{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T05:47:49Z","timestamp":1784958469142,"version":"3.55.0"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T00:00:00Z","timestamp":1763337600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T00:00:00Z","timestamp":1763337600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100006390","name":"University of Lausanne","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100006390","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Nephrol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Chronic Kidney Disease Associated-Pruritus (CKD-aP) is frequent among hemodialysis patients. Its associations with hemodiafiltration or conventional hemodialysis and clinical characteristics are inconsistent in observational studies. This study aimed to assess the prevalence, severity and factors associated with CKD-aP among patients on hemodialysis in the French-speaking part of Switzerland, where hemodiafiltration is widely used.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional design was used. Adults on hemodialysis for \u2265\u20096 months and free of cognitive impairment were recruited from 15 dialysis centers. A research nurse collected sociodemographic, clinical, laboratory data and assessed CKD-aP using the Visual Analogue Scale (VAS) and Verbal Rating Scale (VRS). A multilevel mixed-effects model with maximum likelihood estimation was performed to investigate associations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 413 participants, mean age was 69.68 years (SD 13.52), were included; 66% were men, 73% on hemodiafiltration. CKD-aP prevalence was 25%. VAS average itch score of participants with CKD-aP was 4.74\u2009\u00b1\u20091.99, versus 6.62\u2009\u00b1\u20092.18 for the worst intensity itch. According to VRS, most participants with CKD-aP suffered moderate (61.4%) to severe (22%) itch within the past 24\u00a0h. Higher phosphorus levels were significantly associated with increased CKD-aP severity, but not prevalence. Depression, smoking, and polypharmacy were associated with increased CKD-aP severity, whereas hemodialysis modality, volume substitution, filter or access type were not.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Despite high dialysis standards, CKD-aP remains a frequent symptom in Switzerland. Depression is associated with CKD-aP and its severity while hemodialysis modality is not. These results suggest that effective management of CKD-aP requires not only optimal dialysis prescription but also a holistic approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>Registered at ClinicalTrials.gov (NCT05524467) on 10.06.2022.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12882-025-04570-w","type":"journal-article","created":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T20:35:09Z","timestamp":1763411709000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Prevalence, severity, and determinants of CKD-associated pruritus in a Swiss hemodialysis population with widespread use of hemodiafiltration: a cross-sectional study"],"prefix":"10.1186","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6443-8122","authenticated-orcid":false,"given":"Nancy","family":"Helou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dina","family":"Nobre","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanguy","family":"Corre","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Bonny","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin","family":"Chazot","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Cherpillod","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"De Seigneux","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Fumeaux","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zina","family":"Fumeaux","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoine","family":"Humbert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Jaques","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ould