Search Results (30,701)

Background and Objectives: Chronic kidney disease (CKD) and end-stage kidney disease (ESKD) are characterized by persistent inflammation, malnutrition, and immune dysfunction, all of which contribute to poor outcomes in hemodialysis (HD) patients. The C-reactive protein albumin lymphocyte (CALLY) index has been proposed as a novel biomarker that integrates these mechanisms. This study aimed to evaluate the prognostic value of the CALLY index together with established markers, including the C-reactive protein-to-albumin ratio (CAR), neutrophil-to-lymphocyte ratio (NLR), and monocyte-to-lymphocyte ratio (MLR) for all-cause mortality in HD patients. Materials and Methods: This retrospective cohort study was conducted on 106 patients undergoing HD. Demographic, clinical, and laboratory parameters were obtained three months after the effects of HD initiation was reviewed. Results: During a median follow-up of 24.5 months, 29 patients (27.3 percent) died. Non-survivors were significantly older (65.3 vs. 52.5 years, p < 0.001), had a higher prevalence of coronary artery disease (31 percent vs. 2.6 percent, p < 0.001), or shorter dialysis duration (14 vs. 27 months, p < 0.001). They also showed lower hemoglobin (9.2 vs. 10.1 g/dL, p = 0.007), creatinine (5.3 vs. 6.3 mg/dL, p = 0.048), and albumin levels (28 vs. 34 g/L, p = 0.001), as well as a higher MLR (0.329 vs. 0.254, p = 0.014). In multivariate analysis, age, CAR, and NLR independently predicted mortality, explaining 83.8% of the variation. ROC analysis identified age and MLR as significant predictors, with MLR showing a high negative predictive value (83.9%). The CALLY index did not demonstrate independent prognostic value. Conclusions: Age, CAR, NLR, and MLR were independent predictors of mortality in HD patients, whereas the CALLY index was not prognostic in this cohort. Among these markers, MLR may be a practical biomarker with strong negative predictive power. Larger prospective studies are needed to validate these findings. Full article

Background/Objectives: The advent of biologics targeting key inflammatory pathways has significantly advanced psoriasis treatment. Among them, the Interleukin-23 inhibitors Guselkumab and Risankizumab have demonstrated high efficacy and rapid clinical response in both clinical trials and real-world studies. However, up to 30% of patients fail to respond. This study aimed to identify pharmacogenetic markers associated with treatment response using a genome-wide association study (GWAS) and protein network-based approach. Methods: Fifty-three patients of Greek origin with moderate-to-severe plaque psoriasis were treated with Guselkumab or Risankizumab. Based on Psoriasis Area and Severity Index (PASI) improvement at 3 and 6 months, patients were categorized as responders or non-responders. Approximately 730,000 single-nucleotide polymorphisms (SNPs) were genotyped. After filtering, a GWAS was performed to identify variants associated with treatment response. Additionally, protein–protein interaction (PPI) network analysis was applied to the two Interleukin-23 subunits and SNPs within or near genes encoding Interleukin-23-interacting proteins to test for their association. Results: The GWAS identified two novel variants, rs73641950 and rs6627462, significantly associated with treatment response, with both surpassing the genome-wide significance threshold after Bonferroni correction. The PPI-based approach revealed rs13086445, located downstream of the Interleukin-12 subunit alpha (IL12A) gene, as another associated variant. All three SNPs lie in genomic regions with potential regulatory roles. Conclusions: This study identifies three novel genetic variants associated with response to Interleukin-23 inhibitors in psoriasis. These findings provide promising pharmacogenetic markers which, upon validation in larger, independent cohorts, will enable the translation of a patient’s genotype into a response phenotype, thereby guiding clinical decisions and improving drug effectiveness. Full article

