首页 > 最新文献

Kidney & blood pressure research最新文献

英文 中文
Research progress on cognitive frailty in Older Adults with chronic kidney disease. 关于患有慢性肾病的老年人认知能力衰弱的研究进展。
IF 2.8 4区 医学 Q2 Medicine Pub Date : 2024-04-25 DOI: 10.1159/000538689
Yuqing Yuan, Jing Chang, Qian-Mei Sun
BACKGROUNDAs the medical challenges posed by the ageing population become increasingly severe, the proportion of older people among patients with chronic kidney disease (CKD) is increasing every year. The prevalence of frailty in patients with CKD is significantly higher than that in the general population, and older patients are also a high-risk group for frailty and cognitive impairment. Cognitive frailty, as an important subtype of frailty, is a syndrome characterised by cognitive dysfunction caused by physiological factors, excluding Alzheimer's disease and other types of dementia. It is characterised by the coexistence of physical frailty and cognitive impairment. Previous studies have mainly focused on cognitive impairment, and there is limited research on cognitive frailty, particularly in older patients with CKD.SUMMARYThis article provides a comprehensive review of the concept, epidemiology, screening methods, prevention and treatment measures and possible pathogenesis of cognitive frailty in patients with CKD.
背景 随着人口老龄化带来的医疗挑战日益严峻,慢性肾脏病(CKD)患者中老年人的比例也在逐年增加。慢性肾脏病患者的虚弱患病率明显高于普通人群,老年患者也是虚弱和认知障碍的高危人群。认知功能虚弱是虚弱的一个重要亚型,是一种由生理因素引起的认知功能障碍综合征,不包括阿尔茨海默病和其他类型的痴呆症。其特点是身体虚弱和认知功能障碍并存。本文对认知虚弱的概念、流行病学、筛查方法、预防和治疗措施以及慢性肾脏病患者认知虚弱的可能发病机制进行了全面综述。
{"title":"Research progress on cognitive frailty in Older Adults with chronic kidney disease.","authors":"Yuqing Yuan, Jing Chang, Qian-Mei Sun","doi":"10.1159/000538689","DOIUrl":"https://doi.org/10.1159/000538689","url":null,"abstract":"BACKGROUND\u0000As the medical challenges posed by the ageing population become increasingly severe, the proportion of older people among patients with chronic kidney disease (CKD) is increasing every year. The prevalence of frailty in patients with CKD is significantly higher than that in the general population, and older patients are also a high-risk group for frailty and cognitive impairment. Cognitive frailty, as an important subtype of frailty, is a syndrome characterised by cognitive dysfunction caused by physiological factors, excluding Alzheimer's disease and other types of dementia. It is characterised by the coexistence of physical frailty and cognitive impairment. Previous studies have mainly focused on cognitive impairment, and there is limited research on cognitive frailty, particularly in older patients with CKD.\u0000\u0000\u0000SUMMARY\u0000This article provides a comprehensive review of the concept, epidemiology, screening methods, prevention and treatment measures and possible pathogenesis of cognitive frailty in patients with CKD.","PeriodicalId":17813,"journal":{"name":"Kidney & blood pressure research","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140654065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Understanding the Korean dialysis cohort for mineral, vascular calcification, and fracture (ORCHESTRA) Study: Design, method, and baseline characteristics. 了解韩国透析队列的矿物质、血管钙化和骨折(ORCHESTRA)研究:设计、方法和基线特征。
IF 2.8 4区 医学 Q2 Medicine Pub Date : 2024-04-24 DOI: 10.1159/000539030
Shin Young Ahn, Gang-Jee Ko, Hyeon Seok Hwang, K. Jeong, Kyubok Jin, Y. Kim, J. Moon, Sang Ho Lee, So-Young Lee, Dong-Ho Yang, Ji Yong Jung, Kook-Hwan Oh, Young-Ki Lee, Gheun-Ho Kim, Soo Wan Kim, Yeong Hoon Kim, Dong-Young Lee, Y. Hong, Hyeong Cheon Park, Sun Ae Yoon, Bum Soon Choi, Tae Hyun Ban, Hyojin Kim, Young Joo Kwon
INTRODUCTIONEnd-stage renal disease (ESRD) is a growing disease in Korea and worldwide and is an important condition that affects patient outcomes. In order to provide optimal management for mineral disturbance, vascular calcification, and bone disease of ESRD patients, the ORCHESTRA study (Korean dialysis cohort for mineral, vascular calcification, and fracture) was conducted and enrolled Korean dialysis patients.METHODSSixteen university-affiliated hospitals and one Veterans Health Service Medical Center participated in this study. This prospective cohort study enrolled approximately 900 consecutive dialysis patients between May 2019 and January 2021. Enrolled subjects were evaluated at baseline for demographic information, laboratory tests, radiologic imaging, and bone mineral densitometry (BMD) scans. After enrollment, regular assessments of patients were performed and their biospecimens were collected according to the study protocol. Primary outcomes were occurrence of major adverse cardiovascular events (MACE), invasive treatment for peripheral artery disease (PAD), and osteoporotic fractures. Secondary outcomes were hospitalization for cerebro-cardiovascular disease or progression of abdominal aortic calcification (AAC). Participants will be assessed for up to three years to determine whether primary or secondary outcomes occur.RESULTSFrom May 2019 to January 2021, all participating centers recruited 900 consecutive dialysis patients, including 786 undergoing hemodialysis (HD) and 114 undergoing peritoneal dialysis (PD). The mean age of subjects was 60.4 ± 12.3 years. Males accounted for 57.7%. The mean dialysis vintage was 6.1 ± 6.0 years. The HD group was significantly older, had a longer dialysis vintage, and more comorbidities. Overall, the severity of vascular calcification was higher and the level of BMD was lower in the HD group than in the PD group.CONCLUSIONThis is a nationwide, multicenter, prospective cohort study that focuses on CKD-mineral and bone disorder (CKD-MBD) and aims to provide clinical evidence to establish optimal treatment guidelines for Asian dialysis patients.
