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Celebrating the life and scientific contributions of Barry Brenner in nephrology. 纪念巴里-布伦纳(Barry Brenner)在肾脏病学方面的生平和科学贡献。
IF 4.8 2区 医学 Q1 TRANSPLANTATION Pub Date : 2025-02-28 DOI: 10.1093/ndt/gfae206
Giuseppe Remuzzi
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引用次数: 0
Biomarker-guided infliximab therapy for immune checkpoint inhibitor-induced acute interstitial nephritis. 生物标记物引导的英夫利西单抗疗法治疗免疫检查点抑制剂诱发的急性间质性肾炎
IF 4.8 2区 医学 Q1 TRANSPLANTATION Pub Date : 2025-02-28 DOI: 10.1093/ndt/gfae257
Elena-Bianca Barbir, Arjunmohan Mohan, Priscilla Koirala, Luis E Gutierrez, Callen D Giesen, John C Lieske, Sandra M Herrmann
{"title":"Biomarker-guided infliximab therapy for immune checkpoint inhibitor-induced acute interstitial nephritis.","authors":"Elena-Bianca Barbir, Arjunmohan Mohan, Priscilla Koirala, Luis E Gutierrez, Callen D Giesen, John C Lieske, Sandra M Herrmann","doi":"10.1093/ndt/gfae257","DOIUrl":"10.1093/ndt/gfae257","url":null,"abstract":"","PeriodicalId":19078,"journal":{"name":"Nephrology Dialysis Transplantation","volume":" ","pages":"602-604"},"PeriodicalIF":4.8,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142624548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Remote monitoring of automated peritoneal dialysis reduces mortality, adverse events and hospitalizations: a cluster-randomized controlled trial. 远程监控自动腹膜透析可降低死亡率、不良事件和住院率:分组随机对照试验。
IF 4.8 2区 医学 Q1 TRANSPLANTATION Pub Date : 2025-02-28 DOI: 10.1093/ndt/gfae188
Ramón Paniagua, Alfonso Ramos, Marcela Ávila, María-de-Jesús Ventura, Armando Nevarez-Sida, Abdul Rashid Qureshi, Bengt Lindholm

Background: Remote monitoring (RM) of patients on automated peritoneal dialysis (APD) prevents complications and improves treatment quality. We analyzed the effect of RM-APD on mortality and complications related to cardiovascular disease, fluid overload and insufficient dialysis efficiency.

Methods: In a cluster-randomized, open-label, controlled trial, 21 hospitals with APD programs were assigned to use either RM-APD (10 hospitals; 403 patients) or conventional APD (11 hospitals; 398 patients) for the treatment of adult patients starting PD. Primary outcomes were time to first event of: (i) Composite Index 1 comprising all-cause mortality, first adverse events and hospitalizations of any cause, and (ii) Composite Index 2 comprising cardiovascular mortality, first adverse event and hospitalizations related to cardiovascular disease, fluid overload and insufficient dialysis efficiency. Secondary outcomes were time to first event of individual components of the two composite indices, and rates of adverse events, hospitalizations, unplanned visits and transfer to hemodialysis. Patients were followed for a median of 9.5 months. Primary outcomes were evaluated by competing risk analysis and restricted mean survival time (RMST) analysis.

Results: While time to reach Composite Index 1 did not differ between the groups, Composite Index 2 was reached earlier (ΔRMST: -0.86 months; P = .02), and all-cause mortality [55 vs 33 deaths, P = .01; sub-hazard ratio (sHR) 1.69 (95% confidence interval 1.39-2.05), P < .001] and hospitalizations of any cause were higher in APD group than in RM-APD as were cardiovascular deaths [24 vs 13 deaths, P = .05; sHR 2.44 (95% confidence interval 1.72-3.45), P < .001] and rates of adverse events and hospitalizations related to cardiovascular disease, fluid overload or insufficient dialysis efficiency. Dropouts were more common in the APD group (131 vs 110, P = .048).

Conclusions: This randomized controlled trial shows that RM may add significant advantages to APD, including improved survival and reduced rate of adverse events and hospitalizations, which can favorably impact the acceptance and adoption of the therapy.

