RENAL FAILURE肾衰竭
RENAL FAILURE(英文缩写 RENAL FAILURE),ISSN 0886-022X,eISSN 1525-6049,中文译名:肾衰竭 是一本学术期刊。本页汇总该期刊的最新影响因子、分区信息以及最新收录于 PubMed 的文献,帮助您快速了解期刊全貌。
发文量统计区间：2025-10-01 至 2026-09-30，按本站收录文献的发表日期统计。
期刊介绍
历年影响因子趋势
| JCR 数据年份 | 影响因子 | JCR 分区 |
|---|---|---|
| 2021 | 3.222 | Q2 |
| 2022 | 3.000 | Q2 |
| 2023 | 3.000 | Q1 |
| 2024 | 3.000 | Q1 |
| 2025 | 3.800 | Q1 |
RENAL FAILURE 最新收录文献
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1. Esaxerenone attenuates renal injury by inhibiting NR3C2-mediated inflammatory and fibrotic pathways.
PMID:日期:2026-10-04Renal inflammation and fibrosis are pathological features of various types of kidney diseases. High-salt diet and aldosterone are risk factors for inducing kidney disease. Esaxerenone is the mineralocorticoid receptor blocker which is effective in treating hypertension. The aim of this study is to observe the effect of esaxerenone on renal inflammation in a rat model of high-salt diet plus aldosterone infusion. We found that rats treated with high-salt diet plus aldosterone showed more serious renal pathological injury. As well as, the expression of kidney injury molecule-1, toll-like receptor 4 (TLR4), phospho-nuclear factor kappa-B (p-NF-κB), F4/80, interleukin-6, tumor necrosis factor-alpha, and interferon gamma were increased ( < 0.05). In addition, high-salt diet plus aldosterone could upregulate the expression of transforming growth factor-beta (TGF-β), p-Smad2, p-Smad3, alpha-smooth muscle actin, vimentin, and collagen I ( < 0.05). However, administration of esaxerenone could ameliorate high-salt diet plus aldosterone - induced these expressions and renal pathological injury ( < 0.05). These data suggest that esaxerenone may alleviate high-salt plus aldosterone-induced renal inflammation and fibrosis by regulating the TLR4/NF-κB and TGF-β/Smad signaling pathways.
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2. Baseline characteristics and practice patterns in geriatric vs. non-geriatric hemodialysis patients: initial results from a Thai nationwide multicenter prospective cohort (Thai-HDcohort).
PMID:日期:2026-10-04Older adults represent a rapidly growing segment of the hemodialysis (HD) patient population. However, the specific clinical variations and dialysis management strategies employed for geriatric patients in Thailand remain poorly characterized. We analyzed baseline data from 839 hemodialysis patients enrolled in the Thai-HDcohort, a prospective multicenter study across 13 clinical sites in Thailand. Patients were stratified into a geriatric group (≥ 65 years of age, = 412) and a younger control cohort (< 65 years of age, = 427). Demographics, vascular access modalities, baseline laboratory markers, pharmacotherapy, and dialysis prescriptions were compared between the two groups. Geriatric patients were more frequently treated in hospital-based facilities (75.0% vs. 67.4%, = .002). The geriatric group exhibited lower body weight (57.7 vs. 63.0 kg, < .001) and lower serum albumin (hypoalbuminemia prevalence: 11.6% vs. 5.1%, = .001). Regarding practice patterns, geriatric patients relied more heavily on tunneled cuffed catheters at enrollment (38.1% vs. 27.7%, = .005) and were likely to initiate HD using a catheter (41.0% vs. 27.1%, < .001). Geriatric prescriptions also favored a higher utilization of a 3.0 mmol/L dialysate potassium bath (40.0% vs. 23.7%, < .001), and a higher dialysate calcium bath of 3.0 mmol/L (19.9% vs. 12.9%, = .011). In this cross-sectional study, geriatric hemodialysis patients showed distinct variations in prescriptions and vascular access. Longitudinal follow- up is essential to determine whether these conservative, individualized strategies improve clinical and survival outcomes.
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3. Development and validation of a nomogram for peritoneal dialysis-associated peritonitis.
