Introduction: Children with type 1 diabetes are at increased risk of developing diabetic ketoacidosis (DKA), a life‑threatening complication often accompanied by electrolyte disturbances and kidney injury. Understanding the prevalence and patterns of these metabolic derangements is crucial for improving clinical management and outcomes in pediatric populations. Objectives: This study aimed to provide insight into the prevalence of electrolyte imbalances and acute kidney injury (AKI) among children with type 1 diabetes with DKA, to highlight key implications for early recognition and intervention. Materials and Methods: This single-center, retrospective cross-sectional study was conducted at Besat hospital in Hamadan, Iran, over 10 years (2011–2021) and included pediatric and adolescent patients (<18 years) with type 1 diabetes who were hospitalized for acute DKA. Eligible cases were identified from hospital records and extracted. Demographic, clinical, and laboratory information, including electrolyte profiles and renal parameters, was extracted from medical records, and AKI was classified according to KDIGO criteria. All data were entered into structured tables and analyzed descriptively using frequencies and percentages to determine the prevalence of electrolyte disorders and AKI in the study population. Results: The results indicated that among 94 pediatric patients with DKA, 59 (62.8%) experienced electrolyte disturbances, while 61 (64.9%) developed AKI, with grade 1 being the most frequent stage (39 cases, 63.9%). The most common electrolyte abnormalities were hyponatremia in 16 patients (17%), hyperkalemia in 22 patients (23.4%), and hypocalcemia in 9 patients (9.6%). Conclusion: Electrolyte disturbances and AKI were common among pediatric patients with DKA, with hyponatremia, hyperkalemia, and grade 1 AKI being the most frequent findings. These results underscore the importance of early detection and close monitoring of metabolic and renal complications in this population.
Insulin resistance in polycystic ovary syndrome (PCOS) contributes to renal dysfunction through multiple interconnected mechanisms. In PCOS, insulin resistance leads to compensatory hyperinsulinemia, which exacerbates metabolic disturbances including hyperandrogenism and systemic inflammation. These factors collectively promote renal injury. Meanwhile, insulin resistance in PCOS promotes hypertension and endothelial dysfunction, which impair renal microcirculation. Hyperinsulinemia increases sodium retention and activates the renin-angiotensin-aldosterone system (RAAS), further elevating blood pressure and causing glomerular hyperfiltration and damage. Insulin resistance also contributes to dyslipidemia and oxidative stress, accelerating atherosclerosis and renal vascular injury. Moreover, insulin resistance worsens hyperuricemia by reducing renal uric acid excretion, which is a direct nephrotoxic factor. Persistent hyperuricemia leads to inflammation and fibrosis within the kidneys, potentially progressing to chronic kidney disease (CKD). In addition, systemic low-grade inflammation and oxidative stress driven by insulin resistance and PCOS-related hyperandrogenism also induce renal tissue injury through inflammatory cytokines and apoptotic pathways, contributing to impairment in renal function.
