Effect of Sheng Xue Ning Tablets on Renal Anemia in Patients Subject to Maintenance Hemodialysis and Safety Evaluation: A Multi-setting Prospective Randomized Study

This study compared Sheng Xue Ning(SXN)tablets with ferrous succinate(FS)tablets in terms of their efficacy for the treatment of iron-deficient renal anemia and safety in patients subject to maintenance hemodialysis(MHD).A total of 94 patients undergoing MHD were randomly assigned to an experiment group(receiving oral SXN tablcts,SXN group)and a control group(orally given FS tablets,FS group)and followed up for 12 weeks.Erythropoietin(EPO)was used in both groups.The eficacy was assessed by detecting the subsequent changes in hemoglobin(Hb),serum iron(SI),SF and transferrin saturation(TSAT).At the 12th week,Hb and TSAT levels in both groups were significantly increased compared to those in the screening period(P<0.05).However,no significant difference in Hb and TSAT was found between the two groups.The average weekly EPO dosage used was lower in SXN group than in FS group(P<0.05)at the 10th week and the 12th week.Our study showed that SXN tablets can effectively ameliorate renal anemia and keep iron metabolism stable in MHD patients,and its efficacy is virtually close to that of FS tablets.Meanwhile,SXN tablets can reduce the dosage of EPO and have a good safety profile.

Antisense Smad2 inhibits high glucose-stimulated production of extracellular matrix in cultured rat glomerular mesangial cells

Objective：Hyperglycemia stimulates secretion of transforming growth factor-βl （TGF-βl） in cultured glomerular mesangial cells, thereby increases production of extracellular matrix （ECM）. We examined the effect of antisense mRNA for Smad2 on high glucose-induced ECM production in rat mesangial cells. Methods..A mammalian expression vector, pES2a, which expresses antisense Smad2 mRNA and green fluorescent protein （EGFP）, was transfected into mesangial cells. Following incubation in high glucose medium, EGFP expression and Smad2 mRNA level were determined by fluorescence microscopy and PCR, respectively. Secreted fibronectin and type IV collagen were assessed by enzyme-linked immunosorbent assay. Results ：Within 48 h of incubation in high glucose medium, Smad2 mRNA level significantly increased by 1.6 fold in association with increases in prodtaction of both fibronectin （from [45.86±2.73] to [84.19±6.81] ng/ml） and type IV collagen （from [16. 28±0. 90] to [55.27±4.75] ng/ml） in nontransfected cells （P〈0.05）. In pES2a-transfected cells, the high glucose-induced increase in Smad2 mRNA was abrogated completely, in parallel with significant suppression of the high glucose-indtmed increase in fibronectinproduction （[54.44±4.99] ng/ml） and type Ⅳ collagen （[20.96±2.47] ng/ml）. An empty vector was without effects. Coneluslon：These findings demonstrate that Smad2 plays a critical role in mediating high glucose-stimulated ECM production in mesangial cells, indicating that inhibition of Smad2 activity by antisense Smad2 mRNA may be an effective means to attenuate glomerular matrix accumulation in diabetic nephropathy.

Expression of PKD2 gene in human renal tissue and other tissues

Objective: To study the expression of PKD2 gene in human kidney and other tissues. Methods: The expression of PKD2 was detected by reverse transcription PCR(RT-PCR) and in situ hybridization(ISH) . The results of ISH were analyzed by micromegakargooytes. Results: Distribution of pkd-2 in normal adult kidney was stronger in proximal convoluted tubule, Henle's loop ascending branch, distal convoluted tubule and cortical collecting ducts, and inferior signal were observed in fetal kidney. Negative was seen in ADPKD 2 kidney. Conclusion: Down-regulation of PKD2 gene expression in kidney may take effect on the occurrence and development of ADPKD2.

