to explore the current landscape of AI and machine learning applications in DKD, specifically examining existing literature on risk scores and machine learning approaches for predicting DKD development. A literature search was conducted using Medline (PubMed), Google Scholar, and Scopus databases until July 2023. Relevant keywords were used to extract studies that described the role of AI in DKD. The review revealed that AI and machine learning have been successfully used to predict DKD progression, outperforming traditional risk score models. Artificial intelligence-driven research for DKD extends beyond prediction models, offering opportunities for integrating genetic and epigenetic data, advancing understanding of the disease's molecular basis, personalizing treatment strategies, and fostering the development of novel drugs. However, challenges remain, including the requirement for large datasets and the lack of standardization in AI-driven tools for DKD. Artificial intelligence and machine learning have the potential to revolutionize the management and care of DKD patients, surpassing the limitations of traditional methods reliant on existing knowledge. Future research should address the challenges associated with AI and machine learning in DKD and focus on developing AI-driven tools for clinical practice.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141916988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-12DOI: 10.1007/s40620-024-02042-2
Beatriz Donato, Rita Almeida, Mário Raimundo, Sónia Velho, Ana Primitivo, Filipa Correia, Luís Falcão, Catarina Teixeira, Sónia Silva, Edgar Almeida
Background: Low muscle mass quantity and quality (myosteatosis) can be evaluated by computed tomography (CT) by measuring skeletal muscle area and muscular attenuation, respectively, at the third lumbar vertebra. We aimed to define cut-off points of skeletal muscle area and muscular attenuation to predict mortality in non-dialysis chronic kidney disease (CKD) patients.
Methods: We conducted a retrospective study including non-dialysis CKD patients over two years, who underwent an opportunistic computed tomography within a two year period, and for whom creatinine was measured within 90 days of CT. Skeletal muscle area was normalized for stature to calculate the skeletal muscle index. Area under the receiver operating characteristic (AuROC) curve and Youden's index were used, to identify the cut-point, separately according to sex.
Results: One hundred sixty-seven patients (50.9% male, mean age of 68.3 ± 16.4 years) were included, most with CKD stages 3 and 4. During a median follow-up of 4.9 (4.2) years, 39 (23.4%) patients died. Muscular attenuation showed a better ability to predict mortality (AuROC curve 0.739 [95% CI 0.623-0.855] in women and 0.744 in men [95% CI 0.618-0.869]) than skeletal muscle index (AuROC curve 0.491 [95% CI 0.332-0.651] in women and 0.711 [95% CI 0.571-0.850] in men). For muscular attenuation, the best cut-off values to predict mortality were 27.56 Hounsfield units in women and 24.58 Hounsfield units in men. For skeletal muscle index, the best cut-off values were 38.47 cm2/m2 in women and 47.81 cm2/m2 in men. In univariable Cox-regression both low muscle mass and myosteatosis were associated with increased mortality. In multivariable Cox-regression models only myosteatosis maintained a significant association with mortality (Hazard Ratio 2.651 (95% CI 1.232-5.703, p = 0.013)).
Conclusions: We found sex-specific cut-off values for muscle parameters using CT analysis in non-dialysis CKD patients that were associated with mortality. In this population, myosteatosis may be more closely associated with mortality than muscle quantity.
