Iranian journal of kidney diseases最新文献

Introduction: Autophagy related genes (ARGs) may play important roles in various biological processes involving kidney transplantation (KT); however, their expression characteristics are rarely used to study the relationship between autophagy and prognosis in KT patients. This study aims to construct a new autophagy related gene feature based on high-throughput sequencing datasets.

Methods: Differentially expressed ARGs (DEARGs) were identified in KT patients based on the Gene Expression Omnibus (GEO) database. Gene Ontology (GO)and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses were performed to explore potential biological and pathological functions of DEARGs. Univariate and Lasso Cox regression analyses identified survival-related DEARGs and established a prognostic gene signature whose performance was evaluated by Kaplan-Meier curve and receiver operating characteristic (ROC). Moreover, the prognostic value of the gene signature was further validated in 48 KT patients from the GSE21374 dataset.

Results: A total of 28 common DEARGs were identified between rejection and non-rejection samples in 3 datasets, including GSE21374, GSE36059, and GSE48581. GO and KEGG enrichment analyses showed that DEARGs were mainly involved in regulating apoptotic processes. In addition, we identified and validated 7 DEARGs (CASP1, CASP3, FKBP1A, RAB11A, NFKB1, RGS19, and CCL2) as the prognostic signatures. The Kaplan-Meier (K-M) analysis showed that the survival rate of the high-risk patients was significantly lower than that of the low-risk patients.

Conclusion: The effectiveness of autophagy related features was validated by using 48 KT patients in the GSE21374 dataset, and establishing and confirming a new ARG signal with independent survival prognostic value for KT patients.

Introduction: Protein-energy wasting (PEW) is highly prevalent among patients undergoing peritoneal dialysis (PD), and it has been proposed that oxidative stress (OS) may contribute to its pathogenesis. This study was an attempt to determine the association between the presence of PEW and OS levels in PD patients.

Methods: This analytical cross-sectional study involved 62 clinically stable PD patients aged ≥ 18 years, between September 2017 and July 2018. PEW was assessed using PEW definition criteria, 7-point Subjective Global Assessment (SGA), and Malnutrition-Inflammation Score (MIS). Redox state was evaluated through oxidants (lipoperoxides, 8-Isoprostane, nitric oxide), antioxidants (superoxide dismutase, catalase, glutathione peroxidase-GPx, total antioxidant capacity), and oxidative DNA damage [8-hydroxy2'-deoxyguanosine-8-OHdG, 8-Oxoguanine-DNA-N-Glycosylase-1(8-OHdG)].

Results: Among study participants, 38 (61.2%) were males and 24 (38.8%) were females; 22 (35.4%) had diabetes mellitus [males 15 (68.1%) and females 7 (31.8%)]. The average PD duration was 11 (4-27) months, body mass index: 23.5 ± 4.1 kg/m2, energy intake: 1138.4 ± 394.2 kcal/day, and protein intake: 50.2 ± 18.5 g/day. Prevalence of PEW varied based on the assessment method used (50-88.7%). Plasma 8-OHdG levels were higher in patients with PEW evaluated by MIS (0.1 [0.1-56.4] vs. 1.8 [0.1-74.7] ng/mL, P = .028), while GPx activity was lower in the presence of PEW as measured by MIS (3.6 [3.1-7.6] vs. 2.8 [1.2-10] nmol/min/mL, P = .021). No significant differences were observed between PEW markers and remaining OS levels.

Conclusions: In PD patients with PEW, assessed by MIS, 8-OHdG was significantly increased, while GPx activity was significantly low.

Introduction: To evaluate the impact of TACI fusion protein (TACI-Ig) on IgA nephropathy (IgAN) in rats, and to explore its mechanism and relationship with TLR4/MyD88/NF-κB pathway.

Method: Sprague Dawley(SD)rats were divided into six groups: control, model, TACI-Ig low dose (TACI-Ig-L), medium dose (TACI-Ig-M), high dose (TACI-Ig-H), and prednisone acetate (PAT) group. The control group and model group received physiological saline injections, while the TACI-Ig groups were administered doses of 7.18, 14.36, and 28.72 mg/kg of TACI-Ig, respectively. PAT group was pretreated with prednisone acetate. After 8 weeks, kidney weight/body weight ratios, 24-hour urine protein (24 h UP), serum creatinine (SCr), and blood urea nitrogen (BUN) levels were measured. Additionally, concentrations of B cell activating factor (BAFF), APRIL, and Gd-IgA1 were evaluated by using ELISA. Pathological changes in kidney tissues were scored, and TLR4, MyD88, NF-κB expression levels were detected through western blot (WB) and RT-qPCR.

