Ji Hye Kim

Miran Park, Jun Su Lee, Soon Man Yoon, Ji Hye Kim, Sun Moon Kim. Clin Transplant Res -0001;0:. https://doi.org/10.4285/ctr.25.0100

Protein-energy wasting (PEW) is a strong indicator of adverse outcomes such as all-cause death and cardiovascular events. Although this association has been established in dialysis patients, it has not been clearly demonstrated in those with non-dialysis-dependent chronic kidney disease (NDD-CKD). This study aimed to evaluate the association between PEW and all-cause death or cardiovascular events in patients with NDD-CKD. We investigated the association between PEW and adverse outcomes in patients with NDD-CKD through a prospective cohort study of 1,847 patients (median follow-up: 6.94 years). The definition of PEW followed the International Society of Renal Nutrition and Metabolism criteria: serum albumin <3.8 g/dL, body mass index <23.0 kg/m2, skeletal muscle mass <19.7 kg in women, <26.9 kg in men, and protein intake <0.6 g/kg/day. During follow-up, 129 deaths and 264 composite outcomes (all-cause death or cardiovascular events) occurred. In Cox regression analysis, all-cause death and composite outcomes were significantly increased in patients with two or more PEW parameters. All-cause death was significantly increased in patients with two PEW parameters (hazard ratio [HR], 2.78; 95% confidence interval [CI], 1.61-4.08; p < 0.001) or ≥3 PEW parameters (HR, 3.78; 95% CI, 1.81-7.89; p < 0.001). Composite outcomes were also significantly increased in patients with two PEW parameters (HR, 2.16; 95% CI, 1.51-3.11; p < 0.001) or ≥3 PEW parameters (HR, 2.30; 95% CI, 1.30-4.07; p = 0.004). PEW was a strong indicator of all-cause death and composite outcomes among NDD-CKD patients.

Kim JH, et al. J Korean Med Sci. 2024 Dec;40:e50. https://doi.org/10.3346/jkms.2025.40.e50

Background: Varying peritoneal dialysis (PD)-related clinical outcomes have been reported in different countries. As a participant of the Peritoneal Dialysis Outcomes and Practice Patterns Study (PDOPPS), this study investigated the characteristics of Korean PD patients, PD facilities and the incidence rates of clinical outcomes including mortality and PD-related outcomes. Methods: From July 2019 to December 2021, a total of 766 Korean PD patients were included for analysis. Poisson regression analysis was used to explore the incidence rates of various clinical events including mortality, modality transfer, exit site or catheter tunnel infection and peritonitis. Results: Among the 766 patients (median age 55.5 years, males 59.5%), 276 were incident and 490 were prevalent PD patients. The incidence rates of events were as follows: all-cause mortality (0.048), modality transfer (0.051), exit site or catheter tunnel infection (0.054) and peritonitis (0.136) events per person year. The most common causative organism for exit site or tunnel infection was staphylococcus species (47%) and that for peritonitis was streptococcus (28%) followed by staphylococcus (27%) species. Conclusions: Up to now, PDOPPS Korea has recruited 766 Korean PD patients and started documentation of major PD-related outcomes which occurred during the follow-up period. The overall incidence rates of clinical outcomes in Korean PD patients were relatively favourable. There was no statistically significant difference in the incidence rates of clinical outcomes according to both facility and patient factors.