Introduction: The neutrophil percentage-to-albumin ratio (NPAR) has emerged as a valuable biomarker for the detection and assessment of inflammatory conditions. Given the prominent role of inflammation in the pathophysiology of kidney disorders, the present study aimed to examine the association between NPAR and the risk of developing kidney disease. Materials and Methods: This study was conducted as a systematic review and meta‑analysis, designed in accordance with the PRISMA guidelines. In line with this framework, the Cochrane, Scopus, Web of Science, Embase, and PubMed databases, as well as the Google Scholar search engine, were systematically searched up to December 19, 2025. All statistical analyses were performed using STATA version 14. Results: Elevated NPAR was significantly associated with an increased risk of kidney disease in the overall population (OR = 1.62, 95% CI: 1.37–1.91), as well as among men (OR = 1.31, 95% CI: 1.15–1.50), women (OR = 1.30, 95% CI: 1.14–1.48), and individuals younger than 60 years (OR = 1.71, 95% CI: 1.42–2.06). Participants in the highest NPAR quartile demonstrated a markedly greater risk of kidney disease compared with those in the first quartile (OR = 2.04, 95% CI: 1.46–2.84), the third quartile (OR = 1.40, 95% CI: 1.13–1.72), and the second quartile (OR = 1.19, 95% CI: 1.07–1.31). Similarly, individuals in the third NPAR tertile exhibited a substantially higher risk relative to the first tertile (OR = 4.40, 95% CI: 2.26–8.58) and the second tertile (OR = 2.63, 95% CI: 1.34–5.19). Furthermore, elevated NPAR was identified as a significant risk factor for both chronic kidney disease (CKD) (OR = 1.46, 95% CI: 1.17–1.82) and diabetic kidney disease (OR = 1.86, 95% CI: 1.43–2.43). Conclusion: Elevated NPAR was associated with a higher likelihood of developing kidney disease, and this risk increased progressively with rising NPAR levels. Men demonstrated a slightly greater vulnerability compared with women, and a younger age (<60 years) further amplified this association. Additionally, individuals with higher NPAR values exhibited a greater propensity for developing diabetic kidney disease than CKD. Registration: This study has been compiled based on the PRISMA checklist, and its protocol was registered on the PROSPERO (ID: CRD420251273807) and Research Registry (UIN: reviewregistry2069) websites.
Introduction: Chronic obstructive pulmonary disease (COPD) is recognized as the third leading cause of death globally. On the other hand, patients with COPD who have comorbidities have increased length of hospital stay, mortality, and healthcare costs. Therefore, the aim of this study was to investigate the association between acute kidney injury (AKI) and mortality risk in patients with COPD. Materials and Methods: This study was designed the assistance of the PRISMA guideline. To achieve this, data were searched and collected from Cochrane, Scopus, Web of Science, Embase, and PubMed databases, as well as the Google Scholar search engine, up to January 1, 2026. The authors used STATA 14 software for statistical analysis of the data. Results: In general, higher mortality rates are observed in patients with AKI and COPD compared to patients with COPD without AKI (OR: 3.30, 95% CI: 2.40, 4.53). In China (OR: 4.13, 95%: 1.72, 9.94), UK (OR: 1.80, 95% CI: 1.60, 2.02), USA (OR: 2.36, 95% CI: 2.12, 2.63), and Italy (OR: 3.85, 95% CI: 2.87, 5.15), patients with COPD and AKI had higher mortality compared to patients with COPD and without AKI. Additionally, the risk of mortality in patients with COPD and AKI whose mean age was less than 75 years (OR: 2.09, 95% CI: 1.67, 2.62) was lower than in patients who were 75 years or older (OR: 2.91, 95% CI: 1.80, 4.71). Conclusion: Patients with AKI and COPD face higher mortality rates than patients without AKI, and these rates rise with increasing age. Geographically, the highest mortality rate was reported in China. Registration: This study has been compiled based on the PRISMA checklist, and its protocol was registered on the PROSPERO (ID: CRD420261294995).
Introduction: Quercetin, a polyphenolic compound, exhibits potent antioxidant and anti-inflammatory activities in oxidative stress conditions. Objectives: This study aimed to determine whether quercetin pretreatment could alleviate oxidative stress and hepatorenal dysfunction in rats exposed to renal ischemia-reperfusion (IR) injury. Materials and Methods: This experimental study employed an animal model with a post-test-only control group design. Thirty male Sprague–Dawley rats were randomly allocated into three groups (n = 10): control (vehicle); IR, which received the vehicle and underwent IR; and quercetin-pretreated group (IR + Quercetin), which was pretreated with quercetin (50 mg/kg/day) prior to IR induction. The rats were orally pretreated with either vehicle or quercetin for 15 consecutive days prior to IR exposure. To induce kidney ischemia, both kidney pedicles were compressed using atraumatic clamps (45 min), and reperfusion (24 h) was initiated by removing the clamps. Results: Serum levels of triglycerides, cholesterol, low-density lipoprotein, very low-density lipoprotein, urea, and creatinine, as well as the activities of gamma-glutamyltransferase (GGT), alkaline phosphatase (ALP), and alanine aminotransferase (ALT), were markedly reduced in the IR + Quercetin group compared to the IR group. The concentration of high-density lipoprotein cholesterol was significantly increased in the IR + Quercetin group compared to the IR group. In rats exposed to IR, quercetin pretreatment significantly decreased malondialdehyde concentrations and promoted glutathione contents as well as catalase and glutathione peroxidase activities in serum, renal, and hepatic samples compared to the IR group. Conclusion: Quercetin pretreatment exerted protective effects against hepatorenal dysfunction and oxidative stress in rats subjected to kidney IR injury.
