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  • Springer Science and Business Media LLC  (26)
  • Kim, Dong Ki  (26)
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  • Springer Science and Business Media LLC  (26)
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  • 1
    Online Resource
    Online Resource
    Red blood cell distribution width as a predictor of mortality among patients regularly visiting the nephrology outpatient clinic
    Springer Science and Business Media LLC ; 2021
    In:  Scientific Reports Vol. 11, No. 1 ( 2021-12-21)
    Details
    In: Scientific Reports, Springer Science and Business Media LLC, Vol. 11, No. 1 ( 2021-12-21)
    Abstract: The association between increased red blood cell distribution width (RDW) and mortality among patients treated on an outpatient basis in the nephrology outpatient clinic is unclear. Therefore, our study aimed to investigate the association between baseline and time-averaged RDW and mortality risk in patients treated in our nephrology outpatient clinic. Our multi-center retrospective analysis was based on data of 16,417 outpatient nephrology patients with available baseline renal function and RWD values. The median baseline RDW was 13.0% (range, 10.0–32.1%). The high-RDW group was defined as the top quartile (≥ 13.8%, n  = 4302). The crude mortality rate was 15.0% ( n  = 1806) at a median follow-up of 127.5 months. From the results of the multivariate Cox proportional hazards regression model adjusted for covariates, including eGFR, hemoglobin, and factors of anemia treatment, patients with a high time-averaged RDW had increased mortality risk (adjusted hazard ratio, 1.505; 95% confidence interval, 1.326–1.708; P   〈  0.001), irrespective of sex, presence of anemia, and chronic kidney disease, except in individuals aged  〈  45 years. Thus, increased baseline and time-averaged RDW were significantly associated with increased mortality in patients aged  〉  45 years treated on an outpatient basis in the nephrology clinic.
    Type of Medium: Online Resource
    ISSN: 2045-2322
    URL: Article
    DOI: 10.1038/s41598-021-03530-2
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2615211-3
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  • 2
    Online Resource
    Online Resource
    Prediction of the Mortality Risk in Peritoneal Dialysis Patients using Machine Learning Models: A Nation-wide Prospective Cohort in Korea
    Springer Science and Business Media LLC ; 2020
    In:  Scientific Reports Vol. 10, No. 1 ( 2020-05-04)
    Details
    In: Scientific Reports, Springer Science and Business Media LLC, Vol. 10, No. 1 ( 2020-05-04)
    Abstract: Herein, we aim to assess mortality risk prediction in peritoneal dialysis patients using machine-learning algorithms for proper prognosis prediction. A total of 1,730 peritoneal dialysis patients in the CRC for ESRD prospective cohort from 2008 to 2014 were enrolled in this study. Classification algorithms were used for prediction of N-year mortality including neural network. The survival hazard ratio was presented by machine-learning algorithms using survival statistics and was compared to conventional algorithms. A survival-tree algorithm presented the most accurate prediction model and outperformed a conventional method such as Cox regression (concordance index 0.769 vs 0.745). Among various survival decision-tree models, the modified Charlson Comorbidity index (mCCI) was selected as the best predictor of mortality. If peritoneal dialysis patients with high mCCI ( 〉 4) were aged ≥70.5 years old, the survival hazard ratio was predicted as 4.61 compared to the overall study population. Among the various algorithm using longitudinal data, the AUC value of logistic regression was augmented at 0.804. In addition, the deep neural network significantly improved performance to 0.841. We propose machine learning-based final model, mCCI and age were interrelated as notable risk factors for mortality in Korean peritoneal dialysis patients.
