Hong Kong Journal of Nephrology最新文献

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Hong Kong Journal of Nephrology

Pub Date : 2016-10-01 DOI: 10.1016/S1561-5413(16)30040-0

引用次数: 0

The analysis of patients with primary and secondary glomerular diseases: A single-center experience 原发性和继发性肾小球疾病患者的分析:单中心经验

Hong Kong Journal of Nephrology

Pub Date : 2016-10-01 DOI: 10.1016/j.hkjn.2016.05.001

Yavuz Ayar , Alparslan Ersoy , Emel Isiktas , Gokhan Ocakoglu , Abdulmecit Yildiz , Aysegül Oruc , Dilay Demirayak , Ismail Bayrakci , Hakan Duger , Tugba Bozbudak

Background/Purpose

Glomerulonephritis is among the most important group of diseases causing end-stage renal disease (ESRD). The prevalence of glomerulonephritis varies depending on age, sex, geographical features, etc. In the present study, we evaluated the clinical and laboratory parameters of patients who underwent renal biopsy.

Methods

In this retrospective study, demographic and clinical characteristics, specific diagnoses of glomerular diseases, and biopsy findings of all patients in whom native renal biopsy was performed in our hospital between January 2009 and December 2014 were analyzed.

Results

A total of 384 patients were divided into two groups as primary glomerular diseases (PGD) and secondary glomerular diseases (SGD). Some 37.1% of patients with PGD and 49.2% of patients with SGD were female. The mean age was 43.8 ± 14.1 years in the PGD group and 47.3 ± 16.1 years in the SGD group (p = 0.044). Nephrotic syndrome in the PGD group and unexplained renal dysfunction in the SGD group were observed more frequently at the time of admission. In the SGD group, biopsy findings (crescents, sclerosis, vascular involvement, etc.) were dominant and more pronounced (p < 0.001). In the PGD group, responsiveness to the therapy was higher than in the SGD group (p < 0.001). Mortality rates were 2.27% in the PGD group and 18.3% in the SGD group. According to the multivariate analysis, the increase of creatinine level after treatment (odds ratio 1.49) and presence of SGD (odds ratio 7.74) were independent risk factors for patient death (p < 0.001).

Conclusion

The present study showed important data about the etiology, clinical findings, follow ups, and prognosis of PGD and SGD among adults in our center. We observed that mortality was higher in patients with SGD.

背景 / 目的

腎小球腎炎是導致末期腎病 (ESRD) 的最重要疾病,其盛行率與年齡、性別、及地域特性有關。在本研究中,我們在接受腎臟組織活檢的腎小球疾病患者間,對相關的臨床及檢驗特徵進行了調查。

方法

在本回溯性研究中,對象為於 2009 年 1 月至 2014 年 12 月期間,在本院接受自身腎臟組織活檢的病人。我們對其人口學與臨床特徵、腎小球疾病診斷、及活檢結果進行了分析。

結果

調查對象為 384 位原發性腎小球疾病 (PGD) 或次發性腎小球疾病 (SGD) 患者。在 PGD 及 SGD 組別中,女性比例分別佔 37.1% 及 49.2%,平均年齡分別為 43.8 ± 14.1 歲及 47.3 ± 16.1 歲 (p = 0.044)。入院時,PGD 組以腎病症候群較常見,SGD 組則以原因不明之腎臟功能障礙較常見。在 SGD 組間,活檢結果較多樣化 (新月形、硬化、血管病變等) 且較明顯 (p < 0.001)。治療反應比率以 PGD 組高於 SGD 組 (p < 0.001),死亡率分別為 PGD 組的 2.27% 及 SGD 組的 18.3%。多變項分析顯示,治療後肌酸酐的增加 (OR 1.49)、及 SGD 的存在 (OR 7.74) 是病人死亡的獨立危險因子 (p < 0.001)。