PMID:日期:2026-10-01Peritoneal dialysis (PD)-associated peritonitis is a leading cause of technique failure. We aimed to develop and internally validate a Cox regression‑based nomogram for predicting peritonitis‑free survival in incident PD patients. This single-center retrospective cohort study included 372 patients who underwent peritoneal dialysis between June 2018 and December 2024, with follow-up through December 2025. LASSO‑Cox regression was used to select predictors from 23 candidate variables. A nomogram was constructed to predict 6‑, 12‑, and 24‑month peritonitis‑free survival. Model performance was assessed by concordance index (C‑index), time‑dependent ROC, calibration curves, and decision curve analysis. Over a median follow‑up of 26.3 months, 92 (35.4%) and 34 (30.4%) peritonitis events occurred in the training and validation cohorts, respectively. Nine predictors (education, start age, BMI, hemoglobin, potassium, sodium, albumin, calcium, phosphorus) were retained. Independent predictors were lower education (≤9 vs >9 years: HR 1.93, 95% CI 1.03-3.64), lower hemoglobin (HR 0.99, 0.97-1.00), lower albumin (HR 0.92, 0.87-0.97), and lower phosphorus (HR 0.53, 0.29-0.99). The C‑index was 0.707 (95% CI 0.650-0.765). Time‑dependent ROCs in the training cohort were 75.8%, 77.5%, and 69.7% at 6, 12, and 24 months; in the validation cohort, they were 77.7%, 63.8%, and 58.4%, respectively. Calibration was satisfactory at 6 and 12 months (Brier scores 6.0%-11.1%), with wider clinical net benefit at 12-24 months. This nomogram using nine routinely available variables demonstrated moderate discrimination and satisfactory calibration for predicting peritonitis‑free survival in PD patients. While promising, the model requires external validation in larger, multicenter cohorts to confirm its generalizability before routine clinical use.
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4. GABA ameliorates diabetic kidney disease-induced podocyte injury via JAML-FPR2 axis-mediated suppression of macrophage infiltration.
4. γ-氨基丁酸通过JAML-FPR2轴介导的巨噬细胞浸润抑制改善糖尿病肾病诱导的足细胞损伤PMID:日期:2026-10-01This study demonstrates that gamma-aminobutyric acid (GABA) ameliorates diabetic kidney disease (DKD) by modulating macrophage-driven inflammation and podocyte injury through the JAML/FPR2 signaling axis. In streptozotocin (STZ)-induced DKD mice, GABA administration significantly improved renal function by reducing serum creatinine, urea nitrogen, 24-hour urine protein, attenuated glomerular hypertrophy/mesangial expansion, and suppressed pro-inflammatory cytokine production (TNF-α, IL-1β, iNOS) in renal tissue and serum. GABA inhibited glomerular macrophage infiltration (CD68 cells) and M1 polarization while mitigating renal apoptosis and podocyte injury by restoring nephrin and podocin. In a high glucose (HG)-stimulated macrophage-podocyte co-culture model, GABA reduced HG-induced podocyte apoptosis in a macrophage ratio-dependent manner by reversing M1 polarization and inflammatory cytokine overproduction. Mechanistically, GABA normalized DKD-elevated JAML expression in renal tissues and podocytes, while JAML overexpression abolished GABA's renoprotective effects by reactivating inflammation, macrophage recruitment, and podocyte apoptosis. Co-IP confirmed JAML interacted with receptor formyl peptide receptor 2 (FPR2), which mediated DKD-driven macrophage infiltration, as FPR2 knockdown abrogated JAML-induced CD68 cell accumulation. Collectively, GABA alleviated DKD progression by disrupting the JAML/FPR2 axis to suppress macrophage-mediated inflammation and podocyte injury, highlighting its therapeutic potential for diabetic kidney disease.
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5. Initial side effects of roxadustat on thyroid function in patients undergoing hemodialysis.