背景和假设:对自动腹膜透析(APD)患者进行远程监测(RM)可预防并发症并提高治疗质量。我们分析了RM-APD对死亡率以及与心血管疾病(VD)、液体超负荷和透析效率不足有关的并发症的影响:在一项分组随机、开放标签、对照试验中,21 家拥有 APD 项目的医院被分配使用 RM-APD(10 家医院;403 名患者)或传统 APD(11 家医院;398 名患者)治疗开始透析的成年患者。主要研究结果是下列指标首次出现的时间1)综合指数-1,包括全因死亡率、首次不良事件和任何原因的住院治疗;2)综合指数-2,包括心血管死亡率、首次不良事件以及与心血管疾病、体液超负荷和透析效率不足有关的住院治疗。次要结果包括:两个综合指数的各个组成部分发生首次事件的时间、不良事件发生率、住院率、计划外就诊率和转入血液透析率。对患者的随访时间中位数为 9.5 个月。主要结果通过竞争风险分析和限制性平均生存时间(RMST)分析进行评估:结果:虽然两组患者达到综合指数-1的时间没有差异,但达到综合指数-2的时间更早(ΔRMST:-0.85个月;p=0.02),全因死亡率(55例死亡 vs. 33例死亡,p=0.01;sHR 1.69(95%CI 1.39-2.05),p结论:这项随机对照试验表明,远程监测可为 APD 带来显著优势,包括提高存活率、降低不良事件和住院率,这将对该疗法的接受和采用产生有利影响。
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引用次数: 0
IgA class-switched CD27-CD21+ B cells in IgA nephropathy. IgA 肾病中的 IgA 类切换 CD27-CD21+ B 细胞。
IF 4.8 2区 医学 Q1 TRANSPLANTATION Pub Date : 2025-02-28 DOI: 10.1093/ndt/gfae173
Anna Popova, Baiba Slisere, Karlis Racenis, Viktorija Kuzema, Roberts Karklins, Mikus Saulite, Janis Seilis, Anna Jana Saulite, Aiga Vasilvolfa, Kristine Vaivode, Dace Pjanova, Juta Kroica, Harijs Cernevskis, Aivars Lejnieks, Aivars Petersons, Kristine Oleinika

Background: Immunoglobulin A nephropathy (IgAN) is characterized by the production of galactose-deficient IgA1 (GdIgA1) antibodies. As the source of pathogenic antibodies, B cells are central to IgAN pathogenesis, but the B cell activation pathways as well as the potential B cell source of dysregulated IgA secretion remain unknown.

Methods: We carried out flow cytometry analysis of peripheral blood B cells in patients with IgAN and control subjects with a focus on IgA-expressing B cells to uncover the pathways of B cell activation in IgAN and how these could give rise to pathogenic GdIgA1 antibodies.

Results: In addition to global changes in the B cell landscape-expansion of naïve and reduction in memory B cells-IgAN patients present with an increased frequency of IgA-expressing B cells that lack the classical memory marker CD27, but are CD21+. IgAN patients furthermore have an expanded population of IgA+ antibody-secreting cells, which correlate with serum IgA levels. Both IgA+ plasmabalsts and CD27- B cells co-express GdIgA1. Implicating dysregulation at mucosal surfaces as the driver of such B cell differentiation, we found a correlation between lipopolysaccharide in the serum and IgA+CD27- B cell frequency.

Conclusion: We propose that dysregulated immunity in the mucosa may drive de novo B cell activation within germinal centres, giving rise to IgA+CD27- B cells and subsequently IgA-producing plasmablasts. These data integrate B cells into the paradigm of IgAN pathogenesis and allow further investigation of this pathway to uncover biomarkers and develop therapeutic interventions.