    Type of Medium: Online Resource
    ISSN: 2045-2322
    URL: Article
    DOI: 10.1038/s41598-020-64184-0
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
    detail.hit.zdb_id: 2615211-3
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  • 3
    Online Resource
    Online Resource
    Urinary adiponectin and albuminuria in non-diabetic hypertensive patients: an analysis of the ESPECIAL trial
    Springer Science and Business Media LLC ; 2015
    In:  BMC Nephrology Vol. 16, No. 1 ( 2015-12)
    Details
    In: BMC Nephrology, Springer Science and Business Media LLC, Vol. 16, No. 1 ( 2015-12)
    Type of Medium: Online Resource
    ISSN: 1471-2369
    URL: Article
    DOI: 10.1186/s12882-015-0124-3
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2015
    detail.hit.zdb_id: 2041348-8
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  • 4
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    The association of moderate renal dysfunction with impaired preference-based health-related quality of life: 3rdKorean national health and nutritional examination survey
    Springer Science and Business Media LLC ; 2012
    In:  BMC Nephrology Vol. 13, No. 1 ( 2012-12)
    Details
    In: BMC Nephrology, Springer Science and Business Media LLC, Vol. 13, No. 1 ( 2012-12)
    Abstract: Only a few large-scale studies have investigated the association between health-related quality of life (HRQOL) and renal function. Moreover, the HRQOL of patients with moderate renal dysfunction is frequently underestimated by healthcare providers. This study assessed the impact of renal function on preference-based HRQOL in Korean adult population. Methods We analyzed data for 5,555 adults from the 3 rd Korean National Health and Nutritional Examination Survey 2005. The EuroQol-5D (EQ-5D) utility score was used to evaluate HRQOL. The study subjects were stratified into three groups based on their estimated glomerular filtration rates (eGFRs): ≥ 90.0, 60.0-89.9 and 30.0-59.9 mL/min/1.73 m 2 . Individuals with advanced renal dysfunction were excluded from the analysis. Results The proportions of participants who reported problems in each of the five EQ-5D dimensions increased significantly with decreasing eGFR. However, a significant decrease in the EQ-5D utility score was observed among participants with an eGFR of 30.0-59.9 mL/min/1.73 m 2 . Participants with an eGFR of 30.0-59.9 mL/min/1.73 m 2 had an almost 1.5-fold higher risk of impaired health utility (the lowest quartile of EQ-5D utility score) compared with those participants with eGFRs ≥ 90.0 mL/min/1.73 m 2 , after adjustment for age, gender, health-related behaviors, socioeconomic and psychological variables, and other comorbidities. Among the five dimensions of the EQ-5D, an eGFR of 30.0-59.9 mL/min/1.73 m 2 was an independent determinant of self-reported problems in the mobility and pain/discomfort dimensions. Conclusions Although age affects the association between renal dysfunction and the EQ-5D, moderate renal dysfunction seems to be an important determinant of impaired health utility in a general population and may affect the mobility and pain/discomfort dimensions of health utility.
    Type of Medium: Online Resource
    ISSN: 1471-2369
    URL: Article
    DOI: 10.1186/1471-2369-13-19
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2012
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  • 5
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    Online Resource
    The impact of sunlight exposure on mortality of patients with end stage renal disease
    Springer Science and Business Media LLC ; 2019
    In:  Scientific Reports Vol. 9, No. 1 ( 2019-02-18)
    Details
    In: Scientific Reports, Springer Science and Business Media LLC, Vol. 9, No. 1 ( 2019-02-18)
    Abstract: Recent data suggest that reduced sunlight exposure is associated with increased mortality in the general population. To date, the association between sunlight exposure and mortality in dialysis patients has not been examined. Among 134,478 dialysis patients in the Korean end-stage renal disease (ESRD) cohort from 2001 to 2014, 31,291 patients were enrolled from seven metropolitan cities, and data were analyzed using bi-directional case-crossover design. We examined the association between short-term sunlight exposure and mortality in ESRD patients. We adjusted for temperature, humidity, and daily concentrations of nitrogen dioxide (NO 2 ), sulfur dioxide (SO 2 ), ozone (O 3 ), carbon monoxide (CO), and particle matter (PM 10 ) as confounders. The characteristics of the study population included age (65.6 ± 12.26 (mean ± standard deviation [SD]) years), sex (male, 59.96%; female, 41.04%), comorbidity (diabetes, 53.58%; hypertension, 40.5%), and kidney dialysis type (hemodialysis, 73.02%; peritoneal dialysis, 26.98%). The mean ± SD follow-up time was 4.68 ± 4.37 years. The daily sunlight exposure was significantly decreased in the case group compared with the control group (P = 0.004). Sunlight exposure was associated with all-cause death overall (ORs [95% CI] : 0.99 [0.98–0.99], P = 0.042) in a fully adjusted model. Patients with diabetes (ORs [95% CI] : 0.98 [0.97–0.99], P = 0.016) or aged higher than 75 years (ORs [95% CI] ; 0.97 [0.96–0.99], P = 0.020) had higher risks of mortality than patients without diabetes or aged below 75 years, respectively. These findings suggest that sunlight exposure is inversely correlated with all-cause mortality in dialysis patients.
