BACKGROUND Diabetic kidney disease is one of the common complications of type 2 diabetes(T2D).There are no typical symptoms in the early stage,and the disease will progress to moderate and late stage when albuminuria ...BACKGROUND Diabetic kidney disease is one of the common complications of type 2 diabetes(T2D).There are no typical symptoms in the early stage,and the disease will progress to moderate and late stage when albuminuria reaches a high level.Treatment is difficult and the prognosis is poor.At present,the pathogenesis of diabetic kidney disease is still unclear,and it is believed that it is associated with genetic and environmental factors.AIM To explore the relationship between the glucokinase regulatory protein(GCKR)gene rs780094 polymorphism and T2D with albuminuria.METHODS We selected 252 patients(126 males and 126 females)with T2D admitted to our hospital from January 2020 to October 2020,and 66 healthy people(44 females and 22 males).According to the urinary albumin/creatinine ratio,the subjects were divided into group I(control),group II(T2D with normoalbuminuria),group III(T2D with microalbuminuria),and group IV(T2D with macroalbuminuria).Additionly,the subjects were divided into group M(normal group)or group N(albuminuria group)according to whether they developed albuminuria.We detected the GCKR gene rs780094 polymorphism(C/T)of all subjects,and measured the correlation between GCKR gene rs780094 polymorphism(C/T)and T2D with albuminuria.RESULTS Gene distribution and genotype distribution among groups I-IV accorded with the Hardy-Weinberg equilibrium.Genotype frequency was significantly different among the four groups (P = 0.048, χ^(2)= 7.906). T allele frequency in groups II, III, and IV was significantly higherthan that in group I. Logistic regression analysis of the risk factors for T2D with albuminuria showed that the CT +TT genotype (odds ratio = 1.710, 95% confidence interval: 1.172-2.493) was a risk factor.CONCLUSION CT + TT genotype is a risk factor for T2D with albuminuria. In the future, we can assess the risk of individualscarrying susceptible genes to delay the onset of T2D.展开更多
目的:观察基于名中医经验的中医辨证组方对老年慢性肾炎(CKD1-3a期)患者的有效性和安全性。方法:将84例老年慢性肾炎患者随机分成治疗组(42例)和对照组(42例)。治疗组采用西医基础联合中医辨证组方治疗;对照组仅接受西医基础治疗,疗程均...目的:观察基于名中医经验的中医辨证组方对老年慢性肾炎(CKD1-3a期)患者的有效性和安全性。方法:将84例老年慢性肾炎患者随机分成治疗组(42例)和对照组(42例)。治疗组采用西医基础联合中医辨证组方治疗;对照组仅接受西医基础治疗,疗程均为24周。观察两组治疗前后24 h尿蛋白定量(24 h UPQ)、肾小球滤过率(eGFR)等临床指标变化,以及疗效和安全性。结果:与本组基线比较,两组治疗后12、18、24周24 h UPQ均显著下降(P<0.01),且24周时治疗组优于对照组(P<0.01)。治疗组总有效率为67.57%,对照组总有效率41.67%,治疗组显著高于对照组(P<0.05)。将慢性肾脏病(CKD)3a期患者进行亚组分析提示,24周后治疗组eGFR较本组基线及同期对照组显著升高(P<0.01,P<0.05),而对照组治疗前后无显著变化。治疗组不良反应发生4例,对照组2例,两组无严重不良反应出现。结论:基于名中医经验的中医辨证组方治疗老年慢性肾炎(CKD1-3a期),可减少尿蛋白,提高临床疗效,对其中的CKD3a期患者可能具有改善eGFR作用,且安全性较好。展开更多
目的:探讨体检人群甘油三酯/高密度脂蛋白胆固醇(triglyceride/high density lipoprotein cholesterol ratio,TG/HDL-C)、甘油三酯-葡萄糖乘积(riglyceride-glucose index,TyG)指数及其衍生指数水平与白蛋白尿异常的相关性,同时分析TG/H...目的:探讨体检人群甘油三酯/高密度脂蛋白胆固醇(triglyceride/high density lipoprotein cholesterol ratio,TG/HDL-C)、甘油三酯-葡萄糖乘积(riglyceride-glucose index,TyG)指数及其衍生指数水平与白蛋白尿异常的相关性,同时分析TG/HDL-C、TyG以及TyG-BMI(riglyceride-glucose index-body mass index,TyG-BMI)预测白蛋白尿的能力。方法:获取2022年1月至12月体检中心年龄在18岁以上3739例受检者进行回顾性分析,将研究对象分为白蛋白尿异常组(n=841)和对照人群(n=2898),将TG/HDL-C、TyG以及TyG-BMI按四分位数进行分组,采用logistic回归模型分析与体检人群白蛋白尿异常风险之间的关系。采用限制性立方样条回归模型分析不同水平TG/HDL-C、BMI、TyG以及TyG-BMI与白蛋白尿的剂量反应关系。通过受试者工作特征曲线分析单一指标与联合指标对白蛋白尿的预测价值。结果:除平均血红蛋白浓度、高密度脂蛋白胆固醇外,异常组年龄、中性粒细胞、单核细胞、血小板、血白细胞计数、平均红细胞体积、红细胞分布宽度SD、红细胞分布宽度、血小板压积、总蛋白、白蛋白、谷氨酰转肽酶、空腹血糖、糖化血红蛋白、总胆固醇、低密度脂蛋白胆固醇、甘油三酯(triglyceride,TG)、体质指数(body mass index,BMI)、收缩压、舒张压、脉率、碱性磷酸酶、TyG指数、TyG-BMI、TG/HDL-C均高于对照组。