Protective Effects of Mongolian Medicine Borantunggal on Rats with Chronic Renal Insufficiency

[Objectives]To observe the protective effects of Mongolian medicine Borantunggal on rats with chronic renal insufficiency.[Methods]Male Wister rats were gavaged with 50 mg/kg/d adenine for 12 consecutive weeks,and were intervened with positive control drug Niaoduqing and three groups of different doses of Mongolian medicine Borantunggal.The rats general state,such as body posture,hair color,activity status,renal function,thyroid gland,adrenal gland,and gonadal hormone levels,expression levels of inflammatory mediators,α-smooth muscle actin(α-SMA)and nuclear factor-κB(P65)in renal tissue,and histopathological changes of rat kidney were observed before and after treatment.[Results]The recovery of the general state of rats with chronic renal insufficiency in the low dose group after intervention with Mongolian medicine Borantunggal was the most obvious.Compared with the model group,the level of CRE in the low dose Mongolian medicine group decreased,and the difference was statistically significant(P<0.05).Compared with the normal group,the 24-h urinary protein in the low dose Mongolian medicine group had a declining trend,but the difference was not statistically significant(P>0.05).The urea level in low,medium and high dose Mongolian medicine groups showed a declining trend,and the effect of low dose Mongolian medicine was better.Compared with the model group,the feed intake of the low dose Mongolian medicine group had an increasing trend,while P and TCHO also had a declining trend.Compared with the model group,the levels of LH and COR in the low,medium and high dose Mongolian medicine groups decreased significantly,and the difference was statistically significant(P<0.05).The levels of T,T3 and T4 were significantly increased,the difference was statistically significant(P<0.05),and the effect of low dose Mongolian medicine was better.Compared with the model group,the levels of IL-6,TNF-αand HIF-1 in the low,medium and high dose Mongolian medicine groups were significantly reduced,and the difference was statistically significant(P<0.05).The levels of TGF-β1 and Ang II in the low dose Mongolian medicine group were significantly reduced,and the difference was statistically significant(P<0.05).The level of TGF-β1 in the medium and high dose Mongolian medicine groups decreased,and the difference was statistically significant(P<0.05).The expression of NF-κB P65 andα-SMA proteins in the low dose Mongolian medicine group showed a declining trend,which was better than Niaoduqing.[Conclusions]Mongolian medicine Borantunggal has significant protective and preventive effects on rats with adenine-induced chronic renal insufficiency.In particular,the dose of 0.31 kg/d had the most significant protective effect.Its action mechanism may be related to regulating hormone levels in the body,improving renal function,reducing renal inflammatory response,reducing the"three highs"in the kidney,and inhibiting renal tubular epithelial cell-to-mesenchymal transition and deposition of extracellular matrix(ECM).

Expression of HO-1 in Chronic Renal Insufficiency Rat Kidney and Implication

The expression, activity and clinical implication of heme oxygenase-1 (HO-1) in the chronic renal insufficiency (CRI) rat kidney and its mechanism were investigated The 5/6 nephrectomized rats were assigned to sham operation group, CRI group and Hemin group At the 8th week after second operation, blood pressure, urinary protein, serum creatinine(Scr) and BUN were measured Renal pathologic changes were observed The activity of HO and contents of erythropoietin (EPO) in serum and renal tissue were determined Immunohistochemistry was used to detect the expression and distribution of HO-1 in the CRI rat kidney As compared with CRI group, the urinary protein, blood pressure, Scr and BUN in Hemin group were reduced significantly ( P< 0 05) The glomerular mesangial proliferation, inflammatory cellular infiltration of renal interstitium and interstitial fibrosis were ameliorated significantly Immunohistochemistry and measurement of HO-1 activity revealed that the expression and activity of HO-1 was decreased in renal tissues and increased in serum in CRI group as compared with normal rats HO-1 distributed mainly in tubular epithelial cells The EPO contents in Hemin group were significantly higher than in CRI group Through up-regulating the EPO level in serum and renal tissues, HO-1 retards the progression of CRI

Real-time shear wave elastography combined with biochemical indicators for evaluating liver injury in patients with chronic kidney disease