简介终末期肾病(ESRD)在韩国和全世界都是一种日益严重的疾病,是影响患者预后的重要疾病。为了对 ESRD 患者的矿物质紊乱、血管钙化和骨病进行优化管理,我们开展了 ORCHESTRA 研究(韩国透析患者矿物质、血管钙化和骨折队列),并招募了韩国透析患者。这项前瞻性队列研究在 2019 年 5 月至 2021 年 1 月期间连续招募了约 900 名透析患者。入组对象在基线时接受了人口统计学信息、实验室检查、放射成像和骨矿物质密度测量(BMD)扫描评估。入组之后,根据研究方案对患者进行定期评估,并收集他们的生物样本。主要结果是主要不良心血管事件(MACE)的发生、外周动脉疾病(PAD)的侵入性治疗和骨质疏松性骨折。次要结果是脑心血管疾病住院或腹主动脉钙化(AAC)进展。将对参与者进行长达三年的评估,以确定是否出现主要或次要结果。结果从2019年5月到2021年1月,所有参与中心连续招募了900名透析患者,包括786名接受血液透析(HD)的患者和114名接受腹膜透析(PD)的患者。受试者的平均年龄为 60.4 ± 12.3 岁。男性占 57.7%。平均透析年限为 6.1 ± 6.0 年。HD 组年龄明显偏大,透析年份更长,合并症更多。结论 这是一项全国性、多中心、前瞻性队列研究,重点关注 CKD-矿物质和骨质紊乱(CKD-MBD),旨在为亚洲透析患者制定最佳治疗指南提供临床证据。
{"title":"Understanding the Korean dialysis cohort for mineral, vascular calcification, and fracture (ORCHESTRA) Study: Design, method, and baseline characteristics.","authors":"Shin Young Ahn, Gang-Jee Ko, Hyeon Seok Hwang, K. Jeong, Kyubok Jin, Y. Kim, J. Moon, Sang Ho Lee, So-Young Lee, Dong-Ho Yang, Ji Yong Jung, Kook-Hwan Oh, Young-Ki Lee, Gheun-Ho Kim, Soo Wan Kim, Yeong Hoon Kim, Dong-Young Lee, Y. Hong, Hyeong Cheon Park, Sun Ae Yoon, Bum Soon Choi, Tae Hyun Ban, Hyojin Kim, Young Joo Kwon","doi":"10.1159/000539030","DOIUrl":"https://doi.org/10.1159/000539030","url":null,"abstract":"INTRODUCTION\u0000End-stage renal disease (ESRD) is a growing disease in Korea and worldwide and is an important condition that affects patient outcomes. In order to provide optimal management for mineral disturbance, vascular calcification, and bone disease of ESRD patients, the ORCHESTRA study (Korean dialysis cohort for mineral, vascular calcification, and fracture) was conducted and enrolled Korean dialysis patients.\u0000\u0000\u0000METHODS\u0000Sixteen university-affiliated hospitals and one Veterans Health Service Medical Center participated in this study. This prospective cohort study enrolled approximately 900 consecutive dialysis patients between May 2019 and January 2021. Enrolled subjects were evaluated at baseline for demographic information, laboratory tests, radiologic imaging, and bone mineral densitometry (BMD) scans. After enrollment, regular assessments of patients were performed and their biospecimens were collected according to the study protocol. Primary outcomes were occurrence of major adverse cardiovascular events (MACE), invasive treatment for peripheral artery disease (PAD), and osteoporotic fractures. Secondary outcomes were hospitalization for cerebro-cardiovascular disease or progression of abdominal aortic calcification (AAC). Participants will be assessed for up to three years to determine whether primary or secondary outcomes occur.\u0000\u0000\u0000RESULTS\u0000From May 2019 to January 2021, all participating centers recruited 900 consecutive dialysis patients, including 786 undergoing hemodialysis (HD) and 114 undergoing peritoneal dialysis (PD). The mean age of subjects was 60.4 ± 12.3 years. Males accounted for 57.7%. The mean dialysis vintage was 6.1 ± 6.0 years. The HD group was significantly older, had a longer dialysis vintage, and more comorbidities. Overall, the severity of vascular calcification was higher and the level of BMD was lower in the HD group than in the PD group.\u0000\u0000\u0000CONCLUSION\u0000This is a nationwide, multicenter, prospective cohort study that focuses on CKD-mineral and bone disorder (CKD-MBD) and aims to provide clinical evidence to establish optimal treatment guidelines for Asian dialysis patients.","PeriodicalId":17813,"journal":{"name":"Kidney & blood pressure research","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140665142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Identification of Plasma hsa_circ_0001230 and hsa_circ_0023879 as Potential Novel Biomarkers for Focal Segmental Glomerulosclerosis and circRNA-miRNA-mRNA network analysis. 血浆 hsa_circ_0001230 和 hsa_circ_0023879 作为局灶性肾小球硬化症潜在新型生物标记物的鉴定及 circRNA-miRNA-mRNA 网络分析。
IF 2.8 4区 医学 Q2 Medicine Pub Date : 2024-04-22 DOI: 10.1159/000538825
Lingyu Ran, Wei Li, Huhai Zhang, Jie Lin, Longyin Zhu, Huanping Long, Lunli Xiang, Liping Chen, Qixuan Li, Yuhan Hu, Min Gong, Hongwen Zhao, Bin Xiao
Introduction Focal segmental glomerulosclerosis (FSGS) is a common glomerulopathy with unclear mechanism. The demand for FSGS clinical diagnostic biomarkers has not yet been met. Circular RNA (circRNA) is a novel non-coding RNA with multiple functions, but its diagnostic value for FSGS remains unexplored. This study aimed to identify circRNAs that could aid in early clinical diagnosis and to investigate their mechanisms in podocyte injury. Methods The signature of plasma circRNAs for FSGS was identified by circRNA microarray. The existence of circRNAs was confirmed by qRT-PCR, RNase R assay, and DNA sequencing. Plasma levels of circRNAs were evaluated by qRT-PCR. The diagnostic value was appraised by receiver operating characteristic curve. The circRNA-miRNA-mRNA network was built with Cytoscape 7.3.2. Statistically significant differences were calculated by the Mann-Whitney U-test. Results A total of 493 circRNAs (165 upregulated, 328 downregulated) were differentially expressed in the plasma of FSGS patients (n = 3) and normal controls (n = 3). Eight candidate circRNAs were demonstrated to be circular and stable transcripts. Among them, hsa_circ_0001230 and hsa_circ_0023879 were significantly upregulated in FSGS patients (n = 29) compared to normal controls (n = 51). The areas under the curve value of hsa_circ_0001230 and hsa_circ_0023879 were 0.668 and 0.753, respectively, while that of two-circRNAs panel was 0.763. The RNA pull-down analysis revealed that hsa_circ_0001230 and hsa_circ_0023879 could sponge hsa-miR-106a. Additionally, hsa_circ_0001230 and hsa_circ_0023879 positively regulated hsa-miR-106a target genes phosphatase and tensin homolog (PTEN) and Bcl-2-like protein 11 (BCL2L11) in podocytes. Conclusion Hsa_circ_0001230 and hsa_circ_0023879 are novel blood biomarkers for FSGS. They may regulate podocyte apoptosis by competitively binding to hsa-miR-106a.