Maouloud","family":"Hemett","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Mehier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grzegorz","family":"Nowak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Phan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne-H\u00e9l\u00e8ne","family":"Reboux","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alain","family":"Rossier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Floriane","family":"Seydtaghia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Teta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00e9rard","family":"Vogel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Menno","family":"Pruijm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,11,17]]},"reference":[{"key":"4570_CR1","doi-asserted-by":"publisher","first-page":"222","DOI":"10.1159\/000504081","volume":"49","author":"S Arzhan","year":"2020","unstructured":"Arzhan S, Roumelioti M-E, Unruh ML. Itch and ache on dialysis: new approaches to manage uremic pruritus and restless legs. Blood Purif. 2020;49:222\u20137. https:\/\/doi.org\/10.1159\/000504081.","journal-title":"Blood Purif"},{"key":"4570_CR2","doi-asserted-by":"publisher","first-page":"3495","DOI":"10.1093\/ndt\/gfl461","volume":"21","author":"RL Pisoni","year":"2006","unstructured":"Pisoni RL, Wikstr\u00f6m B, Elder SJ, Akizawa T, Asano Y, Keen ML, et al. Pruritus in haemodialysis patients: international results from the dialysis outcomes and practice patterns study (DOPPS). Nephrol Dial Transpl. 2006;21:3495\u2013505. https:\/\/doi.org\/10.1093\/ndt\/gfl461","journal-title":"Nephrol Dial Transpl"},{"key":"4570_CR3","doi-asserted-by":"publisher","first-page":"e10633","DOI":"10.1097\/MD.0000000000010633","volume":"97","author":"X Hu","year":"2018","unstructured":"Hu X, Sang Y, Yang M, Chen X, Tang W. Prevalence of chronic kidney disease-associated pruritus among adult dialysis patients. Med (Baltim). 2018;97:e10633. https:\/\/doi.org\/10.1097\/MD.0000000000010633","journal-title":"Med (Baltim)"},{"key":"4570_CR4","doi-asserted-by":"publisher","first-page":"2000","DOI":"10.2215\/CJN.03280317","volume":"12","author":"HC Rayner","year":"2017","unstructured":"Rayner HC, Larkina M, Wang M, Graham-Brown M, van der Veer SN, Ecder T, et al. International comparisons of prevalence, awareness, and treatment of pruritus in people on hemodialysis. Clin J Am Soc Nephrol. 2017;12:2000\u20137. https:\/\/doi.org\/10.2215\/CJN.03280317.","journal-title":"Clin J Am Soc Nephrol"},{"key":"4570_CR5","doi-asserted-by":"publisher","first-page":"2069","DOI":"10.1016\/j.jid.2017.05.020","volume":"137","author":"D Schoch","year":"2017","unstructured":"Schoch D, Sommer R, Augustin M, St\u00e4nder S, Blome C. Patient-reported outcome measures in pruritus: a systematic review of measurement properties. J Invest Dermatol. 2017;137:2069\u201377. https:\/\/doi.org\/10.1016\/j.jid.2017.05.020.","journal-title":"J Invest Dermatol"},{"key":"4570_CR6","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1016\/j.ijnss.2018.09.010","volume":"5","author":"H Li","year":"2018","unstructured":"Li H, Xie L, Yang J, Pang X. Symptom burden amongst patients suffering from end-stage renal disease and receiving dialysis: a literature review. Int J Nurs Sci. 2018;5:427\u201331. https:\/\/doi.org\/10.1016\/j.ijnss.2018.09.010.","journal-title":"Int J Nurs Sci"},{"key":"4570_CR7","doi-asserted-by":"publisher","first-page":"699","DOI":"10.3390\/medicina55100699","volume":"55","author":"IU Rehman","year":"2019","unstructured":"Rehman IU, Chohan TA, Bukhsh A, Khan TM. Impact of pruritus on sleep quality of hemodialysis patients: a systematic review and meta-analysis. Med (Mex). 