调整混杂因素后,逻辑回归结果显示,与第2、第3分位数相比,TG/HDL-C、TyG、TyG-BMI指数第4四分位数组发生风险最高,其分别为1.895倍(95%CI=1.355~2.653)、2.377倍(95%CI=1.657~3.417)、2.319(95%CI=1.666~3.237)。BMI、TyG-BMI指数与白蛋白尿异常呈明显的非线性剂量反应关系,曲线呈近似“U”型,TyG、TG/HDL-C与白蛋白尿异常之间的剂量反应关系呈逐渐递增趋势,曲线呈近似“J”型。受试者工作特征(receiver operating characteristic,ROC)曲线结果显示,TyG-BMI预测能力优于其他3个指标,其AUC值为0.640。除TyG-BMI+TG/HDL-C之外,其余联合预测能力均优于单一预测指标,TyG-BMI+TG/HDL-C+TyG指数预测白蛋白尿的能力最优,AUC为0.6504。结论:TyG指数、TG/HDL-C比值升高与白蛋白尿异常密切相关,均对白蛋白尿具有一定的预测价值。综合考虑,TyG-BMI+TG/HDL-C+TyG指数是较佳白蛋白尿预测联合指标。展开更多
Background: Neuttrophil gelatinase associated lipocalin (NGAL) was shown to be a good marker for predicting acute kidney injury (AKI). Some recent reports demonstrated that NGAL may be an early biomarker for kidney af...Background: Neuttrophil gelatinase associated lipocalin (NGAL) was shown to be a good marker for predicting acute kidney injury (AKI). Some recent reports demonstrated that NGAL may be an early biomarker for kidney affection in diabetic patients. The aim of this work is to investigate urinary NGAL (UNGAL) in type 2 diabetic patients with and without albuminuria. Methods: This study included 46 type 2 diabetic patients and 15 healthy age and sex matched individuals as the control group. Diabetic patients were divided into three groups according to urinary albumin excretion (UAE), normoalbuminuria, microalbuminuria and macroalbuminuria. UNGAL was measured in all populations and corrected to urinary creatinine to account for day to day variation in urine volume and transformed log. Comparison between 4 groups (control, normoalbuminuria, microalbuminuria and macroalbuminuria) was done. Results: Log UNGAL/Creatinine ratio showed significant difference when comparing control group (0.70 ± 0.58) versus normoalbuminuria (1.71 ± 1.06), microalbuminuria (1.57 ± 0.72) and macroalbuminuria (1.92 ± 0.63), however, there was no significant difference among diabetic groups. Pearson’s correlation showed that log UNGAL/Creatinine ratio positively correlated with glycated hemoglobin (HbA1c) and inversely with estimated glomerular filtration rate (eGFR). Regression analysis showed that HbA1c, urinary creatinine and eGFR were the independent predictors of log UNGAL/Creatinine ratio. Conclusion: Tubular markers like UNGAL may be early elevated in type 2 diabetic patients even before the incidence of glomerular injury detected by microalbuminuria and it can be used as an early marker for detection of kidney involvement in diabetic patients.展开更多
Background: Diabetic nephropathy is the most common cause of chronic kidney disease and the number afflicted patients continues to rise. The presence of proteinuria has been considered as a prerequisite for the diagno...Background: Diabetic nephropathy is the most common cause of chronic kidney disease and the number afflicted patients continues to rise. The presence of proteinuria has been considered as a prerequisite for the diagnosis of diabetic nephropathy. But one third to one half of type 2 diabetics with CKD have no proteinuria and the pathology of non proteinuric CKD in this group remains unclear as renal biopsy is commonly not performed in these patients. The present study addresses the question: Can a classical diabetic nephropathy occur in the absence of proteinuria? Method: We examined renal biopsies of subjects who underwent nephrectomy from 1999 to 2009 for renal cancer, had eGFR < 60 ml/min and no microalbuminuria or proteinuria. 