A retrospective Aliskiren and Losartan study in non-diabetic chronic kidney disease

AIM： To assess the effcacy of combined Aliskiren and Losartan vs high dose Losartan and Aliskiren alone in chronic kidney disease （CKD）.METHODS： This is a retrospective study of 143 pa-tients with non-diabetic CKD comparing combined Aliskiren （150 mg/d） with Losartan （100 mg/d） therapy vs High dose Angiotensin receptor blockers （ARB） （Losartan 200 mg/d） and the third group Aliskiren （150 mg/d） alone. This study involved only patient medi-cal records. Entry criteria included those patients who had been treated with the above drugs for at least 36 mo within the 5 years period; other criteria included proteinuria of 1 g or more and or CKD Stage 3 at the start of the 36 mo period. The study utilised primary renal end points of estimated Glomerular Filtration Rate （eGFR） 〈 15 mL/min or end stage renal failure. RESULTS： Patients treated with high dose ARB com-pared to the other two treatment groups had signifcantly less proteinuria at the end of 36 mo （ P 〈 0.007）. All 3 groups had signifcant reduction of proteinuria （ P 〈 0.043, P 〈 0.001）. Total urinary protein was signifcantly differ-ent between the 3 groups over the 3-year study period （ P = 0.008）, but not eGFR. The changes in eGFR from baseline to each year were not signifcantly different be-tween the 3 therapeutic groups （ P 〈 0.119）. There were no significant differences in the systolic and diastolic blood pressure between the 3 drug groups throughout the 3 years. The incidence of hyperkalemia （〉 5.5 mmol/L） was 14.2% （7/49） in the Combined Aliskiren and ARB group, 8.7% （4/46） in the Aliskiren alone group and 6.3% （3/48） in the High dose ARB group （ P 〈 0.001）.CONCLUSION： This study in non-diabetic CKD pa-tients showed that Combination therapy with Aliskiren and ARB was effective but was not safe as it was asso-ciated with a high prevalence of hyperkalaemia.

MACHINE LEARING FOR MOBILE EDGE COMPUTING

In recent years,mobile edge computing has attracted a considerable amount of attention from both academia and industry through its many advantages(such as low latency,computation efficiency and privacy)caused by its local model of providing storage and computation resources.

Disease Progression, Response to ACEI/ATRA Therapy and Influence of ACE Gene in IgA Nephritis

Various studies have shown that angiotensin-converting enzyme （ACE） gene insertion/deletion （ID） polymorphism may play a role in the progression to end stage renal failure （ESRF） in patients with IgA nephritis （IgAN）. In this randomized controlled trial, patients were followed up for 5 years to determine their long-term renal outcome to ACEI/ATRA therapy and to ascertain if their ACE gene profile could play a role in determining their response to therapy. Seventy-five patients with IgAN were enlisted. Thirty-seven were on ACEI/ATRA therapy for 62 ± 5 months and thirty-eight were untreated and served as controls. All patients had their ACE gene ID polymorphism genotyped. Compared to controls, treated patients had lower serum creatinine （p 〈 0.001）, lower proteinuria （p 〈 0.002） and fewer numbers progressing to ESRF （p 〈 0.002）. Among patients with genotype II, there were less ESRF in the treatment group when compared to the untreated control group （p 〈 0.02）. The advantage of therapy was not seen in patients with ID or DD genotypes. ACEI/ATRA therapy was found to be effective in retarding disease progression in IgAN with years to ESRF significantly extended in patients at all levels of renal function, including patients whose outcome were ESRF. Genotyping showed better response to therapy only for those with genotype Ⅱ. The common mechanism is probably through lower levels of ACE, glomerular pressure and proteinuria resulting in reduced renal damage and retardation of progression to ESRF. Cellular ＆ Molecular Immunology.

Towards a respondent-preferred k_i-anonymity model

Recently, privacy concerns about data collection have received an increasing amount of attention. In data collection process, a data collector （an agency） assumed that all respondents would be comfortable with submitting their data if the published data was anonymous. We believe that this assumption is not realistic because the increase in privacy concerns causes some re- spondents to refuse participation or to submit inaccurate data to such agencies. If respondents submit inaccurate data, then the usefulness of the results from analysis of the collected data cannot be guaranteed. Furthermore, we note that the level of anonymity （i.e., k-anonymity） guaranteed by an agency cannot be verified by respondents since they generally do not have access to all of the data that is released. Therefore, we introduce the notion of ki-anonymity, where ki is the level of anonymity preferred by each respondent i. Instead of placing full trust in an agency, our solution increases respondent confidence by allowing each to decide the preferred level of protection. As such, our protocol ensures that respondents achieve their preferred kranonymity during data collection and guarantees that the collected records are genuine and useful for data analysis.