Background: Cutaneous synthesis of vitamin D depends primarily on exposure to solar ultraviolet B (UVB) radiation. Nevertheless, populations in the Mediterranean region, including pregnant women, continue to experience high rates of hypovitaminosis D. Pregnancy is a particularly vulnerable period due to increased physiological demands and reduced outdoor activity. The aim of this study was to examine the seasonal and environmental determinants of maternal and neonatal vitamin D status in an urban Greek population. Methods: We conducted a cross-sectional observational study on 248 pregnant women and their neonates admitted for delivery at Tzaneio General Hospital of Piraeus between September 2019 and January 2022. Serum 25-hydroxyvitamin D [25(OH)D] concentrations were measured and temporally matched with environmental variables including UV index, sunshine hours, ambient temperature, and PM2.5 levels. Results: Both maternal and neonatal 25(OH)D levels exhibited marked seasonal variation, with levels peaking in late summer and declining sharply in winter. A significant positive correlation was observed between UV index and vitamin D concentrations (r = 0.45, p < 0.001), while elevated PM2.5 concentrations were inversely associated with vitamin D status. Despite supplementation, insufficiency persisted in most neonates, particularly during the low-UV season. This underlines the need for comprehensive prenatal care strategies, integrating both supplementation policies and individualized nutritional counseling, to better secure maternal and neonatal vitamin D adequacy. Conclusions: Seasonal and environmental factors, particularly solar radiation and particulate air pollution, have a decisive role in determining maternal and neonatal vitamin D status, even in regions with abundant sunlight. These findings emphasize the importance of adaptive prenatal care strategies that combine supplementation with dietary counseling and take into account seasonal variation and air quality. In addition, the study provides novelty by integrating maternal–neonatal vitamin D status with environmental exposure metrics such as UV and PM2.5. Full article

Background: Food allergies represent a growing global health concern, yet the current diagnostic methods often fail to distinguish between true allergies and food sensitivities, leading to misdiagnoses and inadequate treatment. Epigenetic alterations, such as DNA methylation (DNAm), may offer novel biomarkers for precise diagnosis. Methods: This study employed a computational machine learning framework integrated with DNAm data to identify potential biomarkers and enhance diagnostic accuracy. Differential methylation analysis was performed using the limma package to identify informative CpG features, which were then analyzed with advanced algorithms, including SVM (polynomial and RBF kernels), k-NN, Random Forest, and artificial neural networks (ANN). Deep learning via a stacked autoencoder (SAE) further enriched the analysis by uncovering epigenetic patterns and reducing feature dimensionality. To ensure robustness, the identified biomarkers were independently validated using the external dataset GSE114135. Results: The hybrid machine learning models revealed LDHC and SLC35G2 methylation as promising biomarkers for food allergy prediction. Notably, the methylation pattern of the LDHC gene showed significant potential in distinguishing individuals with food allergies from those with food sensitivity. Additionally, the integration of machine learning and deep learning provided a robust platform for analyzing complex epigenetic data. Importantly, validation on GSE114135 confirmed the reproducibility and reliability of these findings across independent cohorts. Conclusions: This study demonstrates the potential of combining machine learning with DNAm data to advance precision medicine in food allergy diagnosis. The results highlight LDHC and SLC35G2 as robust epigenetic biomarkers, validated across two independent datasets (GSE114134 and GSE114135). These findings underscore the importance of developing clinical tests that incorporate these biomarkers to reduce misdiagnosis and lay the groundwork for exploring epigenetic regulation in allergic diseases. Full article

Background: Evidence on acute endocrine responses to K-1 kickboxing is limited. This pilot study assessed pre-to-post changes in GH, IGF-1 and insulin after a single K-1 bout and explored relationships with training experience (TE), final heart rate (HRFINAL) and perceived exertion (RPE). Methods: Elite male K-1 athletes (n = 10) completed an interclub, referee-supervised three-round bout (3 × 2 min). Venous blood was sampled pre-fight and +2 min. GH, IGF-1 and insulin were assayed (ELISA). Paired t-tests and Pearson’s r quantified changes and associations. Results: GH rose from 1.20 ± 2.05 to 11.27 ± 8.82 ng/mL (p = 0.007; d = 1.85), and insulin from 5.95 ± 1.56 to 12.95 ± 5.95 µU/mL (p = 0.002; d = 1.86); IGF-1 showed no change (200.90 ± 55.89 to 203.00 ± 54.10 ng/mL; p = 0.497). ΔGH and Δinsulin correlated positively with HRFINAL (rp = 0.89 and 0.88, both p < 0.001) and RPE (rp = 0.70 and 0.68; p = 0.024 and 0.031), and negatively with TE (rp = −0.72 and −0.68; p = 0.019 and 0.031). Conclusions: A single K-1 fight elicited large acute increases in GH and insulin but not IGF-1 at +2 min. HRFINAL and RPE tracked response magnitude, while more experienced athletes showed smaller deltas. Findings are preliminary and limited by a small sample, elite-only cohort, in an interclub setting, with immediate sampling and absence of a control group. Full article