导言 局灶节段性肾小球硬化症(FSGS)是一种常见的肾小球病变,其发病机制尚不清楚。FSGS临床诊断生物标志物的需求尚未得到满足。环状 RNA(circRNA)是一种新型的非编码 RNA,具有多种功能,但其对 FSGS 的诊断价值仍有待探索。本研究旨在鉴定有助于早期临床诊断的 circRNA,并研究其在荚膜细胞损伤中的作用机制。方法 通过 circRNA 微阵列确定了 FSGS 血浆 circRNAs 的特征。通过 qRT-PCR、RNase R 检测和 DNA 测序证实了 circRNAs 的存在。通过 qRT-PCR 评估血浆中 circRNAs 的水平。诊断价值通过接收者操作特征曲线进行评估。circRNA-miRNA-mRNA 网络用 Cytoscape 7.3.2 建立。统计学差异通过曼-惠特尼 U 检验进行计算。结果 共有 493 个 circRNAs(165 个上调,328 个下调)在 FSGS 患者(n = 3)和正常对照组(n = 3)的血浆中差异表达。有 8 个候选 circRNAs 被证明是环状稳定转录本。其中,hsa_circ_0001230 和 hsa_circ_0023879 在 FSGS 患者(n = 29)和正常对照组(n = 51)中显著上调。hsa_circ_0001230和hsa_circ_0023879的曲线下面积值分别为0.668和0.753,而双circRNAs面板的曲线下面积值为0.763。RNA 拉取分析表明,hsa_circ_0001230 和 hsa_circ_0023879 可以海绵状连接 hsa-miR-106a。此外,hsa_circ_0001230 和 hsa_circ_0023879 还能正向调节荚膜细胞中 hsa-miR-106a 的靶基因磷酸酶和天丝同源蛋白(PTEN)以及类 Bcl-2 蛋白 11(BCL2L11)。结论 Hsa_circ_0001230 和 hsa_circ_0023879 是 FSGS 的新型血液生物标记物。它们可能通过与 hsa-miR-106a 竞争性结合来调节荚膜细胞凋亡。
{"title":"Identification of Plasma hsa_circ_0001230 and hsa_circ_0023879 as Potential Novel Biomarkers for Focal Segmental Glomerulosclerosis and circRNA-miRNA-mRNA network analysis.","authors":"Lingyu Ran, Wei Li, Huhai Zhang, Jie Lin, Longyin Zhu, Huanping Long, Lunli Xiang, Liping Chen, Qixuan Li, Yuhan Hu, Min Gong, Hongwen Zhao, Bin Xiao","doi":"10.1159/000538825","DOIUrl":"https://doi.org/10.1159/000538825","url":null,"abstract":"Introduction Focal segmental glomerulosclerosis (FSGS) is a common glomerulopathy with unclear mechanism. The demand for FSGS clinical diagnostic biomarkers has not yet been met. Circular RNA (circRNA) is a novel non-coding RNA with multiple functions, but its diagnostic value for FSGS remains unexplored. This study aimed to identify circRNAs that could aid in early clinical diagnosis and to investigate their mechanisms in podocyte injury. Methods The signature of plasma circRNAs for FSGS was identified by circRNA microarray. The existence of circRNAs was confirmed by qRT-PCR, RNase R assay, and DNA sequencing. Plasma levels of circRNAs were evaluated by qRT-PCR. The diagnostic value was appraised by receiver operating characteristic curve. The circRNA-miRNA-mRNA network was built with Cytoscape 7.3.2. Statistically significant differences were calculated by the Mann-Whitney U-test. Results A total of 493 circRNAs (165 upregulated, 328 downregulated) were differentially expressed in the plasma of FSGS patients (n = 3) and normal controls (n = 3). Eight candidate circRNAs were demonstrated to be circular and stable transcripts. Among them, hsa_circ_0001230 and hsa_circ_0023879 were significantly upregulated in FSGS patients (n = 29) compared to normal controls (n = 51). The areas under the curve value of hsa_circ_0001230 and hsa_circ_0023879 were 0.668 and 0.753, respectively, while that of two-circRNAs panel was 0.763. The RNA pull-down analysis revealed that hsa_circ_0001230 and hsa_circ_0023879 could sponge hsa-miR-106a. Additionally, hsa_circ_0001230 and hsa_circ_0023879 positively regulated hsa-miR-106a target genes phosphatase and tensin homolog (PTEN) and Bcl-2-like protein 11 (BCL2L11) in podocytes. Conclusion Hsa_circ_0001230 and hsa_circ_0023879 are novel blood biomarkers for FSGS. They may regulate podocyte apoptosis by competitively binding to hsa-miR-106a.","PeriodicalId":17813,"journal":{"name":"Kidney & blood pressure research","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140674771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The effect of clothes on blood pressure measurement in normotensive and hypertensive subjects in a real-life setting. 在现实生活中,衣服对正常血压和高血压受试者血压测量的影响。
IF 2.8 4区 医学 Q2 Medicine Pub Date : 2024-04-20 DOI: 10.1159/000538164
Edwin Castillo Velarde, Jorge Roca-Sánchez-Moreno, Alison Núñez Muñoz, Alessandra Guillen Rivera, Mary Hidalgo Babilonia, Jherson García Meneses, Lisseth Mamani Turpo, Willian Cepeda Horna
INTRODUCTIONThe effect of clothing on the recording of blood pressure in a normotensive and hypertensive population remains essential remains to diagnosing and managing.METHODSThis is a cross-sectional study to measure blood pressure using a validated oscillometric sphygmomanometer in two populations. The records were made over the thicker sleeve arm and non-sleeved arm (either on bare arm or indicating the removal of the outermost garment). Clothing was categorized according to how patients attended the outpatient clinic based on the real world.RESULTSA total of 75 patients were included with a diagnosis of hypertension whose mean age was 67.1 years (SD ± 16.3). The group of normotension included 63 patients whose mean age was 21.1 years (DS ± 2.2). There was not variability related to technique or inherent to the condition of the subject on the first and second measurements of blood pressure. In the comparative analysis, the group with normotension did not report a significant difference in systolic or diastolic blood pressure due to the effect of clothing during the first or second measurement (p> 0.05). In the group with hypertension, a significant difference was observed in the first measurement, between the group over the sleeve and non-sleeved arm (systolic blood pressure, p: 0.021, and diastolic, p: 0.001). However, when the variable order of measurement was analyzed by randomizing the initial registry with or without clothing was not found a statistical difference.CONCLUSIONClothing does not a significant difference in the measure of blood pressure in a normotensive or hypertensive population.
方法这是一项横断面研究,在两个人群中使用经过验证的示波血压计测量血压。记录的对象分别是袖子较厚的手臂和无袖手臂(裸露手臂或表示已脱掉最外面的衣服)。结果共纳入 75 名诊断为高血压的患者,他们的平均年龄为 67.1 岁(SD ± 16.3)。正常血压组包括 63 名患者,平均年龄为 21.1 岁(标准差 ± 2.2)。在第一次和第二次测量血压时,没有出现与技术或受试者状况有关的变异。在对比分析中,正常血压组在第一次或第二次测量时,收缩压或舒张压没有因衣服的影响而出现显著差异(P> 0.05)。在高血压组中,第一次测量时,穿袖套和不穿袖套的手臂之间出现了显著差异(收缩压,p:0.021;舒张压,p:0.001)。然而,当通过随机化初始登记穿或不穿衣服来分析测量的变量顺序时,并没有发现统计学差异。