背景:IgA肾病(IgAN)的特征是产生半乳糖缺乏性IgA1(GdIgA1)抗体。作为致病抗体的来源,B 细胞是 IgAN 发病机制的核心,但 B 细胞活化途径以及 IgA 分泌失调的潜在 B 细胞来源仍不清楚:我们对 IgA 肾病患者和对照组的外周血 B 细胞进行了流式细胞术分析,重点研究表达 IgA 的 B 细胞,以揭示 IgAN 中 B 细胞活化的途径以及这些途径如何导致致病性 GdIgA1 抗体的产生:IgAN患者的B细胞结构发生了全面变化--幼稚B细胞增多,记忆B细胞减少--此外,IgA表达的B细胞频率增加,这些B细胞缺乏经典的记忆标记CD27,但具有CD21pos。IgAN 患者的 IgApos 抗体分泌细胞群进一步扩大,这与血清 IgA 水平相关。IgApos 浆细胞和 CD27neg B 细胞共同表达 GdIgA1。我们发现血清中的脂多糖(LPS)与 IgAposCD27neg B 细胞频率之间存在相关性,这意味着粘膜表面的失调是这种 B 细胞分化的驱动因素:我们认为,粘膜免疫功能失调可能会驱动生殖中心内的 B 细胞从头活化,产生 IgAposCD27neg B 细胞,进而产生产生 IgA 的浆细胞。这些数据将 B 细胞纳入了 IgAN 发病机制的范式,有助于进一步研究这一途径,以发现生物标志物并开发治疗干预措施。
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引用次数: 0
Personalized disease recurrence modeling using iPSC-derived podocytes in patients with idiopathic nephrotic syndrome.
IF 4.8 2区 医学 Q1 TRANSPLANTATION Pub Date : 2025-02-28 DOI: 10.1093/ndt/gfaf045
Bartholomeus T van den Berge, Martijn van den Broek, Gianluca Di Giovanni, Hanna Debiec, Sharon Gloudemans, Quinty Leusink, Dirk den Braanker, Jack F M Wetzels, Pierre Ronco, Bart Smeets, Jitske Jansen, Rutger J Maas

Background and hypothesis: Primary focal segmental glomerulosclerosis (FSGS) is characterized by podocyte injury and treatment-resistant nephrotic syndrome. Recurrence of the original disease after kidney transplantation (rFSGS) occurs in 10-50% of patients. Unidentified circulating permeability factors (CPF) are likely involved in FSGS pathogenesis. We hypothesized that donor podocyte susceptibility to CPF is also relevant. We developed a personalized model for (r)FSGS using induced pluripotent stem cell (iPSC)-derived podocytes from patients and kidney donors.

Methods: Five patients and their respective living kidney donors were included. Three patients had developed rFSGS, and two patients manifested no symptoms of rFSGS. One patient (P5) had heterozygous mutations in NPHS2. Peripheral blood mononuclear cells were reprogrammed to iPSC, and differentiated to podocytes. iPSC-derived podocytes from either patients or donors were exposed to presumed CPF-containing plasma/serum of corresponding patients. Three assays to detect podocyte injury were performed: (1) reactive oxygen species (ROS) formation, (2) cellular granularity induction, and (3) quantitative assessment of F-actin redistribution (FAR), a new quantitative method. Crossmatch experiments with donor iPSC-derived podocytes and patients samples assessed individual susceptibility to CPF-induced injury.

Results: Successful podocyte differentiation was confirmed by morphology and protein expression. Only FAR differentiated consistently between patient and healthy donor samples. All pre-transplant patient samples except P5 caused significant FAR in corresponding patient podocytes. Significant FAR was observed in donor podocytes exposed to corresponding patient samples in the setting of rFSGS, and not in donor podocytes exposed to samples of patients who did not develop rFSGS. Effects of FSGS patient samples on non-corresponding donor podocytes were variable.

Conclusions: In vitro assays using iPSC-derived donor podocytes may allow individualized assessment of rFSGS. Prospective studies in a larger cohort are required to validate our findings.

