{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T16:39:31Z","timestamp":1786639171295,"version":"build-2736575974"},"reference-count":58,"publisher":"S. Karger AG","license":[{"start":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:00:00Z","timestamp":1782950400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:00:00Z","timestamp":1782950400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nephron"],"abstract":"<jats:p>Objective: High-altitude hypoxia impairs frontal executive functions. This study examines whether serum creatinine (CR) mediates the relationship between altitude acclimatization (AAI) peripheral oxygen saturation (SpO&lt;sub&gt;2&lt;\/sub&gt;)\/hematocrit (HCT) ratio and frontal neural oscillations. Methods: In 190 adults at 3,650 m (Lhasa), we measured SpO&lt;sub&gt;2&lt;\/sub&gt;, hematocrit, CR, and resting-state frontal electroencephalography. Power spectral density was calculated across multiple frequency bands (1\u201380 Hz) and Z-standardized. Mediation analysis with bootstrap tested the indirect effect of AAI on each band via CR. Results: AAI significantly negatively predicted CR (p &lt; 0.001). CR significantly negatively predicted frontal Z-PSD in theta (4\u20137 Hz), alpha (8\u201313 Hz), and beta (14\u201330 Hz) bands (all p &lt; 0.01), but not in other bands. The indirect effect via CR was significant for theta (p = 0.011, partial mediation), alpha (p = 0.031, full mediation), and beta (p = 0.020, full mediation). Conclusion: The kidney-brain axis mediates hypoxic neurocognitive adaptation with frequency-specific patterns. CR dynamics reflect acclimatization efficacy, suggesting a target for preserving frontal executive function at high altitude.<\/jats:p>","DOI":"10.1159\/000552915","type":"journal-article","created":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T16:21:42Z","timestamp":1783009302000},"page":"1-10","source":"Crossref","is-referenced-by-count":0,"title":["The Impact of High-Altitude Acclimatization on Frontal Lobe Executive Function: The Mediating Effect of 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