Introduction: Chronic kidney disease (CKD) is a progressive condition associated with high morbidity and mortality, requiring strict adherence to therapeutic regimens to optimize outcomes. Patients' attitudes and practices play a critical role in determining treatment compliance, self-management, and long-term prognosis. Understanding the patients' attitude and practice levels and identifying demographic and clinical factors that influence these behaviors helps guide targeted interventions to improve outcomes. Objectives: The aim of this cross-sectional study was to comprehensively evaluate the attitudes and practices of patients with CKD toward their therapeutic regimens and to identify the demographic and clinical factors that influence these behaviors. By analyzing these relationships, the study aimed to provide evidence on how sociodemographic characteristics shape health-related attitudes and practices, thereby informing the design of targeted interventions. Ultimately, the goal is to identify vulnerable subgroups who may require additional educational and behavioral support to improve adherence, enhance self-management, and optimize long-term outcomes in CKD care. Patients and Methods: This prospective cross-sectional study was conducted in 2025 at the nephrology clinics in Yazd and enrolled 285 patients with CKD. Data were collected using a valid and reliable researcher-developed questionnaire consisting of 16 items across two domains (attitude and practice). Demographic and clinical information, including age, gender, education level, and dialysis status, was recorded, and questionnaire scores were calculated to quantify patient engagement and adherence. The primary outcome was the assessment of patients' attitudes and practice levels toward therapeutic regimens, with secondary outcomes examining associations with demographic and clinical factors. Results: This study of 285 CKD patients found that attitudes and practices toward therapeutic regimens were generally moderate. Education and age emerged as significant determinants, with academically educated and older patients demonstrating more positive attitudes, stronger practices, and higher overall engagement, while gender and dialysis status showed no meaningful influence. Conclusion: Patients with CKD showed moderate attitudes and practices, shaped mainly by education and age, while gender and dialysis status had no impact; interventions should prioritize younger and less-educated patients to improve engagement and health behaviors.
Oxidative stress and reactive oxygen species (ROS) generation are central drivers of calcium oxalate kidney stone pathogenesis by promoting renal tubular epithelial cell injury, inflammation, cell death, and extracellular matrix remodeling, which collectively create a renal environment conducive to crystal deposition, retention, and stone growth. Targeting oxidative stress pathways with antioxidants and modulators of ROS production presents a promising avenue for therapeutic intervention to prevent kidney stone recurrence and progression. This insights from molecular, cellular, and pathophysiological studies showing that calcium oxalate crystals set off a cascade of oxidative and inflammatory events that culminate in kidney stone formation, and also accentuates the importance of maintaining redox balance and renal cellular health in mitigating the burden of calcium oxalate nephrolithiasis.
