Pub Date : 2025-12-01Epub Date: 2025-08-27DOI: 10.1016/j.nefro.2025.501409
María Dolores Arenas Jiménez, Julia Audije-Gil, Paula Manso, David Hernán, Fabiola Dapena, Ana Balseiro, Cristina Sanz
{"title":"Alfabetización en salud renal en la era digital: la experiencia de la plataforma Salud Renal Siempre","authors":"María Dolores Arenas Jiménez, Julia Audije-Gil, Paula Manso, David Hernán, Fabiola Dapena, Ana Balseiro, Cristina Sanz","doi":"10.1016/j.nefro.2025.501409","DOIUrl":"10.1016/j.nefro.2025.501409","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 10","pages":"Article 501409"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145610410","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 : 2025-12-01Epub Date: 2025-06-11DOI: 10.1016/j.nefro.2025.501365
Yumei Fang, Xia Cao
Objective
This study aims to identify risk factors for thrombosis in arteriovenous grafts and construct a predictive model to assess thrombosis risk in patients undergoing maintenance hemodialysis (MHD).
Methods
A total of 160 MHD patients with arteriovenous graft were included and divided into a thrombosis group (n = 39) and a control group (n = 121). Univariate and multivariate logistic regression analyses were performed to identify independent risk factors. A nomogram prediction model was developed using R software, and its predictive performance was evaluated through calibration curves and C-index validation.
Results
Multivariate analysis identified diabetes, hypotension during dialysis, arteriovenous graft stenosis, compression hemostasis > 30 min, and calcium-phosphorus product > 55 mg2/dL2 as independent risk factors for arteriovenous graft thrombosis. The nomogram model demonstrated good predictive accuracy, with an initial C-index of 0.753 and a validated C-index of 0.735.
Conclusion
The established nomogram effectively predicts arteriovenous graft thrombosis risk, aiding early identification and targeted intervention for high-risk patients.
{"title":"Construction of risk factors and prediction model for arteriovenous graft thrombosis","authors":"Yumei Fang, Xia Cao","doi":"10.1016/j.nefro.2025.501365","DOIUrl":"10.1016/j.nefro.2025.501365","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to identify risk factors for thrombosis in arteriovenous grafts and construct a predictive model to assess thrombosis risk in patients undergoing maintenance hemodialysis (MHD).</div></div><div><h3>Methods</h3><div>A total of 160 MHD patients with arteriovenous graft were included and divided into a thrombosis group (<em>n</em> <!-->=<!--> <!-->39) and a control group (<em>n</em> <!-->=<!--> <!-->121). Univariate and multivariate logistic regression analyses were performed to identify independent risk factors. A nomogram prediction model was developed using R software, and its predictive performance was evaluated through calibration curves and C-index validation.</div></div><div><h3>Results</h3><div>Multivariate analysis identified diabetes, hypotension during dialysis, arteriovenous graft stenosis, compression hemostasis<!--> <!-->><!--> <!-->30<!--> <!-->min, and calcium-phosphorus product<!--> <!-->><!--> <!-->55<!--> <!-->mg<sup>2</sup>/dL<sup>2</sup> as independent risk factors for arteriovenous graft thrombosis. The nomogram model demonstrated good predictive accuracy, with an initial C-index of 0.753 and a validated C-index of 0.735.</div></div><div><h3>Conclusion</h3><div>The established nomogram effectively predicts arteriovenous graft thrombosis risk, aiding early identification and targeted intervention for high-risk patients.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 10","pages":"Article 501365"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145610413","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 : 2025-12-01Epub Date: 2025-06-11DOI: 10.1016/j.nefro.2025.501355
Guillermina Barril Cuadrado , Ana Avellón Calvo , Elena Jiménez Vibora , Luisa García Buey , Rosa María Ruiz-Calero Cendrero , Antonio Cirugeda García , José Ibeas López , Cristina García Fernández , Federico García García , Roberto Alcázar Arroyo
{"title":"Posicionamiento sobre el manejo de la infección oculta por el virus B de la hepatitis (OBI) y anti-HBc+ en las unidades de hemodiálisis","authors":"Guillermina Barril Cuadrado , Ana Avellón Calvo , Elena Jiménez Vibora , Luisa García Buey , Rosa María Ruiz-Calero Cendrero , Antonio Cirugeda García , José Ibeas López , Cristina García Fernández , Federico García García , Roberto Alcázar Arroyo","doi":"10.1016/j.nefro.2025.501355","DOIUrl":"10.1016/j.nefro.2025.501355","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 10","pages":"Article 501355"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145610386","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 : 2025-12-01Epub Date: 2025-07-22DOI: 10.1016/j.nefro.2025.501391
Víctor Joaquín Escudero-Saiz , Elena Cuadrado-Payán , María Rodríguez-García , Gregori Casals , Lida María Rodas , Néstor Fontseré , José Jesús Broseta , Francisco Maduell
Introduction
Protein-bound uremic toxins (PBUTs) have a high affinity for albumin and they are associated with increased cardiovascular morbidity and mortality in hemodialysis patients. Among them, p-cresyl sulfate (pCS) and indoxyl sulfate (IS) stand out due to their high toxicity. Post-dilution hemodiafiltration (HDF) is one of the dialysis techniques that has shown the greatest benefits in terms of patient survival.