Objective To observe the value of real-time shear wave elastography(SWE)combined with biochemical indicators for evaluating liver injury in patients with chronic kidney disease(CKD).Methods Totally 210 patients with CKD(CKD group)and 64 healthy subjects(control group)were retrospectively enrolled.Patients in CKD group were further divided into CKD1—5 subgroups according to CKD stages.SWE parameters of liver and kidney,including mean value,the maximum value and the median value of Young's modulus(EQI mean,EQI max and EQI med)were compared between CKD subgroups and control group.Spearman correlation analysis were performed to explore the correlations of liver and kidney SWE parameters with CKD stage,as well as of liver SWE parameters with biochemical indicators.Multivariate logistic regression analysis was used to screen independent predictors of liver injury in CKD patients.Receiver operating characteristic curves were drawn,the area under the curves(AUC)were calculated to evaluate the efficacy of the independent predictors alone and their combination for assessing liver injury in CKD patients.Results Significant differences of liver and kidney SWE parameters were found among CKD subgroups and control group(all P≤0.001).Pairwise comparison showed that liver SWE parameters in CKD5 subgroup and liver EQI max in CKD4 subgroup were all higher than those in control group(all P<0.003).Kidney SWE parameters in CKD3 subgroup were all higher than those in control group,while in CKD4 subgroup were all higher than those in control group and CKD1—3 subgroup(all P<0.003).Kidney EQI mean and EQI med in CKD5 subgroup were all higher than those in control group and CKD1—4 subgroup,while kidney EQI max in CKD5 subgroup were higher than those in control group and CKD1—3 subgroup(all P<0.003).Liver and kidney SWE parameters were lowly-moderately and positively correlated with CKD stages(r=0.364—0.665,all P<0.001).Liver SWE parameters of CKD were weakly and positively correlated with alkaline phosphatase(ALP)(r=0.229—0.248,all P<0.01).Theγ-glutamyl transferase,ALP and liver EQI max were all independent predictors of liver injury in CKD patients(all P<0.01),with AUC for evaluating liver injury in CKD patients alone of 0.645,0.756 and 0.741,respectively,lower than that of their combination(0.851,all P<0.01).Conclusion Real-time SWE combined with liver function indicators could reflect degree of liver injury in patients with different CKD stages.

Heparin-induced thrombocytopenia in renal insufficiency undergoing dialysis and percutaneous coronary intervention after acute myocardial infarction:A case report

BACKGROUND Heparin-induced thrombocytopenia(HIT)is a rare complication of heparin therapy,and is characterized by arteriovenous thrombosis and bleeding events.The incidence of HIT after percutaneous coronary intervention(PCI)in patients with myocardial infarction complicated with renal failure is rarely reported.CASE SUMMARY We report a 73-year-old man with acute myocardial infarction and renal failure who underwent hemodialysis and PCI,and developed a progressive decline in platelets and subcutaneous hemorrhage of both upper limbs after heparin treatment.In addition to a gradual decrease in platelets,the patient’s 4T's score was 7,and HIT antibody was positive,confirming the diagnosis of HIT.CONCLUSION Patients receiving heparin combined with antiplatelet therapy should be monitored closely,especially for their platelet count.In the case of thrombocytopenia,HIT should be highly suspected.When the diagnosis of HIT is confirmed,timely individualized treatment should be delivered.

Retroperitoneal laparoscopic partial resection of the renal pelvis for urothelial carcinoma:A case report

BACKGROUND The standard treatment of transitional cell carcinoma of the upper urinary tract consists of radical nephroureterectomy with bladder cuff removal,which can be performed either in open or laparoscopy or robot-assisted laparoscopy.Treatment of chronic renal insufficiency patients with upper urothelial tumor is in a dilemma.Urologists weigh and consider the balance between tumor control and effective renal function preservation.European Association of Urology guidelines recommend that select patients may benefit from endoscopic treatment,but laparoscopic treatment is rarely reported.CASE SUMMARY In this case report,we describe a case of 79-year-old female diagnosed with urothelial carcinoma of the renal pelvis and adrenal adenoma with chronic renal insufficiency.The patient was treated with retroperitoneal laparoscopic partial resection of the renal pelvis and adrenal adenoma resection simultaneously.CONCLUSION Retroperitoneal laparoscopic partial resection of the renal pelvis is an effective surgical procedure for the treatment of urothelial carcinoma of the renal pelvis.

Effects of Oenethera Oil on Plasma Lipid，Thromboxane A2 and Angiotensin Ⅱ of Chronic Renal Insufficiency

Oenethera biennis oil was administered (6 g per day) in 23 chronic renal insufficiency pa-tients over a 4 week period. Changes of serum creatinine, creatinine clearance, plasma lipid, renin activity,and angiatensin , urinary thromboxane B2 and 6-keto-prostaglandin F1 were observed before and after thetreatment. Results showed that after treatment. the creatinine clearance increased, serum total cholesterol,triglyceride and low density lipoprotein decreased, high density lipoprotein increased, plasma renin activity,angiotensin and urinary thromboxane B2 decreased significantly. The conclusion was that Oenethera bien-nis oil could improve the pathological process of renal diseases, and has benoficial effects on plasma lipiddisorder and glomerular hemodynamics .