5. 罗沙司他对血液透析患者甲状腺功能的初期副作用PMID:日期:2026-10-01Roxadustat, a hypoxia-inducible factor prolyl hydroxylase (HIF-PH) inhibitor, is effective for treating renal anemia, with efficacy noninferior to erythropoiesis-stimulating agents. However, data on its adverse effects remain scarce. In medical practice, roxadustat administration reportedly leads to central hypothyroidism; however, the frequency of its occurrence remains unclear. We investigated thyroid function in patients undergoing dialysis who received roxadustat at Saiseikai Yokohamashi Tobu Hospital, with particular focus on the timing of the decrease in serum thyroid-stimulating hormone (TSH) levels after roxadustat initiation and the subsequent course of thyroid function. HIF-PH inhibitors were administered to 43 chronic kidney disease patients including dialysis. After 2 weeks of roxadustat administration, we extracted the data of 16 hemodialysis patients who exhibited absence of residual urine and were able to undergo blood tests. All patients revealed decreased serum TSH levels. In contrast, changes in serum free triiodothyronine and free thyroxine levels were minor. None of the patients reported fatigue, bradycardia, or constipation, which are common symptoms of hypothyroidism. Our findings revealed that roxadustat may cause TSH reduction after 2 weeks of administration, though some patients showed subclinical hypothyroidism with high TSH levels. In a few cases, TSH levels decreased to one-tenth of the normal values. Despite these rapid changes, none of the patients exhibited clinical symptoms. Hence, regular thyroid hormone level monitoring is necessary with roxadustat administration, regardless of patients' history of thyroid function.
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6. Association between renal vascular lesions and echocardiographic indices related to diastolic function in patients with diabetic nephropathy: a biopsy-based cross-sectional study.
PMID:日期:2026-09-27Renal vascular lesions are common in diabetic nephropathy (DN), but their association with echocardiographic indices related to diastolic function remains unclear. This study investigated the relationship between renal vascular lesion severity and echocardiographic indices in biopsy-confirmed DN. This biopsy-based cross-sectional study included 360 patients with biopsy-confirmed DN and available echocardiographic data. Renal vascular lesions were evaluated using a composite score of arteriolar hyalinosis and arteriosclerosis, and patients were categorized into three severity groups (scores 0-1, 2-3, and 4). Echocardiographic indices included E/e', e', and left atrial diameter (LA). Multivariable linear regression models were used to assess the associations between renal vascular lesion severity and echocardiographic parameters. Sensitivity analyses were performed using continuous vascular lesion scores and additional covariate adjustment. Among 360 patients, 53, 253, and 54 were classified into the 0-1, 2-3, and 4 score groups, respectively. Compared with the 0-1 group, moderate and severe vascular lesions were associated with higher E/e' (β = 1.814 and 2.910, respectively) and larger LA (β = 1.722 and 2.917, respectively) after multivariable adjustment. Continuous score analysis showed that each 1-point increase in vascular lesion score was associated with higher E/e', larger LA, and lower e'. Associations with E/e' and LA were generally consistent across sensitivity analyses, whereas the association with e' was less stable. In patients with biopsy-confirmed DN, greater renal vascular lesion severity was associated with higher E/e' and larger LA, highlighting a potential link between renal vascular pathology and echocardiographic indices related to diastolic function.
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7. Effects of automated peritoneal dialysis and continuous ambulatory peritoneal dialysis on residual kidney function in Chinese patients with new-onset end stage kidney disease.
PMID:日期:2026-09-27Automated peritoneal dialysis (APD) is a widely used dialysis modality for patients with end-stage kidney disease (ESKD). However, controversy remains regarding the rate of residual kidney function (RKF) decline between patients treated with APD and continuous ambulatory peritoneal dialysis (CAPD). This study aimed to investigate the effect of peritoneal dialysis modality on the rate of RKF decline in Chinese patients with new-onset ESKD. We conducted a single-center retrospective study to explore the association between PD modalities and RKF decline. A total of 53 patients with new-onset ESKD were enrolled. Of these, 19 patients started with APD and 34 with CAPD. The rates of RKF decline were compared between two groups. Multivariate linear regression was performed to identify risk factors for rapid decline of RKF. Baseline RKF and urine output were comparable between the APD and CAPD groups. At 6 months after PD initiation, RKF was 1.9 ± 1.6 mL/min/1.73 m in the APD group, significantly lower than 3.0 ± 1.7 mL/min/1.73 m in the CAPD group ( = 0.043). The APD group had a significantly faster mean rate of RKF decline (-6.6 ± 2.5 vs. -4.3 ± 2.3 mL/min/1.73 m/year, = 0.002). In multivariate linear regression adjusted for established risk factors, APD use (vs. CAPD) (β = 0.93; = 0.004) and baseline RKF (β = 0.38; < 0.001) were significantly associated with accelerated RKF decline. Our findings indicate that Chinese patients initiating dialysis with APD experience faster RKF decline within the first 6 months compared with those starting PD with CAPD. Furthermore, high baseline RKF is associated with rapid RKF decline.
