BACKGROUND Diabetic kidney disease(DKD),characterized by increased urinary microalbumin levels and decreased renal function,is the primary cause of end-stage renal di-sease.Its pathological mechanisms are complicated ...BACKGROUND Diabetic kidney disease(DKD),characterized by increased urinary microalbumin levels and decreased renal function,is the primary cause of end-stage renal di-sease.Its pathological mechanisms are complicated and multifactorial;Therefore,sensitive and specific biomarkers are needed.Urinary exosome originate from diverse renal cells in nephron segments and partially mirror the pathological changes in the kidney.The microRNAs(miRNAs)in urinary exosome are remark-ably stable and highly tissue-specific for the kidney.METHODS Type 2 diabetic mellitus(T2DM)patients were recruited from the Second Hospital of Hebei Medical University and were divided into two groups:DM,diabetic pa-tients without albuminuria[urinary albumin to creatinine ratio(UACR)<30 mg/g]and DKD,diabetic patients with albuminuria(UACR≥30 mg/g).Healthy subjects were the normal control(NC)group.Urinary exosomal miR-145-5p,miR-27a-3p,and miR-29c-3p,were detected using real-time quantitative polymerase chain reaction.The correlation between exosomal miRNAs and the clinical in-dexes was evaluated.The diagnostic values of exosomal miR-145-5p and miR-27a-3p in DKD were determined using receiver operating characteristic(ROC)analysis.Biological functions of miR-145-5p were investigated by performing RESULTS Urinary exosomal expression of miR-145-5p and miR-27a-3p was more upregulated in the DKD group than in the DM group(miR-145-5p:4.54±1.45 vs 1.95±0.93,P<0.001;miR-27a-3p:2.33±0.79 vs 1.71±0.76,P<0.05)and the NC group(miR-145-5p:4.54±1.45 vs 1.55±0.83,P<0.001;miR-27a-3p:2.33±0.79 vs 1.10±0.51,P<0.001).The exosomal miR-145-5p and miR-27a-3p positively correlated with albuminuria and serum creatinine and negatively correlated with the estimated glomerular filtration rate.miR-27a-3p was also closely related to blood glucose,gly-cosylated hemoglobin A1c,and low-density lipoprotein cholesterol.ROC analysis revealed that miR-145-5p had a better area under the curve of 0.88[95%confidence interval(CI):0.784-0.985,P<0.0001]in diagnosing DKD than miR-27a-3p with 0.71(95%CI:0.547-0.871,P=0.0239).Bioinformatics analysis revealed that the target genes of miR-145-5p were located in the actin filament,cytoskeleton,and extracellular exosome and were involved in the pathological processes of DKD,including apoptosis,inflammation,and fibrosis.CONCLUSION Urinary exosomal miR-145-5p and miR-27a-3p may serve as novel noninvasive diagnostic biomarkers or promising therapeutic targets for DKD.展开更多
Objective:To observe the effect of laparoscopic peritoneal dialysis(PD)catheterization on stress response.Methods:The clinical data of 60 patients with stage 5 chronic kidney disease treated in our hospital from March...Objective:To observe the effect of laparoscopic peritoneal dialysis(PD)catheterization on stress response.Methods:The clinical data of 60 patients with stage 5 chronic kidney disease treated in our hospital from March 2016 to October 2019 were analyzed retrospectively.According to the different operation methods,they were divided into two groups.34 patients who received open PD catheterization were included in the control group,and 26 patients who received laparoscopic PD catheterization were used as the observation group.The intraoperative indexes,C-reactive protein(CRP),procalcitonin(PCT)levels and complications were compared between the two groups.Results:In the observation group,the bleeding volume was(16.27±4.13)mL,less than that in the control group,the operation time was(48.93±10.16)min,shorter than that in the control group,the incidence of catheter displacement was lower than that in the con-trol group,the difference was statistically significant(P<0.05).There was no significant difference in the levels of CRP and PCT between the two groups(P>0.05);the levels of CRP(47.25±16.91)mg/L and PCT(0.07±0.01)μg/L in the observation group were lower than those in the control group(P<0.05).Conclusion:Laparoscopic PD catheteri-zation in the treatment of end-stage renal disease has the advantages of small trauma,mild stress response and quick postoperative recovery,and it can reduce the occurrence of catheter displacement and the risk of PD catheterization.展开更多
基金Supported by the Nature Science Foundation of Hebei Province,No.H2023104011.
