Thongprayoon, Charat

ABSTRACTBackgroundMetabolic dysfunction‐associated steatotic liver disease (MASLD) affects over one third of the global population and is closely linked to gastrointestinal, oncological, and cardiovascular diseases. As the most common cause of steatotic liver disease (SLD), MASLD is often referred to as “fatty liver” in general health information searches. With the Internet becoming a primary source of healthcare information, this study aimed to evaluate global and regional public interest in steatotic liver disease using Google Trends data from January 2004 to December 2024.MethodsA comprehensive analysis was performed using Google Trends with the search term “fatty liver disease.” Interest levels were quantified using Google Trends indices, and temporal patterns were evaluated using average annual percent change (AAPC). Regional variations were assessed to identify geographic hotspots of public interest.ResultsGlobal interest in MASLD demonstrated significant growth (AAPC: 6.77%, 95% Confidence interval [CI]: 5.33–8.23), with a 264% increase from 2004 to 2024. Peak interest was observed in August 2024 (index: 100) compared to the lowest point in June 2007. Iran showed the highest country‐specific search volume (index: 100), while within the United States, West Virginia demonstrated the greatest relative interest (index: 100). Key topics associated with MASLD included “liver,” “symptoms,” “disease,” and “therapy.”ConclusionsSubstantial growth in global public interest in MASLD, with distinct temporal and geographical patterns, provides insights to develop targeted awareness campaigns and educational interventions, particularly in regions with low search volumes. Future research should examine the relationship between online search patterns and clinical outcomes in MASLD.

Background/Objectives: Malnutrition is a prevalent yet under-recognized condition in patients with advanced chronic kidney disease (CKD), contributing to increased morbidity, mortality, and healthcare burden. The aim of this study is to determine the prevalence and trends of malnutrition and investigate the impact of malnutrition on in-hospital outcomes, treatments, and resource utilization in hospitalized patients with advanced CKD. Methods: This study utilized the National Inpatient Sample (NIS) database to identify hospitalized patients with advanced CKD from 2016 to 2021. This study investigated temporal trends in the prevalence and in-hospital mortality across different degrees of malnutrition in advanced CKD patients. Multivariable regression models were used to assess the association between malnutrition and in-hospital outcomes. Results: Out of 1,244,415 advanced CKD patients, 67,587 (5.4%) had mild to moderate malnutrition, and 63,785 (5.1%) had severe malnutrition. Malnourished patients exhibited significantly higher in-hospital mortality, with adjusted odds ratios of 1.70 (95% confidence interval (CI), 1.64–1.75) for mild to moderate cases and 2.67 (95% CI, 2.60–2.75) for severe cases. Severely malnourished patients were associated with longer mean hospital stay by 7.0 days and higher hospitalization costs by $97,767 compared with non-malnourished patients. The prevalence of severe malnutrition showed a significant uptrend from 4.2% in 2016 to 5.5% in 2021 (p for trend < 0.001). Conclusions: Malnutrition in advanced CKD is an increasingly prevalent condition linked to worsened in-hospital outcomes and heightened healthcare resource utilization. The rising trend of severe malnutrition underscores the need for early nutritional screening and the need for future interventional studies to mitigate adverse clinical outcomes in this high-risk population.

Background/Objectives: With the growing population of kidney transplant recipients (KTRs) in intensive care units (ICUs), understanding their prognostic outcomes is critical. As conflicting findings exist, we aim to systematically evaluate and meta-analyze ICU outcomes in kidney transplant recipients compared to non-recipients. Methods: We conducted a comprehensive search of the PubMed, Embase, and Cochrane databases, from inception through 23 December 2024, to identify relevant studies comparing the outcomes of KTRs and non-transplant ICU patients. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated for dichotomous outcomes, and weighted mean differences (WMDs) were calculated for continuous outcomes. The risk of bias was assessed using the ROBINS-I V2 tool. The study protocol was registered in the International Prospective Register of Systematic Reviews (CRD42024595104). Results: Seven studies, including 12,062 patients, were analyzed. Demographics, including age and sex, were comparable across groups. No statistically significant associations were found for overall mortality (OR: 1.82, 95% CI: 0.79 to 4.16), ICU mortality (OR: 1.06, 95% CI: 0.45 to 2.48), or 28/30-day mortality (OR: 2.06, 95% CI: 0.30 to 14.10) in KTRs, though there was a trend suggesting a potential increase in the odds of overall mortality. KTRs tended to have longer ICU stays (WMD: +1.96 days, 95% CI: 0.81–3.11) and higher Sequential Organ Failure Assessment (SOFA) scores (WMD: +0.79, 95% CI: −0.78–2.36), but these findings did not reach statistical significance. One study reported higher 1-year and 5-year mortality for KTRs. Sensitivity analyses revealed one influential study. Begg’s test for overall mortality suggested non-significant publication bias (p = 1.0). Conclusions: KTRs in ICUs are at significantly higher risk for long-term mortality, emphasizing the need for tailored critical care strategies and long-term management. Future research should focus on standardizing methodologies, reducing heterogeneity, and addressing gaps in data to improve evidence-based care for this vulnerable population.