    Type of Medium: Online Resource
    ISSN: 2045-2322
    URL: Article
    DOI: 10.1038/s41598-019-38522-w
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2019
    detail.hit.zdb_id: 2615211-3
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  • 6
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    Mendelian randomization uncovers a protective effect of interleukin-1 receptor antagonist on kidney function
    Springer Science and Business Media LLC ; 2023
    In:  Communications Biology Vol. 6, No. 1 ( 2023-07-14)
    Details
    In: Communications Biology, Springer Science and Business Media LLC, Vol. 6, No. 1 ( 2023-07-14)
    Abstract: Interleukins (ILs), key cytokine family of inflammatory response, are closely associated with kidney function. However, the causal effect of various ILs on kidney function needs further investigation. Here we show two-sample summary-level Mendelian randomization (MR) analysis that examined the causality between serum IL levels and kidney function. Genetic variants with strong association with serum IL levels were obtained from a previous genome-wide association study meta-analysis. Summary-level data for estimated glomerular filtration rate (eGFR) were obtained from CKDGen database. As a main MR analysis, multiplicative random-effects inverse-variance weighted method was performed. Pleiotropy-robust MR analysis, including MR-Egger with bootstrapped error and weighted median methods, were also implemented. We tested the causal estimates from nine ILs on eGFR traits. Among the results, higher genetically predicted serum IL-1 receptor antagonist level was significantly associated with higher eGFR values in the meta-analysis of CKDGen and the UK Biobank data. In addition, the result was consistent towards eGFR decline phenotype of the outcome database. Otherwise, nonsignificant association was identified between other genetically predicted ILs and eGFR outcome. These findings support the clinical importance of IL-1 receptor antagonist-associated pathway in relation to kidney function in the general individuals, particularly highlighting the importance of IL-1 receptor antagonist.
    Type of Medium: Online Resource
    ISSN: 2399-3642
    URL: Article
    DOI: 10.1038/s42003-023-05091-8
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2919698-X
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  • 7
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    Long-term ozone exposure and mortality in patients with chronic kidney disease: a large cohort study
    Springer Science and Business Media LLC ; 2024
    In:  BMC Nephrology Vol. 25, No. 1 ( 2024-02-28)
    Details
    In: BMC Nephrology, Springer Science and Business Media LLC, Vol. 25, No. 1 ( 2024-02-28)
    Abstract: Epidemiologic studies on the effects of long-term exposure to ozone (O 3 ) have shown inconclusive results. It is unclear whether to O 3 has an effect on chronic kidney disease (CKD). We investigated the effects of O 3 on mortality and renal outcome in CKD. Methods We included 61,073 participants and applied Cox proportional hazards models to examine the effects of ozone on the risk of end-stage renal disease (ESRD) and mortality in a two-pollutants model adjusted for socioeconomic status. We calculated the concentration of ozone exposure one year before enrollment and used inverse distance weighting (IDW) for interpolation, where the exposure was evenly distributed. Results In the single pollutant model, O 3 was significantly associated with an increased risk of ESRD and all-cause mortality. Based on the O 3 concentration from IDW interpolation, this moving O 3 average was significantly associated with an increased risk of ESRD and all-cause mortality. In a two-pollutants model, even after we adjusted for other measured pollutants, nitrogen dioxide did not attenuate the result for O 3 . The hazard ratio (HR) value for the district-level assessment is 1.025 with a 95% confidence interval (CI) of 1.014–1.035, while for the point-level assessment, the HR value is 1.04 with a 95% CI of 1.035–1.045. The impact of ozone on ESRD, hazard ratio (HR) values are, 1.049(95%CI: 1.044–1.054) at the district unit and 1.04 (95%CI: 1.031–1.05) at the individual address of the exposure assessment. The ozone hazard ratio for all-cause mortality was 1.012 (95% confidence interval: 1.008–1.017) for administrative districts and 1.04 (95% confidence interval: 1.031–1.05) for individual addresses. Conclusions This study suggests that long-term ambient O 3 increases the risk of ESRD and mortality in CKD. The strategy to decrease O 3 emissions will substantially benefit health and the environment.
    Type of Medium: Online Resource
    ISSN: 1471-2369
    URL: Article
    DOI: 10.1186/s12882-024-03500-6
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2024
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  • 8
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    Nonlinear causal effects of estimated glomerular filtration rate on myocardial infarction risks: Mendelian randomization study
    Springer Science and Business Media LLC ; 2022
    In:  BMC Medicine Vol. 20, No. 1 ( 2022-12)
    Details
    In: BMC Medicine, Springer Science and Business Media LLC, Vol. 20, No. 1 ( 2022-12)
    Abstract: Previous observational studies suggested that a reduction in estimated glomerular filtration rate (eGFR) or a supranormal eGFR value was associated with adverse cardiovascular risks. However, a previous Mendelian randomization (MR) study under the linearity assumption reported null causal effects from eGFR on myocardial infarction (MI) risks. Further investigation of the nonlinear causal effect of kidney function assessed by eGFR on the risk of MI by nonlinear MR analysis is warranted. Methods In this MR study, genetic instruments for log-eGFR based on serum creatinine were developed from European samples included in the CKDGen genome-wide association study (GWAS) meta-analysis ( N =567,460). Alternate instruments for log-eGFR based on cystatin C were developed from a GWAS of European individuals that included the CKDGen and UK Biobank data ( N =460,826). Nonlinear MR analysis for the risk of MI was performed using the fractional polynomial method and the piecewise linear method on data from individuals of white British ancestry in the UK Biobank ( N =321,024, with 12,205 MI cases). Results Nonlinear MR analysis demonstrated a U-shaped (quadratic P value 〈  0.001) association between MI risk and genetically predicted eGFR (creatinine) values, as MI risk increased as eGFR declined in the low eGFR range and the risk increased as eGFR increased in the high eGFR range. The results were similar even after adjustment for clinical covariates, such as blood pressure, diabetes mellitus, dyslipidemia, or urine microalbumin levels, or when genetically predicted eGFR (cystatin C) was included as the exposure. Conclusion Genetically predicted eGFR is significantly associated with the risk of MI with a parabolic shape, suggesting that kidney function impairment, either by reduced or supranormal eGFR, may be causally linked to a higher MI risk.
