KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease

Kidney International, Journal Year: 2024, Volume and Issue: 105(4), P. S117 - S314

Published: March 13, 2024

This article is published as part of a supplement sponsored by Kidney Disease: Improving Global Outcomes (KDIGO). The opinions or views expressed in this are those the authors and do not necessarily reflect recommendations International Society Nephrology Elsevier. Dosages, indications, methods use for products that referred to may their clinical experience be derived from professional literature other sources.

Language: Английский

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Advances in kidney disease: pathogenesis and therapeutic targets

Frontiers in Medicine, Journal Year: 2025, Volume and Issue: 12

Published: Feb. 14, 2025

Chronic kidney disease (CKD) is a global public health issue characterized by progressive loss of function, which end-stage (ESKD) the last stage. The increase in prevalence CKD linked to increasing traditional risk factors, including obesity, hypertension, and diabetes mellitus, as well metabolic particularly insulin resistance, dyslipidemia, hyperuricemia. Mortality comorbidities, such cardiovascular complications, rise steadily function deteriorates. Patients who progress ESKD require long-term replacement therapy, transplantation or hemodialysis/peritoneal dialysis. It currently understood that crucial aspect involves persistent, low-grade inflammation. In addition, increased oxidative stress, endothelial dysfunction, vascular calcification from poor calcium phosphate metabolism, difficulties with coagulation are some complex molecular pathways underlying CKD-related ESKD-related issues. Novel mechanisms, microbiome dysbiosis apolipoprotein L1 gene mutation, have improved our understanding mechanisms. High Africa has been APOL1 high-risk alleles. 3-fold African Americans compared European mainly attributed variants chromosome 22q12 locus. Additionally, role new therapies SGLT2 inhibitors, mineralocorticoid receptor antagonists, channel inhibitors offers therapeutic targets slowing down progression chronic disease. This review describes recent mechanisms emerging targets.

Language: Английский

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Causal effects of systemic inflammatory regulators on chronic kidney diseases and renal function: a bidirectional Mendelian randomization study

Frontiers in Immunology, Journal Year: 2023, Volume and Issue: 14

Published: Aug. 30, 2023

While targeted systemic inflammatory modulators show promise in preventing chronic kidney disease (CKD) progression, the causal link between specific factors and CKD remains uncertain.Using a genome-wide association study of 41 serum cytokines from 8,293 Finnish individuals, we conducted bidirectional two-sample Mendelian randomization (MR) analysis. In addition, genetically predicted associations 5 phenotypes, including CKD, estimated glomerular filtration rate (eGFR), dialysis, rapid progression decline eGFR. Inverse variance weighting (IVW) served as primary MR method, while MR-Egger, weighted median, MR-pleiotropy residual sum outlier (MR-PRESSO) were utilized for sensitivity Cochrane's Q test heterogeneity. Leave-one-out method ensured stability results, Bonferroni correction assessed relationship strength.Seventeen associated with diverse renal outcomes. Among them, after test, higher tumor necrosis factor alpha levels decrease eGFR (OR = 1.064, 95% CI 1.028 - 1.103, P 0.001), interleukin-4 an increase (β 0.003, 0.001 0.005, 0.002), growth regulated oncogene (GROα) increased risk (OR=1.035, 1.012 1.058, 0.003). contrast, genetic susceptibility to was GROa, may lead stem cell factor. We did not find presence horizontal pleiotropy during analysis.We discovered causally related that contribute initiation at prediction level.

Language: Английский

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A systematic review of epigenetic interplay in kidney diseases: Crosstalk between long noncoding RNAs and methylation, acetylation of chromatin and histone

Biomedicine & Pharmacotherapy, Journal Year: 2024, Volume and Issue: 176, P. 116922 - 116922

