{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T14:41:04Z","timestamp":1785508864190,"version":"3.56.0"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2025,7,11]],"date-time":"2025-07-11T00:00:00Z","timestamp":1752192000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004191","name":"Novo Nordisk","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004191","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100014503","name":"JCF","doi-asserted-by":"publisher","award":["INT24\/00051"],"award-info":[{"award-number":["INT24\/00051"]}],"id":[{"id":"10.13039\/100014503","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100014503","name":"JCF","doi-asserted-by":"publisher","award":["ISCIII"],"award-info":[{"award-number":["ISCIII"]}],"id":[{"id":"10.13039\/100014503","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100008530","name":"Fondo Europeo de Desarrollo Regional","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008530","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Subcutaneous semaglutide has shown kidney-protective effects in people with type 2 diabetes (PWT2D), but data on oral semaglutide remain limited. This multicentre real-world study evaluates the clinical effectiveness of oral semaglutide on kidney outcomes in PWT2D.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We included PW2TD \u226518\u00a0years of age who initiated oral semaglutide in routine practice between 2021 and 2022 in the Spanish National Health System, with at least one report of clinical follow-up (FU) data at 3\u00a0months. Co-primary endpoints were changes in urine albumin:creatinine ratio (UACR) and estimated glomerular filtration rate (eGFR) slope at 6\u201312\u00a0months. We also assessed baseline predictors of response, drug persistence and safety by CKD severity.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Data were available for 819 PWT2D (median age 63\u00a0years, eGFR 88.1\u00a0ml\/min\/1.73\u00a0m2, UACR 12\u00a0mg\/g, 45.8% female, median FU 8.96\u00a0months). Oral semaglutide decreased UACR by 30.3% and 40.0% in the overall cohort, by 40.2% and 50.7% in those with a UACR \u226530\u00a0mg\/g and by 40.6% and 49.9% in those with a UACR \u2265300\u00a0mg\/g at 6 and 12\u00a0months of FU, respectively. PWT2D with a low age-adjusted risk of liver fibrosis by the Fibrosis-4 index had increased odds of achieving a &amp;gt;30% reduction in UACR [adjusted odds ratio 5.50 (95% confidence interval 1.6\u201318.7)] regardless of baseline background. Metabolic and weight loss effectiveness, safety and persistence of oral semaglutide were consistent across CKD severities.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In a real-world setting, oral semaglutide treatment for up to 52\u00a0weeks resulted in clinically meaningful reductions in albuminuria without changes in the eGFR slope in PWT2D. Effectiveness, safety and tolerability were not influenced by CKD severity.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ckj\/sfaf227","type":"journal-article","created":{"date-parts":[[2025,7,11]],"date-time":"2025-07-11T13:27:45Z","timestamp":1752240465000},"source":"Crossref","is-referenced-by-count":5,"title":["Effects of oral semaglutide on kidney outcomes in people with type 2 diabetes: a nationwide, multicentre, retrospective, observational study (Renal_ENDO2S-RWD substudy)"],"prefix":"10.1093","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8670-6404","authenticated-orcid":false,"given":"Oscar","family":"Moreno-P\u00e9rez","sequence":"first","affiliation":[{"name":"General University Hospital Dr Balmis of Alicante, Institute of Health and Biomedical Research of Alicante Department of Endocrinology and Nutrition, \u00a0 Alicante ,","place":["Spain"]},{"name":"Miguel Hern\u00e1ndez University Department of Clinical Medicine, , Alicante ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1729-4431","authenticated-orcid":false,"given":"Rebeca","family":"Reyes-Garcia","sequence":"additional","affiliation":[{"name":"Endocrinology Unit , , Almer\u00eda , , , Madrid ,","place":["Spain Spain"]},{"name":"University Hospital of Torrec\u00e1rdenas , , Almer\u00eda , , , Madrid ,","place":["Spain Spain"]},{"name":"CIBER de Fragilidad y Envejecimiento Saludable \u201cCIBERFES\u201d, Instituto de Salud Carlos III , , Almer\u00eda , , , Madrid ,","place":["Spain Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6803-6988","authenticated-orcid":false,"given":"Cristina","family":"Guillen-Morote","sequence":"additional","affiliation":[{"name":"General University Hospital Dr Balmis of Alicante, Institute of Health and Biomedical Research of Alicante Department of Endocrinology and Nutrition, \u00a0 Alicante ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0178-0040","authenticated-orcid":false,"given":"Viyey Kishore","family":"Doulatram-Gamgaram","sequence":"additional","affiliation":[{"name":"Regional University Hospital of Malaga, Biomedical Research Institute of Malaga (IBIMA), Faculty of Medicine, University of Malaga Department of Endocrinology and Nutrition, , Malaga ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-8648-5370","authenticated-orcid":false,"given":"Carlos","family":"Casado Cases","sequence":"additional","affiliation":[{"name":"University Hospital Fundaci\u00f3n Jim\u00e9nez D\u00edaz Department of Endocrinology and Nutrition, , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nieves","family":"Arias Mendoza","sequence":"additional","affiliation":[{"name":"General University Hospital of Elda Department of Endocrinology and Nutrition, , Alicante ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2987-5922","authenticated-orcid":false,"given":"Cristina","family":"Tejera-P\u00e9rez","sequence":"additional","affiliation":[{"name":"University Hospital Complex of Ferrol Department of Endocrinology and Nutrition, , A Coru\u00f1a ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2485-484X","authenticated-orcid":false,"given":"Jersy","family":"C\u00e1rdenas-Salas","sequence":"additional","affiliation":[{"name":"University Hospital Fundaci\u00f3n Jim\u00e9nez D\u00edaz Department of Endocrinology and Nutrition, , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Mart\u00ednez-Fuster","sequence":"additional","affiliation":[{"name":"General University Hospital of Elda Department of Endocrinology and Nutrition, , Alicante ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7520-1489","authenticated-orcid":false,"given":"Beatriz","family":"Lardi\u00e9s-S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Obispo Polanco Hospital Department of Endocrinology and Nutrition, , Teruel ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4914-4131","authenticated-orcid":false,"given":"Rosa","family":"M\u00e1rquez-Pardo","sequence":"additional","affiliation":[{"name":"Hospital Juan Ram\u00f3n Jim\u00e9nez Department of Endocrinology and Nutrition, , Huelva ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4406-3647","authenticated-orcid":false,"given":"Pedro","family":"Pin\u00e9s","sequence":"additional","affiliation":[{"name":"Albacete University Hospital Complex Department of Endocrinology and Nutrition, , Albacete ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7954-5753","authenticated-orcid":false,"given":"Antonio","family":"Tejera-Mu\u00f1oz","sequence":"additional","affiliation":[{"name":"General University Hospital Dr Balmis of Alicante, Institute of Health and Biomedical Research of Alicante Department of Endocrinology and Nutrition, \u00a0 Alicante ,","place":["Spain"]},{"name":"Health Sciente Faculty-HM Hospitals, Camilo Jos\u00e9 Cela University , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2229-8488","authenticated-orcid":false,"given":"Jos\u00e9 Carlos","family":"Fern\u00e1ndez-Garc\u00eda","sequence":"additional","affiliation":[{"name":"Regional University Hospital of Malaga, Biomedical Research Institute of Malaga (IBIMA), Faculty of Medicine, University of Malaga Department of Endocrinology and Nutrition, , Malaga ,","place":["Spain"]},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Diabetes y Enfermedades Metab\u00f3licas Asociadas (CIBERDEM), Instituto de Salud Carlos III , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3060-449X","authenticated-orcid":false,"given":"In\u00e9s","family":"Modrego-Pardo","sequence":"additional","affiliation":[{"name":"Marina Baixa Hospital, Villajoyosa Department of Endocrinology and Nutrition, ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,7,11]]},"reference":[{"key":"2025081221073256200_bib1","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1053\/j.ackd.2017.10.011","article-title":"The Global epidemiology of diabetes and kidney disease","volume":"25","author":"Koye","year":"2018","journal-title":"Adv Chronic Kidney Dis"},{"key":"2025081221073256200_bib2","doi-asserted-by":"publisher","first-page":"sfae039","DOI":"10.1093\/ckj\/sfae039","article-title":"Are we ready for an adipocentric approach in people living with type 2 diabetes and chronic kidney disease?","volume":"17","author":"Moreno-P\u00e9rez","year":"2024","journal-title":"Clin Kidney J"},{"key":"2025081221073256200_bib3","doi-asserted-by":"publisher","first-page":"110563","DOI":"10.1016\/j.diabres.2023.110563","article-title":"Metabolic dysfunction-associated fatty liver disease can significantly increase the risk of chronic kidney disease in adults with type 2 diabetes","volume":"197","author":"Wei","year":"2023","journal-title":"Diabetes Res Clin Pract"},{"key":"2025081221073256200_bib4","doi-asserted-by":"crossref","first-page":"101506","DOI":"10.1016\/j.diabet.2023.101506","article-title":"Steatotic liver disease, MASLD and risk of chronic kidney disease","volume":"50","author":"Bilson","year":"2024","journal-title":"Diabetes Metab"},{"key":"2025081221073256200_bib5","doi-asserted-by":"publisher","first-page":"3248","DOI":"10.3390\/nu15143248","article-title":"Change in liver fibrosis associates with progress of diabetic nephropathy in patients with nonalcoholic fatty liver disease","volume":"15","author":"Terasaka","year":"2023","journal-title":"Nutrients"},{"key":"2025081221073256200_bib6","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1056\/NEJMoa2403347","article-title":"Effects of semaglutide on chronic kidney disease in patients with type 2 diabetes","volume":"391","author":"Perkovic","year":"2024","journal-title":"N Engl J Med"},{"key":"2025081221073256200_bib7","doi-asserted-by":"publisher","first-page":"278","DOI":"10.1038\/s41591-024-03327-6","article-title":"Semaglutide in patients with overweight or obesity and chronic kidney disease without diabetes: a randomized double-blind placebo-controlled clinical trial","volume":"31","author":"Apperloo","year":"2025","journal-title":"Nat Med"},{"key":"2025081221073256200_bib8","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1016\/S2213-8587(19)30192-5","article-title":"Efficacy and safety of oral semaglutide in patients with type 2 diabetes and moderate renal impairment (PIONEER 5): a placebo-controlled, randomised, phase 3a trial","volume":"7","author":"Mosenzon","year":"2019","journal-title":"Lancet Diabetes Endocrinol"},{"key":"2025081221073256200_bib9","doi-asserted-by":"publisher","first-page":"1639","DOI":"10.1161\/CIRCULATIONAHA.125.074545","article-title":"Oral semaglutide and cardiovascular outcomes in persons with type 2 diabetes, according to SGLT2i use: prespecified analyses of the SOUL randomized trial","volume":"151","author":"Marx","year":"2025","journal-title":"Circulation"},{"key":"2025081221073256200_bib10","doi-asserted-by":"publisher","first-page":"2001","DOI":"10.1056\/NEJMoa2501006","article-title":"Oral semaglutide and cardiovascular outcomes in high-risk type 2 diabetes","volume":"392","author":"McGuire","year":"2025","journal-title":"N Engl J Med"},{"key":"2025081221073256200_bib11","doi-asserted-by":"publisher","first-page":"2745","DOI":"10.1038\/s41591-024-03273-3","article-title":"How to make cardiology clinical trials more inclusive","volume":"30","author":"Zannad","year":"2024","journal-title":"Nat Med"},{"key":"2025081221073256200_bib12","doi-asserted-by":"publisher","first-page":"1763","DOI":"10.1007\/s12325-018-0805-y","article-title":"Interpretation and impact of real-world clinical data for the practicing clinician","volume":"35","author":"Blonde","year":"2018","journal-title":"Adv