2019;55:699. https:\/\/doi.org\/10.3390\/medicina55100699.","journal-title":"Med (Mex)"},{"key":"4570_CR8","doi-asserted-by":"publisher","first-page":"WC01","DOI":"10.7860\/JCDR\/2016\/16273.7488","volume":"10","author":"MK Ibrahim","year":"2016","unstructured":"Ibrahim MK, Elshahid AR, El Baz TZ, Elazab RM, Elhoseiny SA, Elsaie ML. Impact of uraemic pruritus on quality of life among end stage renal disease patients on dialysis. J Clin Diagn Res JCDR. 2016;10:WC01\u20135. https:\/\/doi.org\/10.7860\/JCDR\/2016\/16273.7488.","journal-title":"J Clin Diagn Res JCDR"},{"key":"4570_CR9","doi-asserted-by":"publisher","first-page":"484","DOI":"10.1093\/ckj\/sfab218","volume":"15","author":"E Poku","year":"2022","unstructured":"Poku E, Harnan S, Rooney G, James MM-S, Hern\u00e1ndez-Alava M, Schaufler T, et al. The relationship between chronic kidney disease\u2013associated pruritus and health-related quality of life: a systematic review. Clin Kidney J. 2022;15:484\u201399. https:\/\/doi.org\/10.1093\/ckj\/sfab218.","journal-title":"Clin Kidney J"},{"key":"4570_CR10","doi-asserted-by":"publisher","first-page":"691","DOI":"10.1016\/j.jaad.2020.08.035","volume":"84","author":"T Hawro","year":"2021","unstructured":"Hawro T, Przyby\u0142owicz K, Spindler M, Hawro M, Ste\u0107 M, Altrichter S, et al. The characteristics and impact of pruritus in adult dermatology patients: a prospective, cross-sectional study. J Am Acad Dermatol. 2021;84:691\u2013700. https:\/\/doi.org\/10.1016\/j.jaad.2020.08.035.","journal-title":"J Am Acad Dermatol"},{"key":"4570_CR11","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1016\/j.xkme.2020.08.011","volume":"3","author":"N Sukul","year":"2021","unstructured":"Sukul N, Karaboyas A, Csomor PA, Schaufler T, Wen W, Menzaghi F, et al. Self-reported pruritus and clinical, dialysis-related, and patient-reported outcomes in hemodialysis patients. Kidney Med. 2021;3:42\u2013e531. https:\/\/doi.org\/10.1016\/j.xkme.2020.08.011.","journal-title":"Kidney Med"},{"key":"4570_CR12","doi-asserted-by":"publisher","first-page":"1","DOI":"10.2147\/IJNRD.S52985","volume":"7","author":"K Ramakrishnan","year":"2013","unstructured":"Ramakrishnan K, Bond TC, Claxton A, Sood VC, Kootsikas M, Agnese W, et al. Clinical characteristics and outcomes of end-stage renal disease patients with self-reported pruritus symptoms. Int J Nephrol Renov Dis. 2013;7:1\u201312. https:\/\/doi.org\/10.2147\/IJNRD.S52985.","journal-title":"Int J Nephrol Renov Dis"},{"key":"4570_CR13","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1093\/ckj\/sfac187","volume":"16","author":"R Agarwal","year":"2022","unstructured":"Agarwal R, Burton J, Gallieni M, Kalantar-Zadeh K, Mayer G, Pollock C, et al. Alleviating symptoms in patients undergoing long-term hemodialysis: a focus on chronic kidney disease-associated pruritus. Clin Kidney J. 2022;16:30\u201340. https:\/\/doi.org\/10.1093\/ckj\/sfac187.","journal-title":"Clin Kidney J"},{"key":"4570_CR14","doi-asserted-by":"publisher","first-page":"363","DOI":"10.1111\/bjd.14910","volume":"176","author":"S Steinke","year":"2017","unstructured":"Steinke S, Bruland P, Blome C, Osada N, Dugas M, Fritz F, et al. Chronic pruritus: evaluation of patient needs and treatment goals with a special regard to differences according to pruritus classification and sex. Br J Dermatol. 2017;176:363\u201370. https:\/\/doi.org\/10.1111\/bjd.14910.","journal-title":"Br J Dermatol"},{"key":"4570_CR15","doi-asserted-by":"publisher","first-page":"1387","DOI":"10.1016\/j.ekir.2020.04.027","volume":"5","author":"HA Verduzco","year":"2020","unstructured":"Verduzco HA, Shirazian S, CKD-associated pruritus: new insights into diagnosis, pathogenesis, and management. Kidney Int Rep. 2020;5:1387\u2013402. https:\/\/doi.org\/10.1016\/j.ekir.2020.04.027.","journal-title":"Kidney Int Rep"},{"key":"4570_CR16","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1053\/j.ajkd.2016.07.031","volume":"69","author":"JS Scherer","year":"2017","unstructured":"Scherer JS, Combs SA, Brennan F, Sleep disorders, restless legs syndrome, and uremic pruritus: diagnosis and treatment of common symptoms in dialysis patients. Am J Kidney Dis. 2017;69:117\u201328. https:\/\/doi.org\/10.1053\/j.ajkd.2016.07.031.","journal-title":"Am