{"title":"The effect of clothes on blood pressure measurement in normotensive and hypertensive subjects in a real-life setting.","authors":"Edwin Castillo Velarde, Jorge Roca-Sánchez-Moreno, Alison Núñez Muñoz, Alessandra Guillen Rivera, Mary Hidalgo Babilonia, Jherson García Meneses, Lisseth Mamani Turpo, Willian Cepeda Horna","doi":"10.1159/000538164","DOIUrl":"https://doi.org/10.1159/000538164","url":null,"abstract":"INTRODUCTION\u0000The effect of clothing on the recording of blood pressure in a normotensive and hypertensive population remains essential remains to diagnosing and managing.\u0000\u0000\u0000METHODS\u0000This is a cross-sectional study to measure blood pressure using a validated oscillometric sphygmomanometer in two populations. The records were made over the thicker sleeve arm and non-sleeved arm (either on bare arm or indicating the removal of the outermost garment). Clothing was categorized according to how patients attended the outpatient clinic based on the real world.\u0000\u0000\u0000RESULTS\u0000A total of 75 patients were included with a diagnosis of hypertension whose mean age was 67.1 years (SD ± 16.3). The group of normotension included 63 patients whose mean age was 21.1 years (DS ± 2.2). There was not variability related to technique or inherent to the condition of the subject on the first and second measurements of blood pressure. In the comparative analysis, the group with normotension did not report a significant difference in systolic or diastolic blood pressure due to the effect of clothing during the first or second measurement (p> 0.05). In the group with hypertension, a significant difference was observed in the first measurement, between the group over the sleeve and non-sleeved arm (systolic blood pressure, p: 0.021, and diastolic, p: 0.001). However, when the variable order of measurement was analyzed by randomizing the initial registry with or without clothing was not found a statistical difference.\u0000\u0000\u0000CONCLUSION\u0000Clothing does not a significant difference in the measure of blood pressure in a normotensive or hypertensive population.","PeriodicalId":17813,"journal":{"name":"Kidney & blood pressure research","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140679856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Measurement of glomerular filtration rate in patients undergoing renal surgery for cancer: eGFR vs mGFR in the era of precision medicine. 癌症肾脏手术患者的肾小球滤过率测量:精准医疗时代的 eGFR 与 mGFR。
IF 2.8 4区 医学 Q2 Medicine Pub Date : 2024-04-18 DOI: 10.1159/000538854
Francesco Trevisani, Mariadelina Simeoni, A. Bettiga, A. Cinque, Matteo Floris
BACKGROUNDIn the era of precision medicine, determining reliable renal function assessment remains a critical and debatable issue, especially in nephrology and oncology.SUMMARYThis paper delves into the significance of accurately measured Glomerular Filtration Rate (mGFR) in clinical practice, highlighting its essential role in guiding medical decisions and managing kidney health, particularly in the context of renal cancer (RC) patients undergoing nephrotoxic anti-cancer drugs. The limitations and advantages of traditional GFR estimation methods, primarily using serum biomarkers like creatinine and cystatin C, are discussed, emphasizing their possible inadequacy in cancer patients. Specifically, newer formulae designed for GFR estimation in cancer patients may not perform at best in RC patients. The paper explores various methods for direct GFR measurement, including the gold standard inulin clearance and alternatives like iohexol plasma clearance.KEY MESSAGEDespite the logistical challenges of these methods, their implementation is crucial for accurate renal function assessment. The paper concludes by emphasizing the need for continued research and innovation in GFR measurement methodologies to improve patient outcomes, particularly in populations with complex medical needs.
摘要 本文深入探讨了精确测量肾小球滤过率(mGFR)在临床实践中的意义,强调了其在指导医疗决策和管理肾脏健康方面的重要作用,尤其是在肾癌(RC)患者接受肾毒性抗癌药物治疗的情况下。本文讨论了传统 GFR 估算方法(主要使用肌酐和胱抑素 C 等血清生物标记物)的局限性和优势,强调了这些方法在癌症患者中可能存在的不足。具体来说,专为癌症患者设计的较新的 GFR 估算公式在 RC 患者中的表现可能并不尽如人意。本文探讨了直接测量 GFR 的各种方法,包括黄金标准菊粉清除率和替代方法(如碘己醇血浆清除率)。本文最后强调,有必要继续研究和创新 GFR 测量方法,以改善患者的预后,尤其是有复杂医疗需求的人群。
{"title":"Measurement of glomerular filtration rate in patients undergoing renal surgery for cancer: eGFR vs mGFR in the era of precision medicine.","authors":"Francesco Trevisani, Mariadelina Simeoni, A. Bettiga, A. Cinque, Matteo Floris","doi":"10.1159/000538854","DOIUrl":"https://doi.org/10.1159/000538854","url":null,"abstract":"BACKGROUND\u0000In the era of precision medicine, determining reliable renal function assessment remains a critical and debatable issue, especially in nephrology and oncology.\u0000\u0000\u0000SUMMARY\u0000This paper delves into the significance of accurately measured Glomerular Filtration Rate (mGFR) in clinical practice, highlighting its essential role in guiding medical decisions and managing kidney health, particularly in the context of renal cancer (RC) patients undergoing nephrotoxic anti-cancer drugs. The limitations and advantages of traditional GFR estimation methods, primarily using serum biomarkers like creatinine and cystatin C, are discussed, emphasizing their possible inadequacy in cancer patients. Specifically, newer formulae designed for GFR estimation in cancer patients may not perform at best in RC patients. The paper explores various methods for direct GFR measurement, including the gold standard inulin clearance and alternatives like iohexol plasma clearance.\u0000\u0000\u0000KEY MESSAGE\u0000Despite the logistical challenges of these methods, their implementation is crucial for accurate renal function assessment. The paper concludes by emphasizing the need for continued research and innovation in GFR measurement methodologies to improve patient outcomes, particularly in populations with complex medical needs.","PeriodicalId":17813,"journal":{"name":"Kidney & blood pressure research","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140686289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Management and Clinical Outcomes of Membranous Nephropathy, IgA Nephropathy, and Minimal Change Disease Two Years Post-Kidney Biopsy. 肾活检两年后膜性肾病、IgA 肾病和微小病变的管理和临床疗效。