Published: June 13, 2024

The intricate crosstalk between long noncoding RNAs (lncRNAs) and epigenetic modifications such as chromatin/histone methylation acetylation offer new perspectives on the pathogenesis treatment of kidney diseases. lncRNAs, a class transcripts longer than 200 nucleotides with no protein-coding potential, are now recognized key regulatory molecules influencing gene expression through diverse mechanisms. They modulate by recruiting or blocking enzymes responsible for adding removing methyl acetyl groups, DNA, N6-methyladenosine (m6A) histone acetylation, subsequently altering chromatin structure accessibility. In diseases acute injury (AKI), chronic disease (CKD), diabetic nephropathy (DN), glomerulonephritis (GN), renal cell carcinoma (RCC), aberrant patterns DNA/RNA/histone have been associated onset progression, revealing complex interplay lncRNA dynamics. Recent studies highlighted how lncRNAs can impact pathology affecting function genes involved in cycle control, fibrosis, inflammatory responses. This review will separately address roles diseases, particular emphasis elucidating bidirectional effects underlying mechanisms conjunction addition to potential exacerbating renoprotective pathologies. Understanding reciprocal relationships not only shed light molecular underpinnings pathologies but also present avenues therapeutic interventions biomarker development, advancing precision medicine nephrology.

Language: Английский

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Association between frailty and bone health in early-stage chronic kidney disease: a study from the population-based CARTaGENE cohort

Clinical Kidney Journal, Journal Year: 2025, Volume and Issue: 18(2)

Published: Jan. 16, 2025

ABSTRACT Background Frailty is a clinical syndrome that particularly prevalent in patients with chronic kidney disease (CKD). We aimed to assess the associations between renal function and presence of frailty criteria association bone outcomes. Methods have conducted retrospective study from population-based cohort, which represents 1% people aged 40–69 years Canadian province, excluding individuals an estimated glomerular filtration rate (eGFR) <30 mL/min/1.73 m2. was defined Fried's criteria. Bone density quantitative ultrasound at calcaneus measuring speed sound (SOS) broadband attenuation (BUA). Time first fracture event assessed analyses were using logistic regressions, multiple linear regressions Cox models. Results Overall, 19 973 included: mean ± standard deviation age 54.2 7.8 years, women 51.6%, 47.0% CKD stage G2, 3.9% G3, 34.8% least one criterion. observed U-shaped eGFR odds ratio (OR) presenting criterion, minimum OR around 77 m2 [per 10 increase, respectively, for <77 >77, = 0.93, 95% confidence interval (CI) 0.86–1.01 1.09, CI 1.06–1.13]. After median follow-up 5.8 there 837 events. Having criterion negatively associated SOS (β –3.97, P < .0001) BUA –1.82, .0001). higher risk (hazard 1.23, 1.07–1.42). Conclusion In conclusion, having lower mineral density.

Language: Английский

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Research on the development of an intelligent prediction model for blood pressure variability during hemodialysis

BMC Nephrology, Journal Year: 2025, Volume and Issue: 26(1)

Published: Feb. 17, 2025

Blood pressure fluctuations during dialysis, including intradialytic hypotension (IDH) and hypertension (IDHTN), are common complications among patients undergoing maintenance hemodialysis. Early prediction of IDH IDHTN can help reduce the occurrence these fluctuations. With development artificial intelligence, machine learning deep models have become increasingly sophisticated in field Utilizing to predict blood dialysis has a viable predictive method. Our study included data from 67,524 hemodialysis sessions conducted at Ningbo No.2 Hospital Xiangshan First People's August 1, 2019, September 30, 2023. 47,053 were used for model training testing, while 20,471 external validation. We collected 45 features, general information, vital signs, routine, biochemistry, other relevant data. Data not meeting inclusion criteria excluded, feature engineering was performed. The definitions clarified, 10 algorithms build models. For development, randomly split into set (80%) testing (20%). To evaluate performance, six metrics used: accuracy, precision, recall, F1 score, ROC-AUC, PR-AUC. Shapley Additive Explanation (SHAP) method employed identify eight key which develop clinical application utilizing Streamlit framework. Statistical analysis showed that occurred 56.63% sessions, incidence 23.53%. Multiple (e.g., CatBoost, RF) developed events. XGBoost performed best, achieving ROC-AUC scores 0.89 both internal validation, with PR-AUC 0.95 0.78, high scores. SHAP identified pre-dialysis systolic pressure, BMI, mean arterial as top three important features. It been translated convenient use settings. Using is feasible provides clinically reliable performance. This timely implement interventions prevent problems, improve patient outcomes.

