Background: Encapsulating peritoneal sclerosis (EPS) can result in abdominal organ encasement, and bowel obstruction, and is associated with a high mortality rate. While various risk factors have been identified for the development of EPS, the factors influencing patient outcomes in EPS are less well-studied. This study aims to investigate the prognostic factors that affect the clinical course and survival of EPS patients.
View Article and Find Full Text PDFJ Chin Med Assoc
August 2025
Chronic kidney disease (CKD) management requires a comprehensive and multidisciplinary approach to optimize clinical outcomes. This review systematically outlines essential components of CKD care from A to Z, offering evidence-based guidance to enhance patient management. Anemia treatment emphasizes iron supplementation, erythropoiesis-stimulating agents, and novel hypoxia-inducible factor prolyl hydroxylase inhibitors.
View Article and Find Full Text PDFLeft ventricular dysfunction is a known risk factor for morbidity and mortality in hemodialysis patients. The prognostic value of left ventricular global longitudinal strain (LV GLS) among those with preserved left ventricular ejection fraction (LVEF) remains uncertain. Subjects with end-stage renal disease initiated hemodialysis at Taipei Veteran General Hospital between 2015 and 2018 were registered.
View Article and Find Full Text PDFBackgroundDespite the exceptional quality of peritoneal dialysis (PD) care in Taiwan and the country's globally high PD patient survival rates, PD utilization has declined. This trend is likely due to limited patient awareness and disparities in financial incentives between hemodialysis (HD) and PD. To address this issue, a new initiative has been launched to rebalance these incentives and promote PD adoption, with the goal of reversing the declining trend.
View Article and Find Full Text PDFThe management of kidney failure has advanced considerably, with peritoneal dialysis (PD) established as a reliable treatment option that uses the peritoneal membrane to remove excess fluid and toxins. PD has shown particular benefits in the initial stages of treatment, potentially leading to better outcomes compared to hemodialysis. Successful PD, however, depends heavily on the correct placement of the PD catheter.
View Article and Find Full Text PDFJ Appl Stat
November 2024
This paper proposes a mixture regression model for competing risks data, where the logistic regression model is specified for the marginal probabilities of the failure types and the mean residual lifetime (MRL) model is assumed for the failure time given the failure of interest. The estimating equations (EEs) are derived to infer the logistic regression and MRL model separately. We further consider the situation where the covariates are subject to measurement error.
View Article and Find Full Text PDFJ Formos Med Assoc
May 2025
Introduction: While far-infrared (FIR) therapy has improved the treatment of various diseases, its effects on peritoneal dialysis (PD) remain understudied. The study aims to investigate the impact of FIR therapy on the cardiovascular and infectious outcomes in PD patients.
Methods: A prospective observational study was conducted for six months, comparing a group receiving FIR therapy (n = 49) with a control group (n = 50).
J Formos Med Assoc
July 2025
Hypertension is a serious concern among the elderly, posing health risks and treatment challenges. In the first part of this review, we explore the pathophysiological mechanisms linking hypertension and aging, focusing on physiological changes such as arterial stiffening, in autonomic nervous system dysfunction, disruption of the renin-angiotensin-aldosterone system, aging-induced alterations in renal function, and the impact of salt-sensitive hypertension. The mnemonic "King/A+++/Hermès" aids in recalling the pathophysiology of aging-related hypertension.
View Article and Find Full Text PDFClin Kidney J
April 2025
Background: Sacubitril/valsartan improves heart function in maintenance hemodialysis (HD) patients with heart failure with a reduced ejection fraction of <40% (HFrEF). However, the effect of sacubitril/valsartan on vascular access flow (Qa) in this population is still unclear.
Methods: Hemodialysis patients with HFrEF were enrolled and divided into sacubitril/valsartan and non-sacubitril/valsartan treatment groups and received echocardiographic and Qa measurements at baseline and after 12 months.
Introduction: Dry weight management in dialysis patients is crucial but often subjective, primarily based on symptoms. Due to continuous fluid removal in peritoneal dialysis (PD) and intermittent ultrafiltration in hemodialysis (HD), symptom-based assessments may be biased, leading to varying results. Surprisingly, no direct comparison of dry weight changes between PD and HD has been conducted.
View Article and Find Full Text PDFBackground: Chemical modifications on RNA profoundly affect RNA function and regulation. m6A, the most abundant RNA modification in eukaryotes, plays a pivotal role in diverse cellular processes and disease mechanisms. However, its importance is understudied in human CKD samples regarding its influence on pathological mechanisms.
View Article and Find Full Text PDFJ Chin Med Assoc
December 2024
Background: The coronavirus disease 2019 (COVID-19) pandemic has had a profound impacted on various aspects of society, including the healthcare system and patient care. In this context, this study aimed to evaluate the impact of COVID-19 control strategies on the lipid profile and blood sugar levels of peritoneal dialysis (PD) patients in Taiwan, a crucial focus for understanding the pandemic's influence on individuals with chronic kidney disease (CKD).