Results: Renal function assessments showed that the IgAN model group exhibited increased in 24 h UP, SCr, BUN, and elevated serum levels of BAFF, APRIL, Gd-IgA1, alongside higher TLR4/MyD88/NF-κB protein expression. TACI-Ig treatment significantly reduced proteinuria, SCr, BUN, levels of BAFF, APRIL, and Gd-IgA1 in IgAN rats. Pathologically, TACI-Ig ameliorated glomerular mesangial deposition and fibrosis. It also inhibited TLR4/MyD88/NF-κB protein expression, demonstrating anti-inflammatory and immune regulatory effects.

Conclusions: TACI-Ig mitigates renal injury in IgAN rats by reducing inflammatory infiltration and IgA deposition and suppressing the pathway of TLR4/MyD88/NF-κB, offering data for developing effective treatments for IgAN.

Introduction: This study aimed to analyze the correlation between blood pressure variability (BPV), crystalloid osmotic pressure, and cardiovascular events (CEs) in patients undergoing maintenance hemodialysis (MHD).

Methods: This retrospective analysis was conducted on 71 patients with end-stage kidney disease who underwent hemodialysis at Beilun District People's Hospital from September 2021 to September 2022. The patients were divided into two groups based on the occurrence of CEs: a cardiovascular event group and a non-cardiovascular event group.

Results: The 71 patients were divided into two groups based on the occurrence of CEs: the CEs group (25 patients who experienced CEs) and the non-CEs group (46 patients who did not experience CEs). The CEs group had significantly higher levels of crystalloid osmotic pressure, standard deviation of systolic BP (SBP-SD), coefficient of variation of SBP (SBP-CV), SD of diastolic BP (DBP-SD), and DBP-CV (P < .05). Multivariate logistic regression analysis identified crystalloid osmotic pressure, SBP-CV, and DBP-CV as independent risk factors for CEs. The ROC curve analysis indicated that the combined predictive value of crystalloid osmotic pressure, SBP-CV, and DBP-CV was significant, with an area under the curve (AUC) of 0.963.

Conclusion:

Introduction: To explore the construction of a diagnostic prediction model of diabetic nephropathy (DN) in type 2 diabetic patients for prognostic risk prediction and observe the therapeutic effect of Epalrestat combined with Dapagliflozin on DN.

Methods: The study consisted of two phases, phase I: A retrospective analysis was conducted on the case information and clinical treatment related data of a total of 460 patients who underwent kidney biopsy from June 2018 to June 2021. They were randomly divided into validation queue and training queue. The predictive factors of the diagnostic prediction model were obtained through multivariate logistic regression.

Phase ii: An interventional study of 94 patients with DN admitted between January 2022 and August 2023 was conducted, and they were randomized into a control group (n = 47) receiving Dapagliflozin and a research group (n = 47) receiving Epalrestat combined with Dapagliflozin. The glucose metabolism, renal function, and treatment safety of the two groups before and after treatment were compared. In addition, the adverse reactions during the treatment of the two groups were counted.

Results: In the phase I of the study, the DN risk model established showed a good performance in the diagnosis and risk assessment of patients with DN and could provide certain reference opinions for future clinical practice. In the phase II of the study, the research group showed better glucose metabolism and renal function than the control group after treatment (P < .05), but no statistical difference was identified between groups in the incidence of adverse reactions (P > .05). Conclusion. Epalrestat combined with Dapagliflozin is significantly effective in the treatment of DN, which can effectively improve glucose metabolism and renal function in DN patients.

Since the beginning of the COVID-19 pandemic, vaccination has been crucial in reducing deaths and hospitalizations. However, vaccination may trigger autoimmune responses. We present the first case of new-onset systemic lupus erythematosus in a 12-year-old girl, three weeks after receiving the first dose of Sinopharm BIBP COVID-19 vaccine. Complications of COVID-19 vaccines are typically mild. There have been reports of a potential association between the vaccines and autoimmune disorders. However, severe events are rare. Vaccination for COVID-19 is recommended even for those with a genetic predisposition to autoimmune disease, as the advantages of preventing COVID-19 outweigh the potential risks of acquiring autoimmune diseases.

Introduction: The objective was to use bioinformatics to analyze the potential key genes involved in the mechanism of sulforaphane's protective effects in sepsis-associated acute kidney injury (SA-AKI) and to identify potential intervention targets.