Language: Английский

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Construction and validation of a nomogram to predict 1-year mortality risk in patients with HIV/AIDS undergoing maintenance hemodialysis

Renal Failure, Journal Year: 2025, Volume and Issue: 47(1)

Published: Feb. 17, 2025

This single-center retrospective study aimed to explore the 1-year mortality risk factors in 166 patients with human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) undergoing maintenance hemodialysis (MH) between 6 June 2017 and 2023, construct a prediction model. The were classified into survival groups based on follow-up results, training validation sets at ratio of 1:1 (53 mortalities 53 survivors set 48 58 set). Stepwise logistic regression was used model visualize it as nomogram. Receiver operating characteristic (ROC) analysis, calibration curves, decision curves for nomogram evaluation set. Age (≥52 years) (OR (95% CI): 2.05 (3.191–18.892), p < .001), neutrophil albumin (NAR) (≥0.135) 4.753 (2.011–11.234), HIV-RNA (≥24,650) 13.786 (5.493–34.598), represents three five independent HIV/AIDS MH. AUC 0.908 CI: 0.853–0.963) 0.939 0.896–0.983), respectively. showed good separation capacity, clinical net benefit, which may benefit management

Language: Английский

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The association between nutritional-inflammatory status and chronic kidney disease prognosis: a population-based study

Renal Failure, Journal Year: 2025, Volume and Issue: 47(1)

Published: March 14, 2025

Background Chronic kidney disease (CKD) prognosis is closely tied to the interplay between nutrition and inflammation. However, comprehensive nutritional-inflammatory indices for prognostic evaluation are rare in CKD. This study explored association of advanced lung cancer inflammation index (ALI) with estimated glomerular filtration rate (eGFR) all-cause mortality CKD patients.

Language: Английский

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Recent Progresses in Optical Biosensors for Interleukin 6 Detection

Biosensors, Journal Year: 2023, Volume and Issue: 13(9), P. 898 - 898

Published: Sept. 21, 2023

Interleukin 6 (IL-6) is pleiotropic cytokine with pathological pro-inflammatory effects in various acute, chronic and infectious diseases. It involved a variety of biological processes including immune regulation, hematopoiesis, tissue repair, inflammation, oncogenesis, metabolic control, sleep. Due to its important role as biomarker many types diseases, detection small amounts high selectivity particular importance medical fields. Laboratory methods enzyme-linked immunoassays (ELISAs) chemiluminescent (CLIAs) are the most common conventional for IL-6 detection. However, these techniques suffer from complexity method, expensiveness, time-consuming process obtaining results. In recent years, too attempts have been conducted provide simple, rapid, economical, user-friendly analytical approaches monitor IL-6. this regard, biosensors considered desirable tools because their special features such sensitivity, rapid time, ease use, miniaturization. review, current progresses different optical favorable discussed, evaluated, compared.

Language: Английский

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Association of Dietary Inflammatory Index with CKD progression and estimated glomerular filtration rate in the American CKD population: A cross-sectional study

PLoS ONE, Journal Year: 2024, Volume and Issue: 19(2), P. e0297916 - e0297916

Published: Feb. 22, 2024

Purpose The number of CKD patients is on the rise worldwide, and diet has become an essential aspect influencing treatment prognosis CKD. However, limited research explored association Dietary Inflammatory Index (DII) with progression kidney function indicator, eGFR, in patients. This study aimed to analyze between DII eGFR US population using data from National Health Nutrition Examination Survey (NHANES). Methods utilized obtained (NHANES) spanning 2007 2018, a total sample size 2,488 individuals. Study used multiple imputation, based 5 replications chained equation approach method R MI procedure, account for missing data. Weighted logistic regression was relationship risk higher stage weighted analysis assess eGFR. Generalized Additive Models smoothed curve fitting were applied detect potential non-linear relationships this association. Results In all three models, it found that positively associated ( P < 0.0001), increase decrease 0.0001). trend across quartiles remained statistically significant, revealing gradual elevation reduction levels second, third, fourth compared lowest quartile Upon adjusting age, gender, race, education level, poverty income ratio (PIR), marital status, body mass index (BMI), metabolic equivalent (MET) score, drinking, smoking, history hypertension, diabetes, cotinine, systolic blood pressure, diastolic triglycerides, cholesterol, we positive correlation (OR = 1.26, 95% CI: 1.14–1.40). Further investigation revealed (β -1.29, -1.75, -0.83). Smooth curves illustrated risk, while negative observed Conclusions Our results indicate increased models. fully adjusted model, by 26% decreased 1.29 ml/min/1.73 m 2 each unit DII. finding suggests US, improved lower values may help slow decline delay

Language: Английский

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