結論

對於本中心的 PGD 與 SGD 成年患者,本研究提供了成因、臨床表現、追蹤、及預後等方面的重要數據,並觀察到 SGD 患者的死亡率較高。

背景/目的肾小球肾炎是导致终末期肾病(ESRD)最重要的一类疾病。肾小球肾炎的患病率因年龄、性别、地理特征等而异。在本研究中，我们评估了接受肾活检患者的临床和实验室参数。方法回顾性分析2009年1月至2014年12月在我院行肾活检患者的人口学、临床特点、肾小球疾病的具体诊断及活检结果。结果384例患者分为原发性肾小球疾病(PGD)组和继发性肾小球疾病(SGD)组。37.1%的PGD患者和49.2%的SGD患者为女性。PGD组的平均年龄为43.8±14.1岁，SGD组的平均年龄为47.3±16.1岁(p = 0.044)。PGD组肾病综合征和SGD组不明原因肾功能障碍在入院时更为常见。在SGD组中，活检结果(新月形、硬化症、血管受累等)占主导地位，且更为明显(p <0.001)。PGD组对治疗的反应性高于SGD组(p <0.001)。PGD组和SGD组的死亡率分别为2.27%和18.3%。多因素分析显示，治疗后肌酐水平升高(优势比1.49)和SGD的存在(优势比7.74)是患者死亡的独立危险因素(p <0.001)。结论本研究为本中心成人PGD和SGD的病因、临床表现、随访及预后提供了重要资料。我们观察到SGD患者的死亡率更高。背景/目的腎小球腎炎是導致末期腎病(ESRD)的最重要疾病,其盛行率與年齡,性別,及地域特性有關。在本研究中,我們在接受腎臟組織活檢的腎小球疾病患者間,對相關的臨床及檢驗特徵進行了調查。方法在本回溯性研究中,對象為於 2009 年 1 月至 2014 年 12 月期間,在本院接受自身腎臟組織活檢的病人。我們對其人口學與臨床特徵、腎小球疾病診斷、及活檢結果進行了分析。【中文】:全英文，全英文，全英文，全英文。在PGD及SGD組別中,女性比例分別佔37.1%及49.2%,平均年齡分別為歲43.8±14.1及47.3±16.1歲(p = 0.044)。。在SGD組間,活檢結果較多樣化(新月形,硬化,血管病變等)且較明顯(p & lt;0.001)。(p <0.001)， 19.7%， 18.3%。多變項分析顯示,治療後肌酸酐的增加(或1.49)的风险,及SGD的存在(或7.74)的风险是病人死亡的獨立危險因子(p & lt;0.001)。結論對於本中心的PGD與SGD成年患者,本研究提供了成因,臨床表現,追蹤,及預後等方面的重要數據,並觀察到SGD患者的死亡率較高。

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引用次数: 4

Mission accomplished 任务完成。

Hong Kong Journal of Nephrology

Pub Date : 2016-10-01 DOI: 10.1016/j.hkjn.2016.08.007

Alex W. Yu

引用次数: 0

Carotid intima-media thickness in kidney transplant recipients 肾移植受者颈动脉内膜-中膜厚度

Hong Kong Journal of Nephrology

Pub Date : 2016-10-01 DOI: 10.1016/j.hkjn.2016.08.001

Rizna Abdul Cader , Noor Izyani Zakaria , Yazmin Yaacob , Shamsul Azhar Shah

Background/Purpose

Cardiovascular disease is the leading cause of mortality among kidney transplant recipients. Carotid intima-media thickness (CIMT) of the common carotid artery is a surrogate marker for early atherosclerosis. We wanted to compare the prevalence of increased CIMT among kidney transplant recipients with matched controls and its association with clinical and laboratory parameters.

Methods

A comparative cross-sectional study involving kidney transplant recipients and controls matched for age, sex, chronic kidney disease staging, and cardiovascular risks was used. CIMT measurements were done using carotid ultrasound and considered increased if >75^th percentile matched for age- and sex-matched normal controls. Standard laboratory investigations, high sensitivity C-reactive protein, and asymmetric diamethylarginine were analyzed.