Background/Objectives: To assess overall and type-specific HPV vaccine effectiveness in central and eastern Europe (CEE), the age-stratified prevalence of cervical HPV infection was determined among Slovenian women aged 20 to 64 attending a cervical cancer screening program 14 years after implementation of a national HPV vaccination program, which was then compared with 2009–2010 pre-vaccination data using the same methodological approach. Methods: Cervical samples of 4419 women were tested in 2023–2025 using the clinically validated Alinity m HR HPV Assay, and individual HPV types were determined by the Allplex HPV HR Detection assay. Results were compared with 2009–2010 pre-vaccination data generated using the same assay on an age-range matched cohort of women. Results: The overall prevalence of the 14 Alinity-targeted HPV types was 10.0% in 2023–2025 versus 13.3% in 2009–2010 (p < 0.001). HPV16 prevalence declined from 3.5% to 1.5% (p < 0.001), and HPV18 prevalence from 1.1% to 0.5% (p = 0.005). In women aged 20 to 24 with 40% uptake of quadrivalent HPV vaccine, overall HPV prevalence dropped from 25.3% to 12.8% (p < 0.001). No single case of HPV16/HPV18 infection was detected among vaccinated women. Conclusions: The first large-scale, systematic, and methodologically consistent study of HPV vaccine effectiveness in CEE showed a substantial reduction in high-risk HPV prevalence after implementation of the national program, with the greatest decline among women aged 20 to 24, who harbored the highest HPV burden in the pre-vaccination era. These locally acquired data will considerably inform public health strategies on cervical cancer elimination in CEE. Full article

Background/Objectives: Placenta accreta spectrum (PAS) is an obstetric condition with placental adherence to the underling myometrium characterized by significant surgical morbidity at time of delivery. PAS delivery is most commonly performed by cesarean hysterectomy. The most common morbidities associated with PAS cesarean hysterectomy are blood transfusion, intensive care unit admission and urinary tract injuries. This requires interdisciplinary team management including obstetricians and urologists. Our objective was to identify pre- and intra-operative risk factors for urologic injury in this high-risk condition. Methods: A retrospective cohort study was performed at a single tertiary center with the Center for the Management of Placenta Accreta Spectrum disorders from 2012 to 2022. Urologic injuries were considered as injury to either the bladder or ureters. Furthermore, bladder injuries were subdivided into those inherent to the procedure (intentional cystotomy) and those considered unplanned complications (incidental cystotomy). Inclusion criteria required complete antenatal documentation for assessment, and these were accessed by electronic medical records. Multivariate analysis was performed for significant variables on univariate analysis. Results: During the 11-year study period, 146 cases of PAS were managed by our team. Of these, 39 (26.7%) were complicated by urologic injury. Intentional cystotomies were performed in 28.2% (11/39) of cases. There were 28 (28/39, 71.8%) incidental cystotomies and 5 (5/39, 12.8%) ureteral injuries were encountered. Of note, all 5 patients with ureteral injuries also had cystotomies. Upon univariate analysis, anterior placentation (OR 2.96 [1.94, 4.67], p = 0.04), percreta by antenatal ultrasound (OR 2.59 [1.13, 5.9], p = 0.02) and >2 pre-delivery vaginal bleeding episodes (OR 4.27 [1.54, 12.16], p = 0.005) were associated with urologic injury. Multivariate analysis revealed the independent significance of these variables. Of note, the presence of zero, one, two, and all three risk factors were associated with urologic injury rates of 11.1%, 22.5%, 41.9%, and 71.4%, respectively. Conclusions: Urologic injury during cesarean hysterectomy occurs in almost one-third of cases. Pre-operative risk factors may be used to identify those at greater risk for this surgical complication. Determining patient risk allows for the use of resources such as formal urology consultation, surgical planning, and intraoperative assistance, as well as detailed patient counseling. Full article

