Publications by authors named "Shang Jyh Hwang"

The malnutrition-inflammation score (MIS) is a practical and accessible tool for evaluating protein energy wasting (PEW) in patients on dialysis. However, the severity of PEW at each stage of chronic kidney disease (CKD), especially with late dialysis initiation, is unclear. We evaluated the MIS of 3659 patients with CKD stages 1-5 and the changes in their MIS results at baseline and at the time before dialysis initiation.

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  • - Omicron, a variant of SARS-CoV-2, was first detected in Taiwan at the end of 2021, leading the government to end its strict "zero-COVID" policy in March 2022, after which COVID-19 outbreaks began.
  • - Researchers conducted a study using nasopharyngeal swabs and medical records from Kaohsiung Medical University Hospital to track Omicron subvariant replacements and identify factors affecting hospitalization risk.
  • - Findings indicated that older age, comorbidities, and male sex heightened the risk of hospitalization and mortality, while COVID-19-related cases and deaths generally decreased over time from August 2022 to October 2023.
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  • The study investigates the link between dietary patterns, glycemic control, and the risk of diabetic retinopathy (DR) in type 2 diabetes patients, focusing on how poor glucose management and oxidative stress may worsen vision loss.* -
  • It involved 136 diabetic patients with retinopathy and 466 without, analyzing their hemoglobin A1c (HbA1c) and dietary habits, finding that high HbA1c levels significantly increase the risk of DR, particularly in those with diets high in animal protein and low in vegetables.* -
  • Results suggest that poor glycemic control combined with specific dietary patterns elevates the risk of DR, highlighting the need for more extensive research to confirm these findings.*
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Traumatic brain injury (TBI) patients are recommended to receive anti-seizure medication (ASM) as posttraumatic seizure (PTS) prophylaxis. However, the utilization of ASM, including the prescription patterns and associated clinical characteristics, is limited in Taiwan. Thus, this study aimed to investigate the ASM trends and clinical characteristics.

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Context: Type 2 diabetes (T2D) is the major contributor to chronic kidney disease and end-stage kidney disease (ESKD). The influence of trimethylamine N-oxide (TMAO) on kidney outcomes in T2D remains unclear.

Objective: To examine the association between fasting serum TMAO levels and adverse kidney outcomes in patients with T2D.

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Indole-3-acetic acid (IAA), a protein-bound uremic toxin resulting from gut microbiota-driven tryptophan metabolism, increases in hemodialysis (HD) patients. IAA may induce endothelial dysfunction, inflammation, and oxidative stress, elevating cardiovascular and cognitive risk in HD patients. However, research on the microbiome-IAA association is limited.

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  • The World Health Organization has issued interim guidance for eliminating hepatitis C virus (HCV), and a study was conducted to demonstrate "treatment as prevention" in hemodialysis patients.
  • A universal screening in 22 hemodialysis centers revealed a significant number of patients with HCV, and the majority linked to treatment achieved a sustained virological response.
  • The follow-up screening showed a dramatic decrease in HCV viremia rates and demonstrated that effectively treating patients can prevent new infections and reinfections within the hemodialysis population.
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Chronic kidney diseases (CKD) is an important public health issue worldwide, and diabetes mellitus is the main cause of CKD. Having sufficient disease knowledge and good self-care behavior both help to prevent the progression of diabetes mellitus and CKD. This cross-sectional study enrolled 181 type 2 diabetic patients with CKD from July 2017 to October 2017.

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Article Synopsis
  • The Omicron variant of SARS-CoV-2, noticed first in October 2021, had many mutations and led to a significant COVID-19 outbreak in Taiwan between January and September 2022, primarily driven by the BA.2.3.7 subvariant.
  • This subvariant, detected in March 2022, showed increased severity and was correlated with higher risks for older patients and those with comorbidities during the outbreak.
  • Despite the outbreaks, Taiwan’s case fatality rate (CFR) dropped to 0.16% during this period, lower than the global average, thanks to improved public health measures, vaccination drives, and effective antiviral treatments.
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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.