10 diabetics were matched with 10 non diabetics for age, hypertension and baseline creatinine. Results: The diabetic subjects had advanced diabetic lesions even in absence of proteinuria. Tubules and tubular-interstitium was relatively well preserved. Diabetic glomerulosclerosis can occur in the absence of microalbuminuria. Conclusions: It is becoming increasingly apparent that a considerable proportion of subjects with type 2 diabetes can develop renal impairment in the absence of albuminuria. Diabetic glomerulosclerosis may develop before the proteinuria can be detected and relying on albumin excretion as first sign for renal involvement may be too late in diagnosing and modifying the progression of the kidney disease.展开更多
AIM： To access the association between albuminuria levels and arterial stiffness in non-diabetic patients with hypertension and chronic kidney disease （CKD） stages 1-2, treated with renin angiotensin blockade agent...AIM： To access the association between albuminuria levels and arterial stiffness in non-diabetic patients with hypertension and chronic kidney disease （CKD） stages 1-2, treated with renin angiotensin blockade agents plus other hypertensive drugs when needed.METHODS： One hundred fifteen patients [median age 52 years （68% males）] were consequently enrolled in the study. For each patient, we recorded gender, age, body mass index （BMI）, peripheral systolic blood pressure （pSBP）, peripheral diastolic blood pressure, peripheral pulse pressure, central systolic blood pressure （cSBP）, central diastolic blood pressure （cDBP）, central pulse pressure （cPP）, hematocrit, hemoglobin, hsCRP, total cholesterol triglycerides, high-density lipoprotein-C, low-density lipoprotein-C, calcium, phosphorus, parathormone, and albumin, as well as 24 h urine albumin excretion. According to 24-h urine albumin collection, patients were then classified as those with moderately increased albuminuria （formerly called macroalbuminuria） （≤ 300 mg/d） and those with severely increased albuminuria （formerly called macroaluminuria （〉 300 mg/d）. We considered aortic stiffness （AS） indices [carotid femoral pulse wave velocity （PWVc-f） and augmentation index （AIx）] as primary outcomes of the study. We explored potential correlations between severely increased albuminuria and AS indices using a multiple linear regression model. RESULTS： Fifty-eight patients were included in the moderately increased albuminuria group and 57 in the severely increased albuminuria. Blood pressure measurements of the study population were 138 ± 14/82 ± 1.3 mmHg （systolic/diastolic）. There were no significant differences in age, sex, and BP measurements between the two groups. Patients with severely increased albuminuria had higher PWV and AIx than patients with moderately increased albuminuria （P 〈 0.02, P 〈 0.004, respectively）. In addition these patients exhibited higher BMI （P 〈 0.03）, hsCRP （P 〈 0.001）, and fibrinogen levels （P 〈 0.02） compared to patients with moderately increased albuminuria. In multivariate linear regression analysis, severely increased albuminuria （β = 1.038, P 〈 0.010） pSBP （β = 0.028, P 〈 0.034） and Ht （β = 0.171, P = 0.001） remained independent determinants of the increased PWVc-f. Similarly, severely increased albuminuria （β = 4.385, P 〈 0.012）, cSBP （β = 0.242, P 〈 0.001）, cPP （β = 0.147, P 〈 0.01） and Ht levels （β = 0.591, P 〈 0.013） remained independent determinants of increased AIx.CONCLUSION： These fndings demonstrate an independent association between AS indices and severely increased albuminuria in non-diabetic, hypertensive patients with CKD stages 1-2 treated with renin angiotensin aldosterone system blockers.展开更多