Background: Osteoporosis screening in dental practice is challenging because dual-energy X-ray absorptiometry is not easily applicable to jaw bones. Objective: This study aimed to evaluate the diagnostic performance of a logistic regression model combining intraoral bone mineral density (BMD) using DentalSCOPE with the panoramic mandibular cortical index (MCI) for osteoporosis screening. Methods: Among 104 patients included in the study, 83 who underwent both intraoral and panoramic radiography were retrospectively selected as a training cohort to develop a logistic regression model for osteoporosis prediction. The mean age was 52.4 years, and 65.1% were female. Intraoral radiographs were analyzed using DentalSCOPE^® (Media Co., Tokyo, Japan) to determine BMD in the alveolar region (al-BMD). On panoramic radiographs, experienced radiologists determined the MCI. An additional 21 patients (mean age 63.1 years; 81.0% female) were prospectively enrolled as an external validation cohort. The trained model was applied to both the training (internal) and external cohorts to evaluate its diagnostic performance, which was compared with that of intraoral or panoramic radiography, using receiver operating characteristic (ROC) analysis. Results: In the training cohort, areas under the ROC curve (AUCs) of al-BMD and MCI were 0.74 and 0.82, respectively, while the combined model showed improved performance with an AUC of 0.88. In the external validation cohort, the AUCs were 0.92 and 0.97 for al-BMD and MCI, respectively. The performance of the combined model improved with an area under the AUC of 1.00. Conclusions: DentalSCOPE-based al-BMD, particularly when combined with panoramic MCI, offers a reliable and practical approach for opportunistic osteoporosis screening in dental care. Full article

Background: Macular edema (ME) secondary to retinal vein occlusion (RVO) is a significant cause of vision impairment. Many patients show suboptimal responses to anti-vascular endothelial growth factor (anti-VEGF) monotherapy, prompting the exploration of alternative treatments. Faricimab is a bispecific antibody that targets VEGF-A and angiopoietin-2. We report 9-month real-world outcomes of switching to faricimab in therapy-resistant RVO-associated ME. Methods: In this retrospective study at a single tertiary center, patients with persistent or recurrent ME despite prior treatments (ranibizumab, aflibercept, or dexamethasone implant) were switched to faricimab. All eyes received a loading phase of four monthly faricimab injections, followed by a treat-and-extend regimen individualized per response. Key outcomes included best-corrected visual acuity (BCVA, logMAR), the central subfield thickness (CST, μm), and the intraretinal fluid (IRF) status on optical coherence tomography, assessed from the baseline (month 0, mo0) through the loading phase (mo1–mo3) and at month 9 (mo9). Results: Nineteen eyes (19 patients, mean age 64.8 years) were analyzed. The median BCVA improved from 0.20 to 0.00 logMAR by month 3 (p < 0.01) and was maintained at month 9. The median CST decreased from 325 μm at the baseline to 285 μm at month 3 (p < 0.01) and remained at 285 μm at month 9. IRF was present in 100% of eyes at the baseline, 26% at month 3, and 26% at month 9 (p < 0.01 for the baseline vs. month 9). Among eyes previously on anti-VEGF therapy (n = 14), the median treatment interval increased from 45.50 days at the baseline to 56.50 days at month 9 (p = 0.01; δ = 0.86). No intraocular inflammation or other adverse events were observed in this cohort over nine months. Conclusions: In this retrospective series, switching to faricimab was associated with improvements in vision and retinal anatomy that were maintained over 9 months; injection intervals were extended in a subset of eyes. These exploratory findings warrant confirmation in larger, controlled studies to define long-term effectiveness, safety, and dosing strategies. Full article

Background: Fulminant idiopathic intracranial hypertension (IIH) is a rare and vision-threatening variant of IIH, characterized by rapid visual deterioration and a high risk of irreversible blindness. Urgent intervention is required to prevent permanent optic nerve damage. Cerebral transverse venous stenting (CTVS) has emerged as an effective treatment for medically refractory IIH, but data on its use in fulminant cases remain limited. Methods: A retrospective consecutive cohort study was conducted at a tertiary center and included all patients with fulminant IIH diagnosed by modified Dandy criteria, with bilateral transverse sinus stenosis > 50% and a trans-stenotic pressure gradient ≥ 8 mmHg on venography. Before stenting, patients received high-dose acetazolamide (up to 3000 mg/day) and IV methylprednisolone (1000 mg/day × 3). Neuro-ophthalmic assessment included BCVA, Ishihara color vision, pupillary exam, disc edema grading, Humphrey visual fields, and optical coherence tomography (OCT). Follow-up occurred at baseline (admission), 1 week, 1 month, 3 months, and 12 months. Results: Five young female patients underwent successful CTVS without peri- or post-procedural complications. Significant improvement in headache and stabilization or recovery of visual function were observed in all patients. OCT revealed early retinal nerve fiber layer thinning within one week, preceding clinical resolution of papilledema. Conclusions: Emergent CTVS appears to be a safe and effective vision-preserving procedure in fulminant IIH, offering rapid intracranial pressure reduction and early neuro-ophthalmologic improvement. OCT may serve as a useful early predictor of treatment success, supporting its role in post-procedural monitoring. Larger prospective studies are warranted. Full article