背景:计算机断层扫描(CT)可通过测量第三腰椎处的骨骼肌面积和肌肉衰减程度来评估肌肉质量和数量(肌骨质疏松症)。我们旨在确定骨骼肌面积和肌肉衰减的临界点,以预测非透析慢性肾病(CKD)患者的死亡率:我们进行了一项回顾性研究,研究对象包括两年内接受过计算机断层扫描的非透析慢性肾脏病患者,这些患者在计算机断层扫描后 90 天内测量了血肌酐。骨骼肌面积根据身材进行归一化处理,以计算骨骼肌指数。使用接收者操作特征曲线下面积(AuROC)和尤登指数来确定切点,并根据性别进行区分:共纳入 167 名患者(50.9% 为男性,平均年龄为 68.3 ± 16.4 岁),其中大多数为慢性肾脏病 3 期和 4 期患者。在中位 4.9 (4.2) 年的随访期间,39 名患者(23.4%)死亡。与骨骼肌指数(女性为 AuROC 曲线 0.491 [95% CI 0.332-0.651],男性为 0.711 [95% CI 0.571-0.850])相比,肌肉衰减显示出更好的预测死亡率的能力(女性为 AuROC 曲线 0.739 [95% CI 0.623-0.855],男性为 0.744 [95% CI 0.618-0.869])。在肌肉衰减方面,女性预测死亡率的最佳临界值为 27.56 哈恩斯菲尔德单位,男性为 24.58 哈恩斯菲尔德单位。在骨骼肌指数方面,女性的最佳临界值为 38.47 cm2/m2,男性为 47.81 cm2/m2。在单变量 Cox 回归中,低肌肉质量和肌骨骼疏松都与死亡率增加有关。在多变量 Cox 回归模型中,只有肌骨质疏松症与死亡率有显著关联(危险比 2.651 (95% CI 1.232-5.703, p = 0.013)):我们通过 CT 分析发现,非透析慢性肾脏病患者肌肉参数的特定性别临界值与死亡率有关。在这一人群中,肌肉骨质疏松症与死亡率的关系可能比肌肉数量更密切。
{"title":"Myosteatosis: an underrecognized risk factor for mortality in non-dialysis chronic kidney disease patients.","authors":"Beatriz Donato, Rita Almeida, Mário Raimundo, Sónia Velho, Ana Primitivo, Filipa Correia, Luís Falcão, Catarina Teixeira, Sónia Silva, Edgar Almeida","doi":"10.1007/s40620-024-02042-2","DOIUrl":"https://doi.org/10.1007/s40620-024-02042-2","url":null,"abstract":"<p><strong>Background: </strong>Low muscle mass quantity and quality (myosteatosis) can be evaluated by computed tomography (CT) by measuring skeletal muscle area and muscular attenuation, respectively, at the third lumbar vertebra. We aimed to define cut-off points of skeletal muscle area and muscular attenuation to predict mortality in non-dialysis chronic kidney disease (CKD) patients.</p><p><strong>Methods: </strong>We conducted a retrospective study including non-dialysis CKD patients over two years, who underwent an opportunistic computed tomography within a two year period, and for whom creatinine was measured within 90 days of CT. Skeletal muscle area was normalized for stature to calculate the skeletal muscle index. Area under the receiver operating characteristic (AuROC) curve and Youden's index were used, to identify the cut-point, separately according to sex.</p><p><strong>Results: </strong>One hundred sixty-seven patients (50.9% male, mean age of 68.3 ± 16.4 years) were included, most with CKD stages 3 and 4. During a median follow-up of 4.9 (4.2) years, 39 (23.4%) patients died. Muscular attenuation showed a better ability to predict mortality (AuROC curve 0.739 [95% CI 0.623-0.855] in women and 0.744 in men [95% CI 0.618-0.869]) than skeletal muscle index (AuROC curve 0.491 [95% CI 0.332-0.651] in women and 0.711 [95% CI 0.571-0.850] in men). For muscular attenuation, the best cut-off values to predict mortality were 27.56 Hounsfield units in women and 24.58 Hounsfield units in men. For skeletal muscle index, the best cut-off values were 38.47 cm<sup>2</sup>/m<sup>2</sup> in women and 47.81 cm<sup>2</sup>/m<sup>2</sup> in men. In univariable Cox-regression both low muscle mass and myosteatosis were associated with increased mortality. In multivariable Cox-regression models only myosteatosis maintained a significant association with mortality (Hazard Ratio 2.651 (95% CI 1.232-5.703, p = 0.013)).</p><p><strong>Conclusions: </strong>We found sex-specific cut-off values for muscle parameters using CT analysis in non-dialysis CKD patients that were associated with mortality. In this population, myosteatosis may be more closely associated with mortality than muscle quantity.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141916989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-09DOI: 10.1007/s40620-024-01999-4
