Background: Artificial intelligence is rapidly advancing within the domains of medicine and transplantology. In this comprehensive review, we provide an in-depth exploration of current AI methodologies, with a particular emphasis on machine learning and deep learning techniques, and their diverse subtypes. These technologies are revolutionizing how data are processed, analyzed, and applied in clinical decision making. Methods: A meticulous literature review was conducted with a focus on the application of artificial intelligence in kidney transplantation. Four research questions were formulated to establish the aim of the review. Results: We thoroughly examined the general applications of AI in the medical field, such as feature selection, dimensionality reduction, and clustering, which serve as foundational tools for complex data analysis. This includes the development of predictive models for transplant rejection, the optimization of personalized immunosuppressive therapies, the algorithmic matching of donors and recipients based on multidimensional criteria, and the sophisticated analysis of histopathological images to improve the diagnostic accuracy. Moreover, we present a detailed comparison of existing AI-based algorithms designed to predict kidney graft survival in transplant recipients. In this context, we focus on the variables incorporated into these predictive models, providing a critical analysis of their relative importance and contribution to model performance. Conclusions: This review highlights the significant advancements made possible through AI and underscores its potential to enhance both clinical outcomes and the precision of medical interventions in the field of transplantology.

Background: Normal-anion-gap metabolic acidosis (AGMA) and high-anion-gap metabolic acidosis (HAGMA) are two forms of metabolic acidosis, which is a common complication in patients with chronic kidney disease (CKD). The aim of this study is to identify the prevalence of various acid–base disorders in patients with advanced CKD using point-of-care testing (POCT) and to determine the relationship between POCT parameters. Methods: In a group of 116 patients with CKD in stages G4 and G5, with a mean age of 62.5 ± 17 years, a sample of arterial blood was taken during the arteriovenous fistula procedure for POCT, which enables an assessment of the most important parameters of acid–base balance, including: pH, base excess (BE), bicarbonate (HCO₃⁻), chloride(Cl⁻), anion gap (AG), creatinine and urea concentration. Based on this test, patients were categorized according to the type of acidosis-base disorder. Results: Decompensate acidosis with a pH < 7.35 was found in 68 (59%) patients. Metabolic acidosis (MA), defined as the concentration of HCO₃⁻ ≤ 22 mmol/L, was found in 92 (79%) patients. In this group, significantly lower pH, BE, HCO₃⁻ and Cl⁻ concentrations were found. In group of MA patients, AGMA and HAGMA was observed in 48 (52%) and 44 (48%) of patients, respectively. The mean creatinine was significantly lower in the AGMA group compared to the HAGMA group (4.91 vs. 5.87 mg/dL, p < 0.05). The AG correlated positively with creatinine (r = 0.44, p < 0.01) and urea (r = 0.53, p < 0.01), but there was no correlation between HCO₃⁻ and both creatinine (r = −0.015, p > 0.05) and urea (r = −0.07, p > 0.05). The Cl⁻ concentrations correlated negatively with HCO₃⁻ (r = −0.8, p < 0.01). Conclusions: The most common type of acid–base disturbance in CKD patients in stages 4 and 5 is AGMA, which is observed in patients with better kidney function and is associated with compensatory hyperchloremia. The initiation of renal replacement therapy was significantly earlier for patients diagnosed with HAGMA compared to those diagnosed with AGMA. The more advanced the CKD, the higher the AG.

Background: The number of senior chronic kidney disease (CKD) patients is steadily increasing worldwide. Falls are more frequent in this group than in the general population, and they are associated with a variety of complications ranging from minor (bruises) to severe (fracture, brain injury, or death). The significant burden of comorbidities, particularly cardiovascular disorders, impacts coordination. The aim of the study was to assess coordination disorders in CKD patients in the context of cardiovascular complications and vascular status. Methods: In this prospective study, 132 patients with CKD 2–5, including 40 (30%) hemodialysis patients, were enrolled. The short form physiological profile assessment (S-PPA) was used to assess coordination. Results: During a 2-year follow-up period, 49 individuals experienced 84 falls. The median S-PPA score (Z score) was 3.36. Based on this, we divided our cohort into two groups: a Z score of <3.36 and a Z score of ≥3.36. The groups with high scores (≥3.36) characterized by higher parameters of vessel stiffness, including AIx@75, augmentation pressure, and PWV, experienced considerably greater numbers of falls (41 vs. 8, p < 0.001), CV events (10 vs. 2, p < 0.05), and deaths (14 vs. 0, p < 0.001). Conclusions: Coordination impairments and the associated risk of falls in CKD patients are directly related to cardiovascular diseases and vascular conditions. Lower arterial compliance has been linked with the largest coordination disorder. Visual impairments, especially contrast sensitivity, are an independent risk factor for falls.