Results

Thirty-six kidney transplant recipients (25 men, 11 women) with a median age of 41 years [interquartile range (IQR), 38–52 years] and 36 matched controls with a median age of 44 years (IQR, 37–53 years) were enrolled. There were no demographic differences between the two groups. Kidney transplant recipients had a significantly increased CIMT, 0.8 mm (IQR, 0.6–0.9) compared to matched-controls 0.55 mm (IQR, 0.5–0.7, p = 0.001). Two thirds of kidney transplant recipients had increased CIMT, which was associated with a higher low density lipoprotein (LDL) (p = 0.022) and higher hemoglobin (p = 0.006). Smoking status (p = 0.058) and male sex (p = 0.073) had a trend towards significance to increased CIMT. Multiple linear stepwise regression demonstrated both age and hemoglobin were independent predictors of CIMT (p < 0.001). We found no relationship between high sensitivity C-reactive protein and asymmetric diamethylarginine with CIMT.

Conclusion

CIMT among our kidney transplant recipients was significantly higher compared to controls thereby increasing their cardiovascular risk.

背景

心血管疾病是腎臟移植接受者的主要死因,總頸動脈的內膜中膜厚度 (CIMT) 則是早期動脈粥樣硬化的替代性指標。在本研究中,我們比較了 CIMT 增厚於腎臟移植接受者與匹配對照組之間的盛行率,並調查了 CIMT 與臨床及實驗室參數之間的關聯。

方法

這是一項橫斷式比較性研究,涉及的對象包括腎臟移植接受者、及與其匹配 (年齡、性別、慢性腎病分期及心血管風險) 的對照者。CIMT 以頸動脈超音波測量,增厚的定義為對應年齡性別匹配正常對照組之 > 75^th 百分位數。其他測量項目除了標準實驗室參數外,亦包括高敏感度 C-reactive protein (hs-CRP) 及 asymmetric diamethylarginine (ADMA)。

結果

分析對象包括 36 位年齡中位數 41 歲 (38,52) 之腎臟移植接受者 (25 男、11 女) 及 36 位年齡中位數 44 歲 (37,53) 之匹配對照者,兩組間的人口學特徵並無不同。腎臟移植接受者之 CIMT 為0.8 mm (0.6,0.9 mm),明顯高於匹配對照者之 0.55 mm (0.5,0.7 mm) (p = 0.001)。腎臟移植接受者之間,3 分之 2 呈現 CIMT 增厚的情形,較厚的 CIMT 與較高的低密度脂蛋白 (p = 0.022) 及較高的血色素 (p = 0.006) 有關。吸煙狀況 (p = 0.058) 及男性性別 (p = 0.073) 亦有傾向與 CIMT 增厚有關。多變項線性逐步迴歸分析顯示,年齡及血色素均是CIMT的獨立預測因子 (p &

