Gastrointestinal symptoms in patients undergoing peritoneal dialysis: Multivariate analysis of correlated factors

AIM: To investigate gastrointestinal (GI) symptoms in peritoneal dialysis (PD) patients and to explore related factors contributing to GI symptoms. METHODS: One hundred and twelve patients undergoing PD participated in the study. The gastrointestinal symptom rating scale was used for measuring GI symptoms. Information on age, height, weight, body mass index, disease leading to chronic renal failure, history of corticosteroid therapy, presence of predialytic GI symptoms, daily dosage of pills, and duration, type and daily dialysate volume of PD was obtained by interviewing patients and/or reviewing the medical records. Hemoglobin, albumin and Kt/V data were obtained from follow-up database. We used multiple regression analysis with stepwise backward variable selection to test for factors predicting GSRS scores with significance level of selection entry at 0.05 and selection of stay at 0.10. RESULTS: The prevalence of eating dysfunction, reflux and indigestion in the PD patients was 44.2%, 32.7%,32.7%, respectively. A history of corticosteroid therapy (b = 8.93, P < 0.001) and all pills daily intake (b = 0.16, P = 0.007) were positively correlated to GI symptoms, while residual renal Kt/V (b =-3.47, P = 0.009) was negatively correlated to GI symptoms. Other factors were proven to be not associated with GI symptoms, with P > 0.05. CONCLUSION: Eating dysfunction, reflux and indigestion were common in PD patients. Daily dosage of pills and corticosteroid history predicted GI symptoms, while residual renal function prevented them.

Role and mechanism of phosphate myosin light chain in chronic allograft nephropathy of rats

Objective To investigate role and mechanism of phosphate myosin light chain ( pMLC) in rat kidney of chronic allograft nephropathy ( CAN) model. Methods Left donor kidneys from Fisher ( F344) rats were ortho-topically transplanted into Lewis recipients,Meanwhile, F344 rats and LEW rats with resection of right

Effect and mechanism of adrenomedullin on apoptosis of renal tubular epithelial cell in rats induced by renal ischemia reperfusion injury

Objective To investigate the effect and mechanism of adrenomedullin ( AM ) on apoptosis of renal tubular epithelial cell in rats induced by renal ischemia reperfusion injury. Methods Thirty-two Wistar rats were randomly divided into 4 groups: control group,IRI group, empty plasmid group and AM group. One week after re-

Orthotopic urinary diversion in women

To investigate the therapeutic effects of orthotopic urinary diversion in women.Methods From September 1995 to December 2003,34 female patients (mean age,58 years;ranging,53-64 years) with bladder cancer were included.Of them,30 cases were of primary tumors and 4,of recurrent ones.Pathology showed transitional cell carcinoma in 30 cases,bladder adenocarcinoma in 3 and squamous cell carcinoma in 1.Radical cystectomy was performed in all the 34 cases; and the technique of cystectomy with nerve-sparing was performed in 24 of them.Intraoperative frozen section of the distal urethra surgical margin showed no evidence of tumor,and ileal neobladder was formed in all.The clinical therapeutic effects were analyzed retrospectively.Results The mean operative time was 360 min (ranging,280-420 min),and mean blood transfusion was 600 ml(ranging,300-1000 ml).Thirty cases were followed up for a mean of 61 months (ranging,6-108 months).At 6 months after surgery the continence rate was 90% (27/30) during the day and 86% (26/30) at night.Twenty-three cases could empty the neobladder one time and 2 needed intermittent catheterization due to hyper-continence;the other 5 needed pushing the abdomen to empty the neobladder.Twenty-three patients had good urodynamic findings;the vesical capacity ranged 300-520 ml and maximum intravesical pressure were <23 cm H2O;functional urethral length ranged 2.6-3.5 cm and the residual urine volume ranged 0-38 ml.IVU showed that all the neobladders were ball-shaped with no ureteral stenosis,but reflux in 1 case and mild hydroureter and hydronephrosis in another 1.Renal function and electrolyte metabolism were normal in the 30 cases.No one suffered from urethral recurrence or neobladder tumor.Conclusion The results of orthotopic urinary diversion in women are satisfactory and this surgical technique can be preferred in selected women with bladder cancer after radical cystectomy.14 refs.

Canagliflozin attenuates human podocyte injury through inhibiting reactive oxygen species/NOD-like receptor thermal protein domain associated protein 3 signaling pathway

Objective To investigate the efficacy and mechanism of canagliflozin (Cana) in the treatment of high glucoseinduced human podocyte (HPC) injury.Methods The HPCs were divided into 5 groups:normal glucose group(NG group),mannitol group(MA group),high glucose group(HG group),Cana low dose(0.3μmol/L) group and Cana high dose (1.0μmol/L) group.

