{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T06:51:14Z","timestamp":1792133474819,"version":"4.4.0"},"reference-count":48,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T00:00:00Z","timestamp":1760486400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Graduate School of Life Sciences of the University of Wuerzburg"},{"name":"European Renal Association"},{"DOI":"10.13039\/100006662","name":"NIHR","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006662","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"US National Institutes of Health","doi-asserted-by":"publisher","award":["R01 HL133399"],"award-info":[{"award-number":["R01 HL133399"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"US National Institutes of Health","doi-asserted-by":"publisher","award":["R56 HL133399"],"award-info":[{"award-number":["R56 HL133399"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"US National Institutes of Health","doi-asserted-by":"publisher","award":["K08 HL121801"],"award-info":[{"award-number":["K08 HL121801"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and hypothesis<\/jats:title>\n                    <jats:p>Urea accumulated in CKD patients\u2019 blood can spontaneously decompose into reactive isocyanate and bind to plasma proteins in a reaction called carbamylation. Recent studies suggest a direct link between protein carbamylation and the pathogenesis of cardiovascular events and mortality in dialysis patients. We investigated whether carbamylation of albumin (C-Alb) is associated with increased mortality, major adverse cardiovascular events, and need for dialysis in older patients with advanced CKD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The European Quality Study (EQUAL) is a multicentre prospective cohort study. CKD patients aged 65 or older with advanced CKD (eGFR \u226420 ml\/min\/1.73 m\u00b2) not on kidney replacement therapy were followed up for 5 years. In a subgroup of 1117 patients, C-Alb was measured at baseline using combined liquid chromatography and mass spectrometry. Multivariable analyses were adjusted for important confounders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Mean C-Alb was 13.5\u00a0\u00b1\u00a06.5 mmol\/mol. Men had higher C-Alb values than women, as well as patients with chronic heart failure compared to patients without. C-Alb correlated positively with age, creatinine, urea, and negatively with eGFR, but not with total albumin. Each unit increase of log-transformed C-Alb was associated with increased risk of overall mortality (adj. HR 1.92, 95%CI 1.40\u20132.64) and start of dialysis therapy (adj. HR 1.59, 95%CI 1.21\u20132.09).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In older advanced CKD patients not on dialysis, increased levels of C-Alb were associated with higher mortality and need for dialysis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ckj\/sfaf302","type":"journal-article","created":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T12:15:06Z","timestamp":1760530506000},"source":"Crossref","is-referenced-by-count":4,"title":["Protein carbamylation is associated with increased mortality and CKD progression in patients with CKD: results from the EQUAL study"],"prefix":"10.1093","volume":"18","author":[{"given":"Tilla C","family":"Folttmann","sequence":"first","affiliation":[{"name":"Comprehensive Heart Failure Center, University Hospital of W\u00fcrzburg Department of Clinical Research and Epidemiology, , W\u00fcrzburg 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