Decreased Number of CD14+TLR4+ Monocytes and Their Impaired Cytokine Responses to Lipopolysaccharide in Patients with Chronic Kidney Disease

This study aimed to examine the number of circulating Toll-like receptor 4（TLR4） ＋ CD14＋ monocytes in patients with different stages of chronic kidney disease（CKD）, their responses to lipopolysaccharide（LPS）, and to explore the potential association of the number of TLR4＋CD14＋ monocytes with clinical laboratory measures. The numbers of TLR4＋CD14＋, LPS-stimulated TNF-？＋CD14＋ and interleukin（IL）-6＋CD14＋ monocytes were determined by flow cytometry in 9 patients with stage 3 CKD, 11 with stage 4 CKD, 16 with stage 5 CKD, and 19 healthy controls（HCs）. Their laboratory tests were performed by routine methods and the potential association among these measures was analyzed by Pearson＇s correlation analysis. The numbers of CD14＋, CD14＋TLR4＋, LPSstimulated TNF-？＋CD14＋ and IL-6＋CD14＋ monocytes in patients with CKD were significantly less than those of HCs（all P〈0.05）, and were negatively associated with patient disease severity. The number of CD14＋TLR4＋ monocytes was positively correlated with estimated glomerular filtration rate（e GFR, P〈0.001） and the levels of hematocrit（P〈0.01）, but negatively correlated with the levels of blood urine nitrogen, serum creatinine, and C-reactive protein（P〈0.001 for all）, in the CKD patients. Our data indicate that significant reduction in the number of TLR4＋ monocytes and their impaired responses to LPS may be associated with the progression of CKD in Chinese patients.

Prevalence of Uropathogenic Escherichia coli among Adult Male Patients 40 Years and above with Haematuria and Impaired Kidney Attending General Hospitals in Benue State

Haematuria is the presence of red blood cells in urine. It is most often caused by urinary tract infections of which Escherichia coli is frequently implicated. Impairment of kidney functions could occur as a result of infection or other complications of the kidney. The aim of the study was to determine the prevalence of uropathogenic Escherichia coli among adult male patients with haematuria and impaired kidneys attending a general hospital in Benue state. Three hundred and sixty-eight (368) samples of urine were collected from 368 male patients (≥ 40 years) attending the 23 general hospitals in Benue state. Each of the urine samples was divided into two parts for haematuria and isolation and identification of Escherichia coli. Blood samples (368) were also collected from the patients and used for quantitative determination of creatinine and estimation of glomerular filtration rate. The presence of haematuria was 45.1% and ranges from 12.5% to 100%. Prevalence of haematuria with respect to age shows that patients within the age group of 90 - 99 years had the highest rate (100%) and the least were those within the ages of 40 - 49 years (20.0%). Isolation rate of uropathogenic Escherichia coli was 16.3% and ranged from 6.3 to 37.5%. Patients within the age group of 90 - 99 years had the highest elevated impaired renal function of 4 (80%), followed by patients within the ages of 80 - 89 years [17 (77.3%)] and the lowest were those within the ages of 40 - 49 [6 (10.0%)]. The overall presence of haematuria in the patients was high (45.1%) with similar high Escherichia coli isolation rate and impaired renal function which could mean that acute or chronic kidney disease may set in.