Influencing factors of cardiac autonomic dysfunction in hemodialysis patients

Objective To investigate the influencing factors of cardiac autonomic dysfunction in maintenance hemodialysis(MHD)patients by recording 48 h heart rate variability.Methods It was a single-center crosssectional study.MHD patients at the Hemodialysis Center of Peking University People's Hospital between October 1,2021 and December 31,2022 were enrolled in the study.These patients initiated hemodialysis for more than three months and were older than 18 years old,and patients with tachyarrhythmia,implanted cardiac pacemaker and the recording time less than 48 h wereexcluded.Demographiccdata,comorbidity,laboratory data,hemodialysis session data and heart rate variability were collected.Multivariate linear regression model was used to analyze the influencing factors for cardiac autonomic dysfunction in MHD patients.Results A total of 110 patients were enrolled in the study,including 37 females(33.6%)and 36 diabetic patients(32.7%).The age of the patients was(57.8±14.8)years old,and the median dialysis vintage was 73.00(27.75±130.25)months.At baseline,the serum phosphate level was(1.6±0.4)mmol/L,and the Nterminal pro B-type natriuretic peptide(NT-proBNP)after In transformed/In[NT-proBNP(ng/L)]was 8.4±1.2.

Analysis on clinicopathology and prognosis of primary IgA nephropathy in children with massive proteinuria.

Objective To investigate the clinicopathological features and the prognosis of IgA nephropathy (IgAN) in children with massive proteinuria.Methods It was a retrospective cohort study.Clinical data of IgAN children with massive proteinuria admitted to the Department of Nephrology,Children's Hospital Affiliated to Capital Institute of Pediatrics from January 2008 to December 2021 were retrospectively analyzed.

Efficacy and safety of sacubitril-valsartan in lowering blood pressure in non-dialysis-dependent patients with stage 3-5 chronic kidney disease

Objective To evaluate the efficacy and safety of sacubitril-valsartan (SV) in reducing blood pressure in patients with non-dialysis-dependent chronic kidney disease(NDD-CKD) stage 3-5 and concomitant hypertension.

Clinical features and risk factors of the mortality in hemodialysis patients infected with SARS-CoV-2

Objective To investigate the clinical features of patients with maintenance hemodialysis(MHD)infected with SARS-CoV-2 and analyze the risk factors of death after SARS-CoV-2 infection,and to provide clinical data for early detection of critically ill patients and timely intervention.Methods It was a cross-sectional investigation study.MHDpatients in the hemodialysis centersof four tertiaryhospitals with geographical representation in Shanxi province from December 1,2022 to January 31,2023 were enrolled,and the demographic data,dialysis-related indicators,laboratory test results and clinical features of SARS-CoV-2 infection were collected by distributing the questionnaires on SARS-CoV-2 infection,and consulting the hospital medical record system and the outpatient hemodialysis information system.SARS-CoV-2-infected patients were divided into survival group and death group according to whether all-cause death occurred and the differences of baseline data between the two groups were compared.Multivariate logistic regression analysis method was used to analyze the risk factors of mortality in MHD patients infected with SARS-CoV-2.

Forkhead box K1 deficiency alleviates ischemia-reperfusion-induced acute kidney injury

Objective To investigate the effect and mechanism of forkhead box K1 (FOXK1) in acute kidney injury(AKI),and to provide new ideas and targets for preventing and treating AKI.Methods Three models of AKI were established:30 male specific pathogen free wild type C57BL/6 mice aged 8-10 weeks and weighing 22-24 g were randomly divided into saline group(0.9%normal saline 0.1 ml/10 g,intraperitoneal injection),lipopolysaccharide(LPS) group(LPS solution 10 mg/kg,intraperitoneal injection),cisplatin group (cisplatin solution 20 mg/kg,intraperitoneal injection),ischemia-reperfusion (IR) group,and sham-operated group by the random number table,with 6 mice in each group.

Influencing factors for hemodialysis initiation in non-diabetic kidney disease patients with predialysis fistula after arteriovenous fistula creation

Objective To explore the influencing factors of hemodialysis(HD)initiation in non-diabetic kidney disease(NDKD)patients with predialysis arteriovenous fistula(AVF)creation.Methods This was a singlecenter prospective cohort study.The NDKD patients undergoing predialysis AVF creation were enrolled at the First Affiliated Hospital of Xi'an Jiaotong University from 2015 to 2018.According to the estimated glomerular filtration rate(eGFR,the Chronic Kidney Disease Epidemiology Collaboration equation)and age,patients were divided into different subgroups,eGFR:group 1[eGFR<10 ml·min^(-1)·(1.73 m^(2))^(-1)],group 2[eGFR between 10 to 15 ml·min^(-1).(1.73 m^(2))^(-1)].

Association of body mass index and waist circumference with risk of all-cause mortality in middle-aged and elderly patients receiving maintenance hemodialysis

Objective To investigate the association between body mass index (BMI) and waist circumference (WC)with all-cause mortality in middle-aged and elderly patients receiving maintenance hemodialysis (MHD).Methods The clinical data of MHD patients aged≥50years old from eleven hemodialysis centers from April to June 2017 in Beijing were analyzed.