Materials and methods
This observational, single-center, cross-sectional study evaluated PBUT clearance in 137 patients undergoing post-dilution HDF, analyzing the factors that influence their removal. Reduction ratios (RRs) of IS and pCS were measured, as well as their correlation with dialysis parameters and clinical variables.
Results
The mean RR for IS was 53.4% ± 9.3%, and for pCS, 48.2% ± 11.3%. A significant correlation was observed between the RR of both toxins (r = 0.606; P < 0.01), suggesting similar elimination mechanisms. In addition, total convective volume showed a positive correlation with the RR of pCS (r = 0.19; P = 0.027) and a weak correlation with the RR of IS (r = 0.155; P = 0.07). A significant difference in clearance was found according to sex, with higher RRs in women (P < 0.001 for IS and P = 0.008 for pCS).
Conclusions
The clearance of PBUTs is primarily diffusive. Enhancing all variables related to this physical principle will improve the elimination of these toxins. Post-dilution HDF with high convective volume slightly increases this clearance. However, the results remain insufficient given the high toxicity of these molecules. New strategies, such as the use of adsorptive membranes and competitive molecules, are needed to optimize their removal and reduce the negative cardiovascular impact in hemodialysis patients.
蛋白结合尿毒症毒素（PBUTs）对白蛋白具有高亲和力，并且与血液透析患者心血管发病率和死亡率增加有关。其中，对甲酚硫酸盐（pCS）和吲哚酚硫酸盐（IS）因其高毒性而引人注目。稀释后血液滤过（HDF）是透析技术之一，在患者生存方面显示出最大的好处。材料和方法本观察性、单中心、横断面研究评估了137例稀释后HDF患者的PBUT清除情况，分析了影响清除的因素。测定IS和pCS的降低率（rr），并与透析参数和临床变量进行相关性分析。结果IS和pCS的平均RR分别为53.4%±9.3%和48.2%±11.3%。两种毒素的相对危险度呈显著相关（r = 0.606; P < 0.01），表明两种毒素的消除机制相似。总对流体积与pCS的RR呈正相关（r = 0.19, P = 0.027），与IS的RR呈弱相关（r = 0.155, P = 0.07）。根据性别发现清除率有显著差异，女性的rr较高（IS为P <； 0.001， pc为P = 0.008）。结论PBUTs的清除以弥漫性清除为主。加强与这一物理原理有关的所有变量将有助于消除这些毒素。高对流体积的稀释后HDF稍微增加了这个间隙。然而，考虑到这些分子的高毒性，结果仍然不够充分。需要新的策略，如使用吸附膜和竞争分子，来优化它们的去除并减少血液透析患者的负面心血管影响。
{"title":"Factores que influyen en la depuración de toxinas urémicas unidas a proteínas en hemodiafiltración","authors":"Víctor Joaquín Escudero-Saiz , Elena Cuadrado-Payán , María Rodríguez-García , Gregori Casals , Lida María Rodas , Néstor Fontseré , José Jesús Broseta , Francisco Maduell","doi":"10.1016/j.nefro.2025.501391","DOIUrl":"10.1016/j.nefro.2025.501391","url":null,"abstract":"<div><h3>Introduction</h3><div>Protein-bound uremic toxins (PBUTs) have a high affinity for albumin and they are associated with increased cardiovascular morbidity and mortality in hemodialysis patients. Among them, p-cresyl sulfate (pCS) and indoxyl sulfate (IS) stand out due to their high toxicity. Post-dilution hemodiafiltration (HDF) is one of the dialysis techniques that has shown the greatest benefits in terms of patient survival.</div></div><div><h3>Materials and methods</h3><div>This observational, single-center, cross-sectional study evaluated PBUT clearance in 137 patients undergoing post-dilution HDF, analyzing the factors that influence their removal. Reduction ratios (RRs) of IS and pCS were measured, as well as their correlation with dialysis parameters and clinical variables.</div></div><div><h3>Results</h3><div>The mean RR for IS was 53.4%<!--> <!-->±<!--> <!-->9.3%, and for pCS, 48.2%<!--> <!-->±<!--> <!-->11.3%. A significant correlation was observed between the RR of both toxins (<em>r</em> <!-->=<!--> <!-->0.606; <em>P</em> <!--><<!--> <!-->0.01), suggesting similar elimination mechanisms. In addition, total convective volume showed a positive correlation with the RR of pCS (<em>r</em> <!