cometadata/datacite-titles-descriptions-related-identifiers huggingface dataset:
DOI: 10.6084/m9.figshare.27965171.v1
title: Risk factors for mortality in patients with sepsis on extracorporeal membrane oxygenation and/or continuous renal replacement therapy: a retrospective cohort study based on MIMIC-IV database

description: This study aimed to identify risk factors for mortality in septic patients undergoing extracorporeal membrane oxygenation (ECMO) and/or continuous renal replacement therapy (CRRT). Data from the MIMIC-IV database were retrospectively reviewed for 24,502 septic patients treated with ECMO or CRRT between 2008 and 2019. After applying inclusion and exclusion criteria, 70 patients receiving ECMO, 513 receiving CRRT, and 22 receiving both were included in the final analysis. Univariate and multivariate stepwise Cox regression analyses were performed to identify independent risk factors for mortality. Model performance was assessed using receiver operating characteristic (ROC) curve analysis. We also provided model-agnostic explanations for each Cox regression model. For septic patients on ECMO, prothrombin time (per 1-s increase, HR 1.037, 95% CI 1.007–1.068, <i>p</i> = .015) was the key independent risk factor. For septic patients undergoing CRRT, SOFA score (per one-point increase, HR 1.100, 95% CI 1.055–1.147, <i>p</i> &lt; .001) was the most significant factor. For septic patients requiring both ECMO and CRRT, prior history of hypertension (HR 4.342, 95% CI 1.332–14.153, <i>p</i> = .015) was the sole independent risk factor. ROC analysis showed satisfactory model performance (AUC &gt; 0.75). For septic patients requiring ECMO, prothrombin time was the key independent risk factor. For those needing CRRT, SOFA score was the most significant independent risk factor. Prior history of hypertension was the primary independent risk factor for septic patients needing both CRRT and ECMO.
DOI: 10.6084/m9.figshare.27188617
title: Significance of pyroptosis-related genes in the diagnosis and classification of diabetic kidney disease

description: This study aimed to identify the potential biomarkers associated with pyroptosis in diabetic kidney disease (DKD). Three datasets from the Gene Expression Omnibus (GEO) were downloaded and merged into an integrated dataset. Differentially expressed genes (DEGs) were filtered and intersected with pyroptosis-related genes (PRGs). Pyroptosis-related DEGs (PRDEGs) were obtained and analyzed using functional enrichment analysis. Random forest, Least Absolute Shrinkage and Selection Operator, and logistic regression analyses were used to select the features of PRDEGs. These feature genes were used to build a diagnostic prediction model, identify the subtypes of the disease, and analyze their interactions with transcription factors (TFs)/miRNAs/drugs and small molecules. We conducted a comparative analysis of immune cell infiltration at different risk levels of pyroptosis. qRT-PCR was used to validate the expression of the feature genes. A total of 25 PRDEGs were obtained. These genes were coenriched in biological processes and pathways, such as the regulation of inflammatory responses. Five key genes (<i>CASP1, CITED2, HTRA1, PTGS2, S100A12)</i> were identified and verified using qRT-PCR. The diagnostic model based on key genes has a good diagnostic prediction ability. Five key genes interacted with TFs and miRNAs in 67 and 80 pairs, respectively, and interacted with 113 types of drugs or molecules. Immune infiltration of samples with different pyroptosis risk levels showed significant differences. Thus, <i>CASP1, CITED2, HTRA1, PTGS2</i> and <i>S100A12</i> are potential DKD biomarkers. Genes that regulate pyroptosis can be used as predictors of DKD. Early diagnosis of DKD can aid in its effective treatment.
DOI: 10.6084/m9.figshare.27188617.v1
title: Significance of pyroptosis-related genes in the diagnosis and classification of diabetic kidney disease