背景/目的心血管疾病是肾移植受者死亡的主要原因。颈总动脉内膜-中膜厚度(CIMT)是早期动脉粥样硬化的替代指标。我们想比较肾移植受者与匹配对照中增加的CIMT患病率及其与临床和实验室参数的关系。方法采用一项比较横断面研究，涉及肾移植受者和对照组，年龄、性别、慢性肾脏疾病分期和心血管风险相匹配。使用颈动脉超声进行CIMT测量，如果与年龄和性别匹配的正常对照组匹配第75个百分位数，则认为CIMT增加。标准实验室检查、高灵敏度c反应蛋白和不对称直径精氨酸分析。结果入选36例肾移植受者(男性25例，女性11例)，中位年龄41岁[四分位间距(IQR)， 38-52岁]，36例匹配对照，中位年龄44岁(IQR, 37-53岁)。两组之间没有人口统计学上的差异。肾移植受者的CIMT显著增加，为0.8 mm (IQR, 0.6-0.9)，而配对对照组为0.55 mm (IQR, 0.5-0.7, p = 0.001)。三分之二的肾移植受者CIMT升高，这与较高的低密度脂蛋白(LDL) (p = 0.022)和较高的血红蛋白(p = 0.006)相关。吸烟状况(p = 0.058)和男性(p = 0.073)对CIMT升高有显著性影响。多元线性逐步回归表明，年龄和血红蛋白是CIMT的独立预测因子(p <0.001)。我们发现高敏c反应蛋白和不对称直径精氨酸与CIMT没有关系。结论肾移植受者的cimt明显高于对照组，从而增加了他们的心血管风险。背景心血管疾病是腎臟移植接受者的主要死因,總頸動脈的內膜中膜厚度测量則是早期動脈粥樣硬化的替代性指標。在本研究中,我們比較了测量增厚於腎臟移植接受者與匹配對照組之間的盛行率,並調查了测量與臨床及實驗室參數之間的關聯。方法這是一項橫斷式比較性研究,涉及的對象包括腎臟移植接受者、及與其匹配 (年齡、性別、慢性腎病分期及心血管風險) 的對照者。CIMT，;第75期:其他測量項目除了標準實驗室參數外,亦包括高敏感度c反应蛋白(hs-CRP)及不对称diamethylarginine (ADMA)。結果分析對象包括36位年齡中位數41歲(38岁,52)之腎臟移植接受者(25男,女11日)及36位年齡中位數44歲(37岁,53)之匹配對照者,兩組間的人口學特徵並無不同。腎臟移植接受者之测量為0.8毫米(0.6、0.9毫米),明顯高於匹配對照者之0.55毫米(0.5、0.7毫米)(p = 0.001)。腎臟移植接受者之間,3分2之呈現CIMT’增厚的情形,較厚的测量出與較高的低密度脂蛋白(p = 0.022)及較高的血色素(p = 0.006)有關。吸煙狀況(p = 0.058)及男性性別(p = 0.073)亦有傾向與CIMT’增厚有關。(p <)0.001)。因之，CIMT, hs-CRP, ADMA，因之，因之。■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■

