Renal Failure最新文献

Background and objective: The occurrence of urinary stone disease (USD) is associated with several factors. However, no conclusive results have been reached regarding the treatment of USD risk factors. This study conducted a detailed bibliometric analysis of USD risk factors to determine research hotspots and provide future development directions.

Methods: Articles and reviews on the USD risk factors published between 2010 and 2023 were retrieved from the Web of Science Core Collection. Co-occurrence and collaboration analyses of countries, institutions, authors, journals, references, and keywords were conducted using CiteSpace, VOSviewer, and R-Bibliometrix.

Results: A total of 436 articles on USD risk factors were included in the study. China and the United States have emerged as the leading countries in this field, with the Mayo Clinic having the highest amount of publication output. Among all the authors, Ferraro PM had the highest number of publications, while Taylor EN was the highly cited author. The journal with the highest number of publications was UROLITHIASIS. Scales reported the reference with the highest burst strength. The current citation themes in research on USD risk factors were 'multifaceted relationship' and 'kidney stone disease recurrence'. 'Medical-management' was identified as a major keyword, indicating future research hotspots.

Conclusion: This study employed bibliometric methods to conduct a comprehensive visual analysis of USD risk factors to show publication trends and popular topics in this area over the past decade. The results provide a valuable reference for future research on the risk factors of USD.

Background: The risk of cardiovascular events (CVEs) in peritoneal dialysis (PD) patients is high, but varies widely among individuals. Metabolic acidosis is prevalent in PD patients and may be involved in the development of CVEs. The aim of the study was to evaluate serum bicarbonate as a risk factor and derive a model of new CVE.

Methods: A predictive model was established by performing an observational study in 187 PD patients obtained from the First Affiliated Hospital of Anhui Medical University. The variables were extracted using least absolute shrinkage and selection operator (LASSO) regression, and the modeling was developed using multivariable Cox regression.

Results: Left ventricular hypertrophy (HR = 1.965, 95%CI 1.086-3.557) and history of CVEs (HR = 2.435, 95%CI 1.342-4.49) were risk parameters for a new CVE. Serum albumin (HR = 0.924, 95%CI 0.864-0.989) and bicarbonate levels (HR = 0.817, 95%CI 0.689-0.969) were protective parameters, in which the risk of CVEs was reduced by 7.6% and 18.3% for each 1-unit increase in serum albumin (g/L) and bicarbonate (mmol/L) levels, respectively. A nomogram based on the above predictive indicators was proposed with a C-statistic of 0.806, indicating good discrimination. Moreover, it successfully stratified patients into low-, intermediate-, and high-risk groups.

Conclusions: We performed a risk prediction model for the development of CVEs in patients with PD, which may help physicians to evaluate the risk of new CVEs and provide a scientific basis for further interventions. Further studies are needed to externally validate current risk models before clinical application.

Introduction: The prevalence of chronic kidney disease (CKD) is gradually increasing in the elderly population. At the same time, frailty has become one of the research hotspots in the field of geriatrics. Bibliometric analyses help to understand the direction of a field. Therefore, this study aimed to analyze the status and emerging trends of frailty in CKD patients.

Data and methods: The Web of Science Core Collection (WoSCC) database was screened for relevant literature published between 1 January 2000 and 31 December 2021. Next, publications were analyzed for information including authors, journals, cited references, citing journals, institutions, countries and regions, high-frequency keywords and co-citations using VOSviewer, Microsoft Excel, and R software.

Results: A total of 2223 articles were obtained, from which 613 relevant articles were selected based on title and abstract screening. There was an upward trend in the number of annual publications and Johansen KL was considered the most contributing author in the field. The Clinical Journal of the American Society of Nephrology was the most productive research journal. Johns Hopkins University is the most published organization. The United States is the global leader in the field and contributes the most to research. Research hotspots focus on epidemiological studies of frailty and frailty intervention.

Conclusions: This study presents a comprehensive bibliometric analysis of CKD and frailty research. Key findings highlight the current focus on early screening and assessment of frailty in CKD patients, as well as physical function interventions in frail patients.

Background: Inflammation plays a crucial role in occurrence of kidney injury, and specific dietary patterns can influence systemic inflammation levels. However, the relationship between dietary inflammatory potential and early-stage kidney damage remains unclear.