description: This study aimed to identify the potential biomarkers associated with pyroptosis in diabetic kidney disease (DKD). Three datasets from the Gene Expression Omnibus (GEO) were downloaded and merged into an integrated dataset. Differentially expressed genes (DEGs) were filtered and intersected with pyroptosis-related genes (PRGs). Pyroptosis-related DEGs (PRDEGs) were obtained and analyzed using functional enrichment analysis. Random forest, Least Absolute Shrinkage and Selection Operator, and logistic regression analyses were used to select the features of PRDEGs. These feature genes were used to build a diagnostic prediction model, identify the subtypes of the disease, and analyze their interactions with transcription factors (TFs)/miRNAs/drugs and small molecules. We conducted a comparative analysis of immune cell infiltration at different risk levels of pyroptosis. qRT-PCR was used to validate the expression of the feature genes. A total of 25 PRDEGs were obtained. These genes were coenriched in biological processes and pathways, such as the regulation of inflammatory responses. Five key genes (<i>CASP1, CITED2, HTRA1, PTGS2, S100A12)</i> were identified and verified using qRT-PCR. The diagnostic model based on key genes has a good diagnostic prediction ability. Five key genes interacted with TFs and miRNAs in 67 and 80 pairs, respectively, and interacted with 113 types of drugs or molecules. Immune infiltration of samples with different pyroptosis risk levels showed significant differences. Thus, <i>CASP1, CITED2, HTRA1, PTGS2</i> and <i>S100A12</i> are potential DKD biomarkers. Genes that regulate pyroptosis can be used as predictors of DKD. Early diagnosis of DKD can aid in its effective treatment.
DOI: 10.6084/m9.figshare.27241174
title: Association between dietary fiber intake and chronic kidney disease in adults with and without hypertension in the United States: a cross-sectional study of NHANES 2009–2020

description: While previous research has highlighted the potential advantages of increasing dietary fiber intake (DFI) for managing hypertension and chronic kidney disease (CKD), there is a gap in large-scale empirical studies examining the relationship between DFI and CKD among hypertensive and nonhypertensive cohorts independently. This study involved 22,871 participants sourced from the NHANES database spanning 2009 to 2020, who were divided into hypertensive (<i>n</i> = 9,861) and nonhypertensive (<i>n</i> = 13,010) groups. The analysis revealed a significant inverse correlation between DFI and CKD prevalence across the sample after adjusting for various covariates (OR = 0.98, 95% CI: 0.97–0.99, <i>p</i> = 0.001). Within the subset of hypertensive individuals, this inverse association mirrors the findings of the overall sample, indicating that a higher DFI was associated with a reduced occurrence of CKD (OR = 0.97, 95% CI: 0.96–0.99, <i>p</i> &lt; 0.001). However, this correlation was not detected in the nonhypertensive group (OR = 0.99, 95% CI: 0.98–1.01, <i>p</i> = 0.285). The RCS analysis further confirmed a pronounced nonlinear inverse relationship between DFI and CKD prevalence in both the entire cohort and the hypertensive group but not in the nonhypertensive group. Further scrutiny of the hypertensive group revealed that individuals with a higher DFI had 33% lower odds of CKD progression for the moderate risk level and 36% lower odds for the high to very high risk level. Subgroup analyses confirmed the consistency of these relationships across various demographics. In summary, this investigation revealed a significant inverse relationship between DFI and CKD prevalence in US adults with hypertension, a relationship not observed in nonhypertensive individuals.
DOI: 10.6084/m9.figshare.27241174.v1
title: Association between dietary fiber intake and chronic kidney disease in adults with and without hypertension in the United States: a cross-sectional study of NHANES 2009–2020

description: While previous research has highlighted the potential advantages of increasing dietary fiber intake (DFI) for managing hypertension and chronic kidney disease (CKD), there is a gap in large-scale empirical studies examining the relationship between DFI and CKD among hypertensive and nonhypertensive cohorts independently. This study involved 22,871 participants sourced from the NHANES database spanning 2009 to 2020, who were divided into hypertensive (<i>n</i> = 9,861) and nonhypertensive (<i>n</i> = 13,010) groups. The analysis revealed a significant inverse correlation between DFI and CKD prevalence across the sample after adjusting for various covariates (OR = 0.98, 95% CI: 0.97–0.99, <i>p</i> = 0.001). Within the subset of hypertensive individuals, this inverse association mirrors the findings of the overall sample, indicating that a higher DFI was associated with a reduced occurrence of CKD (OR = 0.97, 95% CI: 0.96–0.99, <i>p</i> &lt; 0.001). However, this correlation was not detected in the nonhypertensive group (OR = 0.99, 95% CI: 0.98–1.01, <i>p</i> = 0.285). The RCS analysis further confirmed a pronounced nonlinear inverse relationship between DFI and CKD prevalence in both the entire cohort and the hypertensive group but not in the nonhypertensive group. Further scrutiny of the hypertensive group revealed that individuals with a higher DFI had 33% lower odds of CKD progression for the moderate risk level and 36% lower odds for the high to very high risk level. Subgroup analyses confirmed the consistency of these relationships across various demographics. In summary, this investigation revealed a significant inverse relationship between DFI and CKD prevalence in US adults with hypertension, a relationship not observed in nonhypertensive individuals.
DOI: 10.6084/m9.figshare.27188612
title: Roxadustat has risks of reversible central hypothyroidism in patients undergoing hemodialysis: a single-center retrospective cohort study