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引用次数: 0
Correction to: Associations of neutral pH, low-GDP peritoneal dialysis solutions with patient survival, transfer to haemodialysis and peritonitis. 更正:中性 pH 值、低 GDP 腹膜透析液与患者存活率、转入血液透析和腹膜炎的关系。
IF 4.8 2区 医学 Q1 TRANSPLANTATION Pub Date : 2025-02-28 DOI: 10.1093/ndt/gfae073
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引用次数: 0
Kidney outcomes with SGLT2 inhibitor versus DPP4 inhibitor use in older adults with diabetes. 老年糖尿病患者使用 SGLT2 抑制剂与 DPP4 抑制剂对肾脏的影响。
IF 4.8 2区 医学 Q1 TRANSPLANTATION Pub Date : 2025-02-28 DOI: 10.1093/ndt/gfae158
Yuta Suzuki, Hidehiro Kaneko, Akira Okada, Jin Komuro, Toshiyuki Ko, Katsuhito Fujiu, Norifumi Takeda, Hiroyuki Morita, Akira Nishiyama, Masaki Ieda, Koichi Node, Hideo Yasunaga, Masaomi Nangaku, Issei Komuro

Background: While the kidney-protective effects of sodium-glucose co-transporter 2 (SGLT2) inhibitors have attracted much attention, there are limited real-world clinical data examining the effects of SGLT2 inhibitors on kidney function in older individuals. We aimed to compare the kidney outcomes between SGLT2 inhibitor and dipeptidyl peptidase 4 (DPP4) inhibitor use in older adults with diabetes.

Methods: Using a nationwide claims database, we studied 6354 older adults (≥60 years of age) who had diabetes and were newly initiated on SGLT2 inhibitors or DPP4 inhibitors. A 1:4 propensity score matching algorithm was used to compare changes in estimated glomerular filtration rate (eGFR) between SGLT2 inhibitor and DPP4 inhibitor users. The primary outcome was a decrease in the rate of eGFR, which was obtained using a linear mixed-effects model with an unstructured covariance.

Results: Following propensity score matching, 6354 individuals including 1271 SGLT2 inhibitor users and 5083 DPP4 inhibitor users {median age 68 years [interquartile range (IQR) 65-70], male 60.4%, median eGFR 69.0 ml/min/1.73 m2 [IQR 59.1-79.0], median haemoglobin A1c [HbA1c] 6.9% [IQR 6.5-7.4]} were analysed. SGLT2 inhibitor users had a slower eGFR decline than did DPP4 inhibitor users [-0.97 ml/min/1.73 m2/year (95% CI -1.24 to -0.70) versus -1.83 ml/min/1.73 m2/year (95% CI -1.97 to -1.69); P for interaction <.001]. This finding remained consistent across subgroups based on age, sex, body mass index, HbA1c level, renin-angiotensin system inhibitor use and baseline eGFR. Additionally, the risk of a ≥20%, ≥30% and ≥40% decrease in eGFR from baseline was significantly lower in SGLT2 inhibitor users than in DPP4 inhibitor users.

Conclusions: Our analysis, utilizing a nationwide epidemiological dataset, demonstrated that the decrease in eGFR was slower in individuals ≥60 years of age with diabetes who were prescribed SGLT2 inhibitors compared with those prescribed DPP4 inhibitors, suggesting a potential advantage of SGLT2 inhibitors for kidney outcomes even in older individuals with diabetes.