Vincenzo Antonio Panuccio, Rocco Tripepi, Maria Carmela Versace, Domenico Russo, Luigi Francesco Pio Morrone, Giovanni Luigi Tripepi, Pasquale Fabio Provenzano, Carlo Alfieri
{"title":"Dialysis after contrast agent administration in patients on chronic hemodialysis: do all Italian nephrologists think the same way?","authors":"Vincenzo Antonio Panuccio, Rocco Tripepi, Maria Carmela Versace, Domenico Russo, Luigi Francesco Pio Morrone, Giovanni Luigi Tripepi, Pasquale Fabio Provenzano, Carlo Alfieri","doi":"10.1007/s40620-024-01999-4","DOIUrl":"https://doi.org/10.1007/s40620-024-01999-4","url":null,"abstract":"","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141906864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-08DOI: 10.1007/s40620-024-02060-0
Ronen Schneider, Bshara Mansour, Caroline M Kolvenbach, Florian Buerger, Daanya Salmanullah, Katharina Lemberg, Lea M Merz, Nils D Mertens, Ken Saida, Kirollos Yousef, Gijs A C Franken, Aaron Bao, Seyoung Yu, Selina Hölzel, Camille Nicolas-Frank, Andrew Steinsapir, Kevin A Goncalves, Shirlee Shril, Friedhelm Hildebrandt
{"title":"Correction to: Phenotypic quantification of Nphs1‑deficient mice.","authors":"Ronen Schneider, Bshara Mansour, Caroline M Kolvenbach, Florian Buerger, Daanya Salmanullah, Katharina Lemberg, Lea M Merz, Nils D Mertens, Ken Saida, Kirollos Yousef, Gijs A C Franken, Aaron Bao, Seyoung Yu, Selina Hölzel, Camille Nicolas-Frank, Andrew Steinsapir, Kevin A Goncalves, Shirlee Shril, Friedhelm Hildebrandt","doi":"10.1007/s40620-024-02060-0","DOIUrl":"10.1007/s40620-024-02060-0","url":null,"abstract":"","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141902019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-05DOI: 10.1007/s40620-024-02044-0
Áine M de Bhailis, Edward Lake, Constantina Chrysochou, Darren Green, Rajkumar Chinnadurai, Philip A Kalra
{"title":"Correction to: Improving outcomes in atherosclerotic renovascular disease: importance of clinical presentation and multi‑disciplinary review.","authors":"Áine M de Bhailis, Edward Lake, Constantina Chrysochou, Darren Green, Rajkumar Chinnadurai, Philip A Kalra","doi":"10.1007/s40620-024-02044-0","DOIUrl":"https://doi.org/10.1007/s40620-024-02044-0","url":null,"abstract":"","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-05DOI: 10.1007/s40620-024-02041-3
Elena Zakharova
{"title":"Two writers and physicians-examples of dedication to humanism.","authors":"Elena Zakharova","doi":"10.1007/s40620-024-02041-3","DOIUrl":"https://doi.org/10.1007/s40620-024-02041-3","url":null,"abstract":"","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-05DOI: 10.1007/s40620-024-02032-4
Davide Bolignano, Marta Greco, Pierangela Presta, Anila Duni, Mariateresa Zicarelli, Simone Mercuri, Efthymios Pappas, Lampros Lakkas, Michela Musolino, Katerina K Naka, Sara Pugliese, Roberta Misiti, Daniela Patrizia Foti, Michele Andreucci, Giuseppe Coppolino, Evangelia Dounousi
Background: Mortality and cardiovascular (CV) risk prediction in individuals with end-stage kidney disease (ESKD) on chronic hemodialysis (HD) remains challenging due to the multitude of implicated factors. In a multicenter ESKD-HD cohort, we tested the prognostic yield of the assessment of circulating Humanin, a small mitochondrial-derived peptide involved in CV protection, on CV events and mortality.