description: Roxadustat, a hypoxia-inducible factor-prolyl hydroxylase inhibitor, has proven efficacy in the treatment of renal anemia; however, evidence indicates that it may cause central hypothyroidism. The prevalence and reversibility of roxadustat-induced central hypothyroidism in patients undergoing hemodialysis remain unclear. Here, we retrospectively analyzed thyroid-stimulating hormone (TSH), free thyroxine (FT4), and free triiodothyronine (FT3) levels in 51 patients (mean age: 72.3 ± 10.7 years; 58.8% male) undergoing hemodialysis before, during, and after halting roxadustat treatment. TSH levels were significantly decreased from a median of 2.46 (interquartile range:1.60–4.51) mU/L before roxadustat treatment to 1.36 (0.72–2.41) mU/L during treatment (<i>p</i> &lt; 0.001), and improved to 2.56 (1.78–4.63) mU/L after halting roxadustat (<i>p</i> &lt; 0.001). Similarly, FT4 levels decreased from 1.11 (0.97–1.24) ng/dL before roxadustat treatment to 0.92 (0.71–1.03) ng/dL during treatment (<i>p</i> &lt; 0.001) and improved to 1.05 (0.93–1.17) ng/dL after halting roxadustat (<i>p</i> &lt; 0.001). FT3 levels were 2.04 (1.78–2.31) pg/mL before starting roxadustat, 1.97 (1.69–2.27) pg/mL during treatment, and 1.90 (1.63–2.18) pg/mL after halting roxadustat, with no significant difference between each group. Moreover, 2.0% of patients exhibited extremely low TSH levels (≤0.1 mU/L) and low TSH levels (&gt;0.1 mU/L to &lt;0.4 mU/L) before starting roxadustat and that percentage increased to 5.9% and 7.8%, respectively, during treatment. After roxadustat cessation, extremely low or low TSH levels recovered in all patients. Taken together, the results indicate that roxadustat can cause reversible central hypothyroidism in patients undergoing hemodialysis.
DOI: 10.6084/m9.figshare.27188612.v1
title: Roxadustat has risks of reversible central hypothyroidism in patients undergoing hemodialysis: a single-center retrospective cohort study

description: Roxadustat, a hypoxia-inducible factor-prolyl hydroxylase inhibitor, has proven efficacy in the treatment of renal anemia; however, evidence indicates that it may cause central hypothyroidism. The prevalence and reversibility of roxadustat-induced central hypothyroidism in patients undergoing hemodialysis remain unclear. Here, we retrospectively analyzed thyroid-stimulating hormone (TSH), free thyroxine (FT4), and free triiodothyronine (FT3) levels in 51 patients (mean age: 72.3 ± 10.7 years; 58.8% male) undergoing hemodialysis before, during, and after halting roxadustat treatment. TSH levels were significantly decreased from a median of 2.46 (interquartile range:1.60–4.51) mU/L before roxadustat treatment to 1.36 (0.72–2.41) mU/L during treatment (<i>p</i> &lt; 0.001), and improved to 2.56 (1.78–4.63) mU/L after halting roxadustat (<i>p</i> &lt; 0.001). Similarly, FT4 levels decreased from 1.11 (0.97–1.24) ng/dL before roxadustat treatment to 0.92 (0.71–1.03) ng/dL during treatment (<i>p</i> &lt; 0.001) and improved to 1.05 (0.93–1.17) ng/dL after halting roxadustat (<i>p</i> &lt; 0.001). FT3 levels were 2.04 (1.78–2.31) pg/mL before starting roxadustat, 1.97 (1.69–2.27) pg/mL during treatment, and 1.90 (1.63–2.18) pg/mL after halting roxadustat, with no significant difference between each group. Moreover, 2.0% of patients exhibited extremely low TSH levels (≤0.1 mU/L) and low TSH levels (&gt;0.1 mU/L to &lt;0.4 mU/L) before starting roxadustat and that percentage increased to 5.9% and 7.8%, respectively, during treatment. After roxadustat cessation, extremely low or low TSH levels recovered in all patients. Taken together, the results indicate that roxadustat can cause reversible central hypothyroidism in patients undergoing hemodialysis.
DOI: 10.6084/m9.figshare.27617463
title: Histone deacetylase 9 promotes osteogenic trans-differentiation of vascular smooth muscle cells via ferroptosis in chronic kidney disease vascular calcification