IF 2.8 4区 医学 Q2 Medicine Pub Date : 2024-04-12 DOI: 10.1159/000538851
Xiao-xiao Guo, Xuan Tie, Yuyu Zhang, Yemei Dai, Shulei Yao, Xi Qiao, Lihua Wang, Xiaole Su
Introduction This study evaluated the phenotypic and pathology characteristics of patients undergoing kidney biopsy at a single center, while also determining the frequency and factors associated with clinical outcomes. Methods The incidence and distribution of biopsy-proven kidney diseases in 2000-2019 were surveyed. Consecutive individuals diagnosed with membranous nephropathy (MN), immunoglobulin A nephropathy (IgAN), and minimal change disease (MCD) between August 2015 and December 2019 were enrolled in the prospective two-year follow-up study. Outcomes included remission of proteinuria and kidney disease progression events. Multivariable adjusted Cox proportional hazards model was applied. Results 4,550 kidney biopsies were performed in 2000-2019, showing a noticeable increase in the proportion of MN. 426 patients were enrolled in follow-up cohort. 346 (81.2%) achieved remission of proteinuria, 39 (9.2%) suffered kidney disease progression and 51.3% of them were diagnosed with IgAN. Kidney pathological diagnosis (MN vs. MCD: hazard ratio [HR], 0.42; 95% confidence interval [95% CI], 0.31-0.57; IgAN vs. MCD: 0.58; 0.39-0.85), levels of 24-h urine protein at biopsy (1.04; 1.00-1.08) and presence of nodular mesangial sclerosis (0.70; 0.49-0.99) were significantly correlated with remission of proteinuria after adjusting for baseline variables. 24-h urine protein levels at biopsy (1.14; 1.04-1.25) and the presence of crescents (2.30; 1.06-4.95) were the independent risk factors for kidney disease progression events after adjusting for baseline variables. Conclusion The increasing frequency of MN was affirmed over the past two decades. The therapeutic status, clinical outcomes, and factors influencing these outcomes were presented in this single-center study for the three primary glomerular diseases. Number of China Clinical Trial Registry: ChiCTR2100043001.
简介:本研究评估了在一个中心接受肾活检的患者的表型和病理特征,同时还确定了与临床结果相关的频率和因素。方法 调查了 2000-2019 年活检证实的肾脏疾病的发病率和分布情况。2015年8月至2019年12月期间被诊断为膜性肾病(MN)、免疫球蛋白A肾病(IgAN)和微小病变(MCD)的连续患者被纳入为期两年的前瞻性随访研究。研究结果包括蛋白尿缓解和肾病进展事件。采用多变量调整考克斯比例危险模型。结果 2000-2019年共进行了4550例肾脏活检,MN比例明显增加。426 名患者被纳入随访队列。346人(81.2%)蛋白尿得到缓解,39人(9.2%)肾病恶化,其中51.3%被诊断为IgAN。调整基线变量后,肾脏病理诊断(MN vs. MCD:危险比 [HR],0.42;95% 置信区间 [95%CI],0.31-0.57;IgAN vs. MCD:0.58;0.39-0.85)、活检时 24 小时尿蛋白水平(1.04;1.00-1.08)和是否存在结节性间质硬化(0.70;0.49-0.99)与蛋白尿缓解显著相关。活检时的 24 小时尿蛋白水平(1.14;1.04-1.25)和新月体的存在(2.30;1.06-4.95)是调整基线变量后肾脏疾病进展事件的独立风险因素。结论 在过去二十年中,MN 的发病率不断增加,这一点已得到证实。本项单中心研究介绍了三种原发性肾小球疾病的治疗现状、临床结果以及影响这些结果的因素。中国临床试验注册中心编号:ChiCTR2100043001。
{"title":"Management and Clinical Outcomes of Membranous Nephropathy, IgA Nephropathy, and Minimal Change Disease Two Years Post-Kidney Biopsy.","authors":"Xiao-xiao Guo, Xuan Tie, Yuyu Zhang, Yemei Dai, Shulei Yao, Xi Qiao, Lihua Wang, Xiaole Su","doi":"10.1159/000538851","DOIUrl":"https://doi.org/10.1159/000538851","url":null,"abstract":"Introduction This study evaluated the phenotypic and pathology characteristics of patients undergoing kidney biopsy at a single center, while also determining the frequency and factors associated with clinical outcomes. Methods The incidence and distribution of biopsy-proven kidney diseases in 2000-2019 were surveyed. Consecutive individuals diagnosed with membranous nephropathy (MN), immunoglobulin A nephropathy (IgAN), and minimal change disease (MCD) between August 2015 and December 2019 were enrolled in the prospective two-year follow-up study. Outcomes included remission of proteinuria and kidney disease progression events. Multivariable adjusted Cox proportional hazards model was applied. Results 4,550 kidney biopsies were performed in 2000-2019, showing a noticeable increase in the proportion of MN. 426 patients were enrolled in follow-up cohort. 346 (81.2%) achieved remission of proteinuria, 39 (9.2%) suffered kidney disease progression and 51.3% of them were diagnosed with IgAN. Kidney pathological diagnosis (MN vs. MCD: hazard ratio [HR], 0.42; 95% confidence interval [95% CI], 0.31-0.57; IgAN vs. MCD: 0.58; 0.39-0.85), levels of 24-h urine protein at biopsy (1.04; 1.00-1.08) and presence of nodular mesangial sclerosis (0.70; 0.49-0.99) were significantly correlated with remission of proteinuria after adjusting for baseline variables. 24-h urine protein levels at biopsy (1.14; 1.04-1.25) and the presence of crescents (2.30; 1.06-4.95) were the independent risk factors for kidney disease progression events after adjusting for baseline variables. Conclusion The increasing frequency of MN was affirmed over the past two decades. The therapeutic status, clinical outcomes, and factors influencing these outcomes were presented in this single-center study for the three primary glomerular diseases. Number of China Clinical Trial Registry: ChiCTR2100043001.","PeriodicalId":17813,"journal":{"name":"Kidney & blood pressure research","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140711081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Prognosis of IgA Nephropathy with Stage 3b-5 CKD. 伴有 3b-5 期慢性肾脏病的 IgA 肾病的预后。
IF 2.8 4区 医学 Q2 Medicine Pub Date : 2024-04-02 DOI: 10.1159/000538506
Zhanfei Wu, Hongfen Li, Youxia Liu, Fanghao Wang, Yue Xing, Wenying Li, Junya Jia, Tiekun Yan