Background: The distal ulnar-basilic arteriovenous fistula (UBAVF) is a rarely used alternative type of vascular access for haemodialysis. The location of the vein on the back aspect of the forearm forces an extremely uncomfortable external rotation of the upper limb during surgery when the patient is in a supine position. Methods: We present a new approach towards creating UBAVF, which involves placing the patient in the prone position, thus eliminating the aforementioned inconvenience. The procedure was performed and described in a 46-year-old patient with chronic kidney disease (CKD) due to diabetic nephropathy. In the period from September 2021 to December 2021, we created an additional three UBAVFs with such modifications. Results: All fistulas were patent both immediately after the procedure and 2 weeks after surgery. Conclusions: The prone position may improve the comfort of both the operator and the patient during the procedure. On top of this, it may have a positive impact on the quality of the arteriovenous anastomosis.

(1) Background: Cognitive impairment (CI) is more prevalent in hemodialysis (HD) patients than in the general population. The purpose of this study was to examine if behavioral, clinical, and vascular variables are linked with CI in individuals with HD. (2) Methods: Initially, 47 individuals with chronic HD volunteered to participate in the trial, but only 27 patients ultimately completed the Montreal Cognitive Assessment (MoCA) and the Computerized Cognitive Assessment Tool (CompBased-CAT). We collected information on smoking, mental activities, physical activity (Rapid Assessment of Physical Activity, RAPA), and comorbidity. The oxygen saturation (rSO2) and pulse wave velocity (PWV; IEM Mobil-O-Graph) of the frontal lobes were measured. (3) Results: Significant associations were discovered between MoCA and rSO2 (r = 0.44, p = 0.02 and r = 0.62, p = 0.001, right/left, respectively), PWV (r = −0.69, p = 0.0001), CCI (r = 0.59, p = 0.001), and RAPA (r = 0.72, p = 0.0001). Those who actively occupied their time during dialysis and non-smokers achieved higher cognitive exam results. A multivariate regression study demonstrated that physical activity (RAPA) and PWV had separate effects on cognitive performance. (4) Conclusions: Cognitive skills are related to inter-dialysis healthy habits (physical activity, smoking) and intra-dialysis activities (tasks and mind games). Arterial stiffness, oxygenation of the frontal lobes, and CCI were linked with CI.

Motor disorders are increasingly recognized as a significant complication of chronic kidney disease (CKD), yet they remain underdiagnosed, undertreated, and often overlooked in clinical practice. Patients with CKD experience a broad spectrum of motor disturbances, including restless legs syndrome, myoclonus, flapping tremor, periodic limb movements in sleep, Parkinsonism, and peripheral neuropathy. These disorders arise from complex and often overlapping mechanisms such as uremic neurotoxicity, vascular injury, electrolyte and hormonal imbalances, or inflammatory processes, reflecting the systemic impact of impaired renal function on the central and peripheral nervous systems. The presence of motor disorders in CKD is associated with substantial clinical consequences for quality of life, contributing to impaired mobility, persistent insomnia, daytime fatigue, higher fall risk, and diminished independence. Moreover, these disturbances have been linked to increased cardiovascular morbidity and mortality, further exacerbating the already high burden of disease in this population. Current management approaches focus on optimizing kidney function through dialysis or transplantation, pharmacological therapies such as dopaminergic agents, gabapentinoids, and iron supplementation, as well as non-pharmacological interventions including structured exercise programs and sleep hygiene measures. Despite these strategies, robust evidence on long-term outcomes, comparative effectiveness, and optimal treatment algorithms remains limited. Greater recognition of the clinical impact of motor disorders in CKD, combined with targeted research efforts, is urgently needed to improve patient-centered outcomes and guide evidence-based care.