{"title":"Carotid intima-media thickness in kidney transplant recipients","authors":"Rizna Abdul Cader , Noor Izyani Zakaria , Yazmin Yaacob , Shamsul Azhar Shah","doi":"10.1016/j.hkjn.2016.08.001","DOIUrl":"10.1016/j.hkjn.2016.08.001","url":null,"abstract":"<div><h3>Background/Purpose</h3><p>Cardiovascular disease is the leading cause of mortality among kidney transplant recipients. Carotid intima-media thickness (CIMT) of the common carotid artery is a surrogate marker for early atherosclerosis. We wanted to compare the prevalence of increased CIMT among kidney transplant recipients with matched controls and its association with clinical and laboratory parameters.</p></div><div><h3>Methods</h3><p>A comparative cross-sectional study involving kidney transplant recipients and controls matched for age, sex, chronic kidney disease staging, and cardiovascular risks was used. CIMT measurements were done using carotid ultrasound and considered increased if >75<sup>th</sup> percentile matched for age- and sex-matched normal controls. Standard laboratory investigations, high sensitivity C-reactive protein, and asymmetric diamethylarginine were analyzed.</p></div><div><h3>Results</h3><p>Thirty-six kidney transplant recipients (25 men, 11 women) with a median age of 41 years [interquartile range (IQR), 38–52 years] and 36 matched controls with a median age of 44 years (IQR, 37–53 years) were enrolled. There were no demographic differences between the two groups. Kidney transplant recipients had a significantly increased CIMT, 0.8 mm (IQR, 0.6–0.9) compared to matched-controls 0.55 mm (IQR, 0.5–0.7, <em>p</em> = 0.001). Two thirds of kidney transplant recipients had increased CIMT, which was associated with a higher low density lipoprotein (LDL) (<em>p</em>  =0.006). Smoking status (<em>p</em>  =0.073) had a trend towards significance to increased CIMT. Multiple linear stepwise regression demonstrated both age and hemoglobin were independent predictors of CIMT (<em>p</em> < 0.001). We found no relationship between high sensitivity C-reactive protein and asymmetric diamethylarginine with CIMT.</p></div><div><h3>Conclusion</h3><p>CIMT among our kidney transplant recipients was significantly higher compared to controls thereby increasing their cardiovascular risk.</p></div><div><h3>背景</h3><p>心血管疾病是腎臟移植接受者的主要死因,總頸動脈的內膜中膜厚度 (CIMT) 則是早期動脈粥樣硬化的替代性指標。在本研究中,我們比較了 CIMT 增厚於腎臟移植接受者與匹配對照組之間的盛行率,並調查了 CIMT 與臨床及實驗室參數之間的關聯。</p></div><div><h3>方法</h3><p>這是一項橫斷式比較性研究,涉及的對象包括腎臟移植接受者、及與其匹配 (年齡、性別、慢性腎病分期及心血管風險) 的對照者。CIMT 以頸動脈超音波測量,增厚的定義為對應年齡性別匹配正常對照組之 > 75<sup>th</sup> 百分位數。其他測量項目除了標準實驗室參數外,亦包括高敏感度 C-reactive protein (hs-CRP) 及 asymmetric diamethylarginine (ADMA)。</p></div><div><h3>結果</h3><p>分析對象包括 36 位年齡中位數 41 歲 (38,52) 之腎臟移植接受者 (25 男、11 女) 及 36 位年齡中位數 44 歲 (37,53) 之匹配對照者,兩組間的人口學特徵並無不同。腎臟移植接受者之 CIMT 為0.8 mm (0.6,0.9 mm),明顯高於匹配對照者之 0.55 mm (0.5,0.7 mm) (<em>p</em> = 0.001)。腎臟移植接受者之間,3 分之 2 呈現 CIMT 增厚的情形,較厚的 CIMT 與較高的低密度脂蛋白 (<em>p</em> = 0.022) 及較高的血色素 (<em>p</em> = 0.006) 有關。吸煙狀況 (<em>p</em> = 0.058) 及男性性別 (<em>p</em> = 0.073) 亦有傾向與 CIMT 增厚有關。多變項線性逐步迴歸分析顯示,年齡及血色素均是CIMT的獨立預測因子 (<em>p</em> &","PeriodicalId":100611,"journal":{"name":"Hong Kong Journal of Nephrology","volume":"19 ","pages":"Pages 36-41"},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.hkjn.2016.08.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88884974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Time to say goodbye 是时候说再见了

Hong Kong Journal of Nephrology

Pub Date : 2016-10-01 DOI: 10.1016/j.hkjn.2016.08.006

Sing Leung Lui

引用次数: 0

So long, farewell, auf wiedersehen, adieu—Au revoir to our beloved journal 再见了，再见了，auf wiedersehen，再见了，我们心爱的杂志

Hong Kong Journal of Nephrology

Pub Date : 2016-10-01 DOI: 10.1016/j.hkjn.2016.08.011

Desmond Y.H. Yap

引用次数: 0

Farewell 告别

Hong Kong Journal of Nephrology

Pub Date : 2016-10-01 DOI: 10.1016/j.hkjn.2016.08.003

Cheuk-Chun Szeto

引用次数: 0

ECE1 gene variant shows tendency toward chronic kidney disease advancement among autosomal polycystic kidney disease patients 常染色体多囊肾病患者有慢性肾病进展的趋势

Hong Kong Journal of Nephrology

Pub Date : 2016-04-01 DOI: 10.1016/j.hkjn.2016.02.001

Shiva Nagendra Reddy Annapareddy , Vinuutna Sravani Kumbakonam , Ramprasad Elumalai , Gnanasambandan Ramanathan , Soundararajan Periyasamy , Bhaskar V.K.S. Lakkakula

Background/Purpose

Autosomal dominant polycystic kidney disease (ADPKD) is characterized by numerous epithelium-lined cysts in the kidney and is the leading genetic cause of end-stage renal disease worldwide. Endothelin-1 is a potent vasoactive peptide implicated in the regulation of basal vascular tone. Endothelin (ET)-converting enzyme 1 (ECE1) is well known for its critical role in the process of ET.