Objective To investigate whether immunosuppressive therapy is beneficial in IgA nephropathy (IgAN) patients with eGFR < 45ml/min/1.73m2. Methods This retrospective study involved 110 IgAN patients for whom clinical data was available; of these, 90 had complete follow-up data. Patients were grouped based on whether they received immunotherapy during follow-up, their renal function, proteinuria levels, and the percentage of crescentic glomeruli observed at the time of renal biopsy. Results The mean eGFR for the participants was 32.0 ± 10.2 ml/min/1.73 m². The average follow-up duration was 46.1 ± 37.9 months. The mean rate of decline in eGFR was 3.6 ml/min/1.73 m² per year. There were 43 (47.8%) composite kidney endpoint occurred in these patients. In the group that received immunotherapy, the incidence of kidney endpoint events was lower than in the untreated group (45.1% vs. 57.9%), but the difference was not statistically significant (P = 0.320). Among patients with stage CKD 3b, the incidence of endpoint events was lower than in those with stages CKD 4 and 5 (36.8% vs. 66.7%, P = 0.006). Conversely, the high proteinuria group saw a higher incidence of endpoint events compared to the low proteinuria group (51.9% vs. 23.1%), although this difference was not statistically significant (P = 0.054). Meanwhile, there was no significant difference in the incidence of endpoint events between the two crescent glomerular ratio groups (48.7% vs. 41.7%, P = 0.649). Kaplan-Meier survival analysis indicated that renal function level (P<0.001) and proteinuria (P = 0.023) were associated with renal survival in IgAN patients. In contrast, the administration of immunosuppressive therapy (P = 0.288) and the prevalence of C lesions (P = 0.982) did not show a significant association with renal survival. Further, Cox regression analysis identified systolic blood pressure, fibrinogen, and CKD stage as risk factors for eGFR decline in IgAN patients (all P < 0.05). Conclusions IgAN patients with stage 3b-5 CKD exhibited a poor prognosis. It appears that in this specific cohort of IgAN patients, immunosuppressive therapy may not provide significant advantages over supportive care therapeutic regimens in terms of disease management.
目的 探讨免疫抑制疗法是否有益于 eGFR < 45 毫升/分钟/1.73 平方米的 IgA 肾病(IgAN)患者。方法 这项回顾性研究涉及 110 名有临床数据的 IgAN 患者,其中 90 人有完整的随访数据。根据随访期间是否接受免疫治疗、肾功能、蛋白尿水平以及肾活检时观察到的新月体肾小球百分比对患者进行分组。结果 参与者的平均 eGFR 为 32.0 ± 10.2 ml/min/1.73 m²。平均随访时间为 46.1 ± 37.9 个月。eGFR 平均下降率为每年 3.6 毫升/分钟/1.73 平方米。在这些患者中,有 43 人(47.8%)出现了综合肾脏终点。接受免疫疗法组的肾脏终点事件发生率低于未接受治疗组(45.1% 对 57.9%),但差异无统计学意义(P = 0.320)。在 CKD 3b 期患者中,终点事件的发生率低于 CKD 4 期和 5 期患者(36.8% 对 66.7%,P = 0.006)。相反,与低蛋白尿组相比,高蛋白尿组的终点事件发生率更高(51.9% 对 23.1%),但差异无统计学意义(P = 0.054)。同时,两组新月体肾小球比率之间的终点事件发生率无明显差异(48.7% 对 41.7%,P = 0.649)。Kaplan-Meier 生存分析表明,肾功能水平(P<0.001)和蛋白尿(P = 0.023)与 IgAN 患者的肾脏存活率相关。相比之下,接受免疫抑制治疗(P = 0.288)和C病变的发生率(P = 0.982)与肾脏存活率无显著相关性。此外,Cox 回归分析发现收缩压、纤维蛋白原和 CKD 分期是导致 IgAN 患者 eGFR 下降的危险因素(所有 P <0.05)。结论 3b-5 期 CKD 的 IgAN 患者预后较差。在这一特殊的 IgAN 患者群中,免疫抑制疗法在疾病管理方面可能不会比支持性治疗方案有明显优势。
{"title":"Prognosis of IgA Nephropathy with Stage 3b-5 CKD.","authors":"Zhanfei Wu, Hongfen Li, Youxia Liu, Fanghao Wang, Yue Xing, Wenying Li, Junya Jia, Tiekun Yan","doi":"10.1159/000538506","DOIUrl":"https://doi.org/10.1159/000538506","url":null,"abstract":"Objective To investigate whether immunosuppressive therapy is beneficial in IgA nephropathy (IgAN) patients with eGFR < 45ml/min/1.73m2. Methods This retrospective study involved 110 IgAN patients for whom clinical data was available; of these, 90 had complete follow-up data. Patients were grouped based on whether they received immunotherapy during follow-up, their renal function, proteinuria levels, and the percentage of crescentic glomeruli observed at the time of renal biopsy. Results The mean eGFR for the participants was 32.0 ± 10.2 ml/min/1.73 m². The average follow-up duration was 46.1 ± 37.9 months. The mean rate of decline in eGFR was 3.6 ml/min/1.73 m² per year. There were 43 (47.8%) composite kidney endpoint occurred in these patients. In the group that received immunotherapy, the incidence of kidney endpoint events was lower than in the untreated group (45.1% vs. 57.9%), but the difference was not statistically significant (P = 0.320). Among patients with stage CKD 3b, the incidence of endpoint events was lower than in those with stages CKD 4 and 5 (36.8% vs. 66.7%, P = 0.006). Conversely, the high proteinuria group saw a higher incidence of endpoint events compared to the low proteinuria group (51.9% vs. 23.1%), although this difference was not statistically significant (P = 0.054). Meanwhile, there was no significant difference in the incidence of endpoint events between the two crescent glomerular ratio groups (48.7% vs. 41.7%, P = 0.649). Kaplan-Meier survival analysis indicated that renal function level (P<0.001) and proteinuria (P = 0.023) were associated with renal survival in IgAN patients. In contrast, the administration of immunosuppressive therapy (P = 0.288) and the prevalence of C lesions (P = 0.982) did not show a significant association with renal survival. Further, Cox regression analysis identified systolic blood pressure, fibrinogen, and CKD stage as risk factors for eGFR decline in IgAN patients (all P < 0.05). Conclusions IgAN patients with stage 3b-5 CKD exhibited a poor prognosis. It appears that in this specific cohort of IgAN patients, immunosuppressive therapy may not provide significant advantages over supportive care therapeutic regimens in terms of disease management.","PeriodicalId":17813,"journal":{"name":"Kidney & blood pressure research","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140753891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pitfalls of Current Diagnostic Criteria of Tumor Lysis Syndrome. 肿瘤溶解综合征现行诊断标准的误区。
IF 2.8 4区 医学 Q2 Medicine Pub Date : 2024-03-12 DOI: 10.1159/000538328
Naji Alhamid, Bana Sabbagh, Asmaa Alsarraj, Edgar Lerma, Tiffany Caza, Biruh Workeneh, Jacqueline Claudia Barrientos, Kenar D Jhaveri