Background: The 2009 Chronic Kidney Disease Epidemiology Collaboration creatinine-based estimated glomerular filtration rate (eGFRcr) equation contains a race component that is not based on biology and may cause a bias in results. Therefore, the 2021 eGFRcr and creatinine-cystatin C–based eGFR (eGFRcr-cysC) equations were developed with no consideration of race. This study compared the cardiovascular event (CVE) and all-cause mortality and CVE combined predictability among the three eGFR equations in Korean chronic kidney disease (CKD) patients. Methods: This study included 2,207 patients from the KoreaN Cohort Study for Outcome in Patients With Chronic Kidney Disease. Receiver operating characteristic (ROC) and net reclassification improvement (NRI) index were used to compare the predictability of the study outcomes according to the 2009 eGFRcr, 2021 eGFRcr, and 2021 eGFRcr-cysC equations. Results: The overall prevalence of CVE and all-cause mortality were 9% and 7%, respectively. There was no difference in area under the curve of ROC for CVE and mortality and CVE combined among all three equations. Compared to the 2009 eGFRcr, both the 2021 eGFRcr (NRI, 0.013; 95% confidence interval [CI], – 0.002 to 0.028) and the eGFRcr-cysC (NRI, –0.001; 95% CI, –0.031 to 0.029) equations did not show improved CVE predictability. Similar findings were observed for mortality and CVE combined predictability with both the 2021 eGFRcr (NRI, –0.019; 95% CI, –0.039–0.000) and the eGFRcr-cysC (NRI, –0.002; 95% CI, –0.023 to 0.018). Conclusion: The 2009 eGFRcr equation was not inferior to either the 2021 eGFRcr or eGFRcr-cysC equation in predicting CVE and the composite of mortality and CVE in Korean CKD patients.

The health benefits of physical activity (PA) are well known. However, the association between an adequate amount of moderate–vigorous PA (MVPA) and clinical outcomes has limited evidence in chronic kidney disease (CKD). We assessed PA using a self-administered questionnaire. The amount of MVPA was categorized into four groups: none, low, moderate, and high (0, 2. Age and sex modified the relationships between MVPA and clinical outcomes. MVPA is associated with various beneficial outcomes across the amount of MVPA. PA plans should be tailored for individual adults with CKD.

Objective The aim of this study is to compare the gender-different associations between secondhand smoke (SHS) exposure and diabetes in self-reported never smokers verified by cotinine. Methods Self-reported never smokers verified by cotinine levels (= 1 hour/day, >= 3 times/week, and >= 10 years showed an increased risk of diabetes by more than 50% compared to those without SHS exposure. Conclusions SHS exposure was significantly associated with diabetes in female never smokers with dose-dependent relationship. However, further longitudinal studies are needed to elucidate the gender difference in the incidence of diabetes associated with SHS exposure.

Background: No study has reported the association between secondhand smoke (SHS) exposure and metabolic syndrome (MetS) in self-reported never smokers verified by both self-reported questionnaire and urine cotinine.Methods: A total of 118,609 self-reported and cotinine-verified never smokers (38,385 male; age 34.8±7.1 years) who participated in the Kangbuk Samsung Health Study between 2011 and 2016 were included. Cotinine-verified never smokers were defined as individuals with urinary cotinine <50 ng/mL. SHS exposure was defined as current exposure to passive smoking indoors at home or workplace.Results: Prevalence of SHS exposure in the overall population was 22.6% (27.4% for males and 20.3% for females (P<0.001). The overall prevalence of MetS was 6.8% and was higher in males than in females (10.7% vs. 4.9%, P<0.001). In both genders, MetS prevalence was higher in the SHS exposure group than the non-SHS exposure group (11.3% vs. 10.4%, P=0.010 for males; 5.8% vs. 4.6%, P<0.001 for females). However, there was significant gender interaction for the association between SHS exposure and MetS (P for interaction=0.010). In the multivariate regression analyses, SHS exposure was associated with increased MetS odds only in females (odds ratio [95% confidence interval], 1.02 [0.94 to 1.11] in male vs. 1.17 [1.06 to 1.29] in female). In particular, females with SHS exposure of ≥1 hour/day and ≥3 times showed increased odds of MetS compared with those without SHS exposure (1.22 [1.02 to 1.45], 1.30 [1.14 to 1.49]).Conclusion: This cross-sectional study showed that SHS exposure was significantly associated with prevalence of MetS in self-reported and cotinine-verified female never smokers.

Kim JH, et al. Diabetes Metab J. 2019 Jan;43:e56. https://doi.org/10.4093/dmj.2019.0068