Methods

We investigated ECE1 gene variants to unravel ECE1 modifier effects associated with renal disease progression in ADPKD. Three ECE1 functional polymorphisms [rs213046 (−839 A>C), rs213045 (−338 G>T), and rs1076669 (Thr338Ile)] were genotyped using a fluorescence resonance energy transfer-based KASPar method in 106 ADPKD patients and 112 healthy participants. A Chi-square test was used to determine the relationship between ADPKD and ECE1 variants, and multivariate logistic regression analysis was performed to assess the effect of ECE1 variants on chronic kidney disease (CKD) progression. Mantel-Haenszel stratified analysis was performed to assess relationships between different CKD stages, hypertension, and their interaction.

Results

All loci are polymorphic and followed a Hardy-Weinberg equilibrium. Distribution of ECE1 genotypes in controls and ADPKD groups was not statistically significant, and linkage disequilibrium was not strong between pairs of single-nucleotide polymorphisms. The rs213046 variant genotypes were overrepresented in advanced CKD stages (p = 0.031).

Conclusion

Significant confounding effects of hypertension on CKD progression in ADPKD were observed. These results suggested that the ECE1 gene variant is a modifier of CKD advancement among ADPKD patients.

背景

自體顯性多囊性腎病 (ADPKD) 的特點，是腎臟呈現相當多由上皮構成的囊腫，在全球是導致末期腎病 (ESRD) 的主要遺傳性原因。Endothelin-1 (ET-1) 是一種具有高度血管活性的胜肽，被認為與基礎血管張力的調節有關。眾所周知，endothelin (ET) 轉化酵素 1 (ECE1) 則在 ET 代謝上佔有重要的角色。

方法

在本研究中，我們調查了在 ADPKD 患者間，ECE1 基因變體與 CKD 病情發展的可能關聯。我們採用以 FRET 為基礎的 KASPar 方法，對 106 位 ADPKD 患者及 112 位健康人士，作出 3 種 ECE1 功能性多態性 [rs213046 (-839 A>C)、rs213045 (-338 G>T) 及 rs1076669 (Thr338Ile)] 的基因型辨識。對於 ADPKD 與 ECE1 基因變體的關聯，我們採取卡方檢驗；ECE1 基因變體與 CKD 病情發展的關聯，以多變項邏輯迴歸進行分析；CKD 分期與高血壓的關聯及兩者的交互作用，則採用 Mantel-Haenszel 分層分析。

結果

所有基因座 (loci) 均呈現多態性，且遵循 Hardy-Weinberg 平衡。ADPKD 患者與對照組間的 ECE1 基因型分佈並無明顯差別。單核苷酸多態性鹼基對 (SNP pairs) 之間，並未呈現出明顯的連鎖不平衡 (LD)。在晚期 CKD 患者間，rs213046 變體基因型呈現過度的表達 (p = 0.031)。

結論

我們觀察到，在 ADPKD 患者間，高血壓是 CKD 病情發展的一個明顯的干擾因素。以上結果意味著，在 ADPKD 患者間，ECE1 基因變體可影響 CKD 的病情發展。