Podocyte loss was well known in type 2 diabetic nephropathy patients. The objective of the present study was to determine the number of podocytes and the degree of albuminuria in diabetic KK-Ay/Ta (KK-Ay) mice which h...Podocyte loss was well known in type 2 diabetic nephropathy patients. The objective of the present study was to determine the number of podocytes and the degree of albuminuria in diabetic KK-Ay/Ta (KK-Ay) mice which had been reported as diabetic nephropathy model. Diabetic KK-Ay mice, diabetic KK/Ta mice and non-diabetic BALB/cA Jcl (BALB/cA) mice were studied. We analyzed glomerular lesions in all mice by morphometric analysis and immunofluorescence to determine the number of podocytes. Level of urinary albumin was also measured. Glomerular enlargement and mesangial expansion were observed in KK-Ay mice. Mean number of podocytes per glomerulus (NG pod) in diabetic KK-Ay mice was significantly lower than that in non-diabetic BALB/cA mice. Mean NG pod/glomerular area (GA) per glomerulus was also significantly decreased in diabetic KK-Ay mice. The level of urinary albumin/creatinine ratio (ACR) in diabetic KK-Ay mice was significantly higher than that in non-diabetic BALB/cA mice. These data suggest that podocyte loss might induce albuminuria in KK-Ay mice. This finding confirmed our previous report that KK-Ay mice, especially in terms of histological findings, are a suitable animal model for glomerular injury in type 2 diabetic nephropathy.展开更多
基金the Key R&D Project of the Ministry of Science and Technology,No.2016YFC0901200 and 2016YFC0901205.
文摘BACKGROUND Diabetic kidney disease is one of the common complications of type 2 diabetes(T2D).There are no typical symptoms in the early stage,and the disease will progress to moderate and late stage when albuminuria reaches a high level.Treatment is difficult and the prognosis is poor.At present,the pathogenesis of diabetic kidney disease is still unclear,and it is believed that it is associated with genetic and environmental factors.AIM To explore the relationship between the glucokinase regulatory protein(GCKR)gene rs780094 polymorphism and T2D with albuminuria.METHODS We selected 252 patients(126 males and 126 females)with T2D admitted to our hospital from January 2020 to October 2020,and 66 healthy people(44 females and 22 males).According to the urinary albumin/creatinine ratio,the subjects were divided into group I(control),group II(T2D with normoalbuminuria),group III(T2D with microalbuminuria),and group IV(T2D with macroalbuminuria).Additionly,the subjects were divided into group M(normal group)or group N(albuminuria group)according to whether they developed albuminuria.We detected the GCKR gene rs780094 polymorphism(C/T)of all subjects,and measured the correlation between GCKR gene rs780094 polymorphism(C/T)and T2D with albuminuria.RESULTS Gene distribution and genotype distribution among groups I-IV accorded with the Hardy-Weinberg equilibrium.Genotype frequency was significantly different among the four groups (P = 0.048, χ^(2)= 7.906). T allele frequency in groups II, III, and IV was significantly higherthan that in group I. Logistic regression analysis of the risk factors for T2D with albuminuria showed that the CT +TT genotype (odds ratio = 1.710, 95% confidence interval: 1.172-2.493) was a risk factor.CONCLUSION CT + TT genotype is a risk factor for T2D with albuminuria. In the future, we can assess the risk of individualscarrying susceptible genes to delay the onset of T2D.