Ther"},{"key":"2025081221073256200_bib13","doi-asserted-by":"publisher","first-page":"5166","DOI":"10.3390\/jcm13175166","article-title":"Efficacy and safety in a real-world study of the new oral formulation of semaglutide in patients with chronic kidney disease and type 2 diabetes mellitus","volume":"13","author":"Marques Vidas","year":"2024","journal-title":"J Clin Med"},{"key":"2025081221073256200_bib14","doi-asserted-by":"publisher","first-page":"107040","DOI":"10.1016\/j.phrs.2023.107040","article-title":"Type 2 diabetes mellitus pharmacological remission with dapagliflozin plus oral semaglutide","volume":"199","author":"Lunati","year":"2024","journal-title":"Pharmacol Res"},{"key":"2025081221073256200_bib15","doi-asserted-by":"crossref","first-page":"1519","DOI":"10.1111\/dom.15431","article-title":"Real-world effectiveness and safety of oral semaglutide in people living with type 2 diabetes: a nationwide multicentre retrospective observational study (ENDO2 S-RWD)","volume":"26","author":"Moreno-P\u00e9rez","year":"2024","journal-title":"Diabetes Obes Metab"},{"key":"2025081221073256200_bib16","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1016\/j.clinthera.2024.11.005","article-title":"Real-world evidence on oral semaglutide for the management of type 2 diabetes. A narrative review for clinical practice","volume":"47","author":"Marassi","year":"2025","journal-title":"Clin Ther"},{"key":"2025081221073256200_bib17","doi-asserted-by":"publisher","first-page":"1317","DOI":"10.1002\/hep.21178","article-title":"Development of a simple noninvasive index to predict significant fibrosis in patients with HIV\/HCV coinfection","volume":"43","author":"Sterling","year":"2006","journal-title":"Hepatology"},{"key":"2025081221073256200_bib18","doi-asserted-by":"publisher","first-page":"2375","DOI":"10.1007\/s00125-024-06196-3","article-title":"EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD): executive summary","volume":"67","author":"European Association for the Study of the Liver, European Association for the Study of Diabetes, European Association for the Study of Obesity","year":"2024","journal-title":"Diabetologia"},{"key":"2025081221073256200_bib19","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1053\/j.ajkd.2019.06.009","article-title":"Change in albuminuria and GFR as end points for clinical trials in early stages of CKD: a scientific workshop sponsored by the National Kidney Foundation in collaboration with the US Food and Drug Administration and European Medicines Agency","volume":"75","author":"Levey","year":"2020","journal-title":"Am J Kidney Dis"},{"issue":"4 Suppl","key":"2025081221073256200_bib20","doi-asserted-by":"publisher","first-page":"S117","DOI":"10.1016\/j.kint.2023.10.018","article-title":"KDIGO 2024 clinical practice guideline for the evaluation and management of chronic kidney disease","volume":"105","author":"Kidney Disease: Improving Global Outcomes CKD Work Group","year":"2024","journal-title":"Kidney Int"},{"key":"2025081221073256200_bib21","doi-asserted-by":"publisher","first-page":"1680","DOI":"10.1056\/NEJMp2200089","article-title":"Real-world evidence\u2014where are we now?","volume":"386","author":"Concato","year":"2022","journal-title":"N Engl J Med"},{"key":"2025081221073256200_bib22","doi-asserted-by":"publisher","first-page":"1412","DOI":"10.1161\/CIRCULATIONAHA.124.069220","article-title":"Well-conducted real-world evidence studies can complement essential evidence from clinical trials","volume":"150","author":"Patorno","year":"2024","journal-title":"Circulation"},{"key":"2025081221073256200_bib23","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1016\/j.annepidem.2020.12.004","article-title":"Urinary albumin-to-creatinine ratio within normal range and all-cause or cardiovascular mortality among U.S. adults enrolled in the NHANES during 1999\u20132015","volume":"55","author":"Inoue","year":"2021","journal-title":"Ann Epidemiol"},{"key":"2025081221073256200_bib24","doi-asserted-by":"publisher","first-page":"e2348333","DOI":"10.1001\/jamanetworkopen.2023.48333","article-title":"Urinary albumin-to-creatinine ratio in normal range, cardiovascular health, and