Methods: Gene Expression Omnibus (GEO) gene chip datasets containing gene expression profiles from kidney tissues of SA-AKI patients and normal controls were selected. Upregulated differentially expressed genes (DEGs) were identified using GEO2R. Protein-protein interaction (PPI), GO, and KEGG enrichment analyses were performed. Allyl isothiocyanate's target genes were analyzed in the ChEMBL database, and intersections with the above DEGs were presented in Venn diagrams. Rat tissues were examined for FKBP1A expression using qRT-PCR.

Results: A total of 17 DEGs related to SA-AKI were obtained (|log fold change| > 0 and P < .05). KEGG pathway analysis indicated that the primary pathways linked to the elevated DEGs were glycogen breakdown, leukocyte trans-endothelial migration, and T-cell receptor, TNF, and NF-κB signaling. The module and PPI network analysis of common DEGs revealed one cluster and four candidate genes, including OASL, TRRAP, FKBP1A, and BANF. ChEMBL database analysis identified 339 target genes for allyl isothiocyanate, and the intersection with upregulated DEGs related to SA-AKI injury yielded two co-expressed genes, FKBP1A and TRRAP. According to the findings of the qRT-PCR assay, the kidney tissues of the model cohort showed significantly higher expression levels of FKBP1A mRNA than the control cohort (P = .0142).

Conclusion: Allyl isothiocyanate may alleviate SA-AKI injury by targeting FKBP1/NF-κB.

Introduction: To explore PTEN-induced putative kinase 1 (PINK1) expression and its clinical value in diabetic nephropathy.

Methods: Ninety patients with diabetic nephropathy were recruited and divided into metformin hydrochloride monotherapy group, telmisartan monotherapy group and combination therapy (metformin and telmisartan) group. Renal function indices and PINK1 expression, inflammatory factors, reactive oxygen species (ROS), mitochondrial membrane potential (MMP) levels were detected. The correlation between PINK1 and inflammatory factors, renal function indicators including estimated glomerular filtration rate (eGFR), urinary albumin-to-creatinine ratio (UACR) and serum creatinine (SCr)] were analyzed by Pearson correlation.

Results: Following treatments, the combination therapy group exhibited increased PINK1 expression levels and decreased ROS levels compared to the groups receiving metformin hydrochloride or telmisartan monotherapy. The combination therapy group showed significant improvements in renal function indices and inflammatory markers. Additionally, the MMP ratio in the combination therapy group was higher compared to the two monotherapy groups. Furthermore, PINK1 was negatively correlated with UACR, SCr, tumor necrosis factor (TNF-α) and interleukin-6 (IL-6), while positively correlated with eGFR and interleukin-2 (IL-2).

Conclusion: PINK1 exhibits low expression levels in patients with diabetic nephropathy and its expression is strongly associated with the inhibition of disease progression, thereby offering significant clinical diagnostic value. Additionally, it may serve as a potential biological marker for clinical diagnosis and treatment of diabetic nephropathy.

Introduction: Prompt resolution of arteriovenous fistula (AVF) thrombosis is essential to minimize the need for temporary dialysis catheters. Identifying the ideal timing for the management of thrombosed arteriovenous fistula (AVF) is an area that has not been thoroughly explored. Herein, we examined a local infusion of urokinase for thrombolysis followed by ultrasound-guided percutaneous transluminal balloon angioplasty (PTA) in acute and subacute AVF thromboses.

Methods: This retrospective cohort research assessed thrombosed AVF in patients referred to the Second Xiangya Hospital. We included patients who underwent local thrombolysis followed by ultrasound-guided PTA treatment between January 1, 2018, and January 1, 2020.

Results: We enrolled the records of 86 patients into the present study, including 44 patients with acute AVF thrombosis (group 1: thrombus age, < 72 hours) and 42 patients with subacute AVF thrombosis (group2: thrombus age, 72 hours to seven days). The thrombolytic success rate was 79.5% in group 1 and 42.9% in group 2 (P < .001). All patients underwent ultrasound-guided PTA to dissolve any residual thrombi regardless of thrombolytic success. Technical success after PTA procedures was achieved in 93.2% of patients in group 1 and 88.1% in group 2 (P = .417). Primary patency at six months was comparable between the two groups (67.5% vs. 64.8%, P = .564). We observed that thrombolytic effect does not affect PTA success rate, and six-month patency rate.

Conclusion: Direct local infusion of urokinase to the affected area followed by ultrasound-guided PTA constitutes a minimally invasive and effective method for salvaging thrombosed AVF in contrast to abandoning the occluded fistula.