文摘目的:观察基于名中医经验的中医辨证组方对老年慢性肾炎(CKD1-3a期)患者的有效性和安全性。方法:将84例老年慢性肾炎患者随机分成治疗组(42例)和对照组(42例)。治疗组采用西医基础联合中医辨证组方治疗;对照组仅接受西医基础治疗,疗程均为24周。观察两组治疗前后24 h尿蛋白定量(24 h UPQ)、肾小球滤过率(eGFR)等临床指标变化,以及疗效和安全性。结果:与本组基线比较,两组治疗后12、18、24周24 h UPQ均显著下降(P<0.01),且24周时治疗组优于对照组(P<0.01)。治疗组总有效率为67.57%,对照组总有效率41.67%,治疗组显著高于对照组(P<0.05)。将慢性肾脏病(CKD)3a期患者进行亚组分析提示,24周后治疗组eGFR较本组基线及同期对照组显著升高(P<0.01,P<0.05),而对照组治疗前后无显著变化。治疗组不良反应发生4例,对照组2例,两组无严重不良反应出现。结论:基于名中医经验的中医辨证组方治疗老年慢性肾炎(CKD1-3a期),可减少尿蛋白,提高临床疗效,对其中的CKD3a期患者可能具有改善eGFR作用,且安全性较好。
文摘目的:探讨体检人群甘油三酯/高密度脂蛋白胆固醇(triglyceride/high density lipoprotein cholesterol ratio,TG/HDL-C)、甘油三酯-葡萄糖乘积(riglyceride-glucose index,TyG)指数及其衍生指数水平与白蛋白尿异常的相关性,同时分析TG/HDL-C、TyG以及TyG-BMI(riglyceride-glucose index-body mass index,TyG-BMI)预测白蛋白尿的能力。方法:获取2022年1月至12月体检中心年龄在18岁以上3739例受检者进行回顾性分析,将研究对象分为白蛋白尿异常组(n=841)和对照人群(n=2898),将TG/HDL-C、TyG以及TyG-BMI按四分位数进行分组,采用logistic回归模型分析与体检人群白蛋白尿异常风险之间的关系。采用限制性立方样条回归模型分析不同水平TG/HDL-C、BMI、TyG以及TyG-BMI与白蛋白尿的剂量反应关系。通过受试者工作特征曲线分析单一指标与联合指标对白蛋白尿的预测价值。结果:除平均血红蛋白浓度、高密度脂蛋白胆固醇外,异常组年龄、中性粒细胞、单核细胞、血小板、血白细胞计数、平均红细胞体积、红细胞分布宽度SD、红细胞分布宽度、血小板压积、总蛋白、白蛋白、谷氨酰转肽酶、空腹血糖、糖化血红蛋白、总胆固醇、低密度脂蛋白胆固醇、甘油三酯(triglyceride,TG)、体质指数(body mass index,BMI)、收缩压、舒张压、脉率、碱性磷酸酶、TyG指数、TyG-BMI、TG/HDL-C均高于对照组。调整混杂因素后,逻辑回归结果显示,与第2、第3分位数相比,TG/HDL-C、TyG、TyG-BMI指数第4四分位数组发生风险最高,其分别为1.895倍(95%CI=1.355~2.653)、2.377倍(95%CI=1.657~3.417)、2.319(95%CI=1.666~3.237)。BMI、TyG-BMI指数与白蛋白尿异常呈明显的非线性剂量反应关系,曲线呈近似“U”型,TyG、TG/HDL-C与白蛋白尿异常之间的剂量反应关系呈逐渐递增趋势,曲线呈近似“J”型。受试者工作特征(receiver operating characteristic,ROC)曲线结果显示,TyG-BMI预测能力优于其他3个指标,其AUC值为0.640。除TyG-BMI+TG/HDL-C之外,其余联合预测能力均优于单一预测指标,TyG-BMI+TG/HDL-C+TyG指数预测白蛋白尿的能力最优,AUC为0.6504。结论:TyG指数、TG/HDL-C比值升高与白蛋白尿异常密切相关,均对白蛋白尿具有一定的预测价值。综合考虑,TyG-BMI+TG/HDL-C+TyG指数是较佳白蛋白尿预测联合指标。
文摘Background: Neuttrophil gelatinase associated lipocalin (NGAL) was shown to be a good marker for predicting acute kidney injury (AKI). Some recent reports demonstrated that NGAL may be an early biomarker for kidney affection in diabetic patients. The aim of this work is to investigate urinary NGAL (UNGAL) in type 2 diabetic patients with and without albuminuria. Methods: This study included 46 type 2 diabetic patients and 15 healthy age and sex matched individuals as the control group. Diabetic patients were divided into three groups according to urinary albumin excretion (UAE), normoalbuminuria, microalbuminuria and macroalbuminuria. UNGAL was measured in all populations and corrected to urinary creatinine to account for day to day variation in urine volume