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8. Treatment, characteristics and prognosis of central venous occlusion in hemodialysis patients with tunneled cuffed catheter dysfunction.
PMID:日期:2026-09-27Central venous occlusion (CVO) is a severe complication in hemodialysis patients with tunneled cuffed catheters (TCC), leading to catheter dysfunction and poor outcomes. Optimal treatment remains controversial. This retrospective study included 123 hemodialysis patients with TCC dysfunction and CVO between February 2017 and December 2025. Patients underwent either exchange of the existing catheter or placement of a new catheter at a different venous site, with or without concurrent balloon angioplasty or stenting. The cohort had a mean age of 61.02 ± 13.66 years, 29.2% male, with mean hemodialysis vintage of 7.86 years. Brachiocephalic vein occlusion was the most common lesion (74.8%), followed by superior vena cava occlusion (63.4%). Median catheter survival was 735 days. Recurrent dysfunction requiring reintervention occurred in 39.0% of patients (median time 255 days). Atrial thrombus (17.8%) and fibrin sheath (38.2%) were significantly associated with shorter catheter survival ( < 0.05). Most patients had reduced right ventricular basal diameter (98.0%) and increased left ventricular mass index (40.9%). Catheter exchange and endovascular treatment for central venous occlusion are safe and effective. Percutaneous superior vena cava puncture provides a valuable salvage option for this complex population, supporting durable long-term vascular access. Thrombosis and fibrin sheath predict poorer catheter survival.
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9. Machine learning-based nomogram for acute kidney injury after liver transplantation.
PMID:日期:2026-09-27Acute kidney injury (AKI) after liver transplantation (LT) is a frequent complication associated with adverse outcomes, yet practical early postoperative prediction tools remain limited. This retrospective study developed and internally validated an interpretable model for AKI after LT using perioperative variables available by the time of the first urgent postoperative blood test, generally obtained within 1 h after surgery. Adult LT recipients treated from June 2023 to January 2026 were screened. AKI was defined according to Kidney Disease: Improving Global Outcomes criteria. Among 146 screened recipients, 127 were included and randomly divided into training and validation cohorts at a 3:1 ratio. Least absolute shrinkage and selection operator regression selected estimated glomerular filtration rate calculated using the CKD-EPI equation, anhepatic phase time, postoperative natural logarithm-transformed D-dimer, and postoperative alanine aminotransferase. Multivariable logistic regression showed that lower estimated glomerular filtration rate and longer anhepatic phase time were independently associated with AKI. The nomogram achieved area under the receiver operating characteristic curve values of 0.861 in the training cohort and 0.761 in the validation cohort. Five-fold cross-validation and bootstrap internal validation were performed to assess model stability and optimism. Among five evaluated models, support vector machine showed the numerically highest validation AUC of 0.846. Shapley additive explanations identified estimated glomerular filtration rate as the dominant predictor. This early postoperative model may help identify high-risk recipients for intensified renal monitoring and individualized management. External multicenter validation is required before routine clinical implementation.
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10. Lactate in acute kidney injury: pathobiology, risk stratification, and clinical interpretation.
PMID:日期:2026-09-27Lactate is frequently measured in patients with acute kidney injury (AKI), but its interpretation remains challenging because circulating lactate reflects systemic metabolic stress rather than kidney injury. Although elevated lactate levels are associated with adverse outcomes in critically ill patients with AKI, its biological and clinical significance varies according to disease context, timing, and the clinical question being addressed. This structured expert narrative review integrates mechanistic insights and clinical evidence to establish a context-dependent framework for interpreting lactate in AKI. We summarize the role of the kidney in lactate metabolism and discuss how impaired renal function, altered perfusion, mitochondrial dysfunction, and immune-metabolic remodeling contribute to lactate accumulation. We further evaluate clinical evidence regarding lactate in AKI risk assessment, severity evaluation, organ-support requirement, and mortality prediction, while emphasizing limitations related to confounding factors and clinical heterogeneity. Emerging clinical contexts, including extracorporeal membrane oxygenation-supported patients, are also considered. Overall, this framework supports a more precise interpretation of lactate as a context-dependent risk marker and metabolic signal rather than a kidney-specific biomarker.