背景与假设:尽管钠葡萄糖共转运体-2(SGLT2)抑制剂对肾脏的保护作用备受关注,但研究 SGLT2 抑制剂对老年人肾功能影响的实际临床数据却很有限。我们旨在比较老年糖尿病患者使用 SGLT2 抑制剂和二肽基肽酶 4 (DPP4) 抑制剂对肾脏的影响:我们利用一个全国性的索赔数据库,对 6 354 名患有糖尿病且新近开始服用 SGLT2 抑制剂或 DPP4 抑制剂的老年人(≥ 60 岁)进行了研究。采用 1:4 倾向得分匹配算法比较了 SGLT2 抑制剂和 DPP4 抑制剂使用者的 eGFR 变化。主要结果是估计肾小球滤过率(eGFR)的下降率,该结果是使用非结构化协方差线性混合效应模型得出的:经过倾向得分匹配,对 6 354 人进行了分析,其中包括 1 271 名 SGLT2 抑制剂使用者和 5 083 名 DPP4 抑制剂使用者(中位年龄:68 [65-70] 岁;男性,60.4%;中位 eGFR:69.0 [59.1-79.0] ml/min/1.73m2,中位血红蛋白 A1c [HbA1c]:6.9 [6.5-7.4] %)。与 DPP4 抑制剂使用者相比,SGLT2 抑制剂使用者的 eGFR 下降较慢(-0.97 [95% CI, -1.24 to -0.70] ml/min/1.73m2 vs. -1.83 [95% CI, -1.97 to -1.69] ml/min/1.73m2 per year; p for interaction 结论:我们利用全国范围的流行病学数据集进行的分析表明,与服用 DPP4 抑制剂的糖尿病患者相比,服用 SGLT2 抑制剂的 60 岁以上糖尿病患者的 eGFR 下降速度较慢,这表明 SGLT2 抑制剂对老年糖尿病患者的肾脏预后具有潜在优势。
{"title":"Kidney outcomes with SGLT2 inhibitor versus DPP4 inhibitor use in older adults with diabetes.","authors":"Yuta Suzuki, Hidehiro Kaneko, Akira Okada, Jin Komuro, Toshiyuki Ko, Katsuhito Fujiu, Norifumi Takeda, Hiroyuki Morita, Akira Nishiyama, Masaki Ieda, Koichi Node, Hideo Yasunaga, Masaomi Nangaku, Issei Komuro","doi":"10.1093/ndt/gfae158","DOIUrl":"10.1093/ndt/gfae158","url":null,"abstract":"<p><strong>Background: </strong>While the kidney-protective effects of sodium-glucose co-transporter 2 (SGLT2) inhibitors have attracted much attention, there are limited real-world clinical data examining the effects of SGLT2 inhibitors on kidney function in older individuals. We aimed to compare the kidney outcomes between SGLT2 inhibitor and dipeptidyl peptidase 4 (DPP4) inhibitor use in older adults with diabetes.</p><p><strong>Methods: </strong>Using a nationwide claims database, we studied 6354 older adults (≥60 years of age) who had diabetes and were newly initiated on SGLT2 inhibitors or DPP4 inhibitors. A 1:4 propensity score matching algorithm was used to compare changes in estimated glomerular filtration rate (eGFR) between SGLT2 inhibitor and DPP4 inhibitor users. The primary outcome was a decrease in the rate of eGFR, which was obtained using a linear mixed-effects model with an unstructured covariance.</p><p><strong>Results: </strong>Following propensity score matching, 6354 individuals including 1271 SGLT2 inhibitor users and 5083 DPP4 inhibitor users {median age 68 years [interquartile range (IQR) 65-70], male 60.4%, median eGFR 69.0 ml/min/1.73 m2 [IQR 59.1-79.0], median haemoglobin A1c [HbA1c] 6.9% [IQR 6.5-7.4]} were analysed. SGLT2 inhibitor users had a slower eGFR decline than did DPP4 inhibitor users [-0.97 ml/min/1.73 m2/year (95% CI -1.24 to -0.70) versus -1.83 ml/min/1.73 m2/year (95% CI -1.97 to -1.69); P for interaction <.001]. This finding remained consistent across subgroups based on age, sex, body mass index, HbA1c level, renin-angiotensin system inhibitor use and baseline eGFR. Additionally, the risk of a ≥20%, ≥30% and ≥40% decrease in eGFR from baseline was significantly lower in SGLT2 inhibitor users than in DPP4 inhibitor users.</p><p><strong>Conclusions: </strong>Our analysis, utilizing a nationwide epidemiological dataset, demonstrated that the decrease in eGFR was slower in individuals ≥60 years of age with diabetes who were prescribed SGLT2 inhibitors compared with those prescribed DPP4 inhibitors, suggesting a potential advantage of SGLT2 inhibitors for kidney outcomes even in older individuals with diabetes.</p>","PeriodicalId":19078,"journal":{"name":"Nephrology Dialysis Transplantation","volume":" ","pages":"495-504"},"PeriodicalIF":4.8,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141590918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A novel real-time model for predicting acute kidney injury in critically ill patients within 12 hours. 预测重症患者 12 小时内急性肾损伤的新型实时模型。
IF 4.8 2区 医学 Q1 TRANSPLANTATION Pub Date : 2025-02-28 DOI: 10.1093/ndt/gfae168
Tao Sun, Xiaofang Yue, Xiao Chen, Tiancha Huang, Shaojun Gu, Yibing Chen, Yang Yu, Fang Qian, Chunmao Han, Xuanliang Pan, Xiao Lu, Libin Li, Yun Ji, Kangsong Wu, Hongfu Li, Gong Zhang, Xiang Li, Jia Luo, Man Huang, Wei Cui, Mao Zhang, Zhihua Tao