    Type of Medium: Online Resource
    ISSN: 1741-7015
    URL: Article
    DOI: 10.1186/s12916-022-02251-1
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2131669-7
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  • 9
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    An independent validation of the kidney failure risk equation in an Asian population
    Springer Science and Business Media LLC ; 2020
    In:  Scientific Reports Vol. 10, No. 1 ( 2020-07-31)
    Details
    In: Scientific Reports, Springer Science and Business Media LLC, Vol. 10, No. 1 ( 2020-07-31)
    Abstract: Predicting the risk of end-stage renal disease (ESRD) progression facilitates appropriate nephrology care of patients with chronic kidney disease (CKD). Previously, the kidney failure risk equations (KFREs) were developed and validated in several cohorts. The purpose of this study is to validate the KFREs in a Korean population and to recalibrate the equations. A total of 38,905 adult patients, including 13,244 patients with CKD stages G3–G5, who were referred to nephrology were recruited. Using the original KFREs (4-, 6- and 8-variable equations) and recalibration equations, we predicted the risk of 2- and 5-year ESRD progression. All analyses were conducted in CKD stages G3-G5 patients as well as the total population. In CKD stages G3–G5 patients, All the original 4-, 6- and 8-variable equations showed excellent areas under the receiver operating characteristic curve of 0.87 and 0.83 for the 2- and 5-year risk of ESRD, respectively. The results of net reclassification improvement, integrated discrimination index and Brier score showed that recalibration improved the prediction models in some cases. The original KFREs showed high discrimination in both CKD stages G3–G5 patients and the total population referred to nephrology in this large Korean cohort. KFREs can be implemented in Korean health systems and can guide nephrology referrals and other CKD-related treatment decisions.
    Type of Medium: Online Resource
    ISSN: 2045-2322
    URL: Article
    DOI: 10.1038/s41598-020-69715-3
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
    detail.hit.zdb_id: 2615211-3
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  • 10
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    Safety and efficacy of PG102P for the control of pruritus in patients undergoing hemodialysis (SNUG trial): study protocol for a randomized controlled trial
    Springer Science and Business Media LLC ; 2019
    In:  Trials Vol. 20, No. 1 ( 2019-12)
    Details
    In: Trials, Springer Science and Business Media LLC, Vol. 20, No. 1 ( 2019-12)
    Abstract: Pruritus in patients undergoing hemodialysis is a highly prevalent complication that affects quality of life. Several medications are currently used for the treatment of uremic pruritus, but these are not satisfactory. PG102P, which is prepared from Actinidia arguta , has an immune-modulating effect on pruritus. This trial is designed to assess the antipruritic effect of PG102P compared with placebo. Methods This multicenter, randomized, double-blind, placebo-controlled clinical trial will include 80 patients undergoing hemodialysis. The patients will be randomized in a 1:1 ratio to a treatment group (PG102P 1.5 g/day) or a control group (placebo). The treatment will last for 8 weeks, followed by a 2-week observational period. During the observational period, all of the patients will maintain the antipruritic treatment previously used. The primary endpoint will be measured as the difference in visual analog scale between the groups before and after treatment. Secondary outcomes include serum levels of total immunoglobulin E, eosinophil cationic protein, potassium, calcium, phosphorus, intact parathyroid hormone, and blood eosinophil count between weeks 0 and 8. Kidney Disease and Quality of Life and Beck’s Depression Inventory questionnaires will be conducted. Safety assessments and any adverse events that occur will also be evaluated. Discussion The SNUG is a clinical study that aims to investigate the antipruritic effect of PG102P to ameliorate itching in patients undergoing hemodialysis. Trial registration Clinical Trials.gov, NCT03576235 . Registered on 4 July 2018.
    Type of Medium: Online Resource
    ISSN: 1745-6215
    URL: Article
    DOI: 10.1186/s13063-019-3753-1
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2019
    detail.hit.zdb_id: 2040523-6
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