Introduction: Favipiravir, an antiviral agent widely used during the COVID-19 pandemic, has demonstrated therapeutic potential but has raised concerns regarding organ toxicity. Although its clinical benefits are well established, evidence of its nephrotoxic effects remains inconsistent. Objectives: This study aimed to evaluate the nephrotoxic effects of favipiravir and assess whether co-administration of silymarin could mitigate favipiravir-induced kidney injury. Materials and Methods: In this experimental study, 15 adult albino rats were randomly allocated into three groups (n = 5); group 1 received saline (control), group 2 was treated with favipiravir (1800 mg/kg on day one, followed by 800 mg/kg twice daily for 13 days), and group 3 received the same favipiravir regimen combined with silymarin (50 mg/kg twice daily). At the end of the 14-day treatment period, blood samples were collected to measure serum creatinine, blood urea, and blood urea nitrogen (BUN) levels. Kidneys were harvested for histopathological examination and immunohistochemical analysis using cytokeratin 7 (CK7) and paired box gene 8 (PAX8) markers. Results: No significant differences were observed in serum creatinine, blood urea, or BUN among the groups. However, histopathological analysis revealed glomerular atrophy, coagulative necrosis, lymphocytic infiltration, and interstitial hemorrhage in the kidneys of favipiravir-treated rats. These changes were less severe in rats treated with silymarin. Immunohistochemical staining showed strong CK7 and PAX8 expression in favipiravir-treated rats, whereas both markers were absent in control and silymarin-treated groups. Conclusion: Although favipiravir did not significantly alter kidney function parameters, histopathological findings indicate renal injury. The partial improvement observed in the silymarin-treated group suggests a potential nephroprotective effect, which warrants further investigation.
Introduction: Vancomycin is widely used for treating serious gram-positive infections; however, its clinical utility can be limited by nephrotoxicity. Early detection of vancomycin-induced acute kidney injury (AKI) remains a clinical challenge, as traditional markers such as serum creatinine often rise only after significant renal damage has occurred. Objectives: Urinary gamma-glutamyl transferase (GGT), an early tubular injury biomarker. may provide a sensitive indicator for detecting nephrotoxicity before overt renal impairment develops. Materials and Methods: This prospective observational study was conducted between 2023 and 2024 at Loghrhan Hakim Hospital, Tehran, involving 14 patients receiving vancomycin who had no prior kidney disease. Demographic and clinical data were collected, and urinary GGT levels were measured on days 1, 3, and 6 after treatment initiation. The outcome was to compare urinary GT levels between patients with and without AKI, to evaluate GGT as a potential biomarker for predicting vancomycin-associated AKI. Results: The results demonstrated that urinary GGT in relation to the occurrence of vancomycin-induced AKI demonstrated no statistically significant associations across different time points of day 1, 3, and 3 after the administration of vancomycin. The area under the curve (AUC) values for predicting the occurrence of AKI were non-significant and were 0.633 on day, 0.556 on day 3, and 0.733 on day 6, respectively (P > 0.05) The optimal urinary GGT cut-off values for AKI occurrence were 31 on day 1, 33.5 on day 3, and 47.35 on day 6, yielding sensitivities of 40%, 50%, and 60% and specificities of 56%, 67%, and 67%, respectively, suggesting only modest discriminative ability of urinary GGT for AKI. Conclusion: In conclusion, urinary GGT showed no clinically meaningful or statistically significant ability to predict vancomycin-induced AKI at any evaluated time point and therefore cannot be recommended as a reliable standalone biomarker in this setting.
Introduction: Nephrotic syndrome in children is characterized by substantial proteinuria, yet 24-hour urine collection remains difficult to perform reliably in pediatric practice. The spot urine protein-to-creatinine ratio (UP/CrR) offers a more feasible alternative for estimating daily protein loss. Objectives: This study evaluated the accuracy and predictive performance of this surrogate measure compared with 24-hour urine protein excretion in children with nephrotic syndrome. Materials and Methods: This cross-sectional study was conducted on 100 children aged 3-14 years who attended two pediatric clinics in Yazd between June and December 2025. Participants with nephrotic syndrome who provided informed written consent and had complete demographic and laboratory data, including spot UP/CrR and 24-hour urine protein excretion, were included. The primary measurement outcome was assessing the correlation between the spot UP/CrR and 24-hour urine protein excretion. Results: The study included 100 pediatric patients with nephrotic syndrome, with a mean age of 8.82 +/- 3.29 years. A significantly strong positive correlation was observed between the UP/CrR and 24-hour urine protein excretion across the whole cohort (r = 0.772) and within sex-specific subgroups. Linear regression analyses further confirmed this association in both unadjusted and adjusted models. For all participants, each unit increase in the UP/CrR was associated with a proportional 2.89 mg rise in 24-hour urine protein excretion, an effect that remained stable after adjusting for age, body mass index (BMI), and gender (B = 2.94). Conclusion: These findings demonstrate that the UP/CrR is a strong and reliable predictor of 24-hour urine protein excretion in children with nephrotic syndrome, and the use of the spot UP/CrR as a practical, cost-effective, and accessible surrogate for quantifying daily proteinuria in clinical settings is suggested.