J Kidney Dis"},{"key":"4570_CR17","doi-asserted-by":"publisher","first-page":"S117","DOI":"10.1016\/j.kint.2023.10.018","volume":"105","author":"PE Stevens","year":"2024","unstructured":"Stevens PE, Ahmed SB, Carrero JJ, Foster B, Francis A, Hall RK, et al. KDIGO 2024 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int. 2024;105:S117\u2013314. https:\/\/doi.org\/10.1016\/j.kint.2023.10.018.","journal-title":"Kidney Int"},{"key":"4570_CR18","doi-asserted-by":"publisher","first-page":"1238","DOI":"10.1016\/S0140-6736(16)32064-5","volume":"389","author":"AC Webster","year":"2017","unstructured":"Webster AC, Nagler EV, Morton RL, Masson P. Chronic kidney disease. Lancet. 2017;389:1238\u201352. https:\/\/doi.org\/10.1016\/S0140-6736(16)32064-5.","journal-title":"Lancet"},{"key":"4570_CR19","doi-asserted-by":"publisher","first-page":"1495","DOI":"10.1016\/j.ijsu.2014.07.013","volume":"12","author":"E von Elm","year":"2014","unstructured":"von Elm E, Altman DG, Egger M, Pocock SJ, G\u00f8tzsche PC, Vandenbroucke JP. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. Int J Surg. 2014;12:1495\u20139. https:\/\/doi.org\/10.1016\/j.ijsu.2014.07.013.","journal-title":"Int J Surg"},{"key":"4570_CR20","doi-asserted-by":"publisher","first-page":"502","DOI":"10.2340\/00015555-1246","volume":"92","author":"NQ Phan","year":"2012","unstructured":"Phan NQ, Blome C, Fritz F, Gerss J, Reich A, Ebata T, et al. Assessment of pruritus intensity: prospective study on validity and reliability of the visual analogue scale, numerical rating scale and verbal rating scale in 471 patients with chronic pruritus. Acta Derm Venereol. 2012;92:502\u20137. https:\/\/doi.org\/10.2340\/00015555-1246.","journal-title":"Acta Derm Venereol"},{"key":"4570_CR21","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1016\/S0022-2496(02)00028-7","volume":"47","author":"IJ Myung","year":"2003","unstructured":"Myung IJ. Tutorial on maximum likelihood estimation. J Math Psychol. 2003;47:90\u2013100. https:\/\/doi.org\/10.1016\/S0022-2496(02)00028-7.","journal-title":"J Math Psychol"},{"key":"4570_CR22","doi-asserted-by":"publisher","first-page":"700","DOI":"10.1056\/NEJMoa2304820","volume":"389","author":"PJ Blankestijn","year":"2023","unstructured":"Blankestijn PJ, Vernooij RWM, Hockham C, Strippoli GFM, Canaud B, Hegbrant J, et al. Effect of hemodiafiltration or hemodialysis on mortality in kidney failure. N Engl J Med. 2023;389:700\u20139. https:\/\/doi.org\/10.1056\/NEJMoa2304820.","journal-title":"N Engl J Med"},{"key":"4570_CR23","doi-asserted-by":"publisher","first-page":"961","DOI":"10.1016\/j.kint.2024.07.014","volume":"106","author":"M Rose","year":"2024","unstructured":"Rose M, Fischer FH, Liegl G, Strippoli GFM, Hockham C, Vernooij RWM, et al. The CONVINCE randomized trial found positive effects on quality of life for patients with chronic kidney disease treated with hemodiafiltration. Kidney Int. 2024;106:961\u201371. https:\/\/doi.org\/10.1016\/j.kint.2024.07.014.","journal-title":"Kidney Int"},{"key":"4570_CR24","doi-asserted-by":"publisher","first-page":"816","DOI":"10.2340\/00015555-2087","volume":"95","author":"M Weiss","year":"2015","unstructured":"Weiss M, Mettang T, Tschulena U, Passlick-Deetjen J, Weisshaar E. Prevalence of chronic itch and associated factors in haemodialysis patients: a representative cross-sectional study. Acta Derm Venereol. 