Disease burden of chronic kidney disease and change trend in Belt and Road countries

Objective To analyze the disease burden of chronic kidney disease (CKD) in the Belt and Road countries and its change trend.Methods It was a cross-sectional epidemiological study based on surveillance data.Data on age-standardized prevalence rate (ASPR) and age-standardized mortality rate(ASMR) of CKD were derived from the 2019 Global Burden of Disease Study.

Effect of miR-130a targeting phosphase and tensin homology deleted on chromosome ten/ phosphoinositol 3 kinase/protein kinase B axis on apoptosis of renal tissue cells in rats with diabetic kidney disease

Objective To investigate the effect of miR-130a targeting phosphase and tensin homology deleted on chromosome ten(PTEN)/phosphoinositide 3 kinase(PI3K)/protein kinase B(AKT)pathway on renal tissue cell apoptosis in diabetic kidney disease(DKD)rats.Methods The DKD rat model was constructed by feeding high-sugar and high-fat diet combined with intraperitoneal injection of streptozotocin(STZ).72 rats were divided into normal control group(NC),DKD model group(DKD),miR-13Oa agonist negative control group(NC agomir),and miR-130a agonist group(miR-130a agomir),miR-130a agomir+PTEN overexpression negative control group(miR-13a agomir+pcDNA),and miR-130a agomir+PCDNA-PTEN over-expression group(miR-130a Agomir+PCDNA-PTEN),with 12 rats in each group.Urinary microalbumin kit was used to detect 24 h urine albumin(UAlb).Fasting blood glucose(FBG),serum creatinine(Scr)and blood urea nitrogen(BUN)were detected by automatic biochemical analyzer.Pathological changes of renal tissue were detected by HE staining.The levels of serum IL-6 and TNF-αwere detected by ELISA.The apoptosis of renal tissue was detected by TUNEL staining.The expression of miR-130a was detected by qRT-PCR,and the expression of B-cell lymphoma-2-associated X protein(Bax).

Cross-sectional study on the correlation between Chinese medicine syndrome types and mucosal immunity in IgA nephropathy

Objective To explore the Chinese medicine (CM)syndrome classification and its correlation with mucosal immunity in patients with IgA nephropathy (IgAN).Methods A cross-sectional study was performed,including 410 patients with IgAN.The data of CM syndrome were collected,and the CM syndrome classification was summarized by factor analysis and cluster analysis.

Analysis of clinical characteristics of pediatric atypical hemolytic uremic syndrome in a single center

Objective To analyze the clinical characteristics of pediatric atypical hemolytic uremic syndrome (aHUS),and provide clinical experience for the diagnosis and treatment of aHUS in China.Methods It was a single-center retrospective study.

Study on the effect of platycodin D on HG-induced podocyte injury in mice and cyclooxygenase-2/nuclear factor KB pathway

Objective To explore the effect of platycodin D(PD) on podocyte injury induced by high glucose and cyclooxygenase-2 (COX-2)/nuclear factor kappa B(NF-κB) pathway in mice.Methods MPC5 cells were divided into normal control (Con) group,high glucose(HG) group,HG+PD 5 mg/L group(HG+PD5).

Clinical application of iohexol plasma clearance assay for determination of glomerular filtration rate in chronic kidney disease

Objective To evaluate the clinical application value of iohexol plasma clearance assay in assessing glomerular filtration rate (GFR) in patients with chronic kidney disease (CKD),and identify alternative methods of~(99m)Tc-diethylene triamine pentaacetic acid renal kinetic imaging (Gates) method for measuring GFR (~(99m)Tc-mGFR).

High-risk screening combined with family screening for Fabry disease in adult hemodialysis population-a family report of GLA IVS4+919G>A mutation in Fabry disease

Objective To explore the combination of high risk screening and family screening for potential patients with Fabry disease in adult hemodialysis population,and to improve the diagnostic efficiency of the disease.Methods It was a cross-sectional investigation study.High-risk screening for Fabry disease was performed on adult hemodialysis patients with end-stage kidney disease who were admitted to Yongkang First People's Hospital of Zhejiang Province between November 2022 and February 2023.Dry blood paperα-galactosidase A(α-Gal A)detection assay was performedin males,or glycosphingolipids(Lyso-CL-3)detection assay was performed in females.GLA genetic assay was performed for further diagnosis after abnormal screening results.Family screening was carried out on the family members of the confirmed Fabry disease patients,andα-Gal A activity and Lyso-GL-3 of peripheral blood were measured.Additionally,urine routine,blood biochemistry,eye examination,hearing test,cranial magnetic resonance imaging,and electrocardiogram were performed to assess organ ndamage.Results Among 244 hemodialysis patients,139(56.97%)were males and 105(43.03%)were females.

Research on predictive value of serum antiphospholipase A2 receptor antibody in pathological diagnosis in patients with type 2 diabetes mellitus and proteinuria

Objective To investigate the predictive value of serum anti-phospholipase A2 receptor (PLA2R)antibody in pathological diagnosis inpatients with type 2 diabetes mellitus(T2DM)and proteinuria.Methods Eighty-seven patients with T2DM complicated with proteinuria who underwent kidney biopsy were enrolled in this study from Hebei General Hospital during January 2017 to December 2019.