Introduction: Hypertension accelerates kidney damage in type 2 diabetes mellitus (T2DM), making effective blood pressure control essential for renal protection. Due to magnesium deficiency as a common disorder in this population. Objectives: This study aimed to assess the effect of oral magnesium supplementation on blood pressure. Materials and Methods: The study was a randomized, single-blind, placebo-controlled clinical trial conducted at Loqman Hakim Hospital, Tehran, Iran, from 2025 to 2026. Adults with T2DM were enrolled and randomly assigned to receive either 300 mg of oral magnesium citrate daily (n = 30) or a matching placebo (n = 30) for a period of two months. Demographic data and informed written consent were collected at baseline, and blood pressure parameters, including systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP), were measured at baseline, one month, and two months using standardized procedures. The outcomes were compared both within and between groups across the follow-up period. Results: After one month, compared to the baseline, the magnesium group showed decreases of-6.30 mmHg in SBP (4.16%down arrow), -4.30 mmHg in DBP (4.83%down arrow), and-3.10 mmHg in MAP (2.83%down arrow), all with P < 0.05, while the control group showed smaller, non-significant changes. By two months, reductions in the magnesium group increased to-12.00 mmHg in SBP (7.94%down arrow), -8.70 mmHg in DBP (9.78%down arrow), and-7.90 mmHg in MAP (7.21%down arrow), each with P < 0.001, whereas the control group again demonstrated non-significant declines. In comparison between one and two months, the magnesium group continued to improve, with additional reductions of-5.70 mmHg in SBP (3.93%down arrow), -4.40 mmHg in DBP (5.19%down arrow), and-4.80 mmHg in MAP (4.51%down arrow), all statistically significant (P < 0.05), while the control group showed minimal, non-significant fluctuations across all parameters. Conclusion: The results indicate that magnesium citrate is an effective adjunct strategy for improving blood pressure control in patients with T2DM.
Introduction: Patients with end-stage renal disease (ESRD) frequently experience disturbances in acid-base homeostasis, which contribute to adverse clinical outcomes and complicate management. Emerging evidence suggests that modulation of the gut microbiota through probiotic supplementation may influence systemic metabolic and respiratory parameters. Objectives: This study aimed to evaluate the effect of probiotic supplementation on acid-base homeostasis compared with standard care. Materials andMethods: This randomized, double-blind, controlled clinical trial was conducted at Loghman Hakim hospital, Tehran, Iran, between 2023 and 2024. Twenty-one patients with ESRD and metabolic acidosis were included in the final analysis. Participants were randomized to the intervention group (n = 12) receive daily probiotic supplementation (Cap Lactocare, 109 CFU, once after lunch for three months) plus standard care, or standard care alone (n = 9). Arterial blood gas parameters (ABG), including pH, carbon dioxide (PCO2), and bicarbonate (HCO3-), were measured before and after intervention, and statistical analyses were performed using non-parametric tests to compare within-and between-group changes. Results: The final analysis included 12 probiotic and 9 control patients. Before intervention, ABG parameters showed no significant differences in pH, PCO2), and HCO3-. After intervention, the probiotic group demonstrated significantly higher pH (7.39 vs. 7.36), lower PCO2 (39.26 vs. 41.72 mm Hg), and elevated HCO3-(27.22 vs. 24.51 mmol/L) compared with controls (P < 0.05). Within-group analyses confirmed significant improvements in pH (Delta +1.93%) and HCO3-(Delta +32.78%) alongside a reduction in PCO2 (Delta -5.80%) in the probiotic group (P < 0.05), whereas the control group showed increases in pH (Delta +1.37%) and HCO3-(Delta +16.99%) (P < 0.05), without significant change in PCO2 (P = 0.931). Conclusion: Probiotic supplementation in patients with ESRD indicated a more comprehensive modulation of both metabolic and respiratory components of acid-base homeostasis compared with standard care. Trial Registration: The trial protocol was approved by the Iranian Registry of Clinical Trials with code (IRCT20230608058421N1; https://irct.behdasht.gov.ir/trial/70981), and ethical code from Shahid Beheshti University of Medical Sciences (IR.SBMU.MSP.REC.1402.099).