description: Vascular calcification, a common complication of chronic kidney disease (CKD), remains an unmet therapeutic challenge. The trans-differentiation of vascular smooth muscle cells (VSMCs) into osteoblast-like cells is crucial in the pathogenesis of vascular calcification in CKD. Despite ferroptosis promotes vascular calcification in CKD, the upstream or downstream regulatory mechanisms involved remains unclear. In this study, we aimed to investigate the regulatory mechanism involved in ferroptosis in CKD vascular calcification. Transcriptome sequencing revealed a potential relationship between HDAC9 and ferroptosis in CKD vascular calcification. Subsequently, we observed increased expression of HDAC9 in calcified arteries of patients undergoing hemodialysis and in a rat model of CKD. We further demonstrated that knockout of HDAC9 attenuates osteogenic trans-differentiation and ferroptosis in VSMCs stimulated by high calcium and phosphorus. In addition, RSL3 exacerbated ferroptosis and osteogenic trans-differentiation of VSMCs exposed to high levels of calcium and phosphorus, and these effects were suppressed to some extent by HDAC9 knockout. In summary, our findings suggest that HDAC9 promotes VSMCs osteogenic trans-differentiation involving ferroptosis, providing new insights for the therapy of CKD vascular calcification.
DOI: 10.6084/m9.figshare.27617463.v1
title: Histone deacetylase 9 promotes osteogenic trans-differentiation of vascular smooth muscle cells via ferroptosis in chronic kidney disease vascular calcification

description: Vascular calcification, a common complication of chronic kidney disease (CKD), remains an unmet therapeutic challenge. The trans-differentiation of vascular smooth muscle cells (VSMCs) into osteoblast-like cells is crucial in the pathogenesis of vascular calcification in CKD. Despite ferroptosis promotes vascular calcification in CKD, the upstream or downstream regulatory mechanisms involved remains unclear. In this study, we aimed to investigate the regulatory mechanism involved in ferroptosis in CKD vascular calcification. Transcriptome sequencing revealed a potential relationship between HDAC9 and ferroptosis in CKD vascular calcification. Subsequently, we observed increased expression of HDAC9 in calcified arteries of patients undergoing hemodialysis and in a rat model of CKD. We further demonstrated that knockout of HDAC9 attenuates osteogenic trans-differentiation and ferroptosis in VSMCs stimulated by high calcium and phosphorus. In addition, RSL3 exacerbated ferroptosis and osteogenic trans-differentiation of VSMCs exposed to high levels of calcium and phosphorus, and these effects were suppressed to some extent by HDAC9 knockout. In summary, our findings suggest that HDAC9 promotes VSMCs osteogenic trans-differentiation involving ferroptosis, providing new insights for the therapy of CKD vascular calcification.
DOI: 10.6084/m9.figshare.27088799
title: SACrA score to predict the initiation of renal replacement therapy in critically ill patients: a single-center retrospective study

description: Acute kidney injury (AKI) is a prevalent complication in critically ill patients that affects the timing of renal replacement therapy (RRT) initiation. This study aimed to develop and validate the SACrA score for predicting non-emergent initiations (BUN ≥112 mg/dL or oliguria for &gt;72 h) of RRT in critically ill patients. We conducted a retrospective cohort study using data from two cohorts. The derivation cohort included patients admitted to the ICU between November 2021 and December 2023, whereas the validation cohort included patients admitted between September 2019 and October 2021. The primary outcome was non-emergent RRT initiation. The multivariate logistic regression with stepwise selection based on the Akaike information criterion finalized the model, including the variables, such as sex, albumin (Alb), creatinine (Cr), and APACHE II score (SACrA). The derivation and validation cohorts comprised 470 and 476 patients, respectively. The SACrA score showed a strong predictive performance for non-emergent RRT initiation in both the cohorts. Cohort 1 had an ROC–AUC of 0.971, with a calibration slope of 0.982 and an intercept of 0.009, whereas cohort 2 had an ROC–AUC of 0.918, with a calibration slope of 0.988 and an intercept of 0.004. The SACrA score is a robust tool for predicting non-emergent RRT initiation in critically ill patients using readily available clinical variables. Though additional data are needed to validate the SACrA score, our analysis suggests the tool may help clinicians make informed decisions, reduce unnecessary RRT, and thereby improve patient outcomes.
DOI: 10.6084/m9.figshare.27088799.v1
title: SACrA score to predict the initiation of renal replacement therapy in critically ill patients: a single-center retrospective study