-->=<!--> <!-->0.19; <em>P</em> <!-->=<!--> <!-->0.027) and a weak correlation with the RR of IS (<em>r</em> <!-->=<!--> <!-->0.155; <em>P</em> <!-->=<!--> <!-->0.07). A significant difference in clearance was found according to sex, with higher RRs in women (<em>P</em> <!--><<!--> <!-->0.001 for IS and <em>P</em> <!-->=<!--> <!-->0.008 for pCS).</div></div><div><h3>Conclusions</h3><div>The clearance of PBUTs is primarily diffusive. Enhancing all variables related to this physical principle will improve the elimination of these toxins. Post-dilution HDF with high convective volume slightly increases this clearance. However, the results remain insufficient given the high toxicity of these molecules. New strategies, such as the use of adsorptive membranes and competitive molecules, are needed to optimize their removal and reduce the negative cardiovascular impact in hemodialysis patients.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 10","pages":"Article 501391"},"PeriodicalIF":2.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145610415","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 : 2025-11-01Epub Date: 2025-08-11DOI: 10.1016/j.nefro.2025.501399
Luis M. Ruilope , Bertram Pitt , Alejandro de la Sierra , Gema Ruiz-Hurtado
{"title":"Towards a better prevention in cardio-kidney metabolic syndrome: Role of aldosterone and albuminuria","authors":"Luis M. Ruilope , Bertram Pitt , Alejandro de la Sierra , Gema Ruiz-Hurtado","doi":"10.1016/j.nefro.2025.501399","DOIUrl":"10.1016/j.nefro.2025.501399","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 9","pages":"Article 501399"},"PeriodicalIF":2.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145384312","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 : 2025-11-01Epub Date: 2025-06-09DOI: 10.1016/j.nefro.2025.501354
Manuel Macía , Gema Fernández-Juárez , Ana I. Ávila , Mar Espino , Mario Espinosa , Xavier Fulladosa , Clara García-Carro , Marian Goicoechea , Enrique Morales , Luis F. Quintana , Jorge E. Rojas-Rivera , Manuel Praga
In 2023, the Spanish Society of Nephrology's Glomerular Diseases Study Group (GLOSEN) published a consensus document containing the most pertinent information and clinical recommendations for the diagnosis, treatment, and follow-up of lupus nephritis (LN). GLANCE is a project that emerged from the need to evaluate the extent of knowledge and application of these GLOSEN recommendations in routine clinical practice for the management of LN. To achieve this, an online self-administered survey was conducted to gather opinions on the recommendations and assess their impact on clinical practice. Fifty-one Spanish nephrologists with more than three years of experience in managing LN and handling more than one LN patient per month, participated in the survey. All participants demonstrated a comprehensive understanding and high overall acceptance of the GLOSEN recommendations. However, discrepancies were noted regarding criteria for partial remission and relapse, as well as treatment goals during the initial months of progression, underscoring the need for a more detailed consensus. Other findings highlighted the limited number of nephrologists using specific scales to assess extrarenal manifestations and the tendency to extend immunosuppressive treatments beyond the recommended 3–5-year period outlined in the document. This emphasizes the necessity for further studies on the discontinuation of these drugs and their association with the risk of relapse in LN.