Introduction: Catheter-related infection is one of the most important complications in patients with end-stage renal disease, often leading to increased mortality and prolonged hospitalization. Rapid and accurate diagnosis of these infections plays a crucial role in effective clinical management; however, the standard method of blood culture, despite its widespread use, has limitations such as being time-consuming. Technetium-99m labeled ubiquicidin peptide fragment, amino acids 29-41 (UBI-mTc 99-29-41) scintigraphy has emerged as a novel imaging technique that enables faster and more precise detection of catheter-associated infections. Objectives: This study aimed to evaluate the diagnostic value of the UBI-mTc 99-29-41 scan compared with blood culture for identifying hemodialysis catheter infections. Patients and Methods: This cross-sectional study was conducted on 54 hemodialysis patients with suspected catheter-site infection who were hospitalized at Labbafinezhad hospital in Tehran in 2025. Venous blood samples were collected from all participants for blood culture and they underwent UBI-mTc 99-29-41 scintigraphy assessment. Diagnostic performance measures, including overall accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), were calculated using standard statistical methods and Cohen's kappa coefficient to compare the diagnostic efficacy of UBI-mTc 99-29-41 scintigraphy with blood culture in detecting hemodialysis catheter infections. Results: Compared with blood culture, the UBI-mTc 99-29-41 scan demonstrated an overall accuracy of 90.7%, sensitivity of 95.5%, specificity of 87.5%, PPV of 84%, NPV of 96.6%, falsepositive rate of 12.5%, and false-negative rate of 4.5%. According to statistical standards, all parameters except the true positive ratio were significant, indicating the high diagnostic value of UBI-mTc 99-29-41 scintigraphy in identifying hemodialysis catheter infections. Conclusion: UBI-mTc 99-29-41 scintigraphy demonstrated high diagnostic accuracy, sensitivity, and specificity compared to blood culture as a diagnostic standard reference in detecting hemodialysis catheter infections. These findings highlight its potential as a reliable and rapid diagnostic tool, supporting improved patient management and outcomes.
Introduction: One of the non-communicable diseases that requires significant costs due to its long treatment duration and expensive equipment is chronic kidney disease (CKD). The high cost of treatment for patients with CKD undergoing hemodialysis drives the need for a pharmacoeconomic review, as individuals face limited resources and treatment costs continue to rise over time. Objectives: The aim of this study is to determine the total costs for CKD patients undergoing hemodialysis, analyze the minimal costs and cost-effectiveness, and to assess the utility of hemodialysis patients. Patients and Methods: This study is an observational study using secondary data obtained from patient's medical records and hospital financial data, as well as primary data through interviews and questionnaires. The entire population was taken as a sample, consisting of 34 CKD patients undergoing hemodialysis. The cost of illness (COI) was determined by calculating the total costs, minimal costs by calculating fixed and variable costs, costeffectiveness by calculating average cost effectiveness ratio (ACER) and incremental cost effectiveness ratio (ICER), and also cost-utility analysis (CUA) using the EQ-5D-5L and visual analog scale (VAS) questionnaires. Results: The research results showed that the COI for hemodialysis patients was USD 3884.27. The antihypertensive drug amlodipine was the more cost-minimizing and most cost-effective option compared to candesartan. The average utility value for hemodialysis patients was 0.692 (feeling fairly healthy), and the VAS utility score was 72.3 (moderately healthy health status). Conclusion: The pharmacoeconomic profile, including COI, cost minimization analysis (CMA), cost-effectiveness analysis (CEA), and CUA, are interrelated. The costs incurred by patients, along with the financial and health-related losses due to illness, impact the quality of life of CKD patients undergoing hemodialysis.