Background: Tumor Lysis syndrome (TLS) is a well-recognized medical emergency in patients with cancer diagnosis. The diagnostic criteria of TLS have been revised many times since it was recognized, but still have many drawbacks limit diagnosis accuracy.

Summary: Autopsy studies in patients with perimortem diagnoses of TLS have shown that they may not have actually had TLS. Therefore, many cancer patients who are at risk for TLS, clinical and laboratory criteria may be fulfilled due to other causes of acute kidney injury. In this review, we aim to cast a spotlight on the shortcomings and pitfalls of the current diagnostic criteria for TLS, and propose a roadmap for developing a more rigorous criteria that improve on the diagnostic accuracy.

Key messages: Causes of AKI in patients with cancer other than TLS should be considered. Because current diagnostic criteria may miss those differential diagnosis, specific biomarkers that can tell when TLS is the underlying process is an important need, besides appropriate criteria that can jump over the pitfalls in the current criteria and enhance the recognition of TLS among other causes.

背景:肿瘤溶解综合征(TLS)是癌症患者中公认的急症。摘要:对死前诊断为 TLS 的患者进行的尸检研究表明,他们可能实际上并没有患 TLS。因此,许多有 TLS 风险的癌症患者,其临床和实验室标准可能符合急性肾损伤的其他原因。在这篇综述中,我们旨在揭示目前 TLS 诊断标准的缺陷和隐患,并提出制定更严格标准的路线图,以提高诊断准确性:关键信息:癌症患者发生 AKI 的原因应考虑 TLS 以外的因素。由于目前的诊断标准可能会遗漏这些鉴别诊断,因此除了制定适当的标准来克服目前标准中的缺陷并在其他病因中提高对 TLS 的识别率外,还需要能够判断 TLS 是否为潜在病因的特异性生物标志物。
{"title":"Pitfalls of Current Diagnostic Criteria of Tumor Lysis Syndrome.","authors":"Naji Alhamid, Bana Sabbagh, Asmaa Alsarraj, Edgar Lerma, Tiffany Caza, Biruh Workeneh, Jacqueline Claudia Barrientos, Kenar D Jhaveri","doi":"10.1159/000538328","DOIUrl":"https://doi.org/10.1159/000538328","url":null,"abstract":"<p><strong>Background: </strong>Tumor Lysis syndrome (TLS) is a well-recognized medical emergency in patients with cancer diagnosis. The diagnostic criteria of TLS have been revised many times since it was recognized, but still have many drawbacks limit diagnosis accuracy.</p><p><strong>Summary: </strong>Autopsy studies in patients with perimortem diagnoses of TLS have shown that they may not have actually had TLS. Therefore, many cancer patients who are at risk for TLS, clinical and laboratory criteria may be fulfilled due to other causes of acute kidney injury. In this review, we aim to cast a spotlight on the shortcomings and pitfalls of the current diagnostic criteria for TLS, and propose a roadmap for developing a more rigorous criteria that improve on the diagnostic accuracy.</p><p><strong>Key messages: </strong>Causes of AKI in patients with cancer other than TLS should be considered. Because current diagnostic criteria may miss those differential diagnosis, specific biomarkers that can tell when TLS is the underlying process is an important need, besides appropriate criteria that can jump over the pitfalls in the current criteria and enhance the recognition of TLS among other causes.</p>","PeriodicalId":17813,"journal":{"name":"Kidney & blood pressure research","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140110599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Five-year Trajectory about Screening for Complication of Diabetes Kidney Disease and Cardiovascular Disease Mortality : Focusing on Regional Difference. 糖尿病并发症肾病和心血管疾病死亡率筛查的五年轨迹:关注地区差异。
IF 2.8 4区 医学 Q2 Medicine Pub Date : 2024-03-07 DOI: 10.1159/000538244
Jina Han, Gawon Kim, Yeong Jun Ju, Soon Young Lee

Backgrounds: The overall screening rate for complication of diabetes kidney disease is improving; however, regional variations are increasing. It is necessary to select regions vulnerable to change and understand their characteristics.

Methods: Group-based trajectory analysis was performed to derive change patterns in the complication of diabetes kidney disease screening rate in 244 regions using Community Health Survey data between 2015 and 2019. ANOVA test was conducted to examine the differences in regional characteristics and CVD in each change pattern.

Results: The change patterns in complication of diabetes kidney disease screening rate were classified into four groups: high and rapidly increasing (Group 1, 5.2%), steady high (Group 2, 8.2%), moderate and increasing (Group 3, 52.9%), and low and slightly increasing (Group 4, 23.8%). Group 4 had many rural areas and worse socioeconomic status, healthcare systems, health behaviors, and diabetes management, and these regions had higher CVD mortality rates.

Conclusions: Regions where the screening for complication of diabetes kidney disease rate did not improve compared to other regions were vulnerable not only in socioeconomic status, healthcare system, and health behavior, but also in disease management. This suggests the need for local and environmental support, as well as aggressive health service interventions in relatively vulnerable areas.

背景:糖尿病肾病并发症的总体筛查率正在提高;然而,地区差异正在扩大。有必要选择易受变化影响的地区并了解其特点:方法:利用 2015 年至 2019 年间的社区健康调查数据,对 244 个地区的糖尿病肾病并发症筛查率进行了基于群体的轨迹分析,以得出其变化规律。对每种变化规律进行方差分析,以检验地区特征和心血管疾病的差异:糖尿病肾病并发症筛查率的变化规律分为四组:高且快速增长(第1组,5.2%)、稳中有高(第2组,8.2%)、中度增长(第3组,52.9%)、低且略有增长(第4组,23.8%)。第 4 组有许多农村地区,社会经济状况、医疗系统、健康行为和糖尿病管理较差,这些地区的心血管疾病死亡率较高:结论:与其他地区相比,糖尿病肾病并发症筛查率没有改善的地区不仅在社会经济地位、医疗系统和健康行为方面处于弱势,而且在疾病管理方面也处于弱势。这表明,在相对脆弱的地区,需要地方和环境的支持,以及积极的医疗服务干预。
{"title":"Five-year Trajectory about Screening for Complication of Diabetes Kidney Disease and Cardiovascular Disease Mortality : Focusing on Regional Difference.","authors":"Jina Han, Gawon Kim, Yeong Jun Ju, Soon Young Lee","doi":"10.1159/000538244","DOIUrl":"https://doi.org/10.1159/000538244","url":null,"abstract":"<p><strong>Backgrounds: </strong>The overall screening rate for complication of diabetes kidney disease is improving; however, regional variations are increasing. It is necessary to select regions vulnerable to change and understand their characteristics.</p><p><strong>Methods: </strong>Group-based trajectory analysis was performed to derive change patterns in the complication of diabetes kidney disease screening rate in 244 regions using Community Health Survey data between 2015 and 2019. ANOVA test was conducted to examine the differences in regional characteristics and CVD in each change pattern.</p><p><strong>Results: </strong>The change patterns in complication of diabetes kidney disease screening rate were classified into four groups: high and rapidly increasing (Group 1, 5.2%), steady high (Group 2, 8.2%), moderate and increasing (Group 3, 52.9%), and low and slightly increasing (Group 4, 23.8%). Group 4 had many rural areas and worse socioeconomic status, healthcare systems, health behaviors, and diabetes management, and these regions had higher CVD mortality rates.</p><p><strong>Conclusions: </strong>Regions where the screening for complication of diabetes kidney disease rate did not improve compared to other regions were vulnerable not only in socioeconomic status, healthcare system, and health behavior, but also in disease management. This suggests the need for local and environmental support, as well as aggressive health service interventions in relatively vulnerable areas.</p>","PeriodicalId":17813,"journal":{"name":"Kidney & blood pressure research","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140059784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Protective Effect of Vitexin on Hypertensive Nephropathy Rats. 牡荆素对高血压肾病大鼠的保护作用
IF 2.3 4区 医学 Q2 PERIPHERAL VASCULAR DISEASE Pub Date : 2024-01-01 Epub Date: 2024-07-30 DOI: 10.1159/000540618
Tingting Duan, Minyi Li, Ziyang Lin, Lanqing Meng, Mengqiu Li, Tao Xia, Xianlong Zhang, Guixuan Lin, Lufeng Yan, Mingjie Liang, Quan Zhu, Zhenghai Li, Junzheng Yang