Methods: We conducted a prospective, observational, pilot study on 94 prevalent HD patients. The prognostic capacity of circulating Humanin levels was tested on a primary composite (all-cause mortality + non-fatal CV events) and a secondary exploratory endpoint (all-cause mortality alone).
Results: Baseline Humanin level was comparable in patients reaching the primary or secondary endpoint as compared to others (p = 0.69 and 0.76, respectively). Unadjusted followed by multivariable Cox regression analyses adjusted for age, left ventricular mass index (LVMi), E/e', pulse pressure and diabetes mellitus indicated a non-linear relationship between Humanin levels and the composite outcome with the highest Hazard Ratio (HR) associated with very low (< 450.7 pg/mL; HR ranging from 4.25 to 2.49) and very high (> 759.5 pg/mL; HR ranging from 5.84 to 4.50) Humanin values. Restricted cubic splines fitting univariate and multivariate Cox regression analyses visually confirmed a curvilinear trend with an increasing risk observed for lower and higher Humanin values around the median, respectively. A similar, u-shaped association was also evidenced with the secondary endpoint.
Conclusions: Altered Humanin levels may impart prognostic information in ESKD-HD patients at risk of death or CV events. Future investigations are needed to confirm whether Humanin measurement could improve CV and mortality risk prediction beyond traditional risk models.
{"title":"Unbalanced circulating Humanin levels and cardiovascular risk in chronic hemodialysis patients: a pilot, prospective study.","authors":"Davide Bolignano, Marta Greco, Pierangela Presta, Anila Duni, Mariateresa Zicarelli, Simone Mercuri, Efthymios Pappas, Lampros Lakkas, Michela Musolino, Katerina K Naka, Sara Pugliese, Roberta Misiti, Daniela Patrizia Foti, Michele Andreucci, Giuseppe Coppolino, Evangelia Dounousi","doi":"10.1007/s40620-024-02032-4","DOIUrl":"https://doi.org/10.1007/s40620-024-02032-4","url":null,"abstract":"<p><strong>Background: </strong>Mortality and cardiovascular (CV) risk prediction in individuals with end-stage kidney disease (ESKD) on chronic hemodialysis (HD) remains challenging due to the multitude of implicated factors. In a multicenter ESKD-HD cohort, we tested the prognostic yield of the assessment of circulating Humanin, a small mitochondrial-derived peptide involved in CV protection, on CV events and mortality.</p><p><strong>Methods: </strong>We conducted a prospective, observational, pilot study on 94 prevalent HD patients. The prognostic capacity of circulating Humanin levels was tested on a primary composite (all-cause mortality + non-fatal CV events) and a secondary exploratory endpoint (all-cause mortality alone).</p><p><strong>Results: </strong>Baseline Humanin level was comparable in patients reaching the primary or secondary endpoint as compared to others (p = 0.69 and 0.76, respectively). Unadjusted followed by multivariable Cox regression analyses adjusted for age, left ventricular mass index (LVMi), E/e', pulse pressure and diabetes mellitus indicated a non-linear relationship between Humanin levels and the composite outcome with the highest Hazard Ratio (HR) associated with very low (< 450.7 pg/mL; HR ranging from 4.25 to 2.49) and very high (> 759.5 pg/mL; HR ranging from 5.84 to 4.50) Humanin values. Restricted cubic splines fitting univariate and multivariate Cox regression analyses visually confirmed a curvilinear trend with an increasing risk observed for lower and higher Humanin values around the median, respectively. A similar, u-shaped association was also evidenced with the secondary endpoint.</p><p><strong>Conclusions: </strong>Altered Humanin levels may impart prognostic information in ESKD-HD patients at risk of death or CV events. Future investigations are needed to confirm whether Humanin measurement could improve CV and mortality risk prediction beyond traditional risk models.</p>","PeriodicalId":16542,"journal":{"name":"Journal of Nephrology","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}