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Background: Current healthcare trends emphasize the use of shared decision-making (SDM) for renal replacement treatment (RRT) in patients with chronic kidney disease (CKD). This is crucial to understand the relationship between SDM and illness perception of CKD patients. Few studies have focused on SDM and illness perception status of CKD patients and the impact of illness perception on RRT after SDM.

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  • Chronic Kidney Disease (CKD) affects around 850 million people globally, but current care models may not effectively improve patient outcomes.
  • There are gaps in understanding CKD's causes, prevention strategies, and care resources, highlighting the need for better multidisciplinary approaches rather than relying solely on nephrologists.
  • A proposed novel care structure utilizing modern technologies, such as machine learning and mobile care, aims to enhance CKD management while minimizing human contact and exposure to infections like COVID-19.
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  • * Researchers found that higher urinary melamine levels significantly increased the risk of kidney problems, such as doubling serum creatinine levels and end-stage kidney disease (ESKD).
  • * The adverse effects of melamine exposure were particularly pronounced in male patients with good blood sugar control or normal kidney function at baseline.
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Paraneoplastic nephrotic syndrome (PNS) is a complication seen in cancer patients. Ultrastructural examination shows the accumulation of proteins and the presence of foot process (FP) effacement in the glomeruli of PNS patients. Previously, we reported that orthotopic xenografts of Lewis lung carcinoma 1 in C57BL/6 mice caused them to develop lung cancer with albuminuria.

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In Taiwan, coronavirus disease 2019 (COVID-19) involving the delta variant occurred after that involving the alpha variant in 2021. In this study, we aimed to analyze the Delta variant. A total of 318 patients in Taiwan infected with delta variants were identified.

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Background: Precision is crucial in determining the appropriate procedure for implementing further trials. We conducted a study to explore the reliability of a novel measuring system for human skin color.

Methods: The novel skin color measuring system was used to capture the skin color of four volunteers (2 males and 2 females) from the same location on each subject by the same operator.

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Previous studies about renal protection of sodium-glucose cotransporter 2 inhibitors (SGLT2i) in type 2 diabetes mellitus (T2DM) patients with heart failure (HF) on diuretics were still limited. The goal of the study is to survey the efficacy of SGLT2i to reduce all-cause mortality and renal impairments in patients with T2DM and HF using diuretics. The retrospective cohort study was analyzed from Kaohsiung Medical University Hospital Research Database (KMUHRD) in Taiwan.

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Aims/introduction: Fatty acid desaturase (FADS) genetic polymorphisms are strongly correlated with the risk of dyslipidemia and cardiovascular disease. In this study, we examined the impact of FADS1 and FADS2 genetic variants on plasma lipid status, and assessed interactions between FADS genetic polymorphisms and plasma n-3/n-6 fatty acids regarding lipid status within a population of 816 Taiwanese patients with type 2 diabetes.

Materials And Methods: Selected tag single-nucleotide polymorphisms (FADS1 rs174546 [T/C]; FADS2 rs174602 [A/G] and rs2072114 [A/G]) were genotyped (n = 816).

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Patients with chronic kidney disease (CKD) demonstrate a survival benefit with a high body mass index (BMI); this is the obesity paradox. Central obesity has a higher prognostic value than BMI, even in those with normal weight. Whether total body fat percentage (TBF%) provides more information than BMI and waist circumference (WC) remains unknown.

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Background: Understanding renal function state transition risk and associated factors in community residences is vital for appropriate preventive and care actions. We aim to investigate factors affecting renal function state transitions through 10-year longitudinal community screening surveys.

Methods: The prospective cohort study included participants who attended the screening program ≥2 times from 2001 to 2009 and were divided into two cohorts: those with baseline estimated glomerular filtration rate (eGFR) ≥60 ( = 46,278) and those with eGFR 59-30 mL/min/1.

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A rapid decline in renal function can cause many complications, and therefore it is important to detect associated risk factors. Few studies have evaluated the associations among obesity-related indices and metabolic syndrome (MetS) with renal function decline. This longitudinal study aimed to explore these relationships in a large cohort of Taiwanese participants.

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Uric acid (UA) is elevated in metabolic syndrome (MS) and diabetes (DM). UA is associated with central obesity and blood glucose and is proposed as a criterion of MS. Previous reports showed that UA could predict renal outcome in CKD.

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