Systemic lupus erythematosus in a male teenager manifested with cardiogenic shock and extremities infarction

Systemic lupus erythematosus(SLE)is an autoimmune disease with multisystemic features and a variety of clinical characteristics.Typical clinical manifestations of SLE include alopecia,oral ulcers,cutaneous lesions,arthritis,renal injury,and cardiac damage.[1]Cardiac involvement is one of the common complications of SLE,which is mostly asymptomatic with only approximately 10%of cardiac injury patients experiencing symptoms such as shortness of breath and arrhythmia.However,cardiogenic shock is rare,especially as the initial manifestation of SLE.[2]Herein,we report a case of a 15-year-old male who presented with cardiogenic shock and was eventually diagnosed with SLE.

C509T and T869C polymorphisms of transforming growth factor and the risk of IgA nephropathy： a meta-analysis

Background IgA nephropathy （IgAN） is the most common primary glomerular disease.Transforming growth factor β1 （TGFβ1） plays an important role in pathogenesis of IgAN.Associations between the polymorphisms of TGFβ1 gene and the risk of IgAN remained inconsistent.A meta-analysis was conducted to investigate the association between polymorphisms in the TGFβ1 gene and IgAN susceptibility.Methods Databases including Pubmed,EMBASE,ISI,et al.were searched to find relevant studies.Odds ratios （ORs）with 95％ confidence intervals （CIs） were used to evaluate the strength of associations.Results Ten studies involving 1770 cases and 1953 controls were included.Significant association between C509T polymorphism and IgAN risk was observed （OR 1.42,95％ CI 1.12-1.81,P=0.0004; I2=0％） in Caucasians by the overdominant model （CT vs.CC ＋ TT）,but no significant association was found （P=0.200） in Asians by the dominant model （CC ＋ CT vs.TT）.Significant association between T869C polymorphism and IgAN susceptibility was found （OR 1.21,95％ CI 1.02-1.44,P=0.030） in overall populations by the dominant model （TT ＋ TC vs.CC）.Subgroup analysis found T allele of T869C polymorphism was associated with IgAN susceptibility in Caucasians （P=0.030）,but not in Asians （P=0.290）.Conclusion Both heterozygotes of C509T polymorphism and T allele of T869C polymorphism in TGFβ1 were associated with the risk of IgAN in Caucasians,but not in Asians.

Prevalence, awareness, treatment, and control of hypertension in the non-dialysis chronic kidney disease patients

Background Data on the epidemiology of hypertension in Chinese non-dialysis chronic kidney disease （CKD） patients are limited.The aim of the present study was to investigate the prevalence,awareness,treatment,and control of hypertension in the non-dialysis CKD patients through a nationwide,multicenter study in China.Methods The survey was performed in 61 tertiary hospitals in 31 provinces,municipalities,and autonomous regions in China （except Hong Kong,Macao,and Taiwan）.Trained physicians collected demographic and clinical data and measured blood pressure （BP） using a standardized protocol.Hypertension was defned as systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg,and/or use of antihypertensive medications.BP 〈140/90 mmHg and 〈130/80 mmHg were used as the 2 thresholds of hypertension control.In multivariate logistic regression with adjustment for sex and age,we analyzed the association between CKD stages and uncontrolled hypertension in non-dialysis CKD patients.Results The analysis included 8927 non-dialysis CKD patients.The prevalence,awareness,and treatment of hypertension in non-dialysis CKD patients were 67.3%,85.8%,and 81.0%,respectively.Of hypertensive CKD patients,33.1% and 14.1% had controlled BP to 〈140/90 mmHg and 〈130/80 mmHg,respectively.With successive CKD stages,the prevalence of hypertension in non-dialysis CKD patients increased,but the control of hypertension decreased （P〈0.001）.When the threshold of BP 〈130/80 mmHg was considered,the risk of uncontrolled hypertension in CKD 2,3a,3b,4,and 5 stages increased 1.3,1.4,1.4,2.5,and 4.0 times compared with CKD 1 stage,respectively （P〈0.05）.Using the threshold of 〈140/90 mmHg,the risk of uncontrolled hypertension increased in advanced stages （P〈0.05）.Conclusions The prevalence of hypertension Chinese non-dialysis CKD patients was high,and the hypertension control was suboptimal.With successive CKD stages,the risk of uncontrolled hypertension increased.