Background/Objective: The recurrence of hallux valgus (HV) after primary surgical correction remains a clinical challenge, often requiring combined approaches to address both bony realignment and soft tissue imbalance. While locking plates have shown some biomechanical advantages in HV correction, evidence regarding their application in revision procedures is limited. This study presents a retrospective single-surgeon experience with a small cohort, aiming to describe radiographic and functional outcomes and to share practical insights rather than provide definitive conclusions. Methods: In this retrospective case series, patients undergoing revision surgery for failed HV correction over the past ten years at a single tertiary institution were analyzed. Radiographic parameters—hallux valgus angle (HVA), intermetatarsal angle (IMA), distal metatarsal articular angle (DMAA), and sesamoid position—were assessed. Functional outcomes included the American Orthopaedic Foot and Ankle Society (AOFAS) score and the Visual Analog Scale for pain. Surgical strategies were tailored according to recurrence mechanisms, and some cases involved Wilson osteotomy with intramedullary plate fixation. The Mann–Whitney U test and the Wilcoxon signed-rank test were applied to assess efficacy. Results: A total of 11 feet treated by one surgeon were included. Both soft tissue procedures and combined osteotomy with intramedullary plate fixation led to statistically significant but preliminary improvements in HVA, IMA, DMAA, and sesamoid alignment. Functional scores improved, and the complication rate was within the range reported in the previous literature. Conclusions: This retrospective single-surgeon study with a limited sample size suggests that Wilson osteotomy combined with intramedullary plate fixation may represent a joint-preserving and biomechanically supportive option for recurrent HV, particularly in cases with large DMAAs and severe sesamoid displacement. However, the findings should be interpreted cautiously given the small cohort, retrospective design, and absence of multi-angle radiographic visualization. The results highlight a potential approach in specific clinical settings rather than a definitive solution. Larger, prospective, multi-center studies are required to confirm long-term utility. Full article

Background/Objectives: The gastrin-releasing peptide receptor (GRPR) shows high-density expression in prostate cancer (PCa), especially in the early stages of the disease. The introduction of a safe radiotracer for assessing GRPR-expression in PCa may serve as an alternative or complementary tracer to PSMA-directed probes for patients with insufficient PSMA expression. In the present study, the tolerability and safety, biodistribution, and dosimetry of the new GRPR-targeting radiopeptide [^99mTc]Tc-DB8 were investigated for the first time in male PCa patients. A mass escalation study was performed, aiming to improve tumor-to-background contrast and, thereby, to enhance diagnostic accuracy. Methods: Sixteen male patients were enrolled in a single-center diagnostic open-label exploratory Phase I clinical trial. Patients were administered a single intravenous injection of 40, 80, or 120 µg of [^99mTc]Tc-DB8 peptide (n = 5–6) and underwent whole-body planar imaging (anterior and posterior) 2, 4, 6, and 24 h post-injection (pi) and SPECT-CT acquisition 2, 4, and 6 h pi. Results: Administration of [^99mTc]Tc-DB8 was well tolerated at all tested peptide masses. The effective dose did not differ significantly between the injected peptide mass and was 0.005 ± 0.003 mSv/MBq. High activity uptake was observed in the pancreas and kidneys, which 3-fold decreased with an increasing injected peptide mass from 40 to 120 µg. The activity uptake in primary tumors did not differ significantly between cohorts injected with different peptide masses [SUV_max 1.65–9.96]. The tumor-to-muscle ratios increased with time and were the highest for the cohort injected with 120 µg of peptide, 7.2 ± 3.1 (4.64-11-25) at 4 h pi. Conclusions: Single intravenous administration of [^99mTc]Tc-DB8, for visualization of GRPR expression in PCa using SPECT imaging was well tolerated in a peptide mass range of 40–120 µg. An injected peptide mass of 80–120 µg/patient and SPECT acquisition 2–4 h pi were found to be optimal for further clinical studies due to the significantly lower activity accumulation in the pancreas and kidneys. Full article