背景/目的常染色体显性多囊肾病(ADPKD)的特点是肾脏内有大量上皮囊肿，是世界范围内终末期肾脏疾病的主要遗传原因。内皮素-1是一种有效的血管活性肽，参与调节基底血管张力。内皮素(ET)转换酶1 (ECE1)在ET发生过程中发挥着重要作用。方法研究ECE1基因变异，揭示ECE1修饰因子在ADPKD肾脏疾病进展中的作用。采用基于荧光共振能量转移的KASPar方法对106例ADPKD患者和112名健康参与者的3个ECE1功能多态性rs213046(−839 a >C)、rs213045(−338 G>T)和rs1076669 (Thr338Ile)进行基因分型。采用卡方检验确定ADPKD与ECE1变异之间的关系，并采用多变量logistic回归分析评估ECE1变异对慢性肾脏疾病(CKD)进展的影响。采用Mantel-Haenszel分层分析评估不同CKD分期与高血压之间的关系及其相互作用。结果所有基因座均具有多态性，符合Hardy-Weinberg平衡。ECE1基因型在对照组和ADPKD组的分布无统计学意义，单核苷酸多态性对之间的连锁不平衡不强。rs213046变异基因型在CKD晚期被过度表达(p = 0.031)。结论高血压对ADPKD患者CKD进展有显著的混杂影响。这些结果表明，ECE1基因变异是ADPKD患者CKD进展的一个修饰因子。背景自體顯性多囊性腎病(ADPKD)的特點,是腎臟呈現相當多由上皮構成的囊腫,在全球是導致末期腎病(ESRD)的主要遺傳性原因。Endothelin-1 (ET-1)是一種具有高度血管活性的胜肽,被認為與基礎血管張力的調節有關。眾所周知,内皮素(ET)轉化酵素1 (ECE1)則在等代謝上佔有重要的角色。方法在本研究中,我們調查了在ADPKD患者間,ECE1基因變體與CKD病情發展的可能關聯。我們採用以烦恼為基礎的卡斯帕·方法,對106位ADPKD患者及112位健康人士,作出3種ECE1功能性多態性[rs213046 (-839 A> C), rs213045 (-338 G> T)及rs1076669 (Thr338Ile)]的基因型辨識。對於ADPKD與ECE1基因變體的關聯,我們採取卡方檢驗;ECE1基因變體與CKD病情發展的關聯,以多變項邏輯迴歸進行分析,CKD分期與高血壓的關聯及兩者的交互作用,則採用Mantel-Haenszel分層分析。(基因座);(基因座)笨笨，笨笨，笨笨，笨笨。(SNP对)，(LD)。(p = 0.031)。【中文翻译:中文翻译:。(1)、(2)、(3)、(4)、(4)

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引用次数: 2

A peritoneal dialysis patient with osmotic demyelination syndrome 腹膜透析合并渗透性脱髓鞘综合征1例

Hong Kong Journal of Nephrology

Pub Date : 2016-04-01 DOI: 10.1016/j.hkjn.2015.10.001

Hing Ming Cheng, Siu Hung Li

A peritoneal dialysis patient with cirrhosis presented with drowsiness, vomiting, and mild hyponatremia. Despite no active correction of hyponatremia, she developed convulsion and quadriplegia. Magnetic resonance imaging of the brain showed changes of osmotic demyelination syndrome. This case illustrates that osmotic demyelination syndrome may occur in peritoneal dialysis without rapid correction of hyponatremia.

腹膜透析合并肝硬化患者表现为嗜睡、呕吐和轻度低钠血症。尽管没有积极纠正低钠血症，她出现抽搐和四肢瘫痪。脑磁共振成像显示渗透性脱髓鞘综合征的变化。本病例说明渗透性脱髓鞘综合征可能发生在腹膜透析没有迅速纠正低钠血症。

引用次数: 0

Cognitive impairment in hemodialysis patients: What can slow this decline? 血液透析患者的认知障碍:什么可以减缓这种下降?

Hong Kong Journal of Nephrology

Pub Date : 2016-04-01 DOI: 10.1016/j.hkjn.2015.08.003

Mitesh Patel, Indranil Dasgupta, George Tadros, Jyoti Baharani

With over 70% of hemodialysis (HD) patients, aged ≥55 years, having moderate to severe chronic cognitive impairment (CI), in an increasingly aging population, the need to stop this cognitive decline is paramount. CI amongst HD patients raises patient safety concerns, while limiting their ability to understand information such as medical advice and their decision-making ability. Unfortunately, the data available on assessment of cognition in HD patients and interventions utilized remain extremely limited. This paper discusses assessment of cognition, the theories of CI in HD patients, and current literature on cognitive interventions in chronic disease, with many not applicable to the HD population. An encouraging psychological intervention called cognitive stimulation therapy helps improve cognition as well as social skills in CI. This is the first review article discussing the possibility of cognition stimulation during HD which has not been investigated previously. With cognitive stimulation therapy showing improvements in cognition at 6-month follow-up, as well as being recommended by the National Institute for Health and Care Excellence for use in dementia, we suggest the need to study whether this therapy has any effect on cognition in HD patients both in short term, with respect to daily activities and decision making, and in long term, with respect to the possibility of reducing the risk of dementia.