Methods: A retrospective cohort study was conducted, analyzing data from the medical records of 170 PD patients who visited the nephrology division of Taipei Veterans General Hospital in 2021.
The prevalence of chronic kidney disease (CKD) varies by race because of genetic and environmental factors. The Glu504Lys polymorphism in aldehyde dehydrogenase 2 (ALDH2), commonly observed among East Asian people, alters the enzyme's function in detoxifying alcohol-derived aldehydes, affecting kidney function. This study investigated the association between variations in ALDH2 levels within the kidney and the progression of kidney fibrosis.
View Article and Find Full Text PDFThe quality of life (QoL) and sleep quality are closely linked to the physical and psychological health of end-stage renal disease (ESRD) patients, especially those underwent hemodialysis (HD) therapy. This study aims to investigate the impact of 830 nm laser treatment on improving QoL and sleep quality in HD patients. Forty ESRD patients participated in this study.
View Article and Find Full Text PDFNephrol Dial Transplant
November 2024
Background: Arterial medial calcification (AMC) is a common complication in individuals with chronic kidney disease (CKD), which can lead to cardiovascular morbidity and mortality. The progression of AMC is controlled by a key transcription factor called runt-related transcription factor 2 (RUNX2), which induces vascular smooth muscle cells (VSMCs) transdifferentiation into an osteogenic phenotype. However, RUNX2 has not been targeted for therapy due to its essential role in bone development.
View Article and Find Full Text PDFBackground: Fetuin-A is implicated in the pathogenesis of vascular calcification in chronic kidney disease (CKD); however, the relationship between fetuin-A, histopathologic lesions and long-term kidney outcomes in patients with various types of kidney disease remains unclear.
Methods: We measured urinary fetuin-A levels in 335 individuals undergoing clinically indicated native kidney biopsy. The expressions of mRNA and protein in the kidney were assessed using RNA sequencing and immunohistochemistry.
Background: Diabetes mellitus is a significant risk factor for cardiovascular events and mortality in dialysis patients. The impact of different dialysis modalities on the risk of new onset diabetes mellitus (NODM) remains a subject of debate. Previous studies did not adequately account for critical confounding factors such as pre-dialysis glycemic status, medication use, and nutritional status, which may influence the association between dialysis modality and NODM risk.
View Article and Find Full Text PDFBackground: Identification of reliable biomarkers to assess kidney fibrosis severity is necessary for patients with CKD. Activin A, a member of the TGF- β superfamily, has been suggested as a biomarker for kidney fibrosis. However, its precise utility in this regard remains to be established.
View Article and Find Full Text PDFAims: Patients with high-flow arteriovenous (AV) access are at risk of developing high-output cardiac failure (HOCF) and subsequent hospitalization. However, diagnosing HOCF is challenging and often requires invasive procedures. The role of systemic vascular resistance (SVR) in diagnosing HOCF is underestimated, and its predictive value is limited.
View Article and Find Full Text PDFJ Microbiol Immunol Infect
December 2023
Background: Hemodialysis (HD) patients are particularly vulnerable to severe coronavirus disease 2019 (COVID-19) due to their immunocompromised state and comorbid conditions. Timely vaccination could be the most effective strategy to reduce morbidity and mortality. However, data on the survival benefit of the COVID-19 vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and death among HD patients are limited, especially during the Omicron-dominant period.
View Article and Find Full Text PDFFront Med (Lausanne)
September 2023
Background: Hemostatic abnormality has contributed to vascular access thrombosis in patients with chronic kidney disease (CKD). Previous studies have demonstrated that far-infrared radiation (FIR) therapy can maintain the patency and maturity of arteriovenous fistulas of patients undergoing hemodialysis (HD). However, prolonged access bleeding is observed once FIR is conducted at the end of dialysis.
View Article and Find Full Text PDFNephrology (Carlton)
December 2023
Aim: This cross-sectional survey aimed to determine the prevalence of Interventional Nephrology (IN) practice amongst nephrologists in the Asia-Pacific Region (APR), specifically related to dialysis access (DA).
Methods: The Association of VA and intervenTionAl Renal physicians (AVATAR) Foundation from India conducted a multinational online survey amongst nephrologists from the Asia-Pacific to determine the practice of IN in the planning, creation, and management of dialysis access. The treatment modalities, manpower and equipment availability, monthly cost of treatment, specifics of dialysis access interventions, and challenges in the training and practice of IN by nephrologists were included in the survey.
Aims: A subset of IgA nephropathy (IgAN) patients exhibiting minimal change disease (MCD) like features present with nephrotic-range proteinuria and warrants immunosuppressive therapy (IST). However, the diagnosis of MCD-like IgAN varied by reports. We aimed to identify the key pathological features of MCD-like IgAN.
View Article and Find Full Text PDFIntroduction: Peritoneal dialysis (PD) is a well-established treatment choice for end-stage kidney disease (ESKD). While there are several methods for PD catheter insertion, they each have limitations. In this study, we present a new hybrid method for PD catheter insertion and compare it to the conventional laparoscopic method.
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