description: Acute kidney injury (AKI) is a prevalent complication in critically ill patients that affects the timing of renal replacement therapy (RRT) initiation. This study aimed to develop and validate the SACrA score for predicting non-emergent initiations (BUN ≥112 mg/dL or oliguria for &gt;72 h) of RRT in critically ill patients. We conducted a retrospective cohort study using data from two cohorts. The derivation cohort included patients admitted to the ICU between November 2021 and December 2023, whereas the validation cohort included patients admitted between September 2019 and October 2021. The primary outcome was non-emergent RRT initiation. The multivariate logistic regression with stepwise selection based on the Akaike information criterion finalized the model, including the variables, such as sex, albumin (Alb), creatinine (Cr), and APACHE II score (SACrA). The derivation and validation cohorts comprised 470 and 476 patients, respectively. The SACrA score showed a strong predictive performance for non-emergent RRT initiation in both the cohorts. Cohort 1 had an ROC–AUC of 0.971, with a calibration slope of 0.982 and an intercept of 0.009, whereas cohort 2 had an ROC–AUC of 0.918, with a calibration slope of 0.988 and an intercept of 0.004. The SACrA score is a robust tool for predicting non-emergent RRT initiation in critically ill patients using readily available clinical variables. Though additional data are needed to validate the SACrA score, our analysis suggests the tool may help clinicians make informed decisions, reduce unnecessary RRT, and thereby improve patient outcomes.
DOI: 10.6084/m9.figshare.26555164
title: Risk factors for unplanned weaning of continuous renal replacement therapy in ICU patients: a meta-analysis

description: To systematically review the risk factors for unplanned weaning during continuous renal replacement therapy in ICU patients. A combination of subject words + free words was used to search the relevant literature published in CNKI, Wanfang, VIP, CBM, PubMed, EMbase, Web of Science, Cochrane Library, Mediline and other databases. The search period was from the establishment of the databases to June 25, 2024. Revman 5.4 software and Stata15.0 software was used to meta-analyze the risk factors for unplanned weaning during continuous renal replacement therapy in ICU patients. A total of 23 studies were included in this meta-analysis, describing 15 variables, 3793 patients, and using 7197 filters. Meta-analysis results showed that risk factors for unplanned weaning during continuous renal replacement therapy in ICU patients were as follows: Low mean arterial pressure [OR = 1.02, 95%CI (1.00, 1.03), <i>p</i> &lt; 0.05], hypothermia [OR = 3.40, 95%CI (1.78, 6.47), <i>p</i> &lt; 0.05], age (≥60 years) [OR = 4.45, 95%CI (3.18, 6.22), <i>p</i> &lt; 0.05], comorbid underlying disease [OR = 3.63, 95%CI (2.70, 4.88), <i>p</i> &lt; 0.05], agitation [OR = 4.97, 95%CI (3.20, 7.74), <i>p</i> &lt; 0.05], no anticoagulant use [OR = 1.65, 95%CI (1.25, 2.17), <i>p</i> &lt; 0.05], short activated partial prothrombin time [OR = 1.23, 95%CI (1.13, 1.34), <i>p</i> &lt; 0.05], hyper-hematocrit [OR = 1.73, 95%CI (1.13, 2.66), <i>p</i> = 0.01], low ionized calcium concentration [OR = 1.48, 95% CI (1.08, 2.02), <i>p</i> = 0.01], CRRT that was treated at a high dose [OR = 1.42, 95%CI (1.14, 1.76), <i>p</i> &lt; 0.05], mechanical ventilation [OR = 4.25, 95%CI (2.67, 6.77), <i>p</i> &lt; 0.05], and lack of dedicated care [OR = 5.08, 95%CI (2.51, 10.28), <i>p</i> &lt; 0.05]. However, it is unclear whether platelet count, prothrombin activity, and blood flow velocity are risk factors for unplanned weaning during CRRT in ICU patients, and more studies are needed for further validation. Available evidence suggests that a variety of factors contribute to unplanned weaning of CRRT in ICU patients. Early detection of these risk factors is essential for healthcare professionals to develop preventive and curative strategies. This study is registered on the PROSERO website under registration number CRD42024543554.