2015;95:816\u201321. https:\/\/doi.org\/10.2340\/00015555-2087.","journal-title":"Acta Derm Venereol"},{"key":"4570_CR25","doi-asserted-by":"publisher","first-page":"3097","DOI":"10.1007\/s11136-016-1340-4","volume":"25","author":"M Weiss","year":"2016","unstructured":"Weiss M, Mettang T, Tschulena U, Weisshaar E. Health-related quality of life in haemodialysis patients suffering from chronic itch: results from GEHIS (German epidemiology haemodialysis itch Study). Qual Life Res. 2016;25:3097\u2013106. https:\/\/doi.org\/10.1007\/s11136-016-1340-4.","journal-title":"Qual Life Res"},{"key":"4570_CR26","doi-asserted-by":"publisher","first-page":"657","DOI":"10.1111\/hdi.12158","volume":"18","author":"N Kimata","year":"2014","unstructured":"Kimata N, Fuller DS, Saito A, Akizawa T, Fukuhara S, Pisoni RL, et al. Pruritus in hemodialysis patients: results from the Japanese dialysis outcomes and practice patterns study (JDOPPS). Hemodial Int. 2014;18:657\u201367. https:\/\/doi.org\/10.1111\/hdi.12158.","journal-title":"Hemodial Int"},{"key":"4570_CR27","doi-asserted-by":"publisher","first-page":"685","DOI":"10.1038\/ki.2013.454","volume":"87","author":"T Mettang","year":"2015","unstructured":"Mettang T, Kremer AE. Uremic pruritus. Kidney Int. 2015;87:685\u201391. https:\/\/doi.org\/10.1038\/ki.2013.454.","journal-title":"Kidney Int"},{"key":"4570_CR28","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1016\/j.krcp.2016.02.002","volume":"35","author":"J-W Min","year":"2016","unstructured":"Min J-W, Kim S-H, Kim YO, Jin DC, Song HC, Choi EJ, et al. Comparison of uremic pruritus between patients undergoing hemodialysis and peritoneal dialysis. Kidney Res Clin Pract. 2016;35:107\u201313. https:\/\/doi.org\/10.1016\/j.krcp.2016.02.002.","journal-title":"Kidney Res Clin Pract"},{"key":"4570_CR29","doi-asserted-by":"publisher","first-page":"i1","DOI":"10.1093\/ckj\/sfab142","volume":"14","author":"D Kim","year":"2021","unstructured":"Kim D, Pollock C. Epidemiology and burden of chronic kidney disease-associated pruritus. Clin Kidney J. 2021;14:i1\u20137. https:\/\/doi.org\/10.1093\/ckj\/sfab142.","journal-title":"Clin Kidney J"},{"key":"4570_CR30","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1186\/s12877-020-1485-4","volume":"20","author":"C Roux-Marson","year":"2020","unstructured":"Roux-Marson C, Baranski JB, Fafin C, Exterman G, Vigneau C, Couchoud C, et al. Medication burden and inappropriate prescription risk among elderly with advanced chronic kidney disease. BMC Geriatr. 2020;20:87. https:\/\/doi.org\/10.1186\/s12877-020-1485-4.","journal-title":"BMC Geriatr"},{"key":"4570_CR31","doi-asserted-by":"publisher","first-page":"735","DOI":"10.1159\/000518454","volume":"52","author":"JMT Colombijn","year":"2021","unstructured":"Colombijn JMT, Bonenkamp AA, van Eck A, Bijlsma JA, Boonstra AH, \u00d6zyilmaz A, et al. Impact of polypharmacy on health-related quality of life in dialysis patients. Am J Nephrol. 2021;52:735\u201344. https:\/\/doi.org\/10.1159\/000518454.","journal-title":"Am J Nephrol"}],"container-title":["BMC Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12882-025-04570-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12882-025-04570-w","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12882-025-04570-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T13:03:36Z","timestamp":1781615016000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12882-025-04570-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,17]]},"references-count":31,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["4570"],"URL":"https:\/\/doi.org\/10.1186\/s12882-025-04570-w","relation":{},"ISSN":["1471-2369"],"issn-type":[{"value":"1471-2369","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,17]]},"assertion":[{"value":"26 May 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 October 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 November 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was registered at ClinicalTrials.gov (NCT05524467) on 10.06.2022, approved by the Swiss Ethics Commission for Research on Human Beings CER-VD (ID 2022\u2009\u2212\u200900670) and performed according to the declaration of Helsinki. All participants received detailed information about the study objectives and procedures. Written informed consent was obtained from all participants prior to data collection. Participation was voluntary, and all data were anonymized to ensure participant confidentiality.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"640"}}