在 55 歲或以上的血液透析 (HD) 病人間, 逾 70% 有中至重度的慢性認知障礙 (CI), 在目前老年化的人口中, 這是必須要解決的問題。在接受 HD 後, CI 可引發病人安全的隱憂, 同時亦限制患者接受資訊如醫囑、及決策的能力。然而, 至今關於 HD 病人認知功能與改善方案的數據仍非常有限。本文探討了認知功能的評估方法、及 CI 發生於 HD 的相關理論, 亦回顧了目前有關慢性病中認知功能改善方案的文獻, 雖然很多並不特定於 HD 病人群。我們注意到一種稱為認知刺激療法 (cognitive stimulation therapy, CST) 的心理治療方案, 可望改善 CI 患者的認知功能和社交技能。本文將首度就這種療法對 HD 病人的效應作出探討。事實上, CST 經證實可於 6 個月期間達到認知功能的改善, 亦是英國 NICE (National Institute for Health and Care Excellence) 建議的失智症療法, 我們認為有需要研究 CST 對 HD 病人認知功能的影響, 不論是在短期 (日常活動及決策能力)、或長期層面 (失智症的預防)。

在日益老龄化的人口中，超过70%的年龄≥55岁的血液透析(HD)患者患有中度至重度慢性认知障碍(CI)，因此阻止这种认知能力下降的必要性至关重要。HD患者的CI引起了患者安全问题，同时限制了他们理解医疗建议等信息的能力和决策能力。不幸的是，关于HD患者认知评估和干预措施的可用数据仍然非常有限。本文讨论了认知评估、HD患者CI理论以及目前关于慢性疾病认知干预的文献，其中许多文献并不适用于HD人群。一种被称为认知刺激疗法的令人鼓舞的心理干预有助于提高认知能力和CI中的社交技能。这是第一个讨论认知刺激在HD期间的可能性的综述文章，以前没有研究过。认知刺激疗法在6个月的随访中显示认知改善，并且被国家健康和护理卓越研究所推荐用于痴呆症，我们建议有必要研究这种疗法是否对HD患者的认知有任何影响，无论是在短期内，关于日常活动和决策，还是在长期内，关于降低痴呆症风险的可能性。在55歲或以上的血液透析(HD)病人間,逾70%有中至重度的慢性認知障礙(CI),在目前老年化的人口中,這是必須要解決的問題。中文名称:中文名称:中文名称:中文名称:中文名称:中文名称:中文名称:中文名称:中文名称:中文名称:中文名称:中文名称:中文名称:中文名称:中文名称:中文名称:中文名称:中文名称:中文名称:中文名称:中文名称:中文名称:中文名称:中文名称:中文名称:中文名称:中文名称:中文名称:中文名称:中文意思:“”“”“”“”“”。本文探討了認知功能的評估方法,及CI發生於高清的相關理論,亦回顧了目前有關慢性病中認知功能改善方案的文獻,雖然很多並不特定於HD病人群。我們注意到一種稱為認知刺激療法(认知刺激疗法,CST)的心理治療方案,可望改善CI患者的認知功能和社交技能。中文:中文:中文:中文:事實上,春秋国旅經證實可於個6月期間達到認知功能的改善,亦是英國不错(国家健康和保健研究所)建議的失智症療法,我們認為有需要研究中科對HD病人認知功能的影響,不論是在短期(日常活動及決策能力),或長期層面(失智症的預防)。

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