Background: A major challenge in the prevention and early treatment of acute kidney injury (AKI) is the lack of high-performance predictors in critically ill patients. Therefore, we innovatively constructed U-AKIpredTM for predicting AKI in critically ill patients within 12 h of panel measurement.

Methods: The prospective cohort study included 680 patients in the training set and 249 patients in the validation set. After performing inclusion and exclusion criteria, 417 patients were enrolled in the training set and 164 patients were enrolled in the validation set. AKI was diagnosed by Kidney Disease: Improving Global Outcomes (KDIGO) criteria.

Results: Twelve urinary kidney injury biomarkers (mALB, IgG, TRF, α1MG, NAG, NGAL, KIM-1, L-FABP, TIMP2, IGFBP7, CAF22, and IL-18) exhibited good predictive performance for AKI within 12 h in critically ill patients. U-AKIpredTM, combined with three crucial biomarkers (α1MG, L-FABP, and IGFBP7) by multivariate logistic regression analysis, exhibited better predictive performance for AKI in critically ill patients within 12 h than the other 12 kidney injury biomarkers. The area under the curve (AUC) of the U-AKIpredTM, as a predictor of AKI within 12 h, was 0.802 (95% CI: 0.771-0.833, P < .001) in the training set and 0.844 (95% CI: 0.792-0.896, P < .001) in the validation cohort. A nomogram based on the results of the training and validation sets of U-AKIpredTM was developed that showed optimal predictive performance for AKI. The fitting effect and prediction accuracy of U-AKIpredTM was evaluated by multiple statistical indicators. To provide a more flexible predictive tool, the dynamic nomogram (https://www.xsmartanalysis.com/model/U-AKIpredTM) was constructed using a web calculator. Decision curve analysis and a clinical impact curve were used to reveal that U-AKIpredTM with the three crucial biomarkers had a higher net benefit than these 12 kidney injury biomarkers, respectively. The net reclassification index and integrated discrimination index were used to improve the significant risk reclassification of AKI compared with the 12 kidney injury biomarkers. The predictive efficiency of U-AKIpredTM was better than the NephroCheck® when testing for AKI and severe AKI.

Conclusion: U-AKIpredTM is an excellent predictive model of AKI in critically ill patients within 12 h and would assist clinicians in identifying those at high risk of AKI.

