In natural disasters like earthquakes, building collapses can trap individuals, causing crush syndrome and rhabdomyolysis. This life-threatening condition often leads to acute kidney injury. We aimed to determine the effectiveness of the McMahon score in predicting mortality due to rhabdomyolysis in patients affected by the earthquake. This is a retrospective observational study. In this study, the clinical and laboratory data of patients who presented to the emergency department due to the earthquake were analyzed. The McMahon score was calculated by evaluating factors such as creatine kinase, serum creatinine levels, age, and gender. The study included 151 patients, of whom 74 (49.0%) were male and 77 (51.0%) were female. In the univariate model, significant (P < .05) effectiveness was observed in differentiating between patients with and without mortality for McMahon score and the risk of acute kidney injury. At a McMahon score cutoff of 6, significant effectiveness was also observed, with an area under the curve of 0.723. At this cutoff value, the sensitivity was 80.0% and the specificity was 64.5%. The use of the McMahon score in emergency medicine and disaster management plays a crucial role in rapid decision-making processes due to its effectiveness in predicting mortality. What is already known on this topic Rhabdomyolysis, often associated with crush syndrome and acute renal failure, leads to elevated serum creatinine levels due to muscle breakdown, frequently seen in trauma and earthquake victims. What this study adds The McMahon score helps predict mortality and acute kidney injury in rhabdomyolysis patients, particularly after earthquakes, by evaluating key clinical and demographic factors. How this study might affect research, practice, or policy This study highlights the McMahon score’s reliability in predicting mortality in rhabdomyolysis patients, potentially guiding future research on early intervention strategies and trauma management, informing clinical practices for rapid assessment and treatment.

Introduction: Monocyte to high-density lipoprotein (HDL) cholesterol ratio (MHR) has emerged as a novel marker of endothelial injury, inflammation, and oxidative stress. This study aimed to investigate the effect of MHR on primary nephrotic syndrome (NS) and its relationship with the severity of proteinuria. Methods: This study enrolled 161 patients newly diagnosed with primary NS and 100 healthy individuals. Demographic characteristics of the patients, primary NS diagnosis, basal laboratory parameters, the amount of 24-hour urinary protein excretion, and MHR were recorded. The groups were compared regarding these parameters. Results: MHR was significantly higher in patients with primary NS compared with the healthy group (12.89 ± 4.86 and 9.71 ± 2.30, respectively; p < 0.001). There was no difference between the groups in terms of age and sex. The amount of protein in the 24-hour urine in patients with a diagnosis of primary NS was 6.91 ± 3.73 g/day. The correlation analysis showed a positive correlation between MHR and the amount of proteinuria (r = 0.519, p < 0.001) and creatinine level (r = 0.167, p = 0.034). The multivariate regression analysis found that the severity of proteinuria was independently correlated to MHR (p < 0.001). According to the receiver operating characteristic curve analysis, the optimal cut-off level for MHR in NS was 10.08 (area under the curve of 0.704, sensitivity of 68%, and a specificity of 62%). Conclusion: Our study is the first to compare the severity of proteinuria and renal functions with MHR in patients with primary NS. We believe that MHR can be used as a biomarker to determine inflammation, endothelial injury, and the level of oxidative stress, and may be useful to predict prognosis in patients with primary NS.

Peritoneal dialysis (PD) is an effective and widely used renal replacement therapy that can be applied long-term in individuals with end-stage chronic kidney disease (CKD) [1]. Compared with in-cen...

Background: Recipient minus donor body mass index (BMI) difference is an anthropometric exposure whose anatomical validity is unproven. We evaluated its association with 1-year graft function after living-donor kidney transplantation. Methods: This retrospective cohort included all 249 adult living-donor kidney transplant recipients at one center during 2013–2024. Adjusted linear regression assessed 1-year estimated glomerular filtration rate (eGFR) among recipients alive with functioning grafts. The sensitivity, 6-month, longitudinal, ranked-composite, and clinical-event analyses were exploratory, without adjustment for multiple comparisons. Results: All 14 recipients without 1-year eGFR had experienced graft loss or death, leaving 235 for the primary analysis. The adjusted estimate was −0.55 mL/min/1.73 m² per kg/m² BMI difference (95% confidence interval [CI] −1.06 to −0.05; p = 0.033), equivalent to −2.77 (95% CI −5.31 to −0.23) per 5 kg/m². Alternative BMI parameterizations showed similar fit. Exploratory eGFR estimates varied by visit and model specification. The unadjusted graft-loss/death hazard ratio was 0.88 per 5 kg/m² (95% CI 0.55–1.42; 14 events). The full-cohort ranked-composite interval included zero. Conclusions: The adjusted eGFR association describes survivors with functioning grafts; complementary exploratory analyses do not change this conditional interpretation. Residual confounding remains possible. BMI difference does not quantify anatomical size mismatch, and these findings do not establish causality or donor-selection thresholds.