Is the Distribution of Microorganisms and Peritonitis Affected by Seasonality in Peritoneal Dialysis?

Introduction: Peritonitis continues to be the main complication for patients on peritoneal dialysis (PD). Objective: To determine the frequency of peritonitis according to the disease-causing microorganism and its distribution throughout the year, linking to seasonality. Methods: A retrospective study conducted in the Dialysis Unit of the Hospital S&atildeo Lucas, PUCRS (HSL-PUCRS). Patients undergoing PD between January 1984 and September 2013 were included. Descriptive statistics were used and Fisher’s exact test with Monte Carlo simulation for comparison between the categorical variables. Results: Of 415 evaluated patients, 66% had at least one episode of peritonitis with an incidence rate of 0.68 episode/year. There were 601 peritonitis episodes in total. The most common microorganism was coagulase-negative Staphylococcus (26.6%, n = 160), followed by Staphylococcus aureus (16.3%, n = 98), with 16.3% of the sample being negative culture. Most episodes occurred in the months of January (10.3%, n = 62) and May (10.1%, n = 61), while June had the lowest occurrence (5.2%, n = 31). The number of episodes observed in January and May were significantly higher when compared to June

Effects of the Huangkui capsule(黄葵胶囊)on chronic kidney disease:a systematic review and Meta-analysis

OBJECTIVE:To collect data and investigate the effects of Huangkui capsule(黄葵胶囊,HKC)on chronic kidney disease(CKD).METHODS:PubM ed,Embase,Cochrane Library,and three Chinese databases(China National Knowledge Infrastructure,Wanfang,and China Science and Technology Journal Database)were searched for articles published until October 2020.Randomized controlled trials(RCTs)of HKCs used for treating CKD were reviewed.Data were organized and analyzed using RevMan 5.3 software.RESULTS:HKC significantly lowered the blood urea nitrogen(BUN)level[mean difference(MD)=-2.26;95%confidence interval(CI),-2.91 to-1.61],serum creatinine level(MD=-17.45;95%CI,-22.29 to-12.60),and 24-h urine protein content(MD=-0.73;95%CI,-1.00 to-0.46)and improved the glomerular filtration rate(GFR)(MD=10.69;95%CI,5.57 to 15.81)and serum albumin level(MD=2.20;95%CI,0.49 to 3.90).CONCLUSIONS:Our findings show that HKC could lower the BUN level,serum creatinine level,and 24-h urine protein content.HKC also improved GFR and serum albumin levels.However,high-quality RCTs in other countries with larger sample sizes are warranted to confirm these findings.

Embryonic Stem Cells-loaded Gelatin Microcryogels Slow Progression of Chronic Kidney Disease

Background： Chronic kidney disease （CKD） has become a public health problem.New interventions to slow or prevent disease progression are urgently needed.In this setting, cell therapies associated with regenerative effects are attracting increasing interest.We evaluated the effect of embryonic stem cells （ESCs） on the progression of CKD.Methods： Adult male Sprague-Dawley rats were subjected to 5/6 nephrectomy.We used pedicled greater omentum flaps packing ESC-loaded gelatin microcryogets （GMs） on the 5/6 nephrectomized kidney.The viability of ESCs within the GMs was detected using in vio two-photon fluorescence confocal imaging.Rats were sacrificed after 12 weeks.Renal injury was evaluated using serum creatinine, urea nitrogen, 24 h protein, renal pathology, and tubular injury score results.Structural damage was evaluated by periodic acid-Schiff and Masson trichrome staining.Results： In vitro, ESCs could be automatically loaded into the GMs.Uniform cell distribution, good cell attachment, and viability were achieved from day 1 to 7 in vitro.After 12 weeks, in the pedicled greater omentum flaps packing ESC-loaded GMs on 5/6 nephrectomized rats group, the plasma urea nitrogen levels were 26% lower than in the right nephrectomy group, glomerulosclerosis index was 62% lower and tubular injury index was 40% lower than in the 5/6 nephrectomized rats group without GMs.Conclusions： In a rat model of established CKD, we demonstrated that the pedicled greater omentum flaps packing ESC-loaded GMs on the 5/6 nephrectomized kidney have a long-lasting therapeutic rescue function, as shown by the decreased progression of CKD and reduced glomerular injury.