Evidence map›Paper›PMID 41942634›Full record

ArticleScientific reports2026

Low Fischer's ratio is associated with increased mortality in patients with kidney failure.

Qianying Zhang, Mohamed E Suliman, Abdul Rashid Qureshi, Fujia Guo, Dario Troise, Ricong Xu, Peter Bárány, Olof Heimbürger, Peter Stenvinkel, Bengt Lindholm

Abstract read
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In one paragraph

Article in Scientific reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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0 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Qianying Zhang *Renal Medicine and Baxter Novum, Department of Clinical Sciences, Intervention and Technology, Karolinska University Hospital Huddinge, Karolinska Institutet, Stockholm, 141 86, Sweden.
Mohamed E Suliman *Renal Medicine and Baxter Novum, Department of Clinical Sciences, Intervention and Technology, Karolinska University Hospital Huddinge, Karolinska Institutet, Stockholm, 141 86, Sweden.
Abdul Rashid QureshiRenal Medicine and Baxter Novum, Department of Clinical Sciences, Intervention and Technology, Karolinska University Hospital Huddinge, Karolinska Institutet, Stockholm, 141 86, Sweden.
Fujia GuoRenal Medicine and Baxter Novum, Department of Clinical Sciences, Intervention and Technology, Karolinska University Hospital Huddinge, Karolinska Institutet, Stockholm, 141 86, Sweden.
Dario TroiseRenal Medicine and Baxter Novum, Department of Clinical Sciences, Intervention and Technology, Karolinska University Hospital Huddinge, Karolinska Institutet, Stockholm, 141 86, Sweden.
Ricong XuRenal Medicine and Baxter Novum, Department of Clinical Sciences, Intervention and Technology, Karolinska University Hospital Huddinge, Karolinska Institutet, Stockholm, 141 86, Sweden.
Peter BárányRenal Medicine and Baxter Novum, Department of Clinical Sciences, Intervention and Technology, Karolinska University Hospital Huddinge, Karolinska Institutet, Stockholm, 141 86, Sweden.
Olof HeimbürgerRenal Medicine and Baxter Novum, Department of Clinical Sciences, Intervention and Technology, Karolinska University Hospital Huddinge, Karolinska Institutet, Stockholm, 141 86, Sweden.
Peter StenvinkelRenal Medicine and Baxter Novum, Department of Clinical Sciences, Intervention and Technology, Karolinska University Hospital Huddinge, Karolinska Institutet, Stockholm, 141 86, Sweden.
Bengt LindholmRenal Medicine and Baxter Novum, Department of Clinical Sciences, Intervention and Technology, Karolinska University Hospital Huddinge, Karolinska Institutet, Stockholm, 141 86, Sweden. bengt.lindholm@ki.se.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Metabolic changes in kidney failure, including an altered ratio of plasma branched-chain amino acids (BCAAs) to aromatic amino acids (AAAs), also known as Fischer’s ratio (FR), could potentially affect survival. We analyzed associations of FR with mortality in patients with kidney failure. In 328 kidney failure patients starting dialysis (median age 54 years, 60% men), plasma concentrations of BCAAs (valine, isoleucine, and leucine) and AAAs (phenylalanine, tyrosine) were measured using HPLC. We used Fine-Gray competing-risk regression analysis with renal transplantation as competing risk to compare 5-year survival between low and middle tertiles versus high tertile of FR, and restricted cubic spline analysis to examine associations of BCAA, AAA and FR, as continuous variables, with mortality risk. During median 29.4 (range 0.7–60.0) months of follow-up, 169 patients (52%) underwent renal transplantation and 82 (25%) patients died. Compared to patients in the high FR tertile, those in the combined middle and low tertiles had higher cumulative incidence of mortality (sHR1.74, 95% CI 1.00–3.04, p = 0.04). FR was negatively correlated with inflammation markers and protein-energy wasting. Subgroup and interaction analyses showed that the association of FR with mortality was strongest among patients with cardiovascular disease (OR 4.10, 95% CI 1.53–11.00, p = 0.005; p for interaction = 0.009). A low Fischer’s ratio associated with increased mortality risk among individuals with kidney failure and its prognostic strength was most evident in patients with cardiovascular disease.

Indexed as

Amino Acids, AromaticAmino Acids, Branched-ChainRenal InsufficiencyBiomarkersFemaleHumansKidney TransplantationMaleMiddle AgedRenal DialysisAmino Acids, AromaticAmino Acids, Branched-ChainBiomarkersAromatic amino acidsBranched-chain amino acidsChronic kidney diseaseFischer’s ratioInflammationMortalityProtein energy wasting

Identifiers

PMID41942634
PMCPMC13056974

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.