文摘BACKGROUND Diabetic kidney disease(DKD),characterized by increased urinary microalbumin levels and decreased renal function,is the primary cause of end-stage renal di-sease.Its pathological mechanisms are complicated and multifactorial;Therefore,sensitive and specific biomarkers are needed.Urinary exosome originate from diverse renal cells in nephron segments and partially mirror the pathological changes in the kidney.The microRNAs(miRNAs)in urinary exosome are remark-ably stable and highly tissue-specific for the kidney.METHODS Type 2 diabetic mellitus(T2DM)patients were recruited from the Second Hospital of Hebei Medical University and were divided into two groups:DM,diabetic pa-tients without albuminuria[urinary albumin to creatinine ratio(UACR)<30 mg/g]and DKD,diabetic patients with albuminuria(UACR≥30 mg/g).Healthy subjects were the normal control(NC)group.Urinary exosomal miR-145-5p,miR-27a-3p,and miR-29c-3p,were detected using real-time quantitative polymerase chain reaction.The correlation between exosomal miRNAs and the clinical in-dexes was evaluated.The diagnostic values of exosomal miR-145-5p and miR-27a-3p in DKD were determined using receiver operating characteristic(ROC)analysis.Biological functions of miR-145-5p were investigated by performing RESULTS Urinary exosomal expression of miR-145-5p and miR-27a-3p was more upregulated in the DKD group than in the DM group(miR-145-5p:4.54±1.45 vs 1.95±0.93,P<0.001;miR-27a-3p:2.33±0.79 vs 1.71±0.76,P<0.05)and the NC group(miR-145-5p:4.54±1.45 vs 1.55±0.83,P<0.001;miR-27a-3p:2.33±0.79 vs 1.10±0.51,P<0.001).The exosomal miR-145-5p and miR-27a-3p positively correlated with albuminuria and serum creatinine and negatively correlated with the estimated glomerular filtration rate.miR-27a-3p was also closely related to blood glucose,gly-cosylated hemoglobin A1c,and low-density lipoprotein cholesterol.ROC analysis revealed that miR-145-5p had a better area under the curve of 0.88[95%confidence interval(CI):0.784-0.985,P<0.0001]in diagnosing DKD than miR-27a-3p with 0.71(95%CI:0.547-0.871,P=0.0239).Bioinformatics analysis revealed that the target genes of miR-145-5p were located in the actin filament,cytoskeleton,and extracellular exosome and were involved in the pathological processes of DKD,including apoptosis,inflammation,and fibrosis.CONCLUSION Urinary exosomal miR-145-5p and miR-27a-3p may serve as novel noninvasive diagnostic biomarkers or promising therapeutic targets for DKD.
基金Ganzhou guiding science and technology projeet,grant number:gz2018zsf044
文摘Objective:To observe the effect of laparoscopic peritoneal dialysis(PD)catheterization on stress response.Methods:The clinical data of 60 patients with stage 5 chronic kidney disease treated in our hospital from March 2016 to October 2019 were analyzed retrospectively.According to the different operation methods,they were divided into two groups.34 patients who received open PD catheterization were included in the control group,and 26 patients who received laparoscopic PD catheterization were used as the observation group.The intraoperative indexes,C-reactive protein(CRP),procalcitonin(PCT)levels and complications were compared between the two groups.Results:In the observation group,the bleeding volume was(16.27±4.13)mL,less than that in the control group,the operation time was(48.93±10.16)min,shorter than that in the control group,the incidence of catheter displacement was lower than that in the con-trol group,the difference was statistically significant(P<0.05).There was no significant difference in the levels of CRP and PCT between the two groups(P>0.05);the levels of CRP(47.25±16.91)mg/L and PCT(0.07±0.01)μg/L in the observation group were lower than those in the control group(P<0.05).Conclusion:Laparoscopic PD catheteri-zation in the treatment of end-stage renal disease has the advantages of small trauma,mild stress response and quick postoperative recovery,and it can reduce the occurrence of catheter displacement and the risk of PD catheterization.