all-cause mortality","volume":"6","author":"Mahemuti","year":"2023","journal-title":"JAMA Netw Open"},{"key":"2025081221073256200_bib25","doi-asserted-by":"publisher","first-page":"2046","DOI":"10.1093\/eurjpc\/zwae189","article-title":"The relationship between low levels of albuminuria and mortality among adults without major cardiovascular risk factors","volume":"31","author":"Claudel","year":"2024","journal-title":"Eur J Prev Cardiol"},{"key":"2025081221073256200_bib26","doi-asserted-by":"publisher","first-page":"2849","DOI":"10.1038\/s41591-024-03133-0","article-title":"Effects of semaglutide with and without concomitant SGLT2 inhibitor use in participants with type 2 diabetes and chronic kidney disease in the FLOW trial","volume":"30","author":"Mann","year":"2024","journal-title":"Nat Med"},{"key":"2025081221073256200_bib27","doi-asserted-by":"publisher","first-page":"565","DOI":"10.1161\/CIRCULATIONAHA.121.057934","article-title":"Efpeglenatide and clinical outcomes with and without concomitant sodium-glucose cotransporter-2 inhibition use in type 2 diabetes: exploratory analysis of the AMPLITUDE-O trial","volume":"145","author":"Lam","year":"2022","journal-title":"Circulation"},{"key":"2025081221073256200_bib28","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1097\/MNH.0000000000000894","article-title":"Mechanisms and clinical applications of incretin therapies for diabetes and chronic kidney disease","volume":"32","author":"Alicic","year":"2023","journal-title":"Curr Opin Nephrol Hypertens"},{"key":"2025081221073256200_bib29","doi-asserted-by":"publisher","first-page":"2089","DOI":"10.1056\/NEJMoa2413258","article-title":"Phase 3 trial of semaglutide in metabolic dysfunction-associated steatohepatitis","volume":"392","author":"Sanyal","year":"2025","journal-title":"N Engl J Med"},{"key":"2025081221073256200_bib30","doi-asserted-by":"crossref","first-page":"2058","DOI":"10.1111\/dom.14443","article-title":"Potential kidney protection with liraglutide and semaglutide: exploratory mediation analysis","volume":"23","author":"Mann","year":"2021","journal-title":"Diabetes Obes Metab"},{"key":"2025081221073256200_bib31","doi-asserted-by":"publisher","first-page":"1501","DOI":"10.2337\/dc23-0261","article-title":"Effects of tirzepatide versus insulin glargine on cystatin C-based kidney function: a SURPASS-4 post hoc analysis","volume":"46","author":"Heerspink","year":"2023","journal-title":"Diabetes Care"},{"issue":"Suppl 1","key":"2025081221073256200_bib32","doi-asserted-by":"publisher","first-page":"S239","DOI":"10.2337\/dc25-S011","article-title":"11. Chronic kidney disease and risk management: standards of care in diabetes-2025","volume":"48","author":"American Diabetes Association Professional Practice Committee","year":"2025","journal-title":"Diabetes Care"},{"key":"2025081221073256200_bib33","doi-asserted-by":"publisher","first-page":"716","DOI":"10.1161\/CIRCULATIONAHA.124.071079","article-title":"Albuminuria in cardiovascular, kidney, and metabolic disorders: a state-of-the-art review","volume":"151","author":"Claudel","year":"2025","journal-title":"Circulation"}],"container-title":["Clinical Kidney Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ckj\/advance-article-pdf\/doi\/10.1093\/ckj\/sfaf227\/63727897\/sfaf227.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ckj\/article-pdf\/18\/8\/sfaf227\/63727897\/sfaf227.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ckj\/article-pdf\/18\/8\/sfaf227\/63727897\/sfaf227.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T01:07:38Z","timestamp":1755047258000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ckj\/article\/doi\/10.1093\/ckj\/sfaf227\/8196614"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,11]]},"references-count":33,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2025,8,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ckj\/sfaf227","relation":{},"ISSN":["2048-8505","2048-8513"],"issn-type":[{"value":"2048-8505","type":"print"},{"value":"2048-8513","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,8]]},"published":{"date-parts":[[2025,7,11]]},"article-number":"sfaf227"}}