Preeclampsia can have long-term effects on kidney function in women with chronic kidney disease (CKD). Women with a history of preeclampsia have an increased risk of CKD and end-stage renal disease (ESRD) later in life. Regular check-ups are needed for preeclamptic women, especially those with persistent hypertension or proteinuria. Therefore, prediction models incorporating renal function and pregnancy outcomes in the first trimester can help assess pregnancy risk in CKD patients. Risk stratification models consider disease activity, major organ involvement, maternal risk factors and comorbidities, previous pregnancy complications, teratogenic drugs, and laboratory tests.
The landscape of pulmonary hypertension (PAH) treatment is evolving, with SGLT2 inhibitors being recognized as a potential fourth treatment pathway alongside traditional therapies. Their incorporation into treatment strategies for PAH could represent a significant shift in management approaches.
Renal transplant recipients face a heightened risk of complicated urinary tract infections (cUTIs) due to immunosuppression, anatomical changes, and recurrent urinary abnormalities. Traditional diagnostic methods, including standard urine cultures, are often insufficient in identifying fastidious organisms and multidrug-resistant (MDR) pathogens that contribute to recurrent infections. Emerging technologies, such as next-generation sequencing (NGS), offer a novel, culture-independent approach that improves pathogen detection, especially in cases involving polymicrobial infections or rare microbes. This article explores the role of NGS in addressing diagnostic limitations for renal transplant patients with cUTIs, highlighting its capacity to identify both bacterial and viral pathogens and their resistance profiles. The clinical relevance of NGS in enhancing treatment precision and improving graft outcomes is discussed, emphasizing the potential for reduced nephrotoxic effects from broad-spectrum antibiotics. As the incidence of antimicrobial resistance rises, advanced diagnostic solutions like NGS offer a promising path for optimizing post-transplant care and safeguarding graft function.
Introduction: Chronic kidney disease (CKD) is a progressing illness worldwide and the relationship between remnant-C and CKD is still uncertain. Indeed, this study aims to evaluate the relationship between remnant-C and the risk of CKD development in a systematic review and meta-analysis study. Materials and Methods: This study surveyed databases like Web of Science, Cochrane, ProQuest, PubMed, Embase, and Google Scholar up to December 17, 2024. Data analysis was performed by STATA 14 software, and the test confidential level was P<0.05. Results: Remnant-C causes a higher risk of CKD (OR: 1.31, 95% CI: 1.22, 1.41). In addition, the remnant-C in second quartile (R:1.20, 95% CI: 1.13, 1.27), third quartile (OR:1.26, 95% CI: 1.13, 1.40), 4th quartile (OR:1.62, 95% CI: 1.42, 1.86), second tertile (OR:1.12, 95% CI: 1.06, 1.19) and 3rd tertile (OR:1.23, 95% CI: 1.16, 1.31) further increased CKD risk. According to the subgroup analysis, remnant-C in the group with the range of 40 to 49 years (OR:1.32, 95% CI: 1.18, 1.48), 50 to 59 years (OR:1.26, 95% CI: 1.14, 1.40), 60 to 69 years (OR:1.39, 95% CI: 1.14, 1.69), in men (OR:1.23, 95% CI: 1.13, 1.33) and women (OR:1.51, 95% CI: 1.25, 1.82) lead to higher risk of CKD. Additionally, remnant-C in diabetic patients (OR: 1.35, 95% CI: 1.22, 1.48), individuals with body mass index (BMI) <25 (OR: 1.28, 95% CI: 1.15, 1.43), and individuals with BMI>25 (OR:1.39, 95% CI: 1.20, 1.60) lead to a higher risk of CKD, either. Conclusion: Our study reveals that remnant-C causes a higher risk of CKD, and a higher level of remnant-C leads to a higher risk of CKD. Notably, remnant-C causes CKD in women more than men and in individuals with BMI >25 kg/m2 more than ones with BMI<25 kg/m2 , shedding new light on the gender and BMI-specific risks associated with remnant-C. Registration: This study has been compiled based on the PRISMA checklist, and its protocol was registered on the PROSPERO (ID: CRD42025632075) and Research Registry (UIN: reviewregistry1936) websites.