and transformed log. Comparison between 4 groups (control, normoalbuminuria, microalbuminuria and macroalbuminuria) was done. Results: Log UNGAL/Creatinine ratio showed significant difference when comparing control group (0.70 ± 0.58) versus normoalbuminuria (1.71 ± 1.06), microalbuminuria (1.57 ± 0.72) and macroalbuminuria (1.92 ± 0.63), however, there was no significant difference among diabetic groups. Pearson’s correlation showed that log UNGAL/Creatinine ratio positively correlated with glycated hemoglobin (HbA1c) and inversely with estimated glomerular filtration rate (eGFR). Regression analysis showed that HbA1c, urinary creatinine and eGFR were the independent predictors of log UNGAL/Creatinine ratio. Conclusion: Tubular markers like UNGAL may be early elevated in type 2 diabetic patients even before the incidence of glomerular injury detected by microalbuminuria and it can be used as an early marker for detection of kidney involvement in diabetic patients.
文摘Background: Diabetic nephropathy is the most common cause of chronic kidney disease and the number afflicted patients continues to rise. The presence of proteinuria has been considered as a prerequisite for the diagnosis of diabetic nephropathy. But one third to one half of type 2 diabetics with CKD have no proteinuria and the pathology of non proteinuric CKD in this group remains unclear as renal biopsy is commonly not performed in these patients. The present study addresses the question: Can a classical diabetic nephropathy occur in the absence of proteinuria? Method: We examined renal biopsies of subjects who underwent nephrectomy from 1999 to 2009 for renal cancer, had eGFR < 60 ml/min and no microalbuminuria or proteinuria. 10 diabetics were matched with 10 non diabetics for age, hypertension and baseline creatinine. Results: The diabetic subjects had advanced diabetic lesions even in absence of proteinuria. Tubules and tubular-interstitium was relatively well preserved. Diabetic glomerulosclerosis can occur in the absence of microalbuminuria. Conclusions: It is becoming increasingly apparent that a considerable proportion of subjects with type 2 diabetes can develop renal impairment in the absence of albuminuria. Diabetic glomerulosclerosis may develop before the proteinuria can be detected and relying on albumin excretion as first sign for renal involvement may be too late in diagnosing and modifying the progression of the kidney disease.