Method: 2,108 participants was recruited from 2001-2002 National Health and Nutrition Examination Survey (NHANES). Dietary Inflammatory Index (DII) is utilized to assess dietary inflammatory potential, calculated through a 24-h dietary recall questionnaire. Early renal injury was evaluated using urinary albumin to creatinine (UACR), cystatin C (CysC), β-2 microglobulin (β2M), and estimated glomerular filtration rate (eGFR) based on serum creatinine (eGFRs), cystatin C (eGFRc), and both Scr and CysC (eGFRs&c). Participant characteristics were analyzed, and association between DII, hypertension, and early renal injury markers was explored using multiple linear and logistic regression models.

Results: The average age of participants was 53.9 years. DII exhibited a positive correlation with UACR (β = -0.048[0.017,0.078]), β2M (β = 0.019[0.010,0.027]), CysC (β = 0.012 [0.004,0.021]). Conversely, a negative correlation was observed between DII and eGFRc (β = -1.126[-1.554, -0.699]), eGFRs&c (β=-1.101[-1.653, -0.549]). A significant association was observed between hypertension and abnormality of early kidney damage markers. Subgroup analysis reveals that the positive correlation between DII and the occurrence of abnormal markers of early kidney damage is only observed in individuals with hypertension. Furthermore, an interaction between DII and hypertension was detected in eGFRs&c (OR:1.250[1.042, 1.499], p for interaction = 0.03).

Conclusion: Higher levels of DII may be associated with occurrence of early kidney damage. For individuals with hypertension, avoiding excessive consumption of pro-inflammatory foods may reduce the risk of renal injury.

Background: Renal hypoxia and ischemia significantly contribute to chronic kidney disease (CKD) progression, underscoring the need for noninvasive quantitative assessments. This study employs blood oxygenation level-dependent magnetic resonance imaging (BOLD-MRI) and arterial spin labeling (ASL) MRI to comprehensively evaluate renal oxygenation and blood flow in CKD patients.

Methods: Forty-two CKD patients across stages 1-5 and ten healthy volunteers underwent simultaneous BOLD-MRI and ASL-MRI. We measured oxygenation (T2* values) and renal blood flow (RBF) in both the renal cortex and medulla, assessing their correlations with estimated glomerular filtration rate (eGFR) and other renal function indicators.

Results: BOLD and ASL revealed higher oxygenation and RBF in the renal cortex than in the medulla. Across CKD stages 2-5, both cortical and medullary oxygenation levels, as well as RBF, were lower than those in the control group and progressively decreased with CKD advancement. Additionally, renal oxygenation and blood flow levels positively correlated with serum creatinine (SCr), cystatin C (Cys C), and blood urea nitrogen (BUN), and negatively correlated with estimated glomerular filtration rate (eGFR) (p < 0.001). However, no significant correlation was observed with uric acid (UA) (p > 0.05). Notably, patients with CKD stages 1-3 exhibited strong correlations between renal oxygenation levels, RBF, and eGFR, while those with CKD stages 4-5 displayed weak correlations.

Conclusion: BOLD-MRI and ASL-MRI effectively measure renal oxygenation and perfusion noninvasively, confirming their utility in tracking CKD progression. These modalities provide accurate assessments of renal function and hypoxic-ischemic injuries across CKD stages, particularly in the early stages.