{"title":"Encuesta GLANCE: conocimiento e implementación de las recomendaciones del documento de GLOSEN para el diagnóstico y tratamiento de la nefritis lúpica","authors":"Manuel Macía , Gema Fernández-Juárez , Ana I. Ávila , Mar Espino , Mario Espinosa , Xavier Fulladosa , Clara García-Carro , Marian Goicoechea , Enrique Morales , Luis F. Quintana , Jorge E. Rojas-Rivera , Manuel Praga","doi":"10.1016/j.nefro.2025.501354","DOIUrl":"10.1016/j.nefro.2025.501354","url":null,"abstract":"<div><div>In 2023, the Spanish Society of Nephrology's Glomerular Diseases Study Group (GLOSEN) published a consensus document containing the most pertinent information and clinical recommendations for the diagnosis, treatment, and follow-up of lupus nephritis (LN). GLANCE is a project that emerged from the need to evaluate the extent of knowledge and application of these GLOSEN recommendations in routine clinical practice for the management of LN. To achieve this, an online self-administered survey was conducted to gather opinions on the recommendations and assess their impact on clinical practice. Fifty-one Spanish nephrologists with more than three years of experience in managing LN and handling more than one LN patient per month, participated in the survey. All participants demonstrated a comprehensive understanding and high overall acceptance of the GLOSEN recommendations. However, discrepancies were noted regarding criteria for partial remission and relapse, as well as treatment goals during the initial months of progression, underscoring the need for a more detailed consensus. Other findings highlighted the limited number of nephrologists using specific scales to assess extrarenal manifestations and the tendency to extend immunosuppressive treatments beyond the recommended 3–5-year period outlined in the document. This emphasizes the necessity for further studies on the discontinuation of these drugs and their association with the risk of relapse in LN.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 9","pages":"Article 501354"},"PeriodicalIF":2.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145384314","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 : 2025-11-01Epub Date: 2025-06-09DOI: 10.1016/j.nefro.2025.501356
Cristina Riaza Ortiz , Marta Calvo Arévalo , Marta Álvarez Nadal , Antonio Casado , Ana I. Sánchez-Fructuoso , Clara García-Carro
Thrombotic microangiopathy (TMA) is characterized by endotelial damage, microangiopathic hemolytic anemia, thrombocytopenia and organ damage, particularly renal. In oncology, TMA can be secondary to the cancer itself or related to oncological treatments. TMA associated with gemcitabine has a poor prognosis, with high mortality and complement activation plays a central role in its pathophisiology. While eculizumab has shown efficacy and improved outcomes in this condition, evidence regarding the use of ravulizumab remains scarce. We present the case of an 81-year-old woman with arterial hypertension and a history of left breast cancer treated with surgery and radiotherapy, currently diagnosed with stage iv left breast angiosarcoma treated with gemcitabine after progression on paclitaxel. She developed a hypertensive emergency, anemia (Hb 6.9 g/dL), thrombocytopenia (68,000 platelets), impaired renal function (creatinine 1.64 mg/dL) and elevated LDH (1,126 U/L). Suspecting gemcitabine-induced TMA, the treatment was discontinued and ravulizumab was initiated, resulting in rapid renal and hematological response. Oncological treatment with pazopanib was reintroduced, leading to recurrence of TMA. That treatment was suspended and another dose of ravulizumab was administered, with good response. TMA is a significant cause of morbidity and mortality in cancer patients, contributing to progression to chronic kidney disease and the discontinuation of oncological treatment. This case highlights the role of ravulizumab in gemcitabine-associated TMA, offering advantages in frail patients due to its longer half-life, reduced administration frequency and favorable outcomes.