背景:预防和早期治疗急性肾损伤(AKI)的一个主要挑战是缺乏重症患者的高效预测指标。因此,我们创新性地构建了 U-AKIpredTM,用于预测重症患者在面板测量后 12 小时内的 AKI:前瞻性队列研究将 680 名患者纳入训练集,249 名患者纳入验证集。在执行纳入和排除标准后,417 名患者被纳入训练集,164 名患者被纳入验证集。AKI根据肾病改善全球结局(KDIGO)标准进行诊断:结果:12 个尿液肾损伤生物标志物(mALB、IgG、TRF、α1MG、NAG、NGAL、KIM-1、L-FABP、TIMP2、IGFBP7、CAF22 和 IL-18)对重症患者 12 小时内的 AKI 具有良好的预测性能。通过多变量逻辑回归分析,U-AKIpredTM 与三个关键生物标记物(α1MG、L-FABP 和 IGFBP7)相结合,对危重病人 12 小时内 AKI 的预测效果优于其他 12 个肾损伤生物标记物。作为 12 小时内 AKI 的预测指标,U-AKIpredTM 的曲线下面积(AUC)为 0.802(95% CI:0.771-0.833,P):U-AKIpredTM 是重症患者 12 小时内 AKI 的绝佳预测模型,有助于临床医生识别 AKI 高危人群。
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引用次数: 0
Trends and socioeconomic inequality of the burden of congenital abnormalities of the kidney and urinary tract among children and adolescents. 儿童和青少年肾脏和泌尿道先天畸形负担的趋势和社会经济不平等。
IF 4.8 2区 医学 Q1 TRANSPLANTATION Pub Date : 2025-02-28 DOI: 10.1093/ndt/gfae115
Guohua He, Yunfei Liu, Arvind Bagga, Chinyere Ukamaka Onubogu, Franz Schaefer, Zhiyong Zou, William E Smoyer, Nianzhou Xiao, Tianxin Lin, Ali Asghar Lanewala, Hee Gyung Kang, Muhammad Zeeshan Waheed, Seungkyo Park, Xiaoyun Jiang, Yi Song, Jie Ding

Background: Although congenital abnormalities of the kidney and urinary tract (CAKUT) is the leading cause of childhood-onset chronic kidney disease and kidney failure, comprehensive information on the disease burden among children and adolescents globally is lacking. We aim to report the trends and socioeconomic inequality of CAKUT burden for people aged 0-24 years from 1990 to 2019.

Methods: We reported the prevalence, mortality and disability-adjusted life-years (DALYs) for CAKUT based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, quantified the association of disease burden and socio-demographic index (SDI), and calculated the slope index of inequality, the relative index of inequality and concentration index.

Results: In 2019, the global prevalence, mortality and DALYs of CAKUT among individuals aged 0-24 years were 167.11 (95% confidence interval 166.97, 167.25), 0.30 (0.29, 0.30) and 32.22 (32.16, 32.29), respectively, per 100 000 population. The greatest prevalence, mortality and DALYs were recorded in the 0-4 years age group. The greatest mortality and DALYs were recorded in low SDI countries and territories. During 1990 to 2019, the prevalence, mortality and DALYs decreased globally, while in low and low-middle countries and territories the reduction was much less slower. India, Nigeria and Pakistan had the highest DALYs. Saudi Arabia and China exhibited a markedly decrease of CAKUT burden. Globally for every 0.1 increase in SDI, there was a 20.53% reduction in mortality and a 16.31% decrease in DALYs, but a 0.38% rise in prevalence.

Conclusions: Inequality for disease burden of varying SDI was increasing globally. Thus, specific preventive and health service measures are needed to reduce the global burden from CAKUT.