5-Fluorouracil (5-FU) is one of the most used anticancer drugs. However, its nephrotoxicity-associated drawback is of clinical concern. Lycopene (LYC) is a red carotenoid with remarkable anti-inflammatory and anti-oxidative properties. In this study, rats were divided randomly into five groups: control, lycopene (10 mg) (10 mg/kg/day; P.O), 5-FU (30 mg/kg/day; i.p.), Lycopene (5 mg) + 5-FU (5 mg/kg + 30 mg/kg/day), and lycopene (10 mg) + 5-FU (10 mg/kg + 30 mg/kg/day). LYC attenuated the loss of renal function induced by 5-FU in a dose-dependent manner. Rats co-treated with LYC had lower serum urea, creatinine, uric acid and KIM-1 levels, and a higher serum albumin level than those receiving 5-FU alone. Furthermore, co-treatment with the high dose of LYC maintained renal oxidant-antioxidant balance by ameliorating/preventing the loss of antioxidants and the elevation of malondialdehyde. Rats treated with 5-FU had markedly lower renal levels of PPAR-gamma, HO-1, Nfr2, and Il-10 and higher levels of NF-kB, TNF-alpha, and IL6 compared to the control rats. Co-treatment with LYC attenuated the reduction in PPAR-gamma, HO-1, Nfr2, and IL-10 levels and moderated the elevated levels of NF-kB, TNF-alpha, and IL-6. The kidneys from rats co-treated with lycopene (10 mg) + 5-FU did not show the degenerative changes in the glomerular tufts and tubules observed for the rats treated with 5-FU alone. In conclusion, LYC is a promising therapeutic strategy for attenuating 5-FU-induced nephrotoxicity through the restoration of antioxidant activities and inhibition of inflammatory responses by modulating PPAR-γ, Nrf2/HO-1, and NF-κB/TNF-α/IL-6, signals.

Background: Adequate delivery of hemodialysis (HD), measured by the spKt/V derived from urea reduction, is an important determinant of clinical outcomes in chronic hemodialysis patients. However, the need for pre- and postdialysis blood samples prevented the assessment of spKt/V in every session.

Methods: This retrospective single-center study was performed on end-stage renal disease (ESKD) patients aged ≥ 18 years who received standard thrice-weekly chronic HD therapy. Eighty-seven variables, including general, intradialytic, and laboratory variables, were collected from the medical records for analysis. Five steps of preprocessing procedure were deployed to select only the most relevant variables. Six binary classification models were developed to predict whether spKt/V was higher than 1.4.

Results: A total of 1869 HD sessions from 373 ESKD patients were included in this study. The Random Forest model showed the best prediction for dialysis adequacy, with AUROC scores of 0.860 in the validation dataset and 0.873 in the testing dataset. Notably, an accessible model that solely relied on noninvasively collected general and dialysis-related variables maintained high prediction accuracy, with AUROC scores of 0.854 and 0.868 in the validation and testing datasets, respectively. The five most significant predictive variables were vascular access, gender, body mass index, ultrafiltration volume, and dialysis duration.

Conclusion: The study results suggest that the development of ML models for accurately predicting dialysis adequacy based on general and intradialytic variables is feasible. These models have the potential to be utilized for noninvasive clinical assessments of dialysis adequacy.

Background: The assessment of left ventricular (LV) remodeling and its association with mineral and bone disorder (MBD) in kidney transplant recipients (KTRs) have not been systematically studied. We aimed to evaluate LV remodeling changes one year after kidney transplantation (KT) and identify their influencing factors.

Methods: Ninety-five KTRs (68 males; ages 40.2 ± 10.8 years) were followed before and one year after KT. Traditional risk factors and bone metabolism indicators were assessed. Left ventricular mass index (LVMI), left ventricular ejection fraction (LVEF) and left ventricular diastolic dysfunction (LVDD) were measured using two-dimensional transthoracic echocardiography. The relationship between MBD and LV remodeling and the factors influencing LV remodeling were analyzed.

Results: One year after KT, MBD was partially improved, mainly characterized by hypercalcemia, hypophosphatemia, hyperparathyroidism, 25-(OH) vitamin D deficiency, elevated bone turnover markers, and bone loss. LVMI, the prevalence of left ventricular hypertrophy (LVH), and the prevalence of LVDD decreased, while LVEF increased. LVH was positively associated with postoperative intact parathyroid hormone (iPTH) and iPTH nonnormalization. △LVMI was positively associated with preoperative type-I collagen N-terminal peptide and postoperative iPTH. LVEF was negatively associated with postoperative phosphorous. △LVEF was negatively associated with postoperative iPTH. LVDD was positively associated with postoperative lumbar spine osteoporosis. Preoperative LVMI was negatively associated with △LVMI and positively associated with △LVEF. Advanced age, increased BMI, diabetes, longer dialysis time, lower albumin level, and higher total cholesterol and low-density lipoprotein levels were associated with LV remodeling.

Conclusions: LV remodeling partially improved after KT, showing a close relationship with MBD.