{"title":"Ravulizumab como alternativa en la microangiopatía trombótica inducida por gemcitabina: reporte de un caso clínico","authors":"Cristina Riaza Ortiz , Marta Calvo Arévalo , Marta Álvarez Nadal , Antonio Casado , Ana I. Sánchez-Fructuoso , Clara García-Carro","doi":"10.1016/j.nefro.2025.501356","DOIUrl":"10.1016/j.nefro.2025.501356","url":null,"abstract":"<div><div>Thrombotic microangiopathy (TMA) is characterized by endotelial damage, microangiopathic hemolytic anemia, thrombocytopenia and organ damage, particularly renal. In oncology, TMA can be secondary to the cancer itself or related to oncological treatments. TMA associated with gemcitabine has a poor prognosis, with high mortality and complement activation plays a central role in its pathophisiology. While eculizumab has shown efficacy and improved outcomes in this condition, evidence regarding the use of ravulizumab remains scarce. We present the case of an 81-year-old woman with arterial hypertension and a history of left breast cancer treated with surgery and radiotherapy, currently diagnosed with stage <span>iv</span> left breast angiosarcoma treated with gemcitabine after progression on paclitaxel. She developed a hypertensive emergency, anemia (Hb 6.9<!--> <!-->g/dL), thrombocytopenia (68,000 platelets), impaired renal function (creatinine 1.64<!--> <!-->mg/dL) and elevated LDH (1,126 U/L). Suspecting gemcitabine-induced TMA, the treatment was discontinued and ravulizumab was initiated, resulting in rapid renal and hematological response. Oncological treatment with pazopanib was reintroduced, leading to recurrence of TMA. That treatment was suspended and another dose of ravulizumab was administered, with good response. TMA is a significant cause of morbidity and mortality in cancer patients, contributing to progression to chronic kidney disease and the discontinuation of oncological treatment. This case highlights the role of ravulizumab in gemcitabine-associated TMA, offering advantages in frail patients due to its longer half-life, reduced administration frequency and favorable outcomes.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 9","pages":"Article 501356"},"PeriodicalIF":2.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145384316","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 : 2025-11-01Epub Date: 2025-06-09DOI: 10.1016/j.nefro.2025.501357
Yasemin Coşkun Yavuz , Zeynep Biyik , Firdevs Sak , Muslu Kazım Korez , Sedat Abusoglu , Lutfullah Altintepe
Introduction and objective
It was aimed to examine the relationship between cognitive impairment (CI) and Aβ40, 42, Aβ42/40 ratio and p-tau181 in chronic kidney disease (CKD) patients at all stages.
Patients
The patients were divided into four groups; control, the early stage CKD (stage 1–3), the advanced stage CKD (stage 4–5) and the hemodialysis group. All patients completed the MMSE and MoCA tests for CI. The Aβ40, Aβ42, p-tau181 levels of all participants were measured.
Result
The result of the MMSE was significantly lower in CKD group (p = 0.005). There was a significant negative correlation between the MMSE and CKD stages (Spearman's rho = −0.29, p = 0.001). The Aβ42 level was significantly lower in the hemodialysis patients. The highest Aβ40 level was observed in the hemodialysis patients, and the Aβ40 level was significantly higher in the advanced CKD group as compared to the early CKD patients and controls (p < 0.001). The Aβ42/40 ratio was low in the hemodialysis patients (p = 0.001). There was a significant negative correlation between the MMSE and Aβ40 (Spearman's rho = 0.18, p = .018), and a positive correlation between the MMSE and the Aβ42/40 ratio (Spearman's rho = −0.360, p < .001). MoCA was negatively correlated with the Aβ40 levels (Spearman's rho = −0.185, p = .019). In the multiple analysis with the MMSE, it was determined high Aβ40 level was correlated with the low MMSE score.
Conclusion
It was found that there was a significant relationship between CI and the Aβ40 level in the CKD patients, that CI increased as the CKD stages progressed, that there was a significant negative correlation between the MMSE and MoCA tests and Aβ40, and there was a significant positive correlation between the MMSE and the Aβ42/Aβ40 ratio.