文摘AIM： To access the association between albuminuria levels and arterial stiffness in non-diabetic patients with hypertension and chronic kidney disease （CKD） stages 1-2, treated with renin angiotensin blockade agents plus other hypertensive drugs when needed.METHODS： One hundred fifteen patients [median age 52 years （68% males）] were consequently enrolled in the study. For each patient, we recorded gender, age, body mass index （BMI）, peripheral systolic blood pressure （pSBP）, peripheral diastolic blood pressure, peripheral pulse pressure, central systolic blood pressure （cSBP）, central diastolic blood pressure （cDBP）, central pulse pressure （cPP）, hematocrit, hemoglobin, hsCRP, total cholesterol triglycerides, high-density lipoprotein-C, low-density lipoprotein-C, calcium, phosphorus, parathormone, and albumin, as well as 24 h urine albumin excretion. According to 24-h urine albumin collection, patients were then classified as those with moderately increased albuminuria （formerly called macroalbuminuria） （≤ 300 mg/d） and those with severely increased albuminuria （formerly called macroaluminuria （〉 300 mg/d）. We considered aortic stiffness （AS） indices [carotid femoral pulse wave velocity （PWVc-f） and augmentation index （AIx）] as primary outcomes of the study. We explored potential correlations between severely increased albuminuria and AS indices using a multiple linear regression model. RESULTS： Fifty-eight patients were included in the moderately increased albuminuria group and 57 in the severely increased albuminuria. Blood pressure measurements of the study population were 138 ± 14/82 ± 1.3 mmHg （systolic/diastolic）. There were no significant differences in age, sex, and BP measurements between the two groups. Patients with severely increased albuminuria had higher PWV and AIx than patients with moderately increased albuminuria （P 〈 0.02, P 〈 0.004, respectively）. In addition these patients exhibited higher BMI （P 〈 0.03）, hsCRP （P 〈 0.001）, and fibrinogen levels （P 〈 0.02） compared to patients with moderately increased albuminuria. In multivariate linear regression analysis, severely increased albuminuria （β = 1.038, P 〈 0.010） pSBP （β = 0.028, P 〈 0.034） and Ht （β = 0.171, P = 0.001） remained independent determinants of the increased PWVc-f. Similarly, severely increased albuminuria （β = 4.385, P 〈 0.012）, cSBP （β = 0.242, P 〈 0.001）, cPP （β = 0.147, P 〈 0.01） and Ht levels （β = 0.591, P 〈 0.013） remained independent determinants of increased AIx.CONCLUSION： These fndings demonstrate an independent association between AS indices and severely increased albuminuria in non-diabetic, hypertensive patients with CKD stages 1-2 treated with renin angiotensin aldosterone system blockers.
文摘Podocyte loss was well known in type 2 diabetic nephropathy patients. The objective of the present study was to determine the number of podocytes and the degree of albuminuria in diabetic KK-Ay/Ta (KK-Ay) mice which had been reported as diabetic nephropathy model. Diabetic KK-Ay mice, diabetic KK/Ta mice and non-diabetic BALB/cA Jcl (BALB/cA) mice were studied. We analyzed glomerular lesions in all mice by morphometric analysis and immunofluorescence to determine the number of podocytes. Level of urinary albumin was also measured. Glomerular enlargement and mesangial expansion were observed in KK-Ay mice. Mean number of podocytes per glomerulus (NG pod) in diabetic KK-Ay mice was significantly lower than that in non-diabetic BALB/cA mice. Mean NG pod/glomerular area (GA) per glomerulus was also significantly decreased in diabetic KK-Ay mice. The level of urinary albumin/creatinine ratio (ACR) in diabetic KK-Ay mice was significantly higher than that in non-diabetic BALB/cA mice. These data suggest that podocyte loss might induce albuminuria in KK-Ay mice. This finding confirmed our previous report that KK-Ay mice, especially in terms of histological findings, are a suitable animal model for glomerular injury in type 2 diabetic nephropathy.