Fibromyalgia (FM) affects millions of people around the world, causing widespread physical pain, exhaustion, and psychological disorders. Through this study, we aim to observe the effectiveness of two different rehabilitation programs in reducing the impact of FM on daily functioning and psychological factors. Specifically, we compare a complex conservative program that combines physical therapy and hydrokinetotherapy in a hospital setting with a therapy focused on intrinsic relaxation. Methods: This comparative study involved 63 patients aged between 19 and 69 years diagnosed with FM, divided into two groups: the study group (SG, 32 participants) and the control group (CG, 31 participants). Over 90% of participants are female, 30 in the study group and 28 in the control group. SG followed a conservative physiotherapy combined with thermal water therapy, and CG followed a recovery program through intrinsic relaxation. Participants were evaluated on the first and last day of the rehabilitation program using the Revised Fibromyalgia Impact Questionnaire (FIQR) and the Hamilton Anxiety Rating Scale (Ham—A). The rehabilitation program consisted of 10 sessions conducted over a period of two weeks. Results: After the two-week recovery period, the results showed a significant improvement in both FIQR and Ham—A scores in the study group (p < 0.001). In the control group, there were no significant changes in FIQR variables (p > 0.05), while a significant improvement was observed on the anxiety scale (p < 0.001). Conclusions: The combination of hydrokineto-therapy and physical therapy is more effective in improving the overall condition of patients with FM compared to relaxation. Full article

Background: The gut microbiome is crucial in sustaining intestinal balance and general health. Following rectal cancer surgery, the creation of a diverting stoma to protect the anastomosis results in a defunctioned colon, leading to dysbiosis. The effect of probiotic intake on gut dysbiosis following ileostomy repair remains uncertain. Thus, this study aims to determine the changes in gut microbiota based on the intake of probiotics after diverting stoma repair. Methods: This single-center, parallel, prospective pilot study will include patients with primary rectal cancer planning to undergo a diverting stoma during rectal cancer surgery. The study will comprise 20 patients, with 10 patients receiving synbiotics after stoma repair and 10 patients not receiving probiotics. The primary endpoint is the change in the gut microbiota of the resting colon based on the intake of probiotics, assessed through fecal testing at the following time points: before bowel resection, immediately after diverting stoma repair, and 3 weeks after diverting stoma repair. Changes in gut microbiota will be evaluated using alpha- and beta-diversity analyses based on 16S rRNA sequencing of fecal samples. Discussion: This study is the first prospective cohort trial investigating changes in the gut microbiota of the resting colon based on oral probiotic administration in patients undergoing diverting stoma repair. This trial is anticipated to clarify the impact of probiotic intake in these patients. Trial registration: Clinical Research Information Service (CRIS) of the Republic of Korea, KCT0008392, Registered on 27 April 2023. Full article

Background: Accurate assessment of volume status remains a central challenge in hemodialysis (HD). Although bioimpedance spectroscopy (BIS) can quantify fluid compartments, it is time-consuming and requires a lot of personnel. Modern HD machines provide continuous relative blood volume (RBV) monitoring. We examined whether intradialytic RBV dynamics reflect pre-dialysis extracellular fluid (ECW) status to inform personalized fluid management. Methods: In an ancillary, monocentric, prospective study of the SkInDialysis trial (DRKS00036332), 11 maintenance-HD patients underwent three standardized dialysis sessions with simultaneous measurement of RBV and BIS. BIS was performed at five time points per session (pre-HD; 20, 80, and 160 min after the start of HD; and post-HD). Ultrafiltration (UF), RBV, total body water (TBW), ECW, and intracellular water (ICW) were recorded. Results: Mean total UF was 2809 ± 894 mL/session. RBV declined to 94.7 ± 3.1% at 20 min and to 87.6 ± 5.5% by the end of the session. TBW decreased by 2.9 ± 2.7%, driven by ECW reduction (−3.15 ± 2.9%) over ICW (−1.1 ± 1.65%). Cumulative UF correlated with declines in TBW (R² = 0.18; p = 0.02) and ECW (R² = 0.23; p = 0.01) and more modestly with ICW (R² = 0.16; p = 0.04). In contrast, ΔRBV (pre- vs. post-HD) did not correlate with UF, weight loss, or compartmental water changes. Early steady-state RBV at 80 min correlated with pre-HD ECW (R² = 0.19; p = 0.02) and more strongly with the pre-HD ECW/ICW ratio (R² = 0.34; p = 0.001). Conclusions: In this small, repeated-measures cohort, absolute early steady state RBV levels were associated with pre-dialysis ECW and the ECW/ICW ratio, whereas RBV change (ΔRBV) did not track absolute fluid removal. Our data support a time-anchored RBV level as a pragmatic, device-embedded indicator of the pre-dialysis extracellular reservoir. Full article