目的探讨慢性肾病（CKD）患者认知功能障碍（CI）与Aβ40、42、Aβ42/40比值及p-tau181的关系。患者将患者分为四组；对照组、早期CKD（1-3期）、晚期CKD（4-5期）和血液透析组。所有患者均完成了CI的MMSE和MoCA测试。测量所有参与者的a - β40、a - β42、p-tau181水平。结果CKD组MMSE评分明显低于CKD组（p = 0.005）。MMSE与CKD分期之间存在显著负相关（Spearman’s rho = - 0.29, p = 0.001）。血液透析患者Aβ42水平明显降低。Aβ40水平在血液透析患者中最高，且晚期CKD组Aβ40水平明显高于早期CKD患者和对照组（p < 0.001）。血液透析患者Aβ42/40比值较低（p = 0.001）。MMSE与a - β40呈显著负相关（Spearman’s rho = 0.18, p = 0.018）， MMSE与a - β42/40呈显著正相关（Spearman’s rho = - 0.360, p < 0.001）。MoCA与Aβ40水平呈负相关（Spearman’s rho = - 0.185, p = 0.019）。在与MMSE的多重分析中，确定了高Aβ40水平与低MMSE评分相关。结论CKD患者CI与a β40水平存在显著相关，CI随CKD分期的进展而升高，MMSE和MoCA与a β40呈显著负相关，MMSE与a β42/ a β40呈显著正相关。
{"title":"From stage 1 to end-stage renal failure: Amyloid β42, amyloid β40, amyloid β42/40 ratio, p-tau181 and cognitive function relationship","authors":"Yasemin Coşkun Yavuz , Zeynep Biyik , Firdevs Sak , Muslu Kazım Korez , Sedat Abusoglu , Lutfullah Altintepe","doi":"10.1016/j.nefro.2025.501357","DOIUrl":"10.1016/j.nefro.2025.501357","url":null,"abstract":"<div><h3>Introduction and objective</h3><div>It was aimed to examine the relationship between cognitive impairment (CI) and Aβ40, 42, Aβ42/40 ratio and p-tau181 in chronic kidney disease (CKD) patients at all stages.</div></div><div><h3>Patients</h3><div>The patients were divided into four groups; control, the early stage CKD (stage 1–3), the advanced stage CKD (stage 4–5) and the hemodialysis group. All patients completed the MMSE and MoCA tests for CI. The Aβ40, Aβ42, p-tau181 levels of all participants were measured.</div></div><div><h3>Result</h3><div>The result of the MMSE was significantly lower in CKD group (<em>p</em> <!-->=<!--> <!-->0.005). There was a significant negative correlation between the MMSE and CKD stages (Spearman's <em>rho</em> <!-->=<!--> <!-->−0.29, <em>p</em> <!-->=<!--> <!-->0.001). The Aβ42 level was significantly lower in the hemodialysis patients. The highest Aβ40 level was observed in the hemodialysis patients, and the Aβ40 level was significantly higher in the advanced CKD group as compared to the early CKD patients and controls (<em>p</em> <!--><<!--> <!-->0.001). The Aβ42/40 ratio was low in the hemodialysis patients (<em>p</em> <!-->=<!--> <!-->0.001). There was a significant negative correlation between the MMSE and Aβ40 (Spearman's <em>rho</em> <!-->=<!--> <!-->0.18, <em>p</em> <!-->=<!--> <!-->.018), and a positive correlation between the MMSE and the Aβ42/40 ratio (Spearman's <em>rho</em> <!-->=<!--> <!-->−0.360, <em>p</em> <!--><<!--> <!-->.001). MoCA was negatively correlated with the Aβ40 levels (Spearman's <em>rho</em> <!-->=<!--> <!-->−0.185, <em>p</em> <!-->=<!--> <!-->.019). In the multiple analysis with the MMSE, it was determined high Aβ40 level was correlated with the low MMSE score.</div></div><div><h3>Conclusion</h3><div>It was found that there was a significant relationship between CI and the Aβ40 level in the CKD patients, that CI increased as the CKD stages progressed, that there was a significant negative correlation between the MMSE and MoCA tests and Aβ40, and there was a significant positive correlation between the MMSE and the Aβ42/Aβ40 ratio.</div></div>","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 9","pages":"Article 501357"},"PeriodicalIF":2.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145384315","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 : 2025-11-01Epub Date: 2025-08-30DOI: 10.1016/j.nefro.2025.501410
María Isabel Troya , Jordi Bover , Anna Cia Hidalgo , Susana Malumbres , Maya Sánchez-Bayá , Elisabet Massó , Verónica Coll-Brito , Paula Anton-Pampols , Iara da Silva , Jordi Soler-Majoral , Elisabeth Marcos , Beatriz Moreiras Abril , Noemí Pérez-León , Marta Morera García , Joan Pau Golf Zaragoza , Xavier Jusmet Miguel , Yolanda Lejardi Estevez , Rosa López-Alarcón , Ignacio Blanco , Cristian Morales Indiano , Jordi Ara
{"title":"Importancia de la codificación tras el diagnóstico de enfermedad renal crónica: del código N18.9 (CIE/ICD-10) al papel de los laboratorios clínicos","authors":"María Isabel Troya , Jordi Bover , Anna Cia Hidalgo , Susana Malumbres , Maya Sánchez-Bayá , Elisabet Massó , Verónica Coll-Brito , Paula Anton-Pampols , Iara da Silva , Jordi Soler-Majoral , Elisabeth Marcos , Beatriz Moreiras Abril , Noemí Pérez-León , Marta Morera García , Joan Pau Golf Zaragoza , Xavier Jusmet Miguel , Yolanda Lejardi Estevez , Rosa López-Alarcón , Ignacio Blanco , Cristian Morales Indiano , Jordi Ara","doi":"10.1016/j.nefro.2025.501410","DOIUrl":"10.1016/j.nefro.2025.501410","url":null,"abstract":"","PeriodicalId":18997,"journal":{"name":"Nefrologia","volume":"45 9","pages":"Article 501410"},"PeriodicalIF":2.6,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145384317","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}
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