ObjectiveTo systematically review the efficacy of patient decision aids (PDA) in the selection of treatment modalities for end-stage renal diseases. MethodsThe PubMed, Web of Science, Embase, Cochrane Library, CBM, CNKI and VIP databases were electronically searched to collect randomized controlled trials (RCTs) related to the objectives from inception to March 2023. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Quantitative and qualitative analysis was then performed. ResultsA total of 8 RCTs involving 1 544 patients were included. The systematic review results showed that PDA could improve patient knowledge, reduce patient decision-making conflict, and change patient decision-making discussion rate. ConclusionCurrent evidence shows that patients with end-stage renal diseases can benefit from PDA to improve their decision-making knowledge and reduce conflicts in their decisions, but its impact on the decision-making outcome index is limited.
This review aims to systematically elaborate on the core mechanisms of ferroptosis in acute kidney injury (AKI), and to deeply dissect the molecular basis by which the guanosine triphosphate cyclohydrolase 1 (GCH1)-tetrahydrobiopterin (BH4) pathway inhibits ferroptosis through pathways such as regulating the coenzyme Q10 system and reconstructing the lipid metabolic network. On this basis, the article focuses on exploring therapeutic strategies targeting the GCH1-BH4 axis, including the latest research progress and application potential of GCH1 agonists, gene therapy, and nanomedicine delivery systems in experimental AKI models.