Introduction: The C-reactive protein-to-albumin ratio (CAR) is a marker of inflammation that has been found to be more informative in assessing inflammation conditions in cardiovascular patients than the C-reactive protein (CRP) or albumin (ALB) levels only. Since inflammation has been identified as a factor causing contrast-induced nephropathy (CIN), this research seeks to establish the correlation between the CAR and the risk of CIN. Materials and Methods: This systematic review and meta-analysis was conducted according to the PRISMA protocol. The Cochrane, PubMed, ProQuest, and Web of Science databases, as well as the Google Scholar search engine, were searched with no time limit up to August 8, 2024. Data were analyzed using STATA 14 software at a significance level of P < 0.05 for all tests. Results: The findings of five reviewed studies with a total number of 1,442 participants showed a statistically significant positive correlation between CAR (OR: 2.11, 95% CI: 1.41, 3.14) and CRP (OR: 1.11, 95% CI: 1.02, 1.20), with an increase in the risk of CIN. However, no statistically significant associations were found between the patient age (OR: 1.02, 95% CI: 0.96, 1.09), albumin level (OR: 0.64, 95% CI: 0.14, 2.90), hypertension (OR: 2.12, 95% CI: 0.86, 5.21), and diabetes mellitus (OR: 0.80, 95% CI: 0.28, 2.29) variables and the risk of CIN. Conclusion: Elevated CAR and CRP are CIN risk factors that can be evaluated to provide a good prognosis of this condition. Nevertheless, albumin levels were not significantly related to the development of CIN. Registration: This study has been compiled based on the PRISMA checklist, and its protocol was registered on the PROSPERO (ID: CRD42024580053) and Research Registry (UIN: reviewregistry1874) websites.
Introduction: T Kidney stone is a common urological disease, and high values of cardiometabolic index (CMI) are primarily linked with metabolic disorders, including obesity, insulin resistance and metabolic syndrome, which are associated with the formation of kidney stones (nephrolithiasis). Accordingly, our study aimed to investigate the relationship between high CMI values and the risk of kidney stones. Materials and Methods: Databases such as Web of Science, Cochrane, Scopus, PubMed, Embase, and Google Scholar Search Engine were conducted for articles published until August 27, 2025. Data were analyzed using STATA 14. Tests with P values<0.05 were considered statistically significant. Results: Results revealed that high CMI levels increased the risk of kidney stones (OR=1.39, 95% CI: 1.31, 1.47). As high CMI values in the second one-third (OR=1.38, 95% CI: 1.25, 1.52), third one-third (OR=1.35, 95% CI: 1.22, 1.49), second quartile (OR=1.31, 95% CI: 1.11, 1.56), third quartile (OR=1.45, 95% CI: 1.23, 1.71), and fourth quartile (OR=1.57, 95% CI: 1.33, 1.85) increased the risk of kidney stones. Additionally, high CMI levels increased the risk of kidney stones in men (OR=1.28, 95% CI: 1.16, 1.42), women (OR=1.28, 95% CI: 1.18, 1.39), patients with BMIs 25-30 (OR=1.21, 95% CI: 1.08, 1.35), patients with BMIs ≥ 30 (OR=1.25, 95% CI: 1.12, 1.39), patients younger than 60 (OR=1.24, 95% CI: 1.13, 1.37), patients older than 60 (OR=1.36, 95% CI: 1.26, 1.48), and diabetic individuals (OR=1.52, 95% CI: 1.36, 1.70). Conclusion: High CMI levels increased the risk of kidney stone formation by 39%. The risk was similar in men and women; however, the risk of kidney stones increased with the patients’ age. Furthermore, obese individuals were at a higher risk compared with those who were overweight. Registration: This study has been compiled in accordance with the PRISMA checklist, and its protocol was registered on the PROSPERO (ID: CRD420251141496) and Research Registry (UIN: reviewregistry2044) websites.