背景:尽管先天性肾脏和泌尿道异常(CAKUT)是儿童期慢性肾脏病(CKD)和肾衰竭的主要病因,但全球范围内缺乏有关儿童和青少年疾病负担的全面信息。我们旨在报告 1990 年至 2019 年间 0-24 岁人群慢性肾脏病(CAKUT)负担的趋势和社会经济不平等情况:我们根据《2019年全球疾病、伤害和风险因素负担研究》(GBD)报告了CAKUT的患病率、死亡率和残疾调整生命年(DALYs),量化了疾病负担与社会人口指数(SDI)的关联,计算了不平等斜率指数(SII)、相对不平等指数(RII)和集中指数:2019年,全球0-24岁人口的CAKUT患病率、死亡率和残疾调整寿命年数分别为每10万人167.11(95%置信区间为166.97,167.25)、0.30(0.29,0.30)和32.22(32.16,32.29)。0-4 岁年龄组的发病率、死亡率和残疾调整寿命年数最高。低 SDI 国家和地区的死亡率和残疾调整寿命年数最高。1990 年至 2019 年期间,全球患病率、死亡率和残疾调整寿命年数均有所下降,而中低端国家和地区的下降速度要慢得多。印度、尼日利亚和巴基斯坦的残疾调整寿命年数最高。沙特阿拉伯和中国的 CAKUT 负担明显减轻。在全球范围内,SDI 每增加 0.1,死亡率就会降低 20.53%,残疾调整寿命年数就会减少 16.31%,但患病率却会上升 0.38%:结论:在全球范围内,不同 SDI 疾病负担的不平等正在加剧。因此,需要采取具体的预防和保健服务措施,以减轻 CAKUT 在全球造成的负担。
{"title":"Trends and socioeconomic inequality of the burden of congenital abnormalities of the kidney and urinary tract among children and adolescents.","authors":"Guohua He, Yunfei Liu, Arvind Bagga, Chinyere Ukamaka Onubogu, Franz Schaefer, Zhiyong Zou, William E Smoyer, Nianzhou Xiao, Tianxin Lin, Ali Asghar Lanewala, Hee Gyung Kang, Muhammad Zeeshan Waheed, Seungkyo Park, Xiaoyun Jiang, Yi Song, Jie Ding","doi":"10.1093/ndt/gfae115","DOIUrl":"10.1093/ndt/gfae115","url":null,"abstract":"<p><strong>Background: </strong>Although congenital abnormalities of the kidney and urinary tract (CAKUT) is the leading cause of childhood-onset chronic kidney disease and kidney failure, comprehensive information on the disease burden among children and adolescents globally is lacking. We aim to report the trends and socioeconomic inequality of CAKUT burden for people aged 0-24 years from 1990 to 2019.</p><p><strong>Methods: </strong>We reported the prevalence, mortality and disability-adjusted life-years (DALYs) for CAKUT based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, quantified the association of disease burden and socio-demographic index (SDI), and calculated the slope index of inequality, the relative index of inequality and concentration index.</p><p><strong>Results: </strong>In 2019, the global prevalence, mortality and DALYs of CAKUT among individuals aged 0-24 years were 167.11 (95% confidence interval 166.97, 167.25), 0.30 (0.29, 0.30) and 32.22 (32.16, 32.29), respectively, per 100 000 population. The greatest prevalence, mortality and DALYs were recorded in the 0-4 years age group. The greatest mortality and DALYs were recorded in low SDI countries and territories. During 1990 to 2019, the prevalence, mortality and DALYs decreased globally, while in low and low-middle countries and territories the reduction was much less slower. India, Nigeria and Pakistan had the highest DALYs. Saudi Arabia and China exhibited a markedly decrease of CAKUT burden. Globally for every 0.1 increase in SDI, there was a 20.53% reduction in mortality and a 16.31% decrease in DALYs, but a 0.38% rise in prevalence.</p><p><strong>Conclusions: </strong>Inequality for disease burden of varying SDI was increasing globally. Thus, specific preventive and health service measures are needed to reduce the global burden from CAKUT.</p>","PeriodicalId":19078,"journal":{"name":"Nephrology Dialysis Transplantation","volume":" ","pages":"484-494"},"PeriodicalIF":4.8,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141087689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Kidney expert consultation and the outcomes of in hospital acute kidney injury.
IF 4.8 2区 医学 Q1 TRANSPLANTATION Pub Date : 2025-02-28 DOI: 10.1093/ndt/gfaf043
Turgay Saritas, Vincenzo Cantaluppi, Ana Sanz Bartolome, Stanislas Faguer, Joana Gameiro, Jose Antonio Lopes, Jolanta Malyszko, Marlies Ostermann, Nicholas M Selby, Sophie De Seigneux
{"title":"Kidney expert consultation and the outcomes of in hospital acute kidney injury.","authors":"Turgay Saritas, Vincenzo Cantaluppi, Ana Sanz Bartolome, Stanislas Faguer, Joana Gameiro, Jose Antonio Lopes, Jolanta Malyszko, Marlies Ostermann, Nicholas M Selby, Sophie De Seigneux","doi":"10.1093/ndt/gfaf043","DOIUrl":"https://doi.org/10.1093/ndt/gfaf043","url":null,"abstract":"","PeriodicalId":19078,"journal":{"name":"Nephrology Dialysis Transplantation","volume":" ","pages":""},"PeriodicalIF":4.8,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Nephrology Dialysis Transplantation
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