Introduction: Vitexin is a natural flavonoid compound extracted from Vitex leaves or seeds, exhibiting various pharmacological activities including anticancer, antihypertensive, anti-inflammatory, and spasmolytic effects. However, its protective effects on hypertensive nephropathy (HN) and the underlying mechanisms remain unclear.

Methods: Spontaneous hypertension rats were fed a high-sugar and high-fat diet for 8 weeks to induce the disease HN model. From the 5th week, the rats were administered vitexin via gavage. Blood pressure was measured biweekly using the tail-cuff method. Histopathological changes were assessed using HE staining, and biochemical analyses were performed to evaluate the effects of vitexin on HN rats. The underlying mechanisms of vitexin treatment were investigated through western blotting.

Results: The data demonstrated that vitexin significantly lowered systolic, diastolic, and mean arterial pressures and ameliorated histopathological changes in HN rats. Biochemical analyses revealed that vitexin reduced the levels of creatinine (Cr), blood urea nitrogen (BUN), total cholesterol (TC), triglycerides (TG), total protein (TP), low-density lipoprotein cholesterol (LDL-C), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), malondialdehyde (MDA), and advanced glycation end products (AGEs), while increasing the levels of albumin (ALB) and superoxide dismutase (SOD). Western blotting results indicated that vitexin treatment decreased the expression of TNF-α, IL-6, and nuclear factor kappa-B (NF-κB), while increasing the expression of SOD.

Conclusion: The findings of this study suggest that vitexin exerts protective effects against HN, providing pharmacological evidence for its potential use in HN treatment.

简介荆芥苷是从荆芥叶或种子中提取的一种天然黄酮类化合物,具有多种药理活性,包括抗癌、抗高血压、抗炎和解痉作用。然而,它对高血压肾病(HN)的保护作用及其机制仍不清楚:方法:自发性高血压大鼠以高糖、高脂饮食喂养 8 周,诱导疾病 HN 模型。从第 5 周开始,给大鼠灌胃服用蔓荆子苷。使用尾套法每两周测量一次血压。采用 HE 染色法评估组织病理学变化,并进行生化分析,以评估牡荆素对 HN 大鼠的影响。通过 Western 印迹研究了牡荆素治疗的内在机制:数据显示,牡荆素能显著降低 HN 大鼠的收缩压、舒张压和平均动脉压,并改善组织病理学变化。生化分析表明,牡荆素降低了肌酐(Cr)、血尿素氮(BUN)、总胆固醇(TC)、甘油三酯(TG)、总蛋白(TP)、低密度脂蛋白胆固醇(LDL-C)的水平、肿瘤坏死因子-α (TNF-α)、白细胞介素-6 (IL-6)、丙二醛 (MDA) 和高级糖化终产物 (AGE),同时提高白蛋白 (ALB) 和超氧化物歧化酶 (SOD) 的水平。Western 印迹检测结果表明,牡荆素处理降低了 TNF-α、IL-6 和核因子卡巴-B(NF-κB)的表达,同时增加了 SOD 的表达:本研究结果表明,牡荆素对 HN 具有保护作用,为其在 HN 治疗中的潜在应用提供了药理学证据。
{"title":"The Protective Effect of Vitexin on Hypertensive Nephropathy Rats.","authors":"Tingting Duan, Minyi Li, Ziyang Lin, Lanqing Meng, Mengqiu Li, Tao Xia, Xianlong Zhang, Guixuan Lin, Lufeng Yan, Mingjie Liang, Quan Zhu, Zhenghai Li, Junzheng Yang","doi":"10.1159/000540618","DOIUrl":"10.1159/000540618","url":null,"abstract":"<p><strong>Introduction: </strong>Vitexin is a natural flavonoid compound extracted from Vitex leaves or seeds, exhibiting various pharmacological activities including anticancer, antihypertensive, anti-inflammatory, and spasmolytic effects. However, its protective effects on hypertensive nephropathy (HN) and the underlying mechanisms remain unclear.</p><p><strong>Methods: </strong>Spontaneous hypertension rats were fed a high-sugar and high-fat diet for 8 weeks to induce the disease HN model. From the 5th week, the rats were administered vitexin via gavage. Blood pressure was measured biweekly using the tail-cuff method. Histopathological changes were assessed using HE staining, and biochemical analyses were performed to evaluate the effects of vitexin on HN rats. The underlying mechanisms of vitexin treatment were investigated through western blotting.</p><p><strong>Results: </strong>The data demonstrated that vitexin significantly lowered systolic, diastolic, and mean arterial pressures and ameliorated histopathological changes in HN rats. Biochemical analyses revealed that vitexin reduced the levels of creatinine (Cr), blood urea nitrogen (BUN), total cholesterol (TC), triglycerides (TG), total protein (TP), low-density lipoprotein cholesterol (LDL-C), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), malondialdehyde (MDA), and advanced glycation end products (AGEs), while increasing the levels of albumin (ALB) and superoxide dismutase (SOD). Western blotting results indicated that vitexin treatment decreased the expression of TNF-α, IL-6, and nuclear factor kappa-B (NF-κB), while increasing the expression of SOD.</p><p><strong>Conclusion: </strong>The findings of this study suggest that vitexin exerts protective effects against HN, providing pharmacological evidence for its potential use in HN treatment.</p>","PeriodicalId":17813,"journal":{"name":"Kidney & blood pressure research","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141855935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Kidney & blood pressure research
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1